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Physiol Behav ; 249: 113751, 2022 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-35217067


Improving the housing of pregnant sows by giving them more space and access to deep straw had positive effects on their welfare, influenced their maternal behavior and improved the survival of their offspring. The present study aimed at determining whether these effects were actually due to environmental enrichment and whether the provision of straw pellets and wood can partly mimic the effects of straw bedding during gestation. Three graded levels of enrichment were used, that were, collective conventional pens on slatted floor (C, n = 26), the same pens with manipulable wood materials and distribution of straw pellets after the meals (CE, n = 30), and larger pens on deep straw litter (E, n = 27). Sows were then housed in identical farrowing crates from 105 days of gestation until weaning. Decreased stereotypies, blood neutrophils, and salivary cortisol, and increased behavioral investigation indicated that health and welfare of sows during gestation were improved in the E environment compared with the C environment. The CE sows responded as C or E sows depending on the trait. Piglet mortality rate in the first 12 h after birth was lower in E and CE litters than in C litters, but enrichment level during gestation had only small effects on lactating sow behavior and milk composition postpartum. On days 2 and 3 of lactation, E sows interrupted less often their nursing sequences than C and CE sows. On day 2, milk from both E and CE sows contained more minerals than that from C sows. In one-day-old piglets, the expression levels of genes encoding toll-like receptors (TLR2, TLR4) and cytokines (interleukin-1, -6 and -10) in whole blood after 20-h culture, were greater in E piglets than in CE or C piglets. In conclusion, housing sows in an enriched environment during gestation improved early neonatal survival, probably via moderate and cumulative positive effects on sow behavior, milk composition, and offspring innate immune response. The gradation in the effects observed in C, CE and E housing environment reinforced the hypothesis of a causal relationship between maternal environmental enrichment, sow welfare and postnatal piglet traits.

Abrigo para Animais , Lactação , Animais , Animais Recém-Nascidos , Feminino , Humanos , Imunidade , Lactação/fisiologia , Bem-Estar Materno , Gravidez , Suínos , Desmame
Pediatrics ; 148(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34642233


BACKGROUND: A woman's health in the interconception period has an impact on birth outcomes. Pediatric visits offer a unique opportunity to provide interconception care (ICC). Our aim was to screen and provide interconception and safe sleep screening, counseling, and interventions for 50% of caregivers of children <2 years of age in a pediatric medical setting. METHODS: Two pediatric clinics implemented the March of Dimes' Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques (IMPLICIT) toolkit, in addition to standardized safe sleep assessments. A quality improvement learning collaborative was formed with a local "infant mortality champion" leading quality improvement efforts. Monthly webinars with the clinic teams reviewed project successes and challenges. Framework for Reporting Adaptations and Modifications was used to document adaptations. RESULTS: For each individual IMPLICIT domain, clinics screened and provided needed interventions for ICC and safe sleep in >50% of eligible encounters. Over the course of the quality improvement learning collaborative, the number of caregivers screened for at least 4 of the 5 IMPLICIT domains increased from 0% to 95%. CONCLUSIONS: To successfully implement the IMPLICIT toolkit in pediatrics, adaptations were made to the existing model, which had previously been used in family medicine clinics. Pediatricians should consider providing ICC as an innovative way to impact infant mortality rates in their community. Framework for Reporting Adaptations and Modifications can be used to systematically describe the adaptations needed to improve the fit of IMPLICIT in the pediatric clinic, understand the process of change and potential application to local context.

Recém-Nascido de Baixo Peso , Bem-Estar Materno , Pediatria , Cuidado Pré-Concepcional/métodos , Sono , Intervalo entre Nascimentos , Feminino , Humanos , Lactente , Cuidado do Lactente , Mortalidade Infantil , Bem-Estar do Lactente , Recém-Nascido , Cuidado Pré-Concepcional/normas , Nascimento Prematuro/prevenção & controle , Melhoria de Qualidade
JAMA Pediatr ; 175(5): 494-500, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33646291


Importance: More than 2 million families face eviction annually, a number likely to increase due to the coronavirus disease 2019 pandemic. The association of eviction with newborns' health remains to be examined. Objective: To determine the association of eviction actions during pregnancy with birth outcomes. Design: This case-control study compared birth outcomes of infants whose mothers were evicted during gestation with those whose mothers were evicted at other times. Participants included infants born to mothers who were evicted in Georgia from January 1, 2000, to December 31, 2016. Data were analyzed from March 1 to October 4, 2020. Exposures: Eviction actions occurring during gestation. Main Outcomes and Measures: Five metrics of neonatal health included birth weight (in grams), gestational age (in weeks), and dichotomized outcomes for low birth weight (LBW) (<2500 g), prematurity (gestational age <37.0 weeks), and infant death. Results: A total of 88 862 births to 45 122 mothers (mean [SD] age, 26.26 [5.76] years) who experienced 99 517 evictions were identified during the study period, including 10 135 births to women who had an eviction action during pregnancy and 78 727 births to mothers who had experienced an eviction action when not pregnant. Compared with mothers who experienced eviction actions at other times, eviction during pregnancy was associated with lower infant birth weight (difference, -26.88 [95% CI, -39.53 to 14.24] g) and gestational age (difference, -0.09 [95% CI, -0.16 to -0.03] weeks), increased rates of LBW (0.88 [95% CI, 0.23-1.54] percentage points) and prematurity (1.14 [95% CI, 0.21-2.06] percentage points), and a nonsignificant increase in mortality (1.85 [95% CI, -0.19 to 3.89] per 1000 births). The association of eviction with birth weight was strongest in the second and third trimesters of pregnancy, with birth weight reductions of 34.74 (95% CI, -57.51 to -11.97) and 35.80 (95% CI, -52.91 to -18.69) g, respectively. Conclusions and Relevance: These findings suggest that eviction actions during pregnancy are associated with adverse birth outcomes, which have been shown to have lifelong and multigenerational consequences. Ensuring housing, social, and medical assistance to pregnant women at risk for eviction may improve infant health.

Bem-Estar do Lactente/estatística & dados numéricos , Bem-Estar Materno/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Habitação Popular/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , Estudos de Casos e Controles , Características da Família , Feminino , Georgia , Habitação/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Gravidez , Saúde Pública
JAMA Pediatr ; 175(6): 609-616, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33779712


Importance: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an important source of nutritional support and education for women and children living in poverty; although WIC participation confers clear health benefits, only 50% of eligible women and children currently receive WIC. In 2010, Congress mandated that states transition WIC benefits by 2020 from paper vouchers to electronic benefits transfer (EBT) cards, which are more convenient to use, are potentially less stigmatizing, and may improve WIC participation. Objective: To estimate the state-level association between transition from paper vouchers to EBT and subsequent WIC participation. Design, Setting, and Participants: This economic evaluation of state-level WIC monthly benefit summary administrative data regarding participation between October 1, 2014, and November 30, 2019, compared states that did and did not implement WIC EBT during this time period. Difference-in-differences regression modeling allowed associations to vary by time since policy implementation and included stratified analyses for key subgroups (pregnant and postpartum women, infants younger than 1 year, and children aged 1-4 years). All models included dummy variables denoting state, year, and month as covariates. Data analyses were performed between March 1 and June 15, 2020. Exposures: Statewide transition from WIC paper vouchers to WIC EBT cards, specified by month and year. Main Outcomes and Measures: Monthly number of state residents enrolled in WIC. Results: A total of 36 states implemented WIC EBT before or during the study period. EBT and non-EBT states had similar baseline rates of poverty and food insecurity. Three years after statewide WIC EBT implementation, WIC participation increased by 7.78% (95% CI, 3.58%-12.15%) in exposed states compared with unexposed states. In stratified analyses, WIC participation increased by 7.22% among pregnant and postpartum women (95% CI, 2.54%-12.12%), 4.96% among infants younger than 1 year (95% CI, 0.95%-9.12%), and 9.12% among children aged 1 to 4 years (95% CI, 3.19%-15.39%; P for interaction = .20). Results were robust to adjustment for state unemployment and poverty rates, population, and Medicaid expansion status. Conclusions and Relevance: In this study, the transition from paper vouchers to WIC EBT was associated with a significant and sustained increase in enrollment. Interventions that simplify the process of redeeming benefits may be critical for addressing low rates of enrollment in WIC and other government benefit programs.

Eletrônica , Assistência Alimentar/economia , Feminino , Humanos , Lactente , Bem-Estar do Lactente , Recém-Nascido , Bem-Estar Materno , Pobreza , Gravidez , Estados Unidos
Acta Paul. Enferm. (Online) ; 34: eAPE02843, 2021. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1278057


Resumo Objetivo: Descrever o processo de adaptação transcultural e as evidências de validade e confiabilidade da versão brasileira da Escala de Bienestar Materno en Situación de Parto . Métodos: Estudo do tipo metodológico realizado por meio das etapas de tradução, retrotradução, avaliação por comitê de juízes, pré-teste e validação. O processo de validação incluiu a participação de 500 puérperas que realizaram parto vaginal. Foram realizadas análises fatoriais exploratórias e confirmatórias. Resultados: Após a análise dos juízes, foram aplicadas as alterações sugeridas e todos os itens apresentaram concordância entre os avaliadores acima de 80%. A análise fatorial exploratória e confirmatória indicaram um ajuste satisfatório do modelo com três dimensões e bons índices de confiabilidade (alpha = 0,95 e ômega = 0,94). Conclusão: A versão brasileira abreviada da Escala de Bienestar Materno en Situación de Parto é uma escala de 16 itens que apresenta boas evidências de validade e confiabilidade.

Resumen Objetivo: Describir el proceso de adaptación transcultural y las evidencias de validez y fiabilidad de la versión brasileña de la Escala de Bienestar Materno en Situación de Parto. Métodos: Estudio metodológico realizado mediante las etapas de traducción, retrotraducción, evaluación por comité de jueces, prueba piloto y validación. El proceso de validación incluyó la participación de 500 puérperas que tuvieron parto vaginal. Se realizaron análisis factoriales exploratorios y confirmatorios. Resultados: Después del análisis de los jueces, se aplicaron las modificaciones sugeridas y todos los ítems presentaron concordancia entre los evaluadores superior al 80 %. Los análisis factoriales exploratorios y confirmatorios indicaron un ajuste satisfactorio del modelo con tres dimensiones y buenos índices de fiabilidad (alfa = 0,95 y omega = 0,94). Conclusión: La versión brasileña abreviada de la Escala de Bienestar Materno en Situación de Parto es una escala que presenta buenas evidencias de validez y fiabilidad.

Abstract Objective: To describe the process of cross-cultural adaptation and validity and reliability evidence of the Brazilian version of the Bienestar Materno en Situación de Parto scale (Maternal Well-being in Childbirth Scale). Methods: This is a methodological study carried out through translation, back-translation, assessment by a committee of judges, pre-test, and validation. Validation included participation of 500 mothers who underwent vaginal childbirth. Exploratory and confirmatory factor analyzes were performed. Results: After analysis by judges, the suggested changes were applied, and all items showed agreement among evaluators above 80%. Exploratory and confirmatory factor analysis indicated a satisfactory fit of the model with three dimensions and good reliability indexes (alpha = 0.95 and omega = 0.94). Conclusion: The short Brazilian version of the Bienestar Materno en Situación de Parto scale is a 16-item scale that presents good validity and reliability evidence.

Humanos , Feminino , Gravidez , Adolescente , Trabalho de Parto , Gravidez , Parto , Saúde Materna , Bem-Estar Materno , Tradução , Satisfação do Paciente , Estudo de Validação , Promoção da Saúde
Interface (Botucatu, Online) ; 25(supl.1): e200589, 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1279270


El artículo tiene como objetivo analizar los indicadores asociados al bienestar materno-infantil en los protocolos cubanos de actuación para la Covid-19. Con este fin, se realizó un análisis cualitativo de contenido que combinó una lógica deductiva derivada de la revisión bibliográfica de la literatura sobre bienestar materno-infantil y experiencia positiva del parto, y otra inductiva, con base en el procesamiento de la información empírica de los protocolos cubanos, según las recomendaciones de la OMS y la OPS. El análisis reveló que las guías enfatizan en la vida de la madre y el niño y priorizan la atención de las embarazadas como parte del acceso universal y gratuito a la salud; pero descuidan aspectos cualitativos del bienestar y la calidad del servicio, y con ello, los derechos de las gestantes y madres, y sus necesidades físicas, emocionales, psicológicas, sociales y espirituales. (AU)

O artigo tem como objetivo analisar os indicadores associados ao bem-estar materno-infantil nos protocolos de ação cubanos para o Covid-19. Por tanto, foi realizada uma análise de conteúdo qualitativa que combinou uma lógica dedutiva derivada da revisão bibliográfica da literatura sobre bem-estar materno-infantil e uma experiência positiva de parto, e uma indutiva, baseada no processamento de informações empíricas de protocolos cubanos, a luz das recomendações da OMS e da OPAS. A análise revelou que as orientações enfatizam a vida da mãe e do filho e priorizam o cuidado à gestante como parte do acesso universal e gratuito à saúde. Porém, negligenciam os aspectos qualitativos do bem-estar e da qualidade do serviço e, com isso, os direitos da gestante e da mãe, suas necessidades físicas, emocionais, psicológicas, sociais e espirituais. (AU)

The article aims to analyze indicators associated with maternal and child wellbeing in the Cuban Covid-19 action protocols. We carried out a qualitative content analysis that combined a deductive logic derived from a bibliographic review of the literature on maternal and child wellbeing and positive childbirth experiences, and an inductive logic based on the processing of empirical information from Cuban protocols, in light of the recommendations issued by WHO and PAHO. The analysis revealed that the instructions emphasize the mother's and child's life and prioritize care provided for pregnant women as part of free and universal access to health. However, they neglect the qualitative aspects of wellbeing and service quality and, with this, they also neglect the pregnant woman's and mother's rights, as well as their physical, emotional, psychological, social and spiritual needs. (AU)

Humanos , Feminino , Gravidez , Parto/psicologia , COVID-19 , Bem-Estar Materno , Planejamento de Assistência ao Paciente , Cuba
Rev. gaúch. enferm ; 42(spe): e20200165, 2021.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1280424


ABSTRACT Aim To reflect on the lonely experience of women during the pregnancy-puerperal cycle in times of pandemic by the SARS-CoV-2 virus. Method Theoretical-reflective study on the new Brazilian guidelines for care for women during pregnancy, childbirth and postpartum in times of Covid-19 and its influence on the exacerbation of maternal loneliness. The discussion about the transformations of women in this period refers to Maldonado's studies. Results Motherhood is a lonely process for women. The new technical norms that are in force bring important changes in the assistance to this cycle, mainly with regard to the importance of social distance, which intensifies the feeling of loneliness and helplessness. Final considerations This reflection can guide health professionals, especially the work of nurses in the scope of obstetrics, so that during the assistance to women in the pregnancy-puerperal cycle, they pay attention to the subtlety of feelings of loneliness that can interfere with maternal well-being fetal.

RESUMEN Objetivo Reflexionar sobre la experiencia solitaria de las mujeres durante el ciclo embarazo-puerperal en tiempos de pandemia por el virus SARS-CoV-2. Método Estudio teórico-reflexivo sobre las nuevas pautas brasileñas para el cuidado de las mujeres durante el embarazo, el parto y el posparto en tiempos de Covid-19 y su influencia en la exacerbación de la soledad materna. La discusión sobre las transformaciones de las mujeres en este período se refiere a los estudios de Maldonado. Resultados La maternidad es un proceso solitario para las mujeres. Las nuevas normas técnicas vigentes traen cambios importantes en la asistencia a este ciclo, principalmente con respecto a la importancia de la distancia social, que intensifica el sentimiento de soledad e impotencia. Consideraciones finales Esta reflexión puede orientar a los profesionales de la salud, especialmente la labor del enfermero en el ámbito de la obstetricia, para que durante la asistencia a la mujer en el ciclo embarazo-puerperal, preste atención a la sutileza de los sentimientos de soledad que pueden interferir con el bienestar materno fetal.

RESUMO Objetivo Refletir acerca da vivência solitária da mulher durante o ciclo gravídico-puerperal em tempos de pandemia pelo vírus SARS-CoV-2. Método Estudo teórico-reflexivo sobre as novas diretrizes brasileiras para atendimento às mulheres na gestação, parto e pós-parto em tempos de COVID-19 e sua influência na exacerbação da solidão materna. A discussão acerca das transformações da mulher nesse período remete aos estudos de Maldonado. Resultados A maternidade é um processo solitário para as mulheres. As novas normas técnicas que estão vigorando trazem importantes mudanças na assistência a esse ciclo, principalmente no que tange a importância do distanciamento social, que intensifica o sentimento de solidão e desamparo. Considerações finais Esta reflexão pode nortear os profissionais de saúde, sobretudo enfermeiras do âmbito da obstetrícia, para que durante a assistência à mulher no ciclo gravídico-puerperal atentem-se para as sutilezas de sentimentos de solidão que podem interferir no bem-estar materno-fetal.

Humanos , Feminino , Gravidez , Cuidado Pré-Natal , Período Periparto , Pandemias , COVID-19 , Bem-Estar Materno , Enfermeiras Obstétricas , Ansiedade , Pessoal de Saúde , Emoções , Distanciamento Físico
BMC Pregnancy Childbirth ; 20(1): 754, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33267785


BACKGROUND: The effect of SARS-CoV-2 infection in pregnant women and newborns is incompletely understood. Preliminary data shows a rather fluctuating course of the disease from asymptomatic or mild symptoms to maternal death. However, it is not clear whether the disease increases the risk of pregnancy-related complications. The aim of the study is to describe the maternal and neonatal clinical characteristics and outcome of pregnancies with SARS-CoV-2 infection. METHODS: In this retrospective national-based study, we analyzed the medical records of all pregnant women infected with SARS-CoV-2 and their neonates who were admitted to New-Jahra Hospital (NJH), Kuwait, between March 15th 2020 and May 31st 2020. During the study period and as part of the public health measures, a total of 185 pregnant women infected with SARS-CoV-2, regardless of symptoms, were hospitalized at NJH, and were included. Maternal and neonatal clinical manifestations, laboratory tests and treatments were collected. The outcomes of pregnancies included miscarriage, intrauterine fetal death (IUFD), preterm birth and live birth were assessed until the end date of the outcomes follow-up (November 10th 2020). RESULTS: A total of 185 pregnant women infected with SARS-CoV-2 were enrolled with a median age of 31 years (interquartile range, IQR: 27.5-34), and median gestational age at diagnosis of SARS-CoV2 infection was 29 weeks (IQR: 18-34). The majority (88%) of these women had mild symptoms, with fever (58%) being the most common presenting symptom followed by cough (50.6%). At the time of the analysis, out of the 185, 3 (1.6%) of the pregnant women had a miscarriage, 1 (0.54%) had IUFD which was not related to COVID-19, 16 (8.6%) had ongoing pregnancies and 165 (89%) had a live birth. Only 2 (1.1%) of these women developed severe pneumonia and required intensive care. A total of 167 neonates with two sets of twins were born with median gestational age at birth was 38 (IQR: 36-39) weeks. Most of the neonates were asymptomatic, and only 2 of them tested positive on day 5 by nasopharyngeal swab testing. CONCLUSIONS: In this national-based study, most of the pregnant women infected with SARS-CoV-2 showed mild symptoms. Although mother-to-child vertical transmission of SARS-CoV-2 is possible, COVID-19 infection during pregnancy may not lead to unfavorable maternal and neonatal outcomes.

COVID-19/epidemiologia , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Diagnóstico Pré-Natal/estatística & dados numéricos , Adulto , COVID-19/diagnóstico , Feminino , Humanos , Recém-Nascido , Kuweit , Bem-Estar Materno/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem
Przegl Epidemiol ; 74(2): 276-289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33112124


Around the end of December 2019, a new beta-coronavirus from Wuhan City, Hubei Province, China began to spread rapidly. The new virus, called SARS-CoV-2, which could be transmitted through respiratory droplets, had a range of mild to severe symptoms, from simple cold in some cases to death in others. The disease caused by SARS-CoV-2 was named COVID-19 by WHO and has so far killed more people than SARS and MERS. Following the widespread global outbreak of COVID-19, with more than 132758 confirmed cases and 4955 deaths worldwide, the World Health Organization declared COVID-19 a pandemic disease in January 2020. Earlier studies on viral pneumonia epidemics has shown that pregnant women are at greater risk than others. During pregnancy, the pregnant woman is more prone to infectious diseases. Research on both SARS-CoV and MERS-CoV, which are pathologically similar to SARS-CoV-2, has shown that being infected with these viruses during pregnancy increases the risk of maternal death, stillbirth, intrauterine growth retardation and, preterm delivery. With the exponential increase in cases of COVID-19 throughout the world, there is a need to understand the effects of SARS-CoV-2 on the health of pregnant women, through extrapolation of earlier studies that have been conducted on pregnant women infected with SARS-CoV, and MERS-CoV. There is an urgent need to understand the chance of vertical transmission of SARS-CoV-2 from mother to fetus and the possibility of the virus crossing the placental barrier. Additionally, since some viral diseases and antiviral drugs may have a negative impact on the mother and fetus, in which case, pregnant women need special attention for the prevention, diagnosis, and treatment of COVID-19.

Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Coronavírus da Síndrome Respiratória do Oriente Médio , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , COVID-19 , Feminino , Humanos , Bem-Estar Materno/estatística & dados numéricos , Pandemias , Gravidez , SARS-CoV-2
Enferm. glob ; 19(60): 64-74, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-200733


INTRODUCCIÓN: La atención humanizada del parto se centra en el buen trato a la gestante, sin embargo, algunas maternas experimentan violencia obstétrica, lo cual afecta a su bienestar. Se hace necesario contar con herramientas validadas que permitan informar, comunicar y educar sobre prácticas que contribuyen a hacer del parto una experiencia humanizada. MATERIAL Y MÉTODO: Estudio de validación con el objetivo de desarrollar una cartilla educomunicativa sobre parto humanizado, a partir de la revisión bibliográfica, la posterior validación por parte de 16 especialistas y 100 participantes del público objetivo, en 2019. RESULTADOS: Los especialistas calificaron la cartilla con una media del índice de Validez de Contenido (IVC) de 0,94 y una confiabilidad, Alfa de Cronbach de 0,81. En población objetivo, el nivel de respuesta positiva osciló entre el 87 y el 100 %, con una media de 97,9%. DISCUSIÓN: Haciendo revisión de literatura y cuidando los detalles de escritura, forma y fondo, se logró elaborar una cartilla que mostró alto IVC para brindar educación sobre parto humanizado a gestantes y familiares. Algunas fortalezas fueron: la rigurosidad del proceso, la idoneidad de las encuestadoras y el tamaño de muestra. La principal debilidad es que la recolección de la información se llevó a cabo en instituciones de Salud. CONCLUSIONES: La cartilla elaborada es válida para garantizar el entendimiento, por parte de maternas y familiares, del parto humanizado. Se considera material relevante e innovador para educar en este tema, como un evento de impacto en la vida del binomio madre-hijo y su familia

INTRODUCTION: Humanized childbirth care focuses on the good treatment of pregnant women; however, some mothers experience obstetric violence, which affects their wellbeing. It is necessary to have validated tools that permit informing, communicating, and educating on practices that contribute to making the delivery process a humanized experience. METHODS: This was a validation study consisting on the development of an educational-communicative booklet on humanized childbirth, from a bibliography review, along with subsequent validation by 16 specialists and 100 participants from the target population, in 2020. RESULTS: The specialists scored the booklet with a content validity index (CVI) median of 0.94 and Cronbach's alpha reliability of 0.81. In the target population, the level of positive response ranged between 87% and 100%, with a median of 97.9%. DISCUSSION: Through a literature review and by heeding to writing details, form, and depth, the study managed to elaborate a booklet that showed high CVI to provide education on humanized childbirth to pregnant women and relatives. Study strengths included process rigor, pollster suitability, and simple size. The principal weakness is that information collection was carried out in health institutions. CONCLUSIONS: The booklet elaborated is valid to guarantee understanding, by mothers and their relatives, of humanized childbirth. It is considered relevant and innovative material to educate on this theme, as an impacting event in the lives of the mother-child binomial and their family

Humanos , Feminino , Gravidez , Parto Humanizado , Cuidados de Enfermagem/métodos , Registros de Enfermagem/normas , Educação em Saúde/organização & administração , Enfermagem Obstétrica/métodos , Salas de Parto/organização & administração , Saúde Materna , Bem-Estar Materno/tendências
Rev Esc Enferm USP ; 54: e03606, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32935753


OBJECTIVE: To analyze the association of care practices performed by obstetric professionals with maternal welfare/malaise levels. METHOD: A quantitative study conducted in a Prepartum/Childbirth/Postpartum Unit of a Teaching Hospital with puerperal women who underwent vaginal births. An association was performed between obstetric practices and maternal welfare/malaise levels. RESULTS: There were 104 puerperal women who participated. Obstetric practices which caused mothers to feel unwell and which obtained statistical significance were: amniotomy (p = 0.018), episiotomy (p = 0.05), adoption of horizontal positions in the expulsive period (p = 0.04), the non-use of non-invasive care technologies (p = 0.029), and non-skin-to-skin contact between mother and child (p = 0.002). For most women, the presence of a companion favored welfare, even though it did not have a statistically significant association. After performing logistic regression, non-performance of amniotomy was the only variable which showed significance in maternal welfare. CONCLUSION: Humanized obstetric practices have greater potential to promote maternal welfare. The importance of obstetric nurses conducting practices which provide greater welfare to mothers is emphasized.

Parto Obstétrico , Hospitais de Ensino , Bem-Estar Materno , Amniotomia/estatística & dados numéricos , Criança , Episiotomia/estatística & dados numéricos , Feminino , Humanos , Mães , Parto , Posicionamento do Paciente , Gravidez
Int J Gynaecol Obstet ; 151(1): 17-22, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32698245


OBJECTIVE: To review what is known about COVID-19 and highlight gaps in the context of Nigerian obstetric practice. Research data on COVID-19 are understandably sparse in Africa. Nigeria, like most African countries, is battling a disease she is poorly equipped to fight. METHODS: The current available literature on COVID-19 was reviewed in relation to obstetric practice in the Nigerian context, gaps were identified, and recommendations were made to improve the handling of the COVID-19 pandemic in Nigerian obstetric practice. RESULTS: In and out of hospital, both the obstetrician and the obstetric patient are constantly being put at risk of exposure to the coronavirus because testing and preventive measures are either ineffective or non-existent. CONCLUSION: The pandemic has exposed the gross inadequacies in Nigeria's healthcare system and is therefore a wake-up call to the need for a complete overhaul of infrastructure and services. The government will do well to increase the budget allocation for health from the current paltry 4.14% to the recommended 15% of the total budget. The Nigerian obstetrician stands a high risk of exposure due to inadequate preventive measures, and testing and diagnostic challenges.

COVID-19/prevenção & controle , COVID-19/terapia , Controle de Infecções/organização & administração , Serviços de Saúde Materna/organização & administração , Complicações Infecciosas na Gravidez/prevenção & controle , Prevenção Primária/organização & administração , COVID-19/epidemiologia , Atenção à Saúde , Feminino , Humanos , Bem-Estar Materno/estatística & dados numéricos , Nigéria , Gravidez , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2
BMC Public Health ; 20(1): 1001, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32586374


BACKGROUND: This study aimed to establish whether changes in the socioeconomic context were associated with changes in population-level antenatal mental health indicators in Vietnam. METHODS: Social, economic and public policies introduced in Vietnam (1986-2010) were mapped. Secondary analyses of data from two cross-sectional community-based studies conducted in 2006 (n = 134) and 2010 (n = 419), involving women who were ≥ 28 weeks pregnant were completed. Data for these two studies had been collected in structured individual face-to-face interviews, and included indicators of antenatal mental health (mean Edinburgh Postnatal Depression Scale Vietnam-validation (EPDS-V) score), intimate partner relationships (Intimate Bonds Measure Vietnam-validation) and sociodemographic characteristics. Socioeconomic characteristics and mean EPDS-V scores in the two study years were compared and mediation analyses were used to establish whether indicators of social and economic development mediated differences in EPDS-V scores. RESULTS: Major policy initiatives for poverty reduction, hunger eradication and making domestic violence a crime were implemented between 2006 and 2010. Characteristics and circumstances of pregnant women in Ha Nam improved significantly. Mean EPDS-V score was lower in 2010, indicating better population-level antenatal mental health. Household wealth and intimate partner controlling behaviours mediated the difference in EPDS-V scores between 2006 and 2010. CONCLUSIONS: Changes in the socioeconomic and political context, particularly through policies to improve household wealth and reduce domestic violence, appear to influence women's lives and population-level antenatal mental health. Cross-sectoral policies that reduce social risk factors may be a powerful mechanism to improve antenatal mental health at a population level.

Bem-Estar Materno/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Complicações na Gravidez/prevenção & controle , Adulto , Estudos Transversais , Violência Doméstica/prevenção & controle , Desenvolvimento Econômico , Feminino , Humanos , Bem-Estar Materno/psicologia , Pobreza/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/psicologia , Escalas de Graduação Psiquiátrica , População Rural/estatística & dados numéricos , Vietnã/epidemiologia
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(2): 599-602, Apr.-June 2020.
Artigo em Inglês | Sec. Est. Saúde SP, LILACS, Sec. Est. Saúde SP | ID: biblio-1136436


Abstract This research aims to reflect upon the inherent impacts of social isolation caused by the new coronavirus (COVID-19) pandemic on the health of pregnant women. It brings up a survey on both physical and psychological aspects of this period on a woman's life, such as physiological and emotional changes. It also raises questions about how these aspects can be directly or indirectly affected by periods of isolation, considering recent research and guidance from health reference organizations.

Resumo Esse texto tem como objetivo refletir sobre os impactos inerentes do isolamento social proveniente da pandemia do novo corona vírus (COVID-19) na saúde das gestantes. Traz um levantamento tanto sobre os aspectos físicos como psíquicos específicos desse período da vida da mulher, como as alterações fisiológicas e emocionais. Bem como, levanta questões de como esses aspectos podem ser afetados direto ou indiretamente em um momento de isolamento, apresentando reflexões sobre pesquisas atuais e orientações de órgãos de referência na saúde.

Humanos , Feminino , Gravidez , Isolamento Social/psicologia , Quarentena/psicologia , Gestantes/psicologia , COVID-19 , Bem-Estar Materno