INTRODUCTION:Brazil recently, mainly the Brazilian Northeast, was affected by an epidemic of Zika virus. This epidemic was accompanied by an increase in the birth of infants with microcephaly. In ...addition to microcephaly other injuries were observed.
METHODS:This is a preliminary analysis of a cohort study involving 500 pregnant women with symptoms suggestive of Zika. The women came to the service during the symptoms and blood and urine were collected for RT-PCR. They were subjected to ultrasonography at 24 and 32 weeks. Pregnant women with positive PCR for Zika done neurosonography, amniocentesis and Magnetic resonance.
RESULTS:The findings were then initially classified into three patterns whose findings are repeated in degrees more or less severe1 - the classic pattern of microcephaly, where we observe a reduction in the size of the brain and head, with coarse calcifications, however the structure is more conserved, 2 - the destructive pattern where basic structures not be identified and 3 - a third pattern, with more discrete signals as isolated calcifications, slight alterations in neuronal migration pattern or other extracranial changes. Until this date the most cases showed the pattern I (70%). Most Class II cases died. The pattern III is still rare, with a better prognosis and usually occurs when the infection occurs in later periods of pregnancy.
CONCLUSION:Because it is a new disease, there are still more questions than answers and among them, what are the factors that leads to different aggressiveness patterns and other damage we can find.
Background/Aim: Maternal hemodynamic responses (heart rate, systolic and diastolic blood pressure) were compared during two types of moderate-intensity physical exercise.
Methods: A randomized ...clinical trial compared 120 pregnant women performing physical exercise on a treadmill (n=64) or stationary bicycle (n=56). In 44 of these women (n=23 treadmill; n=21 bicycle), blood pressure was monitored for 24 hours following exercise. Repeated-measures analysis compared maternal heart rate, systolic and diastolic blood pressure before, during and in the 24 hours following exercise in both groups.
Results: Maternal heart rate increased significantly (p<0.001) with both types of exercise (from 84 at rest to 112 bpm on the treadmill and from 87 at rest to 107 bpm on the bicycle), without exceeding the limit of 140 bpm. Systolic pressure increased from 110 at rest to 118 mmHg on the bicycle (p=0.06) and from 112 at rest to 120 mmHg on the treadmill (p=0.02). Systolic pressure dropped steadily following exercise, reaching its lowest level (104 mmHg) after 14 hours, increasing thereafter and returning to pre-exercise levels by the 19th hour. Diastolic pressure increased during exercise irrespective of the type of exercise (p=0.27), from 70 at rest to 75 mmHg on the bicycle (p=0.39) and from 70 at rest to 76 mmHg on the treadmill (p=0.18), with the lowest level (59 mmHg) being at the 13th hour.
Conclusions: A slight increase in blood pressure levels was found during exercise; however, this was not clinically significant and was followed by a substantial hypotensive effect that lasted around 19 hours.
Register: Clinical Trials NCT01383889.
INTRODUCTION:Excessive weight gain during pregnancy has an effect on the health of newborns.
OBJECTIVE:To determine the association between maternal anthropometric measures and subcutaneous and ...visceral adiposity in the newborn.
METHODS:A cross-sectional study involving 116 pairs of mothers and newborns was performed. The dependent variable was abdominal adiposity at birth and independent variables were prepregnancy body mass index (BMI, calculated as weight (kg)/height (m)), BMI in late pregnancy, waist circumference, triceps skinfold, and subscapular skinfold. Visceral fat was measured by ultrasonography. Multiple linear regression analysis was performed, considering the significance level of 5%.
RESULTS:Approximately 49% of women had normal prepregnancy weight. In late pregnancy, 78.2% were overweight. Mean subcutaneous adiposity for neonates small for gestational age (SGA), appropriate for gestational age, and large for gestational age (LGA) was 0.26±0.06 cm, 0.29±0.09 cm, and 0.30 cm±0.07 cm, respectively (P=.32) and mean visceral adiposity for SGA, appropriate for gestational age, and LGA was 2.50±0.94 cm, 3.05±1.38 cm, and 2.28±0.49 cm, respectively (P=.03). There was a positive association between subcutaneous fat of the newborn and maternal waist circumference (r=0.005, P=.002) and triceps skinfold (r=0.04, P=.00). These variables also were associated with visceral fat (r=0.036, P=.006) and triceps skinfold (r=0.04, P=.00).
CONCLUSION:The increase in waist circumference and triceps skinfold during pregnancy directly influences the accumulation of fat in the newborn.
INTRODUCTION:Increased visceral adipose tissue is strongly correlated with lipid profile and insulin resistance in adults and children. However, this correlation has not been assessed in newborns. ...The objective of this study was to verify the correlation between visceral adipose tissue and lipid profile, glucose, insulin, and homeostasis of resistance in newborns.
METHODS:One hundred sixteen health newborns were recruited from Campina Grande, Brazil. Visceral fat was evaluated by ultrasonography. Cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, and insulin were measured from venous blood. homeostasis of resistance was also calculated. Pearsonʼs correlation coefficient was performed to determine the relationship between visceral adipose tissue and lipid profile, glucose, insulin, and homeostasis of resistance.
RESULTS:There was a significant association between visceral adipose tissue and insulin (r=0.30, P=.03) and homeostasis of resistance (r=1.61, P=.01). After multiple linear regression, only homeostasis of resistance remained associated with greater abdominal fat (r=1.61, P=.01).
CONCLUSIONS:These findings suggest that increased visceral adipose tissue may be associated with insulin resistance in newborns. This positive correlation in neonatal period may contribute to early metabolic consequences in these children.
INTRODUCTION:Because of the overweight epidemy, we would like to verify if maternal factors are associated with visceral and subcutaneous adiposity in newborns and check if the relationship between ...these factors could be proved.
METHODS:A cross-sectional study with 116 pairs of mothers and newborns was performed between November 2009 and November 2010 at the Instituto de Saúde Elpídio de Almeida. Abdominal adiposity at birth was the dependent variable. The following independent variables were assessedmaternal age, income, schooling, number of prenatal visits, parity, body mass index before and after pregnancy, waist circumference, glucose, insulin, homeostatic model assessment-estimated insulin resistance, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. A multiple linear regression model was constructed to identify the main factors associated with abdominal adiposity. A significant level of 5% was adopted.
RESULTS:Multiple linear regression analysis showed that newborn subcutaneous fat was positively associated with maternal waist circumference (r=0.005, P=.002) and negatively associated with the number of prenatal visits (r=−0.012, P=.001). Newborn visceral fat was associated with maternal waist circumference (r=0.036, P=.006) and negatively associated with maternal schooling (r=−0.071, P=.03) and the number of prenatal visits (r=−0.166, P=.002).
CONCLUSION:These findings suggest that maternal factors such as waist circumference, number of prenatal visits, and schooling may influence abdominal fat deposition during fetal life.
Objective: This study aims to compare maternal and fetal responses during two physical exercise types.
Design: A randomized clinical trial compared 120 pregnant women, gestational age of 35-37 ...weeks, 56 exercising on a stationary bicycle (Group A) and 64 on a treadmill (Group B).
Methods: Participants were monitored for three 20-minute phases: resting, exercise and recovery. Fetal heart rate (FHR) and maternal heart rate (MHR) were monitored. Glucose and lactate levels were evaluated at rest and during exercise.
Results: After the beginning of exercise, maximum lactate (L) levels were reached at 20 minutes and never exceeded 4 mmol/l. FHR decreased by 22 bpm during exercise in relation to resting values, irrespective of the exercise type (p<0.001). Comparing the exercise types, the incidence of bradycardia after 10’ was 23.2% in Group A and 35.9% in Group B (p>0.05), increasing at 20’ to 32% and 40.6%, respectively, (p>0.05). The FHR decrease during exercise was accompanied by a simultaneous increase in its variability (p<0.001), nevertheless a rapid return to resting values was observed shortly after exercise end. Glucose decreased in both groups irrespective of the exercise type (85 mg/dl at rest; 79 mg/dl during exercise and 81 mg/dl during recovery; p<0.001). There were no hypoglycemia cases.
Conclusions: FHR variability increase and the rapid return to resting values after exercise suggests that the FHR fall and the presence of bradycardia during exercise is the fetal physiologic response to blood flow redistribution, with maintenance of fetal well-being.
Key-words: Exercise; fetal heart rate; glucose; maternal heart rate; pregnancy
Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01383889.
Objectives: to describe and compare the mean values of the body composition and the peak expiratory flow (PEF) in primigravidae and multigravidae and, to determine its correlation with obstetric, ...anthropometric and body composition variables.
Method: it was performed a cross-sectional study of 120 healthy pregnant women at low risk, including 77 primigravidae and 43 multigravidae. The PEF was measured by spirometry and the body composition by multisegmental electrical impedance. The unpaired t test was used to compare the groups and the Pearson correlation test was used to determine the association between PEF and independent variables. A multiple linear regression was used to estimate the relationship between the dependent variable, the PEF and the independent variables.
Results: the body composition variables in multigravidae women showed higher values compared to the primigravidae, being statistically significant, except for fat mass. In primigravidae, the PEF was correlated significantly with maternal age and height. In multigravidae, the PEF was correlated with maternal age, height, pre-pregnancy and current weight, total body water, extracellular water, fat mass, lean mass and fat-free mass. A Multiple linear regression analysis showed that, in primigravidae, height and maternal age were associated with PEF, being responsible for explaining 14.5% of its variability. The current weight and the maternal age explained 42.3% of peak flow variability in multigravidae.
Conclusion: The PEF seemed to be influenced by the number of pregnancies. Changes were observed in relation to the body composition, as it was evidenced in correlation with the PEF in multigravidae women.
Keywords: Pregnancy. Spirometry. Weight gain.
INTRODUÇÃO: A atividade física realizada durante a gestação vem sendo discutida devido aos seus efeitos benéficos tanto para a saúde materna como para o crescimento fetal e desfechos gestacionais, ...porém ainda são escassos estudos sobre o padrão de atividade física neste período. OBJETIVO: Avaliar o padrão de atividade física entre gestantes atendidas pela estratégia Saúde da Família (ESF) do município de Campina Grande/PB. MÉTODOS:Foi acompanhada uma coorte observacional de gestantes (n=118), a partir da 16ª semana gestacional, durante os anos de 2005 a 2006. A cada quatro semanas eram aferidas as condições clínicas, socioeconômicas e obstétricas, incluindo a aplicação de um questionário específico sobre atividade física na 16ª, 24ª e 32ª semanas gestacionais. A avaliação foi feita a partir da somatória do equivalente metabólico (METs) e as atividades cotidianas foram divididas em quatro grupos: atividades laboral, doméstica e caminhada, além de inatividade. As gestantes foram classificadas de acordo com o padrão de atividade física realizado em: sedentárias, praticantes de atividades física leve, moderada e vigorosa. Os dados foram analisados no programa Epi Info 3.4.1. RESULTADOS: As características socioeconômicas da coorte estudada indicaram majoritariamente gestantes de baixo poder aquisitivo, baixa escolaridade e baixo percentual de mulheres economicamente ativas. O padrão de atividade física observado foi baixo desde o primeiro trimestre gestacional, oscilando entre o leve e o sedentário, e foi diminuindo com o evoluir da gravidez, com 100% das gestantes alcançando o padrão sedentário na 32ª semana. Em relação aos grupos de atividades, observou-se um predomínio de atividades domésticas, seguidas pelas atividades de lazer. CONCLUSÃO:Na coorte estudada verificou-se um padrão de atividade física inadequado desde o início da gestação, agravando-se no terceiro trimestre gestacional.
INTRODUÇÃO: A atividade física realizada durante a gestação vem sendo discutida devido aos seus efeitos benéficos tanto para a saúde materna como para o crescimento fetal e desfechos gestacionais, ...porém ainda são escassos estudos sobre o padrão de atividade física neste período. OBJETIVO: Avaliar o padrão de atividade física entre gestantes atendidas pela estratégia Saúde da Família (ESF) do município de Campina Grande/PB. MÉTODOS:Foi acompanhada uma coorte observacional de gestantes (n=118), a partir da 16ª semana gestacional, durante os anos de 2005 a 2006. A cada quatro semanas eram aferidas as condições clínicas, socioeconômicas e obstétricas, incluindo a aplicação de um questionário específico sobre atividade física na 16ª, 24ª e 32ª semanas gestacionais. A avaliação foi feita a partir da somatória do equivalente metabólico (METs) e as atividades cotidianas foram divididas em quatro grupos: atividades laboral, doméstica e caminhada, além de inatividade. As gestantes foram classificadas de acordo com o padrão de atividade física realizado em: sedentárias, praticantes de atividades física leve, moderada e vigorosa. Os dados foram analisados no programa Epi Info 3.4.1. RESULTADOS: As características socioeconômicas da coorte estudada indicaram majoritariamente gestantes de baixo poder aquisitivo, baixa escolaridade e baixo percentual de mulheres economicamente ativas. O padrão de atividade física observado foi baixo desde o primeiro trimestre gestacional, oscilando entre o leve e o sedentário, e foi diminuindo com o evoluir da gravidez, com 100% das gestantes alcançando o padrão sedentário na 32ª semana. Em relação aos grupos de atividades, observou-se um predomínio de atividades domésticas, seguidas pelas atividades de lazer. CONCLUSÃO:Na coorte estudada verificou-se um padrão de atividade física inadequado desde o início da gestação, agravando-se no terceiro trimestre gestacional.
INTRODUCTION: The benefits of physical activity during pregnancy on fetal growth, maternal health and pregnancy outcomes have been debated; however, studies on the physical activity patterns during this period are still scarce. OBJECTIVE: To evaluate the physical activity patterns of pregnant women attending the Family Health Strategy at the municipality of Campina Grande, PB. METHODS:A cohort of 118 pregnant women was followed from 2005 to 2006. Follow up started on the 16th gestational week and continued at every four weeks to assess clinical conditions and collect obstetric and socio-economic information. A specific questionnaire on physical activity was applied on the 16th, 24th and 32nd gestational weeks, which was estimated through the weekly sum of the metabolic equivalent (MET). Daily activities were classified in four groups: labor, household, walking, and inactivity. According to the physical activity pattern, women were classified as sedentary, or performing light, moderate or vigorous activity. The data set was analyzed in Epi Info 3.4.1 RESULTS: The socioeconomic characteristics of the cohort described a population of low levels of income and education. The physical activity pattern observed since the first gestational trimester was low, ranging from light to sedentary and it decreased along pregnancy. On the 32nd gestational week 100% of the women were sedentary. Regarding physical activity groups, women spent more time on household activities followed by recreational activities. CONCLUSION:The physical activity pattern observed was inadequate form the beginning of pregnancy and it worsened in the third gestational trimester.
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