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ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.
RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas.
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OBJECTIVE: To perform a meta-analysis and comparison between high-income, and low- and middle-income countries postpartum depression symptoms prevalences. METHODS: PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO and CINAHL databases were searched until October 2022 for studies that collected data from pandemic. The metaprop command was used in the Stata statistical software v.12.0 to run a random-effects meta-analysis. RESULTS: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of postpartum depression symptoms was 31% (95% CI: 21.85-40.99). The pooled prevalence of postpartum depression symptoms among women from high-income countries [30.5% (95% CI: 16.95-46.02)] did not differ significantly from that among women from low- and middle-income countries [31.5% (95% CI: 19.26-45.15)]. However, studies that analyzed women up to one month after childbirth had a lower prevalence of postpartum depression symptoms [17.5% (95% CI: 9.85-26.62)] compared to those that observed them up to one year after childbirth [38.3% (95% CI: 33.96-42.83)]. CONCLUSIONS: The prevalence of postpartum depression symptoms was high regardless of the country's human development index and it must be regularly tracked around the world to assess, discuss, and recommend more assertive steps that may be implemented based on the particular characteristics of each country.
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Objective: To compare the prevalence of postpartum depression (PPD) symptoms between high-income countries (HIC) and low- and middle-income countries (LMIC) during the COVID-19 pandemic. Methods: The PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO, and CINAHL databases were searched until October 2022 for studies that collected data during the pandemic. The metaprop command was used in the Stata statistical software version 12.0 to run a random-effects meta-analysis. Results: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of PPD symptoms was 31% (95%CI 21.85-40.99). The pooled prevalence of PPD symptoms among women from HIC (30.5% [95%CI 16.95-46.02]) did not differ significantly from that of women from LMIC (31.5% [95%CI 19.26-45.15]). However, studies that analyzed women up to 1 month after childbirth reported a lower prevalence of PPD symptoms (17.5% [95%CI 9.85-26.62]) compared to those that observed them up to 1 year after childbirth (38.3% [95%CI 33.96-42.83]). Conclusions: The prevalence of PPD symptoms was high across countries, regardless of human development index. This condition must be regularly tracked worldwide to assess, discuss, and recommend more assertive steps that may be implemented to address it based on the particular characteristics of each country. Registration number: PROSPERO CRD42022346861.
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ABSTRACT Objective: The objective of this study was to evaluate the influence of maternal and perinatal factors on the nutritional composition of human milk. Methods: A cross-sectional study was conducted between November 2018 and January 2020, with 181 donors selected in Tertiary Health Units of the Unified Health System — from one collection station and five Human Milk Banks. Data were collected through a standardized questionnaire. To be fit to be a donor in a Human Milk Banks and produce mature milk were the eligibility criteria to participate in the study. We excluded milk samples with Dornic acidity above 8° D. The dependent variables were the macronutrients of human milk (i.e., carbohydrates, proteins, lipids, and total energy), that were analyzed using spectroscopy with the Miris Human Milk Analyzer™. The maternal and perinatal factors were the independent variables. Results: Women with pre-gestational obesity and gestational weight gain above the recommendation showed a lower protein concentration compared to eutrophic women (median=0.8, interquartile range (IQR): 0.7-0.9 vs. median=0.8, and IQR: 0.8-1.0) and those with adequate gestational weight gain (median=0.8, IQR: 0.7-0.9 vs. median=0.9, and IQR: 0.8-1.0), respectively. The other analyzed factors (i.e., maternal habits, comorbidities, and perinatal factors) were not associated with the nutritional composition of human milk. Conclusions: The assessment of factors associated with the nutritional composition of human milk is extremely important to assist postpartum care. Pre-gestational obesity and inadequate gestational weight gain were the only factors statistically associated with the nutritional composition of human milk as they impacted its protein content.
RESUMO Objetivo: Avaliar a influência de fatores maternos e perinatais na composição nutricional do leite humano. Métodos: Estudo transversal, realizado entre novembro de 2018 e janeiro de 2020, com 181 doadoras selecionadas em Unidades Terciárias de Saúde do Sistema Único de Saúde de um Posto de Coleta e cinco Bancos de Leite Humano. Foram coletados dados das variáveis maternas e dos recém-nascidos por meio de questionário padronizado. Estar apta para ser doadora em um Banco de Leite Humano e produzir leite maduro foram os critérios de elegibilidade para participar do estudo. As amostras de leite com acidez Dornic acima de 8° D foram excluídas. Os macronutrientes do leite humano, variáveis dependentes (carboidratos, proteínas, lipídeos, energia total) foram analisados pela técnica de espectroscopia de transmissão no infravermelho médio com o Miris Human Milk Analyzer™. Os fatores maternos e perinatais foram as variáveis independentes. Resultados: Mulheres com obesidade pré-gestacional e ganho de peso gestacional acima do recomendado apresentaram menor concentração proteica em relação às eutróficas (mediana=0,8, intervalo interquartil [IQR]: 0,7-0,9 vs. mediana=0,8, IQR: 0,8-1,0) e aquelas com ganho de peso gestacional adequado (mediana=0,8, IQR: 0,7-0,9 vs. mediana=0,9, IQR: 0,8-1,0), respectivamente. Os demais fatores analisados (hábitos maternos, comorbidades, fatores perinatais) não se associaram com a composição nutricional do leite humano. Conclusões: A avaliação dos fatores associados à composição nutricional do leite humano é de extrema importância para auxiliar os cuidados pós-parto. A obesidade pré-gestacional e o ganho de peso gestacional inadequado foram os únicos fatores estatisticamente associados com a composição nutricional do leite humano por terem impactado o seu teor de proteína.
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OBJECTIVE: The objective of this study was to evaluate the influence of maternal and perinatal factors on the nutritional composition of human milk. METHODS: A cross-sectional study was conducted between November 2018 and January 2020, with 181 donors selected in Tertiary Health Units of the Unified Health System - from one collection station and five Human Milk Banks. Data were collected through a standardized questionnaire. To be fit to be a donor in a Human Milk Banks and produce mature milk were the eligibility criteria to participate in the study. We excluded milk samples with Dornic acidity above 8° D. The dependent variables were the macronutrients of human milk (i.e., carbohydrates, proteins, lipids, and total energy), that were analyzed using spectroscopy with the Miris Human Milk Analyzer™. The maternal and perinatal factors were the independent variables. RESULTS: Women with pre-gestational obesity and gestational weight gain above the recommendation showed a lower protein concentration compared to eutrophic women (median=0.8, interquartile range (IQR): 0.7-0.9 vs. median=0.8, and IQR: 0.8-1.0) and those with adequate gestational weight gain (median=0.8, IQR: 0.7-0.9 vs. median=0.9, and IQR: 0.8-1.0), respectively. The other analyzed factors (i.e., maternal habits, comorbidities, and perinatal factors) were not associated with the nutritional composition of human milk. CONCLUSIONS: The assessment of factors associated with the nutritional composition of human milk is extremely important to assist postpartum care. Pre-gestational obesity and inadequate gestational weight gain were the only factors statistically associated with the nutritional composition of human milk as they impacted its protein content.
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Ganho de Peso na Gestação , Bancos de Leite Humano , Gravidez , Feminino , Humanos , Leite Humano/química , Estudos Transversais , ObesidadeRESUMO
The objective of this study is to verify the association between obesity and mortality in hospitalized patients with SARS-CoV-2 taking into account the Human Development Index (HDI). A search was performed in the PubMed, Virtual Health Library (Lilacs/Bireme/VHL Brazil), Embase, Web of Science, and Scopus databases from inception to May 2022. To be eligible, studies had to have cohort or case-control designs, be conducted with hospitalized adults (≥18 years old), and evaluate mortality rates between with obesity and without obesity individuals with SARS-CoV-2 confirmed by laboratory tests. The analyses were performed in Stata 12.0 using relative risk (RR) as a summary measure. Heterogeneity was explored by meta-regression and subgroup analyses considering the HDI, age, sex, and follow-up period. Out of 912 studies screened, 49 studies were eligible for qualitative synthesis, and 33 studies were eligible for quantitative analysis, representing 42,905 patients. The mortality risk from SARS-CoV-2 was higher in individuals with obesity compared with without obesity individuals only in the subgroups of patients <60 years old (RR = 1.31; 95% CI 1.18-1.45, I2 = 0.0%) and living in countries with a low HDI (RR = 1.28; 95% CI 1.10-1.48, I2 = 45.4%).
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COVID-19 , Humanos , Adulto , Adolescente , Pessoa de Meia-Idade , SARS-CoV-2 , Obesidade/complicações , RiscoRESUMO
This systematic review aimed to examine the results of studies that have investigated the induction of panic attacks and/or the anxiogenic effect of the caffeine challenge test in patients with panic disorder. The literature search was performed in PubMed, Biblioteca Virtual em Saúde and the ISI Web of Knowledge. The words used for the search were caffeine, caffeine challenge test, panic disorder, panic attacks and anxiety disorder. In total, we selected eight randomized, double-blind studies where caffeine was administered orally, and none of them controlled for confounding factors in the analysis. The percentage of loss during follow-up ranged between 14.3% and 73.1%. The eight studies all showed a positive association between caffeine and anxiogenic effects and/or panic disorder.
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Transtornos de Ansiedade/diagnóstico , Cafeína , Estimulantes do Sistema Nervoso Central , Transtorno de Pânico/diagnóstico , Transtornos de Ansiedade/induzido quimicamente , Cafeína/efeitos adversos , Cafeína/química , Cafeína/metabolismo , Estimulantes do Sistema Nervoso Central/efeitos adversos , Estimulantes do Sistema Nervoso Central/química , Estimulantes do Sistema Nervoso Central/metabolismo , Técnicas de Diagnóstico Neurológico , Humanos , Transtorno de Pânico/induzido quimicamenteRESUMO
This systematic review aims to identify the effect of polyunsaturated fatty acid omega-3 on depressive disorder. A bibliographical search was conducted in the databases SciELO, PubMed and ISIWEB. The keywords used were: "depression" and "omega-3 fatty acids", "depression" and "omega-3 polyunsaturated fatty acid", "depression" and "n-3 fatty acids". A total of 19 studies were identified: four double-blind randomized studies, four cohorts, two cross-sectional lines and nine case-controls. Only five studies presented dropout of less than 30% and controlled for the most important confounding variables. Of the evaluated studies, 13 showed a significant positive association between omega-3 and depression, while six studies did not show a relationship between the referred variables. Therefore, future studies with similar methodology would aid in determining the precise effect of omega-3 on depressive disorders.
Assuntos
Depressão/tratamento farmacológico , Ácidos Graxos Ômega-3/uso terapêutico , Ensaios Clínicos como Assunto , HumanosRESUMO
A systematic review was conducted, focusing on the relationship between depression during pregnancy and increased risk of low birth weight. The review covered articles published in PubMed, SciELO, and ISIWEB using the key words 'depression', 'pregnancy', 'birth weight' and 'low birth weight'. Ninety-nine studies were located, but after reading the abstracts only 10 articles were selected. According to criteria proposed by Downs & Black (1998) to assess the quality of the selected studies, only one was considered excellent, since it reached the maximum score of 20. Depression during pregnancy was associated with low birth weight in seven studies. Contradictions in the findings are due to differences in the scales used to evaluate depression, sample size, and insufficient control of important limiting factors for evaluating the results. Carefully designed studies are thus needed to elucidate the association between intra-gestational depression and low birth weight.
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Depressão/psicologia , Recém-Nascido de Baixo Peso , Complicações na Gravidez/psicologia , Feminino , Humanos , Recém-Nascido , Gravidez , Fatores de RiscoRESUMO
Realizou-se uma revisão sistemática enfocando o efeito da depressão no período gestacional sobre o maior risco do baixo peso ao nascer. A revisão consistiu na busca de artigos publicados nas bases de dados PubMed, SciELO e ISIWEB utilizando-se as palavras-chave: "depression", "pregnancy", "low birth weight" e "birth weight". Foram localizados noventa e nove estudos, no entanto após a leitura dos resumos foram selecionados dez artigos. Segundo o critério de Downs & Black, utilizado para aferir a qualidade dos estudos selecionados, apenas um foi considerado de excelente qualidade, pois alcançou a pontuação máxima de 20 pontos. A depressão na gestação foi associada ao baixo peso ao nascer em sete estudos. Contradições nos achados devem-se às diferenças nas escalas utilizadas para mensurar a depressão, tamanho amostral e controle insuficiente de importantes fatores limitantes de avaliação dos resultados. Por estes motivos, são necessários estudos cuidadosamente desenhados para esclarecer a associação entre depressão durante o período gestacional e baixo peso ao nascer.
A systematic review was conducted, focusing on the relationship between depression during pregnancy and increased risk of low birth weight. The review covered articles published in PubMed, SciELO, and ISIWEB using the key words "depression", "pregnancy", "birth weight" and "low birth weight". Ninety-nine studies were located, but after reading the abstracts only 10 articles were selected. According to criteria proposed by Downs & Black (1998) to assess the quality of the selected studies, only one was considered excellent, since it reached the maximum score of 20. Depression during pregnancy was associated with low birth weight in seven studies. Contradictions in the findings are due to differences in the scales used to evaluate depression, sample size, and insufficient control of important limiting factors for evaluating the results. Carefully designed studies are thus needed to elucidate the association between intra-gestational depression and low birth weight.