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Summary
Rev Bras Ginecol Obstet. 2014;36(7):283-289
Summary
Rev Bras Ginecol Obstet. 2014;36(7):283-289
Summary
Rev Bras Ginecol Obstet. 2014;36(7):290-295
DOI 10.1590/SO100-720320140004892
To identify the major causes of maternal death in the State of Pará, Brazil.
A descriptive, observational and retrospective study was conducted using data from the Mortality Information System (SIM) of the State Department of Public Health of Pará. SIM information was obtained using the TabWin 3.2 software and recorded in a research protocol developed by the investigators. The sample included 383 maternal deaths of 10-49-year-old women, which occurred from 2006 to 2010. Data were analyzed using non-parametric tests (χ2 and G-tests). The BioStat(r) 5.0 software was used for statistical analysis and Microsoft(r) Excel 2007 for the preparation of database and tables.
The Maternal Mortality Ratio was 51.9 and did not decrease significantly during the period. Most deaths occurred during the postpartum period (up to 42 days) (51.7%), and some diagnostic confirmation was used. Direct obstetric causes were dominant (90.6%), mainly hypertension (34.6%), with emphasis on eclampsia (70%), and hemorrhage (22.2%). All of these maternal deaths were avoidable (100%).
Maternal death in Pará is characterized by occurring during the puerperium (up to 42 days), due mainly to direct obstetric causes, such as hypertension, with emphasis on eclampsia, and hemorrhage. This evidences the need for complete attention with good quality for pregnant women, from prenatal care to puerperium, in the state of Pará.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):290-295
DOI 10.1590/SO100-720320140004892
To identify the major causes of maternal death in the State of Pará, Brazil.
A descriptive, observational and retrospective study was conducted using data from the Mortality Information System (SIM) of the State Department of Public Health of Pará. SIM information was obtained using the TabWin 3.2 software and recorded in a research protocol developed by the investigators. The sample included 383 maternal deaths of 10-49-year-old women, which occurred from 2006 to 2010. Data were analyzed using non-parametric tests (χ2 and G-tests). The BioStat(r) 5.0 software was used for statistical analysis and Microsoft(r) Excel 2007 for the preparation of database and tables.
The Maternal Mortality Ratio was 51.9 and did not decrease significantly during the period. Most deaths occurred during the postpartum period (up to 42 days) (51.7%), and some diagnostic confirmation was used. Direct obstetric causes were dominant (90.6%), mainly hypertension (34.6%), with emphasis on eclampsia (70%), and hemorrhage (22.2%). All of these maternal deaths were avoidable (100%).
Maternal death in Pará is characterized by occurring during the puerperium (up to 42 days), due mainly to direct obstetric causes, such as hypertension, with emphasis on eclampsia, and hemorrhage. This evidences the need for complete attention with good quality for pregnant women, from prenatal care to puerperium, in the state of Pará.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):296-302
DOI 10.1590/SO100-720320140004958
To describe the perinatal outcomes after preterm premature rupture of membranes.
A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded. The pregnant women were hospitalized for conservative treatment with corticosteroids, antibiotics and tocolysis with nifedipine if necessary. The results are reported as frequency distributions and measures of central tendency and dispersion.
Seventeen patients (13.7%) had a gestational age of less than 24 weeks. Mean maternal age was 25.7 years, mean gestational age at the diagnosis of preterm premature rupture of membranes was 29 weeks, mean amniotic fluid index was 3.5 cm, and mean latency period was 10.5 days. Most patients went into spontaneous labor by the 30th week of pregnancy, and the rate of vaginal delivery was 88.2%. Chorioamnionitis was the most frequent maternal complication (34.7%). Neonatal sepsis was observed in 12% of patients, and the perinatal mortality rate was 21.5% for the group at or beyond the 24th week of gestation and 76.5% for the group with less than 24 weeks of gestational age.
A low maternal mortality rate was observed in preterm premature rupture of membranes; however, high rates of complications and perinatal death were observed, suggesting that other conduct protocols should be studied.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):296-302
DOI 10.1590/SO100-720320140004958
To describe the perinatal outcomes after preterm premature rupture of membranes.
A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded. The pregnant women were hospitalized for conservative treatment with corticosteroids, antibiotics and tocolysis with nifedipine if necessary. The results are reported as frequency distributions and measures of central tendency and dispersion.
Seventeen patients (13.7%) had a gestational age of less than 24 weeks. Mean maternal age was 25.7 years, mean gestational age at the diagnosis of preterm premature rupture of membranes was 29 weeks, mean amniotic fluid index was 3.5 cm, and mean latency period was 10.5 days. Most patients went into spontaneous labor by the 30th week of pregnancy, and the rate of vaginal delivery was 88.2%. Chorioamnionitis was the most frequent maternal complication (34.7%). Neonatal sepsis was observed in 12% of patients, and the perinatal mortality rate was 21.5% for the group at or beyond the 24th week of gestation and 76.5% for the group with less than 24 weeks of gestational age.
A low maternal mortality rate was observed in preterm premature rupture of membranes; however, high rates of complications and perinatal death were observed, suggesting that other conduct protocols should be studied.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):303-309
DOI 10.1590/SO100-720320140005012
To identify spatial patterns of neonatal mortality distribution in the micro regions of São Paulo State and verify the role of avoidable causes in the composition of this health indicator.
This ecological exploratory study used neonatal mortality information obtained from Information System and Information Technology Department of the Brazilian National Healthcare System (DATASUS) in the period between the years 2007 and 2011. The digital set of micro regions of São Paulo State was obtained from Instituto Brasileiro de Geografia e Estatística (IBGE). Moran Indexes were calculated for the neonatal mortality total rate and rate from avoidable causes; thematic maps were constructed with these rates, as well as the difference between them; and the Box Map was built.
The overall neonatal mortality rate was 8.42/1,000 live births and neonatal mortality rate from avoidable causes of 6.19/1,000 live births. Moran coefficients (I) for these rates were significant (p-value<0.05) - for the total rate of neonatal mortality I=0.11 and for mortality from preventable causes I=0.19 -, and neonatal deaths were concentrated in southwest region and the Vale do Paraíba. If preventable causes were abolished, there would be a significant reduction in the average rate of overall neonatal mortality, from 8.42 to 2.23 deaths/1,000 live births, representing a decline of 73%.
This study demonstrated that neonatal mortality rate would be close to the rates of developed countries if avoidable causes were abolished.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):303-309
DOI 10.1590/SO100-720320140005012
To identify spatial patterns of neonatal mortality distribution in the micro regions of São Paulo State and verify the role of avoidable causes in the composition of this health indicator.
This ecological exploratory study used neonatal mortality information obtained from Information System and Information Technology Department of the Brazilian National Healthcare System (DATASUS) in the period between the years 2007 and 2011. The digital set of micro regions of São Paulo State was obtained from Instituto Brasileiro de Geografia e Estatística (IBGE). Moran Indexes were calculated for the neonatal mortality total rate and rate from avoidable causes; thematic maps were constructed with these rates, as well as the difference between them; and the Box Map was built.
The overall neonatal mortality rate was 8.42/1,000 live births and neonatal mortality rate from avoidable causes of 6.19/1,000 live births. Moran coefficients (I) for these rates were significant (p-value<0.05) - for the total rate of neonatal mortality I=0.11 and for mortality from preventable causes I=0.19 -, and neonatal deaths were concentrated in southwest region and the Vale do Paraíba. If preventable causes were abolished, there would be a significant reduction in the average rate of overall neonatal mortality, from 8.42 to 2.23 deaths/1,000 live births, representing a decline of 73%.
This study demonstrated that neonatal mortality rate would be close to the rates of developed countries if avoidable causes were abolished.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):310-314
DOI 10.1590/SO100-720320140005008
The objective of this study was to investigate the relationship between overactive bladder syndrome and anxiety in older women.
Of the 198 older women who were invited, 29 were excluded and 166 were then divided into two groups according to the Advanced Questionnaire of Overactive Bladder (OAB-V8): one group with overactive bladder symptoms (OAB-V8≥8) and the other without the symptoms of an overactive bladder (OAB-V8<8). The purpose was to conduct a frequency analysis and to investigate the relation of the social demographic data and anxiety in the two groups. The Beck Anxiety Inventory (BAI) was used to evaluate the level of anxiety. The Kolmogorov-Smirnov test was used to determine the distribution of the data. The differences between the two groups for the continuous variables were analyzed by the Mann-Whitney U test, the differences for the categorical variables were analyzed by the Chi-Square test and the association between the continuous variables was analyzed by the Spearman Correlation test. The tests were two-tailed with a confidence level of 5%.
Overall, the frequency of an overactive bladder was present in 117 (70.5%) of the participants. The body mass index (BMI) of the group with overactive bladder symptoms was significantly higher than the BMI of those without these symptoms (p=0.001). A higher prevalence of mild, moderate and severe anxiety was observed among older women with overactive bladder symptoms. In addition, the overactive bladder symptoms group presented a positive low correlation with anxiety symptoms (r=0.345) and with BMI (r=0.281). There was a small correlation between BMI and anxiety symptoms (r=0.164).
Overactive bladder syndrome was prevalent among older women and the existence of these symptoms was linked to the presence of mild, moderate and/or severe anxiety symptoms.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):310-314
DOI 10.1590/SO100-720320140005008
The objective of this study was to investigate the relationship between overactive bladder syndrome and anxiety in older women.
Of the 198 older women who were invited, 29 were excluded and 166 were then divided into two groups according to the Advanced Questionnaire of Overactive Bladder (OAB-V8): one group with overactive bladder symptoms (OAB-V8≥8) and the other without the symptoms of an overactive bladder (OAB-V8<8). The purpose was to conduct a frequency analysis and to investigate the relation of the social demographic data and anxiety in the two groups. The Beck Anxiety Inventory (BAI) was used to evaluate the level of anxiety. The Kolmogorov-Smirnov test was used to determine the distribution of the data. The differences between the two groups for the continuous variables were analyzed by the Mann-Whitney U test, the differences for the categorical variables were analyzed by the Chi-Square test and the association between the continuous variables was analyzed by the Spearman Correlation test. The tests were two-tailed with a confidence level of 5%.
Overall, the frequency of an overactive bladder was present in 117 (70.5%) of the participants. The body mass index (BMI) of the group with overactive bladder symptoms was significantly higher than the BMI of those without these symptoms (p=0.001). A higher prevalence of mild, moderate and severe anxiety was observed among older women with overactive bladder symptoms. In addition, the overactive bladder symptoms group presented a positive low correlation with anxiety symptoms (r=0.345) and with BMI (r=0.281). There was a small correlation between BMI and anxiety symptoms (r=0.164).
Overactive bladder syndrome was prevalent among older women and the existence of these symptoms was linked to the presence of mild, moderate and/or severe anxiety symptoms.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):315-319
DOI 10.159/S0100-720320140004977
To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease.
This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software.
In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification.
The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):315-319
DOI 10.159/S0100-720320140004977
To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease.
This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software.
In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification.
The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
Apresentar a adaptação transcultural para o português da Escala de Atitudes em Relação ao Ganho de Peso na Gestação.
Essa escala, que contém afirmações que expressavam diferentes atitudes de gestantes em relação ao seu próprio ganho de peso, foi desenvolvida para determinar se as atitudes em relação ao corpo afetariam o ganho de peso durante a gestação. Os procedimentos foram: tradução, retrotradução, avaliação da compreensão, elaboração de versão final, aplicação da escala em 180 gestantes (média 29,6 anos e idade gestacional 25,7 semanas) e análise psicométrica.
Constatou-se equivalência satisfatória entre as versões inglês-português e boa consistência interna (Alpha de Cronbach 0,7). A análise fatorial exploratória sugeriu quatro subescalas com variância total explicada de 51,4%.
A escala se demonstrou válida e pode ser utilizada em estudos com gestantes no Brasil para avaliação de atitudes em relação ao ganho de peso e detecção e prevenção de comportamentos disfuncionais durante a gestação.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
Apresentar a adaptação transcultural para o português da Escala de Atitudes em Relação ao Ganho de Peso na Gestação.
Essa escala, que contém afirmações que expressavam diferentes atitudes de gestantes em relação ao seu próprio ganho de peso, foi desenvolvida para determinar se as atitudes em relação ao corpo afetariam o ganho de peso durante a gestação. Os procedimentos foram: tradução, retrotradução, avaliação da compreensão, elaboração de versão final, aplicação da escala em 180 gestantes (média 29,6 anos e idade gestacional 25,7 semanas) e análise psicométrica.
Constatou-se equivalência satisfatória entre as versões inglês-português e boa consistência interna (Alpha de Cronbach 0,7). A análise fatorial exploratória sugeriu quatro subescalas com variância total explicada de 51,4%.
A escala se demonstrou válida e pode ser utilizada em estudos com gestantes no Brasil para avaliação de atitudes em relação ao ganho de peso e detecção e prevenção de comportamentos disfuncionais durante a gestação.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
To present the cross-cultural adaptation to Brazilian Portuguese language of the Pregnancy and Weight Gain Attitude Scale.
This scale was developed in order to verify whether attitude toward thinness affects weight gain during pregnancy and contains statements that express different attitudes of pregnant women regarding their own weight gain. The procedures were: translation, back translation, comprehension evaluation, preparation of a final version, application of the scale to 180 pregnant women (mean age=29.6, gestational age=25.7 weeks) and psychometric analysis.
Satisfactory equivalence between the versions and satisfactory internal consistency (Cronbach's alpha 0.7) were detected. The exploratory factor analysis suggested four subscales with 51.4% total variance explained.
The scale proved to be valid and can be used in studies with pregnant women in Brazil to assess attitudes toward weight gain and to detect and prevent dysfunctional behaviors during pregnancy.
Summary
Rev Bras Ginecol Obstet. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
To present the cross-cultural adaptation to Brazilian Portuguese language of the Pregnancy and Weight Gain Attitude Scale.
This scale was developed in order to verify whether attitude toward thinness affects weight gain during pregnancy and contains statements that express different attitudes of pregnant women regarding their own weight gain. The procedures were: translation, back translation, comprehension evaluation, preparation of a final version, application of the scale to 180 pregnant women (mean age=29.6, gestational age=25.7 weeks) and psychometric analysis.
Satisfactory equivalence between the versions and satisfactory internal consistency (Cronbach's alpha 0.7) were detected. The exploratory factor analysis suggested four subscales with 51.4% total variance explained.
The scale proved to be valid and can be used in studies with pregnant women in Brazil to assess attitudes toward weight gain and to detect and prevent dysfunctional behaviors during pregnancy.