Doutorado em Saúde Coletiva

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http://repositorio.ufes.br/handle/10/17585

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Navegando Doutorado em Saúde Coletiva por Autor "Almeida, Marcia Valeria de Souza"

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    Agregação de fatores de risco para diabetes mellitus gestacional e a macrossomia fetal em participantes do Projeto Viver
    (Universidade Federal do Espírito Santo, 2023-07-27) Oliveira, Gabriela; Oliveira, Elizabete Regina Araujo de; http://lattes.cnpq.br/4671078095444887; https://orcid.org/0000-0002-2403-5094; http://lattes.cnpq.br/5786768878261180; Calmon, Marcela Vieira; Almeida, Marcia Valeria de Souza; http://lattes.cnpq.br/9372951429429767; Miotto, Maria Helena Monteiro de Barros; http://lattes.cnpq.br/4289442514763843; Pereira, Taisa Sabrina Silva
    The existence of risk factors, modifiable or not, in the lives of pregnant women favors the development of diseases and the presence of more than one risk factor tends to potentiate its effects. This study aimed to analyze the aggregation of risk factors for the development of gestational diabetes mellitus and fetal macrosomia in the participants of Projeto Viver. This is an observational, cross-sectional study, conducted from data collected by Projeto Viver, which was a multicenter, longitudinal and state study with puerperal women and their newborns selected from three maternity hospitals located in the Metropolitan region and North of Espírito Santo. Data collection was carried out between August 2019 and March 2020. First, the need to carry out a systematic review was identified to understand more about the population of interest. The sample for article 2 consisted of 2,488 women who had filled in information about the variables of interest for each study and aimed to analyze the aggregation of risk factors (advanced maternal age, family history of diabetes mellitus, overweight and multiparity). for gestational diabetes mellitus. The prevalence of risk factors, their confidence intervals and distributions according to sociodemographic aspects were calculated, such as: race (white or non-white), years of education (≤8 years or >8 years), currently working (Yes or No) , hospital assistance (Philanthropic ME, Philanthropic NO and Private) and index of goods according to the classification of the Brazilian Association of Population Studies (ABEP) (A and B; C; D and E). Aggregation was evaluated based on the ratio of the prevalence of observed factors to the expected prevalence. The aggregation of the four analyzed factors was verified (O/E=2). In the aggregation of the three risk factors, the most frequent was a family history of diabetes, advanced maternal age and multiparity (O/E=2.8). In the third article, in addition to the aggregation analysis, the Odds Ratio of prevalence was also calculated (ORP) to identify the aggregation of two factors, regardless of the exposure of the other two factors, and aimed to analyze the aggregation of risk factors (gestational diabetes, advanced maternal age, overweight and multiparity) for fetal macrosomia. The sample consisted of 2,488 women and the aggregation of the four risk factors (O/E=3.9) was identified. As for the Odds Ratio of prevalence, there was a greater association between gestational diabetes and advanced maternal age (ORP = 2.76), especially in those who do not work. Although the synergistic effect of risk factors is already known, few studies have explored these relationships, especially in this population. Strategies focused on the health and lifestyle pattern of the female population can contribute to controlling the incidence of gestational diabetes and fetal macrosomia. Understanding the real situation of puerperal women regarding the aggregation of risk factors is an important step to encourage prevention actions and strategies.
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    Estudo sobre: fatores sociodemográficos maternos e obstétricos associados à via de parto em participantes do projeto viver
    (Universidade Federal do Espírito Santo, 2023-10-24) Gabira, Fernanda Garcia; Oliveira, Elizabete Regina Araujo de; https://orcid.org/0000-0002-6616-4273; http://lattes.cnpq.br/4671078095444887; https://orcid.org/0000-0001-7603-3325; http://lattes.cnpq.br/0885248898815204; Leite, Franciele Marabotti Costa; https://orcid.org/0000000261716972; http://lattes.cnpq.br/7170760158919766; Mascarello, Keila Cristina; https://orcid.org/0000-0003-4567-487X; http://lattes.cnpq.br/8417184843741770; Almeida, Marcia Valeria de Souza; https://orcid.org/0000-0002-1318-7084; http://lattes.cnpq.br/9372951429429767; Santos, Dherik Fraga; Pedroso, Marcia Regina de Oliveira
    In recent years, Brazil has had one of the highest cesarean section rates in the world and is always remembered as an example of the excessive use of the procedure. Compared to the rest of the country, cesarean section rates are equally high in the state of Espírito Santo. Therefore, the objective of this study is to evaluate sociodemographic and obstetric factors about the mode of delivery among participants of the Projeto Viver in maternity hospitals in the state of Espírito Santo. The Projeto Viver is a multicenter cohort study whose main objective was to investigate the influence of early determinants of morbidity in the perinatal and neonatal periods of children born in Espírito Santo - Brazil. The Projeto Viver was carried out from August 2019 to March 2020 in three maternity hospitals located in the metropolitan region and north of the state. 3,438 postpartum women and their newborns participated in the research, which consisted of three monitoring stages. The results of this thesis were described in three articles. The first manuscript aimed to identify sociodemographic factors associated with the mode of delivery through a systematic review. The results show that in the last six years, sociodemographic factors continue to influence the type of birth performed, women with a higher socioeconomic level, higher level of education, aged over 35 years, and giving birth in private institutions have a greater chance of having a cesarean section compared to childbirth vaginal. The second article used data from Projeto Viver and aimed to evaluate the sociodemographic, maternal, and gestational factors associated with cesarean sections in Projeto Viver participants. A prevalence of cesarean section was found to be 57.4% of all births, with a higher incidence of cesarean section in women aged ≥35 years (74.5%), in those with an education level of ≥12 years (64.1%), in those belonging to the highest socioeconomic quintile (72.2%) and who gave birth in private hospitals (73.7%). There was a higher prevalence of cesarean section births among women aged 25 or over, with a higher educational level, with obesity and chronic non-communicable diseases, and a lower frequency among those who gave birth in philanthropic hospitals. Finally, a third article evaluated obstetric complications and their association with the mode of delivery among women from Projeto Viver. The results demonstrate that there is a higher proportion of complications in women aged 35 years or over, who belong to the last wealth quintile, with a higher level of education and in private maternity hospitals, as well as in those with obesity and with a gestational age <37 weeks. Regarding the association between obstetric complications due to the route of delivery, we found that women who had fetal distress, amniotic fluid disorders, diabetes mellitus pregnancy, and hypertensive syndrome had a higher prevalence of cesarean sections compared to those without the complications mentioned above. It is concluded throughout this thesis that factors recognized in the literature are present in the studied population. The results presented here are relevant as they have the potential to contribute to the scientific literature and the evaluation of implementations and policies that are in force in the state's maternity hospitals so that strategies can be improved in search of reducing cesarean sections.