Publications by authors named "Rodolfo C Pacagnella"

Background: Pregnant and postpartum women infected by COVID-19 are at increased risk of adverse outcomes, including negative effects on their mental health. Brazilian maternal mortality rate due to COVID-19 is 2.5 times higher than overall mortality rates.

View Article and Find Full Text PDF

Objective: The aim of this study was to assess the predictors of acceptance and hesitancy of additional doses of any SARS-CoV-2 (COVID-19) vaccine among pregnant or recently pregnant and non-pregnant people of reproductive age and partners in Brazil.

Methods: We conducted an online cross-sectional study from June 2022 to April 2023 and invited women and partners between 18 and 49 years old to participate. We employed a snowball strategy to reach all potential eligible participants.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to examine the characteristics of maternal sepsis in pregnant or recently pregnant women at a Brazilian hospital, focusing on clinical, laboratory, and treatment methods during a four-year period.
  • It included 365 women, categorizing them by the severity of sepsis, and identified that pregnancy-related and respiratory tract infections were the main causes, with E. coli being the most common pathogen found.
  • The results showed that resistant infections were rare, Access antibiotics were effectively employed, and there were no maternal fatalities, highlighting the importance of awareness and institutional protocols in managing maternal sepsis.
View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Objectives: To compare maternal and perinatal outcomes among women with obesity, overweight, and normal body mass index, associated with COVID-19 infection during pregnancy and postpartum.

Method: Prospective Cohort Study, within the REBRACO (Brazilian Network of COVID-19 in Pregnancy) multicenter initiative. Confirmed positive cases of SARS-CoV-2 were included, and women categorized into three groups according to their pre-pregnancy BMI: obesity (BMI ≥ 30), overweight (BMI <30 but >25), and normal BMI.

View Article and Find Full Text PDF

Objective: To perform an economic cost analysis of the implementation of a short cervix screening program to reduce preterm birth in singleton pregnancies in a short-term time horizon.

Methods: We performed a cost-benefit economic analysis using the P5 trial database, a randomized multicenter clinical trial for prevention of preterm birth. Data collection was conducted from July 2015 to March 2019 in 17 different Brazilian hospitals.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Objective: Preterm birth, defined as birth before 37 weeks of gestation, is a leading cause of perinatal and infant mortality throughout the world. Preterm birth is also associated with long-term neurological disabilities and other significant health issues in children. A short cervix in the second trimester has been noted to be one of the strongest predictors of subsequent spontaneous preterm birth in both singleton and multiple pregnancies.

View Article and Find Full Text PDF

This narrative review aims to describe the knowledge regarding nutritional evaluation and monitoring in pregnant women. We discuss care provided by non-specialists in nutrition, regarding dietary information and risks during pregnancy, from a theoretical or conceptual viewpoint. A narrative review was conducted following a literature search when scientific databases were investigated, including SciELO, LILACS, Medline, PubMed, theses, government reports, books, and chapters in books.

View Article and Find Full Text PDF

Objective:  To describe a reference curve for cervical length (CL) in mid-trimester twin gestations using transvaginal ultrasound (TVU) and to investigate whether short CL increases spontaneous preterm birth (sPTB) in asymptomatic twin pregnancies.

Methods:  This was a prospective cohort study performed at 17 outpatient antenatal facilities of Brazil with women at 18 0/7 to 22 6/7 weeks of gestation who participated in a randomized clinical trial screening phase (P5 trial) between July 2015 and March 2019. TVU was performed to provide CL measurement in all screened women.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

The present review comes from five previous studies of a multicenter cohort of nulliparous pregnant women from different regions of Brazil. The first study showed a wide difference in consumption of industrialized foods among women from the south and southeast regions compared with northeastern women who chose to eat a healthier diet with fresh natural food. The second investigation intended to understand maternal eating habits, where five dietary patterns were identified: two considered healthy and three with excess protein, ultra-processed foods, fats, and sweets.

View Article and Find Full Text PDF

Nutrition indicators for malnutrition can be screened by many signs such as stunting, underweight or obesity, muscle wasting, and low caloric and nutrients intake. Those deficiencies are also associated with low socioeconomic status. Anthropometry can assess nutritional status by maternal weight measurements during pregnancy.

View Article and Find Full Text PDF
Article Synopsis
  • Brazil faced high maternal deaths and delays in healthcare during the COVID-19 pandemic, prompting a study on how SARS-CoV-2 affects pregnant women.
  • This prospective cohort study included 729 symptomatic pregnant or postpartum women in 15 Brazilian centers from Feb 2020 to Feb 2021, with 51.3% confirmed cases of COVID-19.
  • Key risk factors for severe illness included non-white ethnicity, low education, obesity, public prenatal care, planned pregnancies, and pre-existing health conditions, with the worst outcomes occurring early in the pandemic.
View Article and Find Full Text PDF

Objective: To evaluate the prevalence of preeclampsia among cases of COVID-19 infection during pregnancy and the association between both conditions, in a multicenter cohort of Brazilian women with respiratory symptoms.

Study Design: Ancillary analysis of the Brazilian Network of COVID-19 in Obstetrics (REBRACO) study. We performed a nested case-control analysis selecting all women with COVID-19 and compared outcomes between women with and without PE.

View Article and Find Full Text PDF

Objective: The aim of the study was to assess the impact of the COVID-19 pandemic on sales of modern contraceptive methods in Brazil.

Methods: Monthly sales data were analysed of short-acting reversible contraceptive methods and long-acting reversible contraceptive (LARC) methods (implants and intrauterine contraception) and COVID-19 related deaths. Contraceptive methods were grouped as follows: emergency contraception (EC); oral contraception, vaginal rings and transdermal patches; injectable contraception; LARC methods including the copper intrauterine device (Cu-IUD); and LARC methods excluding the Cu-IUD.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Objective: To test the effectiveness of cervical pessary in addition to vaginal progesterone for the prevention of preterm birth in women with midpregnancy short cervixes.

Methods: We performed a multicenter, open-label, randomized controlled trial in 17 perinatal centers. Asymptomatic women with singleton or twin pregnancies and cervical lengths of 30 mm or less, measured at 18 0/7-22 6/7 weeks of gestation, were randomized to cervical pessary plus vaginal progesterone (pessary plus progesterone group) or vaginal progesterone only (progesterone-only group) (200 mg/day).

View Article and Find Full Text PDF

Objective:  To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it.

Methods:  An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing technicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women's health care in the State of São Paulo, Brazil, participated in the study through an invitation.

View Article and Find Full Text PDF

Background: Risk perception is based on collective indicators, but it is influenced by the individual's self-perception of his health-disease process. This study aims to investigate the risk perception of pregnant women who were identified as high-risk for premature birth and to seek strategies for better management of such cases.

Methods: This is a cross-sectional study where women who had completed their participation in P5 trial were contacted and invited to answer a structured questionnaire with open questions.

View Article and Find Full Text PDF

Although maternal nutrition has an impact on fetal development and gestational outcome, tracking maternal nutrition in outpatient practice is still complex and involves proper technical capacitation in this area. Nevertheless, the association between nutritional variables may broaden the ability to predict the occurrence of gestational disorders and prevention management. We aimed to identify factors that could indicate the probability of adverse outcomes in mid-pregnancy.

View Article and Find Full Text PDF

Assessment of human nutrition is a complex process, in pregnant women identify dietary patterns through mean nutrient consumption can be an opportunity to better educate women on how to improve their overall health through better eating. This exploratory study aimed to identify a posteriori dietary patterns in a cohort of nulliparous pregnant women. The principal component analysis (PCA) technique was performed, with Varimax orthogonal rotation of data extracted from the 24-h dietary recall, applied at 20 weeks of gestation.

View Article and Find Full Text PDF

Introduction: COVID-19 pandemic posed major challenges in obstetric health care services. Preparedness, development, and implementation of new protocols were part of the needed response. This study aims to describe the strategies implemented and the perspectives of health managers on the challenges to face the pandemic in 16 different maternity hospitals that comprise a multicenter study in Brazil, called REBRACO (Brazilian network of COVID-19 during pregnancy).

View Article and Find Full Text PDF

Objective: To evaluate the predictive capacity of vital signs for the diagnosis of postpartum hemorrhage (PPH).

Methods: A prospective cohort study performed at the University of Campinas, Brazil, between February 2015 and March 2016 with women who delivered vaginally. Vital signs and postpartum bleeding were collected over 24 h.

View Article and Find Full Text PDF

Background And Objective: During the past few years, an increased number of postpartum hemorrhages have been noticed, even in high-income countries. It has been suggested that this escalation could be associated with increased obstetric interventions. Among such interventions, anesthesia is one of the most prevalent.

View Article and Find Full Text PDF