[Why pregnant women sleep poorly compared to non-pregnant women? Cross-sectional study]. / ¿Por qué duermen mal las mujeres embarazadas comparadas con las no gestantes? Estudio de corte transversal.

AIMS: To evaluate causes/reasons that fragment sleep related to physiological changes in the different trimesters of pregnancy and compare them with those of non-pregnant women. To identify some sleep disorders in pregnant women (PW) and to compare them with those in non-pregnant women (NPW). METHOD: A cross sectional study was performed. A specific questionnaire was designed for the data collection of the study, Oviedo Sleep Questionnaire, Epworth Sleepiness Scale and others were also used. All the full term expectant mothers who attended the Obstetrics Department were invited to participate; non-pregnant students from College and teaching staff were used as control group. The results were expressed in measures of frequency, percent, mean and standard deviations (SD). Differences were considered significant if p <0.05 for all tests. RESULTS: PW: 1st Trimester (T): n = 106, 2nd. T: n = 104, 3rd T: n = 110. CONTROL GROUP: n = 304 NPW. When comparing both groups we find: ME / MNE: Snoring: p = 0.001. Apnea: p = 0.89. In NPW, the following predominated: Restless legs syndrome: p = 0.01. Bruxism: p = 0.00. CONCLUSIONS: The PW reported more fragmented sleep due to almost all physiological causes, related to pregnancy, who were questioned, but the only sleep disorders found, by survey, were mainly respiratory disorders, nightmares and leg movements. In NPW, however, we found more sleep disorders such as insomnia, hypersomnia and restless legs syndrome, bruxism.

Women's preferences and mode of delivery in public and private hospitals: a prospective cohort study.

BACKGROUND: Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women's preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. METHODS: A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women's preferences: a survey using a tailored questionnaire, and a discrete choice experiment. RESULTS: Only 8 and 6% of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40% ended their pregnancies by caesarean section in public and private hospitals, respectively. CONCLUSIONS: The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35% caesarean sections are unlikely related to their preferences for mode of delivery.

Pregnancy and voice: changes during the third trimester.

INTRODUCTION: From conception to postpartum, pregnancy is a state in which physiologic, metabolic, and anatomic parameters are altered. Pregnancy could affect voice attributes by changing quality and perturbation rates, mainly during the third trimester. The aim of this study was to compare voice attributes between third trimester pregnant and nonpregnant matched women. STUDY DESIGN: A case-control study was undertaken with third trimester pregnant women attending the antenatal care clinic of the Hospital Italiano in Buenos Aires. We analyzed and compared values of fundamental frequency, maximum phonation time, vocal intensity, perturbation rates, and physical acoustic qualities. RESULTS: Most pregnant women showed abnormal parameters of auditory perceptual evaluation, a higher incidence of gastroesophageal reflux, predominance of clavicular breathing, and a reduction of phonation time. CONCLUSIONS: Significant differences found in both groups suggest that physiologic and body changes produced during pregnancy affect voice quality.