Resumo em Português:

Resumo Objetivos: avaliar a prevalência de cegueira noturna entre gestantes adolescentes atendidas em uma maternidade pública do Nordeste brasileiro e verificar sua associação com as variáveis socioeconômicas, nutricionais e obstétricas. Métodos: estudo prospectivo e descritivo, com 126 gestantes adolescentes, acompanhadas do início ao final da gestação. Utilizaram-se informações sobre cegueira noturna no tempo inicial e final da pesquisa, estado nutricional pré-gestacional e no final da gestação, ganho de peso, anemia, consumo de vitamina A, além de alguns dados socioeconômicos e obstétricos. Para análise estatística, foram utilizados o Teste Exato de Fisher (p<0,05) e software Nutwin. Resultados: a prevalência de cegueira noturna foi de 20,6%. Embora não tenha havido diferenças estatísticas significativas, observou-se que o agravo foi mais frequente entre as adolescentes menores de 16 anos, que viviam em condições de saneamento inadequada, sem companheiro, com menor escolaridade e renda per capta, idade ginecológica menor que dois anos, primíparas, que tiveram anemia, parto cesáreo e prematuro, com excesso de peso e ganho ponderal acima do recomendado. Conclusão: a prevalência encontrada indica elevada vulnerabilidade nutricional e social desse grupo. Investigar a cegueira noturna durante o pré-natal contempla uma importante estratégia para prevenção e controle da deficiência de vitamina A e reduzir suas complicações durante a gestação e perinatais.

Resumo em Inglês:

Abstract Objectives: to assess the prevalence of night blindness among pregnant adolescents assisted at a public maternity hospital in Northeast Brazil and to examine its association with socioeconomic, nutritional, and obstetric variables. Methods: prospective descriptive study including 126 pregnant adolescents, followed from the beginning to the end of pregnancy. Information was collected on the presence of night blindness, pre-pregnancy and late-pregnancy nutritional status, weight gain, anemia, vitamin A intake, and socioeconomic and obstetric conditions. Fisher’s Exact Test was used for statistical analysis (p<0.05) and software Nutwin. Results: the prevalence of night blindness was 20.6%. Although no statistically significant associations were found, the condition was more frequent among younger adolescents, those without a partner, with lower education and income, inadequate sanitation, primiparity, gynecological age under two years, anemia, preterm or cesarean delivery, overweight, and excessive gestational weight gain. Conclusion: the prevalence observed reflects the high nutritional and social vulnerability of this population. Systematic investigation of night blindness during prenatal care may represent an important strategy for preventing and controlling vitamin A deficiency and reducing maternal and perinatal complications.

Resumo em Inglês:

Abstract Objectives: to develop and validate an educational booklet for pregnant women experiencing pelvic girdle pain. Methods: this was a methodological development study conducted at the Federal University of São Carlos, Brazil. The educational booklet was developed following a comprehensive literature review and subsequently validated by healthcare professionals and pregnant women. Content and appearance were assessed using the Content Validity Index (threshold: 0.8 or higher) and the percentage of absolute agreement among participants (threshold: 75% or higher). Results: in the first stage, healthcare professionals rated the material with a mean global content validity of 0.93. In the second stage, pregnant women indicated an 89.2% agreement regarding its clarity, relevance, and usability. The final version, titled “What You Need to Know About Gestational Pelvic Pain”, includes an introduction, the definition and location of pain, its relationship with pregnancy, and practical guidance for prevention and self-management. Conclusion: the educational booklet met the acceptability standards established for validation and may contribute to improving prenatal care and self-management of pelvic girdle pain.

Resumo em Inglês:

Abstract Objectives: to assess the COVID-19 pandemic impact on breastfeeding rates during birth hospitalization in a Baby-Friendly certified perinatal hospital in Portugal. Methods: observational retrospective study comparing pre-pandemic (2019) and pandemic (April-December 2020) periods. A total of 900 healthy term mother-newborn dyads in rooming-in were included. Maternal and neonatal variables associated with breastfeeding at discharge were analyzed using chi-square, Student’s t-test, and multivariable logistic regression (p<0.05). Results: breastfeeding rates were higher in the pandemic period (99.3%) than in the pre-pandemic period (97.6%; p=0.031). Exclusive breastfeeding (80.2% vs. 81.6%; p=0.611) and skin-to-skin contact (56.2% vs. 58.0%; p=0.590) did not differ significantly. Exclusive breastfeeding was associated with vaginal delivery (pre-pandemic OR=3.07; 95%CI=1.83-5.13; p<0.001; pandemic OR=2.29; 95%CI=1.39-3.77; p=0.001), weight loss <10% (p<0.001), and absence of phototherapy in the pre-pandemic period (OR=3.38; 95%CI=1.96-7.12; p<0.001). No associations were found with maternal age, parity, sex, or gestational age. Conclusions: exclusive breastfeeding rates were not negatively affected by pandemic restrictions. Maintaining Baby-Friendly practices preserved essential breastfeeding support.

Resumo em Inglês:

Abstract Objectives: to develop an instrument designed to assess pregnant women’s expectations regarding labor and birth. Methods: a cross-sectional study was conducted, utilizing two focus groups for the questionnaire’s construction: one comprising eight obstetrics professionals and another with six pregnant women. Results: based on the focus group discussions, a preliminary 22-item questionnaire was developed. Its psychometric properties were tested in a pilot sample of 67 pregnant women. The results were descriptively analyzed and submitted to the validation process, where reliability measures and the validity of content, criterion and construction values were evaluated. The final instrument was composed of 10 items. Factorial analysis indicated three dimensions of the instrument: safety (four questions), feelings (four questions) and concerns (three questions). Its reliability was assessed using Cronbach’s Alpha and Spearman Brown statistical tests, yielding values of 0.6727 and 0.7658, respectively. Conclusions: the Questionnaire (QEDB) demonstrated adequate psychometric properties to measure pregnant women’s expectations, particularly when examining the responses of women in the third trimester. Due to its ease of administration, the instrument can serve as a valuable tool in clinical obstetrics practice and for future research.

Resumo em Inglês:

Abstract Objectives: to analyze responsiveness, establish the Minimal Important Difference (MID), and conduct factor analysis of the State Anxiety (S-anxiety) subscale of the State-Trait Anxiety Inventory (STAI) adapted for women in labor. Methods: this measurement property study involved 100 women and two assessments of anxiety during labor using the adapted STAI. Responsiveness was evaluated through Effect Size (ES) and Standardized Response Mean (SRM). The MID was calculated based on the standard error of measurement (SEM). Factor analysis was conducted using Bartlett’s test of sphericity and the Kaiser-Meyer-Olkin (KMO) measure (KMO = 0.767; Bartlett’s χ2 = 664.6; p < 0.001). Results: the MID was 11.2 points, indicating low responsiveness (ES = 0.21; SRM = 0.29). The subscale showed good internal consistency, with Cronbach’s alpha of 0.71 (presence of anxiety) and 0.84 (absence of anxiety). After removing item 5, the total score ranged from 18 to 72. Conclusion: the adapted STAI subscale demonstrated good internal consistency and a MID of 11.2 points, representing a distribution-based threshold for interpreting changes in anxiety scores during labor. However, its responsiveness should be further evaluated after interventions or at different stages of labor to better detect variations in anxiety levels.

Resumo em Português:

Resumo Objetivos: avaliar os desfechos maternos em gestantes não-COVID-19 internadas em unidade de alto risco e identificar fatores associados ao desfecho materno adverso (DMA). Métodos: estudo de coorte prospectivo e observacional realizado entre dezembro de 2019 e dezembro de 2020, incluindo todas as gestantes internadas na unidade de alto risco do Instituto de Saúde Elpídio de Almeida, Campina Grande (PB). Foram analisadas variáveis biológicas, sociodemográficas, obstétricas, clínicas e diagnósticas. O desfecho materno adverso (near miss e morte materna) foi a variável dependente. As associações foram avaliadas por regressão logística, adotando-se p<0,05. Resultados: entre 494 gestantes incluídas, 6,1% apresentaram DMA (23 casos de near miss e sete óbitos). Houve associação significativa entre DMA e síndrome HELLP (OR=11,09; IC95%=3,63-33,89), sangramento na segunda metade da gestação (OR=5,18; IC95%=1,50-17,82) e condições médicas preexistentes (OR=3,11; IC95%=1,20-8,05). Conclusões: o DMA foi fortemente associado à síndrome HELLP, ao sangramento na segunda metade da gravidez e às comorbidades maternas prévias. Estratégias preventivas devem priorizar o rastreamento de risco, a profilaxia com aspirina e cálcio em gestantes suscetíveis e o manejo oportuno das complicações hipertensivas e hemorrágicas, incluindo a redução de cesarianas desnecessárias.

Resumo em Inglês:

Abstract Objectives: to evaluate maternal outcomes among pregnant women without COVID-19 hospitalized in a high risk obstetric unit and to identify associated factors with adverse maternal outcomes (AMO). Methods: this prospective observational cohort study was conducted from December 2019 to December 2020 and included all pregnant women hospitalized in the high risk unit of the Instituto de Saúde Elpídio de Almeida, in Campina Grande, Brazil. Biological, sociodemographic, obstetric, clinical, and diagnostic variables were analyzed. The dependent variable was adverse maternal outcome (near miss and maternal death). Logistic regression was used to assess associations, adopting a significance level of p<0.05. Results: among 494 pregnant women included, 6.1% experienced AMO (23 near miss cases and 7 maternal deaths). Significant associations were found between AMO and HELLP syndrome (OR=11.09; 95%CI=3.63-33.89), second half of pregnancy bleeding (OR=5.18; 95%CI=1.50-17.82), and pre existing maternal medical conditions (OR=3.11; 95%CI=1.20-8.05). Conclusions: adverse maternal outcomes were strongly associated with HELLP syndrome, bleeding in the second half of pregnancy, and pre existing maternal comorbidities. Preventive strategies should prioritize risk stratification, prophylaxis with aspirin and calcium for susceptible pregnant women, and timely management of hypertensive and hemorrhagic complications, including the reduction of unnecessary cesarean sections.

Resumo em Português:

Resumo Objetivos: o estudo teve como objetivo refletir a relação entre médicos e enfermeiras obstétricas no cenário de parto a partir do processo de formação de residentes em obstetrícia de ambas as categorias. Métodos: estudo exploratório de abordagem qualitativa, baseado em consultas a especialistas através de grupos focais. Participaram 11 profissionais das categorias médica e de enfermagem. A interpretação dos dados ocorreu por meio da análise temática reflexiva. Resultados: o conteúdo produzido foi categorizado em cinco temáticas emergentes: De quem é o parto? Amulher no centro do cuidado; Os escopos de prática e a continuidade do cuidado; Conhecimento em favor da comunicação e da confiança: o lugar das evidências científicas; Comunicação e aspectos da formação; Relações iguais entre atores desiguais: autonomia, liderança e tomada de decisão. Conclusão: as reflexões suscitadas por esta pesquisa reforçam a educação interprofissional como estratégia para promover o modelo colaborativo de assistência obstétrica, ao mesmo tempo em que revelam a prática colaborativa no cenário brasileiro como um processo complexo, que se delineia ao longo do tempo e é atravessado por aspectos culturais, sociais, políticos e econômicos, demandando intervenções em âmbitos diversos.

Resumo em Inglês:

Abstract Objectives: this study aimed to reflect on the relation between physicians and obstetric nurses in the childbirth setting based on the training process of obstetrics residents from both categories. Methods: an exploratory qualitative approach study, based on consultations with specialists through focus groups. Eleven professionals from the medical and nursing categories participated. Data interpretation was conducted through reflective thematic analysis. Results: the content produced was categorized into five emerging themes: Whose childbirth is it? The woman at the care center; Practice scopes and care continuity; Knowledge in favor of communication and trust: the role on scientific evidence; Communication and training aspects; Equal footing on unequal parties: autonomy, leadership, and decision-making. Conclusion: the reflections prompted by this research reinforce interprofessional education as a strategy to promote a collaborative obstetric care model, while also revealing that collaborative practice in the Brazilian context is a complex process that unfolds over time and is influenced by cultural, social, political, and economical aspects, requiring interventions in various levels.

Resumo em Inglês:

Abstract Objectives: to investigate barriers to mental health care and associated psychosocial factors among perinatal women with psychiatric disorders. Methods: a cross-sectional analytical study was conducted with perinatal women receiving care at a public maternal and mental health hospital in Southern Brazil. Psychiatric diagnoses were established using the Structured Clinical Interview for DSM-5 Disorders (SCID-5). Barriers to care were assessed with the Barriers to Access to Care Evaluation (BACE) scale, and childhood trauma was evaluated using validated instruments. Descriptive and nonparametric analyses were performed (p≤0.05). Results: the mean BACE score was 20.7 ± 19.9, with stigma-related and attitudinal barriers predominating. The most frequently reported obstacles (reported to any degree) were reluctance to discuss emotions (57.1%), wanting to handle problems alone (54.5%), fear of involuntary hospitalization (51.9%), fear of being perceived as weak (44.4%), and concerns about losing child custody (41.8%). Women with a current major depressive episode had higher barrier scores than those without depression (median 24.0 vs. 6.0; p=0.003). Higher scores were also associated with emotional (median 25.0 vs 3.5, p<0.001) and physical childhood abuse (median 33.0 vs 9.5, p=0.002). Conclusions: barriers to perinatal mental health care were mainly related to stigma, attitudinal resistance, and early traumatic experiences.

Resumo em Português:

Resumo Entre 2015 e 2025, consolidou-se uma inflexão profunda na forma como revistas médicas avaliam a qualidade metodológica e o rigor estatístico dos manuscritos submetidos. Esse movimento, impulsionado pela crise de reprodutibilidade, pela crítica ao uso ritualístico do valor de p e pela expansão das diretrizes da Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, levou à emergência de uma “nova bioestatística”, que desloca o foco da mera execução de testes para a integração da estatística em todo o ciclo da pesquisa. Elementos antes periféricos como a definição rigorosa de desfechos, tamanho amostral justificado, manejo transparente de dados ausentes, controle de multiplicidade, planos de análise estatística pré-especificados e avaliação de risco de viés tornaram-se critérios centrais de editoração. Políticas editoriais de ciência aberta, registro de estudos e compartilhamento de dados ampliaram ainda mais as expectativas em relação à transparência e reprodutibilidade. No contexto latino-americano, essas exigências encontram desafios estruturais importantes, mas também oportunidades para fortalecer a integridade científica. Este artigo descreve os pilares conceituais e normativos que moldam a “nova bioestatística”, analisa seus impactos concretos sobre desenho, análise e publicação de estudos e discute implicações para pesquisadores, estatísticos, editores e programas de pós-graduação.

Resumo em Inglês:

Abstract From 2015 to 2025, a profound shift has consolidated in how medical journals progressively adopted stricter methodological and statistical standards, redefining expectations about study design, transparency and reporting. Driven by the reproducibility crisis, the critique of the ritualistic use of p-values and the expansion of Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network guidelines, the emergence of a “new biostatistics” – one that integrates statistical reasoning throughout the research cycle rather than restricting it to data analysis. Formerly peripheral elements, such as precise outcome definitions, justified sample size calculations, transparent handling of missing data, multiplicity control, pre-specified statistical analysis plans and structured risk-of-bias assessments, have become central editorial requirements. Open-science policies, study registration and data-sharing statements further amplify expectations regarding transparency and reproducibility. In Latin America, such demands encounter structural challenges but also create opportunities to strengthen scientific integrity. This article outlines the conceptual and normative pillars shaping this “new biostatistics”, examines its practical consequences for study design, analysis and publication, and discusses implications for researchers, statisticians, editors and graduate programs.

Resumo em Português:

Resumo Os distúrbios hipertensivos da gestação permanecem entre as principais causas de morbidade e mortalidade materna no mundo, com impacto desproporcional em países de baixa e média renda. Nas últimas décadas, a suplementação de cálcio foi amplamente promovida como intervenção simples e potencialmente eficaz para prevenir a pré-eclâmpsia, sustentada por ensaios clínicos pequenos, revisões sistemáticas da Cochrane e recomendações da Organização Mundial da Saúde, o que favoreceu sua incorporação em diretrizes clínicas e políticas públicas. Entretanto, a atualização da revisão Cochrane publicada em 2025 redefiniu esse entendimento. Ao restringir a análise a ensaios considerados confiáveis, exigir registro prospectivo e explorar o impacto de estudos pequenos, a nova revisão conclui que, na análise global, a suplementação de cálcio pode resultar em pouca ou nenhuma diferença na incidência de pré-eclâmpsia (certeza baixa), e que, quando a análise é restrita a ensaios de grande porte e maior robustez metodológica, há evidência de alta certeza de pouca ou nenhuma diferença na incidência de pré-eclâmpsia e de parto pré-termo. Também não se demonstraram reduções consistentes na mortalidade materna, na morbidade materna grave ou nos principais desfechos perinatais adversos. Este artigo revisa criticamente a trajetória do cálcio como estratégia preventiva, discute as implicações da revisão Cochrane de 2025 para diretrizes e práticas clínicas e contrasta seu papel com o da aspirina em baixa dose, sustentada por evidência mais robusta.

Resumo em Inglês:

Abstract Hypertensive disorders of pregnancy remain among the leading causes of morbidity and mortality worldwide, with a disproportionate impact on low- and middle-income countries. In recent decades, calcium supplementation has been widely promoted as a simple and potentially effective intervention to prevent preeclampsia, supported by small clinical trials, Cochrane systematic reviews, and World Health Organization recommendations, which facilitated its incorporation into clinical guidelines and public policies. However, the 2025 update of the Cochrane review published in 2025 redefined this understanding. By restricting the analysis to trustworthy trials, requiring prospective registration, and exploring the impact of small-study effects, the novel review concludes that, in the global analysis, calcium supplementation may result in little or no difference in preeclampsia incidence (low certainty). Furthermore, when the analysis is restricted to large-scale trials with greater methodological robustness, there is high-certainty evidence of little or no difference in the incidence of preeclampsia or preterm birth. Consistent reductions were also not demonstrated in maternal mortality, severe maternal morbidity, or major adverse perinatal outcomes. This article critically reviews the trajectory of calcium as a preventive strategy, discusses the implications of the 2025 Cochrane review guidelines and clinical practice, and contrasts its role with low-dose aspirin, which is supported by more robust evidence.