[Evolution of the completeness and consistency of the gastroschisis registry in the Brazilian Live Birth Information System, from 2005 to 2020]

This study aimed to evaluate the evolution of the completeness and consistency of the gastroschisis registry in the Brazilian Live Birth Information System (SINASC). It is a time-series study on the completeness of the variable "occurrence of congenital anomaly" and the consistency of gastroschisis diagnosis in SINASC, in biennia from 2005 to 2020, for federative units, region, and Brazil. The consistency was estimated by the ratio between deaths from gastroschisis registered in the Brazilian Mortality Information System (SIM) and the total number of cases recorded in SINASC. Temporal trend was analyzed by joinpoint regression. In the period, 46,574,995 live births and 10,024 cases of gastroschisis were recorded. A total of 5,632 infant deaths due to gastroschisis were identified. The percentage of incompleteness decreased from 6.52% to 1.87%, with an annual percentage variation (APV) of -14.5%, and completeness reached excellence (≤ 5% of incompleteness), except in the Central-West Region. Case/death ratios above 1 were found in the North and Northeast regions and in some federative units in the Central-West, but there was a decrease, approaching the mortality found in studies in the South and Southeast regions. Its reduction was more pronounced until 2009-2010 (APV = -10.7%) and smaller later (APV = -4.4%). The quality of the gastroschisis registry reflects regional differences in the overall quality of SINASC, constituting as a marker for malformations that require complex neonatal care.

PRE- AND POSTNATAL MODIFICATIONS IN PARENTAL MENTAL REPRESENTATIONS IN THREE CASES OF FETAL GASTROSCHISIS DIAGNOSED DURING PREGNANCY

The aim of this study was to identify possible effects of gastroschisis on parents' intrapsychic dynamics by applying an observational clinical approach. More specifically, we intend to (a) evaluate the representational style of parents informed about the diagnosis of fetal gastroschisis during pregnancy using the Interview of Maternal Representations During Pregnancy and the Interview of Paternal Representations During Pregnancy (M. Ammaniti, C. Candelori, M. Pola, & R. Tambelli, ) and (b) observe whether the baby's birth influences the parents' representational styles through the application of the same tools (the Interview of Maternal Representations After the Birth, M. Ammaniti & R. Tambelli, , and the Interview of Paternal Representations After the Birth, M. Ammaniti & R. Tambelli, ), adapted to the postnatal period. During the prenatal period, all parents showed a restricted/disinvested style. Three parents-one mother and two fathers-changed their styles from restricted/disinvested to integrated between pregnancy and Month 6 after the birth of their child. Clinical data from the interviews and observations are discussed in an attempt at better defining intrapsychic dynamics of parents after a diagnosis of gastroschisis.

[The association of adherence to a Mediterranean diet during early pregnancy and the risk of gastroschisis in the offspring]

OBJECTIVES

The aim of this study was to study the association of adherence to the Mediterranean diet in early pregnancy maternal and the offspring's risk of gastroschisis.

METHODS

Case-control study. We describe 11 cases of gastroschisis in the region of Murcia from 2007 to 2012 and 34 concurrent controls. At the time of diagnosis each of the cases completed a validated Food Frequency Questionnaire (FFQ) consisting of 98 items on the periconceptional diet. Confounding factors: smoking, exposure to cannabis / marihuana, age of the parents, BMI, income and educational level. We conducted a descriptive and multivariate logistic regression statistical analysis.

RESULTS

Mothers of children with gastroschisis were younger (20.8 years, 95% CI 17.3 to 24.2) and their diet consisted of less caloric intake, saturated fat and monounsaturated fats and proteins than controls. The Odds Ratio (OR) in the multivariate model controlling for confounding factors: maternal age (year) 0.70 (95% CI 0.51 to 0.96), monounsaturated fatty acids (oleic acid, g) 0.79 (95% CI 0.65 to 0, 97) and vegetable intake (rations/week) 0.70 (95% CI 0.48 to 1.00).

CONCLUSION

A maternal diet rich in oleic acid and vegetable products may prevent vascular risk of onphalomesenteric arteries reducing the risk of gastroschisis.