Abstract Introduction: Seat belt aorta is a rare but often severe complication arising from blunt trauma with compression of the abdominal aorta against vertebrae. Seat belt sign is often present as an ecchymosis across the abdomen. The association with abdominal wall disruption and hollow viscus injury has been named seat belt triad; the presence of Chance fracture is sometimes considered a fourth component. Methods: Using Pubmed and Embase databases we reviewed all articles regarding abdominal seat belt aortic injuries and analysed presentation at admission, concomitant lesions, including presence of seat belt triad, treatment and outcomes. Results: Fifty-two cases were reported, from 1968 to 2019. Twenty-nine males (56%), mean age 43 ± 19 years. Most patients were stable at admission, with 29 (55.8%) presenting acute abdomen, 26 (50%) limb ischemia, 9 (17.3%) hypovolemic shock and 2 (3.8%) late-onset claudication. Seat belt sign was identified in 40 patients (76.9%), seat belt triad in 38 (73.1%) and 22 (42.3%) had Chance fractures, of which only 2 were not associated with seat belt triad. Most patients presented with aortic dissection (90.4%), complicated with pseudoaneurysm (11.5%), contained rupture (7.7%) or uncontained rupture (3.8%); 2 patients presented isolated iliac thrombosis and 3 limb ischemia. All patients required immediate surgical intervention, of which 40 (76.9%) required urgent vascular surgery. Forty-eight patients (92.3%) underwent vascular surgery: 39 open revascularizations and 9 endovascular procedures; three were managed conservatively. Ten patients (19.2%) passed away or died, of which 7 had seat belt triad. No patients needed reinterventions for vascular lesions except one, yet 3 required limb amputation. Most patients with seat belt triad required further visceral and abdominal wall repair. Conclusions: Seat belt aorta and especially seat belt triad are severe complications associated with high morbimortality often requiring surgery and multiple interventions. As patients are usually conscious and stable upon admission, this condition should not be disregarded.

Abstract Introduction: The use of statins in hemodialysis patients is a topic of ongoing research and debate. Patients with chronic kidney disease on hemodialysis constitute a large proportion of patients treated in the vascular surgery field. Clinical data of the protective statin effect on this group is scarce and conflicting results exist regarding cardiovascular, cerebrovascular and limb outcomes. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases to understand the relationship between statin effect and cardiovascular, limb outcomes and cerebrovascular outcomes. A narrative review was constructed, based on the obtained literature. Results: Although the use of statins in hemodialysis patients may provide cardiovascular benefits, the optimal dosage and safety profile of these medications in this population remain uncertain. A carefully evaluation of the risks and benefits of statins should be made based on each patient's specific requirements and circumstances. Conclusion: The role of statins for patients with peripheral arterial disease who are on hemodialysis remains unclear. Further analyses should focus on this subgroup of dialysis patients, who are becoming more prevalent on the vascular surgery departments, allowing for an optimized treatment with better patient outcomes.

Abstract Introduction: Blunt thoracic aortic injuries (BTAI) are defined as a tear in the thoracic aorta caused by a high energy blunt trauma. The most common reported mechanism of injury is motor vehicle accidents, and it can be potentially lethal. The Society for Vascular Surgery (SVS) and the European Society for Vascular Surgery (ESVS) guidelines recommend thoracic endovascular aortic repair (TEVAR) as the first line treatment for BTAI. Other controversies regarding BTAI management were reported in the literature, such as the best treatment for minimal aortic injuries with intimal tear, ideal stent graft oversizing, best timing for treatment and necessity to cover the left subclavian artery (LSA). The purpose of this review is to identify and analyze appropriate studies published so far about the management of BTAI. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases. We used the following combination of key words in our search strategy ((aortic injury) AND (blunt thoracic trauma)) AND (vascular surgery* OR treatment* OR TEVAR*). Articles not in English were excluded. The primary subject was results of endovascular treatment. Secondary subjects were indications and results of OSR, best timing for intervention, ideal graft oversizing, need for left subclavian artery (LSA) coverage, and management of BTAI grade I (intimal tear). Results: Data related to our primary and secondary subjects were extracted from the selected articles. TEVAR is considered the primary treatment for BTAI, if the patient has suitable anatomy, with good short and mid-term outcomes, with lower mortality and paraplegia rates at short and mid-term follow-up, compared to OSR. Despite good term results at short-term follow-up after TEVAR, long-term outcomes are still a concern. OSR is still a valid option in selected cases, and it should be considered for patients whose injury location is unsuitable for the endovascular approach. In most patients with BTAI, it is recommended around 10% of graft oversizing. However, a more aggressive approach with oversizing between 10-20% should be considered for patients with considerable hypotension and even >20% for patients presenting with severe hypotensive hemorrhagic shock. A necessity of LSA coverage has been reported in 30% of TEVAR for urgent treatment of BTAI, and it seems to be well tolerated. We should considered expectant approach with serial follow-up CT scans in patients with BTAI grade I injuries with asymptomatic intimal aortic tear. Conclusions: This literature review reports and synthetizes published data about the management strategies for BTAI. TEVAR seems to be effective in the treatment of BTAI, with few complications and good outcomes at short and mid-term follow-up, and it should be the first-line treatment for these patients. OSR should be an option when a patient’s injury is not suitable for endovascular approach.

Abstract Introduction: Blunt thoracic aortic injuries (BTAI) are defined as a tear in the thoracic aorta caused by a high energy blunt trauma. The most common reported mechanism of injury is motor vehicle accidents, and it can be potentially lethal. The Society for Vascular Surgery (SVS) and the European Society for Vascular Surgery (ESVS) guidelines recommend thoracic endovascular aortic repair (TEVAR) as the first line treatment for BTAI. Other controversies regarding BTAI management were reported in the literature, such as the best treatment for minimal aortic injuries with intimal tear, ideal stent graft oversizing, best timing for treatment and necessity to cover the left subclavian artery (LSA). The purpose of this review is to identify and analyze appropriate studies published so far about the management of BTAI. Methods: We performed a thorough electronic search of the literature using PubMed and Embase databases. We used the following combination of key words in our search strategy ((aortic injury) AND (blunt thoracic trauma)) AND (vascular surgery* OR treatment* OR TEVAR*). Articles not in English were excluded. The primary subject was results of endovascular treatment. Secondary subjects were indications and results of OSR, best timing for intervention, ideal graft oversizing, need for left subclavian artery (LSA) coverage, and management of BTAI grade I (intimal tear). Results: Data related to our primary and secondary subjects were extracted from the selected articles. TEVAR is considered the primary treatment for BTAI, if the patient has suitable anatomy, with good short and mid-term outcomes, with lower mortality and paraplegia rates at short and mid-term follow-up, compared to OSR. Despite good term results at short-term follow-up after TEVAR, long-term outcomes are still a concern. OSR is still a valid option in selected cases, and it should be considered for patients whose injury location is unsuitable for the endovascular approach. In most patients with BTAI, it is recommended around 10% of graft oversizing. However, a more aggressive approach with oversizing between 10-20% should be considered for patients with considerable hypotension and even >20% for patients presenting with severe hypotensive hemorrhagic shock. A necessity of LSA coverage has been reported in 30% of TEVAR for urgent treatment of BTAI, and it seems to be well tolerated. We should considered expectant approach with serial follow-up CT scans in patients with BTAI grade I injuries with asymptomatic intimal aortic tear. Conclusions: This literature review reports and synthetizes published data about the management strategies for BTAI. TEVAR seems to be effective in the treatment of BTAI, with few complications and good outcomes at short and mid-term follow-up, and it should be the first-line treatment for these patients. OSR should be an option when a patient’s injury is not suitable for endovascular approach.

Abstract Introduction: Recently published studies on peripheral arterial occlusive disease (PAOD) have revealed marked sex disparities in patient selection and treatment outcomes. In a recent retrospective study with data from 11 different countries, Portugal was highlighted as one of the countries with greater sex discrepancies related to PAOD treatment. We aimed to analyze sex specific differences in the treatment of symptomatic PAOD, concerning different variables, in a single hospital center, in Portugal. Methods: Data on treatment of symptomatic PAOD patients from October 1st, 2020, to December 31st, 2021, were retrospectively collected from clinical registries from a single hospital center in Portugal. Different variables and post-operative outcomes were analyzed dichotomized by sex, with descriptive statistics. Statistical analyses were conducted using the IBM Statistical Package for Social Sciences (SPSS) software v28. Results: A total of 220 patients, 15,9% female and 84,1% male, were treated for PAOD, in the selected period, in a hospital center from Portugal. Female patients were older (mean age of 73.8 years versus 69.5 years in male); were less likely to be treated for intermittent claudication (3% versus 6% of men); more often treated at a more advanced stage of the disease with trophic lesions (91% versus 74% of men); more likely to be offered primary major amputation (14% versus 3% of male patients); less likely to be taking statins as part of PAOD medical management (65.7% versus 77.8% of male); and had a higher 90-day mortality rate (17.1% versus 6.5% in men). They were also more frequently treated with endovascular procedures (40%) than with OSR (26%). Conclusion: Remarkable sex discrepancies in the treatment of PAOD were found in our hospital center. This study brings awareness to the scientific medical community for sex disparities in the management of patients with PAOD.

ABSTRACT The insertion of the tree component in coffee production is a strategy from an economic and environmental perspective. Thus, the objective of this study was to evaluate the temporal influence on the agronomic and productive performance of the coffee crop under the interference of different tree species as a function of spacing. The experiment was set in the municipality of Santo Antônio de Amparo-MG, in 2012, and conducted in a randomized block design with four replications. The treatments were: cultivar ‘Catuai Vermelho IAC 99’ in monoculture (3.40 m x 0.65 m) and intercropped with African mahogany, teak and pink cedar, in two spacings (9 x 13.6 m and 18 x 13.6 m), in coffee rows. Three coffee rows were fixed between rows, totaling 13.6 m. The following variables were evaluated: height (m), stem diameter (cm), crown diameter (m), productivity (bags ha-1) and yield (l/sc) for coffee. From the evaluations, there is a significant effect of height, productivity and yield for the coffee crop. The system intercropped with tree species did not influence coffee productivity and yield until the 3rd harvest and, for the 5th harvest, intercropping with mahogany favored productivity, although the accumulated productivity did not show any treatment effect.

Resumo O Brasil tem avançado em ações de controle do tabaco, resultando em grande declínio da prevalência de tabagismo. Entretanto, é fundamental identificar populações mais vulneráveis, como as pessoas LGBT. Este estudo teve como objetivo analisar a produção discursiva que sustenta a busca de apoio e penetração da indústria tabageira junto à população LGBT, tomando o caso do patrocínio da Philip Morris Brasil à parada LGBT em São Paulo em 2019. A metodologia utilizada foi análise de discurso Crítica de notícia publicada em um blog. A análise da peça aponta para utilização de vocabulários como diversidade, inclusão, modernidade e inovação, que dizem respeito à causa LGBT e ao lançamento de novo produto. O texto traz alto grau de comprometimento e tom cortês, fazendo uso de recursos discursivos que associam a empresa às ideias de inovação técnica e comportamental. Comunica intertextualmente com órgãos regulatórios acerca da entrada no mercado brasileiro de seu novo produto (proibido no Brasil). Faz uso de diferentes operadores ideológicos, como o eufemismo do futuro sem fumaça ou futuro livre de fumaça. O trabalho apresenta uma estratégia da indústria do tabaco para promover seu produto de tabaco aquecido enquanto apoia a causa LGBT e promove imagem corporativa positiva.

Abstract Brazil has advanced in tobacco control actions, with a significant decline in the prevalence of tobacco use. However, it is essential to identify more vulnerable populations, such as LGBT persons. This study aimed to analyze the discursive production sustaining the search for support and penetration of the tobacco industry among the LGBT population, taking the sponsorship of Philip Morris Brasil to the LGBT parade in São Paulo in 2019. We employed the critical discourse analysis of a report published on a blog. The analysis of the piece points to the use of vocabularies such as diversity, inclusion, modernity, and innovation, which concern the LGBT cause and the launch of its new product. The text conveys a high commitment and a courteous tone, using discursive resources that associate the company with technical and behavioral innovation ideas. It communicates intertextually with regulatory bodies about introducing its new product in the Brazilian market (prohibited in Brazil). It uses different ideological operators, such as the euphemism of the smokeless or smoke-free future. The work shows a tobacco industry strategy to promote its heated product while supporting LGBT cause and promoting a positive corporate image.

ABSTRACT Background: Mansonia mosquitoes transmit arboviruses to humans. This study describes the karyotypes and C-banding of Mansonia humeralis, Mansonia titillans, Mansonia pseudotitillans, and Mansonia indubitans. Methods: From the 202 larvae, the brain ganglia were dissected (n=120) for the preparation of slides. Twenty slides with well-distended chromosomes for each species (10 for karyotyping and 10 for C-banding) were selected for further study. Results: The haploid genome and the average lengths of the chromosomal arms differed in relation to the centromere between species, and intraspecific differences also occurred in the distribution of the C-bands. Conclusions: These results are useful for better understanding of the chromosomal variability of Mansonia mosquitoes.

Abstract Brazil has advanced in tobacco control actions, with a significant decline in the prevalence of tobacco use. However, it is essential to identify more vulnerable populations, such as LGBT persons. This study aimed to analyze the discursive production sustaining the search for support and penetration of the tobacco industry among the LGBT population, taking the sponsorship of Philip Morris Brasil to the LGBT parade in São Paulo in 2019. We employed the critical discourse analysis of a report published on a blog. The analysis of the piece points to the use of vocabularies such as diversity, inclusion, modernity, and innovation, which concern the LGBT cause and the launch of its new product. The text conveys a high commitment and a courteous tone, using discursive resources that associate the company with technical and behavioral innovation ideas. It communicates intertextually with regulatory bodies about introducing its new product in the Brazilian market (prohibited in Brazil). It uses different ideological operators, such as the euphemism of the smokeless or smoke-free future. The work shows a tobacco industry strategy to promote its heated product while supporting LGBT cause and promoting a positive corporate image.

Resumo O Brasil tem avançado em ações de controle do tabaco, resultando em grande declínio da prevalência de tabagismo. Entretanto, é fundamental identificar populações mais vulneráveis, como as pessoas LGBT. Este estudo teve como objetivo analisar a produção discursiva que sustenta a busca de apoio e penetração da indústria tabageira junto à população LGBT, tomando o caso do patrocínio da Philip Morris Brasil à parada LGBT em São Paulo em 2019. A metodologia utilizada foi análise de discurso Crítica de notícia publicada em um blog. A análise da peça aponta para utilização de vocabulários como diversidade, inclusão, modernidade e inovação, que dizem respeito à causa LGBT e ao lançamento de novo produto. O texto traz alto grau de comprometimento e tom cortês, fazendo uso de recursos discursivos que associam a empresa às ideias de inovação técnica e comportamental. Comunica intertextualmente com órgãos regulatórios acerca da entrada no mercado brasileiro de seu novo produto (proibido no Brasil). Faz uso de diferentes operadores ideológicos, como o eufemismo do futuro sem fumaça ou futuro livre de fumaça. O trabalho apresenta uma estratégia da indústria do tabaco para promover seu produto de tabaco aquecido enquanto apoia a causa LGBT e promove imagem corporativa positiva.

BACKGROUND Leishmania RNA virus 1 (LRV1) is commonly found in South American Leishmania parasites belonging to the subgenus Viannia, whereas Leishmania RNA virus 2 (LRV2) was previously thought to be restricted to the Old-World pathogens of the subgenus Leishmania. OBJECTIVES In this study, we investigated the presence of LRV2 in strains of Leishmania (L.) infantum, the causative agent of visceral leishmaniasis (VL), originating from different hosts, clinical forms, and geographical regions. METHODS A total of seventy-one isolates were screened for LRV2 using semi-nested reverse transcription-polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. FINDINGS We detected LRV2 in two L. infantum isolates (CUR268 and HP-EMO) from canine and human cases, respectively. MAIN CONCLUSIONS To the best of our knowledge, this is the first detection of LRV2 in the New World.

Abstract Background: Individualized risk assessment using comorbidity adjustment is an important component in modern clinical practice and can be performed considering individual comorbidities or through the use of summary measures. The Charlson Comorbidity Index adjusted to age (CCIa) is the most widely validated and used comorbidity assessment tool. Studies have proved CCIa as a strong predictor of mortality for a variety of medical and surgical conditions; however, its utility in patients submitted to elective endovascular abdominal aortic aneurysm repair (EVAR) has not been studied. Methods: Patients submitted to EVAR between January 1, 2017 and December 31, 2021 in our tertiary, academic Vascular Surgery Department were retrospectively evaluated and 123 patients fulfilled the inclusion criteria. Patient characteristics and peri-operative variables were collected and CCIa was calculated. Surgical complications were classified according to Clavien-Dindo. The area under the curve of the receiver operating characteristic curves was calculated to validate and determine the discriminating ability of CCIa in predicting complications and mortality and the Youden index used to determine the critical value. Results: Mean age was 73.49±7.95 years and mean follow-up was 30.55±16.49 months. 30-day complication rate was 16%, 30-day mortality 1.63% and overall mortality 16%. Patients with higher CCIa had higher overall mortality (p=.002) but CCIa had no impact on 30-day complication rate and on 30-day mortality. Logistic regression showed that even after adjusting for patient´s comorbidities individually, CCIa was the only independent mortality predictor (p=.003). The optimal cutoff associated with higher overall mortality was found to be ≥6. Conclusion: CCIa does not seem to predict complications and early mortality after EVAR but it seems to be a useful predictor of mid-term survival after EVAR. These results show the limited role of this score in predicting outcomes after surgery but may help identify a sub-population whose shorter life-expectancy should be considered towards the benefits of EVAR.

Abstract Objective To analyze the factors associated with infant formula supplementation in newborns referred to rooming-in in Brazilian hospitals. Method Cross-sectional study with data from 14,531 postpartum women and newborns obtained from the "Birth in Brazil" survey, conducted in 2011-2012. The analysis used a logistic regression model with a hierarchical approach. Results In total, 21.2% newborns received infant formula during hospital stay. After adjustment, the following factors were associated with the use of infant formula: maternal age ≥ 35 years (OR = 1.51; IC95%:1.30-1.75), prenatal care in a private service (OR = 2,22; IC:1.72-2.85)/public and private service (OR = 1.67; IC:1.24-2.23), cesarean delivery (OR = 1.83; IC:1.41-2.38), multiple pregnancy (OR = 3.786; IC:2.02-7.06), non-breastfeeding in the delivery room (OR = 1.780; IC:1.43-2.21), birth in a private hospital (OR = 1.695; IC:1.02-2.79), prematurity (OR = 1.656; IC:1.32-2.06) and extremes of birth weight (< 2.500 g: OR = 2.084; IC: 1.585-2.741/ ≥4,000g: OR = 1.672; IC:1.31-2.11). Teenage age (OR = 0.651; IC:0.55-0.76), low maternal education (OR = 0.579; IC:0.43-0.77), multiparity (OR = 0.588; IC:0.510-0.678), and lower economic class (OR = 0.565; IC:0.41-0.76) significantly reduced the probability of using infant formula. Conclusions Of the associated factors, the authors highlight cesarean delivery and non-breastfeeding in the delivery room, showing that it is necessary to strengthen policies that encourage good practices during childbirth care in order to promote exclusive breastfeeding and protect mothers and newborns from all social classes against the misuse of infant formula.

Resumo Introdução: Apesar dos esforços das equipas de saúde, a taxa da amputação em doentes com Isquémia Crítica Ameaçadora de Membro (CLTI) é bastante elevada. Cada vez mais se torna relevante um tratamento individualizado do doente por forma a melhorar a sua qualidade de vida. Contudo, não existe uma escala de qualidade de vida validada para doentes amputados por isquémia crítica. Os autores propõem uma revisão sistemática da literatura com vista a sumarizar as escalas de avaliação de qualidade de vida após amputação. Métodos: Foi feita uma pesquisa por todos os estudos relacionados com avaliação funcional e da qualidade de vida após amputação na base de dados Pubmed. Resultados: Dos 245 artigos foram incluídos 29. Dos artigos analisados apenas 9 avaliaram exclusivamente doentes vasculares com CLTI. Foram identificados 27 testes/escalas diferentes: 14 escalas de avaliação de saúde ou função (física ou mental) e 13 escalas de qualidade de vida ou qualidade de saúde. Os testes de função mais utilizados na população de amputados foram os testes de marcha, validados em amputados, e escalas de atividades de vida diária, e os testes de avaliação de qualidade mais usados foram as escalas gerais World Health Organization Quality of Life Assessment Instrument-Bref (WHOQOL-BREF) e Short Form 36 - General Health Status Survey (SF-36) e a escala específica para amputados Trinity Amputation and Prosthesis Experiences Scales (TAPES). A escala específica para Doença Arterial Obstrutiva Periférica (DAOP) Vascular Quality of Life Questionnaire (VascuQoL) apenas foi utilizada uma vez. Conclusões: Na população de doentes amputados vasculares, escalas gerais podem não representar corretamente os domínios mais valorizados por esta população, geralmente mais idosos e com limitações prévias. Na ausência de uma escala específica para esta população, os índices de avaliação de atividades de vida diária ou os testes de marcha em doentes mais jovens ou protetizados juntamente com o questionário WHOQOL-BREF aparentam ser a melhor opção na avaliação da QoL. São essenciais novos estudos para validar uma escala específica para esta população.

Abstract Cheese ripeness is an important step of cheese manufacturing that provides a kind of food with complex sensory characteristics and nuanced differences. The importance of generating rapid/easy consumer perception of a new product is without question. The aim was to evaluate the Santo Giorno cheese sensory profile, at different ripening times and with different starter cultures, evaluated by trained assessors and consumers using CATA questions. The two methods generated similar results. However, the results from CATA revealed that consumers are able to discriminate between cheeses with different ripening times but not describe them in detail. The application of the technique also made it possible to perceive that the two starter cultures used did not reflect different sensory elements and that the spicy and salty attributes are more easily perceived by consumers when evaluating ripened cheeses.

Resumo O objetivo deste artigo é avaliar a adequação do ganho de peso gestacional total (GPT) segundo características maternas de adolescentes brasileiras. Estudo transversal e de base hospitalar. Foram incluídos 3.904 adolescentes com gestação de feto único e idade gestacional (IG) ao nascimento ≥ 37 semanas. Foi construído um modelo hierarquizado para analisar as variáveis dependentes e a adequação do GPT e das independentes: características sociodemográficas, assistenciais, obstétricas e comportamentais. As chances de GPT insuficiente foram maiores para as adolescentes do Norte (OR = 1,50; IC95%: 1,07-2,10) e Nordeste (OR = 1,68; IC95%: 1,27-2,21). O trabalho remunerado elevou as chances de GPT insuficiente (IC95%: 1,15-2,39) e excessivo (IC95%: 1,01-1,86). O índice de massa corporal pré-gestacional de sobrepeso ou obesidade associou-se ao GPT excessivo (OR = 1,86; IC95%: 1,19-2,92 e OR = 3,06; IC95%: 2,10-4,45, respectivamente), bem como a IG ≥ 42 semanas (OR = 2,23; IC95%: 1,03-4,81). Residir nas regiões Norte e Nordeste aumentou as chances de as adolescentes apresentarem GPT insuficiente. Exercer trabalho remunerado esteve associado a maior chance de GPT excessivo e insuficiente. Além disso, o sobrepeso ou obesidade pré-gestacional e IG ≥ 42 semanas ampliaram as chances de GPT excessivo.

Abstract The scope of this article is to evaluate the adequacy of total gestational weight gain (GWG) according to maternal characteristics of Brazilian adolescents. It involved a cross-sectional, hospital-based study. A total of 3,904 teenagers with a single fetus gestation and gestational age (GA) at birth ≥ 37 weeks were included. A hierarchical model was built to analyze the dependent and independent variables adequacy of GWG: sociodemographic, care, obstetric and behavioral characteristics. The chances of insufficient GWG were higher for adolescents from the North (OR = 1.50, 95%CI: 1.07-2.10) and Northeast (OR = 1.68, 95%CI: 1.27-2.21). Paid work increased the chances of insufficient (95%CI: 1.15-2.39) and excessive (95%CI: 1.01-1.86) GWG. The pre-pregnancy body mass index of overweight or obese adolescents was associated with excessive GWG (OR = 1.86, 95%CI: 1.19-2.92 and OR = 3.06, 95%CI: 2.10-4.45, respectively), as well as GA ≥ 42 weeks (OR = 2.23, 95%CI: 1.03-4.81). Living in the North and Northeast regions increases the chances of adolescents having insufficient GWG. Having paid work was associated with a greater chance of excessive and insufficient GWG. Furthermore, pre-pregnancy excess weight or obesity and GA ≥ 42 weeks increased the chances of excessive GWG.