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Ranzani OT, Marinho MDF, Bierrenbach AL. Usefulness of the Hospital Information System for maternal mortality surveillance in Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230007. [PMID: 36629619 PMCID: PMC9838231 DOI: 10.1590/1980-549720230007.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/30/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To evaluate the capability of hospital records in the Hospital Information System (SIH) to add valuable and complementary information to the Mortality Information System (SIM) in studies on maternal mortality. We calculated and compared the maternal mortality ratio from the SIH and SIM databases, by age group and region, to highlight differences between groups and assess the coverage of maternal deaths using SIH compared with SIM. METHODS Obstetric hospitalizations were defined based on three sources (codes ICD-10 in diagnoses; procedures; billing information). Hospital and SIM mortality ratios were calculated by dividing maternal deaths in hospitals affiliated to the Unified Brazilian Health System (SUS) per live births (SINASC) in the same hospitals. RESULTS In 2019, we identified 2,497,957 obstetric admissions, 0.04% (946) with in-hospital mortality as outcome. The presence of three criteria identified 98% of obstetric hospitalizations and 83% of obstetric hospitalizations with death as outcome. The comparison of mortality ratios between SIH (45.5 MMR; 95%CI 42.7 - 48.5) and SIM (49.7 MMR; 95%CI 46.7 - 52.8) was not statistically significant (p-value: 0.053). CONCLUSION The analysis of SIH was able to provide additional information for the monitoring and surveillance of maternal health in Brazil. Although there are differences between the mortality rates, the SIH, as a complementary information system to the SIM, may be valid in studies on maternal mortality and morbidity.
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Meier A, Kock KDS. Need for oxygen therapy and ventilatory support in premature infants in a hospital in Southern Brazil. World J Crit Care Med 2022; 11:160-168. [PMID: 36331991 PMCID: PMC9136723 DOI: 10.5492/wjccm.v11.i3.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/19/2021] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Prematurity in newborns is a condition that is associated with worse hospital outcomes when compared to birth to term. A preterm infant (PI) is classified when gestational age (GA) < 37 wk.
AIM To analyze prognostic indicators related to the use of oxygen therapy, non-invasive ventilation (continuous positive airway pressure) and mechanical ventilation (MV) in PI.
METHODS This is a retrospective cohort. The sample was composed of PIs from a private hospital in southern Brazil. We included neonates with GA < 37 wk of gestation in the period of January 1, 2018 to December 31, 2018. For data collection, electronic records were used in the Tasy PhilipsTM system, identifying the variables: maternal age, type of birth, prenatal information, GA, Apgar score, birth weight, neonatal morbidities, vital signs in the 1st hour at birth, need for oxygen therapy, continuous positive airway pressure and MV, hospitalization in the neonatal intensive care unit, length of stay and discharge or death.
RESULTS In total, 90 PI records were analyzed. The median (p25-p75) of GA was 34.0 (31.9-35.4) wk, and there were 45 (50%) males. The most common morbidity among PIs was the acute respiratory discomfort syndrome, requiring hospitalization in the neonatal intensive care unit in 76 (84.4%) cases. The utilization rate of oxygen therapy, continuous positive airway pressure and MV was 12 (13.3%), 37 (41.1%) and 13 (14.4%), respectively. The median (p25-p75) length of stay was 12.0 (5.0-22.2) d, with 10 (11.1%) deaths. A statistical association was observed with the use of MV and GA < 28 wk, lower maternal age, low birth weight, Apgar < 8 and neonatal deaths.
CONCLUSION The identification of factors related to the need for MV in prematurity may help in the indication of a qualified team and technologies to promptly meet the unforeseen events that may occur after birth.
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Affiliation(s)
- Amanda Meier
- Department of Physiotherapy, University of South of Santa Catarina, Tubarão 88704-001, SC, Brazil
| | - Kelser de Souza Kock
- Department of Physiotherapy, University of South of Santa Catarina, Tubarão 88704-001, SC, Brazil
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Alves LC, Costa JR, Monteiro JCDS, Gomes-Sponholz FA. Women's sexual health six months after a severe maternal morbidity event. Rev Lat Am Enfermagem 2020; 28:e3293. [PMID: 32578751 PMCID: PMC7304979 DOI: 10.1590/1518-8345.3500.3293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 03/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to investigate female sexual function in women six months postpartum and to compare sexual function among women who had and who did not have severe maternal morbidity (SMM). METHOD a cross-sectional study conducted with 110 women in the postpartum period, with and without SMM. Two instruments were used, one for the characterization of sociodemographic and obstetric variables and the Female Sexual Function Index (FSFI) for sexual function. Univariate, bivariate and regression model analyses were performed. RESULTS FSFI scores showed 44.5% of female sexual dysfunction, of which 48.7% were among women who had SMM and 42.0% among those who had not. There were significant differences between age (P=0.013) and duration of pregnancy (P<0.001) between women with or without SMM. Among the cases of SMM, hypertensive disorders were the most frequent (83%). An association was obtained between some domains of the FSFI and the following variables: orgasm and self-reported skin color, satisfaction and length of relationship, and pain and SMM. CONCLUSION white women have greater difficulty in reaching orgasm when compared to non-white women and women with more than 120 months of relationship feel more dissatisfied with sexual health than women with less time in a relationship. Women who have had some type of SMM have more dyspareunia when compared to women who have not had SMM.
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Affiliation(s)
- Lisiane Camargo Alves
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre at the Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Jessica Ribeiro Costa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre at the Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Juliana Cristina Dos Santos Monteiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre at the Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Flávia Azevedo Gomes-Sponholz
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre at the Nursing Research Development, Ribeirão Preto, SP, Brazil
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Ali MS, Ichihara MY, Lopes LC, Barbosa GC, Pita R, Carreiro RP, dos Santos DB, Ramos D, Bispo N, Raynal F, Canuto V, de Araujo Almeida B, Fiaccone RL, Barreto ME, Smeeth L, Barreto ML. Administrative Data Linkage in Brazil: Potentials for Health Technology Assessment. Front Pharmacol 2019; 10:984. [PMID: 31607900 PMCID: PMC6768004 DOI: 10.3389/fphar.2019.00984] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/31/2019] [Indexed: 12/17/2022] Open
Abstract
Health technology assessment (HTA) is the systematic evaluation of the properties and impacts of health technologies and interventions. In this article, we presented a discussion of HTA and its evolution in Brazil, as well as a description of secondary data sources available in Brazil with potential applications to generate evidence for HTA and policy decisions. Furthermore, we highlighted record linkage, ongoing record linkage initiatives in Brazil, and the main linkage tools developed and/or used in Brazilian data. Finally, we discussed the challenges and opportunities of using secondary data for research in the Brazilian context. In conclusion, we emphasized the availability of high quality data and an open, modern attitude toward the use of data for research and policy. This is supported by a rigorous but enabling legal framework that will allow the conduct of large-scale observational studies to evaluate clinical, economical, and social impacts of health technologies and social policies.
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Affiliation(s)
- M Sanni Ali
- Faculty of Epidemiology and Population Health, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Center for Statistics in Medicine (CSM), University of Oxford, Oxford, United Kingdom
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
- Institute of Public Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | | | - George C.G. Barbosa
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Robespierre Pita
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Roberto Perez Carreiro
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | | | - Dandara Ramos
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Nivea Bispo
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Fabiana Raynal
- Department of Management and Incorporation of Health Technology, Ministry of Health (DGITS/MS), Brasília, Brazil
| | - Vania Canuto
- Department of Management and Incorporation of Health Technology, Ministry of Health (DGITS/MS), Brasília, Brazil
| | - Bethania de Araujo Almeida
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Rosemeire L. Fiaccone
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
- Institute of Public Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Department of Statistics, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Marcos E. Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
- Department of Computing, Federal University of Bahia (UFBA), Salvador, Brazil
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
| | - Mauricio L. Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Osvaldo Cruz, Salvador, Brazil
- Institute of Public Health, Federal University of Bahia (UFBA), Salvador, Brazil
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Ledo DL, Suano-Souza FI, Franco MDCP, Strufaldi MWL. Body Mass Index and Cardiovascular Risk Factors in Children and Adolescents with High Birth Weight. ANNALS OF NUTRITION AND METABOLISM 2018; 72:272-278. [PMID: 29649809 DOI: 10.1159/000488595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/19/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND/AIMS This study aimed to identify a possible association among high birth weight with overweight/obesity, high arterial blood pressure, dyslipidemia, and insulin resistance in children and adolescents. METHODS This is a cross-sectional study with 719 children and adolescents (6-12 years) stratified according to birth weight (low birth weight [LBW] <2,500 g, adequate birth weight [ABW] 2,500-3,999 g, and high birth weight [HBW] ≥4,000 g). Data collected were anthropometric data, arterial blood pressure levels, lipid profile, and insulin resistance (fasting glucose and insulin, used to calculate homeostatic model assessment-IR). RESULTS The mean age of schoolchildren was 9.5 ± 2.0 years and 371 (51.6%) were male. LBW and HBW were observed in 79 of 719 (10.9%) and 40 of 719 (55.6%) children/adolescents, respectively. There was no increased risk of overweight (OR 0.9; 95% CI 0.4-2.1; p = 0.964) and obesity (OR 1.4; 95% CI 0.6-3.5; p = 0.588) in HBW group compared to LBW and ABW groups. HBW was not associated with high blood pressure, dyslipidemia, and insulin resistance. The LBW group was independently associated with higher values of systolic (OR 1.07; 95% CI 1.05-1.10; p < 0.01) and diastolic blood pressure (OR 1.04; 95% CI 1.00-1.07; p = 0.044). CONCLUSION There was no association between HBW with overweight/obesity and classic cardiovascular risk factors in this group of children/adolescents. Only LBW was related to higher blood pressure levels.
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Affiliation(s)
- Daniel L Ledo
- Master's Degree in Pediatrics and Sciences Applied to Pediatrics, Federal University of São Paulo/São Paulo School of Medicine, São Paulo, Brazil
| | - Fabíola Isabel Suano-Souza
- Associate Professor of the Department of Pediatrics, Federal University of São Paulo/São Paulo School of Medicine and Assistant Professor of the Department of Pediatrics, ABC Medicine Faculty, São Paulo, Brazil
| | - Maria do Carmo P Franco
- Associate Professor of the Department of Physiology, Federal University of São Paulo/São Paulo School of Medicine, São Paulo, Brazil
| | - Maria Wany L Strufaldi
- Adjunct Professor of the Department of Pediatrics, Federal University of São Paulo/São Paulo School of Medicine, São Paulo, Brazil
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