A PUERICULTURA NO PRIMEIRO ANO DE VIDA ­ UMA AVALIAÇÃO NA ATENÇÃO PRIMÁRIA EM SAÚDE / CHILDCARE IN THE FIRST YEAR OF LIFE-AN EVALUATION IN PRIMARY HEALTH CARE

Objetivo: avaliar a frequência de consultas no primeiro ano da criança e relacionar com as características maternas, de pré-natal e perinatais. Métodos: Coorte de crianças nascidas entre maio e outubro de 2015 que realizaram no mínimo uma consulta na Unidade Básica de Saúde até seus 13 meses incompletos. As informações maternas, de pré-natal e perinatais foram obtidas do SINASC e o número total e o tipo de consulta pelo prontuário da UBS. Foram realizadas análise descritiva das variáveis e testes de associação das características maternas, informações de pré-natal e perinatais com o número de consultas no primeiro ano. Resultados: das 237 crianças nascidas no período, 35 (14,7%) consultaram até os 13 meses incompletos (m=7,6 atendimentos). Destas, 22 (62,9%) realizaram no mínimo 7 atendimentos de puericultura. A menor escolaridade materna esteve associada a um maior número de consultas no primeiro ano de vida (p=0,050) e houve correlação do número de consultas de pré-natal com as de puericultura (p=0,044). Conclusão: o maior número de atendimentos durante o primeiro ano de vida da criança está associado à menor escolaridade materna ao mesmo tempo em que, o vínculo estabelecido durante o pré-natal, ocasionou um maior número de consultas de puericultura.

Objective: To evaluate the frequency of consultations in the first year of the child and to relate to the maternal, prenatal and perinatal characteristics.Methods: Cohort of children born between May and October 2015 who performed at least one visit to the Basic Health Unit until their 13 months. Maternal, prenatal and perinatal information were obtained from the SINASC and the total number and type of consultation by the UBS medical record. Descriptive analysis of the variables and tests of association of maternal characteristics, prenatal and perinatal information with the number of visits in the first year were performed.Results: Of the 237 children born, 35 (14.7%) consulted until the incomplete 13 months (m = 7.6 visits). Of these, 22 (62.9%) performed at least 7 childcare services. Maternal schooling was associated with a higher number of visits in the first year (p=0.050) and there was a correlation between the number of prenatal consultations and those of childcare (p = 0.044). Conclusions: The higher number of visits during the first year of life of the child is associated with lower maternal schooling, while the link established during the prenatal period has resulted in a greater number of childcare consultations.

Vitamin D Deficiency Increases the Risk of Adverse Neonatal Outcomes in Gestational Diabetes.

BACKGROUND: Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. METHODS: 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement. Vitamin D was measured by chemiluminescence and deficiency was defined as < 20 ng/mL. Participants were followed until puerperium and adverse neonatal outcomes were evaluated. RESULTS: Newborns of women with vitamin D deficiency had higher incidences of hospitalization in intensive care units (ICU) (32 vs 19%, P = 0.048), of hypoglycemia (any, 17.3 vs 7.1%, P = 0.039requiring ICU, 15.3 vs 3.6%, P = 0.008), and were more frequently small for gestational age (SGA) (17.3 vs 5.9%, P = 0.017). After adjustment, relative risk (RR) for hypoglycemia requiring ICU was 3.63 (95%CI 1.09-12.11) and for SGA was 4.32 (95%CI 1.75-10.66). The incidence of prematurity, jaundice and shoulder dystocia was no statistically different between groups. CONCLUSIONS: In this cohort of pregnant women with GDM, vitamin D deficiency was associated with a major increase in the incidence of adverse neonatal outcomes such as SGA newborns and neonatal hypoglycemia.