Pregnancy Archives - Page 4 of 25 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(11):505-511
DOI 10.1590/SO100-720320150005400
To evaluate the factors associated with anemia among pregnant women receiving public health care in a capital city in Northeastern Brazil.
This was a cross-sectional study conducted on a sample of 428 patients obtained on the basis of the estimated prevalence of anemia during pregnancy (50%), a 95% confidence interval (95%CI), an error of 5% and a sample loss of 20%. Pregnant women who lived in the city and were served by the municipal public health network were considered to be eligible for the study. Socioeconomic, lifestyle, clinical and anthropometric data and dietary iron intake were obtained, and capillary hemoglobin was determined. Anemia was identified as a hemoglobin level <11 g/dL, and its association with risk factors was tested using multivariate Poisson regression analysis, with the results expressed as the Prevalence Ratio (PR) and 95%CI.
The prevalence of anemia was 28.3% and was higher among women with more members in the household (PR=1.49; 95%CI 1.01-2.22; p=0.046) and those living with food insecurity (PR=1.43; 95%CI 1.00-2.04; p=0.047).
The prevalence of anemia among pregnant women receiving care from the public health system of the city is a moderate public health problem, requiring the planning of effective measures for its control.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(11):505-511
DOI 10.1590/SO100-720320150005400
To evaluate the factors associated with anemia among pregnant women receiving public health care in a capital city in Northeastern Brazil.
This was a cross-sectional study conducted on a sample of 428 patients obtained on the basis of the estimated prevalence of anemia during pregnancy (50%), a 95% confidence interval (95%CI), an error of 5% and a sample loss of 20%. Pregnant women who lived in the city and were served by the municipal public health network were considered to be eligible for the study. Socioeconomic, lifestyle, clinical and anthropometric data and dietary iron intake were obtained, and capillary hemoglobin was determined. Anemia was identified as a hemoglobin level <11 g/dL, and its association with risk factors was tested using multivariate Poisson regression analysis, with the results expressed as the Prevalence Ratio (PR) and 95%CI.
The prevalence of anemia was 28.3% and was higher among women with more members in the household (PR=1.49; 95%CI 1.01-2.22; p=0.046) and those living with food insecurity (PR=1.43; 95%CI 1.00-2.04; p=0.047).
The prevalence of anemia among pregnant women receiving care from the public health system of the city is a moderate public health problem, requiring the planning of effective measures for its control.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(10):460-466
DOI 10.1590/SO100-720320150005361
To evaluate the effectiveness of an illustrated home exercise guide targeting the pelvic floor muscles in promoting urinary continence during pregnancy.
A randomized clinical trial was performed with 87 participants, evaluated six times during pregnancy and divided into three groups: Gsup, supervised; Gobs, not supervised, and Gref, women who did not perform the home exercises program. A miction diary and perineometry were used to evaluate urinary incontinence (primary outcome) and pelvic floor muscle strength (secondary outcome), respectively. The Kruskal-Wallis test with post hoc Dunn's and chi-square and Z tests with Bonferroni correction were used for continuous variables and proportions, respectively, with the level of significance set at 5%.
At the end of the study, 6.9% of pregnant women in the Gsup and Gobs had urinary incontinence, while 96.6% of Gref women were incontinent. Regarding pelvic floor muscle function, Gsup and Gobs had mean contractions of 10 and 8.9 cmH2O, respectively, while Gref had a value of 4.7 cmH2O. Both results were significant.
An illustrated home exercise guide targeting the pelvic floor muscles is effective in promoting urinary continence during pregnancy, even without permanent supervision.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(10):460-466
DOI 10.1590/SO100-720320150005361
To evaluate the effectiveness of an illustrated home exercise guide targeting the pelvic floor muscles in promoting urinary continence during pregnancy.
A randomized clinical trial was performed with 87 participants, evaluated six times during pregnancy and divided into three groups: Gsup, supervised; Gobs, not supervised, and Gref, women who did not perform the home exercises program. A miction diary and perineometry were used to evaluate urinary incontinence (primary outcome) and pelvic floor muscle strength (secondary outcome), respectively. The Kruskal-Wallis test with post hoc Dunn's and chi-square and Z tests with Bonferroni correction were used for continuous variables and proportions, respectively, with the level of significance set at 5%.
At the end of the study, 6.9% of pregnant women in the Gsup and Gobs had urinary incontinence, while 96.6% of Gref women were incontinent. Regarding pelvic floor muscle function, Gsup and Gobs had mean contractions of 10 and 8.9 cmH2O, respectively, while Gref had a value of 4.7 cmH2O. Both results were significant.
An illustrated home exercise guide targeting the pelvic floor muscles is effective in promoting urinary continence during pregnancy, even without permanent supervision.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):421-427
DOI 10.1590/SO100-720320150005355
To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors.
A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs.
Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis.
The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):421-427
DOI 10.1590/SO100-720320150005355
To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors.
A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs.
Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis.
The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):325-332
DOI 10.1590/S0100-720320150005367
To determine the eating behavior of pregnant women assisted by primary health care and to compare it with women at childbearing age in Brazilian capitals.
A cross-sectional study conducted on 256 pregnant women in the second trimester of gestation, selected by drawing lots from those assisted by primary health care units of a municipality in the state of São Paulo in 2009/2010. Eating habits were investigated via a questionnaire adapted from the VIGITEL system, consisting of questions about eating habits in general and the frequency and consumption characteristics of food groups/specific foods. For tis comparison, we used the indicators reported by the VIGITEL system for women at childbearing age in Brazilian capitals in 2010. The analyses involved the presentation of frequency distribution and descriptive statistics with comparisons according to the age group.
Most patients had breakfast every day (86.7%) and 45.7% habitually exchanged a main meal for a snack once or twice a week. A daily consumption of fruit, raw salad and vegetables was not reported by 48.8%, 41.8% and 55.1% of the women, respectively. Fish was reported to never or almost never be consumed by 64.4% of the pregnant women. At least once a week, 69.9% of them reported the consumption of soda, and 86.4% of wafers/cookies. The comparison between the pregnant women and women at childbearing age in capitals showed a close similar prevalence of overweight, and no difference in the regular consumption of fruit and vegetables. Meat containing excess of fat and whole milk were more consumed by pregnant women, with differences reported in all the age groups analyzed. On the other hand, the pregnant women reported a less regular intake of soft drinks.
The actions that need to be performed in prenatal care are various and very important, promoting the consumption of specific foods and providing guidelines about eating behavior, while reinforcing healthy eating habits already present.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):325-332
DOI 10.1590/S0100-720320150005367
To determine the eating behavior of pregnant women assisted by primary health care and to compare it with women at childbearing age in Brazilian capitals.
A cross-sectional study conducted on 256 pregnant women in the second trimester of gestation, selected by drawing lots from those assisted by primary health care units of a municipality in the state of São Paulo in 2009/2010. Eating habits were investigated via a questionnaire adapted from the VIGITEL system, consisting of questions about eating habits in general and the frequency and consumption characteristics of food groups/specific foods. For tis comparison, we used the indicators reported by the VIGITEL system for women at childbearing age in Brazilian capitals in 2010. The analyses involved the presentation of frequency distribution and descriptive statistics with comparisons according to the age group.
Most patients had breakfast every day (86.7%) and 45.7% habitually exchanged a main meal for a snack once or twice a week. A daily consumption of fruit, raw salad and vegetables was not reported by 48.8%, 41.8% and 55.1% of the women, respectively. Fish was reported to never or almost never be consumed by 64.4% of the pregnant women. At least once a week, 69.9% of them reported the consumption of soda, and 86.4% of wafers/cookies. The comparison between the pregnant women and women at childbearing age in capitals showed a close similar prevalence of overweight, and no difference in the regular consumption of fruit and vegetables. Meat containing excess of fat and whole milk were more consumed by pregnant women, with differences reported in all the age groups analyzed. On the other hand, the pregnant women reported a less regular intake of soft drinks.
The actions that need to be performed in prenatal care are various and very important, promoting the consumption of specific foods and providing guidelines about eating behavior, while reinforcing healthy eating habits already present.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):319-324
DOI 10.1590/S0100-720320150005388
To compare body attitudes of pregnant women in various body mass index categories, during different gestational periods and under gestational risk conditions, as well as to analyze the association of the study variables with the body attitudes of pregnant women.
We included 386 pregnant women in all gestational periods, aged 18 to 46 years (mean 29.32±6.04 years ), who attended prenatal care in the public and private sectors of a city in Southeastern Brazil, excluding women with incomplete data. The instruments for assessment were "Body Attitudes Questionnaire", "Critério de Classificação Econômica Brasil", and a sociodemographic questionnaire. In addition, anthropometric and obstetric data were collected. Descriptive, comparative, and correlational statistical analyses were performed.
The body attitudes of pregnant women were similar in all pregnancy trimesters (F=0.39; p=0.9). Negative body attitudes increased gradually among low weight (108.2±12.5), appropriate weight (116.2±16.0), overweight (125.1±14.3), and obese (132.9±16.4) groups, and among pregnancy women with normal (120.0±17.1) and high-risk pregnancies (124.9±16.7). The sociodemographic, economic, and obstetric variables did not influence the variance of body attitudes. The body mass index explained 11.3% of the variance of body attitudes in pregnant women.
Nutritional status and risk conditions showed an association with negative body image and should therefore be evaluated in pregnant women for a better maternal and child health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):319-324
DOI 10.1590/S0100-720320150005388
To compare body attitudes of pregnant women in various body mass index categories, during different gestational periods and under gestational risk conditions, as well as to analyze the association of the study variables with the body attitudes of pregnant women.
We included 386 pregnant women in all gestational periods, aged 18 to 46 years (mean 29.32±6.04 years ), who attended prenatal care in the public and private sectors of a city in Southeastern Brazil, excluding women with incomplete data. The instruments for assessment were "Body Attitudes Questionnaire", "Critério de Classificação Econômica Brasil", and a sociodemographic questionnaire. In addition, anthropometric and obstetric data were collected. Descriptive, comparative, and correlational statistical analyses were performed.
The body attitudes of pregnant women were similar in all pregnancy trimesters (F=0.39; p=0.9). Negative body attitudes increased gradually among low weight (108.2±12.5), appropriate weight (116.2±16.0), overweight (125.1±14.3), and obese (132.9±16.4) groups, and among pregnancy women with normal (120.0±17.1) and high-risk pregnancies (124.9±16.7). The sociodemographic, economic, and obstetric variables did not influence the variance of body attitudes. The body mass index explained 11.3% of the variance of body attitudes in pregnant women.
Nutritional status and risk conditions showed an association with negative body image and should therefore be evaluated in pregnant women for a better maternal and child health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):266-271
DOI 10.1590/SO100-720320150005254
To investigate the relationship between sexual function and quality of life in
pregnant women living in two cities of Northeastern Brazil.
The sample consisted of 207 pregnant women. The data were collected through a
questionnaire containing questions about socio-demographic, gynecological and
obstetrical data, body and sexual knowledge. Quality of life was assessed by
applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power).
Sexual function was assessed using the Female Sexual Function Index (IFSF). Data
were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon
tests.
The pregnant women studied had a median age of 30 years (quartile 26-33 years)
and were approximately at the 26th gestational week. A significant
decrease in the monthly frequency of sexual relations of the couple was observed,
with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual
dysfunction was detected in 35.7% of the pregnant women studied, whose quality of
life was lower when compared to women with unchanged sexual function (Z=-2.9;
p=0.004).
The results of this study show that sexual dysfunction negatively affected the
quality of life of pregnant women, and this should be an important aspect for
review during prenatal consultations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(6):266-271
DOI 10.1590/SO100-720320150005254
To investigate the relationship between sexual function and quality of life in
pregnant women living in two cities of Northeastern Brazil.
The sample consisted of 207 pregnant women. The data were collected through a
questionnaire containing questions about socio-demographic, gynecological and
obstetrical data, body and sexual knowledge. Quality of life was assessed by
applying the Ferrans & Powers Quality of Life Index (QLI Ferrans and Power).
Sexual function was assessed using the Female Sexual Function Index (IFSF). Data
were statistically analyzed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon
tests.
The pregnant women studied had a median age of 30 years (quartile 26-33 years)
and were approximately at the 26th gestational week. A significant
decrease in the monthly frequency of sexual relations of the couple was observed,
with a median of 12 to 4 times per month (Z=-10.56; p<0.001). Sexual
dysfunction was detected in 35.7% of the pregnant women studied, whose quality of
life was lower when compared to women with unchanged sexual function (Z=-2.9;
p=0.004).
The results of this study show that sexual dysfunction negatively affected the
quality of life of pregnant women, and this should be an important aspect for
review during prenatal consultations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):229-232
DOI 10.1590/SO100-720320150005295
To compare the frequency of an ASCUS Pap Smear result in pregnant and
non-pregnant women, stratified by age group.
We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed
between 2000 and 2009 (ten years) with the purpose of screening for cervical
carcinoma. Comparisons were made between pregnant and non-pregnant women, and the
sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The
χ2 test was used and the magnitude of association was determined by
the by Odds Ratio (OR) with the 95% confidence interval (95%CI).
A Total of 447,489 samples were excluded on the basis of the criteria adopted,
for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women.
An ASCUS result was detected in 1.2% of cases, with a significant difference
between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85;
95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no
difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03).
This study suggested that non-pregnant women have a higher frequency of ASCUS,
most evident in the age group of 20 to 29 years. The collection of cervical cancer
screening should not be a compulsory part of the prenatal routine.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):229-232
DOI 10.1590/SO100-720320150005295
To compare the frequency of an ASCUS Pap Smear result in pregnant and
non-pregnant women, stratified by age group.
We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed
between 2000 and 2009 (ten years) with the purpose of screening for cervical
carcinoma. Comparisons were made between pregnant and non-pregnant women, and the
sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The
χ2 test was used and the magnitude of association was determined by
the by Odds Ratio (OR) with the 95% confidence interval (95%CI).
A Total of 447,489 samples were excluded on the basis of the criteria adopted,
for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women.
An ASCUS result was detected in 1.2% of cases, with a significant difference
between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85;
95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no
difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03).
This study suggested that non-pregnant women have a higher frequency of ASCUS,
most evident in the age group of 20 to 29 years. The collection of cervical cancer
screening should not be a compulsory part of the prenatal routine.