Association between foetal sex and adverse neonatal outcomes in women with gestational diabetes.

AIMS: Foetal male sex is associated with adverse perinatal outcomes. However, studies evaluating the impact of foetal sex on perinatal outcomes in women with gestational diabetes (GDM) are scarce. We studied whether male new-born sex is associated with neonatal outcomes, in women with GDM. METHODS: This is a retrospective study based on the national Portuguese register of GDM. All women with live-born singleton pregnancies between 2012 and 2017 were eligible for study inclusion. Primary endpoints under analysis were neonatal hypoglycaemia, neonatal macrosomia, respiratory distress syndrome (RDS) and neonatal intensive care unit (NICU) admission. We excluded women with missing data on the primary endpoint. Pregnancy data and neonatal outcomes between female and male new-borns were compared. Multivariate logistic regression models were built. RESULTS: We studied 10,768 new-borns in mothers with GDM, 5635 (52.3%) male, 438 (4.1%) had neonatal hypoglycaemia, 406 (3.8%) were macrosomic, 671 (6.2%) had RDS, and 671 (6.2%) needed NICU admission. Male new-borns were more frequently small or large for gestational age. No differences were observed on maternal age, body mass index, glycated haemoglobin, anti-hyperglycaemic treatment, pregnancy complications or gestational age at delivery. In the multivariate regression analysis, male sex was independently associated with neonatal hypoglycaemia [OR 1.26 (IC 95%: 1.04-1.54), p = 0.02], neonatal macrosomia [1.94 (1.56-2.41), p < 0.001], NICU admission [1.29 (1.07-1.56), p = 0.009], and RDS [1.35 (1.05-1.73, p = 0.02]. CONCLUSIONS: Male new-borns have an independent 26% higher risk of neonatal hypoglycaemia, 29% higher risk of NICU admission, 35% higher risk of RDS, and almost twofold higher risk of macrosomia, compared to female new-borns.

Perception of oral contraception - do women think differently from gynaecologists?

PURPOSE: This study aimed to assess the experience and satisfaction with contraceptives and use of Combined Oral Contraceptives (COC) by women and compare their perceptions with those of gynaecologists. METHODS: This was a multicentre survey study conducted in Portugal, during April and May, 2021 with women using contraceptives and gynaecologists. Online quantitative questionnaires were carried out. RESULTS: A total of 1508 women and 100 gynaecologists were included. Cycle control was the pill non-contraceptive benefit most valued by gynaecologists and women. For gynaecologists, the main pill concern was the risk of thromboembolic events, but they believed that weight gain was the main concern for their patients. The pill was the most used contraceptive (70%) and women were largely (92%) satisfied. The pill was associated with health risks for 85% of users, mainly thrombosis (83%), weight gain (47%), and cancer (37%). The attributes of the pill most valued by women are contraceptive efficacy (82%), followed by low risk of thromboembolic events (68%), good cycle control (60%), non-interference with libido and mood (59%) and weight (53%). CONCLUSION: Most women use contraceptive pills and are generally satisfied with their contraceptive. Cycle control was the most valued non-contraceptive benefit for gynaecologists and women, agreeing with physicians' beliefs about women. On the other hand, contrary to physicians' beliefs, that women's main concern is weight gain, women are mainly concerned with risks associated with contraceptives. Thromboembolic events are women's and gynaecologists most valued risk. Finally, this study indicates the need for physicians to better understand what COC users really fear.

Comparing women's perceptions with those of gynaecologists regarding Combined Oral Contraceptives, this study showed that contrary to physicians' beliefs, that women's main concern is weight gain, their main concern are risks associated with contraceptives. So, physicians need to better understand what women really fear.

Prioritization of rehabilitation interventions for urban water assets using multiple criteria decision-aid methods.

The aim of this paper is to compare sorting and ranking methods for prioritization of rehabilitation interventions of sewers, taking into account risk, performance and cost. For that purpose multiple criteria decision-aid (MCDA) methods such as ELECTRE TRI for sorting and ELECTRE III for ranking are applied in a real case-study and the results obtained are compared. The case study is a small sanitary sewer system from a Portuguese utility located in the metropolitan area of Lisbon. The problem to investigate is the prioritization of the sewer candidates for rehabilitation. The decision maker (a panel group of specialists) has chosen five assessment measures: water level and maximum flow velocity (hydraulic performance indices), sewer importance and failure repair cost (collapse-related consequences of failure) and the risk of collapse. The results show that the outcomes from ELECTRE III are easier to understand than those from ELECTRE TRI method. Two different sets of weights were used, and the sorting and ranking results from both methods were found to be sensitive to them. ELECTRE TRI method is not straightforward as it involves technical parameters that are difficult to define, such as reference profiles and cut levels.