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Ganho de peso gestacional = recomendações e adequação entre mulheres brasileiras = Gestational weight gain: recommendation and adequacy among Brazilian women / Gestational weight gain : recommendation and adequacy among Brazilian womenGodoy, Ana Carolina, 1988- 02 June 2015 (has links)
Orientador: Fernanda Garanhani de Castro Surita / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T11:53:37Z (GMT). No. of bitstreams: 1
Godoy_AnaCarolina_M.pdf: 6315489 bytes, checksum: 17704d401caec449a4069f23091baa1e (MD5)
Previous issue date: 2015 / Resumo: Objetivos: Verificar o ganho de peso gestacional das mulheres de Campinas ¿ SP, as recomendações utilizadas no Brasil para o ganho ponderal na gravidez e a proporção de mulheres que aderem essas recomendações. Métodos: foi realizado um estudo do tipo corte transversal na cidade de Campinas ¿ SP que incluiu 1052 mulheres no puerpério imediato, internadas em três maternidades selecionadas, com recém-nascido vivo e gestação única. As participantes foram entrevistadas e responderam às questões sobre dados sociodemográficos e os dados da gestação, do parto, do recém-nascido foram extraídos dos prontuários. O peso pré-gestacional, peso na última consulta e altura da mulher foram extraídos do cartão de pré-natal. Também foi realizada uma revisão sistemática dos artigos que avaliaram as recomendações sobre ganho de peso na gestação em mulheres brasileiras e a adequação do ganho poderal nessas mulheres. Resultados: Nos dados originais da cidade de Campinas encontramos que 13,6% das mulheres eram obesas e 24,6% apresentavm sobrepeso, e que nesses grupos o ganho de peso excessivo foi de 55,9% e 53,7% respectivamente. O sobrepeso e a obesidade se associaram com maior risco para ganho de peso excessivo e parto cesariana. A prematuridade foi mais prevalente nas obesas e em mulheres com baixo IMC pré-gestacional. Na revisão sistemática foram incluídos 17 estudos, verificou-se que não existe padronização das recomendações brasileiras para ganho de peso, as recomendações utilizadas foram as do Institue of Medicine, curva de Atalah e recomendações do Ministério da Saúde. Uma grande parte das mulheres brasileiras inicia a gestação com sobrepeso e obesidade e tende a ganhar peso excessivo na gestação. A metanálise avaliou quatro estudos e verificou que gestantes com sobrepeso apresentaram mais ganho de peso excessivo do que gestantes eutróficas (OR=2,80, IC95%=2,22-3,53). Conclusão: não existe padronização nas recomendações brasileiras para o ganho de peso gestacional e as gestantes com sobrepeso e obesidade são as de maior risco para ganho de peso gestacional excessivo e parto por cesariana. Há necessidade de padronizar as orientações de ganho ponderal na gestação para a população brasileira, os profissionais de saúde e as mulheres, auxiliando dessa forma o conhecimento e melhor adequação do ganho de peso pelas gestantes, melhorando os resultados maternos e neonatais / Abstract: Objectives: To determine the gestational weight gain women of Campinas - SP, the recommendations used in Brazil for weight gain during pregnancy and the proportion of women who join these recommendations. Methods: We performed a study of transversal in the city of Campinas - SP which included 1052 women postpartum, admitted to three hospitals selected with a live newborn and single pregnancy. Participants were interviewed and answered questions about sociodemographic data and the data of pregnancy, childbirth, newborn were extracted from medical records. The pre-pregnancy weight, weight at last visit and height of women were taken from the prenatal card. It was also performed a systematic review of articles assessing the recommendations on weight gain during pregnancy in Brazilian women and the adequacy of ponderal gain in these women. Results: In the original data from Campinas found that 13.6% of women were obese and 24.6% apresentavm overweight, and that these groups gain excessive weight was 55.9% and 53.7% respectively. Overweight and obesity were associated with increased risk for excessive weight gain and cesarean birth. Prematurity was more prevalent in obese and in women with low pre-pregnancy BMI. In the systematic review were included 17 studies, it was found that there is no standardization of Brazilian recommendations for weight gain, the recommendations used were the Institue of Medicine, Atallah curve and the Ministry of Health's recommendations. A large part of Brazilian women start pregnancy overweight and obesity and tends to gain excessive weight during pregnancy. The meta-analysis evaluated 4 studies and found that overweight pregnant women had more excessive weight gain than normal weight pregnant women (OR = 2.80, 95% CI 2.22 to 3.53 =). Conclusion: there is no standardization in Brazilian recommendations for weight gain during pregnancy and pregnant women with overweight and obesity are the most at risk for excessive gestational weight gain and cesarean delivery. There is a need to standardize pondeal gain guidelines during pregnancy for the Brazilian population, health professionals and women, helping in this way the knowledge and best adequacy of weight gain for pregnant women, improving maternal and neonatal outcomes / Mestrado / Saúde Materna e Perinatal / Mestra em Ciências da Saúde
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A qualitative research study on fetal alcohol syndromeIrvin, Miriam, Shepard, Wilma 01 January 1995 (has links)
No description available.
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Identifying community specific barriers to prenatal care servicesHelsper, Linda Pearl 01 January 1998 (has links)
The intent of this research project was to discover the barriers that exist in this community when a woman attempts to access prenatal care. A concern for the well being of the children in the community and a belief in the importance of early intervention to enhance outcomes inspired the idea for this project.
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Prevalence and affective outcomes of prenatal obsessive compulsive disorder amongst clinic attendees in the Capricorn District, Limpopo ProvinceMalemela, Raesetsa Dorothy January 2017 (has links)
Thesis (M. A. (Clinical Psychology)) University of Limpopo, 2017 / The study investigated the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms and their relationship with pregnancy-related anxiety, prenatal depression and clinical anger among African pregnant women. The sample consisted of 206 pregnant women attending their antenatal check-ups at the Mankweng, Nobody and Rethabile clinics, and Mankweng hospital in the Capricorn District, Limpopo Province. When correlational analysis was conducted, the patient characteristics of age, having undergone a medical check-up, and having previously delivered a live baby generally did not correlate with any of the main scales measuring OCD, namely, perinatal depression, pregnancy-related anxiety and clinical anger (p > 0.05). Findings from the study indicated that almost 81% of the pregnant women could be classified as obsessive-compulsive disordered, when using the Foa et al. (2002) cut-off score of 21. Furthermore, findings from the regression analyses indicated that higher age, the number of gestation weeks, having previously experienced pregnancy-related complications, perinatal depression, pregnancy-related anxiety and clinical anger were variably positive predictors of OCI-R measured OCD symptoms. The predictors are specific to each of the symptoms. It can be concluded from the study that there is a relationship between OCD symptoms and all the independent variables used. / National Research Foundation
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Fysisk aktivitet och depressiva symtom hos gravida kvinnor : En kvantitativ studie med korrelerande och komparativ design / Physical activity and depressive symptoms in pregnant women : A quantitative study with correlating and comparative designHansson, Nikki, Gidlund, Therese January 2020 (has links)
Bakgrund: Depressiva symtom (DS) är vanligt förekommande under graviditeten samtidigt som den fysiska aktivitetsnivån tenderar att minska under graviditeten. Få studier har undersökt sambandet mellan fysisk aktivitet (FA) och DS hos gravida kvinnor i Sverige. Syfte: Att kartlägga fysiska aktivitetsnivå och förekomst av DS hos gravida kvinnor i Sverige. Undersöka om det finns samband mellan dessa variabler och om det finns skillnad i DS mellan de som uppnår rekommendationerna för FA och de som inte gör det. Metod: En kvantitativ tvärsnittsstudie som undersökte FA med The International Physical Activity Short Form och DS med Edinburgh Postnatal Depression Scale (EPDS). 86 gravida kvinnor inkluderades i studien. Resultat: Totalt 72% av deltagarna uppnådde rekommendationerna för FA. 29% av deltagarna var fysiskt aktiva på en låg nivå, 47% på en måttlig nivå och 24% på en hög nivå. 21% av deltagarna hade DS enligt EPDS. Det fanns inget signifikant samband mellan FA och poäng på EPDS. Det förekom ingen signifikant skillnad i poäng på EPDS mellan de som uppnådde rekommendationerna för FA och de som inte gjorde det. Konklusion: Majoriteten av deltagarna uppnådde rekommendationerna för FA. Ungefär en femtedel av deltagarna fick över 12 poäng på EPDS vilket indikerar ett behov för utredning av eventuell depression. Det fanns inget samband mellan FA och poäng på EPDS. Ingen signifikant skillnad mellan grupperna kunde påvisas. Vidare forskning behövs för att studera FA som behandling vid DS under graviditet. / Background:Depressive symptoms (DS) are common during pregnancy and physical activity (PA) tend to decrease during pregnancy. Few studies have examined the relationship between PA and DS in pregnant women in Sweden. Purpose:Examine the physical activity level and presence of DS in pregnant women in Sweden. Examine the relationship between these variables and the difference in DS between those who fulfilled the recommendations for PA and those who did not. Methods:A quantitative cross-sectional study investigating PA with The International Physical Activity Short Form and DS with the Edinburgh Postnatal Depression Scale (EPDS). 86 pregnant women were included in the study. Results:A total of 72% of the participants achieved the recommendations for PA. 29% were physically active at a low level, 47% at a moderate level and 24% at a high level. 21% of the participants had DS according to EPDS. There was no significant association between PA and points on EPDS. There was no significant difference in points on EPDS between those who achieved the recommendations for PA and those who did not. Conclusion:The majority of the participants achieved the recommendations for PA. About one-fifth of the participants received more than 12 points on EPDS, indicating a need for an investigation of possible depression. There was no association between FA and points on EPDS. No significant difference between the groups was detected. Further research is needed to study PA as a treatment for DS during pregnancy.
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Determination and evaluation of endocrine disrupting chemicals in urine samples of pregnant women by liquid chromatography-tandem mass spectrometryLi, Jiufeng 26 February 2020 (has links)
Endocrine disrupting chemicals (EDCs) are emerging contaminants that can interfere with the hormone system and may cause cancers, birth defects and reproductive system disorders. Prevalence of endocrine-related dysfunction and disease has increased steadily over the past decades. Although accumulating data suggest that these diseases have fetal origins, associations of EDC exposure during pregnancy and adverse health effects on both mothers and fetuses have not been thoroughly evaluated, particularly at multiple points in time. We firstly developed an analytical method for quantification of 28 EDCs (9 phthalates, 8 bisphenols, 5 parabens, 5 benzophenones and triclosan) in urine samples using ultra high performance liquid chromatography coupled with triple quadrupole mass spectrometer. The method was applied to measure targeted compounds in a total of 5220 urine samples collected from 951 pregnant women at three trimesters and 1501 pregnant women at one or two trimesters in Wuhan, China between 2014 and 2015. Based on the quantification results, exposure patterns and health risks of 28 EDCs on participants were evaluated and discussed in detail below. Among these samples, bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF), methylparaben (MeP), ethylparaben (EtP), propylparaben (PrP), 4-hydroxybenzophenone (4-OH-BP), 2,4-dihydroxybenzophenone (BP-1), 2-hydroxy-4-methoxybenzophenone (BP-3), triclosan, mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethylhexyl) phthalate (MEHHP), monobenzyl phthalate (MBzP), mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP) were determined with detection rates exceeding 50%, in which BPA, BP-3, MeP and MnBP were the predominant compounds. We found the U-shaped trends of urinary concentrations of phthalate metabolites over trimesters. Parabens, benzophenones and triclosan displayed a downward trend over three visits. We also found the levels of targeted compounds varied by exposure-related factors, such as sampling seasons, physical activities, computer using time and decoration information. In addition, multiple EDCs were mostly determined at low doses over trimesters, indicating that real-world exposure of pollutants were dominated by low-dose mixtures. We then evaluated the combined health hazards induced by EDC exposure via calculating the estimated daily intakes on the basis of average urinary concentrations at three trimesters. It was found that 24.9% of participants had potential health risks caused by exposure to phthalate mixtures. The most frequency of cumulative risks occurred in women who were exposed to a high dose of one specific phthalate, di-n-butyl phthalate (DnBP) or di(2-ethylhexyl) phthalate (DEHP). We also evaluated the cumulative health risks of BPA and its alternatives and found that about 1.6% of participants were at risks induced by bisphenol exposure. Combined health hazards were mainly driven by one specific bisphenol (BPS or BPA). Our findings suggested that regional interventions of DnBP, DEHP, BPA and BPS in application and production should be tighten and/or taken. Considering the low-dose effects of BPA, we further investigated the associations of BPA and three major natural estrogens, including estrone (E1), estradiol (E2) and estriol (E3), at three trimesters of pregnancy. We observed non-monotonic dose-response relationships of BPA to E1, E2 and E3 over trimesters even when BPA concentrations were below the current safety thresholds. In the gender-stratified models, we found significant negative relationships (β < 0, p < 0.05) between BPA and E2 among mothers with male fetuses in the first trimester. However, we found that no significant relationship between BPA and E2 among mothers with female fetuses over three trimesters. Significant non-monotonic associations (from significant negative to positive associations) between BPA and E3 were observed among mothers with female fetuses in the second trimester. The above mentioned findings suggested the gender-specific and trimester-specific effects of BPA on estrogens. Our findings also indicated that the current tolerance daily intake value maybe not safe enough to evaluate the potential health risks induced by BPA exposure. We next investigated the effects of maternal exposure to phthalates on both mothers and fetuses. Associations of phthalate exposure with the risks of gestational diabetes mellitus (GDM) and plasma glucose levels were evaluated based on a nested case-control study design. It was found that the levels of phthalate metabolites in women with GDM were significantly higher than those without GDM. Meanwhile, positive associations between urinary concentrations of phthalate metabolites and the risks of GDM were obvious, indicating that phthalate exposure may be a risk factor for GDM. In addition, phthalate levels were related to the increased plasma glucose levels after 75 g oral glucose tolerance test. Our findings suggested that phthalates might disturb the glucose homeostasis and increase GDM risks. Furthermore, we assessed the trimester-specific and gender-specific effects of DEHP exposure on fetal growth, birth size and postnatal growth at 6, 12 and 24 months. We found that among male offspring, 1st-trimester DEHP was negatively related to fetal growth (β < 0, p < 0.05), but positively related to 24-month body mass index (BMI). 2nd-trimester DEHP was negatively related to fetal growth, birth weight and birth length, but positively related to the weight gain rates from birth to 12 months old. 3rd-trimester DEHP was positively (β > 0, p < 0.05) associated with birth weight, BMI at 6 and 12 months. However, among females, 1st-trimester DEHP was associated with increased birth length, while 2nd-trimester DEHP was negatively associated with BMI at 6 and 12 months. A negative association between DEHP and weight gain rates at 6 months was noted among females. Our findings indicated the second trimester maybe the sensitive window of DEHP exposure for offspring growth since 2nd-trimester DEHP levels were related to the decreased fetal growth, decreased birth size, but increased weight gain rates in early childhood age among male offspring. To investigate the mechanism underlying the associations of DEHP exposure with glucose and lipid metabolism, we investigated the biotransformation of DEHP and the disturbed metabolisms induced by MEHP, the putative toxic metabolite of DEHP, in human normal liver cell L02 using metabolomics and lipidomics. We found that MEHP was the major metabolite of DEHP. Decreased uptake of glucose and accumulation of glucose in liver cells were obvious after MEHP exposure. Phospholipid remodeling, incomplete fatty acid β-oxidation, inhibition of purine metabolism and glycolysis, and increased oxidative stress were noted in MEHP-exposed L02 cells, which were related to insulin resistance. In this work, we measured 28 EDCs in a total of 5220 urine samples provided by 951 pregnant women (three trimesters) and 1501 pregnant women (one or two trimesters) and then evaluated the exposure levels, exposure patterns (variations, variability and correlations), health risks and health effects of these compounds on pregnant women and fetuses. Our data suggested that participants had potential health risks induced by exposure to phthalates or bisphenols. Phthalate exposure was related with the increased plasma glucose levels and risks of GDM. Prenatal DEHP exposure may induce the intrauterine growth restriction and catch-up growth among males, which supported the evidence of fetal origin. To explore the underlying mechanisms of MEHP on glucose and lipid metabolic disorders, we exposed the human normal hepatic L02 cells with MEHP, and applied metabolomic and lipidomic approaches for finding potential biomarkers and disturbed pathways. We found that MEHP exposure inhibited glucose uptake, caused phospholipid remodeling and increased oxidative stress in L02. These findings suggest that the usage of products containing EDCs, particularly phthalates, in pregnant women should be limited in China, intervention of BPS should be considered, and threshold values of BPA are called for reevaluation.
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Development of an intervention programme for the prevention of complications of tuberculosis during pregnancy and puerperium period, Limpopo Province, South AfricaNetshimbupfe - Mulondo, Seani Adrinah 18 September 2017 (has links)
PhD (Advanced Nursing Science) / Department of Advanced Nursing Science / See the attached abstract below
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"Ni ska inte tro att jag vet" : Tvåföderskors förväntningar inför kommande förlossning / "Don´t expect me to know everything" : Multiparous women´s expectations of their forthcoming childbirthAxelsson, Mikaela, Vildhede, Emilia January 2018 (has links)
Bakgrund: Det finns samband mellan den gravida kvinnans förväntningar inför förlossning och förlossningsupplevelsen. Trots tidigare förlossningserfarenhet tycks omföderskor förvånansvärt nog inte ha mer realistiska förväntningar inför förlossning än vad förstföderskor har. Syfte: Att synliggöra tvåföderskors förväntningar inför kommande förlossning. Metod: En kvalitativ metod med hermeneutisk textanalys inspirerad av Gadamer användes. Nio tvåföderskor i åldrarna 26-33 år intervjuades med hjälp av en halvstrukturerad intervjuguide. Resultat: De analyserade intervjutexterna mynnade ut i fyra huvudteman: Blandade känslor – förväntningar formas av första förlossningsupplevelsen, Partnern – en stöttepelare för vissa, Barnmorskan som vägledare genom förlossningen och ”Go with the flow” – förväntningar på kontroll under förlossning. I resultatet framgår att det finns en uppfattning hos kvinnorna om att den första förlossningsupplevelsen har stor inverkan på förväntningarna inför kommande förlossning, på gott och ont. Det finns en rädsla hos kvinnorna att det förväntas av dem att de på grund av sin tidigare förlossningserfarenhet redan ”kan”, vilket leder till oro. Konklusion: Tvåföderskorna har överlag positiva förväntningar inför sin kommande förlossning. Trots positiva förväntningar ges uttryck för en oro om att barnmorskan förväntar sig att de på grund av sin tidigare förlossningserfarenhet redan ”kan”. Tvåföderskor är således i behov av barnmorskans individuella och professionella stöd. / Background: There is a connection between the pregnant woman's expectations of childbirth and the actual childbirth experience. Aim: To illustrate multiparous women’s expectations of their forthcoming childbirth. Method: This study used a qualitative method with hermeneutic text analysis inspired by Gadamer. Nine multiparous women aged 26-33 years were interviewed using a semi-structured interview guide. Results: Analysis of the interviews revealed four main themes: Mixed emotions – expectations are formed by the first childbirth experience, The partner – for some, an important source of support, The midwife as a guide through childbirth and “Go with the flow” - expectations of control during childbirth. Results showed that the women held the opinion that the first childbirth experience has a major impact on their expectations for future childbirth, both good and bad. There was a concern amongst the women that because of their previous childbirth experience, they would be expected to "know what to do". Conclusion: Women generally have positive expectations of childbirth. Given the concern of these multiparous women that they may be considered as experienced in childbirth, it is clear that the midwife should be prepared to offer professional support to multiparous women based on their individual needs.
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The nasciturus non-fiction: the Libby Gonen story: contemporary reflections on the status of nascitural personhood in South African lawSchulman, Marc 26 September 2014 (has links)
Thesis (L.L.M.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, School of Law, 2014. / The non-consensual destruction of a nasciturus is a disturbing societal phenomenon that negatively
permeates the lived realities of pregnant women with positive maternal intention. These women choose
to experience a full term gestation and they choose to give birth to a live and healthy infant. At some
point during their gestation they are non-consensually deprived of their choices through active third
party violence by commission or passive third party negligence by omission. These women have no
legal recourse for their loss, because in South African law, the non-consensual destruction of a
nasciturus is not a crime. The nasciturus is not recognised as a victim separate from the pregnant
woman despite the manner in which the pregnant woman freely chooses to interpret her pregnancy. The
consensual destruction of a nasciturus enjoys legal protection in South African law by virtue of the
provisions contained in the Choice on Termination of Pregnancy Act 92 of 1996. The choice to
terminate a pregnancy is therefore legally recognised in South African law, whereas the choice to
continue a pregnancy is not legally recognised. Argument is advanced in this dissertation for the legal
recognition of the choice to continue a pregnancy by criminalising non-consensual nascitural
destruction through the creation of a Choice on Continuation of Pregnancy Act. Non-Consensual
nascitural destruction occurs as a result of violence against pregnant women as well as in situations of
medical negligence. Empirical data is provided to demonstrate how non-consensual nascitural
destruction can occur in medical settings where negligence is suspected. The inherent human need to
safeguard and protect the nasciturus has been in existence since time immemorial. Despite this need, in
South African law, legal subjectivity, and the ability to be recognised as a separate victim of crime,
remain contingent upon a live birth. Evidence suggests that the requirement of live birth in law
developed as an evidentiary mechanism and not as a substantive rule of law. Its relevance in
circumstances of non-consensual nascitural destruction is doubtful at best. The law in South Africa has
failed to take cognisance of the psychosomatic dimensions of personhood and argument is advanced in
favour of a nuanced and constitutionally sensitive approach to matters of moral as well as legal
personhood. Authentic female autonomy and reproductive freedom requires a re-evaluation of the
paradigms that surround nascitural safeguarding and protection, and a transformative approach to
constitutional interpretation. The establishment of a legislative scheme to criminalise the nonconsensual
destruction of a nasciturus is proposed. Within this legislative scheme certain precautions
and fortifications are suggested in order to avoid any potential erosion of the rights of pregnant women
who have negative maternal intention. It is demonstrated that it is in fact possible for pregnant women
with positive maternal intention and pregnant women with negative maternal intention to both enjoy
legal protection without encroaching upon one another’s constitutional rights to reproductive freedom,
bodily autonomy and privacy. It is contended that achieving the aforementioned is the final barrier to
authentic female reproductive freedom in South Africa.
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Psychosocial Well-Being and Efforts to Quit Smoking in Pregnant Women of Rural AppalachiaStubbs, Brittney, Hoots, Valerie M., Clements, Andrea D., Bailey, Beth A. 01 February 2019 (has links)
No description available.
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