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Master's Dissertation
DOI
10.11606/D.5.2010.tde-27092010-142844
Document
Author
Full name
Eliener de Souza Fazio
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2010
Supervisor
Committee
Nomura, Roseli Mieko Yamamoto (President)
Benute, Glaucia Rosana Guerra
Liao, Adolfo Wenjaw
Title in Portuguese
Perfil nutricional de gestantes que receberam orientação dietética: avaliação do ganho ponderal materno total, tipo de parto e resultados perinatais
Keywords in Portuguese
Avaliação nutricional
Ganho de peso
Parto
Resultado da gravidez
Abstract in Portuguese
Este estudo foi realizado na Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com cento e oitenta e sete gestantes sem comorbidades, para conhecer o perfil nutricional de gestantes que receberam orientação dietética e avaliar o ganho ponderal materno total, o tipo de parto e os resultados perinatais. Foi realizada pesquisa retrospectiva e descritiva, por meio de consulta dos formulários de anamnese alimentar, dos bancos de dados clínicos e prontuários das pacientes. As gestantes foram classificadas de acordo com o IMC prégestacional: 23 (12,2%) eram de baixo peso (IMC < 19,8 kg/m2); 84 (45%), eutróficas (IMC de 19,8 a 26,0 kg/m2); 37 (19,8%), sobrepeso (IMC de 26,1 a 29,0 kg/m2) e 43 (23%), obesas (IMC > 29,0 kg/m2). No consumo energético, não se constatou diferença entre os grupos. A média de porcentagem de carboidratos, proteínas e lipídeos ingerida foi semelhante entre os grupos. Sobre o perfil da ingestão de micronutrientes, a de cálcio, vitamina A e vitamina C foi semelhante entre os grupos; a de ferro foi maior nas gestantes eutróficas quando comparadas às com sobrepeso e com obesidade (p<0,001); a de folatos foi maior nas gestantes eutróficas quando comparadas às obesas (p=0,002); a de fibras foi menor nas gestantes de baixo peso quando comparadas às eutróficas (p=0,042). O ganho de peso excessivo (acima do recomendado) foi significativamente maior (p=0,009) nas gestantes com sobrepeso e obesidade, porém o ganho ponderal materno médio foi significativamente menor nas obesas (p<0,001). Não foi observada diferença entre os grupos quanto à idade gestacional no parto e o tipo de parto. O peso dos recém-nascidos das gestantes de baixo peso apresentou média significativamente menor (p=0,005) que dos demais grupos. As gestantes com sobrepeso apresentaram maior porcentagem de recém-nascidos com mais de 4000g (p=0,037) que os demais grupos. A proporção de recém-nascidos grandes para a idade gestacional foi significativamente maior (p=0,006) nas gestantes com sobrepeso e com obesidade quando comparadas aos demais grupos. Os índices de Apgar não apresentaram diferença significativa entre os grupos. A indicação de cesárea por vício pélvico foi significativamente mais frequente em gestantes com baixo peso (p = 0,006) quando comparadas aos outros grupos
Title in English
Nutrition profile of pregnant women who received dietary counseling: assessment of the total maternal weight gain, mode of delivery and perinatal outcomes
Keywords in English
Nutrition assessment
Parturition
Pregnancy outcome
Weight gain
Abstract in English
This study was carried out at Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, with one hundred eighty-seven pregnant women without comorbidities. This study aimed to know the nutrition profile of pregnant women who received dietary counseling and to evaluate the maternal total weight gain, type of delivery and perinatal outcome. A retrospective and descriptive research was carried out through consultation of forms of dietary anamnesis, the clinical databases and medical records. The women were classified according to pre-gestational body mass index (BMI): 23 (12.2%) were underweight (BMI < 19.8 kg/m2), 84 (45%) normal weight (BMI 19.8 to 26.0 kg/m2), 37 (19.8%) overweight (BMI 26.1 to 29.0 kg/m2) and 43 (% 23) obese (BMI > 29.0 kg/m2). No difference was observed in energy consumption between the groups. The averages percentage of carbohydrates, protein and lipid intake were similar between groups. Regarding the profile of micronutrient intake, calcium intake, vitamin A and vitamin C was similar between groups; iron intake was higher in normal weight pregnant women compared to overweight and obese (p<0.001); folate intake was higher in normal weight pregnant women compared to obese (p=0.002); fiber intake was lower in underweight pregnant women compared to normal weight (p=0.042). Excessive weight gain (above the recommended) was significantly higher (p=0.009) in pregnant women with overweight and obesity, however the mean of total maternal weight gain was significantly lower in obese women (p<0.001). No difference was observed between the groups regarding gestational age at delivery and mode of delivery. The weight of newborns of underweight pregnant women had a mean significantly lower (p=0.005) compared to other groups. The overweight pregnant women had a higher percentage of newborns with more than 4000g (p=0.037) compared to other groups. The proportion of newborns large for gestational age was significantly higher (p=0.006) in pregnant women with overweight and obesity compared to other groups. The Apgar scores did not differ significantly between groups. Indication of cesarean for contracted pelvis was significantly more frequent in underweight pregnant women (p=0.006) when compared to other groups
 
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Publishing Date
2010-09-28
 
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