Number Of Prenatal Consultations Research Articles

ASPECTOS SOCIOECONÔMICOS E GESTACIONAIS RELACIONADOS A OCORRÊNCIA DE BAIXO PESO AO NASCER

The objective of this article is to estimate the prevalence and factors related to the risk of Low Birth Weight (LBW), and its impact on socioeconomically disadvantaged populations. A cross-sectional, analytical study was used, based on data available in the Information Technology Department of the Unified Health System (DATASUS), more specifically, in the Live Birth Information System (SINASC). For data analysis, the EPI-INFO 7.0 program was used, where bivariate analysis was used with the Chi-square test considering the Mantel-Haenszel method to identify which factors are associated with LBW. 49,481 live births were examined in the State of Mato Grosso, 8.78% of which were affected by LBW. In the bivariate analysis, LBW was mostly recorded in children of pregnant women who were in the risk age group, marital status in which they lived alone/separated, indigenous race or skin color, black or mixed race, and lived in a region with low HDI . Furthermore, there are other factors related to pregnancy that had a strong influence on LBW, including: number of prenatal consultations and type of pregnancy. Regarding the characteristics of newborns, LBW presented a majority in female babies and those born prematurely and/or with malformations or congenital anomalies. The results found in the present study justify the need to improve actions capable of serving the maternal and child population so that economic and demographic factors have less impact on the occurrence of LBW.

A decade of analysis describe of maternal and neonatal characteristics of live births in southern Brazil

Introduction: Child health is conditioned by the circumstances of pregnancy, childbirth, and early life. Objective: To describe the maternal and neonatal characteristics of live births (LBs) in the Information System on Live Births of Santa Catarina (SC), Brazil. Materials and methods: A cross-sectional study describedthe maternal and neonatal characteristics of 940,059 LBs, from 2010 to 2019. Pearson’s chi-square test and Fisher’s exact test were conducted, with a statistical significance level of p < 0.05. Results: The mean values of maternal age, number of live children, and number of fetal deaths as well as abortions were 27.1 years, 0.9, and 0.2, respectively. The averages of the number of gestation weeks, number of prenatal consultations, the start date of the prenatal care, and birth weight were 38.5 weeks, 8.1 months, 2.5 monthsand 3,217.1 grams, respectively. Low birth weight (LBW) was prevalent among mothers without education (p < 0.001), including those without prenatal visits (p < 0.001). A higher prevalence of being underweight was observed among female neonates (p < 0.001) and with a maternal age of ≥ 40 years (10.8%; p < 0.001) compared to newborns with good vitality. Newborns with good vitality had a low prevalence of underweight (p < 0.001). The frequency of the variables studied increased, comparing the beginning and end of the period and whether the differences are statistically significant. Conclusions: The study draws attention to the need for interventions to improve the indicators that determine LBW.

Aspectos clínicos dos recém-nascidos internados em unidade de terapia intensiva neonatal

Objective: To identify the clinical profile of newborns admitted to Neonatal Intensive Care Units. Methodology: This is an ecological observational study, with a quantitative approach, using data from newborns admitted to Neonatal Intensive Care Units in hospitals in the municipality of Cascavel in the western region of Paraná, Brazil. The following variables were studied: gender, color/race, type of delivery, gestational age, number of prenatal consultations, mother's age, mother's level of education, birth weight, congenital malformation, type of congenital malformation, Apgar score. Results: Based on the results of this study we can identify that the newborns, the majority were male, born by caesarean section, most of them considered adequate for gestational age (AIG), being less than 2,500grams, with apgar scores in the 1st and 5th minutes considered between normal and moderate. Discussion: Knowing the main hospitalization diagnoses and the main reasons for premature births, it is suggested that relationship studies be carried out to compare the variables studied, enhancing understanding of the findings, as well as studies of interventions carried out after identifying results similar to those of this study, in order to identify whether knowing the profile of those admitted to the Neonatal ICU, it is possible to intervene to prevent and avoid damage and sequelae. Conclusion: However, this research has provided insight into the population studied in terms of their growth and the practices carried out in the unit, bringing contributions to the service, enabling changes in the management of these babies and all those who contribute to their development.

Ambient temperature exposure during pregnancy and preterm birth in Brazil

Preterm birth is a global concern with significant adverse effects on neonatal health and long-term outcomes. Brazil, one of the countries with the highest prevalence of preterm birth, presents a unique context for studying this issue due to its diverse climatic conditions, regional disparities in healthcare, and socio-demographic factors. Although several studies have explored the association between ambient temperature and preterm birth, there remains a research gap in investigating this relationship within the Brazilian population. This study aimed to investigate the potential association between ambient temperature exposure during pregnancy and preterm birth in Brazil. We employed a two-stage case-control design. In the first stage, conditional logistic regression models were used to estimate the odds ratios (ORs) for preterm birth associated with ambient temperature exposure during specific trimesters of pregnancy across Brazilian regions. We adjusted the model for PM2.5 levels, mother's race, mother's education level, and number of prenatal consultations. Smoothing spline functions were applied to capture potential nonlinear relationships, while time-stratified sampling controlled for temporal trends. In the second stage, region-specific estimates were pooled using a mixed effects meta-analysis, accounting for intra- and inter-region variability. Our study population includes birth data in Brazil from 2001 to 2018, encompassing a total of 9,906,658 live birth records. Our findings suggest that that, at the national scale, each 1 °C increase in temperature during trimesters 1, 2, and 3 was associated with a higher risk of preterm birth (9.3%, 8.0%, and 8.4% increase in odds, respectively). Regional variations were observed, with the North (where the Amazon is located) and Midwest regions showing higher risks compared to others. These findings provide valuable insights into the relationship between ambient temperature and preterm birth within the Brazilian context, highlighting the importance of considering regional variations. Understanding these associations is critical for developing targeted interventions and policies aimed at reducing the burden of preterm birth.

Proportion and factors associated with Apgar less than 7 in the 5th minute of life: from 1999 to 2019, what has changed?

Although variation between observers in the assessment of the Apgar score, it remains a useful indicator of the general conditions of the newborn. This is a cross-sectional study based on population of live births in Brazil in 1999 and biennium 2018-2019. All declarations of live births (DNV) obtained from the Live Births System database were accessed. Frequencies were compared between groups using Pearson's chi-square test and multivariate logistic regression analysis was performed. A statistical significance level of 0.05 was considered. We included 9.050.521 DNVs in our research. We found that 2,1% of newborns had 5th minute Apgar < 7 in 1999 compared with 0,9% in 2018-2019. Multivariate analysis shows that twins and teenage pregnancy are no longer risk factors. Among risk factors, we observed an increase in prematurity, low birth weight and congenital anomalies. An improvement in maternal markers was observed, especially increase in the number of prenatal consultations and schooling. Such findings demonstrate the importance access and adequate prenatal care and improved socioeconomic conditions as effective strategy to reduce neonatal morbidity and mortality.

Effect of Ultra-Processed Foods Consumption and Some Lifestyle Factors during Pregnancy on Baby’s Anthropometric Measurements at Birth

This study aimed to assess the association between ultra-processed foods (UPF) consumption and some lifestyle factors during pregnancy and the baby's anthropometric measurements at birth. Cross-sectional study conducted with immediate postpartum women and their babies. Food consumption during pregnancy was assessed retrospectively by a semi-quantitative food frequency questionnaire, and the baby's anthropometric measurements were obtained from the medical records. The percentual of energy from UPF was estimated, categorized in tertiles, and associated with the baby's anthropometric measurements using multinomial logistic regression, adjusting by maternal characteristics (per capita income, maternal age, gestational weight gain, parity, physical activity, and number of prenatal consultations). A total of 626 immediate postpartum women and their babies were evaluated. The mean percentual of energy from UPF consumption during pregnancy was 30.56%. Before adjustment, there was a greater chance of insufficient birth weight among babies of immediate postpartum women in the highest tertile of UPF consumption (OR 1.72; 95% CI 1.09-2.70; p = 0.020); however, such an association was not significant in the adjusted analyses. No association between UPF consumption during pregnancy and baby's anthropometric measurements at birth was observed, probably due to the multifactorial nature of anthropometry and the interference of sociodemographic, gestational, and environmental factors in the baby's health outcomes.

The prevalence of exclusive breastfeeding and its associated factors in Cape Verde

BackgroundExclusive breastfeeding (EBF) for the first 6 months of life is essential for maternal and child health. Breast milk is considered the most suitable food for the child in early years of life. Studies carried out in Cape Verde (INE; MSSS, Apresentação dos Principais Resultados Preliminares do IDSR-III, 2018) showed prevalence of EBF below the values recommended by the (WHO & UNICEF, Global Breastfeeding Scorecard, 2018. Enabling Women To Breastfeed Through Better Policies And Programmes, 2019). However, the determinants of EBF across the country have never been identified. The objective of this study is to estimate prevalence and identify the determinants of EBF in Cape Verde.MethodsThis is a quantitative, descriptive and cross-sectional study carried out between July 2018 and March 2019. The study population consisted of 1717 mothers of children aged less than or equal to 2 years, users of the Health Centers of the islands of Santo Antão, S. Vicente, Sal, Santiago and Fogo. A structured questionnaire was applied to mothers through an interview.The prevalence of exclusive breastfeeding was estimated by frequency analysis. The chi-square test was used to assess the association between the duration of EB and the variables maternity leave, mother’s education, family income and health care variables. In order to identify the determinants of EBF, a binary logistic regression analysis was used.ResultsAt the time of data collection, 32.50% of mothers practiced EBF. The present study shows that exclusive breastfeeding is influenced by several factors. The most representatives are maternal age (OR = 0.001*), level of education (OR = 0.028*), parity (OR = 0.004*) and number of prenatal consultations (OR = 0.019*). Receiving breastfeeding counseling was the only health care variable that was associated with the duration of EBF (p = 0.029).ConclusionIn Cape Verde, the prevalence of EBF can be considered reasonable. The present study shows that EBF in the country is influenced by maternal age, level of education, parity and number of prenatal consultations.

Prevalence and maternal risk factors of congenital malformations in newborns from Sergipe, Northeastern Brazil

Introduction: Due to the importance of infant death caused by congenital malformations worldwide, more studies are necessary to determine the prevalence of these disorders serving as the basis for more effective control measures. Objective: To determine the prevalence and evaluate maternal risk factors for congenital malformations in newborns. Methods: A cross-sectional and retrospective study was performed in the reference maternity hospital for high-risk pregnancies in the state of Sergipe, northeastern Brazil. Data were collected from the medical records and declarations of live births of 16,518 births between January 2014 and December 2016, being included children with identified congenital malformations. Data were analyzed using the odds ratio, chi-square, and Fisher's exact test with p&lt;0.05. Results: The study population was composed of 369 newborns with congenital malformations, which corresponds to 2.23% of total births. 53.9% were male, 47.9% had low birth weight and, 52.5% had adequate Apgar score. Anomalies affecting the musculoskeletal system were the most prevalent (30.9%), with polydactyly being the most frequent (53.5%). The number of prenatal consultations, education, and gestational age were the main observed maternal risk factors of congenital malformations. Anomalies of the circulatory system (OR=3.2 CI95% 1.3-7.84), multiple malformations (OR=9.24 CI95% 3.07-27.83), and chromosomal syndromes (OR=2.72 CI95% 1.48-5.01) were the most commonly associated with newborn deaths. Conclusion: The study presents the prevalence and risk factors related to malformations in the state of Sergipe, and improvements on maternal care and socioeconomic variables are important to decrease the number of malformations cases in Brazil.

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys.

IntroductionIdentifying and understanding the factors associated with homebirths can contribute to improving maternal and child health and achieving the Sustainable Development Goals (SDGs). This study aimed to perform a comparative analysis of the factors associated with homebirths in Benin and Mali.MethodThis study is based on the most recent data from the Demographic Health Surveys conducted in Mali and Benin in 2018. The dependent variable was homebirth, and the explanatory variables were the individual characteristics of the woman, the distance to the health center, the place of residence, the number of prenatal consultations had, the frequency of media exposure, and the use of the Internet. The primary survey unit (PSU) was considered in the analysis to measure the effect of context on the choice of the place of delivery. Further, descriptive statistics and multilevel logistic regression analysis were used in the study.ResultsEducational level was associated with homebirth in Benin and Mali; Women with either no education or primary education are more likely to give birth at home. Women who didn't live close to a health facility were more likely to give birth at home than those who didn't face this problem in both countries. Not making visits for antenatal care (ANC) increases the odds of having a homebirth by 31.3 times (CI = 24.10–40.70) in Benin and 12.91 times (CI = 10.21–16.33) in Mali. Similarly, women who went on 1–2 ANC visits were more likely to give birth at home compared with women who made five or more ANC visits in both countries. The number of children per woman was also a significant factor in both countries. Women who often or regularly paid attention to the media messages were less likely to give birth at home compared with those who did not follow relevant media inputs (aOR = 0.42 [CI = 0.26–0.67] in Benin and aOR = 0.65 [CI = 0.50–0.85] in Mali).ConclusionIncreasing the demand and uptake of women's health services by improving the availability and quality of services and establishing community health centers could help reduce the incidence of homebirths that can be risky and, thus, combat maternal and infant mortality.

Clinical and epidemiological characterization of newborns with necrotizing enterocolitis

Introduction: Necrotizing enterocolitis (NEC) is a severe inflammatory disorder that can affect the whole gastrointestinal system, particularly the ileum, and is a major cause of morbidity in premature infants. Objective: To describe the clinical and epidemiological profile of newborns with NEC, seeking to identify the causes, evolution and severity of the disease. Methods: The study selected 94 patients who developed NEC (cases) and 60 patients who did not develop the disease during hospitalization (controls) and presented similar clinical signs of the case group. The variables analyzed divided into maternal and neonatal. The frequency tests were applied using the Statistical Package for the Social Sciences (SPSS) version 21.0 and comparative analysis using the GraphPad Prism® 5.0 software. Results: There was a higher number of prenatal consultations in cases with NEC. Newborns with NEC had shorter hospital stay, longer parenteral nutrition and antibiotics use and a predominant use of infant formula. The Bell criteria modified by Walsh and Kleigman was negatively correlated to maternal age and positively correlated to gestational age, birth weight and time of parenteral nutrition. Conclusion: Although being a disease of the newborn, the present study indicated that maternal characteristics may be related to its onset of NEC. Therefore, the greater number of prenatal consultations and neonatal factors such as length of stay, prolonged use of parenteral nutrition and antibiotic therapy, and formula use may influence the development of the disease.

Rede Cegonha: maternal characteristics and perinatal outcomes related to prenatal consultations at intermediate risk.

to analyze the correlation between maternal characteristics and perinatal outcomes, with the number of prenatal consultations performed. a cross-sectional study, carried out with 1,219 mothers and newborns stratified as intermediate risk according to the Programa Rede Mãe Paranaense, adaptation of the Rede Cegonha at the state level. Data were collected from the Birth Certificates. Spearman, Wilcoxon and Kruskal-Wallis tests were used to analyze the correlation between the variables of interest. married women, with higher education, white and aged 30 years or older were the ones who most attended prenatal consultations. With regard to perinatal outcomes, children whose mothers had more frequent prenatal consultations had better Apgar and birth weight scores. High rates of cesarean delivery were identified before the onset of labor. maternal characteristics influence the process of adherence to prenatal care, impacting perinatal outcomes, indicating the relevance of these risk factors and the need to improve actions aimed at greater compliance with risk stratification and qualified and resolute care for pregnant women at intermediate risk.

Down Syndrome in Brazil: Occurrence and Associated Factors.

Background: Down syndrome is the most frequent genetic cause of intellectual disability, with an estimated birth prevalence of 14 per 10,000 live births. In Brazil, statistical data on the occurrence of babies born with Down syndrome remain unclear. We aimed to estimate the occurrence of Down syndrome between 2012 and 2018, and to observe its association with maternal, gestational, paternal characteristics, and newborn vitality. Methods: A retrospective study was carried out using secondary data included in the Certificate of Live Birth in a state located in the southeastern region of Brazil. Data analysis was performed in the software Stata 14.1. Pearson’s chi-square test for bivariate analysis, and logistic regression for multivariate analysis were performed, with a 95% confidence interval (CI) and a significance of 5%. Results: We observed that 157 cases of Down syndrome were reported among 386,571 live births, representing an incidence of 4 in 10,000 live births. Down syndrome was associated with maternal age ≥ 35 years, paternal age ≥ 30 years, the performance of six or more prenatal consultations, prematurity, and low birth weight (p < 0.05). Conclusions: Women aged 35 and over were more likely to have children born with Down syndrome. In addition, there is an association of Down syndrome with premature birth, low birth weight, and the number of prenatal consultations (≥6).

Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership

BackgroundObstetric interventions performed during delivery do not reflect improvements in obstetric care. Several practices routinely performed during childbirth, without any scientific evidence or basis - such as Kristeller maneuver, routine episiotomy, and movement or feeding restriction - reflect a disrespectful assistance reality that, unfortunately, remains in place in Brazil. The aims of the current study are to assess the coexistence and prevalence of obstetric interventions in maternity hospitals in Belo Horizonte City, based on the Grade of Membership (GoM) method, as well as to investigate sociodemographic and obstetric factors associated with coexistence profiles generated by it.MethodsObservational study, based on a cross-sectional design, carried out with data deriving from the study “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento” (Born in Belo Horizonte: Survey on Childbirth and Birth). The herein investigated interventions comprised practices that are clearly useful and should be encouraged; practices that are clearly harmful or ineffective and should be eliminated; and practices that are inappropriately used, in contrast to the ones recommended by the World Health Organization. The analyzed interventions comprised: providing food to parturient women, allowing them to have freedom to move, use of partogram, adopting non-pharmacological methods for pain relief, enema, perineal shaving, lying patients down for delivery, Kristeller maneuver, amniotomy, oxytocin infusion, analgesia and episiotomy. The current study has used GoM to identify the coexistence of the adopted obstetric interventions. Variables such as age, schooling, skin color, primigravida, place-of–delivery financing, number of prenatal consultations, gestational age at delivery, presence of obstetric nurse at delivery time, paid work and presence of companion during delivery were taken into consideration at the time to build patients’ profile.ResultsResults have highlighted two antagonistic obstetric profiles, namely: profile 1 comprised parturient women who were offered diet, freedom to move, use of partogram, using non-pharmacological methods for pain relief, giving birth in lying position, patients who were not subjected to Kristeller maneuver, episiotomy or amniotomy, women did not receive oxytocin infusion, and analgesia using. Profile 2, in its turn, comprised parturient women who were not offered diet, who were not allowed to have freedom to move, as well as who did not use the partograph or who were subjected to non-pharmacological methods for pain relief. They were subjected to enema, perineal shaving, Kristeller maneuver, amniotomy and oxytocin infusion. In addition, they underwent analgesia and episiotomy. This outcome emphasizes the persistence of an obstetric care model that is not based on scientific evidence. Based on the analysis of factors that influenced the coexistence of obstetric interventions, the presence of obstetric nurses in the healthcare practice has reduced the likelihood of parturient women to belong to profile 2. In addition, childbirth events that took place in public institutions have reduced the likelihood of parturient women to belong to profile 2.Conclusion(s)Based on the analysis of factors that influenced the coexistence of obstetric interventions, financing the hospital for childbirth has increased the likelihood of parturient women to belong to profile 2. However, the likelihood of parturient women to belong to profile 2 has decreased when hospitals had an active obstetric nurse at the delivery room. The current study has contributed to discussions about obstetric interventions, as well as to improve childbirth assistance models. In addition, it has emphasized the need of developing strategies focused on adherence to, and implementation of, assistance models based on scientific evidence.

Data-driven risk stratification for preterm birth in Brazil: a population-based study to develop of a machine learning risk assessment approach

BackgroundPreterm birth (PTB) is a growing health issue worldwide, currently considered the leading cause of newborn deaths. To address this challenge, the present work aims to develop an algorithm capable of accurately predicting the week of delivery supporting the identification of a PTB in Brazil. MethodsThis a population-based study analyzing data from 3,876,666 mothers with live births distributed across the 3,929 Brazilian municipalities. Using indicators comprising delivery characteristics, primary care work processes, and physical infrastructure, and sociodemographic data we applied a machine learning-based approach to estimate the week of delivery at the point of care level. We tested six algorithms: eXtreme Gradient Boosting, Elastic Net, Quantile Ordinal Regression - LASSO, Linear Regression, Ridge Regression and Decision Tree. We used the root-mean-square error (RMSE) as a precision. FindingsAll models obtained RMSE indexes close to each other. The lower levels of RMSE were obtained using the eXtreme Gradient Boosting approach which was able to estimate the week of delivery within a 2.09 window 95%IC (2.090–2.097). The five most important variables to predict the week of delivery were: number of previous deliveries through Cesarean-Section, number of prenatal consultations, age of the mother, existence of ultrasound exam available in the care network, and proportion of primary care teams in the municipality registering the oral care consultation. InterpretationUsing simple data describing the prenatal care offered, as well as minimal characteristics of the pregnant, our approach was capable of achieving a relevant predictive performance regarding the week of delivery. FundingBill and Melinda Gates Foundation, and National Council for Scientific and Technological Development – Brazil, (Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPQ acronym in portuguese) Support of the research project named: Data-Driven Risk Stratification for Preterm Birth in Brazil: Development of a Machine Learning-Based Innovation for Health Care- Grant: OPP1202186

Prevalence and factors associated with low birth weight in full-term newborns

Objective: to estimate the prevalence and verify the factors associated with low birth weight in full-term newborns. Methods: this is a retrospective study conducted with 24,744 newborns. Data were retrieved from the Sistema de Informação sobre Nascidos Vivos (Information System on Live Births). For the analysis, multiple logistic regression was used using the hierarchical model with maternal, gestational, and care variables. Results: the prevalence of low birth weight was 2.4%, with 51.0% of cases in male newborns, 73.7% in women aged 20-34 years; 56.5% were multiparous and 95.0% had eight years of education or more. In the multiple analysis, the association of low weight with the number of prenatal consultations, newborn’s birth order, and sex were observed. Conclusion: the factors associated with low birth weight in full-term newborns were male sex, multiparity, and less than seven prenatal consultations.

Social and obstetric factors associated with the way of delivery: reality of a maternity school in the interior of the northeast

The study aims to identify the social and obstetric factors associated with the mode of delivery of postpartum women attending a public maternity hospital located in the interior of the state of Sergipe, in the northeast region. This is a cross-sectional study that included 1,149 postpartum women in the immediate period, carried out between November 2016 and December 2019, who underwent functional kinesiological assessment for physical therapy care. Descriptive analysis and binary logistic regression were performed using the mode of delivery as the dependent variable. The results showed that the prevalence of cesarean deliveries was of 49.24% (n=565). Most puerperal women were young, married, primiparous and with elementary education. Vaginal delivery was associated with postpartum women with married marital status (OR, 10.463; 95%CI, 2.367-46.254), multipregnancy (OR, 9.54; 95% CI, 7.19-12.65), multiparous (OR, 8.79; 95%CI, 6.66-11.62), with no pain (OR, 2.08; 95%CI, 1.63-2.65), no comorbidities (OR,1.69, 95%CI, 1.23-2.28), number of prenatal consultations from one to seven (OR, 1.534; 95%CI, 1.18-1.98), and without difficulty to breastfeed (OR, 1.373, 95%CI, 1.04-1.80). The cesarean delivery route was associated with abortion in primiparae (OR, 1.69; 95%CI, 1.192-2.415) and education at the elementary level. (OR, 2.99; 95%CI, 1.403-6.411). It is concluded that social factors (education level and marital status), obstetric factors (parity, number of pregnancies, comorbidities, obstetric care) and immediate puerperal complaints (pain and difficulty in breastfeeding) were associated with the modes of delivery.

SYPHILIS IN PREGNANCY, FACTORS ASSOCIATED WITH CONGENITAL SYPHILIS AND NEWBORN CONDITIONS AT BIRTH

ABSTRACT Objectives: to investigate factors associated with the occurrence of congenital syphilis in pregnant women with syphilis and to describe the cases of this disease regarding the justification for notification and aspects related to the newborn. Method: cohort study, with data collection between July and September 2017 which included 158 pregnant women diagnosed with syphilis during pregnancy, reported between 2013 and 2015. The characteristics of pregnant women and newborns are presented descriptively. The outcome under study was the occurrence or not of congenital syphilis. Sociodemographic exposure variables related to prenatal care and the adequacy of maternal syphilis treatment were analyzed by the stepwise selection criteria, and those that presented p&lt;0.20, included in adjusted analysis, when critical p &lt;0.05 was adopted. Results: most pregnant women with syphilis were white, had nine or more years of schooling and did not work. Among the participants, 74 (46.8%) had a newborn with congenital syphilis. Independently, the number of prenatal consultations was the only factor associated with congenital syphilis: as the number of consultations increased, the occurrence decreased (p=0.013, OR=0.87, 95%CI=0.79-0.97). The non-treatment of the mother and partner were the most frequent justifications for defining the case of congenital syphilis, and 33 newborns with syphilis presented complications at birth. Conclusion: considering the association with the number of prenatal consultations, in order to reduce cases of congenital syphilis, the municipality should modify the follow-up in this period, offering consultations, developing health education actions, implementing diagnostic investigation and appropriate treatment for pregnant women, and partnership when necessary.

Risk factors for fine and gross motor development in preterm and term infants.

To investigate the association of sociodemographic, obstetrical and psychosocial factors with fine and gross motor developmental delay in preterm and term infants, in the age group of three months and one day to twelve months and twenty-nine days. The term and preterm infants were evaluated by the Denver II Test for fine and gross motor skills, investigated in three phases: 165 infants in phase 1 (3 months and 1 day to 4 months and 29 days), 130 infants in stage 2 (8 months and 1 day to 9 months and 29 days) and 102 infants in phase 3 (11 months and 1 day to 12 months and 29 days). Sociodemographic, obstetrical and psychosocial data were obtained through an initial interview with family members and the psychic risk assessment through the Child Development Risk Indicators and PREAUT protocols. Statistical analysis was performed using the logistic regression model. Significant factors in the association with fine and gross motor delay were: maternal gestational and obstetric history (planned pregnancy, type of delivery, number of prenatal consultations, use of medication and gestational intercurrence), features and biological risks of the baby (gender, mechanical ventilation, feeding difficulty), sociodemographic factors (career and level of maternal schooling, number of children and people in the house) and psychosocial issues concerning to the family routine participation and presence of psychic risk. There was a significant association between motor development delay of the infants, environmental and biological variables, with emphasis on psychic risk.

Drug use according to risk classification and associated factors among pregnant women: results from NISAMI cohort

This study aimed to investigate the factors associated with drug use in pregnancy by risk categories in pregnant women from Santo Antônio de Jesus, Bahia. It is a cross-sectional cohort study with 1,091 pregnant women attended in primary health care between 2012 and 2014. Drug use during pregnancy was classified according to the FDA’s pregnancy risk classification. Prevalence ratios and respective 95% confidence intervals were adjusted by Poisson regression with robust error variance. The prevalence of drug use was more pronounced in risk categories A, B, C, D, and X, respectively. The use of safe medication was associated with education, number of prenatal consultations, and health problems after data adjustment. Age greater than 24 years, onset of prenatal care during the first trimester, and have any health problem were factors associated with the use of risk medication. Quality prenatal care is important to ensure the safe and conscious use of drugs. Furthermore, investments in continuing vocational education that promote rational antenatal drug use are needed.

Cesarean Section in Low Birth Weight Babies: An Original Research

The high prevalence of high-risk pregnancies, which can lead to premature delivery, contributes to an increasein the rates of preterm and low-birth weight (LBW) infants, with an increase in the number of cesareandeliveries. This study was done to access maternal variables and their associations with cesarean deliveries ofLBW newborns. A retrospective study was conducted by reviewing the medical records of pregnant womenwho underwent cesarean sections for the delivery of LBW infants (weight, ?1500 and 35 weeks at delivery,and 50.8% attended less than eight prenatal consultations. Hypertensive syndrome (23.8%) was the mainindication for cesarean delivery. Among the newborns, 58.3% had an Apgar score of 7 in the first minuteof life, 79.3% had a score of 9 in the fifth minute of life, and 54.3% were females. Conclusions: Severalmaternal variables such as primiparity, education level, number of prenatal consultations, and presence ofmaternal hypertensive syndrome had a statistically significant association with the occurrence of cesareansections for the delivery of LBW infants.