Influence of gestational weight gain on the nutritional status of offspring at birth and at 5 years of age.

OBJECTIVE: To determine the influence of pre-pregnancy maternal BMI and increases in maternal weight during pregnancy on perinatal and child outcomes at birth and at 5 years. RESEARCH DESIGN/SETTING: A prospective cohort study was conducted between November 2016 and December 2021. The participants were a total of 115 women-child dyads, selected from among pregnant women receiving routine prenatal care in different health centres belonging to 2 health districts. Follow-ups were conducted with the women during pregnancy and with their children during the 10 days after birth and at 5 years. FINDINGS: The total weight gain during pregnancy is influenced by an inadequate pre-pregnancy BMI (0.03; 95 % CI, 0.004 - 0.25; P=.001) and a greater increase in maternal BMI during the first and second term of pregnancy. A greater increase in BMI during pregnancy was associated with higher breastfeeding rates both in the short term (1.21; 95 % CI, 1.01-1.44; P = 0.04) and the long term (12 months: 1.30; 95 % CI, 1.02 - 1.67; P = 0.04; 24 months: 1.30; 95 % CI, 1.02 - 1.69; P = 0.04). No links were found between gains in maternal weight and the weight of the newborn, nor between maternal weight and/or pre-pregnancy BMI with the nutritional status of the child. KEY CONCLUSIONS: After studying these results, it was concluded that promoting and implementing health and education policies focused on enhancing maternal nutritional status is essential to improve the nutritional status of children. IMPLICATIONS FOR PRACTICE: Healthy gestational weight gain (GWG) is an important issue to be addressed by the midwife in primary care, both in the preconception period and throughout pregnancy. As a result, it is important that the midwife is trained and has the appropriate resources and tools to work with pregnant women individually and collectively. In addition to paying attention to overweight and obese pregnant women, the midwife should also pay attention to women with a normal BMI, as they seem to have greater difficulty in maintaining a healthy weight gain. Another line of intervention to be addressed is breastfeeding (BF), where the midwife should be the main point of reference from the beginning of this process, taking into account the relationship between BMI and BF.

Nurses' and midwives' perceptions and strategies to cope with perinatal death situations: A systematic literature review.

AIM: The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction at work. DESIGN: Systematic literature review, in accordance with the PRISMA Declaration. DATA SOURCES: (2000-2021) Web of Science, PubMed, Scopus, CINALH and Dialnet, for articles in English and Spanish from the period between January 2000 and March 2021. REVIEW METHODS: The outcome of the review was the perceptions of nurses and midwives who have cared for people in a situation of perinatal loss. RESULTS: Thirteen studies were identified that evaluated the attitudes, experiences and needs of these healthcare professionals. The combined size of all samples was 2196 participants. CONCLUSIONS: The negative effects on these professionals' satisfaction with their situation at work could be mitigated by covering their needs for knowledge, experience, and emotional and technical skills to deal with such events. IMPACT: As potential protective factors against dissatisfaction in nurses and midwives during perinatal death experiences, we identified older age and experience in perinatal care and coping strategies based on communicating one's feelings to peers, empathetic listening to the families cared for, training and institutional support. No Patient or Public Contribution.

Cortisol, Maternal Stress, and Breastfeeding Rate at Hospital Discharge: A Systematic Review.

Introduction: Breastfeeding is considered the best way to provide essential and necessary nutrients to the newborn, intervening in its growth and development. However, early abandonment of this method is quite common, due to various factors such as stress. Objectives: To determine whether the level of postpartum cortisol can serve as an indicator of maternal stress and whether there is a relationship between the level of cortisol and the rate of exclusive breastfeeding (EBF) at hospital discharge. Methodology: Systematic review of the literature under the PRISMA guidelines. PubMed, Web of Science, CINAHL, and Scopus databases were used. Original articles published from 2017 to 2022 in English, French, Portuguese, and Spanish were included. All study designs were eligible. Of the 3,712 records initially identified, 15 studies were included in this review. Results: Elevated cortisol levels, due to immediate postpartum stressors, have direct effects on the performance of the essential hormones in breast milk production. The EBF rates are negatively influenced by perceived maternal stress. Conclusion: Cortisol levels may be a good indicator of the level of stress to which the mother is subjected during the immediate postpartum period.

Impact of dietary mercury intake during pregnancy on the health of neonates and children: a systematic review.

CONTEXT: Growing evidence suggests that prenatal exposure to methyl mercury through the maternal diet could have great influence on the neurological and physical development of neonates and young children. OBJECTIVE: The aim of this review was to evaluate the clinical repercussions of maternal exposure to methyl mercury during pregnancy on the health of fetuses, neonates, and children up to 8 years of age. DATA SOURCES: The Web of Science, PubMed, CINAHL, Scopus, and Dialnet Plus databases were searched for articles published in English or Spanish from 1990 to 2020. STUDY SELECTION: Original articles published in English or Spanish from 1990 to 2020 were eligible for inclusion. All study designs were eligible. Animal studies were excluded. Two authors independently screened studies for inclusion. From the 971 records initially identified, 19 studies were included in the systematic review. DATA EXTRACTION: PRISMA guidelines were followed. Outcomes extracted included maternal dietary exposure to methyl mercury during pregnancy, possible health repercussions in offspring up to 8 years of age, and quantitative measurement of mercury in a biological sample. All studies met the requirements established for assessing both study quality and risk of bias. RESULTS: Prenatal exposure to mercury was consistently associated with lower birth weight, but only one study reported a negative association with length at birth. Higher mercury levels were also related to lower scores in various neuropsychological and developmental tests. CONCLUSION: The literature shows clear evidence of the adverse effects of maternal methyl mercury exposure on anthropometric variables and cognitive or physical development in children. It is noteworthy, however, that mercury toxicity may sometimes be mitigated by other essential nutrients in the maternal diet, such as polyunsaturated fatty acids.

The Effects of the Pilates Method on Pelvic Floor Injuries during Pregnancy and Childbirth: A Quasi-Experimental Study.

The perineal injuries suffered during childbirth have a great impact on the quality of life of the female population. Evidence suggests that the Pilates method is used by pregnant women to improve the physical and psychological outcomes of pregnancy. The aim of this study was to investigate the influence of the Pilates Method during pregnancy on the incidence and degree of intrapartum perineal trauma. A quasi-experimental study was carried out between November 2018 and December 2019 at different health centers in two health districts. Participants were 72 pregnant women attending the antenatal program, who were assigned to a Pilates group or a control group (48 and 24 pregnant women, respectively). The main outcome measurement was perineal trauma during childbirth. After participating in the Pilates program, the women in the experimental group were significantly less likely to suffer perineal trauma in spontaneous deliveries compared to the women in the control group. After evaluating these results, it is concluded that health center managers should promote the training of midwives in the prevention and treatment of pelvic floor injuries during pregnancy and should consider strategies to enhance adhesion and participation with respect to pelvic floor exercise programs throughout pregnancy by means of Apps and other digital media specifically aimed at this phase.

The relevance of Xenophon's Anabasis and Plato's Meno to nursing.

The current situation in which the humanities are disparaged affects all university disciplines, including nursing, in whose historical evolution the humanities have always been present in one form or another. Looking beyond this disrepute, this study proposes that nursing renew its attention to classical philosophy. Specifically, it invites a close reading of Xenophon's Anabasis and Plato's Meno, to get three related goals: to show how the use of ancient texts are very valuable tools for the philosophical initiation of nursing students and can help them reflect on their choice of nursing as a practical activity; to reflect on the problem of virtue and the nature of the good life; and to show how the interaction with ancient texts allows students to reflect on questions and issues of life, theirs and others, that are not open to investigation through a purely scientific method. Consequently, both Anabasis and Meno readings strengthen the intellectual relationship between philosophy and nursing, enabling the latter to delve deeper into the key questions of its own thought as a discipline.

El lugar social del conocimiento enfermero: los editoriales científicos como artefactos lingüísticos desde la perspectiva de Certeau / O lugar social do conhecimento em enfermagem: editores científicos como artefatos lingüísticos na perspectiva de Certeau / The social place of Nursing knowledge: scientific editorials as linguistic artifacts read from a Certeau´s perspective

Resumen: El objetivo de este trabajo es analizar el proceso de producción del conocimiento enfermero. Este propósito se ha acometido desde una perspectiva filosófica, basada en el concepto de lugar social desarrollado por Michel de Certeau. El lugar social incluye la dimensión institucional, los procedimientos utilizados para generar conocimiento y los valores que lo sostienen. Para aplicar este marco epistemológico a la enfermería, los autores se han centrado en el estudio del Journal of Nursing Scholarship (JNS), a través de un análisis textual en el que se han estudiado los editoriales escritos por Susan Gennaro en JNS desde 2007 hasta mayo de 2018, aplicandoles las categorías epistemológicas certeaunianas. Después de una lectura atenta es posible afirmar que JNS puede ser visto como una institución del conocimiento, que mantiene una estrecha relación con el poder, establece acuerdos con autores y revisores, y que escribe su propio discurso sobre la realidad. También han sido identificados los procedimientos clave que marcan cómo ha de ser escrito un artículo para JNS. Finalmente, la práctica, la significación social, la eficiencia, la universalidad, la buena ciencia y el liderazgo han aparecido como los principales valores de JNS. Las aportaciones de este trabajo pueden ayudar a los enfermeros a comprender que ningún conocimiento (ni los artefactos lingüísticos asociados al mismo) está completamente libre de influencias sociales.

Resumo: O objetivo deste trabalho é analisar o processo de produção de conhecimento de enfermagem. Esse objetivo foi realizado a partir de uma perspectiva filosófica, baseada no conceito de lugar social desenvolvido por Michel de Certeau. O lugar social inclui a dimensão institucional, os procedimentos utilizados para gerar conhecimento e os valores que o sustentam. Para aplicar esse quadro epistemológico à enfermagem, os autores se concentraram no estudo da Journal of Nursing Scholarship (JNS), através de uma análise textual na qual os editoriais escritos por Susan Gennaro no JNS foram estudados de 2007 a maio de 2018, aplicando as categorias epistemológicas certeaunianas. Após uma leitura cuidadosa, é possível afirmar que a SNJ pode ser vista como uma instituição do conhecimento, que mantém uma estreita relação com o poder, estabelece acordos com autores e revisores e escreve seu próprio discurso sobre a realidade. Os principais procedimentos que marcam como um artigo para o JNS deve ser escrito também foram identificados. Finalmente, a prática, o significado social, a eficiência, a universalidade, a boa ciência e a liderança apareceram como os principais valores da SAN. As contribuições deste trabalho podem ajudar os enfermeiros a entender que nenhum conhecimento (ou os artefatos lingüísticos a ele associados) está completamente livre de influências sociais.

Summary: The purpose of this article is to analyze the process by which nursing knowledge is produced. It takes a philosophical perspective based on the concept of social place developed by Michel de Certeau. Social place comprises an institutional dimension, the procedures used to create knowledge and the values underlying it. In applying this epistemic framework to nursing, the authors focused on the Journal of Nursing Scholarship (JNS). The study took the form of a textual analysis, using Certeau's epistemic categories, of all JNS editorials by Susan Gennaro from 2007 to 2018. The results of this analysis support the Certeaunian view that the JNS can be regarded as a knowledge institution, which maintains a tight relationship with power, makes contracts with authors and reviewers, and generates its own discourse about reality. The key procedures and conventions for contributing papers to the JNS were also identified. Finally, practice, social significance, efficiency, universality, good science and leadership emerged as the core values of the JNS. The findings of this study can help researchers to appreciate that knowledge (and linguistic artifacts associated with it) is never absolutely free from social constraints.

New ways for nursing inspired by the works of Michel de Certeau.

The focus of this article is the life and work of the French thinker Michel de Certeau, here presented as a philosopher of special interest for nursing. Although in some countries he is relatively unknown, international authors from scientific disciplines regard his texts as a fundamental source in the opening of new intellectual perspectives on current global problems. Some nurses have also considered his ideas as a useful aid for reflecting on their professional activities, and their most important research is cited. Over these pages, we also examine how Certeau's work can enrich nursing philosophy in regard to three specific issues: resistance practices in nursing in the face of pressure from health institutions; the social configuration of nursing knowledge; and the importance of the body in current nursing practice.