Pregnancy Archives - Page 25 of 25 - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Factors associated with postpartum weight retention in a Brazilian cohort

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):164-171

    Summary

    Artigos Originais

    Factors associated with postpartum weight retention in a Brazilian cohort

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):164-171

    DOI 10.1590/SO100-720320150005186

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    PURPOSE:

    To identify the factors associated with weight retention after pregnancy.

    METHODS:

    A cohort study was performed with 145 women receiving maternity care at a hospital in Caxias do Sul, Rio Grande do Sul, Brazil, aged 19 to 45 years, between weeks 38 and 42 of pregnancy. The patients were evaluated at one month, three months, and six months after delivery. Student's t-test or one-way analysis of variance (ANOVA) was used to compare groups, as indicated; correlations were assessed with Pearson's and Spearman's tests, as indicated; to identify and evaluate confounders independently associated with total weight loss, a multivariate linear regression analysis was performed and statistical significance was set at p≤0.05.

    RESULTS:

    There was a significant positive association between total weight gain - and a negative association with physical exercise during pregnancy - with total weight loss. Higher parity, inter-pregnancy interval, calorie intake, pre-pregnancy body mass index (BMI), weight gain related to pre-pregnancy BMI, presence and severity of depression, and lack of exclusive breastfeeding were directly associated with lower weight loss. Among nominal variables, level of education and marital status were significantly associated with total weight loss.

    CONCLUSION:

    In the present study, lower weight retention in the postpartum period was associated with higher educational attainment and with being married. Normal or below-normal pre-pregnancy BMI, physical activity and adequate weight gain during pregnancy, lower parity, exclusive breastfeeding for a longer period, appropriate or low calorie intake, and absence of depression were also determinants of reduced weight retention.

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    Factors associated with postpartum weight retention in a Brazilian cohort
  • Artigos Originais

    Fetal heart rate responses during maternal resistance exercise: a pilot study

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(3):133-139

    Summary

    Artigos Originais

    Fetal heart rate responses during maternal resistance exercise: a pilot study

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(3):133-139

    DOI 10.1590/SO100-720320150005132

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    PURPOSE:

    To determine fetal heart rate (FHR) responses to maternal resistance exercise for the upper and lower body at two different volumes, and after 25 minutes post-exercise.

    METHODS:

    Ten pregnant women (22-24 weeks gestation, 25.2±4.4 years of age, 69.8±9.5 kg, 161.6±5.2 cm tall) performed, at 22-24, 28-32 and 34-36 weeks, the following experimental sessions: Session 1 was a familiarization with the equipment and the determination of one estimated maximum repetition. For sessions 2, 3, 4 and 5,FHR was determined during the execution of resistance exercise on bilateral leg extension and pec-deck fly machines, with 1 and 3 sets of 15 repetitions; 50% of the weight load and an estimated repetition maximum. FHR was assessed with a portable digital cardiotocograph. Results were analyzed using Student's t test, ANOVA with repeated measures and Bonferroni (α=0.05; SPSS 17.0).

    RESULTS:

    FHR showed no significant differences between the exercises at 22-24 weeks (bilateral leg extension=143.8±9.4 bpm, pec-deck fly=140.2±10.2 bpm, p=0.34), 28-30 weeks (bilateral leg extension=138.4±12.2 bpm, pec-deck fly=137.6±14.0 bpm, p=0.75) and 34-36 weeks (bilateral leg extension=135.7±5.8 bpm, pec-deck fly=139.7±13.3 bpm, p=0.38), between the volumes(bilateral leg extension at 22-24 weeks: p=0.36, at 28-30 weeks: p=0.19 and at 34-36 weeks: p=0.87; pec-deck fly at 22-24 weeks: p=0.43, at 28-30 weeks: p=0.61 and at 34-36 weeks: p=0.49) and after 25 minutes post-exercise.

    CONCLUSION:

    Results of this pilot study would suggest that maternal resistance exercise is safe for the fetus.

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    Fetal heart rate responses during maternal resistance exercise: a pilot study
  • Artigos Originais

    Prevalence of toxoplasmosis in pregnant women in two reference centers in a city in Northeast Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(2):64-70

    Summary

    Artigos Originais

    Prevalence of toxoplasmosis in pregnant women in two reference centers in a city in Northeast Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(2):64-70

    DOI 10.1590/SO100-720320150005115

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    PURPOSE:

    To determine the prevalence of toxoplasmosis and to identify the main factors associated with seroreactivity in pregnant women cared for at two reference centers in a city in Northeast Brazil.

    METHODS:

    A cross-sectional study was conducted on 561 pregnant women at two high-risk prenatal reference centers in a city in Northeast Brazil. All women were interviewed using an epidemiological questionnaire and had their blood samples collected for the following serological tests: anti-Toxoplasma gondii IgG and IgM (ELISA), IgG avidity test, and polymerase chain reaction (PCR). Statistical analysis was carried out using SPSS version 18.0 for Windows, calculating odds ratio, confidence interval of 95% and with the level of significance set at 5%.

    RESULTS:

    Seroreactivity for toxoplasmosis was detected in 437 women (77.0%), susceptibility in 124 (22.1%) and active infection in 5 (0.9%). There was no significant association between seroreactivity for toxoplasmosis and age, location, income, education, availability of sewage, number of pregnancies or gestational age. The variables significantly associated (p≤0.05) with seroreactivity were multiparity (p=0.03) and living with stray dogs (p=0.01).

    CONCLUSIONS:

    This study identified high seroreactivity for toxoplasmosis among patients seen during prenatal care, as well as factors associated with seroreactivity. Appropriate guidelines about primary preventive measures should be emphasized and quarterly serological monitoring is recommended for pregnant women in this city and elsewhere in the Northeast of Brazil.

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  • Artigos Originais

    Medication use during the first trimester of pregnancy: drug safety and adoption of folic acid and ferrous sulphate

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):541-547

    Summary

    Artigos Originais

    Medication use during the first trimester of pregnancy: drug safety and adoption of folic acid and ferrous sulphate

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):541-547

    DOI 10.1590/So100-720320140005051

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    PURPOSE:

    To identify the profile of use of medication during the first trimester of pregnancy with emphasis on safety assessment and on the adoption of folic acid and ferrous sulfate by pregnant women attended at a Basic Health Unit in Brazil.

    METHODS:

    This was a cross-sectional study nested in a cohort of pregnant women. Medications were classified according to the Anatomical Therapeutic Chemical (ATC), and their safety was evaluated according to the Food and Drug Administration (FDA) and the Brazilian Health Surveillance Agency (ANVISA). The adoption of ferrous sulfate and folic acid was investigated according to the protocol set forth by the Brazilian Ministry of Health.

    RESULTS:

    The survey included 212 pregnant women, 46.7% of whom were taking medications at the time of pregnancy diagnosis, and 97.6% used medication during the first trimester after diagnosis. The highest percentage of self-medication occurred before the beginning of prenatal care (64.9%). According to the FDA criteria, there was a high level of exposure to D and X risk drugs before the beginning of prenatal care (23.0%), which was also observed for drugs not recommended by ANVISA (36.5%). Of the surveyed sample, 32.5% did not follow the protocol of the Brazilian Ministry of Health. In all, 67.9% of pregnant women had inadequate drug exposure. There was a difference between the proportions of drugs used according to the ATC, and the main anatomical groups identified were the drugs that act on blood and blood-forming organs, and anti-infective medications for systemic use. When pregnancy was diagnosed, the use of a large number of medications that act on the genitourinary system and sex hormones (16.2%) was identified, such as oral contraceptives, a fact probably related to the percentage of unplanned pregnancies (67.0%), on the same occasion 4 pregnant women used folic acid and 3 used ferrous sulphate.

    CONCLUSION:

    The present results show that a large number of medications are used during pregnancy. Even if there was little exposure to drugs at the time of diagnosis, there is an overuse of potentially risky medications and self-medication during the first trimester of pregnancy.

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  • Artigos Originais

    Obesity during pregnancy: gestational complications and birth outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):509-513

    Summary

    Artigos Originais

    Obesity during pregnancy: gestational complications and birth outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(11):509-513

    DOI 10.1590/S0100-720320140005024

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    PURPOSE:

    To evaluate the influence of maternal obesity on pregnancy, childbirth, and neonatal outcomes.

    METHODS:

    A cross-sectional study with 298 postpartum women. Information was obtained through interviews and access to patients' medical records. The patients were divided into three groups according to their pre-gestational body mass index: normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Data are reported as adjusted odds ratios with 95% confidence interval (95%CI) following multinomial logistic regression analysis to account for confounding variables.

    RESULTS:

    Compared to pregnant women with normal body mass index, overweight women had greater chances of having cesarean delivery, odds ratio (OR) of 2.2 and 95%CI 1.3–3.9, and obese women even more (OR=4.2; 95%CI 2.1–8.1). The chances of gestational diabetes increased in the Overweight (OR=2.5; 95%CI 1.1–5.6) and Obese groups (OR=11.1; 95%CI 5.0–24.6). The occurrence of hypertensive syndrome was also higher in overweight (OR=3.2; 95%CI 1.2–8.1) and obese pregnant women (OR=7.5; 95%CI 2.9–19.1). Major postpartum hemorrhage only showed greater values in the obese women group (OR=4.1; 95%CI 1.1–15.8). Regarding the newborns, the probability of a low Apgar score at first minute was higher in the Obese Group (OR=5.5; 95%CI 1.2–23.7) and chances of macrosomia were higher in the Overweight Group (OR=2.9; 95%CI 1.3–6.3). Data regarding neonatal hypoglycemia were not conclusive.

    CONCLUSION:

    Excessive weight (overweight and obesity) during pregnancy increases the chance of maternal complications (gestational diabetes, hypertensive syndrome, and major postpartum hemorrhage) and neonatal outcomes (cesarean delivery, macrosomia, and low Apgar score).

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  • Artigos Originais

    Obesity and cardiometabolic risk factors during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):449-455

    Summary

    Artigos Originais

    Obesity and cardiometabolic risk factors during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):449-455

    DOI 10.1590/SO100-720320140004946

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    PURPOSE:

    To assess cardiometabolic risk factors during normal pregnancy and the influence of maternal obesity on them.

    METHODS:

    This study included 25 healthy pregnant women with a single pregnancy and a gestational age of less than twenty weeks. Longitudinal analysis of blood pressure, body weight, body mass index (BMI), serum concentrations of leptin, adiponectin, cortisol, total cholesterol and fractions, triglycerides, uric acid, fasting glucose, oral glucose tolerance test, HOMA-IR and insulin/glucose ratio was performed each trimester during pregnancy. In order to evaluate the impact of obesity, pregnant women were divided into two groups based on BMI for the first quarter of pregnancy: Gpn for pregnant women with BMI<25 kg/m2 and Gso for BMI≥25 kg/m2. One-Way ANOVA for repeated measurements or Friedman test and Student-t or Mann-Whitney tests for statistical comparisons and Pearson correlations test were used for statistical analysis.

    RESULTS:

    The mean values for the first quarter of pregnancy for the following parameters were: age: 22 years; weight: 66.3 kg and BMI 26.4 kg/m2, with 20.2 and 30.7 kg/m2 for the Gpn and Gso groups, respectively. Mean weight gain during pregnancy was ±12.7 kg with 10.3 kg for the Gso group and 15.2 kg for the Gpn group. Regarding plasma determinations, cortisol, uric acid and lipid profile increased during all trimesters of pregnancy, except for HDL-cholesterol, which did not change. Blood pressure, insulin and HOMA-IR only increased in the third quarter of pregnancy. The Gso group tended to gain more weight and to show higher concentrations of leptin, total cholesterol, LDL-cholesterol, VLDL-cholesterol, TG, glucose, insulin, HOMA-IR, besides lower HDL-cholesterol and greater diastolic blood pressure in the 3rdquarter of pregnancy. Three pregnant women developed gestational hypertension, presented prepregnancy obesity, excessive weight gain, hyperleptinemia and an insulin/glucose ratio greater than two. Weight and BMI were positively correlated with total cholesterol and its LDL fraction, TG, uric acid, fasting blood glucose, insulin and HOMA-IR; and were negatively correlated with adiponectin and HDL-cholesterol. Leptin level was positively correlated with blood pressure.

    CONCLUSIONS:

    The metabolic changes in pregnancy are more significant in obese women, suggesting, as expected, an increased risk of cardiometabolic complications. During their first visit for prenatal care, obese women should be informed about these risks, have their BMI and insulin/glucose ratio calculated along with their lipid profile to identify pregnant women at higher risk for cardiovascular diseases.

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  • Artigos Originais

    Changes in motor behavior during pregnancy in rats: the basis for a possible animal model of restless legs syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):436-441

    Summary

    Artigos Originais

    Changes in motor behavior during pregnancy in rats: the basis for a possible animal model of restless legs syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):436-441

    DOI 10.1590/SO100-720320140005105

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    PURPOSE:

    Pregnant women have a 2-3 fold higher probability of developing restless legs syndrome (RLS – sleep-related movement disorders) than general population. This study aims to evaluate the behavior and locomotion of rats during pregnancy in order to verify if part of these animals exhibit some RLS-like features.

    METHODS:

    We used 14 female 80-day-old Wistar rats that weighed between 200 and 250 g. The rats were distributed into control (CTRL) and pregnant (PN) groups. After a baseline evaluation of their behavior and locomotor activity in an open-field environment, the PN group was inducted into pregnancy, and their behavior and locomotor activity were evaluated on days 3, 10 and 19 of pregnancy and in the post-lactation period in parallel with the CTRL group. The serum iron and transferrin levels in the CTRL and PN groups were analyzed in blood collected after euthanasia by decapitation.

    RESULTS:

    There were no significant differences in the total ambulation, grooming events, fecal boli or urine pools between the CTRL and PN groups. However, the PN group exhibited fewer rearing events, increased grooming time and reduced immobilization time than the CTRL group (ANOVA, p<0.05).

    CONCLUSION:

    These results suggest that pregnant rats show behavioral and locomotor alterations similar to those observed in animal models of RLS, demonstrating to be a possible animal model of this sleep disorder.

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    Changes in motor behavior during pregnancy in rats: the basis for a possible animal model of restless legs syndrome
  • Artigos Originais

    Number of antral follicles and the success of in vitro fertilization: a multivariate analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):473-479

    Summary

    Artigos Originais

    Number of antral follicles and the success of in vitro fertilization: a multivariate analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(10):473-479

    DOI 10.1590/S0100-720320140005046

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    PURPOSE:

    To determine whether the antral follicle count can predict the number of retrieved oocytes in patients undergoing in vitro fertilization (IVF) and to correlate it with maternal age and pregnancy rate.

    METHODS:

    This was a retrospective observational study based on a review of medical records from 193 patients who underwent assisted reproduction techniques between September 2010 and September 2012 in a Clinic for Human Reproduction. The study included women indicated for IVF who had follicle-stimulating hormone levels below 10 mIU/mL on third day of the menstrual cycle, with oocyte recipients being excluded. The patients were divided into three groups according to the number of antral follicle (up to 10 follicles, 11–22 follicles, and 23 or more follicles). To compare these three groups with the group of patients who became pregnant, patients who had not developed oocytes and had not undergone embryo transfer were also excluded. Spearman's correlation coefficient was used to measure the level of association between the numerical variables, and χ2 test was used to compare pregnancy rates with antral follicle count. To assess the likelihood of pregnancy, we used multivariate logistic regression, with the level of significance set at 5%.

    RESULTS:

    The pregnancy rate of the sample was 35.6%. There was a positive significant correlation (sc) between antral follicle count and number of retrieved oocytes (sc=0.5; p<0.05) and a negative correlation between antral follicle count and age (sc= -0.5; p<0.05). There was no significant difference (p=0.16) when groups with different numbers of follicles were compared to the positive pregnancy test group; however, a cutoff of 27 antral follicles was observed in multivariate analysis, after which the probability of successful gestation tended to remain constant.

    CONCLUSIONS:

    The antral follicle count decreases over the years, is a predictor of the number of retrieved oocytes and can predict the likelihood of the success of in vitro fertilization.

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    Number of antral follicles and the success of in vitro fertilization: a multivariate analysis

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