FAMED – Faculdade de Medicina
URI permanente desta comunidadehttps://rihomolog.furg.br/handle/1/2422
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9 resultados
Resultados da Pesquisa
- Item2010 A(H1N1) vaccination in pregnant women in Brazil: identifying coverage and associated factors(2015) Sassi, Raúl Andrés Mendoza; Cesar, Juraci Almeida; Cagol, Jussara Maria; Duarte, Ivanise Almeida; Friedrich, Luana Mostardeiro; Santos, Viviane Kubiszewski dos; Zhang, LinjieO objetivo foi estudar a cobertura vacinal e fatores associados na vacinação contra a gripe pandêmica de 2010 em gestantes brasileiras. Realizou-se um estudo transversal com mulheres que deram à luz em um município do sul do Brasil, em 2010. Dados sobre vacinação contra A(H1N1), características sociodemográficas, morbidades e pré-natal foram coletados. A análise estatística foi realizada utilizando-se a regressão de Poisson. A cobertura foi de 77,4%. A maioria foi vacinada no setor público (97,6%) e no segundo trimestre (47%). Fatores associados que aumentaram a vacinação foram: ser casada, maior idade, estar no primeiro quartil de renda, ter assistência pré-natal e contrair gripe antes da gravidez. Educação e cor da pele não foram associadas significativamente à vacina- ção. A campanha foi extensa e não apresentou desigualdade. O pré-natal foi o fator que afetou mais a cobertura vacinal, refletindo a sua importância para o futuro sucesso das campanhas de vacinação.
- ItemÍndice de massa corporal e ganho de peso gestacional como fatores preditores de complicações e do desfecho da gravidez(2012) Gonçalves, Carla Vitola; Sassi, Raul Andrés Mendonza; Cesar, Juraci Almeida; Castro, Natália Bolbadilha de; Bortolomedi, Ana PaulaOBJETIVO: Avaliar o impacto do índice de massa corporal (IMC) no início da gestação e do ganho de peso no desfecho gestacional, para que esta medida possa ser implantada e valorizada pelos serviços de saúde de pré-natal. MÉTODO: Estudo transversal de base populacional. Na pesquisa, foram incluídos todos os nascimentos ocorridos nas duas únicas maternidades do município do Rio Grande (RS), em 2007. Dentre as 2.557 puérperas entrevistadas, o cálculo do IMC só pôde ser realizado em 1.117 puérperas. A análise foi realizada no programa Stata 11. Nos desfechos hipertensão, diabetes mellitus, trabalho de parto prematuro e cesárea foi realizada regressão logística. No caso do peso ao nascer, o ajuste ocorreu pela regressão logística multinomial, tendo como categoria base o grupo de 2.500 a 4.000 g. Em todas as análises foi adotado valor p<0,05 de um teste bicaudal. RESULTADOS: Não foi observado aumento do risco de hipertensão e diabetes nas pacientes dos diferentes grupos de IMC e ganho de peso. O risco de parto pré-termo foi evidenciado no grupo com ganho de peso ≤8 kg (p<0,05). Em relação à via de parto, observa-se uma tendência, quanto maiores o IMC no início da gestação e o ganho de peso durante a gestação, maior o risco de parto cirúrgico, chegando 11% no grupo de obesas (p=0,004) e a 12% no grupo com ganho ≥17 kg (p=0,001). O peso do recém-nascido foi influenciado pelo IMC e pelo ganho de peso, sendo que quanto maiores o IMC no início da gestação e o ganho de peso gestacional, maior o risco de macrossomia. CONCLUSÕES: O monitoramento do IMC e o ganho ponderal durante a gestação é procedimento de baixo custo e de grande utilidade para o estabelecimento de intervenções nutricionais visando à redução de riscos maternos e fetais.
- ItemDiferentes estratégias de visita domiciliar e seus efeitos sobre a assistência pré-natal no extremo Sul do Brasil(2008) Cesar, Juraci Almeida; Sassi, Raul Andrés Mendonza; Ulmi, Eduardo Fleck; Dall'Agnol, Marinel Mór; Neumann, Nelson ArnsThis non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents, 116 to the group visited by volunteer leaders, and 108 to the control group. Pregnant women visited by community health agents began prenatal visits earlier than other groups, had more prenatal visits, lab tests, and clinical exams, and received more counseling on breastfeeding and iron supplementation. Participation by family members during medical consultations for pregnant women visited by volunteer leaders was higher than for community health agents. Pregnant women visited by community health agents received better prenatal care than the other groups. Home visits can improve the quality of prenatal care for poor women and increase participation by family members (mainly husbands) during the pregnancy.
- 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.
- ItemQualidade e eqüidade na assistência à gestante: um estudo de base populacional no Sul do Brasil(2009) Gonçalves, Carla Vitola; Cesar, Juraci Almeida; Sassi, Raul Andrés MendonzaThis population-based study aimed to evaluate prenatal coverage according to family income in a municipality (county) in Southern Brazil. Data were collected using a questionnaire with mothers in the first 24 hours postpartum. Prenatal coverage, first prenatal consultation in the first trimester, six or more consultations, breast and colposcopic examination, routine prenatal laboratory tests according to the protocol of the Program for Humanization of Prenatal and Delivery Care (PHPN), and prenatal ultrasound increased proportionally with family income, and all were more frequent in women from the highest income quartile (p < 0.001). Despite these results, the prevalence of low birth weight did not show a statistically significant difference between the quartiles. The local health service appeared not to be very effective, since only 26.8% of the women were classified as having received adequate prenatal care according to the PHPN criteria, and care was unequal, since quality of care for women in the lowest income quartile was inferior to that of women in the highest quartile.
- 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.
- ItemPúblico versus privado: avaliando a assistência à gestação e ao parto no extremo sul do Brasil(2011) Cesar, Juraci Almeida; Mano, Patricia de Souza; Carlotto, Kharen; Chica, David Alejandro González; Sassi, Raul Andrés MendonzaObjectives:to compare public and private sector maternity care in the municipality of Rio Grande, in the Brazilian State of Rio Grande do Sul. Methods: a standardized questionnaire was applied to all pregnant women residing in this municipality who had a child in 2007. All aspects, from the beginning of gestation to immediate postpartum were investigated. Statistical analysis took the form of comparison of proportions for these two groups, using the chi-squared test. Results: of the 2584 children born whose mothers resided in the municipality, information was obtained on 2557, representing 98.9% of the total. Of these mothers, 96% received at least one prenatal consultation. Pregnant women attended by the private sector began prenatal care earlier, had a larger number of medical consults, blood tests, pelvic ultrasound examinations, and gynecological examinations of the breasts and cytopathological examinations of the cervix. Pregnant women in the public sector had more urine tests and serum tests for syphilis and were often give iron sulfate supplements. All these differences were statistically significant (p<0.05). Conclusions: pregnant women in the private sector systematically received better prenatal care in terms of consultations and examinations. Their delivery was more often carried out by a physician and they underwent more unnecessary interventions, such as a caesarian section or episiotomy, while they were less likely to receive iron supplements.
- 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.
- ItemDiferenças no processo de atenção ao pré-natal entre unidades da estratégia saúde da família e unidades tradicionais em um município da região Sul do Brasil(2011) Sassi, Raul Andrés Mendonza; Cesar, Juraci Almeida; Teixeira, Tarso Pereira; Ravache, César; Araújo, Gerson Donizete; Silva, Tatiana Corrêa daThis study aimed to evaluate differences in pre-natal care between services under the Family Health Strategy (FHS) and traditional public primary care clinics in Rio Grande, Rio Grande do Sul State, Brazil. A cross-sectional study was performed with all women who gave birth from January 1st to December 31st, 2007, and who received prenatal care in the municipal health system. The procedures recommended by the Ministry of Health were compared according to model of care. Among the 961 pregnant women, those treated under the FHS received a higher percent- age of some forms of care (use of ferrous sulfate, tetanus vaccination, and HIV and syphilis tests). Other procedures were also more frequent under the FHS, but failed to reach the recommended levels (breast examination and Pap smear). Measurement of blood pressure, uterine height, and weight were quite frequent in both groups. Identification of pregnant women in the first trimester failed to reach 70%. Women under the FHS received better care, but some procedures still fell short of expected levels, and efforts are thus needed to improve the quality of prenatal care.