Timing of Etonogestrel-Releasing Implants and Growth of Breastfed Infants: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the growth of breastfed infants whose mothers had inserted an etonogestrel-releasing implant in the immediate postpartum period. METHODS: An open, randomized controlled, and parallel trial of postpartum women who were block-randomized to early (up to 48 hours postpartum before discharge) or conventional (at 6 weeks postpartum) insertion of an etonogestrel implant. The primary outcome was average infant weight at 12 months (360 days) and a difference of equal to or greater than 10% between groups was considered clinically significant. The secondary outcomes were infant's height and head and arm circumferences. These variables were measured at baseline and at 14, 40, 90, 180, 270, and 360 days postpartum. The mixed-effects linear regression model was used to evaluate the outcomes with a power of 80% and a significance level of 1% for the primary outcome and 0.3% for secondary outcomes as a result of correction for multiple hypothesis testing. RESULTS: From June to August 2015, a total of 100 women were randomized: 50 to early and 50 to conventional postpartum etonogestrel insertion. Sociodemographic characteristics were similar between the groups, except for educational attainment. The conventional insertion group included a higher proportion of women with 8 or more years of formal education than the early insertion group (88% [44/50] compared with 70% [35/50], P=.02). There was no difference in infant weight at 360 days between the groups (early [mean±standard deviation] 10.1±1.2 kg compared with conventional 9.8±1.3 kg, mean difference estimate 0.3 kg, 95% confidence interval 0-0.7 kg). Growth curves, height, and head and arm circumferences did not differ between the groups. CONCLUSION: There is no difference in growth at 12 months among breastfed infants whose mothers underwent early compared with conventional postpartum insertion of the etonogestrel implant. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02469454.

La concentración de hemoglobina y el uso de suplementos de productos básicos de hierro durante el embarazo y el parto / Hemoglobin concentration and use of basic iron supplement during pregnancy and childbirth / A concentração de hemoglobina e o uso de suplementos de ferrodurante a gravidez e o parto

La anemia por deficiencia de hierro afecta a más de dos millones de personas en todo el mundo. Mientras que los países desarrollados una disminución en la prevalencia de anemia, no se encuentra en los países en desarrollo. La Organización Mundial de la Salud estima que el 58% de las mujeres embarazadas en los países en desarrollo sufren de anemia. Objetivo: identificar la concentración de hemoglobina y el uso de la suplementación con hierro durante el embarazo y el parto. Material y métodos: se realizó un estudio descriptivo, con abordaje cuantitativo realizado con 121 madres de niños de 3-12 meses de edad que asistían a un servicio de salud para el cuidado de los hijos de consulta. Los datos fueron recolectados a través de entrevistas, tomas de sangre para los gráficos de la hemoglobina y la medicina. Resultados: las edades de las mujeres oscilaba entre 19 y 24 años, y de éstos el 36,3% tenía educación primaria incompleta. Durante el embarazo y el puerperio, el valor medio de hemoglobina que se encuentra en los entrevistadosfue de 12 g / dl. En cuanto a la utilización de suplementos a base de hierro a 81,8% reportó el uso durante el embarazo y 66,9% en el puerperio. Conclusiones: Por lo tanto, podemos identificar que la mayoría de las mujeres hicieron uso desuplementos durante el embarazo y el puerperio y que tenían niveles de hemoglobina superiores a 11 g / dl, o no tenían anemia.

Anemia due to iron deficiency affects over two billion people worldwide. While developed countries will a decrease inthe prevalence of anemia, it is not found in developing countries. The World Health Organization estimates that 58% of pregnant women in developing countries are anemic. Objetive: identify the hemoglobin concentration and the use of supplementation with iron in pregnancy-puerperal cycle. Material and Methods: This is a descriptive study with quantitative approach carried out with 121 mothers of children 3-12 months of age who attended a health service for consultation child care. Data were collected through interviews, blood sampling for hemoglobin and medical charts. Results: The womenÆs ages ranged from 19 to 24 years, and of these 36,3% had incomplete primary education. During pregnancy and puerperium the average value of hemoglobin found in interviewed was 12 g / dl. Regarding the use ofiron-based supplement to 81,8% reported using during pregnancy and 66,9% in the puerperium. Conclusions. Thus, we can identify that most women did supplement use during pregnancy and puerperium and who had hemoglobin levels higher than 11 g / dl, or had no anemia.

A anemia por deficiência de ferro afeta mais de dois bilhões de pessoas no mundo todo. Embora os países desenvolvidos venham apresentando uma redução na prevalência de anemia, o mesmo não é verificado nos países em desenvolvimento. A Organização Mundial da Saúde estima que 58% das gestantes nos países em desenvolvimento sejam anêmicas. Objetivo: identificar a concentração de hemoglobinaeautilização de suplemento à base de ferro no ciclo grávido puerperal. Materiais y métodos: Tratase de um estudo descritivo com abordagem quantitativa realizado com 121 mães de crianças de 3 a 12 meses de idade que compareceram a um serviço de saúde para consulta de puericultura. Os dados foram coletados através de entrevista, coleta de sangue para dosagem de hemoglobina e consulta aos prontuários. Resultados: A idade das mulheres variou entre 19 a 24 anos, sendo que destas 36,3% apresentaram ensino fundamental incompleto. Durante a gestação e o puerpério o valor médio de hemoglobina encontrado nas entrevistadas foi de 12 g/dl. Quanto ao uso de suplemento a base de ferro 81,8% referiu ter usado durante a gestação e 66,9% no puerpério.Conclusões: Assim, conseguimos identificar que a maioria das mulheres fez uso do suplemento durante a gestação e puerpério e que apresentaram hemoglobina maior que 11 g/dl, ou seja, não apresentavam anemia.