Use of antianemics in prenatal care: A population cohort from a capital city in the North region of Brazil.

Anemia during pregnancy is a significant risk factor for adverse maternal and fetal outcomes, including preterm birth, low birth weight, and maternal mortality. In Brazil, anemia prevention and treatment programs are available, but regional variations in prevalence and factors associated with antianemic drug use remain understudied. The objective was to identify the prevalence of gestational anemia and the factors associated with the use of antianemic drugs during pregnancy in a cross-sectional population-based study carried out in Rio Branco, AC. To do so, we planned a cross-sectional, population-based study with a total of 1190 postpartum women who gave birth between April 6 and July 10, 2015, were interviewed about demographic, socioeconomic, reproductive, and prenatal care factors. The prevalence of anemia during pregnancy was found to be 13.8 %, with 93.2 % of women using antianemic drugs, such as ferrous sulfate and folic acid. Factors positively associated with antianemic drug use were higher education (elementary school II RCajust = 2.46; 95 %, CI: 1.01-6.13; high school RCajust = 2.61; 95 %, CI: 1.11-6.12), primiparity (ACadjust = 1.69; 95 %, CI: 0.98-3.74), 6 to 8 prenatal consultations (ACjust = 2.16; 95, CI%: 1.15-4.05), and planned pregnancy (ARjust = 1.94; 95 %, CI: 1.05-3.74). Food security during pregnancy was inversely associated. These findings suggest that while anemia prevention and treatment programs exist, more targeted strategies are needed, particularly for women with lower socioeconomic status, to improve maternal and fetal health outcomes.

Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis.

BACKGROUND: Physical exercise in women with breast cancer has shown benefits in reducing fatigue levels during adjuvant radiotherapy and chemotherapy. However, it is not well understood which type of exercise is more effective. OBJECTIVE: Assess the impact of different types of physical exercises on fatigue and which is the most effective in reducing this adverse effect during adjuvant treatment in breast cancer. METHODS: The inclusion criteria were randomized clinical trials of physical exercise in women diagnosed with breast cancer in stages I to IV, above 18 years, evaluating fatigue using validated questionnaires. The meta-analysis pooled results by standardized mean difference (SMD). RESULTS: A total of 20 randomized clinical trials involving 1793 participants revealed that the practice of physical exercise was statistically effective in reducing fatigue (SMD = - 0.46; 95% CI: - 0.66, - 0.27). Our analysis of subgroups suggests that the supervised combination of resistance training (RT) with aerobic training (AT) is the most effective physical exercise to reduce fatigue (SMD = - 1.13; 95% CI: - 2.09, - 0.17). The supervised RT was more effective (SMD = - 0.30; 95% CI: - 0.46, - 0.15) than supervised AT or mind-body techniques. It was observed that only during chemotherapy, women with breast cancer in the intervention groups showed a significant reduction in fatigue (SMD = - 0.38; 95% CI: - 0.55 to - 0.20). CONCLUSION: Physical exercise during adjuvant chemotherapy and/or radiotherapy in women with breast cancer can be considered beneficial in reducing fatigue, especially for women undergoing chemotherapy and for supervised training of resistance or combined RT and AT.

Anomalias congênitas em nascidos vivos / Congenital anomalies in newborns / Anomalías congénitas de nacidos vivos

Objetivo: Analisar a prevalência e possíveis fatores associados às anomalias congênitas em um município do estado do Acre. Métodos: Estudo transversal, descritivo, baseado nos dados do Sistema de Informações sobre Nascidos Vivos (SINASC) do município de Rio Branco, Acre, Brasil, no período de 2001 a 2013. A variável desfecho foi a presença de anomalias congênitas e as variáveis independentes estavam relacionadas à mãe e ao nascido vivo. Odds Ratio (OR) e intervalos de confiança de 95% foram estimados por regressão logística. Resultados: A prevalência de anomalias congênitas esteve presente em 0,2% dos nascidos vivos no período analisado, e as mais frequentes foram: as deformidades osteomusculares (41,3%), seguidas das malformações do sistema nervoso (17,9%); observando-se associação com a idade da mãe, <15 e ≥35 anos (OR 1,72; IC95% 1,03; 2,87), o parto cesáreo (OR 1,85; IC95% 1,29; 2,65), o menor escore de Apgar no 1º (OR 3,54; IC95% 1,69; 7,42) e 5º minutos (OR 13,65; IC95% 4,00; 46,61) e o peso ao nascer ≤1.499g (OR 5,09; IC95% 2,32; 11,19). Conclusão: A chance de apresentar anomalia congênita foi maior entre: nascidos vivos de mães muito jovens ou em idade avançada; pré-termos com menos de 32 semanas gestacionais; nascidos de parto cesáreo; nascidos vivos que apresentaram grau de dificuldade grave para Apgar 1º e 5º; e neonatos que apresentaram extremo baixo peso.

Objective: To analyze the prevalence and factors potentially associated with congenital anomalies in a municipality of the State of Acre. Methods: Descriptive cross-sectional study of data from the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos ­ SINASC) of the municipality of Rio Branco, Acre, Brazil, from 2001 to 2013. The outcome variable was the presence of congenital anomalies and the independent variables were related to the mother and the live birth. Odds Ratios (OR) and Confidence Intervals of 95% were estimated by logistic regression. Results: The prevalence of congenital anomalies was 0.2% in live births in the analyzed period, and the most frequent were musculoskeletal deformities (41.3%) followed by malformations of the nervous system (17.9%); they were associated with the age of the mother <15 and ≥35 years old (OR 1.72, 95%CI 1.03, 2.87), cesarean section (OR 1.85, 95%CI 1.29, 2.65), lower Apgar score at 1 (OR 3.54, 95%CI 1.69, 7.42) and 5 minutes (OR 13.65, 95%CI 4.00, 46.61) and birth weight ≤1.499g (OR 5.09; 95%CI 2.32, 11.19). Conclusion: The chance of having congenital anomaly was higher in the live births of mothers aged <15 and ≥35 years old; preterm births with less than 32 gestational weeks; cesarean births; live births who presented a degree of severe difficulty for Apgar 1 and for Apgar 5, and neonates who presented extreme low weight.

Objetivo: Analizar la prevalencia y posibles factores asociados con las anomalías congénitas de un municipio del estado de Acre. Métodos: Estudio transversal y descriptivo basado en los datos del Sistema de Informaciones sobre Nacidos Vivos (SINASC) del municipio de Rio Branco, Acre, Brasil, en el periodo entre 2001 y 2013. La variables de desfecho fue la presencia de anomalías congénitas y las variables independientes se relacionaron a la madre y al nacido vivo. Odds Ratio (OR) e intervalos de confianza del 95% fueron estimados a través de regresión logística. Resultados: La prevalencia de anomalías congénitas estuvo presente en el 0,2% de los nacidos vivos del período analizado siendo las más frecuentes: las deformidades osteomusculares (41,3%) seguidas de las malformaciones del sistema nervoso (17,9%); observándose asociación con la edad de la madre, <15 y ≥35 años (OR 1,72; IC95% 1,03; 2,87), el parto por cesárea (OR 1,85; IC95% 1,29; 2,65), la menor puntuación del Apgar en el 1º (OR 3,54; IC95% 1,69; 7,42) y 5º minutos (OR 13,65; IC95% 4,00; 46,61) y el peso al nacer ≤1.499g (OR 5,09; IC95% 2,32; 11,19). Conclusión: La oportunidad de presentar anomalía congénita fue mayor entre los nacidos vivos de madres muy jóvenes o en edad avanzada; los pre términos con menos de 32 semanas de gestación; los nacidos de parto por cesárea; los nacidos vivos que presentaron grado de dificultad grave para el 1º y 5º; y los neonatos que presentaron bajo peso extremo.