[Pre-pregnancy nutritional status, maternal weight gain, prenatal care, and adverse perinatal outcomes among adolescent mothers]

Epidemiology of Adverse Outcomes in Teenage Pregnancy-A Northeastern Romanian Tertiary Referral Center

Background: Despite being a very well-documented subject in the literature, there are still conflicting results regarding teenage pregnancies and their fetal outcomes. Methods: We conducted a retrospective, comparative cohort study that included 1082 mothers aged less than 18 years, compared to 41,998 mothers aged over 18 years, who delivered in our tertiary referral center between January 2015 and December 2021. To check for significant differences between the two groups, the chi-qquared or Fisher’s test for categorical variables were used. Results: We detected statistically significant higher rates of fetal malformation, premature birth, FGR and SGA fetal growth conditions, preeclampsia, condylomatosis and vaginal infection with E. coli in our cohort of teenagers. In this subpopulation of teenagers, the rate for premature birth at less than 32 weeks of gestation was 3.26-fold higher and 3.25-fold higher for condylomatosis, and these results referred to the cohort of adult patients (>18 years old) that gave birth in the same interval of time. Conclusions: Teenage pregnancies still remain a major health problem that burdens all countries worldwide regardless of their income. It needs solutions initially to prevent pregnancy in this young age segment and last but not least to improve both maternal and fetal outcomes.

Recurrence of teenage pregnancy: associated maternal and neonatal factor outcomes

The present study aims to analyze the socioeconomic and demographic factors associated with the recurrence of teenage pregnancy, as well as to verify the association with unfavorable maternal and neonatal outcomes. It is a cross-sectional study, based on data from "Nascer no Brasil", comprised of adolescent mothers and their newborns. Univariate and multiple logistic regression were used to indicate the factors associated with this recurrence. Recurrence of teenage pregnancy was associated with a maternal age of 17-19 years (OR=3.35; 95%CI=2.45-4.59); an inadequate education for their age (OR=4.34; 95%CI=3.50-5.39), with no intention of becoming pregnant; residency in the state capital; and the fact that the partner is the head of the family. However, as independent primiparous teenagers, there is a greater chance of hypertension and restricted intrauterine growth. It can therefore be concluded that there is a high percentage of teenage pregnancies in Brazil. Teenagers with a partner, inadequate education, and no reproductive planning are more likely to have two or more pregnancies before the age of 20, demonstrating difficulties in postponing the first pregnancy. However, as primiparous teenagers, they are more likely to have complications than multiparous teenagers.

Recurrence of teenage pregnancy: associated maternal and neonatal factor outcomes

Abstract The present study aims to analyze the socioeconomic and demographic factors associated with the recurrence of teenage pregnancy, as well as to verify the association with unfavorable maternal and neonatal outcomes. It is a cross-sectional study, based on data from “Nascer no Brasil”, comprised of adolescent mothers and their newborns. Univariate and multiple logistic regression were used to indicate the factors associated with this recurrence. Recurrence of teenage pregnancy was associated with a maternal age of 17-19 years (OR=3.35; 95%CI=2.45-4.59); an inadequate education for their age (OR=4.34; 95%CI=3.50-5.39), with no intention of becoming pregnant; residency in the state capital; and the fact that the partner is the head of the family. However, as independent primiparous teenagers, there is a greater chance of hypertension and restricted intrauterine growth. It can therefore be concluded that there is a high percentage of teenage pregnancies in Brazil. Teenagers with a partner, inadequate education, and no reproductive planning are more likely to have two or more pregnancies before the age of 20, demonstrating difficulties in postponing the first pregnancy. However, as primiparous teenagers, they are more likely to have complications than multiparous teenagers.

Factors associated with the adequacy of gestational weight gain among Brazilian teenagers

The scope of this article is to evaluate the adequacy of total gestational weight gain (GWG) according to maternal characteristics of Brazilian adolescents. It involved a cross-sectional, hospital-based study. A total of 3,904 teenagers with a single fetus gestation and gestational age (GA) at birth ≥ 37 weeks were included. A hierarchical model was built to analyze the dependent and independent variables adequacy of GWG: sociodemographic, care, obstetric and behavioral characteristics. The chances of insufficient GWG were higher for adolescents from the North (OR = 1.50, 95%CI: 1.07-2.10) and Northeast (OR = 1.68, 95%CI: 1.27-2.21). Paid work increased the chances of insufficient (95%CI: 1.15-2.39) and excessive (95%CI: 1.01-1.86) GWG. The pre-pregnancy body mass index of overweight or obese adolescents was associated with excessive GWG (OR = 1.86, 95%CI: 1.19-2.92 and OR = 3.06, 95%CI: 2.10-4.45, respectively), as well as GA ≥ 42 weeks (OR = 2.23, 95%CI: 1.03-4.81). Living in the North and Northeast regions increases the chances of adolescents having insufficient GWG. Having paid work was associated with a greater chance of excessive and insufficient GWG. Furthermore, pre-pregnancy excess weight or obesity and GA ≥ 42 weeks increased the chances of excessive GWG.

Bolsa Familia Program and Perinatal Outcomes: NISAMI Cohort

This study aimed to assess the impact of the Bolsa Familia Program on perinatal outcomes of pregnant women. A cohort study was conducted with pregnant women supported by prenatal services at 17 Family Health Units in Bahia, Brazil. A previously tested structured questionnaire, which has sociodemographic, economic, prenatal care, lifestyle, and nutritional variables, has been used to collect data. The outcomes included premature birth and low birth weight. A hierarchical conceptual model was constructed, and logistic regression analysis was performed. From a total of 1173 pregnant women, the identified average age was 25.44 years and 34.10% had pre-gestational overweight. The non-beneficiary pregnant women presented a 1.54 (95% CI = 0.46-5.09) times higher chance of giving birth to children with low weight and a 1.03 (95% CI = 95% CI = 0.53-2.00) times chance of premature birth when compared to the beneficiary group. In the multilevel model, some variables were statistically significant, such as age between 18 and 24 years (p = 0.003), age greater than or equal to 35 years (p = 0.025), family income (p = 0.008), employment status (p = 0.010), and maternal height (p = 0.009). The Bolsa Familia Program, as an integrated strategy of social inclusion and economic development, is suggested to exert a protective effect on the health of mother-concept binomial.

Factors associated with the adequacy of gestational weight gain among Brazilian teenagers

Abstract The scope of this article is to evaluate the adequacy of total gestational weight gain (GWG) according to maternal characteristics of Brazilian adolescents. It involved a cross-sectional, hospital-based study. A total of 3,904 teenagers with a single fetus gestation and gestational age (GA) at birth ≥ 37 weeks were included. A hierarchical model was built to analyze the dependent and independent variables adequacy of GWG: sociodemographic, care, obstetric and behavioral characteristics. The chances of insufficient GWG were higher for adolescents from the North (OR = 1.50, 95%CI: 1.07-2.10) and Northeast (OR = 1.68, 95%CI: 1.27-2.21). Paid work increased the chances of insufficient (95%CI: 1.15-2.39) and excessive (95%CI: 1.01-1.86) GWG. The pre-pregnancy body mass index of overweight or obese adolescents was associated with excessive GWG (OR = 1.86, 95%CI: 1.19-2.92 and OR = 3.06, 95%CI: 2.10-4.45, respectively), as well as GA ≥ 42 weeks (OR = 2.23, 95%CI: 1.03-4.81). Living in the North and Northeast regions increases the chances of adolescents having insufficient GWG. Having paid work was associated with a greater chance of excessive and insufficient GWG. Furthermore, pre-pregnancy excess weight or obesity and GA ≥ 42 weeks increased the chances of excessive GWG.

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI

Abstract The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

Pregnancy in adolescence in Brazil: associated factors with maternal age

Abstract Objectives: describing maternal characteristics, risk behavior, obstetric data, prenatal care and childbirth in adolescent mothers in Brazil (age groups: 12-16 years and 17-19 years). Methods: hospital-based cross-sectional study substantiated by Nascer no Brasil”, (Born in Brazil) data. The study encompassed puerperal adolescent mothers from all regions in the country, and their newborns. Chi-square test was used to compare adolescents in the 12-16 years old age group and those in the 17-19 years old age group. Results: pregnant women in the 12-16 years old age group mostly lived in the Northeast of Brazil (p=0.014); most of them did not have a partner (p<0.001), unplanned pregnancy (p<0.001), they had inadequate schooling for their age (p=0.033), had less than six prenatal consultations (p=0.021), were subjected to episiotomy (p=0.042) and accounted for the largest number of premature babies (p=0.014). Conclusions: puerperal women in the 12-16 years old age group presented vulnerability in their socioeconomic conditions, inadequate assistance at the prenatal and childbirth care, as well as their babies showed neonatal complications that pointed towards these adolescent mothers’ need of multidisciplinary care.

Adequacy of prenatal care considering nutritional assistance in Southern Brazil: Maternar Cohort Study

We verified the prevalence of adequacy in prenatal care considering nutritional assistance and associated factors. It is a cross-sectional study, part of Maternar Cohort Study, conducted between 2018-2019 in Southern Brazil. Women were interviewed during hospitalization in the immediate postpartum period and data were collected from the prenatal chart. Prenatal adequacy and nutritional care were assessed according to criteria from the Brazilian Ministry of Health. Two outcome models were constructed. Outcome 1 consisted of minimal coverage (early prenatal start and minimum number of visits) and exams, and Outcome 2 comprised minimal coverage, exams, and nutritional assistance. Poisson regression was used to estimate prevalence ratios. A total of 802 women were analyzed, and we identified 57% of adequacy of Outcome 1. Unplanned pregnancy (PR = 0.76; 95%CI: 0.68-0.86), parity (PR = 0.88; 95%CI: 0.83-0.94) and prenatal care outside Porto Alegre, Rio Grande do Sul State (PR = 0.80; 95%CI: 0.69-0.92), were associated with lower prenatal adequacy frequencies. Outcome 2 was considered adequate for 10.2% of women. Follow-up by different professionals during prenatal care was associated with lower adequacy (PR = 0.49; 95%CI: 0.28-0.86). Women with high-risk pregnancies had a higher frequency of adequacy in Outcome 1 (PR = 1.21; 95%CI: 1.07-1.37) and in Outcome 2 (PR = 1.75; 95%CI: 1.16-2.64). General adequacy was considered low in both outcomes. There was a lack of nutritional assistance during prenatal care. Characteristics such as pregnancy planning, lower parity, prenatal care in Porto Alegre, follow-up by the same professional and high-risk pregnancy were predictors for the adequacy of prenatal care.

Associated factors with excessive weight gain in pregnant women from Maceió, Northeastern Brazil

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.

Trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period

This ecological study aimed to analyze the trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period. We evaluated secondary data of pregnant adolescent beneficiaries of the Bolsa Família Program from January 2008 to December 2018, extracted from the public reports of the WEB Food and Nutrition Surveillance System. We accessed the monitoring reports on the consolidated public-access health conditionalities of the Bolsa Família Program, always considering the second validity. An annual variation of -1.2% (95%CI: [-1.6; -0.8] p<0.01) was observed in the prevalence of underweight in Brazil in the studied sample. The prevalence of overweight and obesity in the country had annual variations of 2.9% (95%CI: [2.0; 3.7] p<0.01) and 7.5% (95%CI: [5.7; 9.3] p<0.01), respectively. We conclude by saying, that, in the evaluated period, the prevalence of underweight among pregnant adolescent beneficiaries of the Bolsa Família Program showed a decreasing trend, while the prevalence of overweight and obesity increased throughout Brazil.

Prenatal and puerperium nutritional care from an integrality perspective in a city of Baixada Santista, São Paulo, Brazil

Abstract Objectives: to perform a comparative assessment of the nutritional care process in the prenatal and puerperium periods at a primary care unit in the city of Santos, SP, Brazil before and after the implantation of the Prenatal and Puerperium Nutritional Care Strategy. Methods: a cross-sectional study was composed of 58 pairs of women and their children, of whom, 30 underwent prenatal care before and 28 of them after the implantation by collecting data from perinatal registrations and children's charts. The care was evaluated by the official National guidelines. The chi-square test was used to compare variables between the pre and post intervention groups. Results: there was a significant improvement after the nutritional intervention, regarding to height (p=0.001), registration on pre-pregnancy weight (p=0.032), follow up on Body Mass Index/gestational week (p=0.001), registration on newborn’s weight at discharge (p=0.011) and daily weight gain at the first pediatric consultation (p=0.019). Conclusions: the Prenatal and Puerperal Nutritional Care Strategy contributed to improve maternal-child nutritional care and the data registration on patients’ charts, demonstrating the necessity to establish processes/flows and an integral care for this population.

Maternal Characteristics and Obstetric and Neonatal Outcomes of Singleton Pregnancies Among Adolescents

Background

Adolescent pregnancy remains a global public health issue with serious implications on maternal and child health, particularly in developing countries The aim of this study was to investigate maternal characteristics and obstetric and neonatal outcomes of singleton pregnancies among adolescents.

Material/Methods

A total of 241 adolescent women who gave birth to singletons between January 2015 and December 2015 at our hospital were included in this descriptive cross-sectional study. Data on maternal sociodemographic and obstetric characteristics as well as neonatal outcome were recorded.

Results

Primary school education (66.0%), lack of regular antenatal care (69.7%), religious (36.7%) and consanguineous (37.0) marriage, Southeastern Anatolia hometown (34.9%) and Eastern Anatolia hometown (21.2%) were noted in most of the adolescent pregnancies, while 95% were desired pregnancies within marriage. Pregnancy complications were noted in 19.5% (preeclampsia in 5.8%) and cesarean delivery was performed in 44.8% of adolescent pregnancies. Preterm delivery rate was 27.0% (20.3% were in >34 weeks). Overall, 13.3% of neonates were admitted to neonatal intensive care unit (NICU) in the postpartum period (prematurity in 28.1%), while 25.3% were re-admitted to NICU admission in the post-discharge 1-month (hyperbilirubinemia in 55.7%). Adolescent pregnancies were associated considerably high rates of fetal distress at birth (28.7%), preterm delivery (26.9%), and re-admission to NICU after hospital discharge (25.3%).

Conclusions

In conclusion, our findings indicate that along with considerably high rates of poor antenatal care, maternal anemia and cesarean delivery, adolescent pregnancies were also associated with high rates for fetal distress at birth, preterm delivery, and NICU re-admission within post-discharge 1-month.

Adequate versus inadequate weight gain and socioeconomic factors of pregnant women followed up in primary care

Abstract Objectives: to identify the socioeconomic factors associated with inadequate (excessive and insufficient) weight gain in women followed during prenatal care in Basic Health Units in a Municipality of the Countryside of Ceará. Methods: a study was carried out with 189 pregnant women. Data were tabulated in the Excel Program and data analysis was performed in the Stata Program. In the bivariate analysis, the chisquare or Fisher's exact test was used, and the Poisson multivariate regression was used for the association between variables and the excessive or insufficient weight gain. Results: insufficient weight gain was associated with the absence of the partner (RR=1.15 CI95% = 1.02 - 1.30) and excessive weight gain was associated with non-working women (RR = 0.90 CI95% = 0.84-0.96). Conclusions: absence of partner and lack of work were associated with inadequate weight gain during pregnancy.

Determinants of low birth weight in the children of adolescent mothers: a hierarchical analysis

This study aimed to identify the determinants of low birth weight (LBW) amongst children of adolescent mothers through a hierarchical approach in a cross-sectional study of 751 adolescents attended at a public hospital in Rio de Janeiro. Sociodemographic data, prenatal care, and biological and maternal obstetric conditions were analyzed. Possible determinants of LBW were identified in the bivariate analysis and then hierarchical logistic regression models were tested, considering as taggered hierarchy of distal, intermediate, and proximal levels. Variables with p < 0.05 at each level of analysis were kept in the model, and the adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated. The prevalence of low birth weight was 10%. The determinants of LBW were: distal level - non-acceptance of pregnancy (OR = 10.19, 95% CI = 1.09 to 39.53); intermediate level - having fewer than six prenatal consultations (OR = 4.29; 95% CI = 1.55 to 11.83) and not having standardized nutritional care (OR = 3.18; 95% CI = 1.18 to 8.55); and proximal level - preterm delivery (OR = 10.19, 95% CI = 2.12 to 49.01). The determinants of LBW were maternal characteristics, prenatal care, and birth conditions, which contain certain modifiable social characteristics.

High-fat diet affects pregestational adiposity and glucose tolerance perturbing gestational placental macronutrient transporters culminating in an obese offspring in wild-type and glucose transporter isoform 3 heterozygous null mice

We examined the effect of a high-fat diet (HFD) vs. control diet (CD) upon pregestational and gestational wild-type (wt) and glucose transporter (glut)3 heterozygous (glut3^+/-) female mice and observed an increase in pregestational body weights, white adiposity (wt > glut3^+/-), circulating cholesterol, and high-density lipoproteins, with glucose intolerance in both genotypes. The HFD-exposed offspring displayed reduced birth weight with catch up to CD-fed in wt vs. an increased birth weight persisting as such at weaning by day 21 in glut3^+/- mice. To decipher the mechanism behind this genotype-specific difference in the HFD offspring's phenotype, we first examined placental macronutrient transporters and noted HFD-induced increase in CD36 in wt with no change in other FATPs, sodium-coupled neutral amino acid transporters and system L amino acid transporter in both genotypes. In contrast, while placental Glut1 increased in both the genotypes, only Glut3 increased in the glut3^+/- genotype in response to HFD. Hence, we next assessed glut3^+/- embryonic (ES) cells under differing stressors of low glucose, hypoxia and inhibition of oxidative phosphorylation. Reduced Glut3-mediated glucose uptake in glut3^+/- vs. wt ES cells culminated in deficient growth. We conclude that maternal HFD affects the in utero growth potential of the offspring by altering placental CD36 and Glut1 concentrations. In contrast, a differential effect on placental Glut3 concentrations between glut3^+/- and wt genotypes is evident, with an increase occurring in the glut3^+/- genotype alone. Deficient Glut3 in ES cells interferes with glucose uptake, cell survival and growth being further exaggerated with low glucose, hypoxia and inhibition of oxidative phosphorylation.

High cholesterol dietary intake during pregnancy is associated with large for gestational age in a sample of low-income women of Rio de Janeiro, Brazil

The association between the quality of maternal dietary fat intake during pregnancy and the infant's birthweight (BW) remains controversial. Our goal was to investigate the association between maternal dietary fat intake during pregnancy and the rate of large for gestational age (LGA) newborns. This study employed a cross-sectional analysis of 297 pairs of mothers/children attending a public maternity at Rio de Janeiro, Brazil. BW for gestational age according to the Intergrowth 21st was defined as follows: adequate for gestational age (AGA ≤ 90th percentile) and LGA (>90th percentile). The statistical analysis was a Poisson regression with robust estimations of the standard errors. Maternal dietary fat intake variables comprised lipids (% total energy); saturated (mg/1000 kcal), monounsaturated (mg/1000 kcal) and polyunsaturated (mg/1000 kcal) fats; and cholesterol (mg/1000 kcal), all of which were obtained with a Food Frequency Questionnaire. The mean BW was 3338 g (SD = 446.9), and the rate of LGA newborns was 13.1%. The mean maternal total energy intake was 2880 kcal (SD = 1074), cholesterol was 154.3 mg/1000 kcal (SD = 68.1) and monounsaturated fat was 6.9 mg/1000 kcal (SD = 2). Mothers of LGA newborns reported higher cholesterol dietary intake (195.8 vs. 148 mg/1000 kcal; P < 0.001), pre-pregnancy body mass index (25.1 vs. 23.5 kg/m2 ; P = 0.026) when compared with mothers of AGA newborns. Women with cholesterol intake within the fourth quartile were 2.48 (95% confidence interval: 1.31-4.66) times more likely to have an LGA infant compared with those in the 1-3 quartiles. Dietary intake of cholesterol during pregnancy influences LGA even after adjusting for other confounders.

Maternal and Perinatal Outcomes Among Adolescents and Mature Women: A Hospital-Based Study in the North of Mexico

STUDY OBJECTIVE

To compare maternal and newborn pregnancy outcomes from adolescents and mature women.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional study was carried out in a public hospital, including women with singleton pregnancies, who were classified according to their age, as follows: group 1: younger than 16 years old (n = 37), group 2: 16-19 years old (n = 288), and group 3: 20-34 years old (n = 632).

INTERVENTIONS AND MAIN OUTCOME MEASURES

Information on clinical characteristics, gynecological and obstetric history, pregnancy complications, and perinatal outcomes was obtained through interviews and from clinical records.

RESULTS

Thirty-four percent of deliveries were from adolescents. Mature women were more likely to have prepregnancy overweight or obesity than adolescents (odds ratio [OR] = 2.4, 95% confidence interval [CI], 1.7-3.4). The frequency of maternal complications during pregnancy or delivery was not different between groups. Birth asphyxia was more frequent in group 2 (P = .02). Women with inadequate prenatal care had an increased risk of preterm deliveries (OR = 1.64; 95% CI, 1.06-2.54) and of having newborns with low birth weight (OR = 2.02; 95% CI, 1.22-3.35). Weight of newborns from noncomplicated pregnancies was lower in group 1 (P = .02), after adjustment for prepregnancy body mass index, gestational weight gain, preterm delivery, and newborn sex.

CONCLUSION

The frequency of maternal and perinatal complications was similar in adolescents and mature women. Birth weight was decreased in noncomplicated pregnancies of adolescents younger than 16 years of age. Adequate prenatal care might be helpful in prevention of some adverse perinatal outcomes.

Atenção nutricional no pré-natal e no puerpério: percepção dos gestores da Atenção Básica à Saúde

RESUMO Objetivo: Avaliar a percepção dos gestores quanto à atenção nutricional ao pré-natal e ao puerpério na rede básica de município da Baixada Santista, São Paulo, segundo estrutura e processo. Métodos: Realizou-se censo das 28 unidades básicas da área insular por meio de entrevistas com gestores. Avaliou-se a atenção nutricional segundo infraestrutura, processo de trabalho e vigilância alimentar e nutricional. Resultados: A inserção do nutricionista foi o principal componente insuficiente da dimensão estrutura, interferindo negativamente na atenção nutricional para 60% dos gestores. Encontrou-se baixa conformidade para as seguintes variáveis da dimensão processo: cálculo do índice de massa corporal (35%), acompanhamento do estado nutricional na curva índice de massa corporal/semana gestacional (46%) e realização de aconselhamento nutricional individualizado no pré-natal (14%). Conclusão: A atenção nutricional pré-natal e puerperal é insatisfatória para alcançar a integralidade do cuidado. Faz-se necessário sensibilizar gestores locais e capacitar equipes de saúde para assegurar a efetividade de tais ações em Santos.

Complications in adolescent pregnancy: systematic review of the literature

Sexual activity during adolescence can lead to unwanted pregnancy, which in turn can result in serious maternal and fetal complications. The present study aimed to evaluate the complications related to adolescent pregnancy, through a systematic review using the Medical Subject Headings: “pregnancy complication” AND “adolescent” OR “pregnancy in adolescence”. Only full original articles in English or Portuguese with a clearly described methodology, were included. No qualitative studies, reviews or meta-analyses, editorials, case series, or case reports were included. The sample consisted of 15 articles; in that 10 were cross-sectional and 5 were cohort studies. The overall prevalence of adolescent pregnancy was 10%, and among the Brazilian studies, the adolescent pregnancy rate was 26%. The cesarean delivery rate was lower than that reported in the general population. The main maternal and neonatal complications were hypertensive disorders of pregnancy, prematurity and low birth weight, respectively. Adolescent pregnancy is related to increased frequency of neonatal and maternal complications and lower prevalence of cesarean delivery.

Idade materna e fatores associados a resultados perinatais

OBJETIVO: Analisar e comparar os resultados perinatais de gestantes adolescentes e em idade tardia com mulheres entre 20 a 34 anos, a partir dos dados do Sistema de Informação de Nascidos Vivos. MÉTODOS: Foi realizado um estudo transversal, com coleta de dados retrospectiva de 18009 nascidos vivos a partir de consultas aos dados do Sistema de Informação de Nascidos Vivos. Os registros dos nascidos vivos foram distribuídos em três grupos: grupo I (adolescentes) - 10 a 19 anos; grupo II - 20 a 34 anos e grupo III (idade tardia) - 35 anos ou mais. RESULTADOS: Os resultados mostraram riscos perinatais relacionados à prematuridade (OR 1,35) e Apgar quinto minuto menor que sete (OR 1,44) em mães adolescentes. O baixo peso ao nascer apresentou risco de 1,22 e 1,24 vezes entre as gestantes do grupo I e III. CONCLUSÃO: Os resultados apontaram elevados índices de nascimento pré-termo, baixo peso ao nascer e Apgar no quinto minuto menor que sete nas gestações ocorridas em adolescentes e em mulheres com idade igual ou superior aos 35 anos.

Body composition and newborn birthweight in pregnancies of adolescent and mature women

Teenage pregnancy has been associated with adverse effects for the mother and the newborn (NB). In order to compare body composition (BC) between adolescents (Ad) and mature women (MW) during pregnancy and to determine the difference in birthweight and perinatal morbidity, pregnant Ad (n=40) and MW (n=227) were studied. BC changes between the second and third trimesters were determined by multifrequency bioelectrical impedance analysis, and birthweight and NB morbidity were evaluated. During the second and third trimesters of the pregnancy, fat mass was lower in the Ad group [16 kg (13-19)] than in the MW group [22 kg (17-27)] (P<0.01; median and quartiles 1-3). Fat-free mass increased by 3.09 kg (2.29-4.20) and 2.20 kg (1.0-3.59) (P≤0.01), and total body water increased by 2.77 L (0.84-4.49) vs. 2.04 L (0.55-3.89) (P=0.36), in the Ad and MW groups, respectively (median and quartiles 1-3). Birthweight was not significantly different between NBs of Ad (3223 ± 399 g) and NBs of MW (3312 ± 427 g, P=0.22). The youngest Ad (<18 year old, n=8) had NB with lower birthweight than MW (3031 ± 503 g, P=0.06). NBs of Ad mothers showed a non-significant trend towards a higher rate of morbidity relative to the NBs of MW. In conclusion, the BC of Ad differs from that of MW during pregnancy. In addition, the NB infants of Ad mothers tended to have a lower birthweight than those from MW, a result that suggests that the Ad should be in strict prenatal control.