Prenatal Consultations Research Articles

Balancing survival and suffering: factors influencing parental decision making after periviable consultation.

The objective of this study was to identify factors birthing parents consider related to potential resuscitation of a periviable infant. Birthing parents who received a prenatal consult from a newborn intensive care unit provider between 22.0 and 24.6 weeks gestational age were eligible to participate in a semi-structured interview focused on their periviable decision making. Interview transcripts were coded and analyzed using thematic content analysis. Qualitative analysis shows that birthing parents attribute their decision to a balance between vitality and suffering, with the balance point influenced by various elements. While parents described the choice they made, none reported that the information they received during the prenatal consult had a significant impact. This study highlights the minimal impact that information given during a periviable consult has on parental decision making. Information from this study can be used to develop an improved model of perinatal consultation.

Evaluation par régression logistique binaire de déterminants de la mortalité néonatale dans la province du Kongo Central

Neonatal mortality disturbs the whole of humanity. Its frequency remains very high throughout the world, but more so in developing countries. The DRC is ranked among the countries with the highest number of neonatal deaths in the world with the ratio of 47 per 1000 live births, (Kalonji DC et al 2018). Indeed, the province of Kongo Central has not remained indifferent to this health problem. With a view to improving newborn health during the neonatal period, the present study is conducted and envisages identifying the determinants of neonatal mortality in Kongo Central Province. For this study, the general population consisted of all newborns in the Province of Kongo Central from 2021 to 2022. A random sample of 117 cases met the inclusion criteria, of which we matched 1 case to 2 controls. After data analysis, we found the following results: the overall neonatal mortality rate was 333 per thousand live births. The logistic regression model identified the following determinants of neonatal mortality: age (OR= 1.16562 IC95 [1.035635 -1.3163]. p=0.0105), age less than 2 years (OR= 2.01966 IC95 [1.021601-4.058]. p=0.0449) and acute fetal distress (OR=2.62027IC95 [1.179464-5.878]. p=0.0181). In order to improve neonatal health, pregnant women should be made aware of the importance of prenatal consultations for early detection and appropriate management of high-risk pregnancies. They should be present at the onset of labor and give birth in the presence of qualified personnel.

Implementing a prenatal health screening intervention for future fathers in Montreuil, France: most users are immigrants facing hardship

BackgroundPrenatal care provides pregnant women with repeated opportunities for prevention, screening and diagnosis that have no current extension to future fathers. It also contributes to women’s general better access to health. The goal of PARTAGE study was to evaluate the level and determinants of adherence to a prenatal prevention consultation dedicated to men.MethodsBetween January 2021 and April 2022, we conducted a monocentric interventional study in Montreuil hospital. We assessed the acceptance of a prenatal prevention consultation newly offered to every future father, through their pregnant partner’s prior consent to provide their contact details.ResultsThree thousand thirty-eight women provided contact information used to reach the fathers; effective contact was established with 2,516 men, of whom 1,333 (53%) came for prenatal prevention consultation. Immigrant men were more likely to come than French-born men (56% versus 49%, p < 0·001), and the more they faced social hardship, the more likely they were to accept the offer. In multivariate analysis, men born in Subsaharan Africa and Asia were twice as likely to attend the consultation as those born in Europe or North America.ConclusionAcceptance of this new offer was high. Moreover, this consultation was perceived by vulnerable immigrant men as an opportunity to integrate a healthcare system they would have otherwise remained deprived of.Trial registrationRegistry: ClinicalTrials.gov, US National Library of Medicine https://classic.clinicaltrials.gov/ct2/show/NCT05085717Clinical Trial number: NCT05085717.Date of registration: 20/10/2021.

Study of the Association Between Socioeconomic Determinants and Pregnancy Follow-Up Indicators of Mothers of Low-Birth-Weight Infants: Insights for Achieving Sustainable Development Goals

Aims: This study investigates the association between socioeconomic determinants and pregnancy follow-up among 200 mothers of low-birth-weight newborns. By identifying factors influencing maternal care and birth outcomes, the study contributes to achieving Sustainable Development Goals (SDG) 3, 8, and 10, focusing on improving maternal and child health, reducing socioeconomic disparities, and ensuring equitable healthcare access. Methods: A prospective descriptive study was conducted over 12 months (June 2020–July 2021) at the neonatology and nutrition reference center of Rabat Children's Hospital. The study recruited 206 mother-child pairs, focusing on those with low-birth-weight infants. Results: Among the 200 mothers, 92% followed their pregnancies. Distribution of prenatal consultations was as follows: 0.54% had one visit, 5.98% two visits, 33.7% three, 41.85% four, and 17.93% more than four. Analysis revealed significant associations between pregnancy follow-up and socioeconomic factors. Maternal age (p &lt; 0.001), education level (p &lt; 0.001), and place of residence significantly influenced pregnancy monitoring, with urban mothers more likely to receive follow-up care. Single mothers had a 100% non-tracking rate, while married mothers predominantly monitored their pregnancies. Conclusions: This study demonstrates the strong influence of sociodemographic factors on antenatal care use, aligning with findings from other contexts. It contributes new insights into the specific characteristics of our study population and has practical implications for shaping maternal and child health policies, addressing the unique needs of diverse sub-populations. Achieving SDG 3 (Good Health and Well-being), SDG 8 (Decent Work and Economic Growth), and SDG 10 (Reduced Inequalities) requires targeted interventions that improve equitable access to quality maternal care.

The clinical significance of lack of hindbrain herniation in fetal myelomeningocele/myeloschisis patients.

Hindbrain herniation (HH) is a clinical prerequisite for prenatal repair of myelomeningocele/myeloschisis; however, a subset of patients lack HH on initial fetal imaging and may ultimately progress to exhibit herniation on subsequent prenatal or postnatal imaging. The authors sought to explore the cohort of patients without HH at the time of initial fetal consultation for myelomeningocele/myeloschisis repair to define their clinical characteristics and outcome. From July 2016 to July 2022, patients evaluated at the Children's Hospital of Philadelphia Center for Fetal Diagnosis and Treatment for myelomeningocele/myeloschisis were classified into two cohorts: those with and those without HH. The diagnosis of HH was obtained from prenatal and postnatal MRI. The osseous lesion level, prenatal sac volume, and prenatal ventricular size was obtained from fetal ultrasound. The fronto-occipital horn ratio was measured on the first postnatal ultrasound. Ambulation status was obtained from postnatal evaluation in the spina bifida clinic. A total of 176 patients with prenatal HH had postnatal follow-up, of whom 95 (54%) had HH resolution and 81 (46%) had herniation persistence. Of 73 patients without prenatal HH, 9 (12%) had herniation on subsequent prenatal imaging while 64 (88%) had no herniation on prenatal imaging. Of these 64 patients, 11 (17%) had postnatal HH, 32 (50%) had no postnatal herniation, and 21 (33%) were lost to follow-up or the pregnancy was terminated. For patients without HH throughout, the sac volume was larger (9 cm3) than those who had herniation progression or initial herniation; however, the rate of talipes was not significantly different among the groups. The majority of patients were also ambulators (with assistive devices or independent), and the atrial diameter was also < 10 mm for most patients. Overall, 53% of those with initial HH compared with 35% with progression of herniation required CSF diversion, while only 25% of those without herniation required diversion. This study demonstrates the natural history of HH in patients with a prenatal diagnosis of myelomeningocele/myeloschisis. The majority of patients without any herniation had larger sac sizes but not higher rates of talipes and smaller ventricles and were ambulatory. These findings improve the ability to guide families during prenatal consultation.

Obstetric healthcare experiences and information needs of Dutch women in relation to their vegan diet during pregnancy

ObjectivesThe prevalence of a vegan (strict plant-based) diet is increasing. Adequate access to nutritional information for pregnant women on a vegan diet is vital, as optimal maternal nutrition is important in order to prevent maternal and fetal complications. This study evaluated the obstetric healthcare experiences and information needs of pregnant women following a vegan diet in the Netherlands. MethodsAn online survey examined women’s experiences with obstetric healthcare in relation to their vegan diet during pregnancy. In total, 195 women, all of whom followed a vegan diet during their pregnancy and gave birth between January 2018 and April 2020, completed an online survey about their experiences. Descriptive statistics were used to present the data. ResultsIn total, 36.5% of participants reported that an obstetric healthcare provider had inquired about their diet in general during the first prenatal consultation, and an additional 43.1% of participants proactively informed their healthcare provider about their diet. Only 19.0% of all participants received specific information about their vegan diet during pregnancy, and 25.2% reported having had extra checks, mostly blood tests, during their pregnancy. Of all participants, 35.9% would have preferred to receive additional information regarding their diet. ConclusionsOur data shows that only a minority of pregnant women following a vegan diet received information and recommendations about their diet from their healthcare providers. It is our recommendation that healthcare providers inquire about pregnant women’s diets, and refer those following a vegan diet to reliable sources of dietary information or to a specialized dietitian.

Incidence of serious maternal Morbidity at the RUASHI military hospital (DRC)

Maternal morbidity is a public health problem in developing countries. The aim of our study was to determine the frequency of serious maternal morbidity at the Ruashi military hospital (DRC) with a view to ensuring good care and monitoring of pregnant women. A longitudinal descriptive study was conducted among 154 pregnant women in a prospective manner, data entry and analysis of results were carried out using Microsoft office 2016 and statistical test parameters were made using of Epi Info 7.2. The incidence of maternal morbidity was 24.2%, of which 32.4% had anemia followed by hemorrhage with 27% and finally sepsis and uterine subinvolution with 5.4% each. However, 94.6% had followed the prenatal consultation against 5.4% and 29.7% had a frequency of 3 participations in the prenatal consultation and finally 8.1% had a frequency of 6 participations in the CPN. The analysis showed that the frequency of prenatal consultation and postnatal visits, literacy and socio-economic level are statistically associated with maternal morbidity. Improving the socio-economic level of households, combating illiteracy and monitoring prenatal consultation are among the factors that will determine maternal morbidity.

Research Progress in Magnetic Resonance Imaging of Fetal Ventriculomegaly

Fetal ventriculomegaly is a central nervous system disorder commonly seen in prenatal imaging, and the prognosis ranges from normal health to severe dysfunction. Currently, fetal predictive markers associated with postpartum individual neurodevelopmental function are still not available, which increases the difficulty of prenatal diagnosis and clinical management. Constant advancements in magnetic resonance imaging (MRI) technology have brought better accuracy and reliability of MRI applied in the diagnosis, prognosis assessment, and etiology investigation of ventriculomegaly. MRI plays a critical role in prognostic management and prenatal consultation. Nevertheless, due to the potential safety hazards and economic and technical constraints of MRI, it is not the first choice for prenatal imaging diagnosis. Moreover, there are different opinions regarding the measurement results and grading criteria of ultrasound and MRI. At present, it is accepted that three-dimensional volume may provide reliable information for prognosis. However, accurate segmentation and measurement of brain structure remain serious challenges, and no consensus on the MRI measurement of lateral ventricle volume has been reached. In this paper, based on the latest research reports from China and around the world, we reviewed the progress in applying MRI in the prenatal diagnosis and treatment of ventriculomegaly. This review offers a theoretical foundation for further exploration of the role of lateral ventricle volume measurement in disease diagnosis and management. We suggest that researchers combine two-dimensional width with three-dimensional volume in the future to identify the optimal cutoff value for prognostic prediction of fetal ventriculomegaly.

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.

Spatial pattern of congenital toxoplasmosis incidence and its relationship with vulnerability and national health indicators in Brazil

There is a gap in evidence regarding spatial clusters of the congenital toxoplasmosis (CT) and its association with social and health indicators in the Brazilian territory. Thus, we aimed herein to identify CT risk areas in Brazil and its association with social vulnerability and health indicators. An ecological and population-based study was conducted. The CT incidence coefficient was calculated and smoothed using the Local Empirical Bayesian method. Global regression models and local spatial regression model were applied. High-incidence clusters of the disease were identified throughout the country. Additionally, a positive association was observed between the incidence of congenital toxoplasmosis and the Social Vulnerability Index, coverage of community health agents, and the percentage of prenatal consultations. This association was stronger the further south in the country. Herewith, the implementation and strengthening of public strategies, with focus on priority intersectoral actions for prevention, early diagnosis, and prompt treatment, is urgently required for the effective control of CT in Brazilian municipalities.

Accurate prenatal diagnosis of coarctation of the aorta by 3-step echocardiographic diagnostic protocol

BackgroundCoarctation of the aorta (CoA) is the most common undiagnosed congenital heart defect during prenatal screening. High false positive and false negative rates seriously affect prenatal consultation and postnatal management. The objective of the study was to assess the utility of various measurements to predict prenatal CoA and to derive a diagnostic algorithm.MethodsOne hundred and fifty-four fetuses with suspected CoA who presented at Fuwai Hospital between December 2017 and August 2021 were enrolled and divided into confirmed CoA cases (n = 47) and false positive cases (n = 107), according to their postnatal outcomes. The transverse aortic arch, isthmus, and descending aorta were measured in the long-axis view of the aortic arch. The angle between the transverse aortic arch (TAO) and the descending aortic arch (DAO) was defined as the TAO-DAO angle and measured in the long axis or sagittal view. Based on the database in GE Voluson E10 and the formula (Z = \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\frac{\ ext{x}-{\\mu }}{\\alpha }$$\\end{document}), the standard score (Z-score) of the dimensions of the aorta were calculated in relation to the gestational age. The main echocardiographic indices were combined to design a 3-step diagnostic protocol. The TAO-DAO angle was used as the first step in the diagnostic model. The diameter of the transverse arch and the Z-score of the isthmus were the second step. The third-step indices included a Z-score of the transverse arch, diameter of the isthmus, distance from the left subclavian artery (LSA) to left common carotid artery (LCCA), the ratio of isthmus diameter and LSA diameter and ratio of the distances (the distance between the LSA and LCCA to the distance between the right innominate artery and LCCA). The receiver operating characteristic (ROC) curve determined the predictive capability of each diagnostic parameter, and the kappa test determined the diagnostic accuracy of the proposed model.ResultsThe cases with confirmed CoA had thinner transverse arches (1.92 ± 0.32 mm vs. 3.06 ± 0.67 mm, P = 0.0001), lower Z-scores of the isthmus (-8.97 ± 1.45 vs. -5.65 ± 1.60, P = 0.0001), smaller TAO-DAO angles (105.54 ± 11.51° vs. 125.29 ± 8.97°, P = 0.0001) and larger distance between the LSA and LCCA (4.45 ± 1.75 mm vs. 2.74 ± 1.07 mm, P = 0.0001) than the false positive cases. The area under the curve (AUC) was 0.947 (95% CI 0.91–0.98) for the TAO-DAO angle ≤ 115.75°, 0.942 (95% CI 0.91–0.98) for the transverse arch diameter ≤ 2.31 mm, 0.937 (95% CI 0.90–0.98) for the Z-score of the isthmus ≤ -7.5, and 0.975 (95% CI 0.95–1.00) for the 3-step diagnostic protocol with 97.8% sensitivity and 97.2% specificity. The kappa test showed that the model’s diagnostic accuracy was consistent with postnatal outcomes (kappa value 0.936, P = 0.0001).ConclusionsThe 3-step diagnostic protocol included the three most useful measurements and the additional indices with appropriate cut-off values. The algorithm is useful for the detection of aortic coarctation in fetuses with a high degree of accuracy.Trial registrationRetrospectively registered.

Weight gain during pregnancy and the probability of macrosomia in women with gestational diabetes

Objective. To analyze the association between gestational weight gain in women with gestational diabetes and an increased risk of macrosomia. Materials and methods. Cohort study with 139 pregnant women screened by a single-step oral glucose tolerance curve between 24-28 weeks of gestation were confirmed with gestational diabetes and sent to a hospital. Pre-pregnancy body mass index (BMI) was calculated from pre-pregnancy weight. Weight was measured at each prenatal consultation. The reference category was women with normal prenatal BMI who gained appropriate weight during pregnancy. At each visit, medical nutrition therapy (MNT) consisted of nutritional counseling, physical activity plan, and insulin therapy. Compliance with MNT was measured by capillary glucose measurements taken by each participant at home. Results. 74.8% were primiparous, and 28.8% had normal pre-pregnancy BMI. The no linear logistic regression model showed women with normal pre-pregnancy BMI had twice (OR= 2.08, 95%CI: 1.07,4.05) the possibility of macrosomia, compared to mothers with overweight or obesity, adjusting for Capurro index, number of children in the family, and percent of compliance MNT. Macrosomia was the most prevalent childhood complication (12.3%). Conclusion. Women with normal pre-pregnancy BMI who gained more weight during pregnancy were at higher risk of having macrosomic infants.

Primary care performance measurement in Brazil (Previne Brasil Program), 2022–2023

BackgroundPrevine Brasil is a new way of financing Primary Health Care (PHC) in Brazil that places users of public health services at the center of the system’s analysis and attention through the use of seven performance indicators. This study aims to analyze the performance of Primary Health Care in Brazil under the new financing model (Previne Brasil) in the period from the first four months of 2022 to the first four months of 2023.MethodsThis is a territorial ecological study using secondary data from the Primary Care Health Information System (SISAB). Seven performance indicators were included and analyzed according to Brazil, its regions, states and capitals. A comparative descriptive analysis was carried out between the spatial units.ResultsOf the seven indicators analyzed, only one (Proportion of pregnant women tested for syphilis and HIV) reached the proposed target considering the average of the four-month periods evaluated (target: 60%; Observed: 62.5%). The Northeast was the region with the best performance, surpassing the target in three of the seven indicators (prenatal consultations, tests for syphilis and HIV in pregnant women and dental care for pregnant women). The states and capitals showed progressive improvement in the performance indicators over the four quarters analyzed, although unevenly between the indicators. The indicators related to hypertension and diabetes were the worst. The Final Synthetic Indicator (FSI) showed an increase in the median over the four quarters (4.78; 5.65; 6.02 6.29), which represents an increase of 1.51 in the indicator between the first four months of 2022 and the first four months of 2023.ConclusionAlthough there have been improvements in the performance of Primary Health Care in Brazil, the achievement of the agreed targets for the indicators seems a long way off. The socio-spatial inequalities in the indicators reflect the country’s health complexity and reinforce the need for policies that take into account the local-regional context.

Evaluating decision regret after extremely preterm birth

ObjectivesLittle is known about decision regret following extremely premature birth. We assessed decision regret in women who delivered an extremely premature infant, comparing decision regret scores based on resuscitation decision.MethodsElectronic...

What is the influence of maternal weight gain in different gestational clinical conditions on the prole weight in pre-school age?

The aim of the current study was to assess the influence of maternal weight gain in different clinical gestational conditions on the child's weight at pre-school age. This was a longitudinal observational study of a prospective and controlled multiple cohort of 372 mother-child pairs withfour causal groups of different adverse intrauterine environments (smoking, diabetic, hypertensiveand intrauterine growth-restricted pregnant women) and a control group, in the period of,from 2011 to 2016 in three hospitals in Porto Alegre (Brazil). Sociodemographic, prenatal and perinatal data were analysed. Gestational weight gain (GWG) was categorised as 'insufficient', 'adequate' and 'excessive'. The generalised estimation equations (GEE) model was used to assess changes in the z-score of the child's body mass index from birth to pre-school age according to the GWG and gestational group. The child's GWG and weight gain were adjusted for maternal age and education, marital status, family income, pregnancy planning, number of children, prepregnancy BMI, prenatal consultations and type of delivery. A triple interaction effect was observed involving the gestational group, weight gain and study time (p = 0.020) through an adjusted model. Maternal weight gain above the recommended is associated with a significant increase in the child's z - BMI score over time, except for children from pregnant smokers. Children from diabetic mothers, hypertensive mothersand the control group who had a weight gain above that recommended during pregnancy changed their nutritional status from eutrophic to overweight, becoming obese in the DM and hypertension groups and overweight in control. Monitoring of the GWG, especially in the presence of hypertensive diseases and DM, should be effective to prevent children from developing overweight or obesity in pre-school age with an important impact on health conditions in the future.

Consequences and Explanatory Factors of Late Start to Prenatal Consultation by Pregnant Women at the MAZIBA Reference Health Center, in the Democratic Republic of Congo

Introduction: It is undeniable that the NPC plays a crucial role in the development process of nations; “because maternal and neonatal deaths, which hinder economic growth and cause global losses in productivity, can be avoided thanks to ANC, which is all the more effective if it is early and regularly repeated. This consultation effectively contributes to avoiding “complications of pregnancy and its consequences, which are a major challenge for the health of women of childbearing age; and the leading global cause of morbidity, disability and mortality in this target, especially in developing countries. This research seeks to determine the repercussions and explanations explanations of the beginning late arrival of women to prenatal consultation. Method: This study is quantitative of the cross-sectional descriptive correlational type, carried out at the MAZIBA health and maternity center, more precisely in the Bonhomme district, in the commune of Matete, city of Kinshasa, in the Democratic Republic of Congo, during the period from January 29 2022 to April 8, 2023. It used the survey method, combined with the interview technique and a survey questionnaire as the data collection instrument. Results: The late onset of CPN remains a major public health issue in the study region. The late arrival of pregnant women at the CPN is influenced by different variables such as neglect, fatigue, distance, lack of financial means, high cost of care, poor reception, lack of space, lack of chairs or benches. The consequences linked to late arrival at the ANC are on two levels: the consequence for the pregnant woman and for the fetus. In the pregnant we obtained an average of 18.7% and 31.3% in the fetus. This study demonstrated that there is a significant statistical relationship between It also appears that there is a significant statistical relationship between personal, socio-economic, organizational, cultural factors and the consequences in the fetuses (p = 0.00. P=0.01, and p=0.00). Conclusion: Thus, healthcare professionals have the opportunity to provide ongoing education on the importance of starting prenatal care visits early to avoid adverse pregnancy outcomes, taking into account all the elements mentioned.

Women’s experiences of maternity care in the first wave of the COVID-19 pandemic in Poland: a cross-sectional study

Background: The coronavirus disease-19 (COVID-19) pandemic significantly affected maternal care services.Aim of the study: This study aimed to identify the level of changes in care experienced by pregnant women during the first wave of the COVID-19 pandemic and to compare responses between three major modes of maternity care financing (public, fee-for-service and private healthcare subscriptions). Material and methods: This cross-sectional study of 685 pregnant women in Poland used the author’s questionnaire, which included questions on demographic data, maternity care mode of financing, and different aspects of care.Results: The vast majority (n=608, 95.6%) of respondents experienced during the COVID-19 pandemic. The most frequently reported modification was no possibility of a partner being present during prenatal consultations and medical examinations (n=558, 87.7%). Those who used a private healthcare subscription experienced more frequent medical appointment cancellations (p=0.000), a decrease in the number of consultations (p=0.000), reduced healthcare service duration (p=0.019). Over half of respondents used teleconsultations or e-consultations. The respondents who used a healthcare subscription had lower satisfaction with maternity care across all issues than women who used public and fee-for service care.Conclusions: The COVID-19 pandemic affected women’s maternity care experiences, with the financing mode differentiating their experiences. An increase in the use of telemedicine for maternity care during the SARS-CoV-2 pandemic may provide a beneficial solution for future crises.

Frequency and Risk Factors Associated with Prematurity: A Cohort Study in a Neonatal Intensive Care Unit.

Background/Objectives: Prematurity rates remain high and represent a challenge for the public health systems of any country, with a high impact on neonatal mortality. This study aimed to evaluate the frequency and environmental and maternal-fetal risk factors for premature birth in a cohort of parturient women, with their newborns monitored in a neonatal intensive care unit at a private reference hospital. Methods: A cohort was carried out between 2013 and 2018 among parturient women living in a capital city in the Northeast of Brazil whose newborns were admitted to the neonatal intensive care unit. This study was approved by the Research Ethics Committee of the University of Fortaleza. The information collected comprised data from both medical records and hydrosanitary data from maternal homes. Results: The prevalence of prematurity among live births (n = 9778) between 2013 and 2018 at this hospital was 23%. The frequency of prematurity among those eligible (n = 480) was 76.9%, and the frequency of eligible premature babies (n = 369) in relation to the total number of births in this period was 3.8%. In the multivariate analysis, the significant risk factors for prematurity were primigravida (RR = 1.104, 95%CI: 1.004-1.213) and hypertensive syndromes during pregnancy (RR = 1.262, 95%CI: 1.161-1.371), and the significant protective factor was the highest number of prenatal consultations (RR = 0.924, 95%CI: 0.901-0.947). Conclusions: This study contributes to providing greater visibility to prenatal care and the understanding of complications during pregnancy and childbirth care. These results indicate the need to implement public policies that promote improvements in the population's living conditions and care for pregnant women to reduce premature births and, consequently, neonatal and infant mortality.

Prevalence of chronic diseases and obstetric complications of pregnant women assisted in primary health care

Objective: to verify the prevalence of chronic diseases and associate them with obstetric complications in pregnant women assisted in Primary Health Care. Method: Analytical cross-sectional study, conducted by searching electronic medical records of pregnant women treated in a Family Health Strategy in a city in the state of Rio Grande do Sul. Results: There was no association between systemic arterial hypertension, diabetes mellitus and obesity with hemorrhage, premature birth and late birth. In the case of premature birth, pregnant women with SAH had an approximately 1.9 times higher risk compared to those who did not have this comorbidity. With regard to pregnant women who are obese, the risk of premature birth was approximately 2.5 times higher compared to women who are not obese. Conclusion: The findings highlight the need to monitor pregnant women in prenatal consultations in Primary Health Care and serve as important guidelines for the planning and implementation of health interventions aimed at chronic diseases and obstetric complications in pregnant women.

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 &lt; 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 &lt; 0.001), including those without prenatal visits (p &lt; 0.001). A higher prevalence of being underweight was observed among female neonates (p &lt; 0.001) and with a maternal age of ≥ 40 years (10.8%; p &lt; 0.001) compared to newborns with good vitality. Newborns with good vitality had a low prevalence of underweight (p &lt; 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.