Perinatal care Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(8):405-411
DOI 10.1590/S0100-72032010000800008
PURPOSE: the aim of this study was to describe perinatal and maternal outcomes of pregnancies complicated by sickle cell disease (SCD), comparing to pregnancies of women with sickle cell trait (SCT). METHODS: this was a retrospective cohort study, covering the period from March 2001 to April 2008, which included all pregnant women with SCD (n=42) followed up at a university hospital in the Southeast region of Brazil. The maternal and perinatal outcomes were compared to those of pregnant women with SCT (n=56) who were followed up at the same service. RESULTS:SCD-SS was diagnosed in 42 (82.4%) pregnant women and SC in 9 (17.6%). Mean (±SD) maternal age was significantly lower in the SCD group (26.0 years) compared to SCT women (28.7±7.1 years; p=0.018). The following maternal complications were more common among women with SCD in comparison to SCT: urinary tract infection (25.5 versus 8.9%; p=0.04), pneumonia (23.5 versus 1.8%; p=0.002), pulmonary hypertension (15.7 versus 0%; p=0.002), and blood transfusion during delivery or postpartum (33.3 versus 5.4%; p=0.001). Adverse perinatal outcome was more frequent in the SCD group compared to the SCT group: prematurity (49 versus 25%, p=0.01); mean gestational age at delivery (35.2 versus 37.9 weeks, p<0.001); fetal distress (56.9 versus 28.6%, p=0.006); birth weight <2,500 g (62.7 versus 17.9%, p<0.001); mean birth weight (2,183 versus 2,923 g, p<0.001), and small for gestational age infants (29.4 versus 10.7%, p=0.029). Two maternal deaths (3.9%) occurred in the group with SCD. CONCLUSION: Pregnant women with SCD are at greater risk for maternal morbidity and for adverse perinatal outcomes than women with SCT.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(8):405-411
DOI 10.1590/S0100-72032010000800008
PURPOSE: the aim of this study was to describe perinatal and maternal outcomes of pregnancies complicated by sickle cell disease (SCD), comparing to pregnancies of women with sickle cell trait (SCT). METHODS: this was a retrospective cohort study, covering the period from March 2001 to April 2008, which included all pregnant women with SCD (n=42) followed up at a university hospital in the Southeast region of Brazil. The maternal and perinatal outcomes were compared to those of pregnant women with SCT (n=56) who were followed up at the same service. RESULTS:SCD-SS was diagnosed in 42 (82.4%) pregnant women and SC in 9 (17.6%). Mean (±SD) maternal age was significantly lower in the SCD group (26.0 years) compared to SCT women (28.7±7.1 years; p=0.018). The following maternal complications were more common among women with SCD in comparison to SCT: urinary tract infection (25.5 versus 8.9%; p=0.04), pneumonia (23.5 versus 1.8%; p=0.002), pulmonary hypertension (15.7 versus 0%; p=0.002), and blood transfusion during delivery or postpartum (33.3 versus 5.4%; p=0.001). Adverse perinatal outcome was more frequent in the SCD group compared to the SCT group: prematurity (49 versus 25%, p=0.01); mean gestational age at delivery (35.2 versus 37.9 weeks, p<0.001); fetal distress (56.9 versus 28.6%, p=0.006); birth weight <2,500 g (62.7 versus 17.9%, p<0.001); mean birth weight (2,183 versus 2,923 g, p<0.001), and small for gestational age infants (29.4 versus 10.7%, p=0.029). Two maternal deaths (3.9%) occurred in the group with SCD. CONCLUSION: Pregnant women with SCD are at greater risk for maternal morbidity and for adverse perinatal outcomes than women with SCT.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):224-231
DOI 10.1590/S0100-72032008000500004
PURPOSE: to analyze the association of pregnancy in adolescence with low birth weight (LBW). METHODS: all the patients who gave birth in a teaching Hospital at Maranhão State from July to December 2006 were included in the study and were split in two groups: adolescents (ten to 19 years old) and adults (20 to 34 years old). The variables studied were: skin color, schooling, marital status, family income, number of pre-natal appointments, gestational age at the onset of pre-natal assistance, place where they spend that period, gestation duration, delivery route and birth weight. Data were processed by the Epi-Info program, 3.4.1 version, and the associations between variables were analyzed by the Odds Ratio (OR), with a confidence interval (CI) of 95%. Models of logistic regression were also used. The significance level adopted was 0.05. RESULTS: 1,978 patients were evaluated. A ratio of 25.4% of deliveries in adolescents was observed; they presented low level of schooling, no mates, low number of pre-natal appointments, late onset of pre-natal assistance, low birth weight and prematurity. In the analysis of LBW as end variable, associated to prematurity (OR=29.0), it was clear the association with low number of pre-natal appointments (OR=2.98; 95%CI=2.23-4.00), pre-natal late onset (OR=1.91; 95%CI=1.3-2.6) and low schooling (OR=1.95; 95%CI=1.4-2.5) related to adolescence (OR=1.50; 95%CI=1.1-1.9). Similar results were obtained when the prematurity variable was excluded. Adolescents showed lower incidence of caesarean section (33.3%) than adults (49.4%), a significant difference, besides lower association with pre-eclampsia and cephalo-pelvic disproportion. CONLUSIONS: pregnancy in adolescence was associated to pre-natal late onset and low number of appointments, besides low schooling, low birth weight and a lower incidence of cephalo pelvic disproportion and pre-eclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):224-231
DOI 10.1590/S0100-72032008000500004
PURPOSE: to analyze the association of pregnancy in adolescence with low birth weight (LBW). METHODS: all the patients who gave birth in a teaching Hospital at Maranhão State from July to December 2006 were included in the study and were split in two groups: adolescents (ten to 19 years old) and adults (20 to 34 years old). The variables studied were: skin color, schooling, marital status, family income, number of pre-natal appointments, gestational age at the onset of pre-natal assistance, place where they spend that period, gestation duration, delivery route and birth weight. Data were processed by the Epi-Info program, 3.4.1 version, and the associations between variables were analyzed by the Odds Ratio (OR), with a confidence interval (CI) of 95%. Models of logistic regression were also used. The significance level adopted was 0.05. RESULTS: 1,978 patients were evaluated. A ratio of 25.4% of deliveries in adolescents was observed; they presented low level of schooling, no mates, low number of pre-natal appointments, late onset of pre-natal assistance, low birth weight and prematurity. In the analysis of LBW as end variable, associated to prematurity (OR=29.0), it was clear the association with low number of pre-natal appointments (OR=2.98; 95%CI=2.23-4.00), pre-natal late onset (OR=1.91; 95%CI=1.3-2.6) and low schooling (OR=1.95; 95%CI=1.4-2.5) related to adolescence (OR=1.50; 95%CI=1.1-1.9). Similar results were obtained when the prematurity variable was excluded. Adolescents showed lower incidence of caesarean section (33.3%) than adults (49.4%), a significant difference, besides lower association with pre-eclampsia and cephalo-pelvic disproportion. CONLUSIONS: pregnancy in adolescence was associated to pre-natal late onset and low number of appointments, besides low schooling, low birth weight and a lower incidence of cephalo pelvic disproportion and pre-eclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):446-452
DOI 10.1590/S0100-72032006000800002
PURPOSE: to describe the obstetric outcomes in pregnant adolescents at a tertiary hospital and to compare the maternal and labor outcomes between precocious and late adolescents. METHODS: in a transversal analytical study, 2058 cases were evaluated, considering 322 (15.65%) from the precocious group and 1736 (84.35%) from the late group that delivered at the "Maternidade Escola Assis Chateaubriand/UFC" from January 1, 2000 to December 31, 2000. The clinical complications in the prenatal period, kind of delivery, indications for cesarean section, birth gestational age at birth, birth weight, comparison of birth weight and gestational age, Apgar score at the first and fifth minute, presence of malformations, and neonatal death were analyzed. The exact Fisher and the chi2 tests were used to compare both groups. The prevalence ratio was calculated. RESULTS: from of total of deliveries, 25.95% belonged to adolescents. The average age was 17.19 years. Prenatal visits were made by 88% of the patients, but 60% had an insufficient number of visits. The most frequent clinical situations were preeclampsia (14.72%), anemia (12.97%) and urinary tract infections (6.37%), with no statistical difference between the groups. Thirty-one and three percent of the births were by cesarean section, preeclampsia being the main indication in the two age groups (25 and 23%, respectively). The frequency of an Apgar score less than 7 at the first minute was 19,9% in the precocious adolescent group and 14,2% in the late adolescent group (x²=6,96, p=0.008). There was no statistical difference regarding prematurity rate (20.2 vs 16.1%), low-birth weight infants (12.4 vs 10.4%), low Apgar score at the fifth minute (5.3 vs 3.3%), congenital malformations (3.1 vs 2.7%), and neonatal death (5.3 vs 3.3%). CONCLUSIONS: the precocious and late pregnant adolescents presented similar pregnancy evolution and obstetric outcomes, except for the differences of the first minute Apgar scores.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):446-452
DOI 10.1590/S0100-72032006000800002
PURPOSE: to describe the obstetric outcomes in pregnant adolescents at a tertiary hospital and to compare the maternal and labor outcomes between precocious and late adolescents. METHODS: in a transversal analytical study, 2058 cases were evaluated, considering 322 (15.65%) from the precocious group and 1736 (84.35%) from the late group that delivered at the "Maternidade Escola Assis Chateaubriand/UFC" from January 1, 2000 to December 31, 2000. The clinical complications in the prenatal period, kind of delivery, indications for cesarean section, birth gestational age at birth, birth weight, comparison of birth weight and gestational age, Apgar score at the first and fifth minute, presence of malformations, and neonatal death were analyzed. The exact Fisher and the chi2 tests were used to compare both groups. The prevalence ratio was calculated. RESULTS: from of total of deliveries, 25.95% belonged to adolescents. The average age was 17.19 years. Prenatal visits were made by 88% of the patients, but 60% had an insufficient number of visits. The most frequent clinical situations were preeclampsia (14.72%), anemia (12.97%) and urinary tract infections (6.37%), with no statistical difference between the groups. Thirty-one and three percent of the births were by cesarean section, preeclampsia being the main indication in the two age groups (25 and 23%, respectively). The frequency of an Apgar score less than 7 at the first minute was 19,9% in the precocious adolescent group and 14,2% in the late adolescent group (x²=6,96, p=0.008). There was no statistical difference regarding prematurity rate (20.2 vs 16.1%), low-birth weight infants (12.4 vs 10.4%), low Apgar score at the fifth minute (5.3 vs 3.3%), congenital malformations (3.1 vs 2.7%), and neonatal death (5.3 vs 3.3%). CONCLUSIONS: the precocious and late pregnant adolescents presented similar pregnancy evolution and obstetric outcomes, except for the differences of the first minute Apgar scores.