Prevalência e fatores associados à anemia em gestantes de alto risco de Maceió, Alagoas / Prevalence and factors associated with anemia in high-risk pregnant women in Maceió, Alagoas

Introdução: Alguns agravos ou doenças na gravidez apresentam relação com o aumento da incidência de anemia. Além disso, a anemia pode agravar os sintomas de certas doenças durante esse período. Portanto, a atenção a esse grupo de gestantes quanto a esse aspecto deveria ser redobrada. Objetivo: O objetivo do estudo foi avaliar a prevalência e os fatores associados à anemia em gestantes de alto risco. Método: Estudo transversal envolvendo amostra (n=129) obtida, considerando a prevalência de anemia em gestantes (50%), intervalo de confiança (IC) de 90%, erro de 8%, sendo elegíveis gestantes de alto risco internadas no hospital universitário do município no ano de 2013, por meio de coleta de dados socioeconômicos, de pré-natal, clínicos, antropométricos e medida de hemoglobina. A anemia foi identificada por um nível de hemoglobina < 11 g/dL e sua associação com os fatores de risco foi testada por meio de análise de regressão múltipla de Poisson, com os resultados expressos pela Razão de Prevalência e IC95%. Resultado: A prevalência de anemia foi de 49,6%, com associação dessa variável com: estado nutricional de baixo peso (RP=1,77; IC=1,21; 2,60; p=0,003) e ganho ponderal gestacional insuficiente (RP=0,55; IC=0,38; 0,81; p=0,002). Conclusões: A anemia em gestantes de alto risco de Maceió é um problema de magnitude elevada; no entanto, não ultrapassou os valores esperados para gestantes saudáveis. Somado a isso, essa condição se associou a um estado nutricional comprometido, o que pode elevar ainda mais as taxas de morbimortalidade materna e fetal nesse grupo.(AU)

Introduction: Some injuries or illnesses during pregnancy have relationship with the increased incidence of anemia. Further, anemia can aggravate the symptoms of some diseases during this period. Therefore, attention to this group of pregnant women in this regard should be redoubled. Objective: The objective of the study was to evaluate the prevalence and associated factors with anemia in high-risk pregnant women. Methods: Cross-sectional study conducted on a sample (n=129) obtained on the basis of the estimated prevalence of anemia during pregnancy (50%), a 90% confidence interval (CI), an error of 8%, being eligible high-risk pregnant women admitted to university hospital in the city in 2013, of which were collected socioeconomic, prenatal care and clinical data, anthropometric measure and hemoglobin held. Anemia was identified by a hemo- globin level <11 g / dL and its association with risk factors was tested using multivariate Poisson regression analysis, with the results expressed by the prevalence ratio (PR) and 95% CI. Results: The prevalence of anemia was 49.6%, with association of this variable with: nutritional status of low birth weight (PR=1.77, CI=1.21, 2.60; p=0.003) and insufficient gestational weight gain (PR=0.55, CI=0.38, 0.81; p=0.002). Conclusions: Anemia in high-risk pregnant women from the Maceió is a high magnitude problem; however, did not exceed the expected values for healthy pregnant women. Added to this, this condition was associated with a compromised nutritional status, which can further increase the maternal and fetal morbidity and mortality rates in this group.(AU)

Cardiovascular risk assessment according to the Framingham score and abdominal obesity in individuals seen by a clinical school of nutrition.

OBJECTIVE: To analyze the relation of abdominal obesity on cardiovascular risk in individuals seen by a clinic school of nutrition, classifying them based on Framingham score. METHODS: Cross-sectional study, conducted at the nutrition clinic of a private college in the city of Maceió, Alagoas. We included randomly selected adults and elderly individuals with abdominal obesity, of both sexes, treated from August to December of 2009, with no history of cardiomyopathy or cardiovascular events. To determine the cardiovascular risk, the Framingham score was calculated. All analyzes were performed with SPSS software version 20.0, with p <0.05 as significative. RESULTS: We studied 54 subjects, 83% female, the mean age was 48 years old, ranging from 31 to 73 years. No correlation was observed between measurements of waist circumference and cardiovascular risk in the subjects studied (r=0.065, p=0.048), and there was no relationship between these parameters. CONCLUSION: Abdominal fat distribution was weakly related to cardiovascular risk in patients seen by a clinical school of nutrition.

Cardiovascular risk assessment according to the Framingham score and abdominal obesity in individuals seen by a clinical school of nutrition / Avaliação do risco cardiovascular segundo escore de Framingham e obesidade abdominal em indivíduos atendidos por uma clínica escola de nutrição

Summary Objective: To analyze the relation of abdominal obesity on cardiovascular risk in individuals seen by a clinic school of nutrition, classifying them based on Framingham score. Methods: Cross-sectional study, conducted at the nutrition clinic of a private college in the city of Maceió, Alagoas. We included randomly selected adults and elderly individuals with abdominal obesity, of both sexes, treated from August to December of 2009, with no history of cardiomyopathy or cardiovascular events. To determine the cardiovascular risk, the Framingham score was calculated. All analyzes were performed with SPSS software version 20.0, with p <0.05 as significative. Results: We studied 54 subjects, 83% female, the mean age was 48 years old, ranging from 31 to 73 years. No correlation was observed between measurements of waist circumference and cardiovascular risk in the subjects studied (r=0.065, p=0.048), and there was no relationship between these parameters. Conclusion: Abdominal fat distribution was weakly related to cardiovascular risk in patients seen by a clinical school of nutrition.

Resumo Objetivo: avaliar a relação entre a distribuição central de gordura e o risco cardiovascular em indivíduos atendidos por uma clínica escola de nutrição, classificando-os pelo escore de Framingham. Método: estudo do tipo transversal, realizado em uma clínica escola de nutrição de uma faculdade particular da cidade de Maceió, Alagoas. Foram selecionados aleatoriamente indivíduos adultos e idosos portadores de obesidade abdominal, de ambos os sexos, atendidos no período de agosto a dezembro de 2009, sem histórico de miocardiopatias e eventos cardiovasculares. Para determinação do risco cardiovascular, foi calculado o escore de Framingham. Todas as análises foram realizadas com o auxílio do programa SPSS versão 20.0, considerando p<0,05 como significativo. Resultados: foram estudados 54 indivíduos, sendo 83% do sexo feminino, com idade média de 48 anos, variando de 31 a 73 anos. Foi observada correlação praticamente nula entre as medidas de circunferência da cintura e o risco cardiovascular dos indivíduos estudados (r=0,065; p=0,048), não havendo relação entre esses parâmetros. Conclusão: a distribuição central de gordura se relacionou fracamente com o risco cardiovascular em indivíduos atendidos por uma clínica escola de nutrição.

Maternal Factors and Adverse Perinatal Outcomes in Women with Preeclampsia in Maceió, Alagoas / Fatores Maternos e Resultados Perinatais Adversos em Portadoras de Pré-eclâmpsia em Maceió, Alagoas

Abstract Background: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. Objective: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. Methods: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. Results: We evaluated 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP). A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000) and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040) were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907) were small for gestational age and 25.0% and 23.2% (p = 0.994) were large for gestational age. There was a predominance of cesarean delivery. Conclusion: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries.

Resumo Fundamento: A pré-eclâmpsia tem sido associada a vários fatores de risco e eventos. No entanto, esta doença é merecedora de mais investigações, tendo em vista a multiplicidade de fatores relacionados que acometem diferentes populações. Objetivo: Avaliar os fatores maternos e os resultados perinatais adversos em uma coorte de gestantes com pré-eclâmpsia da rede pública de saúde de Maceió. Métodos: Estudo de coorte prospectivo realizado em 2014 na rede pública de saúde do município com uma amostra de gestantes calculada com base na prevalência de pré-eclâmpsia de 17%, nível de confiança de 90%, poder de 80% e razão de 1:1. Foi aplicado um questionário para coleta de dados socioeconômicos, pessoais e antropométricos, e obtidas variáveis perinatais de prontuário e da declaração de nascido vivo. Análise realizada com regressão de Poisson e teste do qui-quadrado, considerando p < 0,05 como significativo. Resultados: Foram estudadas 90 gestantes com pré-eclâmpsia (GCP) e 90 gestantes sem pré-eclâmpsia (GSP). História prévia de pré-eclâmpsia (razão de prevalência [RP] = 1,57, intervalo de confiança de 95% [IC 95%] 1,47-1,67, p = 0,000) e cor da pele negra (RP = 1,15, IC 95% 1,00-1,33, p = 0,040) estiveram associadas à ocorrência de pré-eclâmpsia. Entre os recém-nascidos das GCP e GSP, 12,5% e 13,1%, respectivamente, eram pequenos para a idade gestacional (p = 0,907) e 25,0% e 23,2%, respectivamente, eram grandes para a idade gestacional (p = 0,994). Houve predomínio da via de parto cesariana. Conclusão: História pessoal de pré-eclâmpsia e cor da pele negra estiveram associadas à ocorrência de pré-eclâmpsia. Houve elevadas frequências de desvios de peso ao nascer e da via de parto cesariana.

Maternal Factors and Adverse Perinatal Outcomes in Women with Preeclampsia in Maceió, Alagoas.

BACKGROUND: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. OBJECTIVE: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. METHODS: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. RESULTS: We evaluated 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP). A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000) and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040) were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907) were small for gestational age and 25.0% and 23.2% (p = 0.994) were large for gestational age. There was a predominance of cesarean delivery. CONCLUSION: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries.