Some studies have suggested that abdominal visceral adipose tissue depth (VAD) measured by ultrasound in early pregnancy, may predict the future onset of gestational diabetes mellitus (GDM). Wheter this is true, independent of pre-pregnancy body mass index (BMi), has been debated, leading the current study. A prospective cohort study was completed, in which VAD was measured at around 14 weeks' gestation. GDM was later assessed by an oral glucose tolerance test at 24 to 28 weeks, according to the iADpSG criteria. Logistic regression analysis and receiver operating curve (Roc) analysis were used to estimate the predictive value of VAD, above and beyond pre-pregnancy BMI. 627 pregnant women were enrolled, and 518 completed the study. VAD was measured at a mean of 14.4 weeks' gestation. 87 women (16.8%) subsequently developed GDM. The unadjusted odds ratio (OR) for developing GDM was 1.99 (95% CI 1.59-2.46) per 1-cm increase in VAD. After adjusting for maternal BMI and age, the OR was 2.00 (95% CI 1.61 to 2.50). The ROC under the curve for developing GDM was higher for VAD (0.70, 95% CI 0.63 to 0.75) than for pre-pregnancy BMI (0.57 95% CI 0.50 to 0.64) (p < 0.001). In conclusion, higher VAD may better predict GDM than pre-pregnancy BMi. Gestational diabetes mellitus (GDM)-glucose intolerance, resulting in new onset in pregnancy-has emerged as a global public health concern 1. GDM is associated with potentially harmful health effects for mother and fetus 2. According to the World Health Organization (WHO), the prevalence of GDM is rising 3 , largely attributed to the worldwide epidemic of obesity, older maternal age at first pregnancy, and a change in the diagnostic criteria for GDM 4. Currently, the International Association of Diabetes recommends screening for GDM among all pregnant women, at 24 to 28 weeks' gestation, using a 75-g oral glucose tolerance test (OGTT) 5. AS this approach lacks a sufficient sensitivity and specificity 6 , a method that may improve the detection of GDM, earlier pregnancy, is desirable. Some studies have shown that abdominal visceral adipose tissue depth (VAD) measured by ultrasound in earlier pregnancy, may predict glucose intolerance, insulin resistance, metabolic syndrome, newborn weight and GDM later in pregnancy 7-13. Recently, Thaware et al. 14 showed that ultrasonography-measured VAD in early pregnancy aided in the early recognition of GDM. They reported that this method, compared with an OGTT alone, could reduce by half number of pregnant women requiring OGTT screening. However, it is not clear whether ultrasonography-measured VAD offers improve discrimination in the detection of GDM compared with simply using pre-pregnancy body mass index (BMI). Herein, we carried out a prospective cohort study among a large sample of pregnant women, to assess the role of VAD in the prediction of GDM. Methods Design and study participants. This was a prospective cohort study of pregnant women, followed from

Background: There is conflicting evidence about the role of oral magnesium supplementation in the prevention of preterm birth and related adverse outcomes. The objective of this study was to compare magnesium citrate with placebo in the prevention of adverse perinatal and maternal outcomes among women at higher risk. Methods: This multicenter, double-masked, placebo-controlled randomized superiority clinical trial compared oral magnesium citrate 300 mg to matched placebo, from 12 to 20 weeks' gestation until delivery. This trial was completed in three centers in northeastern Brazil. Eligible women were those with a singleton pregnancy and ≥ 1 risk factor, such as prior preterm birth or preeclampsia, or current chronic hypertension or pre-pregnancy diabetes mellitus, age > 35 years or elevated body mass index. The primary perinatal composite outcome comprised preterm birth < 37 weeks' gestation, stillbirth > 20 weeks, neonatal death or NICU admission < 28 days after birth, or small for gestational age birthweight < 3rd percentile. The co-primary maternal composite outcome comprised preeclampsia or eclampsia < 37 weeks, severe gestational hypertension < 37 weeks, placental abruption, or maternal stroke or death during pregnancy or ≤ 7 days after delivery. Results: Analyses comprised 407 women who received magnesium citrate and 422 who received placebo. The perinatal composite outcome occurred among 75 (18.4%) in the magnesium arm and 76 (18.0%) in the placebo groupan adjusted odds ratio (aOR) of 1.10 (95% CI 0.72-1.68). The maternal composite outcome occurred among 49 (12.0%) women in the magnesium arm and 41 women (9.7%) in the placebo groupan aOR of 1.29 (95% CI 0.83-2.00). Conclusions: Oral magnesium citrate supplementation did not appear to reduce adverse perinatal or maternal outcomes in high-risk singleton pregnancies. Trial registration: ClinicalTrials.gov NCT02032186, registered January 9, 2014.

Background: Preeclampsia is the major cause of maternal morbidity and mortality in developing countries. Magnesium sulfate is considered first-line therapy against eclampsia and magnesium deficiency in pregnancy has been associated with unfavourable perinatal outcomes. However there are doubts if magnesium supplementation during pregnancy can previne preeclampsia especially in population with high nutritional risk. This trial aims to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women.Methods: This randomized, double-blind, placebo-controlled trial investigated the effect of oral magnesium citrate supplementation for preeclampsia in low-income Brazilian pregnant women, i.e. annual per capita income of US$ 1025 or less. Participants were admitted to the study with gestational age between 12 and 20 weeks. Magnesium serum level was measured pre-randomization and participants with hypermagnesemia were excluded. After randomizationg participants received magnesium citrate capsule (300 mg magnesium citrate) or a daily placebo capsule, until delivery. Intent-to-treat analysis was performed.Results: A total of 416 pregnant women were screened and 318 enrolled according to the inclusion criteria; 159 for each arm. Twenty-eight pregnant women were lost to follow-up. 55/290 (18.9%) of pregnant women developed preeclampsia; 26/143 (18.1%) in magnesium group and 29/147 (19.7%) in the control group; OR 0.90 (CI 95% 0.48-1.69), p = 0.747. No cases of eclampsia were registered.Conclusion: Oral magnesium supplementation did not reduce preeclampsia incidence in low-income and low-risk pregnant women.

Background Oral magnesium for leg cramps treatment in pregnancy is a controversial issue according to recent Cochrane systematic review. This study aims to evaluate the efficacy of Mg ++ supplementation in leg cramps treatment in pregnancy.

Objectives: to describe and discuss interventions and strategies carried out at Faculdade Pernambucana de Saúde (FPS) during the COVID-19 pandemic to mitigate impairment in learning and preserve students, tutors, and staff’s health. Experience report: the teaching methodology used by FPS is problem-based learning, which greatly facilitated the non-discontinuity of theoretical activities carried out in-person in tutorial sessions involving a tutor and 10 to 12 students. This format was transferred to Webex Meetings rooms and held remotely. Practical laboratory activities were suspended and resumed when allowed in July. The teaching outpatient activities (third and fourth year) were suspended and resumed in August. Two years of internship were interrupted for 30 days (fifth year) and for 15 days (sixth year). External activities of practices in primary care were also suspended and resumed gradually. All assessments and activities that required face-to-face meetings, integrations, scientific initiation program orientations, collegiate meetings, meetings of the self-assessment committee were and are being carried out remotely. Conclusions: we believe that we were able to mitigate impairment in students' learning without compromising the conclusion of the school year that was facilitated by Problem Based Learning method.