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  • Review Article

    Do Thyroid Diseases during Pregnancy and Lactation Affect the Nutritional Composition of Human Milk?

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):752-758

    Summary

    Review Article

    Do Thyroid Diseases during Pregnancy and Lactation Affect the Nutritional Composition of Human Milk?

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(11):752-758

    DOI 10.1055/s-0040-1718449

    Views9

    Abstract

    Objective:

    To identify whether the effects of thyroid disease during pregnancy and lactation affect the nutritional composition of human milk.

    Methods:

    Systematic review of the scientific literature using the Medical Literature Analysis and Retrieval System Online/MedLine databases to evaluate the association of thyroid diseases during pregnancy and lactation with the nutritional composition of human milk. There was no delimitation by period or by language, and the searches were completed in March 2019. The following descriptors were applied: human milk AND thyroid AND composition, using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol for data search, selection, and extraction. The flowchart proposed for bibliographic search resulted in 12 articles and, of these, four were selected.

    Results:

    The articles elected for this review were published between 1976 and 2018. Two studies found significant differences in the nutritional composition of mothers' milk with hypothyroidism or overweight compared with the milk of those without hypothyroidism. Studies have shown that the presence of the disease led to changes in the nutritional composition of human milk, especially a higher concentration of human milk fat.

    Conclusion:

    It is extremely important that these women have continuous nutritional follow-up to minimize the impact of these morbidities on the nutritional composition of human milk.

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    Do Thyroid Diseases during Pregnancy and Lactation Affect the Nutritional Composition of Human Milk?
  • Review Article

    Hormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):256-263

    Summary

    Review Article

    Hormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):256-263

    DOI 10.1055/s-0039-1683904

    Views5

    Abstract

    The hypothesis of fetal origins to adult diseases proposes that metabolic chronic disorders, including cardiovascular diseases, diabetes, and hypertension originate in the developmental plasticity due to intrauterine insults. These processes involve an adaptative response by the fetus to changes in the environmental signals, which can promote the reset of hormones and of the metabolism to establish a “thrifty phenotype”. Metabolic alterations during intrauterine growth restriction can modify the fetal programming. The present nonsystematic review intended to summarize historical and current references that indicated that developmental origins of health and disease (DOHaD) occur as a consequence of altered maternal and fetal metabolic pathways. The purpose is to highlight the potential implications of growth factors and adipokines in “developmental programming”, which could interfere in the development by controlling fetal growth patterns. These changes affect the structure and the functional capacity of various organs, including the brain, the kidneys, and the pancreas. These investigations may improve the approach to optimizing antenatal as well as perinatal care aimed to protect newborns against long-termchronic diseases.

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    Hormonal Biomarkers for Evaluating the Impact of Fetal Growth Restriction on the Development of Chronic Adult Disease
  • Review Article

    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):128-141

    Summary

    Review Article

    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):128-141

    DOI 10.1055/s-0037-1599094

    Views9

    Abstract

    Purpose

    To evaluate the effect of supplementation with omega-3 sources on the fatty acid composition of human milk.

    Methods

    The review consisted of the search for articles published in PubMed, Biblioteca Virtual de Saúde (Virtual Health Library[VHL]) andWeb of Science databases using the following keywords: fatty acids, omega-3, human milk and supplementation; for this purpose, we have used the program of research to integrate the services for the maintenance of autonomy (PRISMA) checklist. The following selection criteria were used: articles in English, Portuguese, Spanish or Italian, published between 2000 and 2015, and about studies performed in humans. We found 710 articles that met the established criteria; however, only 22 of them were selected to be part of this study.

    Results

    All studies found a positive relationship between the consumption of omega- 3 sources and their concentration in humanmilk. The differences in the findings are due to the distinct methods used, such as the specific time of the omega-3 supplementation, the type of omega-3 source offered, as well as the sample size.

    Conclusion

    Although the studies were different in several methodological aspects, it was possible to observe the importance of omega-3 supplementation during gestation and/or the puerperium.

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    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review
  • Artigos Originais

    Study of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):238-243

    Summary

    Artigos Originais

    Study of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):238-243

    DOI 10.1590/S0100-72032006000400006

    Views0

    PURPOSE: to evaluate the relationship between S/A ratio in ductus venosus (DV) and perinatal outcomes in fetuses with brain sparing reflex. METHODS: the study was designed as an observational, sectional study with prospectively collected data. Forty-one fetuses with brain sparing reflex and gestational age between 25 and 33 weeks were studied between November 2002 and July 2005. The newborns were observed during the neonatal period in the intensive care unit of "Clínica Perinatal Laranjeiras" in order to find adverse outcomes. The study population was divided into two groups according to DV assessment. In the normal group all the fetuses with S/A ratio values of 3.6 or less were included, and in the abnormal group the fetuses with values of S/A ratio greater than 3.6. The statistical analysis was performed by the Mann-Whitney U-test, chi2 test and Fisher exact test. The results were considered significant when p<0.05. Gestational age, birth weight and Apgar score less than 7 at 5 min were evaluated. Perinatal outcome parameters were: intrauterine death, neonatal mortality, seizures, intraventricular hemorrhage, leukomalacia, need of surfactant, mechanical ventilation, myocardical failure, necrotizing enterocolitis, and length of stay in the intensive care unit. RESULTS: among the assessed 41 fetuses, 26 (63.4%) showed normal DV S/A ratio and the other 15 (36.6%) developed an abnormal DV S/A ratio (>3.6). There was no statistically signicant difference between the groups according to gestational age at delivery and Apgar <7. The only significant association was between abnormal DV S/A ratio and neonatal death (p=0.049; Fisher's exact test). No statistically significant association was observed for the other studied variables. CONCLUSIONS: our results suggest that abnormal DV blood flow detected by Doppler examination is not associated with adverse perinatal outcomes, except for neonatal mortality. This association may be considered statistically borderline (p=0.049). Excluding fetuses with birth weight less than 400 g, there was no other association between DV and neonatal mortality. The abnormal DV S/A ratio was not associated, in our study, with perinatal mortality in viable preterm fetuses.

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    Study of ductus venosus in fetuses with brain sparing reflex: evaluation of perinatal outcomes

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