RESUMO
PURPOSE: To search for maternal, labor-related and fetal variables associated with low Apgar in the fifth minute in term pregnancy. METHODS: A retrospective case-control study with term births was conducted in a public teaching hospital from 2013 to 2020. Cases were term births with Apgar score less than 7 in the fifth minute, and controls, the next one or two births following a case, with Apgar of 7 or more. Non-cephalic presentations, multiples and malformations were excluded. We accessed 100 cases and 190 controls. We considered significant values of p < 0.05. RESULTS: Were accessed 27 variables which could be risk factors, from which 12 were associated with the outcome. We found a protective effect of prelabor cesarean for the outcome, odds ratio (OR) 0.38, p = 0.013. Consequently, we conducted two sets of analyses: in the whole group and in the group of laboring women. The values of OR were in general greater in the group of laboring women, compared with the whole group. We conducted multivariate analysis within the group of women in labor. The variables which fitted best in the model were nulliparity, male sex of the fetus, less than six prenatal visits and abnormal cardiotocography; all remained significant. An association of rupture of membranes more than 360 min with the outcome, even after controlling fpr duration of labor, was found; adjusted OR 2.45, p = 0.023. CONCLUSION: Twelve variables were associated with the outcome. Prelabor cesarean had a protective effect. The time of ruptured membranes was associated with low Apgar.
Assuntos
Doenças do Recém-Nascido , Trabalho de Parto , Gravidez , Recém-Nascido , Masculino , Feminino , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Índice de Apgar , Terceiro Trimestre da GravidezRESUMO
RESUMO Objetivo: Avaliar a prevalência de genuvalgo e fatores associados em alunos do ensino fundamental. Métodos: Estudo transversal, realizado em 2015, com 1.050 crianças e adolescentes matriculados no ensino fundamental de Santos. Foi avaliado o desalinhamento do joelho, medindo-se a distância intermaleolar, considerada se ≥≥8 cm ou <8 cm. O coeficiente Kappa de 0,94 foi obtido para aferir a confiabilidade dos exames entre os avaliadores. O estado nutricional foi verificado segundo a Organização Mundial de Saúde, 2006. Aplicou-se modelo de regressão logística para avaliar fatores associados à presença de genuvalgo. Resultados: Dos escolares analisados, 7,1% apresentaram genuvalgo. Aqueles com sobrepeso ou obesos apresentaram porcentagens maiores de genuvalgo. Em média, os estudantes com genuvalgo são mais velhos do que aqueles sem genuvalgo. Não foi verificada associação com o sexo. No modelo de regressão logística, apenas a avaliação nutricional permaneceu significantemente associada à presença de genuvalgo. A chance de sua ocorrência em escolares com sobrepeso e obesos é, respectivamente, 6,0 e 75,7 vezes maior que a chance de ocorrência em magros ou eutróficos. Conclusões: A prevalência de genuvalgo em crianças e adolescentes do ensino fundamental da rede municipal de Santos foi de 7,1%, sendo maior nos alunos com sobrepeso/obesos, não apresentando associação com o sexo ou a idade.
ABSTRACT Objective: To evaluate the prevalence of genu valgum and associated factors in elementary school students. Methods: Cross-sectional study, carried out in 2015, with 1,050 children and adolescents enrolled in an elementary school in Santos, Southeast Brazil. Misalignment of the knee was assessed by intermalleolar distance, considering ≥8 cm or <8 cm. Inter-examiners reliability was measured by Kappa coefficient, resulting in 0.94. Nutritional status was evaluated according to the World Health Organization 2006 references. Logistic regression model was applied to analyze variables associated with genu valgum. Results: Among schoolchildren, 7.1% had genu valgum. The frequency was higher among overweight or obese schoolchildren. On average, students with genu valgum are older than those without it. There was no association with gender. Upon logistic regression model, only nutritional status was significantly associated with this condition. The chance of occurrence of valgus knee in overweight and obese schoolchildren was, respectively, 6.0 and 75.7 times greater than among thin or eutrophic subjects. Conclusions: The prevalence of genu valgum in elementary school children and adolescents was 7.1%, being higher among overweight/obese students and presenting no association with gender or age.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Geno Valgo/epidemiologia , Instituições Acadêmicas , População Urbana , Brasil/epidemiologia , Índice de Massa Corporal , Prevalência , Estudos Transversais , Geno Valgo/complicações , Obesidade Infantil/complicaçõesRESUMO
OBJECTIVE: To evaluate the prevalence of genu valgum and associated factors in elementary school students. METHODS: Cross-sectional study, carried out in 2015, with 1,050 children and adolescents enrolled in an elementary school in Santos, Southeast Brazil. Misalignment of the knee was assessed by intermalleolar distance, considering ≥8 cm or <8 cm. Inter-examiners reliability was measured by Kappa coefficient, resulting in 0.94. Nutritional status was evaluated according to the World Health Organization 2006 references. Logistic regression model was applied to analyze variables associated with genu valgum. RESULTS: Among schoolchildren, 7.1% had genu valgum. The frequency was higher among overweight or obese schoolchildren. On average, students with genu valgum are older than those without it. There was no association with gender. Upon logistic regression model, only nutritional status was significantly associated with this condition. The chance of occurrence of valgus knee in overweight and obese schoolchildren was, respectively, 6.0 and 75.7 times greater than among thin or eutrophic subjects. CONCLUSIONS: The prevalence of genu valgum in elementary school children and adolescents was 7.1%, being higher among overweight/obese students and presenting no association with gender or age.
OBJETIVO: Avaliar a prevalência de genuvalgo e fatores associados em alunos do ensino fundamental. MÉTODOS: Estudo transversal, realizado em 2015, com 1.050 crianças e adolescentes matriculados no ensino fundamental de Santos. Foi avaliado o desalinhamento do joelho, medindo-se a distância intermaleolar, considerada se ≥≥8 cm ou <8 cm. O coeficiente Kappa de 0,94 foi obtido para aferir a confiabilidade dos exames entre os avaliadores. O estado nutricional foi verificado segundo a Organização Mundial de Saúde, 2006. Aplicou-se modelo de regressão logística para avaliar fatores associados à presença de genuvalgo. RESULTADOS: Dos escolares analisados, 7,1% apresentaram genuvalgo. Aqueles com sobrepeso ou obesos apresentaram porcentagens maiores de genuvalgo. Em média, os estudantes com genuvalgo são mais velhos do que aqueles sem genuvalgo. Não foi verificada associação com o sexo. No modelo de regressão logística, apenas a avaliação nutricional permaneceu significantemente associada à presença de genuvalgo. A chance de sua ocorrência em escolares com sobrepeso e obesos é, respectivamente, 6,0 e 75,7 vezes maior que a chance de ocorrência em magros ou eutróficos. CONCLUSÕES: A prevalência de genuvalgo em crianças e adolescentes do ensino fundamental da rede municipal de Santos foi de 7,1%, sendo maior nos alunos com sobrepeso/obesos, não apresentando associação com o sexo ou a idade.