Defeitos congênitos no Município do Rio de Janeiro, Brasil: uma avaliação através do SINASC (2000-2004) Birth defects in Rio de Janeiro, Brazil: an evaluation through birth certificates (2000-2004)

Avaliou-se a ocorrência de defeitos congênitos em nascidos vivos no Município do Rio de Janeiro, Brasil, com base no Sistema de Informações sobre Nascidos Vivos (SINASC), no período de 1º de janeiro de 2000 a 31 de dezembro de 2004. Através de um estudo seccional e descritivo, estudaram-se as variáveis relativas aos defeitos congênitos (presença e aparelho ou sistema acometido), aos serviços de saúde, às mães, às gestações, aos recém-natos e aos partos. Constatou-se uma prevalência de defeitos congênitos de 83/10 mil nascidos vivos. Os sistemas orgânicos mais afetados foram o osteomuscular, nervoso central, genital, as fendas lábio-palatinas e as anomalias cromossômicas. A maioria dos casos nasceu nas maternidades municipais e na rede privada, e maior prevalência de defeitos congênitos ocorreu no Instituto Fernandes Figueira da Fundação Oswaldo Cruz. Os defeitos congênitos foram mais prevalentes entre os filhos de mulheres mais velhas e menos instruídas. O percentual de casos ignorados foi alto, chegando a 21% em algumas maternidades. Uma maior divulgação das informações do SINASC sobre defeitos congênitos deveria ser estimulada. Estudos de confiabilidade são recomendados para melhor aproveitamento das informações.<br>To evaluate the occurrence of birth defects in the city of Rio de Janeiro, Brazil, using the Live Birth Information System (SINASC), we performed a cross-sectional study on all live newborns with birth defects from January 1, 2000, to December 31, 2004. The variables referred to birth defects (presence and system affected), type of health service, mothers, gestations, live births, and deliveries. Prevalence of birth defects was 83/10,000 live births. The most frequent birth defects involved the musculoskeletal system, central nervous system, cleft lip and palate, and chromosomal anomalies. The majority of cases were born in public (municipal) and private maternity hospitals, with the highest prevalence in the Fernandes Figueira Insitute, Oswaldo Cruz Foundation. Older women and those with less schooling had more live born infants with birth defects. The proportion of reports with missing information was high, reaching 21% in some institutions. Wider dissemination of SINASC data on birth defects should be encouraged. Reliability studies are recommended for better use of these reports

Attachment states of mind and couple relationships in couples seeking to adopt

We present the results of a study carried out in Italy with 39 Italian couples seeking to adopt, aged between 35 and 45 years, and 39 matched non-adoptive couples which compared their attachment states of mind with respect to caregivers and partners and quality of couple relationship. Both partners of the couples completed individually measures of attachment to caregiver (Adult Attachment Interview; AAI), attachment to partner (Current Relationship Interview; CRI and Experiences in Close Relationships Scale-Revised; ECR-R) and marital quality (Dyadic Adjustment Scale; DAS). The results showed that couples seeking to adopt did not differ from the control group with respect to attachment to caregivers (AAI). However potential adoptive fathers were more likely to show secure attachment classifications with respect to partner (CRI) than non-adoptive fathers. Finally, couples seeking to adopt expressed higher levels of positive feelings and thoughts within the couple relationship (ECR-R) and better perceived quality of marital relationship (DAS) than the control group. Overall, these findings suggested that couples seeking to adopt placed a high value on attachment relationships, which is considered a relevant factor for positive outcome of adoption