Atenção nutricional e ganho de peso gestacional em adolescentes: uma abordagem quantiqualitativa

Abstract

This study sought to evaluate the impact of nutritional assistance (intervention) on total gestational weight gain in adolescents and to understand the perceptions of adolescents regarding the intervention. It is a quantitative and qualitative survey using triangulation methods conducted in a public maternity hospital in Rio de Janeiro with 204 adolescents, divided into pre-intervention and intervention groups. The hypothesis of homogeneity of proportions was tested by bivariate and multivariate analysis using Poisson regression with robust variance. The qualitative approach was conducted using semi-structured interviews with 12 adolescents, whose data were submitted to content analysis. The results indicate that the intervention did not have a positive effect on the adequacy of total gestational weight gain. The adolescents perceived the dietary plan as a set of rules incompatible with their conditions as pregnant women. The category "almost every consultation was the same" emerged as a synthesis of the perceptions on the intervention. It was concluded that there is a need to reassess the technical and scientific marker tools of nutritional assistance and turn it into care focused around making shared decisions.

Evolução temporal da prevalência de anemia em adolescentes grávidas de uma maternidade pública do Rio de Janeiro

“…No entanto, apesar de os adolescentes possuírem dieta habitual com excesso de calorias e pobre em frutas, verduras e legumes, as gestantes com sobrepeso/obesidade pré-gestacional, bem como as gestantes que tiveram GPGT acima do recomendado, apresentaram maiores concentrações de Hb. Tal fato pode ser devido ao maior consumo de arroz, feijão e carne, considerados como "comida mesmo" e reconhecidos como alimentos "que tiravam a fome", citado por gestantes adolescentes 27 . Tal refeição pode favorecer a concentração de Hb, pois a carne é uma importante fonte de ferro e um produto de melhor disponibilidade.…”

“…A assistência pré-natal e a assistência nutricional pré--natal também se mostraram relacionadas à proteção contra a anemia. Como verificado em outros estudos, o risco de agravos à saúde da mãe e do seu filho é minimizado quando as gestantes têm acesso à informação e aos serviços de saúde [27][28][29] .…”

The forgotten girls: the state of evidence for health interventions for pregnant adolescents and their newborns in low-income and middle-income countries

“…We mapped interventions identified in our systematic review according to the period of maternity care they addressed; antenatal, delivery and postnatal (up to 42 days post-delivery), and the three domains of the adapted conceptual framework. We used a convergent approach 32 with textual narrative synthesis 33 to integrate qualitative and quantitative data related to the three domains (methods panel, appendix pp [29][30][31][32][33][34][35][36][37][38]. Many interventions fell across more than one domain.…”

“…Most interventions under this component aimed to improve maternal health knowledge and literacy but not specifically for adolescents. [34][35][36][37][38][39][40][41][42][43] Many studies evaluated didactic counselling or group education sessions but did not assess whether knowledge improvement impacted health care uptake. [34][35][36][37] An intervention in Ghana however, used more novel methods such as video and role plays coupled with community mobilisation to increase service demand, which included increased uptake of antenatal and perinatal services.…”

Ciência & Saúde Coletiva - 25 anos: contribuição para os estudos sobre gestação, parto e infância

“…The studies' second main focus was teen pregnancy [29][30][31][32] , including socioeconomic profile 33 and social vulnerability 34 , paternal responsibility 35 , and rape-related pregnancies 36 . The experiences of pregnancy and abortion of the population of children, adolescents, and young people living on the street are also among the topics covered 37 , along with pregnancy and childbirth in prisons 38 .…”