Meireluci Costa Ribeiro

Gravidez e Diabetes Gestacional: uma combinação prejudicial à função sexual feminina?

To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Students t and X2 tests were used to compare differences between groups and p<0.05 was considered significant. RESULTS: The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). CONCLUSIONS: The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.

Female Sexual Function and Gestational Diabetes

INTRODUCTION The number of women with gestational diabetes mellitus (GDM) is growing worldwide in parallel with the obesity epidemic. The diagnosis of GDM leads to substantial modifications in the daily routine of these women, and these adjustments could potentially affect their sexual function. There are no previous studies on the sexual function of patients with GDM. AIM The aim of this study was to investigate the sexual function of patients with GDM in comparison with healthy pregnant women at the same gestational age. METHODS Brazilian women in the third trimester of pregnancy with and without GDM were invited to participate in this cross-sectional study while waiting for their antenatal care visits at a single public tertiary teaching institution between March and December 2010. The Brazilian version of the Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function. MAIN OUTCOME MEASURES Desire, arousal, lubrication, orgasm, sexual satisfaction, and pain during and after coitus in the last 4 weeks, measured according to a standardized and validated questionnaire. RESULTS A total of 87 participants were enrolled (43 healthy women and 44 with GDM). There were no significant differences in the sociodemographic characteristics of both groups. The total FSFI scores of GDM patients was 21.0±9.59 compared with 22.3±9.17 for healthy women (P=0.523). Difficulty in desire was the most common sexual dysfunction symptom in both groups, being reported by 42% and 50% of GDM and healthy women, respectively (P=0.585). CONCLUSION The sexual function of Brazilian patients with GDM does not differ significantly from that of healthy pregnant women at the same gestational age.

Female sexual function of overweight women with gestational diabetes mellitus - a cross-sectional study.

Obesity and gestational diabetes mellitus (GDM) are increasing worldwide and may compromise female sexual function. We hypothesize that among GDM patients in the third trimester of pregnancy, those with excess body fat would have worse female sexual function scores than normal weight women. Our aim was to assess the sexual function of overweight compared to normal weight women with GDM. This was a cross-sectional survey involving 143 Brazilian women with GDM in the third trimester of pregnancy: 76 were overweight (pre-pregnancy body mass index-BMI≥25.0 Kg/m2) and 67 were normal weight (BMI 18.5–24.9 Kg/m2). Participants were recruited from March 2010 to April 2013 at the antenatal clinic of a single public tertiary teaching institution. The Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function. Overall, 51.7% of the 143 participants were at risk for sexual dysfunction symptoms (FSFI scores ≤26); this rate was significantly higher among overweight compared to normal weight women (60.5% versus 41.8%, p = 0.038). Mean total FSFI scores were significantly lower in overweight compared to normal weight women (21.7±9.2 versus 24.9±8.0, p = 0.029). Compared to normal weight women, overweight participants had lower mean scores in desire (3.4±1.2 versus 4.0±1.4, p = 0.007) and lubrication (3.8±2.0 versus 4.5±1.6, p = 0.023). According to these results, overweight women with GDM in the third trimester of pregnancy have lower female sexual function scores than normal weight women with the same disorder.

Maternal overweight and sexual function in pregnancy

Obesity and overweight are increasing worldwide and may compromise female sexual function. Our aim was to compare the sexual function of normal and overweight women in pregnancy.

Qualidade do sono em gestantes com sobrepeso

PURPOSE To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy. METHODS A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant. RESULTS Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04). CONCLUSION Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.OBJETIVO: Comparar a qualidade do sono de gestantes com e sem sobrepeso no segundo e terceiro trimestres.METODOS: Estudo transversal incluindo 223 gestantes com ≥14 semanas: 105 com sobrepeso (indice de massa corporal - IMC - pre-gestacional ≥25,0 km2) e 118 eutroficas (IMC 18,5-24,9 kg/m2) em acompanhamento pre-natal. A versao brasileira do questionario Pittsburgh Sleep Quality Index (PSQI-BR) foi utilizada para avaliacao do sono. Testes do χ2 e t de Student foram utilizados para comparar diferencas entre os grupos; p 5) e essa proporcao foi significativamente mais alta entre as mulheres com sobrepeso (80/105), em comparacao as eutroficas (67/118) (76,2 versus 56,8%, p=0,004). No 2o trimestre, essa proporcao nao alcancou significância estatistica (72,5 versus 53,7%, p=0,06), mas o escore medio total do PSQI-BR foi mais alto entre aquelas com sobrepeso (7,0±3,8 versus 5,5±3,2, p=0,02). Nesse periodo, os escores medios de latencia e qualidade subjetiva do sono foram significativamente mais altos entre as mulheres com sobrepeso (1,4±1,0 versus 1,0±0,9, p=0,02, e 1,3±0,8 versus 0,8±0,8, p=0,02, respectivamente). No 3o trimestre, a proporcao de gestantes com baixa qualidade do sono foi mais alta entre as mulheres com sobrepeso, mas sem diferenca significante (79,6 versus 60,8%, p=0,06). Nessa fase, o escore total do instrumento foi semelhante entre as mulheres com e sem sobrepeso (9,4±4,2 versus 8,3±4,6, p=0,2). No entanto, gestantes com sobrepeso apresentaram escores medios mais altos para disturbios do sono (2,3±0,7 versus 2,0±0,8, p=0,04).CONCLUSAO: Mulheres com sobrepeso pre-gestacional apresentaram sono mais comprometido do que as eutroficas, no segundo e terceiro trimestres da gravidez.

Translation and validation of Warmometer, a tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese

BACKGROUND Empathy in the patient-provider relationship is associated with important outcomes in healthcare practice. Our aim was to translate and validate Warmometer, a visual tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese. DESIGN AND SETTING Cross-sectional study conducted at an antenatal clinic of a public university hospital in São Paulo, Brazil. METHODS The instrument was translated into Brazilian Portuguese and culturally adapted. It was tested for reliability and validity among 32 pregnant women, between June 2015 and January 2016. To assess construct validity, it was correlated with the Consultation and Relational Empathy (CARE) scale (gold standard for patient-provider relationships) and the Interpersonal Reactivity Index (IRI). RESULTS The translated version of Warmometer had good face and content validity, low intra-observer reproducibility (intraclass correlation coefficient, ICC: 0.224; 95% confidence interval, CI -0.589 to 0.621;P = 0.242) and high inter-observer reproducibility (ICC: 0.952; 95% CI 0.902 to 0.977; P < 0.001). There was a strong correlation between Warmometer and CARE (r = 0.632) and a weak correlation between Warmometer and IRI (r = 0.105). CONCLUSIONS Warmometer was translated, culturally adapted and validated for use in Brazilian Portuguese. The translated version is a reliable tool for assessing the degree of empathy perceived by the patient in a patient-provider relationship.

Beliefs About Sexual Activity During Pregnancy: A Systematic Review of the Literature

The aim of this review is to present the beliefs related to sexual activity during pregnancy. We identified 13 studies (3,122 participants). The main positive beliefs about sex in pregnancy were that it makes labor easier, promotes marital harmony, prevents infidelity, and improves fetal well-being. Negative beliefs were more frequent: that sex could harm the unborn child (cause injuries, miscarriage, or fetal infection) and endanger the pregnancy or maternal health (cause membrane rupture, bleeding, preterm labor, and maternal infection). These findings are useful to clinicians and educational program developers.