Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections / Ruptura prematura das membranas fetais pré-termo: associação com fatores sociodemográficos e infecções geniturinárias maternas

OBJECTIVE: tthis study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections. METHODS: this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight > 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression. RESULTS: of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR] = 1.94), with lower level of schooling (PR = 2.43), age > 29 years (PR = 2.49), and smokers (PR = 2.04). It was also associated with threatened miscarriage (PR = 1.68) and preterm labor, (PR = 3.40). There was no association with maternal urinary tract infection or presence of genital discharge. CONCLUSIONS: the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach. .

OBJETIVO: o objetivo deste estudo foi verificar a ocorrência da ruptura prematura das membranas fetais pré-termo em gestações únicas e sua associação com fatores sociodemográficos maternos e infecções geniturinárias autorreferidas. MÉTODOS: estudo transversal de base populacional onde foram incluídas todas as mães dos recém-nascidos dos partos únicos ocorridos no ano de 2010, com peso ao nascer igual ou superior a 500 gramas, residentes no município. As puérperas foram entrevistadas nas duas maternidades da cidade. Foram considerados casos as gestantes que perderam líquido amniótico antes da internação hospitalar e cujo tempo de gestação fosse inferior a 37 semanas. Foi realizada análise estatística por níveis, para controle de fatores de confusão por meio da regressão de Poisson. RESULTADOS: das 2.244 mulheres elegíveis para o estudo, 3,1% apresentaram ruptura prematura das membranas fetais pré-termo, a qual foi mais frequente, após ajuste, nas mulheres de menor nível econômico, razão de prevalência (RP) de 1,94, menor escolaridade, RP de 2,43, com idade superior a 29 anos, RP de 2,49 e tabagistas, RP de 2,04. Também esteve relacionada com ameaça de aborto, RP de 1,68, e de trabalho de parto pré-termo, RP de 3,40. Não houve associação com infecção urinária materna ou presença de corrimento genital. CONCLUSÕES: o desfecho foi mais frequente nas puérperas com menor escolaridade, mais pobres, mais velhas e tabagistas, assim como naquelas com histórico de ameaça de abortamento e trabalho de parto prematuro. Estes fatores devem ser considerados na sua abordagem preventiva, diagnóstica e terapêutica. .

Preterm premature rupture of the fetal membranes: association with sociodemographic factors and maternal genitourinary infections.

OBJECTIVE: this study aimed to investigate the incidence of premature rupture of fetal membranes in preterm singleton pregnancies and its association with sociodemographic factors and maternal self-reported genitourinary infections. METHODS: this was a population-based cross-sectional study, which included all mothers of newborns of singleton deliveries that occurred in 2010, with birth weight ≥ 500 grams, who resided in the city of Rio Grande. Women were interviewed in the two maternity hospitals. Cases were women who had lost amniotic fluid before hospitalization and whose gestational age was less than 37 weeks. Statistical analysis was performed by levels to control for confounding factors using Poisson regression. RESULTS: of the 2,244 women eligible for the study, 3.1% had preterm premature rupture of fetal membranes, which was more frequent, after adjustment, in women of lower socioeconomic status, (prevalence ratio [PR]=1.94), with lower level of schooling (PR=2.43), age > 29 years (PR=2.49), and smokers (PR=2.04). It was also associated with threatened miscarriage (PR=1.68) and preterm labor, (PR=3.40). There was no association with maternal urinary tract infection or presence of genital discharge. CONCLUSIONS: the outcome was more common in puerperal women with lower level of schooling, lower socioeconomic status, older, and smokers, as well as those with a history of threatened miscarriage and premature labor. These factors should be considered in the prevention, diagnosis, and therapy approach.

[Reproductive characteristics and utilization of preventive health services by childbearing-age women: results of two cross-sectional population-based studies in the far South of Brazil]. / Características reprodutivas e utilização de serviços preventivos em saúde por mulheres em idade fértil: resultados de dois estudos transversais de base populacional no extremo Sul do Brasil.

Two surveys were conducted (1995 and 2004) on women 15-49 years of age in Rio Grande, Rio Grande do Sul State, southern Brazil, assess patterns in their use of preventive health services. The sample included 1,339 women in 1995 and 1,311 in 2004. A standardized household questionnaire covered their demographic, socioeconomic, reproductive, and health care-utilization characteristics. The chi-square test was used to compare indicators in the two studies. During the study period, housing conditions, running water, sanitation, and schooling improved, but family income decreased. Mean age at sexual initiation decreased by one year, teenage pregnancy increased 33%, and clinical breast examination and Pap smears increased 48% and 30%, respectively. Overall use of contraceptive methods declined by 3%, but condom use increased from 8% to 21%. Efforts are needed to improve coverage for breast examination and Pap smears, postpone sexual initiation, and promote the use of contraceptive methods, especially condoms.

Características reprodutivas e utilização de serviços preventivos em saúde por mulheres em idade fértil: resultados de dois estudos transversais de base populacional no extremo Sul do Brasil / Reproductive characteristics and utilization of preventive health services by childbearing-age women: results of two cross-sectional population-based studies in the far South of Brazil

Em 1995 e 2004 foram realizados dois estudos transversais representativos com mulheres de 15 a 49 anos em Rio Grande, Rio Grande do Sul, Brasil, visando avaliar alguns indicadores básicos de saúde. A amostra incluiu 1.339 mulheres em 1995 e 1.311 em 2004. Aplicou-se questionário padronizado no domicílio investigando sobre características demográficas, sócio-econômicas, reprodutivas e utilização de serviços preventivos de saúde. A análise consistiu em comparar estes indicadores nos dois estudos pelo teste do qui-quadrado. Observou-se melhoria nas condições de habitação, saneamento, escolaridade, mas piora da renda familiar. A idade média de início das atividades sexuais diminuiu, a taxa de gravidez na adolescência aumentou em 33 por cento assim como aumentou a realização de exame citopatológico de colo uterino em 48 por cento e mama em 30 por cento. A utilização de métodos contraceptivos diminuiu 3 por cento, enquanto o uso de preservativos masculinos passou de 8 por cento para 21 por cento. Esforços deveriam ser feitos não somente visando incentivar a realização de exames de mama e citopatológico de colo uterino como também de retardar o início das atividades sexuais e de promover o uso de métodos contraceptivos, especialmente de preservativos.

Two surveys were conducted (1995 and 2004) on women 15-49 years of age in Rio Grande, Rio Grande do Sul State, southern Brazil, assess patterns in their use of preventive health services. The sample included 1,339 women in 1995 and 1,311 in 2004. A standardized household questionnaire covered their demographic, socioeconomic, reproductive, and health care-utilization characteristics. The chi-square test was used to compare indicators in the two studies. During the study period, housing conditions, running water, sanitation, and schooling improved, but family income decreased. Mean age at sexual initiation decreased by one year, teenage pregnancy increased 33 percent, and clinical breast examination and Pap smears increased 48 percent and 30 percent, respectively. Overall use of contraceptive methods declined by 3 percent, but condom use increased from 8 percent to 21 percent. Efforts are needed to improve coverage for breast examination and Pap smears, postpone sexual initiation, and promote the use of contraceptive methods, especially condoms.

[Self-reported vaginal discharge among pregnant women in an urban area in Southern Brazil: prevalence and associated factors]. / Corrimento vaginal referido entre gestantes em localidade urbana no Sul do Brasil: prevalência e fatores associados.

The purpose of this study was to determine the prevalence and risk factors associated with self-reported vaginal discharge among pregnant women in the city of Rio Grande, South Brazil. Using a cross-sectional design, a standard interview was applied to pregnant women at home by previously trained interviewers, covering the following: demographic, reproductive, and socioeconomic data, household conditions, health care, and illnesses during pregnancy, including vaginal discharge. The chi-square test was used to compare proportions, and Poisson regression was used in the multivariate analysis. Among the 339 pregnant women interviewed, 52% reported vaginal discharge. The following variables were significantly associated with the outcome: age (prevalence rate, PR = 1.49), marital status (PR = 1.31), urinary tract infection (PR = 1.56), hyperglycemia (PR = 1.48), use of an intrauterine device (PR = 2.35), and history of preterm delivery (PR = 1.37), with oral contraception showing a protective effect (PR = 0.79). Prevalence of self-reported discharge was high among this group of pregnant women. Several risk factors were also identified for the disease under study. These findings can contribute to the implementation of preventive interventions.

Corrimento vaginal referido entre gestantes em localidade urbana no Sul do Brasil: prevalência e fatores associados / Self-reported vaginal discharge among pregnant women in an urban area in Southern Brazil: prevalence and associated factors

Por intermédio de delineamento transversal, buscou-se determinar a prevalência e identificar fatores associados à ocorrência de corrimento vaginal referido entre gestantes da cidade de Rio Grande, Rio Grande do Sul, Brasil. Utilizando-se de questionário padrão, foram investigadas características sócio-econômicas, demográficas, reprodutivas, condições de moradia, assistência recebida e ocorrência de corrimento vaginal referido entre estas gestantes. Para as comparações entre proporções utilizou-se teste do qui-quadrado e para análise multivariada regressão de Poisson. Dentre as 339 gestantes estudadas, 51,6 por cento referiram corrimento vaginal na gestação. As seguintes variáveis mostraram-se significativamente associadas à ocorrência de corrimento vaginal referido: idade (razão de prevalências: RP= 1,49), estado civil (RP = 1,31), ocorrência de infecção urinária (RP = 1,56), hiperglicemia na gestação atual (RP = 1,48), uso de dispositivo intra-uterino (RP = 2,35), ocorrência prévia de parto prematuro (RP = 1,37) e utilização de anticoncepcional oral como fator de proteção (RP = 0,79). Este estudo mostrou prevalência elevada de corrimento vaginal referido entre as gestantes estudadas e permitiu identificar aquelas com maior risco de adoecer por esta causa, o que pode contribuir para a adoção de medidas preventivas.

The purpose of this study was to determine the prevalence and risk factors associated with self-reported vaginal discharge among pregnant women in the city of Rio Grande, South Brazil. Using a cross-sectional design, a standard interview was applied to pregnant women at home by previously trained interviewers, covering the following: demographic, reproductive, and socioeconomic data, household conditions, health care, and illnesses during pregnancy, including vaginal discharge. The chi-square test was used to compare proportions, and Poisson regression was used in the multivariate analysis. Among the 339 pregnant women interviewed, 52 percent reported vaginal discharge. The following variables were significantly associated with the outcome: age (prevalence rate, PR = 1.49), marital status (PR = 1.31), urinary tract infection (PR = 1.56), hyperglycemia (PR = 1.48), use of an intrauterine device (PR = 2.35), and history of preterm delivery (PR = 1.37), with oral contraception showing a protective effect (PR = 0.79). Prevalence of self-reported discharge was high among this group of pregnant women. Several risk factors were also identified for the disease under study. These findings can contribute to the implementation of preventive interventions.

Exame citopatológico de colo uterino em mulheres com idade entre 20 e 59 anos em Pelotas, RS: prevalência, foco e fatores associados à sua não realização / Pap smears of 20 - 59 year-old women in Pelotas, Southern Brazil: prevalence, approach and factors associated with not undergoing the test

OBJETIVO: Determinar a prevalência e o foco de realização do exame citopatológico do colo uterino e também fatores associados à sua não realização em mulheres com idade entre 20 e 59 anos residentes na cidade de Pelotas, RS. MÉTODOS: Entre outubro e dezembro de 2003 foi realizado um estudo transversal de base populacional. Através de amostragem por conglomerados foram sorteados 144 setores censitários em múltiplos estágios. Foram investigadas variáveis sociodemográficas e a realização de exame citopatológico do colo uterino. RESULTADOS: Dentre as 1404 mulheres que constituem a população-alvo dos programas de prevenção do câncer do colo uterino, 83,0 por cento realizaram o exame citopatológico do colo uterino nos três anos antecedentes a este estudo. Mostraram-se significativamente associadas (P<0,05) à não realização deste tipo de exame nos últimos três anos as seguintes variáveis: faixas etárias de 20 a 29 anos e 50 a 59 anos em relação às mulheres de 40 a 49 anos de idade, menor escolaridade, menor quintil de pontos obtidos para construção do nível socioeconômico segundo a Associação Nacional de Empresas de Pesquisa (ANEP), cor da pele mulata ou preta e não consultar um ginecologista nos últimos 12 meses. CONCLUSÕES: Apesar de este estudo mostrar alta cobertura na realização de citopatológico do colo uterino nos três anos antecedentes a entrevista, as mulheres com maior número de fatores de risco do câncer de colo uterino apresentaram menor índice de realização deste exame.