Vitamin A is a crucial micronutrient for pregnant women and their fetuses. In addition to being essential for morphological and functional development and for ocular integrity, vitamin A exerts systemic effects on several fetal organs and on the fetal skeleton. Vitamin A requirements during pregnancy are therefore greater. Vitamin A deficiency (VAD) remains the leading cause of preventable blindness in the world. VAD in pregnant women is a public health issue in most developing countries. In contrast, in some developed countries, excessive vitamin A intake during pregnancy can be a concern since, when in excess, this micronutrient may exert teratogenic effects in the first 60 days following conception. Routine prenatal vitamin A supplementation for the prevention of maternal and infant morbidity and mortality is not recommended; however, in regions where VAD is a public health issue, vitamin A supplementation is recommended to prevent night blindness. Given the importance of this topic and the lack of a complete, up-to-date review on vitamin A and pregnancy, an extensive review of the literature was conducted to identify conflicting or incomplete data on the topic as well as any gaps in existing data.
Vitamin A is essential for mother and child; however, vitamin A deficiency (VAD) remains a public health issue in various countries, affecting around 19 million pregnant women. In Brazil, the scarcity and inconsistency of data have prevented the prevalence and epidemiological status of VAD from being established. This study aimed to analyze vitamin A nutritional status in women receiving prenatal care at a reference center in northeastern Brazil. A cross-sectional study was conducted with a sample of 676 women. Serum retinol was measured by high-performance liquid chromatography. Subclinical infection was detected by measuring C-reactive protein (CRP). The World Health Organization criteria were used in the prevalence analysis, VAD classification level, and CRP effect evaluation. The prevalence of VAD (serum retinol <0.70 μmol/L) was 6.2% (95% confidence interval 4.5–8.3). In the univariate analysis, the variables significantly associated with VAD (p < 0.05) were having <12 years of schooling, being in the third trimester of pregnancy, and anemia. In the final multivariate model, the variables that remained significantly associated (p < 0.05) were being in the third trimester of pregnancy and anemia. VAD constituted a mild public health problem in this sample of pregnant women and was associated with the third trimester of pregnancy and maternal anemia.
Objective: to identify the prevalence and factors associated with the occurrence of skin-to-skin contact and the early initiation of breastfeeding in a Baby-friendly hospital in northeastern Brazil. Method: cross-sectional study, composed of pregnant women, in which delivery occurred at the Baby-friendly Hospital. Data were collected between April 2017 and May 2019 through forms containing sociodemographic variables, obstetric history and data on the delivery and birth of the newborn. The possible associated factors were analyzed through the chi-square test, adopting the significance level of 0.05. Result: among the 727 pregnant women, skin-to-skin contact occurred in 83.6% and breastfeeding in 58.3%. Full-term birth, birth weight ≥ 2500g, Apgar index >7 in the first minute, vaginal delivery, 6 or more prenatal consultations and years of study >9 were the factors associated with the practice of skin-to-skin contact. Regarding breastfeeding, in addition to the first five factors related to skin-to-skin contact, a statistical relationship with the beginning of prenatal care in the first trimester, skin-to-skin contact and multiparity was also evidenced. Conclusions: this study found a prevalence rate of skin-to-skin contact appropriate to a Baby-friendly Hospital and a direct association of this practice with breastfeeding.
Objectives: to identify the prevalence and to analyze the factors associated with low birth weight in a subnormal urban cluster in Pernambuco under Family Health Strategy’s care. Methods: a cross-sectional study with a census sample carried out between July and October in 2015. The variables studied were age and years of maternal schooling, social status, housing, water supply, waste disposal, prenatal care, alcohol consumption and cigarette smoking during pregnancy, along with gender, birth weight and prematurity. Stata 12.1 was utilized in order to understand the factors associated with low birth weight through uni-and-multivariate Poisson analysis, adjusted and gross prevalence ratios, composing a final statistical model considering p value <0.05 for statistical significance. Results: regarding the 294 children the LBW prevalence was 12.2% (CI95% = 8.7-16.5). Children whose mothers reported drinking during pregnancy were 2.78 times more at risk of being born with low birth weight (p<0.001) when compared with children whose mothers did not report this practice in gestation. Conclusions: the study evidenced the relevance maternal habits bears in the newborns’ health.
Objetivo: Identificar na literatura científica sobre os diagnósticos e intervenções de enfermagem relacionadas aos pacientes com insuficiência cardíaca congestiva. Métodos: Trata-se de revisão integrativa de literatura. Resultados: De acordo com os 15 artigos resultantes da busca, a literatura apontou 9 diagnósticos e 11 intervenções. A maioria dos estudos apresentou diagnósticos e intervenções de enfermagem relacionados ao comprometimento do sistema cardiopulmonar, decorrentes das complicações da Insuficiência Cardíaca Congestiva (ICC) comumente encontradas em pacientes adultos e idosos baseados na Classificação Internacional para a Prática de Enfermagem (CIPE). Considerações finais: Os diagnósticos de enfermagem mais encontrados na literatura foram dispneia, troca de gases prejudicada, edema de membros inferiores, função cardíaca prejudicada, fadiga, débito cardíaco prejudicado, dor, risco para infecção e risco para queda. Em paralelo, as intervenções utilizadas destinam-se à conservação da estabilidade de órgãos-alvo, como coração e pulmão. Os resultados mostram-se atuais e de qualidade, encontrados em importantes bases de dados em saúde e representativos do estado da arte sobre a temática.
A presente pesquisa analisou a influência da dança sênior na qualidade de vida dos idosos. A amostra foi composta de 25 idosos, frequentadores do Centro de Convivência da Melhor Idade (CCMI). Para realização da coleta de dados foi utilizado o questionário World Heath Organization Quality Of Life - Bref (WHOQOL BREF), aplicado antes e após a intervenção. A metodologia utilizada na pesquisa foi de caráter quanti-qualitativo, com objetivo exploratório e interface na pesquisa ação. Os resultados obtidos foram melhorias na qualidade de vida dos idosos, o que fundamentou a influência positiva da dança sênior durante o período de intervenção.
Objetivo: descrever a evolução temporal do pré-natal quanto o mês do início do pré-natal, vacinação e orientações sobre aleitamento materno nos anos de 1997, 2006 e 2016. Método: estudo transversal operacionalizado em bancos de dados da II, III e IV Pesquisa Estadual de Saúde e Nutrição. Foram descritas as variáveis: mês de início do pré-natal, doses da vacina antitetânica e orientação sobre o aleitamento materno recebidas no pré-natal. Protocolo de pesquisa aprovado pelo comitê de ética em pesquisa da instituição. Resultados: em 2016 observou-se aumento significativo do início precoce do pré-natal quando comparado a 1997 e 2006 (p<0,001). A vacinação antitetânica durante a gravidez apresentou um aumento significativo em 2006 e 2016 comparado a 1997, assim como a proporção de gestantes que receberam orientações sobre aleitamento materno durante o pré-natal (p<0,001). Conclusões: houve melhoria da assistência pré-natal quanto ao início precoce, vacinação antitetânica e orientações sobre aleitamento materno.ABSTRACTObjective: to describe the temporal evolution of prenatal care in terms of the month when prenatal care began, vaccination and guidelines on breastfeeding in 1997, 2006 and 2016. Method: cross-sectional study operationalized in databases of the II, III and IV State Health and Nutrition Survey. The variables were described: month when prenatal care began, doses of tetanus vaccine and guidance on breastfeeding received during prenatal care. Research protocol approved by the Research Ethics Committee. Results: in 2016 there was a significant increase in early prenatal care when compared to 1997 and 2006 (p<0.001). Tetanus vaccination during pregnancy showed a significant increase in 2006 and 2016 compared to 1997, as did the proportion of pregnant women who received guidance on breastfeeding during prenatal care (p<0.001). Conclusions: there was an improvement in prenatal care regarding early initiation, tetanus vaccination and guidelines on breastfeeding.RESUMENObjetivo: describir la evolución temporal de la atención prenatal en función del mes de inicio de la atención prenatal, vacunación y guías de lactancia materna en 1997, 2006 y 2016. Método: estudio transversal operacionalizado en bases de datos de la II, III y IV Encuesta Estatal de Salud y Nutrición. Las variables fueron descritas: mes de inicio de la atención prenatal, dosis de vacuna antitetánica y orientación sobre lactancia materna recibida durante la atención prenatal. Protocolo de pesquisa aprobado por el Comité de Ética en Investigación de la instituición. Resultados: en 2016 hubo un aumento significativo en la atención prenatal temprana en comparación con 1997 y 2006 (p <0,001). La vacunación contra el tétanos durante el embarazo mostró un aumento significativo en 2006 y 2016 en comparación con 1997, al igual que la proporción de mujeres embarazadas que recibieron orientación sobre la lactancia materna durante la atención prenatal (p <0,001). Conclusiones: hubo una mejora en la atención prenatal en cuanto a inicio temprano, vacunación antitetánica y guías de lactancia materna.
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