Effect of sulpiride on menopausal hot flashes: a randomized, double-blind, placebo-controlled clinical trial.

Low doses of sulpiride have been used off-label to treat menopausal hot slashes in Southern Brazil despite limited scientific evidence. This randomized controlled trial aimed at assessing the effects of sulpiride as compared to placebo on the frequency and severity of hot flashes. Postmenopausal women, aged 47-62, were recruited from the Menopause Clinic at Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil, between March 2016 and January 2017. After a baseline assessment of 4 weeks, women were included if they had at least a mean of five moderate to severe hot flashes per day and then randomized to receive for 8 weeks either placebo (n= 14) or sulpiride 50 mg/d (n= 14). The number and severity of hot flashes were evaluated after the 8-week intervention. A generalized estimating equations (GEE) model with Bonferroni correction was used to simultaneously assess the frequency and severity of hot flashes. Baseline frequency and severity of hot flashes/day were similar in both groups. Sulpiride significantly reduced the total weekly mean of hot flash frequency (GEE, pinteraction=.019) and the total weekly mean of severity scores (GEE, pinteraction=.09, pgroup=.006, ptime≤.0001) after 4 and 8 weeks of treatment. Treatment with sulpiride 50 mg/d significantly reduced the frequency and severity of hot flashes. Further studies are needed to confirm its benefits and related mechanisms of action.

Efeitos do fumo materno durante a gestação e complicações perinatais / Effects of maternal smoking during pregnancy and perinatal complications

Objetivos: Avaliar o perfil de puérperas tabagistas no Hospital de Clínicas de Porto Alegre (HCPA), determinar a prevalência do tabagismo nestas pacientes e avaliar efeitos do fumo sobre a gestação e os recém-nascidos (RNs). Métodos: Estudo prospectivo, transversal, com dados coletados a partir de um questionário estruturado. Foram incluídas pacientes hígidas, com gestação a termo. Foram excluídas puérperas que tiveram gestações múltiplas, RNs com crescimento intrauterino restrito, anormalidades cromossômicas, malformações ou infecção intrauterina, e puérperas com dados incompletos no prontuário. As pacientes foram divididas em dois grupos: gestantes fumantes e não-fumantes. Foram avaliadas variáveis demográficas, clínicas e relacionadas à gestação, e variáveis relacionadas ao recém-nascido. Resultados: Foram incluídas no estudo 718 puérperas, sendo que 23% eram fumantes ativas durante a gestação. Não houve diferença estatística com relação à idade materna, número de cesarianas ou abortos e idade gestacional no momento do parto. Foram fatores de risco para o tabagismo na gravidez o maior número de gestações prévias, ser solteira ou separada, não branca, com menor escolaridade e não realizar pré-natal. O peso dos RNs foi estatisticamente menor no grupo das gestantes tabagistas, com uma variação média de 143g a menos nesse grupo. O número de RNs pequenos para idade gestacional foi significativamente maior no grupo de gestantes fumantes. A evolução clínica do RN, o peso da placenta e o índice de Apgar não foram diferentes entre os grupos. Conclusão: Este estudo foi relevante para o melhor conhecimento do perfil das puérperas fumantes do HCPA e aponta para a importância da realização de pré-natal e a busca de estratégias de tratamento para estas pacientes como forma de prevenção de complicações gestacionais e perinatais.

Aims: To evaluate the clinical profile of smoker post-pregnant women at Hospital de Clínicas de Porto Alegre (HCPA), to determine the prevalence of smoking in these patients and to evaluate the effects of smoking on pregnancy and on the newborns. Methods: This is a cross-sectional prospective study, with data collected through a structured questionnaire. Healthy patients with term pregnancies were included. Exclusion criteria were multiple pregnancies, newborns with intrauterine growth restriction, chromosomal abnormalities, malformations or intrauterine infection, and incomplete data on medical records. Patients were divided in two groups: smokers and non-smokers. Demographic and clinical variables were evaluated, as well as data related to the pregnancy and to the newborn. Results: Seven hundred and eighteen post-pregnant women were included in the study, of whom 23% were current smokers during pregnancy. There was no statistic difference regarding maternal age, number of cesarean sections or abortions, and gestational age at childbirth. Higher number of previous pregnancies, being single/separated, non-white, less education and no prenatal follow up visits were risk factors for smoking in pregnancy. The weight of the newborns was statistically lower in the smoking pregnant group, with a negative variation of 143 grams in average in this group. The number of newborns small for gestational age was significantly higher in the smoking pregnant group. Clinical evolution of the newborn, placenta weight and the Apgar score were not different between the groups. Conclusion: This study was relevant to improve the knowledge about the profile of post pregnant smokers at HCPA, underscores the importance of prenatal follow up visits and the need for treatment strategies to these patients as preventive measures to avoid perinatal and gestational complications.