Objetivo: Avaliar o impacto da Iniciativa Hospital Amigo da Criança sobre as práticas de aleitamento materno entre mães da área urbana de Montes Claros (MG).Métodos: Realizou-se uma análise comparativa dos indicadores de aleitamento materno entre dois estudos transversais com amostras aleatórias de crianças com até 2 anos de idade, antes e depois da implantação da Iniciativa Hospital Amigo da Criança para todos os serviços públicos de assistência ao parto na cidade. Curvas de sobrevida de Kaplan-Meyer foram construídas para os diversos padrões de amamentação. O teste de log rank foi usado para calcular o nível de significância das diferenças entre as curvas antes e após a Iniciativa. Resultados:As curvas de sobrevida mostraram que houve aumento nas taxas de aleitamento materno no período estudado. O teste de log rank mostrou diferenças estatisticamente significantes para os diversos padrões de amamentação (p < 0,000). A duração mediana do aleitamento materno em geral passou de 8,9 para 11,6 meses. A duração mediana do aleitamento materno exclusivo passou de 27 dias para 3,5 meses. Conclusões:A implantação da Iniciativa Hospital Amigo da Criança em todas as maternidades públicas de Montes Claros aumentou significativamente as taxas de aleitamento materno do município. Como a situação ideal ainda não foi alcançada, novas estratégias devem ser implementadas para promover e apoiar as práticas de aleitamento materno.

CONTEXT AND OBJECTIVE: Retinopathy of prematurity (ROP) is a known cause of blindness in which diagnosis and timely treatment can prevent serious harm to the child. This study aimed to evaluate the incidence of ROP and its association with known risk factors. DESIGN AND SETTING: Longitudinal incidence study in the neonatal intensive care unit (NICU) of Universidade Estadual de Montes Claros. METHODS: Newborns admitted to the NICU with gestational age less than 32 weeks and/or birth weight less than 1,500 grams, were followed up over a two-year period. The assessment and diagnosis of ROP were defined in accordance with a national protocol. The chi-square test or Fisher's exact test were used to determine associations between independent variables and ROP. Analysis on the independent effect of the variables on the results was performed using multiple logistic regression. RESULTS: The incidence of ROP was 44.5% (95% confidence interval, CI = 35.6-46.1) in the study population. The risk factors associated with the risk of developing the disease were: birth weight less than 1,000 grams (odds ratio, OR = 4.14; 95% CI = 1.34-12.77); gestational age less than 30 weeks (OR = 6.69; 95% CI = 2.10-21.31); use of blood derivatives (OR = 4.14; 95% CI = 2.99-8.99); and presence of sepsis (OR = 1.99; 95% CI = 1.45-2.40). CONCLUSIONS: The incidence of ROP was higher than that found in the literature. The main risk factors were related to extreme prematurity. RESUMO CONTEXTO E OBJETIVO:A retinopatia da prematuridade (ROP) é causa conhecida de cegueira e diagnóstico e tratamento oportunos podem evitar graves danos à criança. Este estudo objetivou avaliar a incidência da ROP e sua associação com fatores de risco conhecidos.

Background. The use of human recombinant erythropoietin (rHuEPO) in pregnant patients has been limited by the fear of eventual maternal and fetal repercussions (either direct or indirect). Methods. The authors present their experience with the use of rHuEPO during pregnancy, with two pregnant women with kidney transplants and in three others with chronic renal insufficiency (one with diabetic nephropathy, another dialysis dependent), all with hematocrit below 30% and adequate iron reserves. Results. Three of the patients had needed blood transfusions before beginning therapy, and another needed transfusion after significant metrorrhagia. The length of the treatment varied between 2 and 23 weeks and the hematocrit at delivery varied between 26% and 36%. Secondary effects (appearance or worsening of hypertension and seizures) were nil. There was one fetal death at 23 weeks of pregnancy (following an abruptio placentce), two neonates weighing between the 5th and the 10th percentiles, and three needing phototherapy (1 to 2 days). One year after birth, all showed a normal ponderal and neurologic development.Conclusions. Among the cases presented, no maternal and perinatal complications attributable to rHuEPO were registered. It is important that institutions report their experiences with the use of rHuEPO, given its restrictive indications and the limited experience of each institution.