A Colaboração Cochrane e a Organização Mundial da Saúde: novas perspectivas para uma antiga relação

Escola Paulista de Medicina Universidade Federal de São Paulo (UNIFESP) Centro Cochrane do BrasilUNIFESP, EPM, EPM, Centro Cochrane do BrasilSciEL

Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

OBJECTIVES: To assess the quality of systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based health journal. METHOD: All systematic reviews and clinical trials on women's health published in the last five years in the Brazilian Journal of Evidence-based Health were retrieved. Two independent reviewers critically assessed the methodological quality of reviews and trials using AMSTAR and the Cochrane Risk of Bias Table, respectively. RESULTS: Systematic reviews and clinical trials accounted for less than 10% of the 61 original studies on women's health published in the São Paulo Medical Journal over the last five years. All five reviews were considered to be of moderate quality; the worst domains were publication bias and the appropriate use of study quality in formulating conclusions. All three clinical trials were judged to have a high risk of bias. The participant blinding, personnel and outcome assessors and allocation concealment domains had the worst scores. CONCLUSIONS: Most of the systematic reviews and clinical trials on women's health recently published in a Brazilian evidence-based journal are of low to moderate quality. The quality of these types of studies needs improvement

Born in Brazil: shining a light for change

The Birth in Brazil study is the largest national hospital-based survey in Brazil regarding birth practices. Conducted in 2011-2012, it collected information from 266 public and private healthcare facilities and interviewed nearly 24,000 postpartum women. It is also the latest effort to map out how labor and delivery are managed in this county in the 21st century. The journal Reproductive Health has published a supplement including 10 articles presenting the results of a series of analyses using this valuable resource.These articles describe a range of practices, determinants and risk factors that affect women and their babies in Brazil, a country of paradoxes. In the era of overmedicalization and high-tech medicine - arguably -, these articles highlight the unprecedented rates of cesarean sections in Brazil and differences between the public and the private sectors. It provides evidence for the need for adequate human resources, medications and emergency care equipment in many settings; and explains the use of non-evidence based interventions during labor and delivery. On the other hand, these studies also point to promising interventions that could be used to change this situation not only in Brazil but also in other countries facing similar challenges.Fil: Torloni, Maria Regina. Universidade Federal de Sao Paulo; BrasilFil: Betrán, Ana Pilar. Organizacion Mundial de la Salud; ArgentinaFil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Obesity and pregnancy

Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de ObstetríciaFaculdade de Medicina do ABCOrganização Mundial da Saúde Departamento de Saúde Reprodutiva e Pesquisa Unidade de Saúde Materna e PerinatalUNIFESP, Depto. de ObstetríciaSciEL

Centro Cochrane do Brasil: 15º aniversário

Universidade Federal de São Paulo (UNIFESP) Program on Internal Medicine and TherapeuticsBrazilian Cochrane CenterDivision of Emergency and Evidence-Based MedicineUNIFESP, Program on Internal Medicine and TherapeuticsSciEL

What do popular Spanish women's magazines say about caesarean section? A 21-year survey

ObjectivesCaesarean section (CS) rates are increasing worldwide and maternal request is cited as one of the main reasons for this trend. Women's preferences for route of delivery are influenced by popular media, including magazines. We assessed the information on CS presented in Spanish women's magazines.DesignSystematic review.SettingWomen's magazines printed from 1989 to 2009 with the largest national distribution.SampleArticles with any information on CS.MethodsArticles were selected, read and abstracted in duplicate. Sources of information, scientific accuracy, comprehensiveness and women's testimonials were objectively extracted using a content analysis form designed for this study.Main outcome measuresAccuracy, comprehensiveness and sources of information.ResultsMost (67%) of the 1223 selected articles presented exclusively personal opinion/birth stories, 12% reported the potential benefits of CS, 26% mentioned the short-term and 10% mentioned the long-term maternal risks, and 6% highlighted the perinatal risks of CS. the most frequent short-term risks were the increased time for maternal recovery (n=86), frustration/feelings of failure (n=83) and increased post-surgical pain (n=71). the most frequently cited long-term risks were uterine rupture (n=57) and the need for another CS in any subsequent pregnancy (n=42). Less than 5% of the selected articles reported that CS could increase the risks of infection (n=53), haemorrhage (n=31) or placenta praevia/accreta in future pregnancies (n=6). the sources of information were not reported by 68% of the articles.ConclusionsThe portrayal of CS in Spanish women's magazines is not sufficiently comprehensive and does not provide adequate important information to help the readership to understand the real benefits and risks of this route of delivery.Department of Reproductive Health of the World Health OrganizationBrazilian Cochrane Ctr, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilFederac Mujeres Jovenes, Madrid, SpainWHO, Dept Reprod Hlth & Res, CH-1211 Geneva, SwitzerlandUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilWeb of Scienc

WHO Statement on Caesarean Section Rates

World Health OrganizationWHO, UNDP, UNFPA,World Bank Special Programme Res, UNICEF,Dev & Res Training Human Reprod,Dept Repro, CH-1211 Geneva, SwitzerlandUniv Fed Sao Paulo, Sao Paulo Sch Med, Brazilian Cochrane Ctr, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Sch Med, Dept Obstet, Sao Paulo, BrazilShanghai Jiao Tong Univ, Sch Med, Shanghai Key Lab Childrens Environm Hlth, Minist Educ,Xinhua Hosp, Shanghai 200030, Peoples R ChinaUniv Fed Sao Paulo, Sao Paulo Sch Med, Brazilian Cochrane Ctr, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Sch Med, Dept Obstet, Sao Paulo, BrazilWHO: 001Web of Scienc

WHO Statement on Caesarean Section Rates

World Health OrganizationWHO, UNDP, UNFPA,World Bank Special Programme Res, UNICEF,Dev & Res Training Human Reprod,Dept Repro, CH-1211 Geneva, SwitzerlandUniv Fed Sao Paulo, Sao Paulo Sch Med, Brazilian Cochrane Ctr, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Sch Med, Dept Obstet, Sao Paulo, BrazilShanghai Jiao Tong Univ, Sch Med, Shanghai Key Lab Childrens Environm Hlth, Minist Educ,Xinhua Hosp, Shanghai 200030, Peoples R ChinaUniv Fed Sao Paulo, Sao Paulo Sch Med, Brazilian Cochrane Ctr, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo Sch Med, Dept Obstet, Sao Paulo, BrazilWHO: 001Web of Scienc