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Objective: To examine the effect of pregnancy on coronavirus disease 2019 (COVID-19) -related in-hospital mortality in women of reproductive age (between 15 and 45 years), with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed with polymerase chain reaction tests, adjusted for factors such as co-infection and intervention that were not considered in existing literature. Methods: Data gathered from a nationwide database in Brazil were analyzed using multivariate logistic regression and multivariate Cox regression. Adjusted odds ratios and hazard ratios of independent factors associated with in-hospital death were calculated. Results: A total of 97 712 women were included in the study. After the adjustment for sociodemographic factors, epidemiologic characteristics, pre-existing medical conditions, and intervention, pregnant women were found to be associated with lower risk for in-hospital mortality as well as longer survival time compared with non-pregnant women. When covariates of intervention were omitted from the analysis, pregnancy did not appear to be a significant factor associated with mortality. Conclusion: With the adjustment for intervention that was shown to be an independent factor associated with mortality, pregnancy appeared to have a favorable effect on SARS-CoV-2 infection. Given the immunosuppressed state of pregnancy, this finding is in line with the hypothetical protective role of a weaker immune response that inhibits the production of proinflammatory cytokine. [ABSTRACT FROM AUTHOR]

Background Despite high seroprevalence of asymptomatic infection in humans, toxoplasmosis can manifest as a severe systemic disease, as occurs in the congenital infection. Here we evaluate the seroprevalence of Toxoplasma infection among pregnant women in a highly urbanized area of Brazil. Methods A robust seroepidemiological study was conducted using laboratory databases of anti- Toxoplasma gondii serological results together with information on age, month/year of diagnosis and place of residence of pregnant women in the public health system of the city of Juiz de Fora, Brazil. Results Of 5895 pregnant women analysed, 54.7% showed seronegativity and 44.4% showed seropositivity for immunoglobulin G (IgG) antibodies against Toxoplasma gondii. This seropositivity rate increased to 68.3% when only considering participants from rural areas. Multivariate analysis revealed higher odds of being seropositive associated with age (odds ratio [OR] 1.06 [confidence interval {CI} 1.05 to 1.07]) and with living in rural areas (OR 2.96 [CI 1.64 to 5.36]). The spatial distribution of IgG seropositivity indicated a higher prevalence concentrated in rural and peripheral neighbourhoods. Conclusions This is the first report to use spatial analysis to show a cluster of Toxoplasma infection in rural and peripheral neighbourhoods of a highly urbanized municipality, which highlights the need for adequate healthcare actions to be implemented for women living in these areas. [ABSTRACT FROM AUTHOR]

Objective: to analyze the knowledge of the Birth Companion's Law from the perspective of multi-gestational pregnant women under prenatal follow-up in the Basic Health Units of rural Cuité, Paraíba. Method: descriptive, exploratory study with qualitative approach. Data collection was performed between May and June 2017 through semi-structured interviews, and analyzed in the light of the literature through the Collective Subject Discourse. Results: there was a lack of knowledge about this Law, because only one of the interviewees stated that she had the experience of a companion during childbirth and emphasized that this plays a role of paramount importance. Final Considerations: the fact that most of the interviewees, who were multi-gestational pregnant women and, consequently, underwent more than one prenatal follow-up during pregnancies, not knowing the Law of Follow-up to Childbirth, points to a failure regarding their dissemination and discussion during prenatal consultations. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of an oral versus sublingual loading dose of nifedipine for tocolysis.Methods: An open, randomized clinical trial conducted between March 1, 2013, and April 31, 2014. Participants were pregnant women with a diagnosis of premature labor, single live fetus, topical pregnancy, gestational age 24-36 weeks, normal fetal vitality, cervical dilatation less than or equal to 4 cm, cervical effacement less than or equal to 80%, and intact amniotic membranes. They were randomized into two groups, oral and sublingual nifedipine, 20 mg loading dose, repeated every 30 minutes (maximum dose of 60 mg). The primary endpoint was the time until tocolysis and the secondary endpoints were the effectiveness of tocolysis within 90 minutes, 12 hours, and 48 hours; premature delivery within 48 hours; and maternal hemodynamic parameters and side effects.Results: There were 80 patients randomized to oral (n=40) and sublingual (n=40) nifedipine. The time required for tocolysis was significantly less with sublingual nifedipine (160 minutes vs 340 minutes; P=0.0003). Sublingual nifedipine was also more successful than oral nifedipine at inhibiting premature labor within 90 minutes (n=8 [20.0%] vs n=1 [2.5%], P=0.014). There was no statistically significant difference between the groups for the other secondary endpoints.Conclusion: Compared with oral administration, a sublingual loading dose of nifedipine resulted in faster tocolysis in patients with premature labor. Brazilian Clinical Trials Registry (ReBEC): U1111-11566186. [ABSTRACT FROM AUTHOR]

To investigate the clustering of health risk behaviors (HRB) and its association with demographics, physical exercise, overweight, perception of health, and diseases in Brazilian pregnant people. This is a cross-sectional study using data from the Risk Factor Surveillance System for Non-communicable Chronic Diseases by Telephone Survey (VIGITEL), the main health survey in Brazil. We used data on fruit and vegetable consumption, TV time, tobacco, and alcohol abuse in individuals who reported being pregnant (n = 4553). We used latent class analysis to identify optimal HRB clustering among participants. Multinomial regression (odds ratio [OR] and 95% confidence intervals [95%CI]) was applied to identify factors associated with HRB cluster. Three clustering classes were identified: "without HRB cluster" (i.e., least unhealthy behaviors) (n = 2402, 52,8%), "moderate HRB cluster" (n = 1983, 43,5%), and "high HRB cluster" (i.e., most unhealthy behaviors) (n = 168, 3,7%). Pregnant people aged 35–50 years (OR = 1.89, 95%CI = 1.01; 3.52) who did not practice physical exercise (OR = 1.94, 95%CI 1.11; 3.39) were more likely to be classified as "high HRB cluster". Participants with 9–11 years (OR = 0.11, 95%CI = 0.07; 0.17) and ≥ 12 (OR = 0.05, 95%CI = 0.02; 0.11) years of education had a lower likelihood of being in the "high HRB cluster". Three HRB clustering patterns were found in this study. Greater maternal age, low education, and absence of physical exercises increased the chances of being in the high HRB cluster group. Participants with higher educational levels were less likely to be in the High HRB cluster. • We found three health risk behavior (HRB) clusters in Brazilian pregnant. • Around 3,7% of Brazilian pregnant composed the High HRB cluster. • Late pregnancy, low education, and physical inactivity were related to the High HRB cluster. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to analyze the epidemiological profile of syphilis cases in pregnant women in a maternity hospital from Teresina, Piauí, in 2016. Method: Descriptive and documental epidemiological research with quantitative approach, carried out at the Epidemiological Surveillance Service of the maternity, from November 2016 to January 2017, based on data from the Notification of Injury Information System (SINANNET). Data were stratified according to age group, education, gestational age in diagnosis, titration of the non-treponemic test, syphilis classification and partner adherence. Results and discussion: In relation to the prevalence, seventy-five cases were notified in 2016, corresponding to 2,8%. The disease was prevalent in women aged from 20 to 29 years old who had incomplete elementary school education. The majority (77,33%) were diagnosed in third trimester, 22,7% of the pregnant women presented VDRL of 1:16, the most frequent clinical classification was tertiary and latent with 61,33% of the cases, with regard to the partners' adherence, only 32% performed the treatment. Conclusions: It's necessary a rigorous diagnosis, treatment and follow-up in the attempt to reduce cases of syphilis in pregnant women and congenital syphilis, as well as to break the chain of transmission with directed strategies and actions in the fight against the disease. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to describe the genetic diversity of HIV-1, as well as the resistance profile of the viruses identified in HIV-1 infected pregnant women under antiretroviral therapy in the state of Pará, Northern Brazil.Methods: Blood samples were collected from 45 HIV-1 infected pregnant to determine the virus subtypes according to the HIV-1 protease (PR) gene and part of the HIV-1 reverse transcriptase (RT) gene by sequencing the nucleotides of these regions. Drug resistance mutations and susceptibility to antiretroviral drugs were analyzed by the Stanford HIV Drug Resistance Database.Results: Out of 45 samples, only 34 could be amplified for PR and 30 for RT. Regarding the PR gene, subtypes B (97.1%) and C (2.9%) were identified; for the RT gene, subtypes B (90.0%), F (6.7%), and C (3.3%) were detected. Resistance to protease inhibitors (PI) was identified in 5.8% of the pregnant, and mutations conferring resistance to nucleoside reverse transcriptase inhibitors were found in 3.3%, while mutations conferring resistance to non-nucleoside reverse transcriptase inhibitors were found in 3.3%.Conclusions: These results showed a low frequency of strains resistant to antiretroviral drugs, the prevalence of subtypes B and F, and the persistent low transmission of subtype C in pregnant of the state of Pará, Brazil. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: analyze the knowledge and practice nurse about obstetrical physical examination. Methodology: descriptive, quantitative research among 24 nurses working in maternity care in public hospitals of the city of Maceió/AL from June to August 2014. It was used a questionnaire containing demographic data, working time and knowledge exam. After this step was carried out a descriptive analysis of data. Results: The breast examination and obstetric palpation are the most neglected by nurses techniques while performing the obstetrical examination. The only techniques unanimously carried by them are Asao measuring the height of the uterus Fund and the vaginal ring. Conclusion: Obstetric examination performed by the nurse is still underused in pregnant women. Nurses demonstrate knowledge on the subject, but the practice performed dismissive informed theory. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to present results of the post-pandemic phase of A(H1N1)pdm09 virus infection in pregnant women in Ceará, Brazil, during the January-June 2012 influenza season. Results One hundred and fifty-four nasopharyngeal swab samples were collected from pregnant women admitted to hospitals with suspected severe acute respiratory infection ( SARI). Fifty-three (34·4%) had laboratory-confirmed A(H1N1)pdm09 virus infection with 15 (28·3%) outpatients and 38 (71·7%) hospitalized. Five (9·4%) women were in the first trimester of pregnancy, 20 (37·7%) in the second trimester of pregnancy, and 24 (45·2%) in the third trimester of pregnancy. Three had no information about the time of pregnancy. Six samples from newborns were also analyzed, of which three were nasopharyngeal swab positive for A(H1N1)pdm09. These swabs were collected immediately after birth, with the exception of one that was collected on the day after birth. Conclusion Our findings suggest that transplacental transfer of influenza viruses could occur as a result of severe illness in pregnancy. It is therefore important to encourage women to be vaccinated against influenza in order to avoid pregnancy complications. [ABSTRACT FROM AUTHOR]

Background As the most frequent pathway of vertical transmission of HTLV-1 is breast-feeding, and considering the higher prevalence in women, it is very important to perform screening examinations for anti-HTLV-1 antibodies as part of routine prenatal care. So far, no studies of HTLV-1 seroprevalence in pregnant women in the Southern region of Bahia, Brazil, have been described. Methods Pregnant women were selected at the two regional reference centers for health care from Southern Bahia. A total of 2766 pregnant women attending the antenatal unit between November 2008 and May 2010 have been analyzed. An extra blood sample was drawn during their routine antenatal testing. A standardized questionnaire was applied and all positive plasma samples were tested by ELISA and were confirmed by Western Blot and PCR. Besides that, positive women were contacted and visited. The family members that were present during the visit were asked to be serologically screened to the virus. A prospective study was also carried out and newborns were followed up to two years for evaluation of vertical transmission. Results HTLV prevalence was 1.05% (CI95%:0.70-1.50). There was no association of HTLV-1 infection with age, education, income and ethnic differences. The association with marital status was borderline (OR = 7.99; 95%CI 1.07-59.3; p = 0.042). In addition, 43 family members of the HTLV-1 seropositive women have been analyzed and specific reactivity was observed in 32.56%, including two children from previous pregnancy. Conclusion: It is very important to emphasize that the lack of HTLV-1 screening in pregnant women can promote HTLV transmission especially in endemic areas. HTLV screening in this vulnerable population and the promotion of bottle-feeding for children of seropositive mothers could be important cost-effective methods to limit the vertical transmission. Besides that, our data reinforce the need to establish strategies of active surveillance in household and family contacts as important epidemiological surveillance actions for the early detection of virus infection and the prevention of transmission by sexual or and parenteral contact. [ABSTRACT FROM AUTHOR]

Background: Maternal dengue antibodies are considered to play a significant role in dengue pathogenesis among infants. Determining the transplacental specific antibody transfer is invaluable for establishing the optimal vaccination age among infants in endemic regions. Methods: We conducted a cross-sectional study among pairs of maternal and corresponding umbilical cord blood samples in public hospitals. The prevalence and incidence of dengue infection were determined in 505 pairs of pregnant women and neonates during a large outbreak (2009-2010) in central Brazil. The women were interviewed at late pregnancy to assess current or past symptoms of dengue. All parturients and their neonates were screened using Dengue IgG Indirect ELISA (Panbio) to assess previous dengue exposure. A semi-quantitative measurement of the IgG antibody expressed by the index ratio was calculated using optical density (OD) values according to the manufacturer's instructions. The studied population of parturients and their offspring was also screened for recent dengue infection by the Dengue IgM-capture ELISA (Panbio). Those participants with history of fever and two or more symptoms of dengue at least 10 days before the delivery were also tested for the dengue NS1 antigen using the Dengue Early ELISA (Panbio) and RT-PCR. Results: The mean maternal age was 25.8 (SD = 6.4), and 83.6% of deliveries were between 37 and 41 weeks. Approximately half of the 505 women and neonates were IgG-seropositive, yielding 99.3% co-positive mother-child frequency of antibody transfer (Kappa = 0.96). The incidence of dengue infection was 2.8% (95% CI 1.4-4.4%) among the women considering 14 IgM-positive results and one DENV2 detected by RT-PCR. The dengue NS1 antigen was undetectable in the matched pairs. Conclusion: This study provides critical data on the prevalence of transplacental transferred maternal-infant anti-dengue antibodies and incidence of infection. The design of future vaccine trials should consider diverse regional epidemiological scenarios. [ABSTRACT FROM AUTHOR]

The study aimed to describe the prenatal care of low risk offered in one Basic Health Unit (BHU) of a municipality belonging to the 12th Regional Health of the State of Paraná. This study involved 31 women who responded to a questionnaire prepared for the interview survey. The results showed that most of the women had age between 16- 20 years (39%) who performed an average of 20 prenatal consultations in previous pregnancies (65%), and that the doctor has always been responsible for examining prenatal care (100% of cases). It was found that most pregnant women began prenatal care at 2 months of pregnancy (74%) who received guidance on: vaccination (77%), nutrition (77%), labor (58%), breast feeding and care with breasts (74%). It was found that most pregnant women attended routine laboratory tests and prenatal consultations (97%). It was concluded that pregnant women surveyed at BHU have a high rate of adherence to prenatal care(97%), which is note worthy because it shows that the program is effective. However, we observed failures and complaints from pregnant women about the care offered by the professional who performed the pre-natal, not ensuring the overall quality of care. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Adolescent pregnancy is a public health concern and many studies have evaluated neonatal outcomes, but few have compared younger adolescents with older using adequate prenatal care. Objective: To compare the risks of adverse neonatal outcomes in younger pregnant adolescents who are properly followed through group prenatal care (GPC) delivered by specialized public services. Methods: This retrospective cohort study followed pregnant adolescents (aged 10-17 years) who received GPC from specialized public services in Brazil from 2009 to 2014. Data were obtained from medical records and through interviews with a multidisciplinary team that treated the patients. The neonatal outcomes (low birth weight, prematurity, Apgar scores with 1 and 5 min, and neonatal death) of newborns of adolescents aged 10-13 years were compared to those of adolescents aged 14-15 years and 16-17 years. Incidence was calculated with 95% confidence intervals (CIs) and compared over time using a chi-squared test to observe trends. Poisson Multivariate logistic regression was used to adjust for confounding variables. The results are presented as adjusted relative risks or adjusted mean differences. Results: Of the 1,112 adolescents who were monitored, 758 were included in this study. The overall incidence of adverse neonatal outcomes (low birth weight and prematurity) was measured as 10.2% (95% CI: 9.7-11.5). Apgar scores collected at 1 and 5 min were found to be normal, and no instance of fetal death occurred. The incidence of low birth weight was 16.1% for the 10-13 age group, 8.7% for the 14-15 age group and 12.1% for the 16-17 age group. The incidence of preterm was measured at 12, 8.5, and 12.6% for adolescents who were 10-13, 14-15, and 16-17 years of age, respectively. Neither low birth weight nor prematurity levels significantly differed among the groups ( p > 0.05). The infants born to mothers aged 10-13 years presented significantly ( p < 0.05) lower Apgar scores than other age groups, but the scores were within the normal range. Conclusions: Our findings showed lower incidence of neonatal adverse outcomes and no risk difference of neonatal outcomes in younger pregnancy adolescents. It potentially suggests that GPC model to care pregnant adolescents is more important than the age of pregnant adolescent, however further research is needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Honorato, Fulone, Silva and Lopes.)

Objectives: This study aimed to investigate the association between child maltreatment and depressive symptomatology during gestation in adolescents., Methods: This was a cross-sectional study with pregnant adolescents aged 12 to 19 years. Data were collected with the Beck Depression Inventory, Childhood Trauma Questionnaire, and Mini International Neuropsychiatric Interview., Results: Compared to adolescents who did not experience each type of neglect or abuse, experiencing them was associated with a higher proportion of depressive symptoms: emotional neglect PR = 1.4 (95% CI 1.1; 1.8); physical neglect PR = 1.7 (95% CI 1.3; 1.7); emotional abuse PR = 1.8 (95% CI 1.4; 2.2); and physical abuse PR = 1.3 (95% CI 1.1; 1.7)., Conclusions: This study demonstrates the association between childhood experiences and mental health in adolescence, especially in vulnerable samples, such as pregnant adolescents. This finding reveals the importance of studying early trauma in life and enabling preventive help, especially in adolescents. High-quality evidence of perinatal mental health problems should be generated to make pregnancy safer for women in low- and middle-income countries.

Background: Children with vertically transmitted hepatitis B virus develop chronic infection up to 90% of the time. This study aimed to verify the prevalence of hepatitis B surface antigen (HBsAg) in pregnant patients treated in a Brazilian public hospital and analyze the prophylactic measures in newborns., Methods: A cross-sectional study was conducted by collcting data in the electronic charts of patients who attended the obstetric and maternity departments, from January 1, 2010, to December 31, 2016, and evaluating the results of pregnant women's HBsAg, prophylaxis in newborns, and clinical follow-up. The data were tabulated and analyzed using Microsoft Excel software., Results: Among the 7,763 participating patients, 109 were reactive to HBsAg, and 3 were indeterminate. However, only 28 had correct information on HBV prophylaxis with the parturient and newborn in the chart, and only 16 completed the follow-up., Conclusions: Most of the HBsAg-positive pregnant women (75%) did not have prophylactic information in the charts, and almost 50% of the pregnant women and newborns who had appropriate prophylaxis did not return for medical follow-up. Failure of prophylaxis can promote vertical/perinatal transmission of hepatitis B virus in newborns of mothers who are HBsAg positive., (Copyright © 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)