The neural tube defect prevalence found in this study was higher than the one described in international and Latin-American literature.

Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.

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ResumoObjetivos: avaliar a prevalência e fatores associados aos defeitos de fechamento do tubo neural em recém-nascidos vivos e natimortos, na maternidade do Hospital das Clínicas da UFMG, entre 01/08/1990 e 31/07/2000.Métodos: trata-se de trabalho descritivo, baseado em banco de dados, seguindo normas do Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC). São confeccionadas fichas dos recém-nascidos vivos e natimortos com anomalias congênitas, com descrição morfológica, resultados de necropsia, exames complementares, história familiar, social, da gravidez, e outros dados clínicos. Cada recém-nascido vivo malformado dá origem a um controle, do mesmo sexo, sem malformações. Os recém-nascidos vivos e natimortos com defeitos de fechamento do tubo neural, no período, foram classificados de acordo com o defeito apresentado e com a presença ou ausência de outros defeitos associados. Foram comparados sexo, peso, idade e paridade materna com os demais recém-nascidos vivos e natimortos do período. A análise estatística utilizou o programa EpiInfo 6.0.Resultados: a prevalência dos defeitos de fechamento do tubo neural foi de 4,73:1.000 partos (89:18.807), tendo sido maior entre os natimortos (23,7:1.000) que entre os recém-nascidos vivos (4,16:1.000), p<0,001. Os defeitos de fechamento do tubo neural foram mais freqüentes entre os recém-nascidos vivos de baixo peso (<2.500g), p<0,001, e menos freqüentes entre os filhos de multíparas (>3 gestações), p=0,007. Não houve associação com sexo ou idade materna. Entre os natimortos não houve associação com sexo, peso, paridade ou idade materna. Os defeitos de fechamento do tubo neural mais freqüen-tes foram mielomeningocele (47,2%), anencefalia (26,9%) e encefalocele (16,9%). Os defeitos se encontravam como anomalia isolada em 71,1% dos recém-nascidos vivos e 38,5% dos natimortos; faziam parte de uma síndrome em 9,2% dos recém-nascidos vivos e em 7,7% dos natimortos.Conclusão: a prevalência dos defeitos de fechamento do tubo neural foi maior do que a descrita na literatura internacional e na literatura latino-americana.J Pediatr (Rio J) 2003;79(2):129-34: anormalidades, defeitos do tubo neural, anencefalia, encefalocele, mielomeningocele. AbstractObjectives: to evaluate the prevalence and factors

Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55%. The overall CSR was 23.53%, distributed across risk levels of low (12.55%), moderate (1.18%), and high (9.80%). Our rates approximate those found in another Brazilian study (18.4%). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95% confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95% CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95% CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.

Methods:A retrospective, database driven study, part of the LatinAmerican collaborative study of congenital malformations. Records were reviewed on all live born (LB) and stillborn (SB) infants with congenital heart diseases diagnosed by postnatal echocardiogram or by autopsy. Data on birth weight, sex, age and parity were collected for the LB and studied for associations. The statistical analysis employed Pearson's chisquare test and multinomial logistic regression.Results: During the period studied there were 29,770 births (28,915 LB and 855 SB). The prevalence of heart disease among the LB was 9.58:1,000 (277/28,915) while among SB the rate was 87.72:1,000 (75/ 855). Heart disease occurred isolated in 37.2% of LB cases and 18.7% of SB cases; was associated with anomalies of other organs and systems, but without a syndromic diagnosis in 31.4% of LB cases and 48.0% of SB cases; and in 23.1% of the LB cases and 32.0% of the SB cases the heart disease was a feature of a syndrome. Multivariate analysis demonstrated an association between heart disease and birth weight ≤ 2,500 g in all types of clinical presentation, between maternal age ≥ 35 years and heart disease in syndromic heart disease and between female sex and isolated heart disease. Conclusions:It was found a high prevalence, which is an alert to the medical significance of heart disease. There was association between birth weight ≤ 2,500 g and all forms of presentation, between increased maternal age and syndromic heart disease besides between female sex and isolated congenital heart disease. J Pediatr (Rio J). 2008;84(1):83-90:Congenital heart disease, prevalence, abnormalities, etiology. Artigo submetido em 28.09.07, aceito em 06.11.07.

Significant decrease in human immunodeficiency virus type 1 (HIV-1) vertical transmission has been observed

A toxoplasmose, transmitida pelo Toxoplasma gondii, é uma das infecções parasitárias mais comuns em humanos, sendo amplamente distribuída em todo o mundo 1 . Quando a priminfecção ocorre durante a gestação, assume importância especial, pois 40% a 50% dos fetos podem ser infectados com possibilidade de desenvolver doença grave 2 . A idade gestacional da infecção materna tem papel determinante no risco da transmissão e no quadro clínico apresentado pela criança, pois quanto mais precoce, menor a possibilidade de transmissão e maior a chance de seqüelas graves ao nascimento 3 . Apesar de a maioria das crianças infectadas não apresentarem sinais clínicos ao nascimento, estima-se que 65% a 85% delas evoluam com problemas oftalmológicos futuros 2 .Como a infecção na gestante é assintomática em cerca de 80%-90% dos casos, o diagnóstico freqüentemente depende de testes laboratoriais 1 . Os exames sorológicos que detectam anticorpos da classe IgM, presentes nas infecções recentes, são os mais utilizados para diagnóstico de toxoplasmose aguda, porém os métodos mais modernos detectam quantidades mínimas por mais de um ano após a infecção inicial (IgM residual). Portanto, quando o primeiro exame realizado durante a gestação mostra resultado positivo, recomenda-se a demonstração do aumento nos títulos de anticorpos em amostras obtidas com