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Original Article
Depressive Symptoms in Pregnancy: The Influence of Social, Psychological and Obstetric Aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):293-300
06-01-2016
Summary
Original ArticleDepressive Symptoms in Pregnancy: The Influence of Social, Psychological and Obstetric Aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):293-300
06-01-2016Views102See moreAbstract
Purpose
To assess the prevalence of depressive symptoms and their association with social, psychological, behavioral and obstetric characteristics in pregnant women.
Methods
This is a cross-sectional study. The sample consisted of 375 pregnant women who attended prenatal clinics in two public maternity hospitals located in the city of Goiania, Brazil. To testify the depressive symptoms, we used the Hospital Anxiety and Depression Scale (HADS). A descriptive statistical analysis was performed using programs such as CDC EPI-INFO(tm), version 7.1.5, and Statistical Package for Social Sciences (IBM SPSS), version 21.0.
Results
the patients had probable depressive symptoms (15.47%) and possible depressive symptoms (25.33%). The bivariate analysis showed a significant association among "depressive symptoms" and the following variables: "single or divorced" (prevalence ratio, PR = 2.08; 95% confidence interval, CI = 1.26 to 3.44); "physical activity during pregnancy" (PR = 3.96; 95%CI = 1.28 to 12.31); exposure to "psychological/emotional" violence (PR = 4.74; 95%CI = 2.94 to 7.64); "prior mental problem" (PR = 2.66; 95%CI =1.49 to 4.73) and "obstetric complications during pregnancy" (PR = 2.53; 95%CI = 1.55 to 4.13). The multivariate analysis confirmed the association of these depressive symptoms with the variables "suffered psychological/emotional violence" (odds ratio, OR = 5.821; 95%CI = 2.939 to 11.528); "physical activity during pregnancy" (OR = 3.885; 95%CI = 1.060 to 14.231); "obstetric complications during pregnancy" (OR = 2.442; 95%CI = 1.233 to 4.834) and "single or divorced" (OR = 2.943; 95%CI = 1.326 to 6.533).
Conclusions
the prevalence of depressive symptoms among pregnant women is of 15.47%, and emotional violence is the main factor associated with gestational depression.
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Artigos Originais
Chlamydia trachomatis and Neisseria gonorrhoeae infection: factors associated with infertility in women treated at a human reproduction public service
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):353-358
08-01-2014
Summary
Artigos OriginaisChlamydia trachomatis and Neisseria gonorrhoeae infection: factors associated with infertility in women treated at a human reproduction public service
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):353-358
08-01-2014DOI 10.1590/SO100-720320140005009
Views71PURPOSE:
To evaluate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women undergoing assisted reproduction in a public reference service in the midwestern region of Brazil.
METHODS:
A cross-sectional study was conducted on 340 women aged from 20 to 47 years with a history of infertility, undergoing assisted reproduction techniques. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae identified in urine specimens by PCR, and the profile of infertility were analyzed. We used the χtest or Fisher's exact test to evaluate the association between infection and variables.
RESULTS:
The prevalence of Chlamydia trachomatis infection was 10.9%, and Neisseria gonorrhoeae co-infection was observed in 2 cases. Women infected with Chlamydia trachomatis had more than 10 years of infertility (54.1%; p<0.0001). The tubal factor was the main cause in infected cases (56.8%; p=0.047). Tubal occlusion was found in 67.6% of cases with positive infection (p=0.004).
CONCLUSION:
There was an association of tubal obstruction with infection by Chlamydia trachomatis and Neisseria gonorrhoeae, reinforcing the need for effective strategies for an early detection of sexually transmitted diseases, especially in asymptomatic women of childbearing age.
Key-words assistedChlamydia infectionsGonorrheaInfertilityPrevalenceReproductive techniquesSexually transmitted diseasesSee more -
Artigos Originais
Why does the prevalence of cytopathological results of cervical cancer screening can vary significantly between two regions of Brazil?
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(5):192-197
05-01-2014
Summary
Artigos OriginaisWhy does the prevalence of cytopathological results of cervical cancer screening can vary significantly between two regions of Brazil?
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(5):192-197
05-01-2014DOI 10.1590/S0100-7203201400050002
Views47See morePURPOSE:
To analyze the prevalence of cervical cytopathological results for the screening of cervical cancer with regard to women's age and time since the last examination in Maceió and Rio de Janeiro, Brazil, among those assisted by the Brazilian Unified Health System.
METHODS:
Cervical cytopathological results available in the Information System of Cervical Cancer Screening for the year 2011 were analyzed, corresponding to 206,550 for Rio de Janeiro and 45,243 for Maceió.
RESULTS:
In Rio de Janeiro, examination at one and two year intervals predominated, while in Maceió examination at one and three year intervals had a higher predominance. Women who underwent cervical smear screening in Maceió were older than those in Rio de Janeiro. The prevalence of invasive squamous cell carcinoma was similar for the two cities, but all the other results presented a higher prevalence in Rio de Janeiro: ASCUS (PR=5.32; 95%CI 4.66-6.07); ASCH (PR=4.27; 95%CI 3.15-5.78); atypical glandular cells (PR=10.02; 95%CI 5.66-17.76); low-grade squamous intraepithelial lesions (PR=6.10; 95%CI 5.27-7.07); high-grade squamous intraepithelial lesions (PR=8.90; 95%CI 6.50-12.18) and adenocarcinoma (PR=3.00; 95%CI 1.21-7.44). The rate of unsatisfactory cervical samples was two times higher in Maceió and that of rejected samples for analysis was five times higher in Maceió when compared to Rio de Janeiro.
CONCLUSIONS:
The prevalence rates of altered cervical cytopathological results was significantly higher in Rio de Janeiro than in Maceió. There is no objective information that may justify this difference. One hypothesis is that there may be a difference in the diagnostic performance of the cervical cancer screening, which could be related to the quality of the Pap smear. Thus, these findings suggest that it would be necessary to perform this evaluation at national level, with emphasis on the performance of cervical cancer screening in order to improve the effectiveness of cervical cancer control.
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Artigos Originais
Climacteric syndrome in a Northeastern Brazilian city: a household survey
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):163-169
04-01-2014
Summary
Artigos OriginaisClimacteric syndrome in a Northeastern Brazilian city: a household survey
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):163-169
04-01-2014DOI 10.1590/S0100-7203201400040002
Views81See morePURPOSE:
To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically.
METHODS:
A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms.
RESULTS:
Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint.
CONCLUSION:
The prevalence of CS was high among women from São Luís, Maranhão, Brazil.
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Artigos Originais
Disability and factors associated with gestational low back pain
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):541-548
02-03-2013
Summary
Artigos OriginaisDisability and factors associated with gestational low back pain
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):541-548
02-03-2013DOI 10.1590/S0100-72032013001200003
Views50See morePURPOSE: To determine the prevalence of low back pain in pregnant women and to describe its characteristics and associated factors. METHODS: The participants were 269 pregnant women in the first to the third trimester of pregnancy, seen at the obstetrics outpatient clinic of a University Hospital in the Brazilian Northeast. We applied a questionnaire in order to obtain data regarding socio-demographic variables, obstetric history and characteristics of low back pain, as well as the Oswestry and Rolland Morris questionnaires to assess disability and a visual analog pain scale to measure pain intensity. RESULTS: The prevalence of low back pain was 73%, with the following characteristics: stabbing (62/31.6%), irradiation (162/82.6%), of daily frequency (105/53.5%), usually starting at night (83/42.3%) when it was also more intense (122/62.2%), and lasting about 1 hour in 118 women (60.2%). Pain improved with rest (100/51%), worsened when the women stood or sat for a long time (86/43.9%) and when they did housework (85/43.4%). The level of disability ranged from "mild" to "moderate" in most cases. Urinary tract infection (p=0.02) and the scores of the Oswestry and Rolland Morris questionnaires showed significant association with the visual analogue pain scale. CONCLUSION: The prevalence of back pain among pregnant women is high, with varying characteristics. The degree of disability is usually moderate and the presence of urinary infection and higher disability scores were associated with greater intensity of low back pain.
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Artigos Originais
Prevalence of Chlamydia trachomatis and risk factors associated with infection detected in endocervical sample
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):379-383
10-10-2013
Summary
Artigos OriginaisPrevalence of Chlamydia trachomatis and risk factors associated with infection detected in endocervical sample
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(8):379-383
10-10-2013DOI 10.1590/S0100-72032013000800008
Views55PURPOSE: It was to determine the prevalence of Chlamydia trachomatis and the risk factors associated with infection in endocervical specimens from women seen in outpatient Obstetrics and Gynecology. METHODS: Samples of endocervical secretion of 200 women treated at the University Hospital of the Federal University of Rio Grande were analyzed for the presence of C. trachomatis by polymerase chain reaction (PCR) using primers that amplify CT05/CT06 281 base pairs of the main outer membrane protein of C. trachomatis. All participants completed a pre-coded and self-report questionnaire. Data were analyzed with the SPSS 17.0 software; for multivariate analysis it was used Poisson regression. RESULTS: Of the 200 women who were included in the study, the prevalence of infection with C. trachomatis was 11% (22 patients) and these 55 (27.5%) were positive for HPV. Risk factors associated with infection by C. trachomatis were: 8 years or less of schooling (p<0.001), family income below the poverty level (p=0.005), first intercourse at age 15 or less (p=0.04) and being a carrier of the virus HIV (p<0.001). After multivariate analysis, only the variables of schooling or less than eight years (PR 6.0; 95%CI 1.26 - 29.0; p=0.02) and presence of HIV (RP 14.1; 95%CI 3.4 - 57.5; p<0.001) remained statistically significant. CONCLUSIONS: The prevalence of C. trachomatis in endocervical specimens by PCR was 11%. The factors associated with a higher infection by C. trachomatis were lower education and being HIV positive.
Key-words Chlamydia infectionsPolymerase chain reactionPrevalenceQuestionnairesRisk factorsSexually transmitted diseasesSee more -
Artigos Originais
Risk factors and prevalence of HPV infection in patients from Basic Health Units of an University Hospital in southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):226-232
07-05-2013
Summary
Artigos OriginaisRisk factors and prevalence of HPV infection in patients from Basic Health Units of an University Hospital in southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):226-232
07-05-2013DOI 10.1590/S0100-72032013000500007
Views134PURPOSE: To determine the HPV prevalence and genotypes and to identify factors associated with infection in pregnant and non-pregnant women with positive or negative HIV-1, treated in Gynecology and Obstetrics Ambulatories and in Health Primary Units, in Rio Grande, Rio Grande do Sul State, Brazil. METHODS: Cervical cells samples from 302 patients were analyzed for HPV presence and genotypes were determined by nested and sequencing polymerase chain reaction. We calculated prevalence ratios associated with the studied variables by Fisher's exact or χ² tests, and Poisson's regression. Women with insufficient material were excluded from the study. RESULTS: HPV was detected in 55 of the 302 women included in the study (18.2%); of these, 31 were pregnant, showing a significant association for HPV (p=0.04) when compared to non-pregnant ones. Risk factors for the infection were: patients aged <20 years-old (p=0.04), early initiation of sexual life (p=0.04), absence of cytological test (p=0.01), diagnosis of altered cytology (p=0.001), and counting <349 cells/mm³ (p=0.05). However, multi-parity was found to be a protective factor for the infection (p=0.01). Multivariate analysis showed that age <20 years-old (PR=2.8; 95%CI 1.0 - 7.7, p=0.04) and an altered cytological result (PR=11.1; 95%CI 3.0 - 4.1, p=0.001) were significantly associated with infection. HPV genotype was determined in 47 samples (85.4%) presenting one genotype per infection: eight HPV 16 and 58; six HPV 6; four HPV 18 and 33; three HPV 53 and 82; two HPV 83 and 61; one HPV 31, 35, 45, 64, 68, 71 and 85. CONCLUSIONS: The prevalence of HPV detection was 18.2%, the most frequent genotypes were 16 and 58, and sociodemographic and gynecological factors were associated with viral infection.
Key-words BrazilHealth centersHospitals, universityPapillomavirus infectionsPolymerase chain reactionPregnant womenPrevalenceRisk factorsSee more -
Artigos Originais
Impact of pregnancy on female sexual function
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):205-209
07-05-2013
Summary
Artigos OriginaisImpact of pregnancy on female sexual function
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):205-209
07-05-2013DOI 10.1590/S0100-72032013000500003
Views61See morePURPOSE: To investigate the impact of pregnancy on female sexual function. METHODS: An analytical, cross-sectional study was conducted on 181 non-pregnant and 177 pregnant women aged 18 to 45 years. The study included premenopausal, sexually active women with a steady partner and excluded those taking antidepressants or with a diagnosis of depression. Eleven of these women (6.2%) were in the first trimester, 50 (28.2%), in the second trimester and 116 (65.5%), in the third trimester of pregnancy. The evaluation consisted of an interview in which the Female Sexual Function Index (FSFI) was applied. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. The nonparametric Mann-Whitney test was used to compare the mean FSFI values of pregnant and non-pregnant women. RESULTS: Sexual dysfunction was 40.4% among pregnant women and 23.3% among non-pregnant women, with a significant difference between the scores of the studied groups (p=0.01). The difference in the mean global FSFI values between the groups was also significant (p<0.0001). There were significant differences between pregnant and non-pregnant women regarding desire (p<0.0001), excitation (p=0.003), lubrication (p=0.02), orgasm (p=0.005) and satisfaction (p=0.03). The same was not observed regarding pain. CONCLUSION: We conclude that pregnancy negatively influences female sexual function, particularly the desire and excitement domains, revealing the importance of addressing the issue by professionals dealing with pregnant women.