Background: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/ RAM hyperglycemic myopathy will be evaluated. Methods: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. Discussion: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.
Research on adolescence pregnancy (AP) indicated heterogeneity regarding to associated causes and consequences to the development of mothers and children. This paper presents the fourth stage of a longitudinal study including eight dyads (mothers / first children born in adolescence), when the children are 14 years-old. The aim of the study was to update data from dyads psychosocial conditions. The instruments used in their households were interviews, home observations, ASR, CBCL and YSR. Results indicated: mother's loss in professional and educational trajectories; relationships with the original family and the fathers which are in similar positions at the time of pregnancy; frequent references to substance use by fathers; problems between mothers/daughters relationship. Better development conditions were presented in dyads whose relations with the original family and the child's father were good. Higher difficulties were found in those dyads with problems in these relationships. The father figure is indicated as a differential element in the positive or negative condition of the dyads development (mothers and children). The continuity of the longitudinal investigation is suggested when the children are adults in order to allow the verification of possible impacts arising from AP in the long-term development trajectory.
Introduction: Low back pain is a symptom with biopsychosocial implications with the potential to reach the whole individual. The school-age coincides with an important period in human development and in which inequalities and compensation resulting from poor posture or structural changes may increase the chance of the emergence of pain. Objective: To estimate the prevalence of low back pain among adolescents. Methods: The sample consisted of 166 adolescents between 11 and 18 years of age (86 girls and 80 boys) enrolled in a private school in a town in the state of Piauí, in the academic year 2012. A structured questionnaire with closed questions on gender and low back pain aspects was used. Results:Almost 80% of the students reported the presence of low back pain in the past year, and nearly half (41.3%) reported pain classified as 3,according tofaces pain scale.About two-thirds of the adolescents (63.1%) said they did not fail to perform their daily activities due to pain.There was no statistically significant association between gender and low back pain (p = 0.117) or pain intensity (p = 0.065), although for the latter a variable marginal p-value was found.
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