ABSTRACT
Abstract Objective To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause. Methods This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis. Results A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253). Conclusion The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Subject(s)
Humans , Female , Pregnancy , Coronavirus Infections/epidemiology , Postpartum Period , Maternal Death , Health Information Systems , SARS-CoV-2/pathogenicity , COVID-19/mortalityABSTRACT
OBJECTIVE: To assess the evolution of COVID-19 among Brazilian pregnant women, identifying sociodemographic and clinical predictors related to admission to ICU - Intensive Care Unit and death. METHOD: Cross-sectional, population-based study, carried out with a secondary database, based on data from the Influenza Epidemiological Surveillance Information System. Descriptive analysis was performed, followed by multiple linear regression with Poisson response, adopting critical p < 0.05. RESULTS: Intensive care admission rates of 28.2% and death rates of 9.5% were identified. Region of residence, gestational trimester, number of comorbidities and respiratory signs and symptoms were associated with the risk of admission to intensive care. Age over 34 years, comorbidities, oxygen saturation equal to or less than 95%, admission to intensive care and ventilatory support, invasive or not, increased the risk of death. CONCLUSION: Sociodemographic and clinical predictors showed an association with hospitalization in intensive care and death of pregnant women with COVID-19.
Subject(s)
COVID-19 , Female , Humans , Pregnancy , Adult , Pregnant Women , SARS-CoV-2 , Brazil/epidemiology , Cross-Sectional Studies , Intensive Care Units , HospitalizationABSTRACT
Introduction: Maternal and child health are essential to public health, especially during pregnancy, where urogenital infections can affect mothers and fetuses. Sexually transmitted infections (STIs) increase obstetric risks and have complex connections with the human immunodeficiency virus HIV. In Brazil, pregnant women with HIV are a growing concern, requiring focus and appropriate interventions. Objective: This study aimed to examine the clinical and epidemiological characteristics of urogenital infections in pregnant women with and without HIV and to assess whether there are notable differences between these groups. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute guidelines. Databases such as Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO) were explored using relevant terms. Inclusion/exclusion criteria selected nine studies for analysis. A Population, Intervention, Comparison, Outcome, and Study Design (PICOS) approach directed the search. Results: Pregnant women with HIV had a high prevalence of STIs, including Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and bacterial vaginosis. HIV infection appears to influence the risk and severity of urogenital infections. Pregnancy increases the risk of STIs, regardless of HIV status. Male partners may also influence the presence of STIs in pregnant women, especially those with HIV. Conclusion: This study highlights the association between HIV status and urogenital infections in pregnant women, indicating the need for appropriate screening and care. Prevention and treatment of STIs in pregnant women are essential for maternal and child health, regardless of HIV status. An in-depth understanding of these issues can improve public policies, clinical practices, and preventive interventions that target the overall health of these vulnerable populations.Keywords: HIV. Signs and symptoms. Female urogenital diseases and pregnancy complications. Pregnant women. Sexually transmitted infections
Introdução: A saúde materna e infantil é essencial na saúde pública, especialmente durante a gravidez, quando infecções urogenitais podem afetar mães e fetos. Infecções sexualmente transmissíveis (IST) aumentam riscos obstétricos e têm conexões complexas com o vírus da imunodeficiência humana (HIV). No Brasil, gestantes com HIV são uma preocupação crescente, requerendo foco e intervenções adequadas. Objetivo: Este estudo teve como objetivo examinar as características clínicas e epidemiológicas das infecções urogenitais em mulheres grávidas com e sem HIV, avaliando se há diferenças notáveis entre esses grupos. Métodos: Uma revisão de escopo foi conduzida, seguindo as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews(PRISMA-ScR) e Joanna Briggs Institute. Bases de dados como Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO) foram exploradas com termos relevantes. Os critérios de inclusão/exclusão selecionaram nove estudos para análise. Uma abordagem do tipo População, Intervenção, Comparação, Desfecho e Desenho do Estudo (PICOS) direcionou a pesquisa. Resultados: Mulheres grávidas com HIV apresentaram alta prevalência de IST, incluindo Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis e vaginose bacteriana. A infecção por HIV parece influenciar o risco e a gravidade das infecções urogenitais. A gravidez aumentou o risco de IST, independentemente do status de HIV. Os parceiros masculinos também podem influenciar a presença de IST em mulheres grávidas, especialmente aquelas com HIV. Conclusão: A associação entre o status de HIV e as infecções urogenitais em mulheres grávidas indica a necessidade de rastreamento e cuidado adequado. A prevenção e o tratamento de IST em gestantes são essenciais para a saúde materno-infantil, independentemente do status de HIV
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications, Infectious , Urinary Tract Infections , HIV Infections/complications , Reproductive Tract Infections , Severity of Illness IndexABSTRACT
ABSTRACT Objective: To assess the evolution of COVID-19 among Brazilian pregnant women, identifying sociodemographic and clinical predictors related to admission to ICU - Intensive Care Unit and death. Method: Cross-sectional, population-based study, carried out with a secondary database, based on data from the Influenza Epidemiological Surveillance Information System. Descriptive analysis was performed, followed by multiple linear regression with Poisson response, adopting critical p < 0.05. Results: Intensive care admission rates of 28.2% and death rates of 9.5% were identified. Region of residence, gestational trimester, number of comorbidities and respiratory signs and symptoms were associated with the risk of admission to intensive care. Age over 34 years, comorbidities, oxygen saturation equal to or less than 95%, admission to intensive care and ventilatory support, invasive or not, increased the risk of death. Conclusion: Sociodemographic and clinical predictors showed an association with hospitalization in intensive care and death of pregnant women with COVID-19.
RESUMEN Objetivo: Evaluar la evolución de la COVID-19 entre gestantes brasileñas, identificando predictores sociodemográficos y clínicos relacionados con el ingreso en unidad de cuidados intensivos y la muerte. Método: Estudio transversal, de base poblacional, realizado con una base de datos secundaria, a partir de datos del Sistema de Información de Vigilancia Epidemiológica de Influenza. Se realizó un análisis descriptivo, seguido de regresión lineal múltiple con respuesta de Poisson, adoptando una p crítica <0,05. Resultados: Se identificaron tasas de ingreso a cuidados intensivos del 28,2% y tasas de mortalidad del 9,5%. La región de residencia, el trimestre gestacional, el número de comorbilidades y los signos y síntomas respiratorios se asociaron con el riesgo de ingreso a cuidados intensivos. La edad mayor de 34 años, las comorbilidades, la saturación de oxígeno igual o inferior al 95%, el ingreso a cuidados intensivos y el soporte ventilatorio, sea invasivo o no, aumentaron el riesgo de muerte. Conclusión: Los predictores sociodemográficos y clínicos mostraron asociación con la hospitalización en cuidados intensivos y la muerte en gestantes con COVID-19.
RESUMO Objetivo: Avaliar a evolução da COVID-19 entre gestantes brasileiras, identificando-se os preditores sociodemográficos e clínicos relacionados à internação em unidade de terapia intensiva e ao óbito. Método: Estudo transversal e de base populacional, realizado com banco de dados secundários, a partir de dados do Sistema de Informação da Vigilância Epidemiológica da Gripe. Realizou-se análise descritiva, seguida de regressão linear múltipla com resposta Poisson, adotando-se p crítico <0,05. Resultados: Identificaram-se taxas de internação em terapia intensiva de 28,2% e de óbito de 9,5%. Região de residência, trimestre gestacional, número de comorbidades e sinais e sintomas respiratórios associaram-se ao risco de internação em terapia intensiva. Idade superior a 34 anos, comorbidades, saturação de oxigênio igual ou inferior a 95%, internação em terapia intensiva e suporte ventilatório, invasivo ou não, aumentaram o risco de óbito. Conclusão: Preditores sociodemográficos e clínicos mostraram associação com a hospitalização em terapia intensiva e com o óbito de gestantes com COVID-19.
Subject(s)
Humans , Female , Pregnancy , Pregnancy , Maternal Death , COVID-19 , Pregnancy Complications, Infectious , Hospitalization , Intensive Care UnitsABSTRACT
The aim of study was to understand care strategies for homeless women, focusing on aspects of sexual and reproductive health from the perspective of Street Outreach Office strategy professionals. This is a qualitative study carried out in a large city in the countryside of São Paulo, Brazil. Data were collected from December 2020 to April 2021 through semi-structured interviews, and the results were obtained through content analysis and thematic modality. Nine health professionals participated in this study, and the analysis of the interviews allowed identifying three thematic categories: (i) being female and sex on the streets (violence and oppression); (ii) gynecology as a gateway to comprehensive care for homeless women; and (iii) pregnancy, puerperium and motherhood in the context of the streets. This study contributes to the reflection of professional practices within the Street Outreach Office, allowing the understanding of challenges in assisting homeless women, aiming to raise awareness of professionals and services that make up the health care network.
Subject(s)
Ill-Housed Persons , Reproductive Health , Brazil , Female , Humans , Male , Pregnancy , Reproduction , Sexual Behavior , Women's HealthABSTRACT
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