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Marinho I, Silva MRG, Paiva T, Santos-Rocha R, Silva HH. Nutritional Knowledge about Maternal and Newborn Health among Physiotherapists during the COVID-19 Pandemic in Minas Gerais, Brazil. Nutrients 2024; 16:180. [PMID: 38257072 PMCID: PMC10820058 DOI: 10.3390/nu16020180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Adequate nutrition before and during pregnancy, as well as postpartum, is among the major contributors to maternal and newborn health. Physiotherapists' knowledge of this area is still scarce, although their clinical practice has been linked to newborns' neuropsychomotor development, which, in turn, is influenced by maternal health and nutritional status. Therefore, this study aimed to evaluate the nutritional knowledge of physiotherapists regarding maternal and newborn health. A total of 70 Brazilian physiotherapists (32.2 ± 6.0 years; 72.9% females) were evaluated between November 2019 and February 2020 for their sociodemographic characteristics, professional experience, and nutritional knowledge about maternal and newborn health through a validated questionnaire personally administered by the same trained researcher. Most of the physiotherapists had graduated but had no specialization in maternal and child physiotherapy (96.1% of the females and all the males). The nutritional knowledge about maternal and newborn health was significantly different between the female and male health professionals, as well as between the less and more experienced participants, i.e., female physiotherapists and the more experienced ones had more correct answers on the nutritional questionnaire than the male and less experienced physiotherapists, respectively (p < 0.05). Our results open an interesting window for the future education and training of Brazilian physiotherapists in nutrition.
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Affiliation(s)
- Isabelle Marinho
- School of Health Sciences, University Fernando Pessoa, 4249-004 Porto, Portugal
| | - Maria-Raquel G. Silva
- FP-I3ID, FP-BHS, CEBIMED and Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal
- CIAS—Research Centre for Anthropology and Health—Human Biology, Health and Society, University of Coimbra, 3000-456 Coimbra, Portugal
- CHRC—Comprehensive Health Research Centre, Nova Medical School, Nova University of Lisbon, 1150-090 Lisbon, Portugal;
- Gymnastics Federation of Portugal—Scientific Committee, 1600-159 Lisbon, Portugal
- CENC—Sleep Medicine Centre, 1649-035 Lisbon, Portugal
| | - Teresa Paiva
- CHRC—Comprehensive Health Research Centre, Nova Medical School, Nova University of Lisbon, 1150-090 Lisbon, Portugal;
- CENC—Sleep Medicine Centre, 1649-035 Lisbon, Portugal
| | - Rita Santos-Rocha
- ESDRM-IPSANTARÉM Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2001-904 Rio Maior, Portugal;
- CIPER—Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Lisbon, Portugal
| | - Hugo-Henrique Silva
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal;
- Portuguese Ministry of Education, 1399-025 Lisbon, Portugal
- Leixões Sport Clube, Senior Female Volleyball Team, 4450-277 Matosinhos, Portugal
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Cunha ACMC, Katz L, Amorim AFC, Coutinho IC, Souza AS, Katz S, Souza G, Souza G, Farias L, Lemos R, Mello MZ, Neves L, Albuquerque M, Feitosa FE, Paiva J, Lima C, Lima M, Amorim MM. Clinical, epidemiological and laboratory characteristics of cases of Covid-19-related maternal near miss and death at referral units in northeastern Brazil: a cohort study. J Matern Fetal Neonatal Med 2023; 36:2260056. [PMID: 37748920 DOI: 10.1080/14767058.2023.2260056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
Objective: Covid-19 poses a major risk during pregnancy and postpartum, resulting in an increase in maternal mortality worldwide, including in Brazil; however, little research has been conducted into cases of a near miss. This study aimed to describe the frequency of COVID-19-related near miss and deaths during pregnancy or in the postpartum in referral centers in northeastern Brazil, as well as the clinical, epidemiological, and laboratory characteristics of the women who experienced a severe maternal outcome.Methods: A retrospective and prospective cohort study was performed between April 2020 and June 2021 with hospitalized pregnant and postpartum women with a diagnosis of COVID-19 confirmed by real-time polymerase chain reaction (RT-PCR). Data from five tertiary hospitals in northeastern Brazil were evaluated. Descriptive statistical analysis was performed using Epi Info, version 7.2.5.0.Results: A total of 463 patients were included. Of these, 64 (14% of the sample) had a severe maternal outcome, with 42 cases of near miss (9%) and 22 maternal deaths (5%). Patients who had a severe maternal outcome were predominantly young (median age 30 years) and 65.6% were black or brown-skinned. The women had between 6 and 16 years of schooling; 45.3% had a stable partner; 81.3% were pregnant at the time of admission to the study; and 76.6% required a Cesarean section. The great majority (82.8%) had severe acute respiratory syndrome (SARS). Other complications included hypertensive syndromes (40.6%), pneumonia (37.5%), urinary tract infections (29.7%), acute renal failure (25.0%) and postpartum hemorrhage (21.9%). Sepsis developed in 18.8% of cases, neurological dysfunction in 15.6%, and hepatic dysfunction and septic shock in 14.1% of cases each. The relative frequency of admission to an intensive care unit was 87.5%, while 67.2% of the patients required assisted mechanical ventilation, and 54.7% required noninvasive ventilation. Antibiotics were prescribed in 93.8% of cases and corticosteroids in 71.9%, while blood transfusion was required in 25.0% of cases and renal replacement therapy in 15.6%. Therapeutic anticoagulants were administered to 12.5% of the patients. Of the patients who had a severe maternal outcome, the frequency of respiratory dysfunction was 93.8%, with 50.0% developing neurological dysfunction and 37.5% cardiovascular dysfunction. Hematological dysfunction was found in 29.7%, renal dysfunction in 18.8%, and uterine dysfunction in 14.1%. Hepatic dysfunction occurred in 7.8% of the sample. The near-miss ratio for Covid-19 was 1.6/1000 live births and the maternal mortality ratio for Covid-19 was 84.8/100,000 live births, with a mortality index of 34.4% in the sample.Conclusion: This study revealed a low Covid-19-related maternal near miss (MNM) ratio of 1.6/1000 live births and a high Covid-19-related maternal mortality ratio (MMR) of 84.81/100,000 live births. The mortality index was also high. Most of the patients were admitted while pregnant, were young, married and black or brown-skinned, and none had completed university education. The majority had SARS and required admission to an intensive care unit and mechanical ventilation. Most were submitted to a Cesarean section.
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Affiliation(s)
- Anna Catharina M C Cunha
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
- Stricto Sensu Postgraduate Program, IMIP, Recife, Brazl
| | - Leila Katz
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
- Stricto Sensu Postgraduate Program, IMIP, Recife, Brazl
| | | | - Isabela Cristina Coutinho
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
- Stricto Sensu Postgraduate Program, IMIP, Recife, Brazl
| | - Alex Sandro Souza
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
| | - Sara Katz
- Universidade de Pernambuco, Recife, Brazil
| | | | | | | | - Raissa Lemos
- Universidade Catolica de Pernambuco, Recife, Brazil
| | | | - Lucas Neves
- Universidade Federal de Campina Grande, Campina Grande, Brazil
| | | | | | - Jordana Paiva
- Maternidade Escola Assis Chateaubriand, Fortaleza, Brazil
| | - Carolina Lima
- Maternidade Escola Assis Chateaubriand, Fortaleza, Brazil
| | - Marcelo Lima
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Petrolina Brazil
| | - Melania Maria Amorim
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, Brazil
- Stricto Sensu Postgraduate Program, IMIP, Recife, Brazl
- Federal University of Campina Grande (UFCG), Campina Grande, Brazil
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