Navegando por Palavras-chave "Premature birth"
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- ItemAcesso aberto (Open Access)Demandas que a maternidade tardia exigirá dos gestores públicos para oferecer o suporte social necessário às crianças(Universidade Federal de São Paulo, 2023-12-13) Lima, Natanael Mendes Caires de [UNIFESP]; Araújo, Luiz Jurandir Simões de [UNIFESP]; http://lattes.cnpq.br/5610166520631974A definição do conceito de maternidade tardia diz respeito à gestação após os 35 anos de idade, sendo classificada como “idade materna avançada”. É notável que nas últimas décadas a maternidade em idade avançada tornou-se um fenômeno mais comum na sociedade. No entanto, a biologia humana não tem mudado tanto, de forma que a fase mais fértil das mulheres é até os 35 anos, então a necessidade de adiar a gravidez pode aumentar os riscos à saúde tanto da mãe quanto do bebê. Na faixa de idade de mães acima dos 35 anos, foi observado um aumento na frequência dos casos de prematuridade, óbitos fetais, anomalia congênita, Síndrome de Down, partos múltiplos, e uma queda nos índices Apgar e peso ao nascer. Na pesquisa bibliográfica e nos dados coletados percebe-se os potenciais desafios humanos e terapêuticos que esse padrão comportamental trará aos gestores públicos (em particular, do SUS e das redes municipais de atendimento). Este trabalho demonstra a importância da Atuária na estimação e projeção dos riscos macro sociais que precisamos mitigar e gerenciar. Há necessidade de aprofundar a metodologia e as estatísticas deste tema, mas com os dados e referências recolhidos, fica clara a urgência da presença de atuários. Para todos os grandes riscos da sociedade, os atuários precisam fincar sua presença. Também se mostra importante estudos sobre as consequências para a mãe como complemento ao tema, podendo ser elaborado com outras bases existentes no Datasus.
- ItemSomente MetadadadosEthnic disparity in spontaneous preterm birth and maternal pre-pregnancy body mass index(Springer, 2012-04-01) Torloni, Maria Regina [UNIFESP]; Fortunato, Stephen J.; Betran, Ana Pilar; Williams, Scott; Brou, Lina; Drobek, Cayce Owens; Merialdi, Mario; Menon, Ramkumar; Universidade Federal de São Paulo (UNIFESP); Centennial Womens Hosp; World Hlth Org; Vanderbilt Univ; Emory Univ; Univ Texas Med Branch GalvestonTo investigate differences in pre-pregnancy BMI status in patients with spontaneous preterm birth (PTB) compared with term birth and assess the role of ethnicity as a risk modifier in BMI-associated PTB.A case-control study involving self-reported African American and Caucasian women delivering singletons in Nashville, TN, USA, 2003-2009. Maternal pre-pregnancy BMI was recorded in 447 PTB-cases (African American = 145, Caucasian = 302) and 1315 term-birth controls (African American = 522; Caucasian = 793). Crude and adjusted odds ratio (OR and AOR) for PTB were calculated using normal BMI (18.5-24.9 kg/m(2)) as reference. Age, education, marital status, income, smoking, parity, previous PTB and pregnancy weight gain were included as covariates in logistic regression.No significant differences were noted in the OR for PTB among different BMI categories when women of different ethnicity were combined. Odds of PTB were greater in obese than in normal weight Caucasian women, even after adjusting for confounders (AOR = 1.84, 95%CI [1.15, 2.95]). Obese African American women had a decreased crude OR for PTB, although this was not significant after adjusting for confounders (AOR = 0.72, 95%CI [0.38, 1.40]). the odds for early PTB (< 32 weeks) were decreased in obese compared with normal weight African American women (OR = 0.23, 95%CI [0.08, 0.70]), whereas they were increased in obese compared with normal weight Caucasian women (OR = 2.30, 95%CI [1.32, 4.00]).The risk for PTB in women with different pre-pregnancy BMI categories differs according to ethnicity.
- ItemAcesso aberto (Open Access)Fatores maternos e neonatais associados a prematuridade em maternidades públicas do acre(Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Santos, Clisangela Lago [UNIFESP]; Schirmer, Janine [UNIFESP]; Dotto, Leila Maria Geromel; http://lattes.cnpq.br/3721636964139813; http://lattes.cnpq.br/1379096849417363; Universidade Federal de São Paulo (UNIFESP)Objective: To analyze the maternal and neonatal factors associated with prematurity in public maternity hospitals in Acre. Methods: Casecontrol studies we selected 383 preterm births (cases) and 396 fullterm births (controls) of mothers who delivered at the highrisk reference maternity hospitals located in Rio Branco and Cruzeiro do Sul, Acre, between October, 2016 and July, 2017. Mothers were interviewed using a validated instrument. Additionally, information was collected from the hospital records regarding the newborns and their mothers, participating of the research. Newborns with divergences between reported Gestational Age (GA) registries that interfered with preterm/term classification were excluded. The variables were divided into five blocks and analyzed according to the conceptual hierarchical model. Descriptive and inferential analyzes were performed using: chisquare test, p value ≤0,20 for the inclusion of variables in the multiple logistic regression analysis between the blocks, and crude and adjusted Odds Ratio with the correspondent intervals of confidence, after established a new cut p value ≤0,05 for inclusion in the multiple regression logistic for hierarquical analysis. Results: 287 (75%) of the mothers had deliveries classified as spontaneous and 96 (25%) by medical indication (all by caesarean section) due to pregnancy complications. Births between 32 and 36 weeks accounted for 89% of all preterm births. Among the cases, 61.1% were classified as underweight while only 3.5% had this status in the control group. After block modeling, newborns born from premature mothers (p = 0.010), with low BMI (p = 0.003), with an interval between pregnancies < 12 months (p = 0.028), previos preterm birth (p<0.001) and maternal stress (p=0.003), maternal physical injury (p=0,045), with inadequate prenatal care type I (p = 0.020) and type II (p = 0.029), with gestation twin (p <0.001), altered volume of uterine fluid (p <0.001), preeclampsia/eclampsia (p <0.001), and hospitalization during pregnancy (p <0.001) had a greater chance of preterm birth. Maternal education level and occupation had a protective effect. Conclusion: Biological characteristics, maternal psychological and emotional conditions, insufficient prenatal care, gestation twin, complications such as bleeding, preeclampsia/eclampsia, and changes in uterine fluid volume were the main risk factors identified. Due to the multicausality of preterm birth, further research with primary data may contribute to the evaluation of the phenotypes of spontaneous and medically indicated preterm delivery in order to verify if there is a difference between the associated factors, seeking to contribute to the elucidation of the riddle of prematurity.
- ItemSomente MetadadadosGrowth of children born to renal transplanted women(Springer, 2017) Dinelli, M. Isabel S. [UNIFESP]; Ono, Erika [UNIFESP]; Viana, Patricia O. [UNIFESP]; dos Santos, Amelia M. N. [UNIFESP]; Isabel de Moraes-Pinto, M. [UNIFESP]Neonates born to transplanted mothers are exposed to immunosuppressive drugs during gestation and have a higher risk of being born prematurely and small for gestational age than the general population. We have prospectively followed up 27 children born to renal transplanted mothers from a single center and 31 healthy children born at term with adequate weight for gestational age. Comparisons of weight and length measurements were made at birth, 1 month (+/- 0.9), 3 months (+/- 1.0), 6 months (+/- 1.0), 9 months (+/- 1.5), and 12 months (+/- 1.49) of age. There were a high rate of prematurity (51.9%) and neonates small for gestational age (40.7%) in the transplant group. At birth, in the transplant group, 28% of neonates had subnormal z-scores for weight and 40%, low z-scores for length. However, at 6 months of age, no significant differences were noticed in mean weight-for-age z-scores between groups (weight -0.43 vs -0.03