Antenatal stress is linked to fetal risks that increase the chances of neonatal complications and reduction of child cognitive ability. Therefore, we aimed to evaluate if maternal stress affects fetal, neonatal or child development. The following databases were searched: MEDLINE (1966 to May 2016), Embase (1980 to May 2016), LILACS (1982 to May 2016) and CENTRAL (1972 to May 2016). Observational studies published in English and Portuguese were included whether there was any relationship between fetal and neonatal outcome, such as birth weight, preterm labor, child development with pregnant women that were subjected to any stress type during at least one month of follow-up. Two independent reviewers screened eligible articles, extracted data and assessed the risk of bias. Thus, 8 cohort studies with about 8,271 pregnant women and 1,081,151 children proved eligible. Results suggested a significant association between antenatal stress exposure and increasing rates of low birth weight (Odds ratio (OR) 1.68 [95% Confidential Interval (CI) 1.19, 2.38]). However, there was no statistically significance difference between non-exposed and exposed groups related to preterm labor (OR 1.98 [95% CI 0.91 to 4.31]; I2 = 68%, p = 0.04). Although, results were inconsistent with primary analysis suggesting a significant association between antenatal stress exposure and the occurrence of higher rates of preterm birth (OR 1.42 [95% CI 1.05 to 1.91]; I2 = 68%, p = 0.04) in the sensitivity analysis. Furthermore, the current review has suggested that stress perceived during antenatal negatively influences fetal life and child development. Yet, further studies are necessary with adequate sample size and longer follow-up time to confirm our findings.

BackgroundTrials have examined on the benefits of vitamin D supplementation in pregnant women.ObjectiveThis review aimed to evaluate whether oral vitamin D supplements, when given to pregnant women with gestational diabetes mellitus (GDM), would improve maternal and neonatal outcomes, compared with no treatment or placebo.MethodWe performed a systematic review following Cochrane methodology, and randomized trials were included where pregnant women with GDM received vitamin D supplementation versus placebo/no treatment or vitamin D and calcium versus placebo/no treatment. Primary outcomes were preeclampsia, preterm birth, cesarean delivery, gestational hypertension, and adverse events related to vitamin D supplementation. The search strategies were applied to the following databases: MEDLINE, Embase, LILACS, and CENTRAL. Similar outcomes in at least two trials were plotted using Review Manager 5.3 software. The quality of evidence was generated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsThe total of 1224 references were identified, eleven trials were potentially eligible, and six were included in this review (totaling 456 women). The meta-analysis of frequency of cesarean deliveries did not show significant differences between groups, none of the trials evaluated the remaining primary outcomes. For secondary outcomes, our results suggest that vitamin D supplementation in pregnant women with GDM may reduce newborn complications such as hyperbilirubinemia, polyhydramnios (RR: 0.40, 95% CI: 0.23 to 0.68; RR: 0.17, 95% CI: 0.03 to 0.89; respectively), and the need for maternal or infant hospitalization (RR: 0.13; 95% CI: 0.02 to 0.98; RR: 0.40, 95% CI: 0.23 to 0.69). However, the evidence was of low or very low quality.ConclusionWe did not find moderate or high quality evidence indicating that vitamin D supplementation, when compared with placebo, improves glucose metabolism, adverse maternal and neonatal outcomes related to GDM in pregnant women.

Objetivo: Identificar os estudos publicados na literatura nacional e internacional sobre a avaliação da qualidade de vida dos profissionais durante a pandemia da COVID-19. Métodos: Revisão integrativa da literatura. A busca dos estudos foi realizada na base de dados e MEDLINE/PubMed, EMBASE e Literatura Latino-Americana e do Caribe em Ciências da Saúde-LILACS. Os dados extraídos dos artigos selecionados foram analisados e apresentados em tabelas. Resultados: Foram selecionados 12 artigos de uma amostral total com 14.215 participantes, sendo a maioria dos participantes dos estudos eram mulheres profissionais da área da enfermagem. Os profissionais de saúde que trabalham na linha frente do COVID-19 apresentaram baixos escores na qualidade de vida, além de alterações significativas na saúde mental e sintomas de distúrbios do sono. Os enfermeiros e médicos relataram piora na qualidade de vida. A depressão também foi identificada nos estudos como consequência nesse período de pandemia, independente se o profissional trabalhava diretamente com paciente com diagnóstico ou suspeita de COVID-19. O sexo feminino apresentou pior qualidade de vida. Profissionais com idade maior que 40 anos apresentaram menor escore para qualidade de vida. Conclusão: Os profissionais de saúde apresentaram uma qualidade de vida prejudicada no período de pandemia da COVID-19 no Brasil, principalmente os profissionais que trabalham na linha de frente.

Objetivo: identificar e analisar as estratégias e barreiras encontradas pela equipe de enfermagem na comunicação com pacientes deficientes auditivos Método: Revisão integrativa, baseado em artigos científicos publicados até julho de 2019 nas bases de dados PubMed, LILACS, BDENF-Enfermagem e MEDLINE. Os descritores foram selecionados a partir do DeCS, sendo: “Pessoas com Deficiência Auditiva”, Comunicação e “Equipe de enfermagem” e no Mesh para o inglês. Não houve restrição de idioma e foram excluídos estudos de revisão de literatura, livros, capítulos e resenhas de livros, manuais e relatórios técnicos. Resultados: As barreiras linguísticas representam o maior dificultante na comunicação entre profissional de enfermagem e o deficiente auditivo. O uso de mimetismo e linguagem corporal têm sido utilizados como estratégias. Ofertar disciplinas na formação profissional, bem como disponibilizar treinamentos e protocolos para obtenção de intérpretes podem ser eficazes no processo de comunicação com deficientes auditivos.

Background There is ample evidence that gestational diabetes mellitus has a direct influence on urinary incontinence and pelvic floor muscles. There are no standardized pelvic floor muscle exercise programs in the literature for the physiotherapy and differ in the type of exercise, intensity, type and duration of application, and the frequency and duration of treatment sessions. The aim of this systematic review will be to investigate that Pelvic Floor Muscle Training can prevent and/or decrease the pregnancy specific urinary incontinence in women with gestational diabetes mellitus or gestational hyperglycemia. Methods We will perform a systematic review according to the Cochrane methodology of Randomized Controlled Trials. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases, with the date of consultation until June 2020. The MeSH terms used will be "Pregnancy", "Hyperglycemia", "Diabetes Mellitus, Type 2", "Diabetes Mellitus, Type 1", "Pregnancy in Diabetics", "Diabetes, Gestational", "Urinary Incontinence", "Pelvic Floor Muscle Strength". Primary outcomes: improvement or cure of pregnancy specific urinary incontinence (which can be assessed by questionnaires, and tools such as tampon test, voiding diary, urodynamic study). Secondary outcomes: improvement of pelvic floor muscle strength (pelvic floor functional assessment, perineometer, electromyography, functional ultrasonography), improved quality of life (questionnaires), presence or absence of postpartum Urinary Incontinence and adverse effects. Quality assessment by Cochrane instrument. Metanalysis if plausible, will be performed by the software Review Manager 5.3. Discussion The present study will be the first to analyze the effectiveness of pelvic floor exercises in pregnant women with Gestational Diabetes Mellitus or Hyperglycemia, who suffer from pregnancy specific urinary incontinence. Randomized Controlled Trials design will be chosen because they present the highest level of evidence. It is expected to obtain robust and conclusive evidence to support clinical practice, in addition to promoting studies on the theme and contributing to new studies. Trial registration Systematic review registration: PROSPERO CRD42017065281.