RESUMEN
BACKGROUND: Gestational weight gain (GWG) is a critical factor for maternal and fetal health. OBJECTIVE: To identify maternal predictors of inadequate GWG according to the 2009 Institute of Medicine (IOM) recommendations and Intergrowth-21st standards. METHODS: A prospective epidemiological cohort study conducted from 2017 to 2023 in southeastern Brazil assessed 1,557 women at three different stages of pregnancy (≤ 18, 20-26, and 30-36 weeks of gestation) and at delivery. Sociodemographic, obstetric, lifestyle, nutritional, and maternal morbidity characteristics were collected, along with biochemical parameters. RESULTS: Among the participants, 38.7% had GWG above IOM recommendations, while 67.5% had GWG above the Intergrowth-21st standards. Multinomial logistic regression analysis showed that women with pre-pregnancy obesity and women with the highest body fat percentage had, respectively, a 95% (OR = 1.95; 95% CI: 1.08-3.51) and 1% (OR = 1.01; 95% CI: 1.01-1.05) higher chance of GWG above IOM recommendations. Pregnant women in the lowest tertile of height, smokers, number of previous pregnancies, and women living in crowded homes had, respectively, a 57% (OR = 0.57; 95% CI: 0.41-0.80), 36% (OR = 0.64; 95% CI: 0.37-0.86), 35% (OR = 0.65; 95% CI: 0.43-0.97), and 14% (OR = 0.86; 95% CI: 0.59-0.86) lower chance of GWG above IOM recommendations. Women with diabetes were 2.53 times more likely (OR = 2.53; 95% CI: 1.32-4.83) to have GWG below IOM recommendations. Using the Intergrowth-21st standards, women with the highest body fat percentage had a 12% (OR = 1.12; 95% CI: 1.02-1.24) higher chance of GWG above the 90th percentile. Pregnant women in the lowest tertile of height were 2.82 times more likely (OR = 2.82; 95% CI: 1.08-8.13) and women with the lowest hemoglobin concentrations had a 41% lower chance (OR = 0.59; 95% CI: 0.39-0.88) of having GWG below the 10th percentile. While both guidelines identified body fat percentage and pre-pregnancy obesity as significant predictors of excessive GWG, the Intergrowth-21st standards captured a higher percentage of women exceeding GWG limits. CONCLUSION: The findings underscore the importance of comparing two instruments for assessing the adequacy of GWG. The IOM and Intergrowth-21st standards provide complementary insights, which can help implement targeted interventions for specific groups of women based on their nutritional and socioeconomic status, lifestyle, and obstetric factors to prevent pregnancy-related complications.
Asunto(s)
Ganancia de Peso Gestacional , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Humanos , Femenino , Embarazo , Adulto , Estudios Prospectivos , Brasil/epidemiología , Adulto Joven , Estados Unidos , Estudios de Cohortes , Complicaciones del Embarazo/epidemiología , Obesidad/epidemiología , Índice de Masa CorporalRESUMEN
AIMS AND METHOD: This cross-sectional study, carried out from 2021 to 2022, investigated the factors associated with domestic violence in 400 Brazilian pregnant women during the COVID-19 pandemic. Violence was assessed with the World Health Organization's Violence Against Women questionnaire and the Abuse Assessment Screen. Demographic, socioeconomic, obstetric, lifestyle and mental health data were collected. RESULTS: Violence at any time in their lives was reported by 52.2% of the women, and psychological violence was the most prevalent type (19.5%). Violence was associated with being single and mental health changes. Pregnant women exposed to any lifetime violence and psychological violence were, respectively, 4.67 and 5.93 times more likely to show mental health changes compared with women with no reported violence. CLINICAL IMPLICATIONS: Training health professionals involved in prenatal care in the early detection of single women and women with mental health changes could be important in preventing domestic violence.
Asunto(s)
Humanos , Femenino , Embarazo , Estado Nutricional , Mujeres Embarazadas , Violencia contra la Mujer , Trastornos MentalesRESUMEN
RESUMO Objetivo Avaliar os tipos de comportamentos alimentares em indivíduos com obesidade e correlacionar com a adesão ao tratamento proposto. Métodos Estudo transversal desenvolvido em instituição de cardiologia em indivíduos com obesidade. Os tipos de comportamentos alimentares foram analisados pela escala The Three Factor Eating Questionnaire - R21 (TFEQ-21) - versão traduzida e adaptada para brasileiros. Nela são abordadas três subescalas: restrição cognitiva (RC), alimentação emocional (AE) e descontrole alimentar (DA). A adesão ao tratamento nutricional foi verificada pelo instrumento desenvolvido pela instituição, baseado nas principais diretrizes de doenças crônicas. Resultados Analisaram-se 100 indivíduos, com maior prevalência do sexo feminino (68%). Em relação à adesão, somente 25% apresentam boa aderência (escore > 60%). Foi possível identificar a relação entre o IMC e a RC; quanto maior o IMC, menor foi a intensidade da RC (p = 0,02). Observou-se correlação positiva entre a RC e adesão ao consumo de gorduras (p = 0,02) e fibra alimentar (p = 0,004). A subescala AE apresentou correlação negativa com a adesão ao consumo de gorduras (p = 0,03) e correlação positiva com a DA (p < 0,01). Conclusões O tipo de comportamento alimentar mais frequente na amostra foi a restrição cognitiva, que não foi correlacionada com o escore total de adesão. A AE foi associada com maior consumo de gorduras, similar ao encontrado em estudos nacionais e internacionais. Nota-se uma lacuna de estudos que relacionam o comportamento alimentar com a adesão ao tratamento nutricional.
ABSTRACT Objective To analyze the types of eating behavior in individuals with obesity and correlated with adherence to the adopted treatment. Methods Cross-sectional study developed at the institution of cardiology in individuals with obesity. The types of eating behavior were analyzed using the scale The Three-Factor Eating Questionnaire - R21 (TFEQ-21) - translated and adapted for Brazilians. Three subscales are addressed: cognitive restriction (CR), emotional eating (EE), and uncontrolled eating (UE). Adherence to nutritional treatment was verified by the instrument developed by the institution, based on the main guidelines for chronic diseases. Results We analyzed 100 individuals, with a higher prevalence of females (68%). Regarding adherence, only 25% have good adherence (score > 60%). It was possible to identify the relationship between the BMI and the CR, the higher or lower the BMI was the intensity of the CR (p = 0.02) There was a positive correlation between CR and adherence to fat (p = 0.02) and dietary fiber (p = 0.004). The EE subscale showed a negative correlation with adherence to fat consumption (p = 0.03) and a positive correlation with UE (p < 0.01). Conclusions The most frequent type of eating behavior in the sample was cognitive restriction and was not correlated with the total adherence score. AE was associated with greater consumption of fats, like national and international studies. There is a gap in studies that relate to eating behavior with adherence to nutritional treatment.
Asunto(s)
Hiperfagia , Trastornos de Alimentación y de la Ingestión de Alimentos , Conducta Alimentaria , Cumplimiento y Adherencia al Tratamiento , ObesidadRESUMEN
O distúrbio mineral e ósseo (DMO) em pacientes dom doença renal crônica (DRC) é descrito como uma síndrome que engloba alterações clínicas, bioquímicas (cálcio, fósforo, paratormônio e vitamina D) e ósseas com remodelação, mineralização e volume ósseo, além de calcificações extra ósseas. As complicações impactam no desequilíbrio de micronutrientes e a terapia nutricional é demonstrada como uma medida simples e de baixo custo que poderá possibilitara a redução da progressão da DMO...