Barbarah Silveira Penatti

347. Study of maternal and perinatal variables in preeclampsia according to its clinical expression

Introduction The severity of the clinical expression of preeclampsia determines maternal-fetal repercussions. Recognize indicators of severity may guide the adoption of behaviors in a timely manner. Objective To relate maternal characteristics and perinatal outcomes in patients with severe preeclampsia and without signs of severity. Method Cross-sectional study. Location: Hospital Guilherme Alvaro-Santos/Brazil, January/2015-May/2016. Patients with preeclampsia (NHBPEP/2000) were divided into two groups: no signs of severity (control) and severe (study). Maternal variables: age, body mass index (BMI), parity, prenatal care, gestational age at birth, serum creatinine, aspartate aminotransferase (AST) and alanine (ALT); and neonatal: weight and admission to the Intensive Care Unit (ICU). Statistical analysis: Fisher’s exact test (p significant Results The preeclampsia group presented more commonly than women without signs of severity: age ⩾40 years (6%), obesity (56.5%) and nulliparity (38%) against 0%, 61.5%, 6.7%, respectively. Absence of prenatal care 24% against 6.7%. The childbirth occurred between 29–346/7weeks in 36% in the group with severe preeclampsia, whereas in the preeclampsia without signs of severity: 6.7%. Average weight of newborns of 3205 g and 02 (13.3%) ICU admissions, against 2528 g and 21 (42.9%). The average creatinine level was similar; AST and ALT was 18.67 and 12.53 in the control group compared to 22.63 and 15.65. Discussion Similar rates of severe preeclampsia were found in the literature. (Batista, 2009). The severe expression of preeclampsia was associated with women in the extremes of age, with previous gestation, obesity and with worse perinatal performance. Noting that these women lack counseling and qualified care. Inadequate follow-up of prenatal care may be explained by the greater number of hospital admissions in severity. It is proposed a reflection on strategies to increase vaginal parturition in this group. The variations of AST-ALT indicate hepatic involvement anterior to the renal, which will be clearer with the continuation of the study.

349. Association between body mass index and preeclamspia

Introduction Lipotoxicity is a consequence from low grade inflammation caused by obesity. Women presenting body mass index (BMI) above 35 kg/m[b] have four times higher risk of preeclampsia development (Bianco, 1998). Objective To characterize the association of BMI and maternal and perinatal variables between puerperas with and withoutpreeclampsia. Method transversal study, Hospital Guilherme Alvaro-Santos/Brazil, (January/2015-March/2016). Antropometric data was collected from 160 women (immediate postpartum), 75 patients without preeclampsia (control group) and 85 with preeclampsia (case group). Variables: blood pressure (hospital admission), gestational age at childbirth and immediate perinatal outcome. Results Average mother age and BMI were 25 years and 26 kg/m[b] for the control group, in the group case: 29 years and 35 kg/m[b]. Patients with pre-eclampsia showed higher blood pressure: medium level of 136 mmHg (sistolyc) and 85 mmHg (diastolic). 84% of the deliveries in the case group were cesarean sections and the majority of these women had gestation resolution above 37 weeks. Newborns out of pre-eclampsia mothers weighed among 2685 g and five-minute Apgar score was 8,7. Those neonates presented higher admission rates in a ICU (36.5%) and 12% were small for gestational age. Cesarean in 84% of births in the case group and 40% case of births occurred in prematurity. Newborns of mothers with preeclampsia weighed on average 2685 g, average 5’ Apgar score of 8,7, higher rates of admission to ICU (36.5%) and 12% were small for gestational age. Discussion Was observed in women with preeclampsia higher average BMI and blood pressure values and their newborns showed smaller weight and 5’ Apgar score, need frequent admission to ICU and prematurity. Reproductive counseling appears to be relevant to the obese women to warn about potential complications, it’s important to adopt strategies for assistance to this population to qualify the attendance, particularly in actions preventive and possible reduction in the rate of cesarean section that could magnify risks.

PREVALÊNCIA DE ESCOLIOSE EM ESCOLARES DO ENSINO FUNDAMENTAL PÚBLICO

ABSTRACT Objective: To evaluate the prevalence of scoliosis and the risk factors in elementary school students. Methods: A cross-sectional study was carried out in 954 students in 2015. The instrument involved was a questionnaire on postural habits, socioeconomic conditions, and demographic factors. The anthropometric measurements, including height and weight, a visual inspection of the deformity of the vertebral column, the leveling of shoulders, and the Adam’s test were obtained. The sample was calculated in the expected frequency of 12.3%, acceptable error rate of 2.0% and confidence level of 95.0%. To compare the proportions, the chi-square test or Fisher’s exact test was applied. The association between scoliosis and risk factors was evaluated by logistic regression, being significant p <0.05. Results: The prevalence of scoliosis was 24.3%, higher in obese patients and students who adopted a sitting position for a long period of time. Obese students showed a 1.8 times higher chance of testing positive Adam’s Forward Bend Test when compared to normal-weight/lean and 2.1 times higher chance compared to overweight students. The sitting position for watching television increases the chance of testing positive Adam’s test in 38.0%, when compared to the lying position. Obesity increases the risk of testing positive Adam’s test in 74.0 and 98.0%, when compared, respectively, to the underweight/normal weight and overweight. Conclusions: There was a high prevalence of scoliosis in students from public elementary schools in Santos. The most influential factors for this deviation of the spine were obesity and the position adopted by students to watch television.