FAMED – Faculdade de Medicina
URI permanente desta comunidadehttps://rihomolog.furg.br/handle/1/2422
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7 resultados
Resultados da Pesquisa
- ItemGravidez não planejada no extremo Sul do Brasil: prevalência e fatores associados(2011) Prietsch, Sílvio Omar Macedo; Chica, David Alejandro González; Cesar, Juraci Almeida; Sassi, Raul Andrés MendonzaThe purpose of this study was to investigate factors associated with unplanned pregnancies in Rio Grande, Rio Grande do Sul State, Brazil. A standardized questionnaire was applied in 2007 to all pregnant women in the city, including demographic characteristics, childbearing history, socioeconomic status, and prenatal and childbirth care. The study used Poisson multivariate regression analysis with robust adjustment of variance. Among the 2,557 women included in the study, 65% had not planned the current pregnancy. After adjusting for confounders, the following variables were significantly associated with unplanned pregnancy: black or mixed race, age < 20 years, single marital status, low family income, household crowding, smoking, and multiparity. Previous abortion was a protective factor against unplanned pregnancy. The high unplanned pregnancy rate, especially among women with increased risk of complications during pregnancy and childbirth, highlights the need to target healthcare programs for this group.
- ItemAtividade física durante a gestação e associação com indicadores de saúde maternoinfantil(2012) Dumith, Samuel de Carvalho; Domingues, Marlos Rodrigues; Sassi, Raul Andrés Mendonza; Cesar, Juraci AlmeidaOBJETIVO: Analisar fatores associados à prática de atividade física durante a gestação e sua relação com indicadores de saúde materno-infantil. MÉTODOS: Estudo transversal realizado com todos os nascimentos ocorridos em maternidades no município de Rio Grande, RS, durante o ano de 2007 (N = 2.557). As informações foram obtidas por entrevista, por meio de um questionário pré-codifi cado aplicado às mães. Os desfechos de saúde maternoinfantil analisados foram: hospitalização durante a gravidez, parto por cesárea, prematuridade (idade gestacional menor de 37 semanas), baixo peso ao nascer (< 2.500 g) e morte fetal. RESULTADOS: Relataram ter praticado atividade física durante a gestação 32,8% (IC95% 31,0;34,6) das mães. Os fatores associados à prática de atividade física na gestação, após ajustes para possíveis confundidores, foram: idade materna (associação inversa), escolaridade (associação direta), ser primigesta, ter feito pré-natal, e ter recebido orientação para a prática de exercícios durante o pré-natal. Mulheres que praticaram atividade física durante a gestação mostraram menor probabilidade de realização de cesariana e de terem fi lho natimorto. Não houve associação entre atividade física e parto prematuro, hospitalização e baixo peso ao nascer. CONCLUSÕES: Apenas um terço das mães relatou ter praticado atividade física durante a gestação. Esse comportamento foi mais frequente entre mulheres mais jovens, com maior escolaridade e que receberam orientação. Mulheres que praticaram atividade física durante a gestação realizaram menos cesarianas e tiveram menor ocorrência de natimorto.
- ItemAssistência à gestação e ao parto: resultados de dois estudos transversais em áreas pobres das regiões Norte e Nordeste do Brasil(2008) Cesar, Maria Aurora Dropa Chrestani; Santos, Iná da Silva dos; Cesar, Juraci Almeida; Winckler, Leonardo Slhessarenko; Gonçalves, Tatiane da Silva; Neumann, Nelson ArnsIn 2002 and 2005, two surveys were conducted in poor areas of North and Northeast Brazil to evaluate prenatal care received by mothers of children under five years old. The study covered 1,528 and 1,529 children in 2002 and 2005, respectively. In this three-year period, maternal schooling and monthly family income increased by 1.5 years and US$ 50.00, respectively, availability of safe drinking water increased from 23% to 41%, the proportion of pregnant woman with six or more prenatal visits increased from 42% to 52%, and immunization against neonatal tetanus increased from 54% to 77%. Coverage of uterine height evaluation increased from 54% to 77%. Testing for HIV and syphilis virtually doubled, from 8% to 16%. Meanwhile, gynecological examinations dropped from 41% to 31% and counseling for breastfeeding decreased from 66% to 55%. Despite improvements, the study’s results show that the target indicators in these areas fall short of those in more developed regions of Brazil. Efforts should be made to reduce this gap.
- ItemAvaliando o conhecimento sobre pré-natal e situações de risco à gravidez entre gestantes residentes na periferia da cidade de Rio Grande, Rio Grande do Sul, Brasil(2007) Sassi, Raul Andrés Mendonza; Cesar, Juraci Almeida; Ulmi, Eduardo Fleck; Mano, Patricia de Souza; Dall'Agnol, Marinel Mór; Neumann, Nelson ArnsThe aim of this study was to assess knowledge on prenatal care and pregnancy risk among women in poor neighborhoods in the city of Rio Grande, Rio Grande do Sul State, Brazil. Data were collected using a cross-sectional design. A standard questionnaire was applied to all preg- nant women from poor neighborhoods. Trained interviewers visited these women at home, covering demographic, socioeconomic, and reproductive data and knowledge concerning prenatal care and pregnancy risk factors. A total of 367 pregnant women were interviewed using nonrandom sampling. Except for urine tests and HIV testing, spontaneously reported as necessary, other procedures were reported by no more than 30% of the women. Digital vaginal examination, clinical breast examination, and Pap smear were reported by a maximum of 7% of the women. Only two-thirds felt that vaginal bleeding and abdominal pain were serious signs during gestation. Other signs and symptoms were reported by a maximum of one-third of the women. In conclusion, knowledge of prenatal tests and situations indicating serious risk fell far short of the desired levels. Improving this level of information in pregnant women could help reduce maternal and child morbidity and mortality.
- ItemThe use of maternal and child health services in three population-based cohorts in Southern Brazil, 1982-2004(2008) Cesar, Juraci Almeida; Manitto, Alicia Matijasevich; Santos, Iná da Silva dos; Barros, Aluísio Jardim Dornellas de; Costa, Juvenal Soares Dias da; Barros, Fernando Celso Fernandes de; Victora, Cesar GomesThis study aimed to describe indicators of health care assistance during antenatal care, delivery and in the first year of life in Pelotas, Rio Grande do Sul State, Brazil. In 1982, 1993, and 2004, all hospital newborns from the urban area of Pelotas were enrolled in a cohort study. In this period, the number of pregnant women that did not attend antenatal care fell from 4.9% to 1.9%; the mean number of appointments increased from 6.7 to 8.1; and the number of women who began antenatal care in the third trimester of pregnancy decreased from 14.8% to 7%; caesarean sections increased from 27.7% to 45.2% and the proportion of deliveries assisted by physicians increased from 61.2% to 89.2%. Improvements in immunization rates during the first year of life mainly occurred between 1982 and 1993, while the number of preventive medical appointments improved among those born in 2004. This increase in coverage was greater for low-income mothers and children, which may reflect the implementation of universal coverage in Brazil; however, coverage levels in 1982 were already high for wealthy mothers and children, reducing the scope for further gains.
- ItemIniquidade na assistência à gestação e ao parto em município do semiárido brasileiro(2011) Mano, Patricia de Souza; Cesar, Juraci Almeida; Chica, David Alejandro González; Neumann, Nelson ArnsObjectives: to evaluate inequality in health care during gestation and delivery for women with children under five years of age resident in the Municipality of Caracol, in the Brazilian State of Piauí. Methods: a household questionnaire was applied to a cross-sectional systematic sample to collect data on the demographic characteristics of mothers and children, health care during pregnancy and deliver and socio-economic status. A tercile score was created using the principal component technique. The associations between this score and variables relating to health care for women during pregnancy and childbirth were evaluated using the chi-square and Kruskal-Wallis test. Results: all the 405 children covered by the study came from families with an income of less than one minimum wage per month; 65% lived in rural areas. Mothers belonging to the highest socioconomic tercile had a larger number of pre-natal consults; they had the largest number of urine tests, hemograms, cytopathological tests of the cervix and ultrasound, and their babies were delivered by a doctor with a higher frequency of caesarian sections. Conclusions: even among the poorest sectors of society there are enormous health inequalities. It is imperative that the factors determining this poverty be addressed with more aggressive social programs and priority given to caring for the poorest of the poor.
- ItemCaracterísticas sociodemográficas e de assistência à gestação e ao parto no extremo sul do Brasil(2011) Cesar, Juraci Almeida; Sassi, Raul Andrés Mendonza; Chica, David Alejandro González; Mano, Patricia de Souza; Goulart-Filha, Sirlei de MouraThis study aimed to compare prenatal and childbirth care received by teenagers and older mothers in Rio Grande, Rio Grande do Sul State, southern Brazil. From January 1st to December 31st 2007, all mothers were interviewed with a standardized questionnaire on the care they received. The chi-square test was used to compare proportions between adolescent and non-adolescent mothers. One-fourth (516) of the infants were born to adolescent mothers. Compared to older mothers, teenagers showed lower rates of the following: completion of at least six prenatal visits (61% x 75%), initiation of prenatal care in the first trimester (58% x 77%), tetanus vaccination (81% x 85%), and completion of prenatal visits with the same health professional (70% x 78%). Meanwhile, teenage motherhood was associated with more: supplementation for iron deficiency (66% x 57%), use of forceps (11% x 6%), and episiotOmy (86% x 66%). The findings show that teenage mothers received worse prenatal and childbirth care than older mothers.