Multiple pregnancy: epidemiology and association with maternal and perinatal morbidity

sem informaçãoTwin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening409554562sem informaçãosem informaçãosem informaçã

Approaching literature review for academic purposes: the literature review checklist

A sophisticated literature review (LR) can result in a robust dissertation/thesis by scrutinizing the main problem examined by the academic study; anticipating research hypotheses, methods and results; and maintaining the interest of the audience in how the dissertation/thesis will provide solutions for the current gaps in a particular field. Unfortunately, little guidance is available on elaborating LRs, and writing an LR chapter is not a linear process. An LR translates students' abilities in information literacy, the language domain, and critical writing. Students in postgraduate programs should be systematically trained in these skills. Therefore, this paper discusses the purposes of LRs in dissertations and theses. Second, the paper considers five steps for developing a review: defining the main topic, searching the literature, analyzing the results, writing the review and reflecting on the writing. Ultimately, this study proposes a twelve-item LR checklist. By clearly stating the desired achievements, this checklist allows Masters and Ph.D. students to continuously assess their own progress in elaborating an LR. Institutions aiming to strengthen students' necessary skills in critical academic writing should also use this tool7

Brazilian Doctor's Perspective On The Second Opinion Strategy Before A C-section

Objective: To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. Methods: Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. Results: Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. Conclusion: Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil. © 2006 Faculdade de Saúde Pública da Universidade de Sao Paulo.402233239Althabe, F., Belizan, J.M., Villar, J., Alexander, S., Bergel, E., Ramos, S., Mandatory second opinion to reduce rates of unnecessary caesarean sections in Latin America: A cluster randomised controlled trial (2004) Lancet, 363 (9425), pp. 1934-1940Belizan, J., Althabe, F., Barros, F.C., Alexander, S., Rates and implications of caesarean sections in Latin America: Ecological study (1999) BMJ, 319 (7222), pp. 1397-1402Chacham, A.S., Perpétuo, I.H.O., The incidence of caesarean deliveries in Belo Horizonte, Brazil: Social and economic determinants (1998) Reprod Health Matters, 6 (11), pp. 115-121Faúndes, A., Perpétuo, I.H.O., Cesárea por conveniência e a ética médica (2002) Ser Médico, 5 (19), pp. 32-34Faúndes, A., Pádua, K.S., Osis, M.J.D., Cecatti, J.G., Sousa, M.H., Opiniāo de mulheres e médicos brasileiros sobre a preferência pela via de parto (2004) Rev Saúde Pública, 38 (4), pp. 488-494Hopkins, K., Are brazilian women really choosing to deliver by cesarean? (2000) Soc Sci Med, 51 (5), pp. 725-740Mello e Souza, C., C-sections as ideal births: The cultural constructions of beneficence and patients' rights in Brazil (1994) Camb Q Healthc Ethics, 3 (3), pp. 358-366Moraes, M.S., Goldenberg, P., Cesáreas: Um perfil epidêmico (2001) Cad Saúde Pública, 17 (3), pp. 509-519Murray, S., Relation between private health insurance and high rates of caesarean section in Chile: Qualitative and quantitative study (2000) BMJ, 321 (7275), pp. 1501-1505Myers, S.A., Gleicher, N., A successful program to lower cesarean-section rates (1988) N Engl J Med, 319 (23), pp. 1511-1516(1998), 1. , Organización Panamericana de la Salud - OPAS. La salud en las Americas. Washington (DC)Osis, M.J.D., Pádua, K.S., Duarte, G.A., Souza, T.R., Faúndes, A., The opinion of brazilian women regarding vaginal labor and cesarean section (2001) Int J Gynaecol Obstet, 75 (SUPPL. 1), pp. S59-S66Penna, L., Arulkumaran, S., Cesarean section for non-medical reasons (2003) Int J Gynaecol Obstet, 82 (3), pp. 399-409Potter, J.E., Berquó, E., Perpétuo, I.H.O., Leal, O.F., Hopkins, K., Souza, M.R., Unwanted caesarean sections among public and private patients in Brazil: Prospective study (2001) BMJ, 323 (7322), pp. 1155-1158Rattner, D., Sobre a hipótese de estabilizaçāo das taxas de cesárea do estado de São Paulo, Brasil (1996) Rev Saúde Pública, 30 (1), pp. 19-33Schenker, J.G., Cain, J.M., FIGO committee report: FIGO committee for the ethical aspects of human reproduction and women's health (1999) Int J Gynaecol Obstet, 64 (3), pp. 317-322Sloan, N.L., Pinto, E., Calle, A., Langer, A., Winikoff, B., Fassihian, G., Reduction of cesarean delivery rate in Ecuador (2000) Int J Gynaecol Obstet, 69 (3), pp. 229-236Walker, R., Turnbull, D., Wilkinson, C., Strategies to address global cesarean section rates: A review of the evidence (2002) Birth, 29 (1), pp. 28-39Wolfe, S., Unnecessary cesarean sections: Curing a national epidemic (1994) Public Citiz Health Res Group, 10, pp. 1-

Water Aerobics In Pregnancy: Cardiovascular Response, Labor And Neonatal Outcomes

Background. To evaluate the association between water aerobics, maternal cardiovascular capacity during pregnancy, labor and neonatal outcomes. Methods. A randomized, controlled clinical trial was carried out in which 34 pregnant women were allocated to a water aerobics group and 37 to a control group. All women were submitted to submaximal ergometric tests on a treadmill at 19, 25 and 35 weeks of pregnancy and were followed up until delivery. Oxygen consumption (VO 2 max), cardiac output (CO), physical fitness, skin temperature, data on labor and delivery, and neonate outcomes were evaluated. Frequency distributions of the baseline variables of both groups were initially performed and then analysis of the outcomes was carried out. Categorical data were compared using the chi-square test, and numerical using Student's t or Mann-Whitney tests. Wilk's Lambda or Friedman's analysis of repeat measurements were applied for comparison of physical capacity, cardiovascular outcomes and maternal temperature. Results. VO 2 max and physical fitness were higher in both groups in the second trimester, returning to basal levels in the third trimester. In both groups, CO increased as pregnancy progressed and peak exercise temperature was higher than resting temperature, increasing further after five minutes of recovery and remaining at this level until 15 minutes after exercise completion. There was no difference between the two groups regarding duration (457.9 ± SD 249.6 vs 428.9 ± SD 203.2 minutes) or type of delivery. Labor analgesia was requested by significantly fewer women in the water aerobics group (27% vs 65%; RR = 0.42 95%CI 0.23-0.77). Neonatal results were similar in both groups. Conclusion. The regular practice of moderate water aerobics by sedentary and low risk pregnant women was not detrimental to the health of the mother or the child. There was no influence on maternal cardiovascular capacity, duration of labor or type of delivery; however, there were fewer requests for analgesia during labor in the water aerobics group. © 2008 Baciuk et al; licensee BioMed Central Ltd.51Artal, R., O'Toole, M., Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period (2003) Br J Sports Med, 37, pp. 6-12. , 12547738. 10.1136/bjsm.37.1.6Davies, G.A.L., Wolfe, L.A., Mottola, M.F., MacKinnon, C., Joint SOGC/CSEP Clinical Practice Guideline: Exercise in Pregnancy and the Postpartum Period (2003) Can J Appl Physiol, 28 (3), pp. 330-341. , 12955862Katz, V.L., Exercise in water during pregnancy (2003) Clin Obstet Gynecol, 469 (2), pp. 432-441. , 10.1097/00003081-200306000-00022College Of Obstetricians, A., Gynecologists, ACOG Committee Opinion. Exercise during pregnancy and the postpartum period. Number 267, January 2002 (2002) Int J Gynecol Obstet, 77, pp. 79-81. , 10.1016/S0020-7292(02)80004-2Kramer, M.S., McDonald, S.W., Aerobic exercise for women during pregnancy (2006) Cochrane Database Syst Rev, 3, p. 000180. , 16855953Prevedel, T.T.S., Calderon, I.M.P., Deconti, M.H., Consonni, E.B., Rudge, M.V.C., [Maternal and perinatal outcomes from hydrotherapy during pregnancy] (2003) Rev Bras Ginecol Obstet, 25 (1), pp. 53-59. , 10.1590/S0100-72032003000100008Sibley, L., Ruhling, R.O., Cameron-Foster, J., Christensen, C., Bolen, T., Swimming and physical fitness during pregnancy (1981) J Nurse Midwif, 26, pp. 3-12. , 10.1016/0091-2182(81)90169-5Barakat, R., Stirling, J.R., Lucia, A., Does exercise training during pregnancy affect gestational age? a randomized controlled trial (2008) Br J Sports Med, 42, pp. 674-678. , 10.1136/bjsm.2008.047837. 18552370Bruce, R.A., Methods of exercise testing: Step test, bicycle, treadmill, isometrics (1977) Exercise in Cardiovascular Health and Disease, pp. 149-160. , New York, NY: York Medical Books Amsterdam EA, Wilmore JH, DeMaria ANBristol, D.R., Sample sizes for constructing confidence intervals and testing hypotheses (1989) Stat Med, 8, pp. 803-811. , 10.1002/sim.4780080705. 2772440Friendly, M., (1995) From SAS System for Statistical Graphics, , Copyright (c) by SAS Institute Inc., Cary, NC, USA - version 1.2 FirstWolfe, L.A., Heenan, A.P., Bonen, A., Aerobic conditioning effects on substrate responses during graded cycling in pregnancy (2003) Can J Physiol Pharmacol, 81, pp. 696-703. , 10.1139/y03-059. 12897817Santos, I.A., Stein, R., Fuchs, S.C., Duncan, B.B., Ribeiro, J.P., Kroeff, L.R., Carballo, M.T., Schmidt, M.I., Aerobic exercise and submaximal functional capacity in overweight pregnant women: A randomized trial (2005) Obstet Gynecol, 106 (2), pp. 243-249. , 16055571Avery, N.D., Wolfe, L.A., Amara, C.E., Davies, G.A., McGrath, M.J., Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold (2001) J Appl Physiol, 90, pp. 321-328. , 11133925Wolfe, L.A., Davies, G.A., Canadian Guidelines for exercise in pregnancy (2003) Clin Obstet Gynecol, 46 (2), pp. 488-495. , 10.1097/00003081-200306000-00027. 12808398Hermida, R.C., Ayala, D.E., Mojón, A., Fernandez, J.R., Alonso, I., Silva, I., Ucieda, R., Iglesias, M., Blood pressure patterns in normal pregnancy, gestational hypertension, and preeclampsia (2000) Hypertension, 36, pp. 149-158. , 10948070Lotgering, F.K., Van Doorn, M.B., Struijk, P.C., Pool, J., Wallenburg, H.C., Maximal aerobic exercise in pregnant women: Heart rate, O2 consumption, CO2 production, and ventilation (1991) J Appl Physiol, 70 (3), pp. 1016-1023. , 1903379O'Toole, M., Physiologic aspects of exercise in pregnancy (2003) Clin Obstet Gynecol, 46 (2), pp. 379-389. , 10.1097/00003081-200306000-00017. 12808388Veille, J.C., Hellerstein, H.K., Cherry, B., Bacevice Jr., A.E., Maternal left ventricular performance during bicycle exercise (1994) Am J Cardiol, 73, pp. 609-610. , 10.1016/0002-9149(94)90345-X. 8147311Rowell, L.B., Human cardiovascular adjustments to exercise and thermal stress (1974) Physiol Rev, 54 (1), pp. 75-159. , 4587247Van Doorn, M.B., Lotgering, F.K., Struijk, P.C., Pool, J., Wallenburg, H.C., Maternal and fetal cardiovascular responses to strenuous bicycle exercise (1992) Am J Obstet Gynecol, 166 (3), pp. 854-859. , 1550154Veille, J.C., Hohimer, A.R., Burry, R.N., Speroff, L., The effect of exercise on uterine activity in the last eight weeks of pregnancy (1985) Am J Obstet Gynecol, 151 (6), pp. 727-730. , 3976780Carpenter, M.W., Sady, S.P., Hoegsberg, B., Sady, M.A., Haydon, B., Cullinane, E.M., Coustan, D.R., Thompson, P.D., Fetal heart rate response to maternal exertion (1988) JAMA, 259 (20), pp. 3006-3009. , 10.1001/jama.259.20.3006. 3285041Soultanakis-Aligianni, H.N., Thermoregulation during exercise in pregnancy (2003) Clin Obstet Gynecol, 46 (2), pp. 442-455. , 10.1097/00003081-200306000-00023. 12808394Larsson, L., Lindqvist, P.G., Low-impact exercise during pregnancy - A study of safety (2005) Acta Obstet Gynecol Scand, 84, pp. 34-38. , 10.1111/j.0001-6349.2005.00696.x. 15603564Lindqvist, P.G., Marsal, K., Merlo, J., Pirhonen, J.P., Thermal response to submaximal exercise before, during and after pregnancy: A longitudinal study (2003) J Matern Fetal Neonatal Med, 13 (3), pp. 152-6. , 10.1080/713605828. 12820836Duncombe, D., Wertheim, E.H., Skouteris, H., Paxton, S.J., Kelly, L., Factors related to exercise over the course of pregnancy including women's beliefs about the safety of exercise during pregnancy Midwifery, , 18063253Clapp III, J.F., The course of labor after endurance exercise during pregnancy (1990) Am J Obstet Gynecol, 163 (6), pp. 1799-1804. , 2256485Ver Dye, T., Fernandez, I.D., Rains, A., Fershteyn, Z., Recent Studies in the epidemiologic assessment of physical activity, fetal growth, and preterm delivery: A narrative review (2003) Clin Obstet Gynecol, 46 (2), pp. 415-422. , 10.1097/00003081-200306000-00020. 12808391Bell, R.J., Palma, S.M., Lumley, J.M., The effect of vigorous exercise during pregnancy on birth-weight (1995) Aust NZ J Obstet Gynaecol, 35 (1), pp. 46-51. , 10.1111/j.1479-828X.1995.tb01829.xMisra, D.P., Strobino, D.M., Stashinko, E.E., Nagey, D.A., Nanda, J., Effects of physical activity on preterm birth (1998) Am J Epidemiol, 147 (7), pp. 628-635. , 9554601Clapp III, J.F., Kim, H., Burciu, B., Lopez, B., Beginning regular exercise in early pregnancy: Effect on fetoplacental growth (2000) Am J Obstet Gynecol, 183 (6), pp. 1484-1488. , 10.1067/mob.2000.107096. 11120515Campbell, M.K., Mottola, M.F., Recreational exercise and occupational activity during pregnancy and birth weight: A case-control study (2001) Am J Obstet Gynecol, 184, pp. 404-408. , 10.1067/mob.2001.10939

Obstetrician's risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia: a qualitative study in Brazil

Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been iden-tified in the use of MgSO4, especially in low and middle-income settings. Objective To describe the obstetrician's perception on possible reasons for underutilizing magnesium sulfate to treat preeclampsia/eclampsia. Method A qualitative clinical study, based on phenomenological reference by semi-structured inter-views and open-ended discussions with obstetricians of the public healthcare system in pri-mary care units (PCU) and referral maternity hospitals (RMH), in a southeastern Brazilian city. Results Fear of drug toxicity was the major cause for not prescribing the medication in PCU. Fear was justified by insufficient technical, structural and organizational resources of healthcare facilities and by a shortage of physicians properly trained for adequate drug use. Conclusion Fear of toxicity of magnesium sulfate was the main barrier towards timely and proper drug use. Periodic skill development and training of obstetricians, along with integration of the medical team in the work environment may contribute to decrease fear, ensuring safety of drug prescription and thus possibly reducing adverse outcomes related to PE.Introduction Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been iden-tified in the use of MgSO4, especially in low and middle-income set123sem informaçãosem informaçã

Twin pregnancy in brazil: a profile analysis exploring population information from the national birth e-registry on live births

sem informaçãoBirth records as SINASC (Brazilian Live Birth Information System) are highlighted in uncommon conditions such as twin pregnancy whose prevalence rarely exceeds 2 to 3% of the total number of births. The objective of this study was to assess the prevalence110sem informaçãosem informaçãosem informaçã

Neonatal Near Miss Approach In The 2005 Who Global Survey Brazil

Objectives: To explore the use of the neonatal near miss concept as a tool to evaluate the quality of neonatal care, as 3 million early neonatal deaths occur every year around the world and the majority of these deaths are avoidable and take place in developing countries. Methods: This is a secondary analysis of the 2005 WHO Global Survey on Maternal and Perinatal Health, a cross-sectional study, using data from 19 randomly selected Brazilian hospitals. A pragmatic definition of neonatal near miss was developed and tested. Near miss indicators were calculated. Results: Among the 15,169 live born infants included in this analysis, 424 presented at least one of the following conditions: very low birth weight, less than 30 gestational weeks at birth or an Apgar score at the 5th minute of life less than 7. According to the operational definition, these survivors from life-threatening conditions were considered neonatal near miss cases. The early neonatal mortality rate was 8.2/1,000 live births, the neonatal near miss rate was 21.4 neonatal near miss cases/1,000 live births. Substantial variations in the mortality among neonates with life-threatening conditions at birth were observed suggesting intra-hospital quality of care issues. Conclusion: The near miss concept and indicators provided information that could be useful to evaluate the quality of care and set priorities for further assessments and health care improvement for newborn infants. Copyright © 2010 by Sociedade Brasileira de Pediatria.8612126(2004) State of the world's children 2005, , UNICEF, New York: UNICEFLawn, J.E., Cousens, S., Zupan, J., Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? (2005) Lancet, 365, pp. 891-900Brazil, (2008) Estimates of mortality, , http://tabnet.datasus.gov.br/cgi/idb2007/matriz.htm#mort.Access:20/02/2009, Brazil:, websiteAraújo, B.F., Bozzetti, M.C., Tanaka, A.C., Early neonatal mortality in Caxias do Sul: A cohort study (2000) J Pediatr (Rio J), 76, pp. 200-206Sarquis, A.L., Miyaki, M., Cat, M.N., The use of CRIB score for predicting neonatal mortality risk (2002) J Pediatr (Rio J), 78, pp. 225-229Sarinho, S.W., Filho, D.A., Silva, G.A., Lima, M.C., Risk factors for neonatal death in Recife: A case-control study (2001) J Pediatr (Rio J), 77, pp. 294-298Castro, E.C., Leite, A.J., Hospital mortality rates of infants with birth weight less than or equal to 1,500 g in the northeast of Brazil (2007) J Pediatr (Rio J), 83, pp. 27-32Say, L., Pattinson, R.C., Gülmezoglu, A.M., WHO systematic review of maternal morbidity and mortality: The prevalence of severe acute maternal morbidity (near miss) (2004) Reprod Health, 1, p. 3Pattinson, R.C., Hall, M., Near misses: A useful adjunct to maternal death enquiries (2003) Br Med Bull, 67, pp. 231-243Say, L., Souza, J.P., Pattinson, R.C., WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss: Towards a standard tool for monitoring quality of maternal health care (2009) Best Pract Res Clin Obstet Gynaecol, 23, pp. 287-296Skinner, J.R., Chung, S.K., Montgomery, D., McCulley, C.H., Crawford, J., French, J., Near-miss SIDS due to Brugada syndrome (2005) Arch Dis Child, 90, pp. 528-529Avenant, T., Neonatal near miss: A measure of the quality of obstetric care (2009) Best Pract Res Clin Obstet Gynaecol, 23, pp. 369-374Villar, J., Valladares, E., Wojdyla, D., Zavaleta, N., Carroli, G., Velazco, A., WHO 2005 global survey on maternal and perinatal health research group. Caesarean delivery rates and pregnancy outcomes: The 2005 WHO global survey on maternal and perinatal health in Latin America (2006) Lancet, 367, pp. 1819-1829Shah, A., Faundes, A., Machoki, M., Bataglia, V., Amokrane, F., Donner, A., Methodological considerations in implementing the WHO Global Survey for Monitoring Maternal and Perinatal Health (2008) Bull World Health Organ, 86, pp. 126-131JP Souza, Cecatti JG, Faundes A, Morais SS, Villar J, Carroli G, et al. WHO 2005 global survey on maternal and perinatal health research group. Maternal near miss and maternal death in the 2005 WHO global survey on maternal and perinatal health. Bull WHO, 2009. [website] http://www.who.int/bulletin/88/2/08-057828.pdf. Access: 19/08/2009Parry, G., Tucker, J., Tarnow-Mordi, W., The CRIB (Clinical Risk Index for Babies) Score: A tool for assessing initial neonatal risk and comparing performance of neonatal intensive-care units (1993) Lancet, 342, pp. 193-19

Declared Maternal Death And The Linkage Between Health Information Systems

Objective: To describe the characteristics of maternal mortality according to the Mortality Information System in relation to the data corresponding to these records that are in other systems. Methods: This was a descriptive study using two information systems on vital data and another on the hospital system, for the 26 state capitals and the Federal District of Brazil, in 2002. Initially, the maternal mortality ratios were calculated and information on declared maternal deaths were obtained. From these data, the Mortality Information System was probabilistically linked with the Live Birth Information System and the Hospital Information System, using the "Reclink II" software, with a multiple-step blocking strategy. For paired records, the diagnoses and hospital procedures brought together by the best-known criteria for severe maternal morbidity were detailed. Results: A total of 339 maternal deaths were recorded in 2002. The official and adjusted maternal mortality ratios were, respectively, 46.4 and 64.9 (deaths per 100,000 live births). By correlating with data from the live birth system, 46.5% of the maternal deaths could be located; and from the hospital information, 55.2%. The most frequent admission diagnosis was infection (13.9%) and the most frequent procedure was intensive care unit admission (39.0%). Conclusions: There were low percentage linkages between the records from the three sources studied. However, the possible failures and/or impossibilities in the linkages indicated may separately or jointly explain these low percentages.412181189AbouZahr, C., Wardlaw, T., (2003) Maternal mortality in 2000: Estimates developed by WHO, , Unicef and UNFPA. Geneva: WHO;Camargo Jr, K.R., Coeli, C.M., Reclink: Aplicativo para o relacionamento de bases de dados, implementando o método probabilistic record linkage (2000) Cad Saúde Pública, 16 (2), pp. 439-447Cecatti, J.G., Faúndes, A., Surita, F.C.C., Maternal mortality in Campinas: Evolution, under-registration and avoidance (1999) São Paulo Med J, 117 (1), pp. 5-12Coeli, C.M., Camargo Jr, K.R., Avaliação de diferentes estratégias de blocagem no relacionamento probabilístico de registros (2002) Rev Bras Epidemiol, 5 (2), pp. 185-196Coeli, C.M., Costa, M.C.E., Almeida, L.M., Probabilistic linkage in household survey on hospital care usage (2003) Rev Saúde Pública, 37 (1), pp. 91-99Fleiss, J.L., (1981) Statistical methods for rates and proportions, , 2nd ed. New York: John Wiley and Sons;Jaro, M.A., Advances in record-linkage methodology as applied to matching the 1985 Census of Tampa, Florida (1989) J Am Stat Assoc, 84, pp. 414-420Laurenti, R., Mello-Jorge, M.H.P., Gotlieb, S.L.D., Reflexões sobre a mensuração da mortalidade materna (2000) Cad Saúde Pública, 16 (1), pp. 23-30Laurenti, R., Mello-Jorge, M.H.P., Gotlieb, S.L.D., A mortalidade materna nas capitais brasileiras: Algumas características e estimativa de um fator de ajuste (2004) Rev Bras Epidemiol, 7 (4), pp. 449-460Machado, C.J., Hill, K., Probabilistic record linkage and an automated procedure to minimize the undecided-matched pair problem (2004) Cad Saúde Pública, 20 (4), pp. 915-925Mantel, G.D., Buchmann, E., Rees, H., Pattinson, R.C., Severe acute maternal morbidity: A pilot study of a definition for a near-miss (1998) Br J Obstet Gynaecol, 105 (9), pp. 985-990Royston, E., AbouZahr, C., Measuring maternal mortality (1992) Br J Obstet Gynaecol, 99, pp. 540-542Sousa, M.H., Cecatti, J.G., Hardy, H.E., Amaral, E., Souza, J.P.D., Serruya, S., Sistemas de informação em saúde e o monitoramento de morbidade materna grave e mortalidade materna (2006) Rev Bras Saúde Matern Infant, 6 (2), pp. 161-168Souza, J.P.D., Cecatti, J.G., Parpinelli, M.A., Sousa, M.H., Serruya, S., Revisão sistemática sobre morbidade materna near miss (2006) Cad Saúde Pública, 22 (2), pp. 255-264Theme Filha, M.M., Silva, R.I., Noronha, C.P., Mortalidade materna no município do Rio de Janeiro, 1993-1996 (1999) Cad Saúde Pública, 15 (2), pp. 397-403Waterstone, M., Bewley, S., Wolfe, C., Incidence and predictors of severe obstetric morbidity: Case-control study (2001) BMJ, 322 (7294), pp. 1089-1093(1999) Reduction of maternal mortality: A joint WHO/UNFPA/Unicef World Bank Statement, , World Health Organization, Geneva;(2004) Beyond the numbers: Reviewing maternal deaths and complications to make pregnancy safer, , World Health Organization, Geneva

Computer-assisted Telephone Interviewing (cati): Using The Telephone For Obtaining Information On Reproductive Health [computer-assisted Telephone Interviewing (cati): Usando Telefone Para A Obtenção De Informações Sobre Saúde Reprodutiva]

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer-assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ2 test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. 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Validação Da Versão De 36 Itens Do Who Disability Assessment Schedule 2.0 (whodas 2.0) Para A Avaliação De Incapacidade E Funcionalidade Da Mulher Associada à Morbidade Materna

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)To validate the translation and adaptation to Brazilian Portuguese of 36 items from the World Health Organizaton Disability Assessment Schedule 2.0 (WHODAS 2.0), regarding their content and structure (construct), in a female population after pregnancy. Methods This is a validation of an instrument for the evaluation of disability and functioning and an assessment of its psychometric properties, performed in a tertiary maternity and a referral center specialized in high-risk pregnancies in Brazil. A sample of 638 women in different postpartum periods who had either a normal or a complicated pregnancy was included. The structure was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), while the content and relationships among the domains were assessed through Pearson’s correlation coefficient. The sociodemographic characteristics were identified, and the mean scores with their standard deviations for the 36 questions of the WHODAS 2.0 were calculated. The internal consistency was evaluated byCronbach’s α. Results Cronbach’s α was higher than 0.79 for both sets of questons of the questionnaire. The EFA and CFA for the main 32 questions exhibited a total variance of 54.7% (Kaiser-Meyer-Olkin [KMO] measure of sampling adequacy = 0.934; p < 0.001) and 53.47% (KMO = 0.934; p < 0.001) respectively. There was a significant correlation among the 6 domains (r = 0.571–0.876), and a moderate correlation among all domains (r = 0.476–0.694). Conclusion The version of the WHODAS 2.0 instrument adapted to Brazilian Portuguese showed good psychometric properties in this sample, and therefore could be applied to populations of women regarding their reproductive history. © 2017 by Thieme-Revinter Publicações Ltda, Rio de Janeiro, Brazil.3924452471142/2011-5, CNPq, Conselho Nacional de Desenvolvimento Científico e TecnológicoConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq