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  • Review Article

    Iron Salts, High Levels of Hemoglobin and Ferritin in Pregnancy, and Development of Gestational Diabetes: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(11):1059-1069

    Summary

    Review Article

    Iron Salts, High Levels of Hemoglobin and Ferritin in Pregnancy, and Development of Gestational Diabetes: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(11):1059-1069

    DOI 10.1055/s-0042-1755460

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    Abstract

    Objective

    The aim of this study was to systematically review literature on the use of iron supplements (not including iron derived from diet), increased levels of hemoglobin and/or ferritin, and the risk of developing gestational diabetes mellitus (GDM).

    Data source

    The following databases were searched, from the study's inception to April 2021: PUBMED, Cochrane, Web of Science, Scopus, Embase, Cinahl and Lilacs.

    Selection of studies

    A total of 6,956 titles and abstracts were reviewed, 9 of which met the final inclusion criteria, with 7,560 women in total.

    Data collection

    Data extraction was performed by two independent reviewers and disagreements were resolved by a third researcher.

    Data synthesis

    Methodological quality in controlled trials were assessed according to the Cochrane Collaboration tools (ROB-2 and ROBINS-1) and for the observational studies, the National Institutes of Health's (NIH) quality assessment tool was used. Among the 5 observational studies, women with a higher hemoglobin or ferritin level were more likely to develop GDM when compared with those with lower levels of these parameters. Among the 3 randomized clinical trials, none found a significant difference in the incidence of GDM among women in the intervention and control groups. However, we identified many risks of bias and great methodological differences among them.

    Conclusion

    Based on the studies included in this review, and due to the important methodological problems pointed out, more studies of good methodological quality are needed to better establish the association between iron supplementation and GDM.

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    Iron Salts, High Levels of Hemoglobin and Ferritin in Pregnancy, and Development of Gestational Diabetes: A Systematic Review
  • Original Article

    Quality of Life of Pregnant Women Living with HIV/AIDS

    Rev Bras Ginecol Obstet. 2016;38(5):246-252

    Summary

    Original Article

    Quality of Life of Pregnant Women Living with HIV/AIDS

    Rev Bras Ginecol Obstet. 2016;38(5):246-252

    DOI 10.1055/s-0036-1584164

    Views5

    Abstract

    Objective

    to evaluate the quality of life of HIV positive (HIVþ) pregnant women using the HIV/AIDS Target Quality of Life (HAT-QoL) instrument.

    Methods

    cross-sectional study, conducted between May 2014 and November 2015 , with HIVþ pregnant women selected by convenience sampling. Sociodemographic and behavioral data were collected through interviews, and the HAT-QoL questionnaire was applied. Clinical and laboratorial data were collected from medical records.

    Results

    twenty-seven pregnant women participated in the study. Their mean age was 27 years (standard deviation - SD: 7.3). The majority (59%) had up to 8 years of education, 52% identified themselves as white, 56% were unemployed, and 59% had a household income higher than the minimum wage. The mean infection time by the virus was 68.4 months (5.7 years). The majority (74%) were contaminated with HIV through sexual intercourse, and 67% declared not having a HIVþrelative. Regarding the use of condoms, 41% reported using them sporadically, and the same number did not have proper knowledge about them. Only 23 patients (85%) reported having been prescribed antiretrovirals. Fourteen (64%) had a CD4 count higher than 500 cells/mm3, and 13 pregnant women (59%) had an undetectable viral load. The scores from the quality of life questionnaire dimensions that were more affected are: infection "disclosure concerns" (mean: 39.8; SD: 27.1), followed by "financial concerns" (mean: 49.1; SD: 36), and "HIV acceptance" (mean: 49.1; SD: 35.8). The dimension with the best score was "medication concerns" (mean: 80.8; SD: 26.5).

    Conclusion

    quality of life has been increasingly used as a clinical outcome evaluation parameter. The results of this study contribute to the establishment of interventions based on the needs of HIVþ pregnant women.

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