Gravidez não planejada no Brasil: estudo nacional em oito hospitais universitários

OBJECTIVE: To estimate the prevalence of unplanned pregnancy in eight public university hospitals, distributed in the five regions that make up Brazil. METHODS: A secondary analysis of a national multicenter cross-sectional study, carried out in eight public university hospitals between June 1 and August 31, 2020, in Brazil. Convenience sample including women who gave birth within sixty consecutive days and met the following criteria: over 18 years old; gestational age over 36 weeks at delivery; with a single and live newborn, without malformations. RESULTS: Sample composed of 1,120 postpartum women, of whom 756 (67.5%) declared that the pregnancy had not been planned. The median prevalence of unplanned pregnancy was 59.7%. The prevalence of unplanned pregnancy across hospitals differed significantly: Campinas (54.8%), Porto Alegre (58.2%), Florianópolis (59%), Teresina (61.2%), Brasília (64.3%), São Paulo (64.6%), Campo Grande (73.9%) and Manaus (95.3%) (p < 0.001). Factors significantly associated with unplanned pregnancy were maternal age, black color, lower family income, greater number of children, greater number of people living in household, and not having a partner. CONCLUSION: In the studied sample, about two thirds of the pregnancies were declared as unplanned. The prevalence of unplanned pregnancies was related to social and demographic factors and varied significantly across the university hospitals evaluated.OBJETIVO: Estimar a prevalência de gestação não planejada (GNP) em oito hospitais públicos universitários, distribuídos nas cinco regiões que compõem o Brasil. MÉTODOS: Análise secundária de um estudo transversal multicêntrico nacional, realizado em oito hospitais universitários públicos, entre 1º de junho e 31 de agosto de 2020, no Brasil. Amostra por conveniência incluindo mulheres que deram à luz em período de sessenta dias consecutivos e atenderam aos seguintes critérios: maiores de 18 anos; idade gestacional acima de 36 semanas no parto; com recém-nascido único e vivo, sem malformações. RESULTADOS: Amostra composta por 1.120 puérperas, das quais 756 (67,5%) declararam que a gravidez não tinha sido programada. A mediana da prevalência de GNP foi de 59,7%. Observou-se diferença significativa na prevalência de GNP entre os hospitais: Campinas (54,8%), Porto Alegre (58,2%), Florianópolis (59%), Teresina (61,2%), Brasília (64,3%), São Paulo (64,6%), Campo Grande (73,9%) e Manaus (95,3%) (p < 0,001). Foram fatores significativamente associados a GNP a idade materna, cor negra, menor renda familiar, maior número de filhos, maior número de pessoas convivendo em casa e não ter parceiro. CONCLUSÃO: na amostra estudada, cerca de dois terços das gestações foram declaradas como não programadas. A prevalência de gestação não planejada teve relação com fatores sociais e demográficos e variou significativamente entre os hospitais universitários avaliados

Aumento do risco de ansiedade materna durante o surto de covid-19 no Brasil entre gestantes sem comorbidades

Objective: To studymaternal anxiety in pregnant womenwithout comorbidities in the context of the COVID-19 outbreak in Brazil and to study maternal knowledge and concerns about the pandemic. Methods: This is a secondary analysis from a national multicenter cross-sectional study performed in 10 cities, from June to August, 2020, in Brazil. Interviewed postpartum women, without medical or obstetrical comorbidities, were included in the present subanalysis. A structured questionnaire and the Beck Anxiety Inventory (BAI) were applied. Results: Out of the 1,662 women, 763 (45.9%)met the criteria for the current analysis and 16.1% presentedwithmoderate and 11.5% with severe maternal anxiety. Moderate or severe maternal anxiety was associated with high school education (odds ratio [OR]:1.58; 95% confidence interval [CI]:1.04–2.40). The protective factor was cohabiting with a partner (OR: 0.46; 95%CI: 0.29–0.73). There was a positive correlation between the total BAI score and receiving information about care in the pandemic (rpartial 0.15; p<0.001); concern about vertical transmission of COVID-19 (rpartial 0.10; p=0.01); receiving information about breastfeeding (rpartial 0.08; p¼0.03); concerns about prenatal care (rpartial 0.10; p¼0.01), and concerns about the baby contracting COVID-19 (rpartial 0.11; p=0.004). The correlation was negative in the following aspects: self-confidence in protecting from COVID-19 (rpartial 0.08; p¼0.04), having learned (rpartial 0.09; p=0.01) and self-confidence in breastfeeding (rpartial 0.22; p<0.001) in the context of the pandemic. Conclusion: The anxiety of pregnant women without medical or obstetrical comorbidities was associated to high school educational level and not living with a partner during the COVID-19 pandemic. Self-confidence in protecting against COVID-19 and knowledge about breastfeeding care during the pandemic reduced maternal anxiety.Objetivo: Estudar a ansiedade materna em gestantes sem comorbidades no contexto do surto de COVID-19 no Brasil e estudar o conhecimento e as preocupações maternas sobre a pandemia. Métodos: Trata-se de análise secundária de um estudo transversal multicêntrico nacional realizado em 10 cidades, de junho a agosto de 2020, no Brasil. Mulheres no pós-parto entrevistadas, semcomorbidadesmédicas ou obstétricas, foramincluídas nesta subanálise. Foram aplicados um questionário estruturado e o Inventário de Ansiedade de Beck (BAI, na sigla em inglês). Resultados: Das 1.662 mulheres, 763 (45,9%) atenderam aos critérios da análise atual e 16,1% apresentaram ansiedade materna moderada e 11,5% ansiedade materna grave. A ansiedade materna moderada ou grave foi associada à escolaridade no ensino médio (odds ratio [OR]: 1,58; intervalo de confiança [IC] 95%: 1,04–2,40). O fator protetor foi coabitar com companheiro (OR: 0,46; IC95%: 0,29–0,73). Houve correlação positiva entre a pontuação total do BAI e o recebimento de informações sobre cuidados na pandemia (rparcial 0,15; p<0,001); preocupação com a transmissão vertical de COVID-19 (rparcial 0,10; p=0,01); receber informações sobre amamentação (rparcial 0,08; p=0,03); preocupações sobre cuidados pré-natais (rparcial 0,10; p=0,01) e preocupações sobre o bebê contrair COVID-19 (rparcial 0,11; p=0,004). A correlação foi negativa com os seguintes aspectos: ter autoconfiança para se proteger (rparcial 0,08; p=0,04), aprender (rparcial 0,09; p=0,01) e ter autoconfiança para amamentar (rparcial 0,22; p<0,001) no contexto da pandemia. Conclusão: A ansiedade de gestantes sem comorbidades médicas ou obstétricas esteve associada à escolaridade no ensino médio e não morar com companheiro durante a pandemia de COVID-19. A autoconfiança na proteção contra COVID-19 e o conhecimento sobre os cuidados com a amamenta

Medical residency in gynecology and obstetrics in times of COVID-19 : recommendations of the National Specialized Commission on Medical Residency of FEBRASGO

* Text prepared by the members of the National Specialized Commission on Medical Residency and endorsed by the Scientific Board and Presidency of the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO)

Performance of Electron Reconstruction and Selection with the CMS Detector in Proton-Proton Collisions at s\sqrt{s} = 8 TeV

The performance and strategies used in electron reconstruction and selection at CMS are presented based on data corresponding to an integrated luminosity of 19.7 fb$^{-1}$, collected in proton-proton collisions at $\sqrt{s}$ = 8 TeV at the CERN LHC. The paper focuses on prompt isolated electrons with transverse momenta ranging from about 5 to a few 100 GeV. A detailed description is given of the algorithms used to cluster energy in the electromagnetic calorimeter and to reconstruct electron trajectories in the tracker. The electron momentum is estimated by combining the energy measurement in the calorimeter with the momentum measurement in the tracker. Benchmark selection criteria are presented, and their performances assessed using Z, $\Upsilon$, and $\mathrm{J}/\psi$ decays into $\mathrm{e}^+$ + $\mathrm{e}^-$ pairs. The spectra of the observables relevant to electron reconstruction and selection as well as their global efficiencies are well reproduced by Monte Carlo simulations. The momentum scale is calibrated with an uncertainty smaller than 0.3%. The momentum resolution for electrons produced in Z boson decays ranges from 1.7 to 4.5%, depending on electron pseudorapidity and energy loss through bremsstrahlung in the detector material

Search for the production of dark matter in association with top-quark pairs in the single-lepton final state in proton-proton collisions at s\sqrt s = 8 TeV

A search is presented for particle dark matter produced in association with a pair of top quarks in pp collisions at a centre-of-mass energy of sqrt(s) = 8 TeV. The data were collected with the CMS detector at the LHC and correspond to an integrated luminosity of 19.7 inverse femtobarns. This search requires the presence of one lepton, multiple jets, and large missing transverse energy. No excess of events is found above the SM expectation, and upper limits are derived on the production cross section. Interpreting the findings in the context of a scalar contact interaction between fermionic dark matter particles and top quarks, lower limits on the interaction scale are set. These limits are also interpreted in terms of the dark matter-nucleon scattering cross sections for the spin-independent scalar operator and they complement direct searches for dark matter particles in the low mass region