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, , , , , Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
, , , , , , To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.
Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.
The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.
No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
, , , , , , To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.
Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.
The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.
No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.
, , , , , Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230
, , , , , , , , To evaluate the effect of the carbohydrate counting method (CCM) on glycemic control,maternal, and perinatal outcomes of pregnant women with pregestational diabetes mellitus (DM).
Nonrandomized controlled clinical trial performed with 89 pregnant women who had pregestational DMand received prenatal care in a public hospital in Rio de Janeiro, state of Rio de Janeiro, Brazil, between 2009 and 2014, subdivided into historic control group and intervention group, not simultaneous. The intervention group (n=51) received nutritional guidance from the carbohydrate counting method (CCM), and the historical control group (n=38), was guided by the traditionalmethod (TM). The Mann-Whitney test or the Wilcoxon test were used to compare intra- and intergroup outcomes andanalysis of variance (ANOVA) for repeated measures, corrected by the Bonferroni post-hoc test,was used to assess postprandial blood glucose.
Only the CCM group showed a reduction in fasting blood glucose. Postprandial blood glucose decreased in the 2nd (p=0.00) and 3rd (p=0.00) gestational trimester in the CCM group, while in the TM group the reduction occurred only in the 2nd trimester (p=0.015). For perinatal outcomes and hypertensive disorders of pregnancy, there were no differences between groups. Cesarean delivery was performed in 82% of the pregnant women and was associated with hypertensive disorders (gestational hypertension or pre-eclampsia; p=0.047).
Both methods of nutritional guidance contributed to the reduction of postprandial glycemia of women and no differences were observed for maternal and perinatal outcomes. However, CCM had a better effect on postprandial glycemia and only this method contributed to reducing fasting blood glucose throughout the intervention. ReBEC Clinical Trials Database The present study was registered in the ReBEC Clinical Trials Database (Registro Brasileiro de Ensaios Clínicos, number RBR-524z9n).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230
, , , , , , , , To evaluate the effect of the carbohydrate counting method (CCM) on glycemic control,maternal, and perinatal outcomes of pregnant women with pregestational diabetes mellitus (DM).
Nonrandomized controlled clinical trial performed with 89 pregnant women who had pregestational DMand received prenatal care in a public hospital in Rio de Janeiro, state of Rio de Janeiro, Brazil, between 2009 and 2014, subdivided into historic control group and intervention group, not simultaneous. The intervention group (n=51) received nutritional guidance from the carbohydrate counting method (CCM), and the historical control group (n=38), was guided by the traditionalmethod (TM). The Mann-Whitney test or the Wilcoxon test were used to compare intra- and intergroup outcomes andanalysis of variance (ANOVA) for repeated measures, corrected by the Bonferroni post-hoc test,was used to assess postprandial blood glucose.
Only the CCM group showed a reduction in fasting blood glucose. Postprandial blood glucose decreased in the 2nd (p=0.00) and 3rd (p=0.00) gestational trimester in the CCM group, while in the TM group the reduction occurred only in the 2nd trimester (p=0.015). For perinatal outcomes and hypertensive disorders of pregnancy, there were no differences between groups. Cesarean delivery was performed in 82% of the pregnant women and was associated with hypertensive disorders (gestational hypertension or pre-eclampsia; p=0.047).
Both methods of nutritional guidance contributed to the reduction of postprandial glycemia of women and no differences were observed for maternal and perinatal outcomes. However, CCM had a better effect on postprandial glycemia and only this method contributed to reducing fasting blood glucose throughout the intervention. ReBEC Clinical Trials Database The present study was registered in the ReBEC Clinical Trials Database (Registro Brasileiro de Ensaios Clínicos, number RBR-524z9n).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):571-577
DOI 10.1590/S0100-720320150005419
To evaluate the nutritional and psychological factors associated with the occurrence of the practice of pica in pregnant women attending a public hospital in Rio de Janeiro, Brazil.
The study was based on a descriptive design with exploratory features, and conducted on 13 adult and adolescent pregnant women aged 16 to 40 years with a diagnosis of pica in the current pregnancy. Pica was diagnosed by a nutritionist in a standardized interview situation, when questions about the occurrence and frequency of pica, and types of substance ingestion were investigated. After signing the Informed Consent Form (ICF), all participants were evaluated by a nutritionist and seven of them were submitted to psychological assessment with standardized instruments to evaluate stress and anxiety, and to assess coping strategies.
The type of pica most frequently reported was pagophagia (30.8%) and the consumption of fruit with salt (30.8%). The most prevalent coping strategies were "religious practice-focused" and "seeking social support", both presented by 42% of the pregnant women. We observed the occurrence of some degree of stress and anxiety in all pregnant women, as well as comorbidities (69.2%) and gastrointestinal symptoms (84.6%).
Considering that pica may be associated with increased perinatal risk, it is very important to investigate this disorder during prenatal care, and to dopt obstetric, psychological and nutritional preventive practices to reduce the complications for mother and fetus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):571-577
DOI 10.1590/S0100-720320150005419
To evaluate the nutritional and psychological factors associated with the occurrence of the practice of pica in pregnant women attending a public hospital in Rio de Janeiro, Brazil.
The study was based on a descriptive design with exploratory features, and conducted on 13 adult and adolescent pregnant women aged 16 to 40 years with a diagnosis of pica in the current pregnancy. Pica was diagnosed by a nutritionist in a standardized interview situation, when questions about the occurrence and frequency of pica, and types of substance ingestion were investigated. After signing the Informed Consent Form (ICF), all participants were evaluated by a nutritionist and seven of them were submitted to psychological assessment with standardized instruments to evaluate stress and anxiety, and to assess coping strategies.
The type of pica most frequently reported was pagophagia (30.8%) and the consumption of fruit with salt (30.8%). The most prevalent coping strategies were "religious practice-focused" and "seeking social support", both presented by 42% of the pregnant women. We observed the occurrence of some degree of stress and anxiety in all pregnant women, as well as comorbidities (69.2%) and gastrointestinal symptoms (84.6%).
Considering that pica may be associated with increased perinatal risk, it is very important to investigate this disorder during prenatal care, and to dopt obstetric, psychological and nutritional preventive practices to reduce the complications for mother and fetus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):208-215
DOI 10.1590/SO100-720320150005321
To describe the evolution of the prevalence of anemia in pregnant adolescents
attended at a public maternity in the city of Rio de Janeiro from 2004 to 2013.
A retrospective cross-sectional study with 628 pregnant/postpartum women divided
into 3 groups: Group A (2004-2006), Group B (2007-2010) and Group C (2013).
Information about anthropometric, clinical, sociodemographic data and obstetric
and prenatal care of adolescents was obtained from medical records of the pregnant
women. A hemoglobin concentration n<11 g/dL was considered to be anemia. Data
were analyzed statistically by the chi-square test, Student's t-test and ANOVA,
and the post hoc Tukey test.
The prevalence of gestational anemia over the years was 43% (GA=138), 36% (GB=80)
and 47.1% (GC=40) and the overall prevalence for the 2004-2013 period was 41.1%
(n=258). The occurrence of anemic pregnant women increased with the progression of
pregnancy; however, in the 3rd quarter there was a decrease in the prevalence of
anemia in GB (29.3%) compared to GA (38.7%; p=0.04). Factors associated with
anemia were number of prenatal visits and prenatal nutritional assistance, place
of residence, pre-pregnancy BMI, and gestational weight gain.
The results showed that the prevalence of anemia among pregnant adolescents seen
at a public maternity is high. There was no reduction of anemia during the study
period and other factors in addition to iron deficiency were involved in the
genesis of anemia in this population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):208-215
DOI 10.1590/SO100-720320150005321
To describe the evolution of the prevalence of anemia in pregnant adolescents
attended at a public maternity in the city of Rio de Janeiro from 2004 to 2013.
A retrospective cross-sectional study with 628 pregnant/postpartum women divided
into 3 groups: Group A (2004-2006), Group B (2007-2010) and Group C (2013).
Information about anthropometric, clinical, sociodemographic data and obstetric
and prenatal care of adolescents was obtained from medical records of the pregnant
women. A hemoglobin concentration n<11 g/dL was considered to be anemia. Data
were analyzed statistically by the chi-square test, Student's t-test and ANOVA,
and the post hoc Tukey test.
The prevalence of gestational anemia over the years was 43% (GA=138), 36% (GB=80)
and 47.1% (GC=40) and the overall prevalence for the 2004-2013 period was 41.1%
(n=258). The occurrence of anemic pregnant women increased with the progression of
pregnancy; however, in the 3rd quarter there was a decrease in the prevalence of
anemia in GB (29.3%) compared to GA (38.7%; p=0.04). Factors associated with
anemia were number of prenatal visits and prenatal nutritional assistance, place
of residence, pre-pregnancy BMI, and gestational weight gain.
The results showed that the prevalence of anemia among pregnant adolescents seen
at a public maternity is high. There was no reduction of anemia during the study
period and other factors in addition to iron deficiency were involved in the
genesis of anemia in this population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):348-353
DOI 10.1590/S0100-72032011001100005
PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (³20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):348-353
DOI 10.1590/S0100-72032011001100005
PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (³20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(1):09-12
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(1):09-12
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
PURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
PURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(7):335-341
DOI 10.1590/S0100-72032009000700003
PURPOSE: to describe alcohol and tobacco use in adult pregnant women and determine its association with the obstetric outcome. METHODS: analytical transversal study, in which 433 adult pregnant women and their newborns have been included, attended at a public maternity hospital in Rio de Janeiro, from 1999 to 2006. Information on the mother and the newborn was collected at the moment of delivery and during puerperium through an interview and inspection of the medical records. "Use of alcohol during gestation" and "use of cigarette during gestation" have been considered when detected at any gestational age and written down on the medical record. RESULTS: it was observed that 5.5 and 7.7% of the pregnant women reported cigarette and alcohol use during gestation, respectively. Maternal features related to tobacco use during pregnancy were marital status (p=0.005), age (p=0.01) and pre-natal nutritional guidance (p=0.003). Tobacco use during pregnancy has been strongly associated with alcohol use, 31.3% of the women reporting concomitant use of both substances (p<0.05). No association between alcohol or tobacco use during gestation and obstetric outcome (gestational age, newborn weight at birth and newborn medical conditions; p>0.05) has been detected. CONCLUSIONS: these results suggest that tobacco and alcohol use should be investigated during pre-natal care among all women, particularly single women, over 35 years old, with history of miscarriage, and with unwanted pregnancy. Nutritional guidance had a protective effect against tobacco use during gestation, and thus pregnant women should be informed as to the harmful effects of substance use to ensure better obstetric outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(7):335-341
DOI 10.1590/S0100-72032009000700003
PURPOSE: to describe alcohol and tobacco use in adult pregnant women and determine its association with the obstetric outcome. METHODS: analytical transversal study, in which 433 adult pregnant women and their newborns have been included, attended at a public maternity hospital in Rio de Janeiro, from 1999 to 2006. Information on the mother and the newborn was collected at the moment of delivery and during puerperium through an interview and inspection of the medical records. "Use of alcohol during gestation" and "use of cigarette during gestation" have been considered when detected at any gestational age and written down on the medical record. RESULTS: it was observed that 5.5 and 7.7% of the pregnant women reported cigarette and alcohol use during gestation, respectively. Maternal features related to tobacco use during pregnancy were marital status (p=0.005), age (p=0.01) and pre-natal nutritional guidance (p=0.003). Tobacco use during pregnancy has been strongly associated with alcohol use, 31.3% of the women reporting concomitant use of both substances (p<0.05). No association between alcohol or tobacco use during gestation and obstetric outcome (gestational age, newborn weight at birth and newborn medical conditions; p>0.05) has been detected. CONCLUSIONS: these results suggest that tobacco and alcohol use should be investigated during pre-natal care among all women, particularly single women, over 35 years old, with history of miscarriage, and with unwanted pregnancy. Nutritional guidance had a protective effect against tobacco use during gestation, and thus pregnant women should be informed as to the harmful effects of substance use to ensure better obstetric outcome.