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Artigos Originais
Severe maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(6):281-286
09-04-2008
Summary
Artigos OriginaisSevere maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(6):281-286
09-04-2008DOI 10.1590/S0100-72032008000600003
Views87See morePURPOSE: to assess the prevalence and risk factors associated with near miss and other severe maternal morbidity at a reference tertiary maternity. METHODS: this is a cross-sectional study on severe maternal morbidity at the Hospital e Maternidade Celso Pierro, Campinas, São Paulo, between October 2005 and July 2006, identified from infirmary, admission and delivery unit logbooks. Pregnant and post-partum women with severe maternal morbidity were identified according to clinical criteria proposed by Waterstone. Later, cases with more severe morbidity, called extremely severe maternal morbidity, were reclassified using Mantel criteria, based on organic dysfunction and clinical management. RESULTS: there were 114 severe maternal morbidity cases among 2,207 birth deliveries, with a ratio of other severe morbidity and extremely severe morbidity near miss of 44.9 and 6.8 cases/1,000 live births, respectively. Mean gestational age at delivery was 35 weeks, and 87% came from the reference area for the maternity service. Hypertension (severe pre-eclampsia) represented 96% of other severe morbidity, while hemorrhage represented 60% of all extremely severe cases, followed by hypertension. The prevalence of extremely severe morbidity among the severe morbidity cases was not associated with marital status, schooling, maternal age, type of delivery, parity, gestational age at birth and home place. CONCLUSIONS: the other morbidities were 6.6 times more frequent than near miss, and it was not possible to differentiate both groups by epidemiological risk factors.
Views87
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisSevere maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(6):281-286
09-04-2008DOI 10.1590/S0100-72032008000600003
Views87See morePURPOSE: to assess the prevalence and risk factors associated with near miss and other severe maternal morbidity at a reference tertiary maternity. METHODS: this is a cross-sectional study on severe maternal morbidity at the Hospital e Maternidade Celso Pierro, Campinas, São Paulo, between October 2005 and July 2006, identified from infirmary, admission and delivery unit logbooks. Pregnant and post-partum women with severe maternal morbidity were identified according to clinical criteria proposed by Waterstone. Later, cases with more severe morbidity, called extremely severe maternal morbidity, were reclassified using Mantel criteria, based on organic dysfunction and clinical management. RESULTS: there were 114 severe maternal morbidity cases among 2,207 birth deliveries, with a ratio of other severe morbidity and extremely severe morbidity near miss of 44.9 and 6.8 cases/1,000 live births, respectively. Mean gestational age at delivery was 35 weeks, and 87% came from the reference area for the maternity service. Hypertension (severe pre-eclampsia) represented 96% of other severe morbidity, while hemorrhage represented 60% of all extremely severe cases, followed by hypertension. The prevalence of extremely severe morbidity among the severe morbidity cases was not associated with marital status, schooling, maternal age, type of delivery, parity, gestational age at birth and home place. CONCLUSIONS: the other morbidities were 6.6 times more frequent than near miss, and it was not possible to differentiate both groups by epidemiological risk factors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Anthropometric measures: predictors of non-transmissible chronic diseases in postmenopausal women in the Southeast region of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(4):182-189
07-02-2008
Summary
Artigos OriginaisAnthropometric measures: predictors of non-transmissible chronic diseases in postmenopausal women in the Southeast region of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(4):182-189
07-02-2008DOI 10.1590/S0100-72032008000400005
Views118PURPOSE: to evaluate the anthropometric measures as predictors of cardiovascular and metabolic risk in non-transmissible chronic diseases in postmenopausal women. METHODS: a clinical and sectional study enrolling 120 sedentary postmenopausal women (amenorrhea for at least 12 months, age 45 to 70 years was conducted). Exclusion criteria included insulin-dependent diabetes and use of statins or hormone therapy within the preceding six months. Anthropometric indicators included: weight, height, body mass index (BMI=weight/height²), and waist circumference (WC). Metabolic profiles as total cholesterol (TC), HDL, LDL, triglycerides (TG), glycemia, and insulin were measured and the atherogenic index of plasma (AIP) and Homeostasis model assessment-insulin resistance (HOMA-IR) were calculated. One-way analysis of variance (ANOVA) and Odds Ratio (OR) were used in the statistical analysis. RESULTS: subjects were classified on average as overweight and showed central fat distribution. Overweight and obesity were observed in 76% and abdominal obesity in 87.3% of the patients. On average, TC, LDL and TG levels were higher than recommended in 67.8, 55.9 and 45.8% of the women, respectively, and HDL was low in 40.7%. Values of WC >88 cm were observed in 14.8% of women with normal weight, 62.5% overweight and 100% obesity p>0.05). On average, the values of AIP, TG, and HOMA-IR increased significantly along with values of BMI and WC, while decreased HDL (p<0.05). Among women with WC >88 cm, a risk association was observed with low HDL (OR=5.86; 95%CI=2.31-14.82), with higher TG (OR=2.61; 95%CI=1.18-5.78), with higher AIP (OR=3.42; 95%CI=1.19-9.78) and with IR (OR=3.63; 95%CI=1.27-10.36). There was a risk of low HDL (OR=3.1; 95%CI=1.44-6.85) with increased obesity (BMI>30 kg/m²). CONCLUSIONS: in the postmenopausal women, the simple measure of WC can predict cardiovascular and metabolic risk of non-transmissible chronic diseases.
Key-words AnthropometryBody compositionCardiovascular diseasesChronic diseaseInsulin resistanceMenopauseObesityPostmenopauseRisk factorsSee moreViews118This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAnthropometric measures: predictors of non-transmissible chronic diseases in postmenopausal women in the Southeast region of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(4):182-189
07-02-2008DOI 10.1590/S0100-72032008000400005
Views118PURPOSE: to evaluate the anthropometric measures as predictors of cardiovascular and metabolic risk in non-transmissible chronic diseases in postmenopausal women. METHODS: a clinical and sectional study enrolling 120 sedentary postmenopausal women (amenorrhea for at least 12 months, age 45 to 70 years was conducted). Exclusion criteria included insulin-dependent diabetes and use of statins or hormone therapy within the preceding six months. Anthropometric indicators included: weight, height, body mass index (BMI=weight/height²), and waist circumference (WC). Metabolic profiles as total cholesterol (TC), HDL, LDL, triglycerides (TG), glycemia, and insulin were measured and the atherogenic index of plasma (AIP) and Homeostasis model assessment-insulin resistance (HOMA-IR) were calculated. One-way analysis of variance (ANOVA) and Odds Ratio (OR) were used in the statistical analysis. RESULTS: subjects were classified on average as overweight and showed central fat distribution. Overweight and obesity were observed in 76% and abdominal obesity in 87.3% of the patients. On average, TC, LDL and TG levels were higher than recommended in 67.8, 55.9 and 45.8% of the women, respectively, and HDL was low in 40.7%. Values of WC >88 cm were observed in 14.8% of women with normal weight, 62.5% overweight and 100% obesity p>0.05). On average, the values of AIP, TG, and HOMA-IR increased significantly along with values of BMI and WC, while decreased HDL (p<0.05). Among women with WC >88 cm, a risk association was observed with low HDL (OR=5.86; 95%CI=2.31-14.82), with higher TG (OR=2.61; 95%CI=1.18-5.78), with higher AIP (OR=3.42; 95%CI=1.19-9.78) and with IR (OR=3.63; 95%CI=1.27-10.36). There was a risk of low HDL (OR=3.1; 95%CI=1.44-6.85) with increased obesity (BMI>30 kg/m²). CONCLUSIONS: in the postmenopausal women, the simple measure of WC can predict cardiovascular and metabolic risk of non-transmissible chronic diseases.
Key-words AnthropometryBody compositionCardiovascular diseasesChronic diseaseInsulin resistanceMenopauseObesityPostmenopauseRisk factorsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Age as an independent prognostic factor in breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(2):67-74
06-03-2008
Summary
Artigos OriginaisAge as an independent prognostic factor in breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(2):67-74
06-03-2008DOI 10.1590/S0100-72032008000200004
Views131See morePURPOSE: to compare the epidemiologic and clinical characteristics, and the follow-up of breast cancer in women diagnosed under and over 40 years of age. METHODS: a retrospective study, case-control type, with analysis of information obtained from medical records of patients attended from January 1994 to June 2004. Cases of intraductal carcinoma and at stage IV were excluded. Three groups were formed: patients under 40 years old at the diagnosis (n=72); patients between 40 and 50 (n=68) and patients over 50 (n=75). Data about age at the moment of diagnosis, lesion largest diameter, clinical stage, type, histological grade, presence of hormonal receptors and state of the lymph nodes were collected and analyzed. The chi2 test was used for qualitative variables. For quantitative variables without normal distribution (such as number of axillary nodes with metastasis and follow-up duration), the Kruskal-Wallis' test was used. For delineating the curves of free-of-disease and global survival, the log-rank test was used. RESULTS: there was no difference among the groups in the stage distribution, concerning the tumoral differentiation grade or in the distribution of histological types, and in the estrogen receptor and c-erb-B2 expression. Difference was found in the RP expression, which was less frequent in the group of patients under 40, than in the group of patients over 50 (36.2% versus 58.4%) respectively. There was no difference among the groups in the mean tumoral diameter (5.1, 4.7 and 5 cm, respectively). There was also no difference among the groups, concerning the rate of axillary lymph node metastasis (63.9, 46.9 and 50%, respectively). The average follow-up was 54 months for all the groups. Disease recurrence occurred in 22.6% of patients under 40 years old, in 60% of patients between 40 and 50, and in 22.6% of patients over 50, with a significant difference among groups (p<0.0001). Death caused by the disease was higher among patients under 40 (46.9%) than among patients between 40 and 50 (26.9%) and over 50 (22.6%), p=0.0019. The logistic analysis showed that "age under 40" and the "presence of more than one metastatic axillary node" were independent death risk factors. CONCLUSIONS: age under 40 is an independent risk factor for breast cancer. The traditional prognostic indicators, such as stage, tumoral diameter, axillary involvement and presence of hormonal receptors are not associated with the disease evolution.
Views131This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAge as an independent prognostic factor in breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(2):67-74
06-03-2008DOI 10.1590/S0100-72032008000200004
Views131See morePURPOSE: to compare the epidemiologic and clinical characteristics, and the follow-up of breast cancer in women diagnosed under and over 40 years of age. METHODS: a retrospective study, case-control type, with analysis of information obtained from medical records of patients attended from January 1994 to June 2004. Cases of intraductal carcinoma and at stage IV were excluded. Three groups were formed: patients under 40 years old at the diagnosis (n=72); patients between 40 and 50 (n=68) and patients over 50 (n=75). Data about age at the moment of diagnosis, lesion largest diameter, clinical stage, type, histological grade, presence of hormonal receptors and state of the lymph nodes were collected and analyzed. The chi2 test was used for qualitative variables. For quantitative variables without normal distribution (such as number of axillary nodes with metastasis and follow-up duration), the Kruskal-Wallis' test was used. For delineating the curves of free-of-disease and global survival, the log-rank test was used. RESULTS: there was no difference among the groups in the stage distribution, concerning the tumoral differentiation grade or in the distribution of histological types, and in the estrogen receptor and c-erb-B2 expression. Difference was found in the RP expression, which was less frequent in the group of patients under 40, than in the group of patients over 50 (36.2% versus 58.4%) respectively. There was no difference among the groups in the mean tumoral diameter (5.1, 4.7 and 5 cm, respectively). There was also no difference among the groups, concerning the rate of axillary lymph node metastasis (63.9, 46.9 and 50%, respectively). The average follow-up was 54 months for all the groups. Disease recurrence occurred in 22.6% of patients under 40 years old, in 60% of patients between 40 and 50, and in 22.6% of patients over 50, with a significant difference among groups (p<0.0001). Death caused by the disease was higher among patients under 40 (46.9%) than among patients between 40 and 50 (26.9%) and over 50 (22.6%), p=0.0019. The logistic analysis showed that "age under 40" and the "presence of more than one metastatic axillary node" were independent death risk factors. CONCLUSIONS: age under 40 is an independent risk factor for breast cancer. The traditional prognostic indicators, such as stage, tumoral diameter, axillary involvement and presence of hormonal receptors are not associated with the disease evolution.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Association between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):580-587
02-27-2007
Summary
Artigos OriginaisAssociation between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):580-587
02-27-2007DOI 10.1590/S0100-72032007001100006
Views131PURPOSE: to investigate women’s age at their first sexual intercourse and its correlation with their present age, human papillomavirus (HPV) infection and cytological abnormalities at Pap smear. METHODS: women from the general population were invited to be screened for cervical cancer and pre-malignant lesions. After answering a behavior questionnaire, they were submitted to screening with cervical cytology and high-risk HPV testing with Hybrid Capture 2 (HC2). This report is part of the Latin American Screening (LAMS) study, that comprises centers from Brazil and Argentina, and the data presented herein refer to the Brazilian women evaluated at the cities of Porto Alegre, São Paulo and Campinas. RESULTS: from 8,649 women that answered the questionnaire, 8,641 reported previous sexual activity and were included in this analysis. The mean age at the interview was 38.1±11.0 years and the mean age at the first sexual intercourse was 18.5±4.0 years. The age at the first sexual intercourse increased along with the age at the interview, i.e., younger women reported they had begun their sexual life earlier than older women (p<0.001). From the total of women who had already begun having sexual intercourse, 3,643 patients were tested for high-risk HPV infection and 17.3% of them had positive results. In all the centers, it became clear that the women with the first sexual intercourse at ages below the mean age of all the population interviewed presented higher rates of HPV infection (20.2%) than the women with the first sexual intercourse at ages above the mean (12.5%) - Odds Ratio (OR) 1.8 (IC95% 1.5-2.2;p<0,001). According to the cytology, the women with first sexual intercourse at ages under the mean, presented higher percentage of abnormal cytology > or = ASC-US (6.7%) than the women with the first sexual intercourse at ages above the mean (4.3%) - OR 1.6 (IC95% 1.3-2.;p<0.001). CONCLUSIONS: the high-risk HPV infection and cytological abnormalities identified during the asymptomatic population screening were significantly associated to the women’s age at the first sexual intercourse. Additionally, we have also identified that the women’s age at the first sexual intercourse has decreased during the last decades, suggesting an important contribution to the increase of HPV infection and the subsequent cervical lesions.
Key-words Papillomavirus infectionsRisk factorsSexual behaviorUterine cervical neoplasmsVaccineVaginal smearsSee moreViews131This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAssociation between age at first sexual intercourse and subsequent human papillomavirus infection: results of a Brazilian screening program
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):580-587
02-27-2007DOI 10.1590/S0100-72032007001100006
Views131PURPOSE: to investigate women’s age at their first sexual intercourse and its correlation with their present age, human papillomavirus (HPV) infection and cytological abnormalities at Pap smear. METHODS: women from the general population were invited to be screened for cervical cancer and pre-malignant lesions. After answering a behavior questionnaire, they were submitted to screening with cervical cytology and high-risk HPV testing with Hybrid Capture 2 (HC2). This report is part of the Latin American Screening (LAMS) study, that comprises centers from Brazil and Argentina, and the data presented herein refer to the Brazilian women evaluated at the cities of Porto Alegre, São Paulo and Campinas. RESULTS: from 8,649 women that answered the questionnaire, 8,641 reported previous sexual activity and were included in this analysis. The mean age at the interview was 38.1±11.0 years and the mean age at the first sexual intercourse was 18.5±4.0 years. The age at the first sexual intercourse increased along with the age at the interview, i.e., younger women reported they had begun their sexual life earlier than older women (p<0.001). From the total of women who had already begun having sexual intercourse, 3,643 patients were tested for high-risk HPV infection and 17.3% of them had positive results. In all the centers, it became clear that the women with the first sexual intercourse at ages below the mean age of all the population interviewed presented higher rates of HPV infection (20.2%) than the women with the first sexual intercourse at ages above the mean (12.5%) - Odds Ratio (OR) 1.8 (IC95% 1.5-2.2;p<0,001). According to the cytology, the women with first sexual intercourse at ages under the mean, presented higher percentage of abnormal cytology > or = ASC-US (6.7%) than the women with the first sexual intercourse at ages above the mean (4.3%) - OR 1.6 (IC95% 1.3-2.;p<0.001). CONCLUSIONS: the high-risk HPV infection and cytological abnormalities identified during the asymptomatic population screening were significantly associated to the women’s age at the first sexual intercourse. Additionally, we have also identified that the women’s age at the first sexual intercourse has decreased during the last decades, suggesting an important contribution to the increase of HPV infection and the subsequent cervical lesions.
Key-words Papillomavirus infectionsRisk factorsSexual behaviorUterine cervical neoplasmsVaccineVaginal smearsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Association between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):511-518
01-09-2007
Summary
Artigos OriginaisAssociation between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):511-518
01-09-2007DOI 10.1590/S0100-72032007001000004
Views91PURPOSE: to analyze the association between maternal pre-gestational nutritional status and maternal outcomes - hypertensive disorders of pregnancy, gestational diabetes, vitamin A deficiency, and anemia - and the newborn outcome - low birth weight. METHODS: cross-sectional study, with 433 adult puerperal women (> 20 years old) and their newborns, attending the Maternidade Escola of Universidade Federal do Rio de Janeiro (UFRJ). Data was collected through interviews and access to their medical records. Maternal pre-gestational nutritional status was established through pre-gestational body mass index according to the cut-offs for adult women defined by the World Health Organization (WHO), in 1995. The association between gestational outcomes and pre-gestational nutritional status was estimated through odds ratio (OR) and a 95% confidence interval (95%CI). RESULTS: frequency of pre-gestational weight deviation (low weight, overweight and obesity) was 31.6%. Considering the pre-gestational nutritional status, overweight and obese women presented a lower weight gain than eutrophic and low-weight women (p<0.05). Women with pre-gestational obesity presented a higher risk of developing hypertensive disordens of pregnancy (OR=6.3; 95%CI=1.9-20.5) and those with low pre-gestational weight were more likely to give birth to low birth weigh infants (OR=7.1; 95%CI=1.9-27.5). There was no evidence of the association between pre-gestational nutritional status and the development of anemia, vitamin A deficiency and gestational diabetes. The mean weight gain among overweight and obese pregnant women was significantly lower when compared to eutrophic and low-weight pregnant women (p=0.002, p=0.049, p=0.002, p=0.009). CONCLUSIONS: the high number of women with pre-gestational weight deviation reinforces the importance of a nutritional guidance that favors a good nutritional state and reduces the risks of maternal and newborn adverse outcomes.
Key-words AnthropometryBirth weightBody weightMaternal nutrition physiologyNutrition assessmentNutritional statusPregnancyRisk factorsSee moreViews91This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAssociation between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):511-518
01-09-2007DOI 10.1590/S0100-72032007001000004
Views91PURPOSE: to analyze the association between maternal pre-gestational nutritional status and maternal outcomes - hypertensive disorders of pregnancy, gestational diabetes, vitamin A deficiency, and anemia - and the newborn outcome - low birth weight. METHODS: cross-sectional study, with 433 adult puerperal women (> 20 years old) and their newborns, attending the Maternidade Escola of Universidade Federal do Rio de Janeiro (UFRJ). Data was collected through interviews and access to their medical records. Maternal pre-gestational nutritional status was established through pre-gestational body mass index according to the cut-offs for adult women defined by the World Health Organization (WHO), in 1995. The association between gestational outcomes and pre-gestational nutritional status was estimated through odds ratio (OR) and a 95% confidence interval (95%CI). RESULTS: frequency of pre-gestational weight deviation (low weight, overweight and obesity) was 31.6%. Considering the pre-gestational nutritional status, overweight and obese women presented a lower weight gain than eutrophic and low-weight women (p<0.05). Women with pre-gestational obesity presented a higher risk of developing hypertensive disordens of pregnancy (OR=6.3; 95%CI=1.9-20.5) and those with low pre-gestational weight were more likely to give birth to low birth weigh infants (OR=7.1; 95%CI=1.9-27.5). There was no evidence of the association between pre-gestational nutritional status and the development of anemia, vitamin A deficiency and gestational diabetes. The mean weight gain among overweight and obese pregnant women was significantly lower when compared to eutrophic and low-weight pregnant women (p=0.002, p=0.049, p=0.002, p=0.009). CONCLUSIONS: the high number of women with pre-gestational weight deviation reinforces the importance of a nutritional guidance that favors a good nutritional state and reduces the risks of maternal and newborn adverse outcomes.
Key-words AnthropometryBirth weightBody weightMaternal nutrition physiologyNutrition assessmentNutritional statusPregnancyRisk factorsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Study of maternal risk factors associated with early-onset neonatal sepsis in a tertiary hospital of the Brazilian Amazonia
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):387-395
11-01-2007
Summary
Artigos OriginaisStudy of maternal risk factors associated with early-onset neonatal sepsis in a tertiary hospital of the Brazilian Amazonia
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):387-395
11-01-2007DOI 10.1590/S0100-72032007000800002
Views98See morePURPOSE: to identify the main maternal risk factors involved in early-onset neonatal sepsis, evaluating the risk associations between bacterial vaginosis and isolated microorganisms found in the maternal urine culture and in the newborn blood culture in the delivery room. METHODS: randomized longitudinal cohort study involving 302 mothers and their newborns. All neonates were followed up for seven days in order to diagnose sepsis. RESULTS: the outcomes were the following: 16 (5.3%) early-onset neonatal sepsis cases (incidence of 53 cases per 1,000 live births). The average number of prenatal appointments with a doctor was 5.2 (SD=1.8). The number of women with prenatal follow-up was 269 (89.1%), but only 117 (43.4%) of them went to six or more medical appointments, 90 (29.8%) had premature rupture of membranes before delivery, but only 22 (7.3%) had it for more than 18 hours. A total of 123 women (40.7%) complained of vaginal discharge, but only 47 (15.6%) of them had bacterial vaginosis, 92 (30.4%) complained of urinary infection, but only 23 (7.6%) of them had bacteriuria, two (0.7%) had fever at home, 122 (40.4%) received intra-partum antibiotic prophylaxis, 40 (13.2%) had premature delivery and 37 (12.3%) had low-birth-weight babies. Gestational age was a significant risk factor (RR=92.9; IC95%:12.6-684.7), as well as the number of prenatal appointments (RR=10,8; IC95%:1,4-80,8), fever (RR=10,0; IC95%:2,3-43,5), low-birth-weight (RR=21,5; IC95%:7,3-63,2) and early neonatal death (RR=89,4; IC95%:11,16-720,6). A significant difference of 5% was found in the comparison of the averages of lower number of prenatal appointments, prematurity and lower birth weight. CONCLUSIONS: the major microorganism isolated in the newborns’ blood culture was the Streptococcus agalactiae. Prematurity, lack of prenatal follow up and low birth weight were the risk factors more associated with early neonatal sepsis.
Views98This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisStudy of maternal risk factors associated with early-onset neonatal sepsis in a tertiary hospital of the Brazilian Amazonia
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):387-395
11-01-2007DOI 10.1590/S0100-72032007000800002
Views98See morePURPOSE: to identify the main maternal risk factors involved in early-onset neonatal sepsis, evaluating the risk associations between bacterial vaginosis and isolated microorganisms found in the maternal urine culture and in the newborn blood culture in the delivery room. METHODS: randomized longitudinal cohort study involving 302 mothers and their newborns. All neonates were followed up for seven days in order to diagnose sepsis. RESULTS: the outcomes were the following: 16 (5.3%) early-onset neonatal sepsis cases (incidence of 53 cases per 1,000 live births). The average number of prenatal appointments with a doctor was 5.2 (SD=1.8). The number of women with prenatal follow-up was 269 (89.1%), but only 117 (43.4%) of them went to six or more medical appointments, 90 (29.8%) had premature rupture of membranes before delivery, but only 22 (7.3%) had it for more than 18 hours. A total of 123 women (40.7%) complained of vaginal discharge, but only 47 (15.6%) of them had bacterial vaginosis, 92 (30.4%) complained of urinary infection, but only 23 (7.6%) of them had bacteriuria, two (0.7%) had fever at home, 122 (40.4%) received intra-partum antibiotic prophylaxis, 40 (13.2%) had premature delivery and 37 (12.3%) had low-birth-weight babies. Gestational age was a significant risk factor (RR=92.9; IC95%:12.6-684.7), as well as the number of prenatal appointments (RR=10,8; IC95%:1,4-80,8), fever (RR=10,0; IC95%:2,3-43,5), low-birth-weight (RR=21,5; IC95%:7,3-63,2) and early neonatal death (RR=89,4; IC95%:11,16-720,6). A significant difference of 5% was found in the comparison of the averages of lower number of prenatal appointments, prematurity and lower birth weight. CONCLUSIONS: the major microorganism isolated in the newborns’ blood culture was the Streptococcus agalactiae. Prematurity, lack of prenatal follow up and low birth weight were the risk factors more associated with early neonatal sepsis.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Correlation of high sensitivity C-reactive protein levels and clinical and laboratory parameters in polycystic ovary syndrome patients
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
10-05-2007
Summary
Artigos OriginaisCorrelation of high sensitivity C-reactive protein levels and clinical and laboratory parameters in polycystic ovary syndrome patients
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
10-05-2007DOI 10.1590/S0100-72032007000500004
Views89PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.
Key-words C-reactive proteinCardiovascular diseasesMetabolic syndrome XPolycystic ovary syndromeRisk factorsSee moreViews89This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisCorrelation of high sensitivity C-reactive protein levels and clinical and laboratory parameters in polycystic ovary syndrome patients
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
10-05-2007DOI 10.1590/S0100-72032007000500004
Views89PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.
Key-words C-reactive proteinCardiovascular diseasesMetabolic syndrome XPolycystic ovary syndromeRisk factorsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998
Summary
Trabalhos OriginaisSecond-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998DOI 10.1590/S0100-72031998000800007
Views109See morePurpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.
Views109This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisSecond-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998DOI 10.1590/S0100-72031998000800007
Views109See morePurpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Risk factors Archives - Page 10 of 11 - Revista Brasileira de Ginecologia e Obstetrícia
