USO DE MÉTODOS NÃO FARMACOLÓGICOS NO TRABALHO DE PARTO E PARTO

Eixo Temático: Práticas de cuidadoIntrodução: As práticas integrativas e complementares são utilizadas por diferentes povos e culturas durante o cuidado e manutenção da vida visando à recuperação da saúde do individuo. A utilização de tais práticas durante o trabalho de parto e parto é crescente no cenário obstétrico tendo em vista que estas medidas promovem a redução da dor, relaxamento e respeito à mulher, ao feto e aos seus acompanhantes durante esse processo tão lindo e único da vida. Sua utilização possibilita a substituição de medidas farmacológicas, principalmente no alivio da dor, sempre com o intuito de tornar esse processo o mais fisiológico possível

Prelabor cesarean section: the role of advanced maternal age and associated factors

OBJECTIVE to evaluate whether advanced maternal age (AMA) is associated with prelabor cesarean section and to identify the factors associated with prelabor cesarean section in AMA women, according to the mode of type of labor financing (private or public). METHODS Based on the Birth in Brazil survey, the research was conducted on representative sample of mothers for the country (Brazil), regions, type of hospital and location (capital or not), in 2011/2012. This study included 15,071 women from two age groups: 20–29 years and ≥ 35 years. The information was collected from interviews with puerperal woman, prenatal cards, and medical records of mothers and newborns. Multiple logistic regression modelling was used to verify the association between prelabor cesarean section and maternal, prenatal and childbirth characteristics, according to the mode of financing. RESULTS Our results showed a higher use of prelabor cesarean section for AMA (≥ 35 years) women in the public service (OR = 1.63; 95%CI 1.38–1.94) and in the private service (OR = 1.44; 95%CI 1.13–1.83), compared with women aged 20–29 years. In the adjusted model, we recorded three factors associated with the prelabor cesarean section in AMA women in both, public and private sectors: the same professional in prenatal care and childbirth (OR = 4.97 and OR = 4.66); nulliparity (OR = 6.17 and OR = 10.08), and multiparity with previous cesarean section (from OR = 5.73 to OR = 32.29). The presence of obstetric risk (OR = 1.94; 95%CI .44–2.62) also contributed to the occurrence of prelabor cesarean section in women who gave birth in the public service. CONCLUSIONS AMA was an independent risk factor for prelabor cesarean in public and private services. In the public, prelabor cesarean in AMA was more influenced by clinical criteria. Higher chance of prelabor cesarean section in nulliparous women increases the chance of cesarean section in multiparous women, as we showed in this study, which increases the risk of anomalous placental implantation

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pregnancy and childbirth among teenagers in Brazil: racial and socioeconomic inequalities in prenatal care and association with preterm birth

Submitted by Repositório Arca ([email protected]) on 2019-07-04T18:51:46Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) andre_henrique_do_vale_de.pdf: 2572804 bytes, checksum: e4aee59fc0bed1ed353bf1441ad13541 (MD5)Approved for entry into archive by Erasmo Martins ([email protected]) on 2019-07-15T13:08:35Z (GMT) No. of bitstreams: 2 andre_henrique_do_vale_de.pdf: 2572804 bytes, checksum: e4aee59fc0bed1ed353bf1441ad13541 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-07-15T13:08:35Z (GMT). No. of bitstreams: 2 andre_henrique_do_vale_de.pdf: 2572804 bytes, checksum: e4aee59fc0bed1ed353bf1441ad13541 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2018Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Este estudo teve o propósito de analisar o perfil das puérperas adolescentes no Brasil, segundo desigualdades raciais e socioeconômicas, bem como o efeito da idade materna no desfecho da prematuridade. Os dois artigos foram realizados com dados do estudo “Nascer no Brasil”. O primeiro deles englobou entrevistas de 3.317 puérperas adolescentes, e objetivou avaliar disparidades socioeconômicas e raciais na assistência ao pré-natal de adolescentes brasileiras. Os resultados apontaram que 84,4% receberam cuidado inadequado durante o pré-natal, com menores índices para as adolescentes de classe econômica mais baixa, menor escolaridade e multíparas. Observou-se maior proporção de adolescentes da classe econômica D/E e de cor da pele preta, que não conseguiram realizar exames preconizados como rotina durante a gravidez, que receberam poucas orientações sobre a gestação e parto, e que mais peregrinaram em busca de maternidade para realização do parto. No segundo artigo, buscou-se analisar a associação entre a idade materna e prematuridade, com ênfase na gravidez na adolescência. Foi utilizado o método de pareamento, baseado nos escores de propensão. Observou-se disparidades sociais, econômicas e assistenciais maternas entre as mulheres segundo a faixa etária, com maior percentual de adolescentes nas regiões menos desenvolvidas do país, Norte e Nordeste, e nas classes econômicas D e E. Depois de equiparadas quanto às características socioeconômicas e assistenciais, foram observadas maiores chances de prematuridade nas adolescentes precoces em comparação às adolescentes tardias e às adultas. O mesmo se observou com a prematuridade espontânea, com destaque para os prematuros precoces. Em conclusão, a adolescência esteve associada ao pré-natal inadequado e maior prematuridade, especialmente nos grupos menos favorecidos socialmente. Os achados apontam para a necessidade de priorizar esse grupo etário no acompanhamento pré-natal, de modo que o serviço de saúde não reproduza as desigualdades, mas ofereça assistência qualificada, a fim de reduzir desfechos negativos ao parto e nascimento, a exemplo da prematuridade. Assim, é sugerida fortemente a ampliação de ações de busca ativa, enfatizando o papel fundamental dos profissionais que atuam na Estratégia de Saúde da Família – ESF.This study aimed to analyze the profile of adolescent puerperal women in Brazil, according to racial and socioeconomic inequalities, as well as the effect of maternal age on the outcome of prematurity. The two articles were carried out with data from the study "Birth in Brazil". The first one included interviews of 3.317 postpartum adolescents, and aimed to evaluate socioeconomic and racial disparities in the prenatal care of Brazilian adolescents. The results indicated that 84,4% received inadequate care during prenatal care, with lower rates for adolescents of lower economic class, lower educational level and multiparous. A higher proportion of D / E and black-skinned adolescents were found, who were not able to perform routinely examinations during pregnancy, received few guidelines on gestation and delivery, and who more traveled in search of maternity to perform labor. In the second article, we sought to analyze the association between maternal age and prematurity, with emphasis on teenage pregnancy. The pairing method, based on propensity scores, was used. Maternal social, economic and maternal disparities were observed among women according to the age group, with a higher percentage of adolescents in the less developed regions of the country, North and Northeast, and in economic classes D and E. After being compared in terms of socioeconomic characteristics and higher odds of prematurity were observed in early adolescents compared to late adolescents and adults. The same was observed with spontaneous prematurity, with emphasis on early preterm. In conclusion, adolescence was associated with inadequate prenatal care and greater prematurity, especially in socially disadvantaged groups. The findings point to the need to prioritize this age group in prenatal care so that the health service does not reproduce inequalities but offers qualified assistance in order to reduce negative outcomes at birth and birth, such as prematurity. Thus, it is strongly suggested the expansion of active search actions, emphasizing the fundamental role of the professionals who work in the Strategy of Family Health - ESF

APLICAÇÃO DE PRÁTICAS INTEGRATIVAS E COMPLEMENTARES NO PROCESSO PARTURITIVO

Eixo Temático: Práticas de cuidadoIntrodução: O parto é um momento muito especial, cheio de sensibilidade e emoção que marca uma mudança profunda na vida da mulher e de toda a sua rede familiar. Durante este processo é normal que sentimentos como medo, estresse, tensão, fome, solidão, desconhecimento sobre o trabalho de parto, desamparo social e afetivo, além do fato de estar em ambiente diferente com pessoas estranhas colaborem para que a mulher tenha uma percepção dolorosa no parto repercutindo no seu estado físico e mental. Diante disso, um parto normal mais confortável e tranquilo, no qual ocorra a aplicação de práticas integrativas e complementares encoraja a mulher a ter uma postura ativa, colaborando para que o seu processo de parto seja uma experiência enriquecedora, especial e ainda mais marcante para mulher e sua família. Tais práticas podem incluir a hidroterapia (que compreende o banho de aspersão e o banho de imersão), o uso da bola suíça (também conhecida como bola de Bobath ou ainda como bola do nascimento), massagem relaxante, uso de rebozo, musicoterapia, dança, dentre outras ações

Baixo peso ao nascer em adolescentes e adultas jovens na Região Nordeste do Brasil

Objetivos: avaliar a associação entre as características sociodemográficas, do pré-natal e do parto de mães adolescentes e adultas jovens com o baixo peso ao nascer, em capitais e outros municípios da Região Nordeste do Brasil, no período de 2011 e 2012. Métodos: estudo transversal, de base hospitalar e nível regional, realizado em 2011 e 2012. As informações foram obtidas por meio de entrevista com a puérpera no pós-parto imediato e coletados dados dos prontuários maternos e dos recém-nascidos. Um modelo teórico conceitual foi estabelecido com três níveis de hierarquia e a variável dependente foi o baixo peso ao nascer (BPN). Resultados: do total de 3009 puérperas entrevistadas, 9,7% apresentaram conceptos com baixo peso. As puérperas que realizaram menos que seis consultas no pré-natal apresentaram uma chance 1,7 vezes maior de ter RN com baixo peso; ser primigesta aumentou a chance da ocorrência do BPN em 1,5 vezes; assim como a prematuridade que representou o principal fator de exposição, elevando em 21 vezes a chance desse desfecho. Conclusões: o estudo demonstrou alta frequência de baixo peso ao nascer entre mães adolescentes e adultas jovens, tendo como principais fatores associados o número insuficiente de consultas pré-natal, primigestação e prematuridade

Economic and racial inequalities in the prenatal care of pregnant teenagers in Brazil, 2011-2012

Abstract Objectives: to analyze the prenatal care of pregnant teenagers interviewed in the post-partum period in Brazilian maternity hospitals, according to economic status and skin color. Methods: data were obtained from the Birth in Brazil study, a national hospital-based survey in 2011 and 2012. Information was obtained from interviews with the postpartum women and from data collected from their prenatal cards. Multivariate logistic regression was used to verify whether maternal and prenatal care characteristics were associated with ina-dequate prenatal care. Results: a total of 3,317 teenage mothers were interviewed in the postpartum period, 84.4% of whom had received inadequate prenatal care, with worse results for lower-income, lower-schooling, and multiparous teens. In the same way, it became evident the higher proportion of black teenagers and those from economic classes D/E among those who failed to receive routine laboratory tests, who received little orientation on the pregnancy, labor, and childbirth, and who were forced to go from one maternity hospital to another before being admitted to give birth. Conclusions: strategies targeted to the most vulnerable pregnant teenagers should be implemented in order to achieve greater equality in teenagers’ prenatal care, seeking to assure easier access, earlier initiation of care, and greater case-resolution capacit