Maternal mortality: protocol of a study integrated to the Birth in Brazil II survey.

The Maternal Mortality Study conducts a hospital investigation of maternal deaths that occurred in 2020/2021 in the maternity hospitals sampled by the Birth in Brazil II survey, with the following objectives: estimate the maternal mortality underreporting; calculate a correction factor and the corrected (MMR); validate the causes of maternal mortality reported in the death certificate (DC); and analyze the factors associated with maternal mortality. The Birth in Brazil II includes approximately 24,250 puerperal women distributed in 465 public, private, and mixed hospitals with ≥ 100 live births/year in the five macroregions of Brazil. The Maternal Mortality Study data will be completed using the same Birth in Brazil II questionnaire, from the consultation of hospital records.

Protocol of Birth in Brazil II: National Research on Abortion, Labor and Childbirth.

Brazil has made advances in obstetric care in public and private hospitals; however, weaknesses in this system still require attention. The Brazilian Ministry of Health, aware of this need, funded the second version of the Birth in Brazil survey. This study aimed to evaluate: prenatal, labor and birth, postpartum, and abortion care, comparing the results with those of Birth in Brazil I; and analyze the main determinants of perinatal morbidity and mortality; evaluate the care structure and processes of obstetrics and neonatology services in maternity hospitals; analyze the knowledge, practices, and attitudes of health professionals who provide birth and abortion care; and identify the main barriers and facilitators related to care of this nature in Brazil.

Agreement between maternal self-report of birth-related information and medical records in Brazil: A comparison study between public, mixed, and private hospitals.

Background: The study aims to assess agreement between data obtained from interviews with postpartum women and their health records about labor and birth characteristics, newborn care, and reasons for cesarean birth.

Methods: The present study analyzes the Birth in Brazil study dataset, a nationwide hospital-based survey that included 23,894 postpartum women. Reliability was assessed using kappa coefficients and 95% confidence intervals.

Impact of an intrapartum care quality improvement intervention in Brazilian private hospitals on care safety measures and adverse outcomes.

Background: In 2015, a quality improvement (QI) intervention to reduce cesarean sections (CS)-the Adequate Childbirth Project (PPA)-was implemented in the private sector in Brazil. This analysis aims to compare safety care measures and adverse outcomes between women exposed to the PPA intervention to those receiving standard care.

Methods: The analysis included a convenience sample of 12 private hospitals that participated in the PPA (2017-2018).

Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study.

Collaborative models (CM) focused on intrapartum care shared between both midwives and obstetricians have been proposed as a strategy to reduce these rates. Our aim was to compare use of evidence-based practices, obstetric interventions and c-section rates in two settings: a maternity hospital that applies a CM of care (MRJ) and data from a pool of maternity hospitals included in the Birth in Brazil Survey (NB) that do not adopt a CM. Data was abstracted from medical and administrative records in MRJ and from medical records and face-to-face interviews in NB.

[Prenatal care for normal-risk pregnant women by obstetric nurses and midwives: cost-effectiveness from the perspective of the Supplementary Health System in Brazil].

In several countries, primary care for pregnant women is performed by obstetric nurses and/or midwives. In Brazil's Supplementary Health System (private health insurance and out-of-pocket care), coverage of prenatal care is mandatory and is performed by medical obstetricians. The objective of this study is to conduct a cost-effectiveness analysis, comparing clinical outcomes and costs associated with the incorporation of prenatal care by obstetric nurses and midwives in the Supplementary Health System, from the perspective of the operator of health plans as the payment source.

COVID-19-related deaths among women of reproductive age in Brazil: The burden of postpartum.

Objective: To compare risk of death due to COVID-19 among pregnant, postpartum, and non-pregnant women of reproductive age in Brazil, using the severe acute respiratory syndrome surveillance system (SARS-SS).

Methods: A secondary analysis was performed of the Brazilian official SARS-SS, with data retrieved up to August 17, 2020. Cases were stratified by pregnancy status, risk factors or co-morbidities, and outcome (death or recovery).

How can countries create outbreak response policies that are sensitive to maternal health?

Ensuring women’s need for sexual and reproductive healthcare are met should be a priority during disease outbreaks, say

The impact of the COVID-19 pandemic on maternal mortality in Brazil: 523 maternal deaths by acute respiratory distress syndrome potentially associated with SARS-CoV-2.

During the study period, 523 pregnant or postpartum women died in Brazil due to confirmed COVID‐19 or undetermined etiology. This results in a projected COVID‐19 MMR of 17.5/100 000 or potentially even higher.

Systematic review with meta-analysis: lubiprostone efficacy on the treatment of patients with constipation.

Background: Lubiprostone is a type 2 chloride channel activator that has been shown to be efficacious and safe in the treatment for chronic constipation.

Objective: To systematically review randomized clinical trials (RCTs) assessing efficacy of lubiprostone for patients with chronic idiopathic constipation (CIC), irritable bowel syndrome with predominant constipation (IBS-C) and opioid-induced constipation (OIC).

Methods: Searches were conducted in PubMed, LILACS, Cochrane Collaboration Database, and Centre for Reviews and Dissemination.

Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil.

Objective: To evaluate whether clinical and social risk factors are associated with negative outcomes for COVID-19 disease among Brazilian pregnant and postpartum women.

Methods: A secondary analysis was conducted of the official Acute Respiratory Syndrome Surveillance System database. Pregnant and postpartum women diagnosed with COVID-19 ARDS until July 14, 2020, were included.

Worldwide maternal deaths due to COVID-19: A brief review.

160 maternal deaths due to COVID‐19 have been reported worldwide, most of them in middle‐income countries, representing a barrier to reducing maternal mortality.

Maternal mortality and COVID-19.

Objective: The aim of this study was to collect and analyze data from different sources to have a general overview of COVID-19-related maternal deaths in Brazil, as well as to compare data with worldwide reports.

Study Design: We systematically searched data about COVID-19 maternal deaths from the Brazilian Ministry of Health surveillance system, State Departments of Health epidemiological reports, and media coverage. Data about timing of symptom onset and death (pregnancy or postpartum), gestational age, mode of birth, maternal age, comorbidities and/or risk factors, date of death, and place of death were retrieved when available.

The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting.

At the time of writing 124 pregnant or postpartum women in Brazil have died due to COVID‐19 (representing a mortality rate of 12.7%), a figure that currently surpasses the total number of COVID‐19‐related maternal deaths reported throughout the rest of the world.

Planning, construction and use of handmade simulators to enhance the teaching and learning in Obstetrics.

Method: to describe the development process and present the results of a pilot study on the use of low-cost handmade simulators for teaching and learning Obstetrics.presentation of 3 low-cost simulators designing, based on educational needs identified in real-world training contexts. The developing process is presented in detail and each simulator was tested and re-tested, being submitted to improvements until their final version.

PATTERNS OF FIBER INTAKE AMONG BRAZILIAN ADULTS: PERCEPTIONS FROM AN ONLINE NATIONWIDE SURVEY.

Background: Adequate fiber intake is associated with digestive health and reduced risk of several noncommunicable diseases and is recognized as essential for human health (World Health Organization, 2003). The World Health Organization (WHO) recommends a daily fiber consumption of ≥25 g, but previous studies observed a fiber intake in Brazil lower than recommended.

Objective: We aimed to describe fiber intake among adults in Brazil and also respondents' knowledge and perceptions about their fiber intake.

Cesarean-section Rates in Brazil from 2014 to 2016: Cross-sectional Analysis Using the Robson Classification.

Objective:  To obtain cesarean-section (CS) rates according to the Robson Group Classification in five different regions of Brazil.

Methods:  A descriptive epidemiological study using data from secondary birth records from the Computer Science Department of the Brazilian Unified Health System (Datasus, in Portuguese) between January 1st, 2014, and December 31st, 2016, including all live births in Brazil.

Results:  The overall rate of CS was of 56%.

Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care.

Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI).

Factors Associated with Preference for Vaginal Birth among Undergraduate Students from Southern Brazil.

Backround: Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been studied aiming to explain these rates. Mode of delivery preferences among university students may provide insights into strategies to reduce those numbers.