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Ferreira RC, Tenório MCDS, Tenório MB, Mello CS, Oliveira ACMD. Associated factors with excessive weight gain in pregnant women from Maceió, Northeastern Brazil. CIENCIA & SAUDE COLETIVA 2021; 25:3017-3026. [PMID: 32785538 DOI: 10.1590/1413-81232020258.23492018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 11/26/2018] [Indexed: 11/22/2022] Open
Abstract
This article aims to evaluate the associated factors with excessive weight gain in pregnant women from Maceió, the capital of Alagoas, Northeastern Brazil. Cross-sectional study with pregnant women attended in public health in the city of Maceió in 2014, of which socioeconomic, clinical (glycemia, capillary hemoglobin, and blood pressure measurement), dietary, and anthropometric data, including in the latter gestational weight gain, classified as insufficient, adequate and excessive according to the US Institute of Medicine, were collected. The combination of excessive weight gain with the independent variables was tested using the Poisson regression expressed by the Prevalence Ratio (PR) and a 95% confidence interval (CI95%). We studied 403 pregnant women with a mean age of 24.08 ± 6.01 years, with 19.9% of them displayed insufficient weight gain; 14.1% displayed adequate weight gain, and 66.0% displayed excessive weight gain, that was associated with maternal hyperglycemia (PR = 1.35; CI95% = 1.17 to 1.57; p < 0.001). Excessive weight gain is common among pregnant women evaluated with the association of this variable with maternal hyperglycemia.
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Affiliation(s)
- Raphaela Costa Ferreira
- Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas (UFAL). Av. Lourival Melo Mota s/n, Tabuleiro do Martins. 57072-900 Maceió AL Brasil.
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Fróes NBM, Lopes MVDO, Pontes CM, Ferreira GL, Aquino PDS. Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women. Rev Bras Enferm 2020; 73:e20190334. [PMID: 32965412 DOI: 10.1590/0034-7167-2019-0334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 04/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women. METHOD The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory. RESULTS We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them. CONCLUSION The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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Silva SDOCD, Saunders C, Zajdenverg L, Moreira LN, Heidelmann SP, Pereira ACDS, Padilha PDC. Predictive factors for birth weight of newborns of mothers with gestational diabetes mellitus. Diabetes Res Clin Pract 2018; 138:262-270. [PMID: 29412146 DOI: 10.1016/j.diabres.2018.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 01/17/2018] [Accepted: 01/26/2018] [Indexed: 12/17/2022]
Abstract
AIMS To evaluate the predictive factors of birth weight (BW) of newborns of women with gestational diabetes mellitus (GDM). METHODS A cross-sectional study was performed among pregnant women with GDM treated in a public maternity unit, Brazil. We selected 283 pregnant women, with nutritional follow-up initiated till the 28th gestational week, singleton pregnancy, without chronic diseases and with birth weight information of the newborns. The predictive factors of BW were identified by multivariate linear regression. RESULTS Mean maternal age was 31.2 ± 5.8 years; 64.4% were non-white; 70.1% were pre-gestational overweight or obese. Mean BW was 3234.3 ± 478.8 g. An increase of 1 kg of weight in the first and third trimesters increased BW by 21 g (p = 0.01) and 27 g (p = 0.03), respectively. Similarly, the other predictive factors of BW were pre-gestational body mass index (β = 17.16, p = 0.02) and postprandial plasma glucose in the third trimester (β = 4.14, p = 0.008), in the model adjusted by gestational age at delivery (β = 194.68, p < 0.001). CONCLUSIONS The best predictors of BW were gestational age at birth, and maternal pre-gestational and gestational anthropometric characteristics. Maternal glycaemic levels may also influence BW. The results may contribute to a review of prenatal routines for pregnant women with GDM.
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Affiliation(s)
- Sara de Oliveira Corrêa da Silva
- Mestrado Profissional em Nutrição Clínica do, Instituto de Nutrição Josué de Castro, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho, 373, bl. J 2°, andar, sala 26, Cidade Universitária, CEP 21941.590 Rio de Janeiro, RJ, Brazil.
| | - Cláudia Saunders
- Mestrado Profissional em Nutrição Clínica do, Instituto de Nutrição Josué de Castro, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho, 373, bl. J 2°, andar, sala 26, Cidade Universitária, CEP 21941.590 Rio de Janeiro, RJ, Brazil; Maternidade Escola da, Universidade Federal do Rio de Janeiro (UFRJ), Rua das Laranjeiras, 180, Laranjeiras, CEP 22240-003 Rio de Janeiro, RJ, Brazil.
| | - Lenita Zajdenverg
- Maternidade Escola da, Universidade Federal do Rio de Janeiro (UFRJ), Rua das Laranjeiras, 180, Laranjeiras, CEP 22240-003 Rio de Janeiro, RJ, Brazil.
| | | | - Sonaly Petronilho Heidelmann
- Maternidade Escola da, Universidade Federal do Rio de Janeiro (UFRJ), Rua das Laranjeiras, 180, Laranjeiras, CEP 22240-003 Rio de Janeiro, RJ, Brazil.
| | - Ariane Cristine Dos Santos Pereira
- Multiprofessional Residency Program in Perinatal Health, Maternity School, Universidade Federal do Rio de Janeiro (UFRJ), Rua das Laranjeiras, 180, Laranjeiras, CEP 22240-003 Rio de Janeiro, RJ, Brazil.
| | - Patricia de Carvalho Padilha
- Mestrado Profissional em Nutrição Clínica do, Instituto de Nutrição Josué de Castro, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho, 373, bl. J 2°, andar, sala 26, Cidade Universitária, CEP 21941.590 Rio de Janeiro, RJ, Brazil; Maternidade Escola da, Universidade Federal do Rio de Janeiro (UFRJ), Rua das Laranjeiras, 180, Laranjeiras, CEP 22240-003 Rio de Janeiro, RJ, Brazil.
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Vernini JM, Moreli JB, Magalhães CG, Costa RAA, Rudge MVC, Calderon IMP. Maternal and fetal outcomes in pregnancies complicated by overweight and obesity. Reprod Health 2016; 13:100. [PMID: 27567898 PMCID: PMC5002321 DOI: 10.1186/s12978-016-0206-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 07/29/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Overweight and obesity are associated with pregnancy complications and adverse perinatal outcomes, posing short and long-term risks for maternal and child health. This study evaluated maternal, delivery and neonatal outcomes in pregnancies complicated by overweight and obesity. METHODS This prospective cross-sectional study included 258 pregnant women. According to prepregnancy body mass index (BMI), participants were classified as normal weight, overweight, or obese. Data were analyzed using the chi-square test and analysis of variance followed by the Tukey test. Logistic regression was performed to calculate odds ratios and 95 % confidence intervals (p < 0.05). RESULTS Most women ≥ 35 years old were overweight (22.7 %) and obese (27.6 %). Prepregnancy diabetes was significantly associated with obesity (15.7 %, p < 0.000). Obese women showed the lowest weight gain (9.6 ± 7.5Kg). Overweight and obese women practiced physical exercise more frequently (p = 0.010) than normal weight women. A greater proportion of obese mothers (13.4 %) had large for gestational age babies (p = 0.021), with higher thoracic circumference (33.6 ± 2.0 cm) and abdominal circumference (31.6 ± 2.3 cm). Obesity increased the risk of developing hypertension (OR = 7.0; 3.1-15.9), hyperglycemic disturbances (OR = 5.5; 2.9-10.6) and HbA1c ≥ 6.5 % (OR = 3.7; 1.2-11.1). The infants born to obese mothers had longer hospital stay (3.9 ± 3.9 days) (p = 0.005). CONCLUSION Our results confirm that obesity in pregnancy can lead to adverse outcomes, and underscore the importance of identifying and treating inadequate weight status during pregnancy.
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Affiliation(s)
- Joice Monaliza Vernini
- Graduate Program in Gynecology, Obstetrics and Mastology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil
| | - Jusciele Brogin Moreli
- Graduate Program in Gynecology, Obstetrics and Mastology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil
| | - Claudia Garcia Magalhães
- Department of Obstetrics and Gynecology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil
| | - Roberto Antônio Araújo Costa
- Department of Obstetrics and Gynecology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil
| | - Marilza Vieira Cunha Rudge
- Graduate Program in Gynecology, Obstetrics and Mastology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil
| | - Iracema Mattos Paranhos Calderon
- Graduate Program in Gynecology, Obstetrics and Mastology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil. .,Department of Obstetrics and Gynecology, Botucatu Medical School, São Paulo State University - Unesp, São Paulo, Brazil.
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Fraga ACSA, Theme Filha MM. Factors associated with gestational weight gain in pregnant women in Rio de Janeiro, Brazil, 2008. CAD SAUDE PUBLICA 2014; 30:633-44. [PMID: 24714952 DOI: 10.1590/0102-311x00085313] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 08/29/2013] [Indexed: 11/22/2022] Open
Abstract
Inadequate weight gain during pregnancy is an important predictor of complications for the mother and infant. This cross-sectional study assessed factors associated with inadequate weight gain among women in the third trimester of pregnancy who received prenatal care under the Brazilian Unified National Health System (SUS) in the city of Rio de Janeiro, Brazil, from November 2007 to July 2008. A total of 1,079 pregnant women were interviewed, and adequacy of weight gain was obtained by calculating weight gain as recommended by the U.S. Institute of Medicine. Social, demographic, and obstetric factors were analyzed as independent variables. A multinomial logistic regression model was used, and pregnant women with weight gain below or above the recommended levels were compared to those with adequate weight gain. Low schooling was associated with insufficient weight gain, while excessive gain was observed in women with hypertension and pre-gestational underweight, overweight, and obesity. Nutritional assessment during prenatal care is essential, and interventions should target cases of inadequate weight gain in order to prevent complications for the mother and infant.
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Alves ADS, Coutinho I, Segatto JCM, Silva LA, Silva MDDS, Katz L. Avaliação da adequação do rastreamento e diagnóstico de Diabetes Mellitus Gestacional em puérperas atendidas em unidade hospitalar de dois municípios da região do Vale do São Francisco - Nordeste do Brasil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: avaliar a adequação do rastreamento e do diagnóstico de diabetes mellitus gestacional em puérperas atendidas em unidade hospitalar de dois municípios da região do Vale do São Francisco. Métodos: estudo descritivo, com 1340 puérperas que pariram no Hospital Dom Malan-IMIP-PE e Maternidade Municipal de Juazeiro-BA, de abril de 2011 a janeiro de 2012. Excluídas aquelas com diagnóstico prévio de diabetes mellitus, sem pré-natal sem exames acessíveis. Foram construídas tabelas de distribuição de frequência e medidas de tendência central e dispersão. Resultados: a média de idade gestacional da solicitação da glicemia de jejum foi 14 semanas, adequada em 46%. A idade gestacional média da realização da glicemia foi 16 semanas, realizada até 30 dias após solicitação em 37,9%; recebimento do resultado ocorreu em média na 20ª semana, adequada em 33,4%. A segunda glicemia de jejum foi solicitada e interpretada adequadamente em 28,1% dos casos; 20,8% tiveram resultados glicêmicos da primeira e segunda glicemia de jejum igual ou superior a 85 mg/dL e 11,9% não realizaram ou receberam a glicemia de jejum. Inadequação no rastreamento/diagnóstico detectada em 76,9% (n=1022), e 5,0% (n=67) de quem realizou Teste Oral de Tolerância a Glicose. Alguma inadequação foi observada em 91,9% durante o rastreio. Conclusões: o rastreio/diagnóstico do diabetes gestacional entre as puérperas estudadas foi realizado inadequadamente.
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Affiliation(s)
| | | | | | | | | | - Leila Katz
- Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
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Sato APS, Fujimori E. Nutritional status and weight gain in pregnant women. Rev Lat Am Enfermagem 2013; 20:462-8. [PMID: 22991107 DOI: 10.1590/s0104-11692012000300006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 11/25/2011] [Indexed: 11/21/2022] Open
Abstract
This study described the nutritional status of 228 pregnant women and the influence of this on birth weight. This is a retrospective study, developed in a health center in the municipality of São Paulo, with data obtained from medical records. Linear regression analysis was carried out. An association was verified between the initial and final nutritional status (p<0.001). The mean of total weight gain in the pregnant women who began the pregnancy underweight was higher compared those who started overweight/obese (p=0.005). Weight gain was insufficient for 43.4% of the pregnant women with adequate initial weight and for 36.4% of all the pregnant women studied. However, 37.1% of those who began the pregnancy overweight/obese finished with excessive weight gain, a condition that ultimately affected almost a quarter of the pregnant women. Anemia and low birth weight were uncommon, however, in the linear regression analysis, birth weight was associated with weight gain (p<0.05). The study highlights the importance of nutritional care before and during pregnancy to promote maternal-infant health.
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Assunção PL, Novaes HMD, Alencar GP, Melo ASDO, Almeida MFD. Fatores associados ao nascimento pré-termo em Campina Grande, Paraíba, Brasil: um estudo caso-controle. CAD SAUDE PUBLICA 2012; 28:1078-90. [DOI: 10.1590/s0102-311x2012000600007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 03/27/2012] [Indexed: 11/22/2022] Open
Abstract
Estudo caso-controle (2008-2009) de base populacional que analisou fatores de risco para nascimento pré-termo em Campina Grande, Paraíba, Brasil. Foram incluídos 341 nascimentos pré-termo e 424 controles. Utilizou-se regressão logística múltipla. Foram fatores de risco: idade materna de 35 ou mais (OR = 2,00; IC95%: 1,00-4,03), pré-termo prévio (OR = 2,32; IC95%: 1,25-4,29), pré-natal inadequado (OR = 2,15; IC95%: 1,40-3,27), ganho ponderal materno insuficiente (OR = 2,33; IC95%: 1,45-3,75), dano físico materno (OR = 2,10; IC95%: 1,22-3,60), hipertensão arterial com eclampsia (OR = 17,08; IC95%: 3,67-79,43) e sem eclampsia (OR = 6,42; IC95%: 3,50-11,76), internação (OR = 5,64; IC95%: 3,47-9,15), alteração do volume amniótico (OR = 2,28; IC95%: 1,32-3,95); sangramento vaginal (OR = 1,54; IC95%: 1,01-2,34) e gestação múltipla (OR = 22,65; IC95%: 6,22-82,46). Elevada e homogênea prevalência de pobreza e baixa escolaridade pode ter contribuído para que as variáveis socioeconômicas não permanecessem com associação significativa para o nascimento pré-termo.
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Rodrigues PL, de Oliveira LC, Brito ADS, Kac G. Determinant factors of insufficient and excessive gestational weight gain and maternal-child adverse outcomes. Nutrition 2009; 26:617-23. [PMID: 19944566 DOI: 10.1016/j.nut.2009.06.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 06/24/2009] [Accepted: 06/25/2009] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To estimate the magnitude and determinant factors of insufficient and excessive gestational weight gain (GWG) and its relation with maternal-child adverse outcomes. METHODS This was a prospective study with 173 pregnant women and their newborns monitored at a primary health care facility in Rio de Janeiro. Multinomial regression models were employed, having as the outcome the adequacy of GWG (insufficient, adequate, or excessive). Covariables were classified as biological, socioeconomic, reproductive, behavioral, and nutritional. RESULTS Forty-one percent of pregnant women had insufficient GWG and 22.0% had excessive GWG. Pregestational overweight was associated with insufficient GWG (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.05-0.78), and pregestational obesity was associated with excessive GWG (OR 4.66, 95% CI 1.34-19.08). Also associated with insufficient GWG were a stature <157 cm (OR 2.25, 95% CI 1.03-4.93) and ages 25-29 y (OR 3.70, 95% CI 1.26-10.84) and >or=30 y (OR 2.88, 95% CI 1.13-7.35) compared with the reference group (18-24 y). Age <12 y at menarche (OR 4.97, 95% CI 1.51-16.30) and being a former smoker (OR 5.18, 95% CI 1.62-16.52) demonstrated an association with excessive GWG compared with non-smokers (reference group). Sixty percent of pregnant women with excessive GWG delivered by cesarean section compared with 39.8% with adequate or insufficient GWG (P < 0.05). Prevalence of macrosomia in the excessive GWG group was 23.5% compared with 4.5% for pregnant women with insufficient GWG (P < 0.001). CONCLUSION Different determinant factors related to insufficient and excessive GWG were observed, which can be identified in the beginning of pregnancy, thus predicting unfavorable gestational outcomes. An increased percentage of women presented GWGs outside recommended levels.
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Affiliation(s)
- Patricia Lima Rodrigues
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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