Publications by authors named "Jose Guilherme Cecatti"

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines.

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Article Synopsis
  • The study investigates the prevalence, complications, and management of ectopic pregnancy (EP) and molar pregnancy (MP) in selected healthcare facilities across 17 countries in Africa and Latin America and the Caribbean (LAC).
  • Data were collected from 280 healthcare facilities, revealing that 9.9% of women had EP or MP, with EP having more severe complications compared to MP.
  • Findings suggest a need for improving quality care for EP and MP, emphasizing the importance of evidence-based management practices to reduce maternal morbidity and mortality in these regions.
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  • The goal of the study was to find out what people think are the important traits for research groups and how they can work well, especially in countries that don't have a lot of money.
  • They talked to eleven people involved in these groups to see what everyone thought about the necessary qualities, like being committed and responsible.
  • The study concluded that having dedicated leaders and members is more important for a network's success than having a lot of money, and support from institutions helps keep the network running.
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Background: Fetal growth restriction is associated with perinatal morbidity and mortality. Early identification of women having at-risk fetuses can reduce perinatal adverse outcomes.

Objectives: To assess the predictive performance of existing models predicting fetal growth restriction and birthweight, and if needed, to develop and validate new multivariable models using individual participant data.

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Objective: To predict birth weight at various potential gestational ages of delivery based on data routinely available at the first antenatal visit.

Design: Individual participant data meta-analysis.

Data Sources: Individual participant data of four cohorts (237 228 pregnancies) from the International Prediction of Pregnancy Complications (IPPIC) network dataset.

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Introduction: To develop and validate a support tool for healthcare providers, enabling them to make precise and critical decisions regarding intensive care unit (ICU) admissions for high-risk pregnant women, thus enhancing maternal outcomes.

Methods: This retrospective study involves secondary data analysis of information gathered from 9550 pregnant women, who had severe maternal morbidity (any unexpected complication during labor and delivery that leads to substantial short-term or long-term health issues for the mother), collected between 2009 and 2010 from the Brazilian Network for Surveillance of Severe Maternal Morbidity, encompassing 27 obstetric reference centers in Brazil. Machine-learning models, including decision trees, Random Forest, Gradient Boosting Machine (GBM), and Extreme Gradient Boosting (XGBoost), were employed to create a risk prediction tool for ICU admission.

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Objective: This study aimed to evaluate the prevalence of hypertensive disorders during pregnancy among Brazilian women with preterm births and to compare the epidemiological characteristics and perinatal outcomes among preterm births of women with and without hypertension.

Methods: This was a secondary cross-sectional analysis of the Brazilian Multicenter Study on Preterm Birth. During the study period, all women with preterm births were included and further split into two groups according to the occurrence of any hypertensive disorder during pregnancy.

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Objective: The objective was to compare the maternal and perinatal characteristics and outcomes between women with and without diabetes in a Brazilian cohort of women with preterm births.

Methods: This was an ancillary analysis of the Brazilian Multicenter Study on Preterm Birth, which included 4,150 preterm births. This analysis divided preterm births into two groups according to the presence of diabetes; pregestational and gestational diabetes were clustered in the same Diabetes Group.

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Adequately reporting of preeclampsia is a challenge. The aim of this study was to compare the diagnosis of preeclampsia based on clinical and laboratory findings and ICD-10 codes (International Classification of Diseases) at admission and discharge in a referral center, over a one-year period. Among 2,839 women admitted for childbirth, 208 presented confirmed preeclampsia, based on chart audits.

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Conditions such as violence, drug abuse, sexual satisfaction, anxiety, depression, and disability interfere with a healthy pregnancy and can also account for maternal morbidity. The instrument WOICE was built by WHO to measure it. We applied WOICE in a prospective cohort of 125 pregnant women, using a before-after approach, during the third trimester of pregnancy, and after 42 until 90 days of childbirth.

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The SARS-CoV-2 (COVID-19) pandemic impacted the health systems between and within countries, and in the course of the pandemic sexual and reproductive health services were the most disrupted. Findings from high-income settings have reported significant changes in preterm birth prevalence during the pandemic period. To understand the possible effects of the COVID-19 pandemic on preterm birth numbers at the Brazilian national level.

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Objective:  To evaluate the impact of the race (Black versus non-Black) on maternal and perinatal outcomes of pregnant women with COVID-19 in Brazil.

Methods:  This is a subanalysis of REBRACO, a Brazilian multicenter cohort study designed to evaluate the impact of COVID-19 on pregnant women. From February 2020 until February 2021, 15 maternity hospitals in Brazil collected data on women with respiratory symptoms.

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Background: Short cervical length measured during the second trimester of pregnancy is an important risk factor for spontaneous preterm birth (sPTB). The aim of this study is to identify the association between mid-pregnancy cervical length (CL) and gestational age at birth in asymptomatic singleton pregnant women.

Methods: This is a prospective cohort study involving singleton pregnant women who participated in the screening phase of a Brazilian multicenter randomized controlled trial (P5 trial) between July 2015 and March 2019.

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Article Synopsis
  • * Results show a high maternal near miss rate (112.9 per 1,000 live births), with a significant number of cases linked to preterm deliveries and greater risks for extended hospital stays and complications such as low birthweight.
  • * The conclusion highlights that SLE significantly raises the chances of severe maternal health issues, longer medical care, and adverse results for both mothers and their newborns.
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Background: Induction of labour is one of the most common obstetric interventions globally. Balloon catheters and vaginal prostaglandins are widely used to ripen the cervix in labour induction. We aimed to compare the effectiveness and safety profiles of these two induction methods.

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Near miss morbidity and maternal death (defined as severe maternal outcomes - SMO) are the most important adverse outcomes in obstetric settings to assess delays and characteristics of health care management. Intensive care units (ICUs) represent an opportunity of adequate care for women who, in several cases, experienced earlier clinical delays in their maternal health care management. Some prognostic scores widely used in ICU have been useful in characterizing patients in terms of severity of illness in clinical studies, for evaluation of ICU performance, in quality improvement initiatives and for benchmark purposes.

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Objective: Since there are populational differences and risk factors that influence the cervical length, the aim of the study was to construct a populational curve with measurements of the uterine cervix of pregnant women in the second trimester of pregnancy and to evaluate which variables were related to cervical length (CL) ≤25 mm.

Materials And Methods: This was a multicenter cross-sectional study performed at 17 hospitals in several regions of Brazil. From 2015 to 2019, transvaginal ultrasound scan was performed in women with singleton pregnancies at 18 0/7 to 22 6/7 weeks of gestation to measure the CL.

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Introduction: WHO has generated standardised clinical and epidemiological research protocols to address key public health questions for SARS-CoV-2 (COVID-19) pandemic. We present a standardised protocol with the aim to fill a gap in understanding the needs, attitudes and practices related to sexual and reproductive health in the context of COVID-19 pandemic, focusing on pregnancy, pregnancy prevention and abortion.

Methods And Analysis Plan: This protocol is a prospective qualitative research, using semi-structured interviews with at least 15 pregnant women at different gestational ages and after delivery, 6 months apart from the first interview.

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Introduction: COVID-19 has led to an unprecedented increase in demand on health systems to care for people infected, necessitating the allocation of significant resources, especially medical resources, towards the response. This, compounded by the restrictions on movement instituted may have led to disruptions in the provision of essential services, including sexual and reproductive health (SRH) services. This study aims to assess the availability of contraception, comprehensive abortion care, sexually transmitted infection prevention and treatment and sexual and gender-based violence care and support services in local health facilities during COVID-19 pandemic.

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Objective: To determine the accuracy of metabolomics in predicting hypertensive disorders in pregnancy.

Design: Systematic review of observational studies.

Data Sources And Study Eligibility Criteria: An electronic literature search was performed in June 2019 and February 2022.

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Article Synopsis
  • The study evaluates the clinical, epidemiological, and laboratory aspects of SARS-CoV-2 infection in pregnant and postpartum women across 16 maternity hospitals through a multicentre approach.
  • It includes a cross-sectional analysis of infection prevalence, a cohort study on maternal and perinatal outcomes, and biological sampling for various analyses, including the relationship between vitamin D levels and infection severity.
  • Ethical approval has been secured, and informed consent will be obtained from participants, with plans to share findings widely through publications and presentations.
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Objective:  To investigate the characteristics of women who had preterm birth (PTB) and related outcomes according to ethnicity.

Methods:  A secondary analysis of a multicenter cross-sectional study conducted in Brazil. Women who had PTB were classified by self-report as white and non-white.

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