OBJECTIVES: to evaluate pregnant women's knowledge on oral health and its association with sociodemographic characteristics.
METHODS: this exploratory cross-sectional study included a convenience sample of 69 women attended at a prenatal referral outpatient clinic in a Brazilian city. Data were collected using an oral health questionnaire adapted from Bianco (2010); higher scores indicated better knowledge. The outcome "knowledge on oral health " was dichotomized at the sample mean (less/more). Sociodemographic and oral health-related variables were obtained from the questionnaire, and associations were tested using Pearson's chi-square/Fisher's exact tests (α=0.05).
RESULTS: most participants who were unemployed, had completed secondary education, and had low family income; 50.7% had less knowledge on oral health. Lower scores involved primary and permanent dentition, tooth eruption and exfoliation, and causes of dental caries, halitosis, and oral cancer. In bivariate analyses, women with lower family income and lower schooling were more frequently classified as having lower knowledge on oral health, whereas employed women were more frequently classified as having higher knowledge.
CONCLUSION: pregnant women showed limited knowledge on oral health, especially among those in socioeconomically more vulnerable groups. Given the cross-sectional design and the use of an unvalidated instrument for pregnant women, findings should be interpreted cautiously and may inform educational strategies in similar services.

Palavras-chave: Oral health, Pregnant women, Knowledge, Cross-sectional study, Observational study

OBJECTIVES: to develop and validate an educational booklet for pregnant women experiencing pelvic girdle pain.
METHODS: this was a methodological development study conducted at the Federal University of São Carlos, Brazil. The educational booklet was developed following a comprehensive literature review and subsequently validated by healthcare professionals and pregnant women. Content and appearance were assessed using the Content Validity Index (threshold: 0.8 or higher) and the percentage of absolute agreement among participants (threshold: 75% or higher).
RESULTS: in the first stage, healthcare professionals rated the material with a mean global content validity of 0.93. In the second stage, pregnant women indicated an 89.2% agreement regarding its clarity, relevance, and usability. The final version, titled "What You Need to Know About Gestational Pelvic Pain", includes an introduction, the definition and location of pain, its relationship with pregnancy, and practical guidance for prevention and self-management.
CONCLUSION: the educational booklet met the acceptability standards established for validation and may contribute to improving prenatal care and self-management of pelvic girdle pain.

Palavras-chave: Pregnancy, Health education, Pelvic girdle pain, Physical therapy, Validation study

OBJECTIVES: to develop an instrument designed to assess pregnant women's expectations regarding labor and birth.
METHODS: a cross-sectional study was conducted, utilizing two focus groups for the questionnaire's construction: one comprising eight obstetrics professionals and another with six pregnant women.
RESULTS: based on the focus group discussions, a preliminary 22-item questionnaire was developed. Its psychometric properties were tested in a pilot sample of 67 pregnant women. The results were descriptively analyzed and submitted to the validation process, where reliability measures and the validity of content, criterion and construction values were evaluated. The final instrument was composed of 10 items. Factorial analysis indicated three dimensions of the instrument: safety (four questions), feelings (four questions) and concerns (three questions). Its reliability was assessed using Cronbach's Alpha and Spearman Brown statistical tests, yielding values of 0.6727 and 0.7658, respectively.
CONCLUSIONS: the Questionnaire (QEDB) demonstrated adequate psychometric properties to measure pregnant women's expectations, particularly when examining the responses of women in the third trimester. Due to its ease of administration, the instrument can serve as a valuable tool in clinical obstetrics practice and for future research.

Palavras-chave: Birth expectations, Childbirth, Measurement instruments, Psychometric properties, Questionnaire

OBJECTIVES: this study aimed to explore, from a maternal perspective, the experiences of Brazilian women regarding prenatal care, childbirth, and immediate postpartum period, including the associated feelings and emotions.
METHODS: a qualitative phenomenological study was conducted with six women, aged 18 years or older, who were in the third trimester of pregnancy during the first part of the study, regardless of parity, and who received care in both public and private healthcare institutions. Semi-structured online interviews were conducted during pregnancy and after birth (30-45 days). Data were analyzed using Interpretative Phenomenological Analysis (IPA).
RESULTS: the findings strongly indicate that perceptions and emotions regarding pregnancy and childbirth varied widely across participants. Common anticipatory feelings included fear, curiosity, and anxiety. Participants who reported negative maternity care experiences expressed feelings of apprehension and stress, whereas positive experiences fostered confidence and peace of mind regarding childbirth.
CONCLUSION: the findings highlight the diverse range of perceptions and emotions during pregnancy, childbirth and immediate postpartum among women in Brazil. The study

Palavras-chave: Pregnancy, Childbirth, Maternal mental health, Experience, Phenomenology

OBJECTIVE: to estimate the prevalence of HIV and syphilis, and their association with gestational complications and newborn outcomes in women admitted for delivery at a mother and child center in the South of Brazil.
METHODS: cross-sectional study based on the review of electronic medical records of parturients (March/2016 to June/2018). Sociodemographic and clinical data were analyzed. HIV and syphilis were considered outcomes, then exposures to assess associations with pregnancy and neonatal variables. Prevalence Ratio (PR) were calculated using Poisson Regression with robust variance and 95% Confidence Interval (CI).
RESULTS: data from 6,527 women were evaluated. HIV prevalence was 0.6% and syphilis 1.5%. Women assisted by the public health system [PR=2.28 95%CI=1.07-4.82 for syphilis; PR=3.52 95%CI=1.06-11.72 for HIV] and drug users [PR=5.47 95%CI=2.49-12.04 for syphilis; PR=4.76 95%CI=1.12-20.19 for HIV] were more affected. Syphilis was more prevalent among younger and non-white women (p=0.001). Adequate prenatal care reduced syphilis by 38% (PR= 0.62 95%CI=0.39-0.97; p=0.006). Neonatal complications occurred in 32.3% of syphilis cases and 17.1% of HIV cases. Of the 98 syphilis cases, 29.6% led to congenital syphilis.
CONCLUSION: women in socially vulnerable conditions, such as drug users, were more affected. Congenital syphilis exceeded the national average, reinforcing the need for timely and comprehensive prenatal care.

Palavras-chave: Syphilis, HIV seropositive, Congenital syphilis, Sexually transmitted diseases, High-risk pregnancy

OBJECTIVES: the objective this study was evaluating the prevalence of maternal colonization by Group B beta-hemolytic Streptococcus (GBS) in pregnant women who delivered preterm and its relationship with adverse maternal/perinatal outcomes.
METHODS: we carried out a retrospective cohort study with singleton pregnancies with or without a culture for GBS (vaginal-rectum) who delivered spontaneously <37 weeks of gestation.
RESULTS: the study included 190 pregnant women, 53.1% (101/190) did not undergo culture for GBS and 46.8% (89/101) have done. Among the patients who had a culture, 13.5% (12/89) had positive culture for GBS and 86.5% (77/89) had a negative culture. Pregnant women without GBS culture had higher prevalence of preterm birth (74.3 vs. 59.6%, p=0.031) and lower prevalence of antibiotic prophylaxis (27.7 vs. 56.2%, p<0.001) than pregnant women with GBS culture. Higher prevalence of crystalline penicillin G use was observed in pregnant women with positive culture compared to pregnant women with negative culture for GBS (100 vs. 39%, p<0.0001). There was no significant association between pregnant women with or without a culture for GBS or positive and negative GBS cultures and adverse maternal/perinatal outcomes.
CONCLUSION: No significant association was found between GBS culture or not, GBS positive or negative culture, adequate or inadequate GBS prophylaxis, and the prevalence of adverse maternal/perinatal outcomes.

Palavras-chave: Group B beta-hemolytic Streptococcus, Screening, Preterm delivery, Antibiotic prophylaxis, Adverse maternal/perinatal outcomes

OBJETIVOS: analisar a relação entre a estimulação oral, o padrão de sucção e o desempenho alimentar de recém-nascidos prematuros.
MÉTODOS: revisão sistemática seguindo as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Foram consultadas as bases PubMed-Central, SciELO, LILACS e CINA-HL Complete, Cochrane Collection Plus, Nursing & Allied Health Collection e Medic Latina via EBSCOHost, sem restrições temporais ou de idioma. A pesquisa foi realizada entre outubro a novembro de 2023. O processo de seleção, triagem e integração dos estudos foi conduzido no programa Rayyan^®, em colaboração com outro pesquisador. A análise de evidências foi feita através do instrumento Quality Assessment Tool For Quantitative Studies.
RESULTADOS: foram encontrados 358 artigos, dos quai 13 foram selecionados após eliminação de duplicados e aplicação dos critérios de qualificação. Três artigos adicionais foram incluídos pela análise de referências, totalizando uma amostra de 16 estudos originais. O nível de evidência variou de fraco (n=1), moderado (n=3) e forte (n=12). Os resultados obtidos demonstraram que a estimulação oral melhorou o padrão de sucção, o desempenho alimentar e contribuiu para alta hospitalar precoce.
CONCLUSÃO: a literatura apoia que técnicas de estimulação oral, sucção não nutritiva e a Premature Infant Oral Motor Intervention têm efeitos benéficos no processo alimentar de recém-nascidos prematuros.

Palavras-chave: Recém-nascido prematuro, Métodos de alimentação, Sucção, Comportamento de sucção, Deglutição

OBJECTIVES: to evaluate changes in breast cancer care among women assisted at a public hospital in Paraíba, Brazil, during the COVID-19 pandemic.
METHODS: retrospective cohort of women using the Sistema Único de Saúde (SUS) (Brazilian Public Health Service) at Hospital Napoleão Laureano (PB), and were diagnosed with in situ or invasive ductal carcinoma in the pre-pandemic (2017-2018) and pandemic (2020) periods. Sociodemographic, clinical and care-related data were collected. Differences between periods were assessed using chi-square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney tests, for continuous variables (p<0.05).
RESULTS: among 218 women included, 114 were treated before the pandemic and 104 during. Most cases were palpable tumors and invasive carcinoma. Mastectomy was the predominant procedure, with immediate reconstruction in 24.8%. The interval between histopathological diagnosis and the first consultation with a specialist increased during the pandemic (p=0.04), and few women outside the capital could access the service (RR=0.63; 95%CI= 0.4-0.9; p=0.01). Delays on the appointment and abandonment of treatment were also higher during the pandemic, whereas immediate breast reconstruction decreased.
CONCLUSION: the pandemic hindered breast cancer care, increasing delays, interruptions of treatment, and reducing immediate reconstructions. These findings highlight the vulnerability of patients dependent of the public health services during health crises.

Palavras-chave: Neoplasias da mama, SARS-CoV-2, Pandemia, Diagnóstico tardio, Tempo para o tratamento

OBJECTIVES: to develop and conduct a pilot test of a risk detection instrument for sexual domestic violence among schoolchildren aged 9 to 11 years, entitled the Risk Detection Instrument - Sexual Domestic Violence (IDR-VSD).
METHODS: this is a mixed method study conducted between January 2019 and December 2022, following the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The qualitative phase included a consensus technique with nine interprofessional experts and cognitive interviews with the target population, including schoolchildren with impairment. A pilot test was conducted with 109 participants, and internal consistency, reliability, and factor structure were analyzed.
RESULTS: the initial version comprised 22 items with playful elements, distributed across four dimensions (biological, psycho-relational, social, and ecological). The intraclass correlation coefficient was 0.602 (95%CI=0.48-0.70; p<0.001). The overall Cronbach's alpha was 0.602. After correcting the item-total correlations, the overall alpha increased to 0.654 for 18 items. One item with a measure of sampling adequacy below 0.50 was removed. Exploratory factor analysis was performed with 17 items, distributed across five factors that explained 53.76% of the total cumulative variance, in accordance with the theoretical model.
CONCLUSION: the IDR-VSD demonstrates favorable measures of reliability and factor structure, despite the complexity of the studied phenomenon.

Palavras-chave: Domestic violence, Sexual violence, Instrument development, Risk assessment, Child

OBJECTIVES: to assess the COVID-19 pandemic impact on breastfeeding rates during birth hospitalization in a Baby-Friendly certified perinatal hospital in Portugal.
METHODS: observational retrospective study comparing pre-pandemic (2019) and pandemic (April-December 2020) periods. A total of 900 healthy term mother-newborn dyads in rooming-in were included. Maternal and neonatal variables associated with breastfeeding at discharge were analyzed using chi-square, Student's t-test, and multivariable logistic regression (p<0.05).
RESULTS: breastfeeding rates were higher in the pandemic period (99.3%) than in the pre-pandemic period (97.6%; p=0.031). Exclusive breastfeeding (80.2% vs. 81.6%; p=0.611) and skin-to-skin contact (56.2% vs. 58.0%; p=0.590) did not differ significantly. Exclusive breastfeeding was associated with vaginal delivery (pre-pandemic OR=3.07; 95%CI=1.83-5.13; p<0.001; pandemic OR=2.29; 95%CI=1.39-3.77; p=0.001), weight loss <10% (p<0.001), and absence of phototherapy in the pre-pandemic period (OR=3.38; 95%CI=1.96-7.12; p<0.001). No associations were found with maternal age, parity, sex, or gestational age.
CONCLUSIONS: exclusive breastfeeding rates were not negatively affected by pandemic restrictions. Maintaining Baby-Friendly practices preserved essential breastfeeding support.

Palavras-chave: Breastfeeding, COVID-19 pandemic, Newborn

OBJETIVOS: evaluar la satisfacción de las pacientes con la atención prenatal mixta durante la pandemia de COVID-19 en un hospital terciario de Lima, Perú.
MÉTODOS: realizamos una evaluación transversal de la satisfacción en pacientes que recibieron atención prenatal mixta, que incluyó consultas presenciales y virtuales. Se incluyeron todas las mujeres que dieron su consentimiento por escrito entre junio y julio de 2021. Se aplico la escala Short Assessment of Patient Satisfaction (SAPS), que evaluó siete dimensiones de satisfacción: acceso e instalaciones, efectividad, información, habilidades técnicas, participación. relación y satisfacción general.
RESULTADOS: la satisfacción global con la atención prenatal mixta fue de 3,28±0,71. La puntuación media del SAPS fue 33,88 (DE = 5,56). En total, 144 pacientes (65%) prefirieron la atención prenatal mixta. La edad materna promedio de las 221 gestantes incluidas fue de 30 años y la edad gestacional promedio en la primera consulta fue de 24 semanas. En total, el 88,2% de los pacientes realizaron hasta 6 consultas entre virtuales y presenciales. Los pacientes sin seguro de salud tuvieron menores índices de satisfacción en comparación con las mujeres embarazadas con seguro de salud público (p=0,026).
CONCLUSIONES: Las mujeres que recibieron atención prenatal mixta durante la pandemia de COVID-19 reportaron un alto nivel de satisfacción. En general, las mujeres embarazadas recomendarían atención prenatal mixta.

Palavras-chave: Atención prenatal, Satisfacción del paciente, Telemedicina, Pandemia de COVID-19

Cervical cancer remains a significant public health challenge in Brazil, characterized by pronounced regional disparities in both incidence and mortality rates. For several decades, the country has predominantly relied on opportunistic cervical cytology (Pap smears) for cervical cancer screening. While cytology-based screening served as a cornerstone of preventive measures, its effectiveness has been hindered by limited coverage, opportunistic administration, and deficiencies in follow-up protocols. Brazil is now undergoing a transition towards primary HPV DNA testing, commencing at age 25, in accordance with international guidelines. This perspective article critically examines the potential implications of this transition for cervical cancer prevention over the next 25 years. Evidence suggests that HPV testing provides enhanced sensitivity, facilitates earlier detection of precancerous lesions, and enables the implementation of organized, population-based screening programs. However, challenges persist, including the risk of over-referral among younger women, existing health system inequalities, and the necessity for rigorous quality assurance and follow-up mechanisms. If successfully implemented, the new strategy could enable the detection of high-grade lesions up to a decade earlier, increase screening coverage, and reduce mortality rates, particularly in underserved regions. Nevertheless, the success of this initiative will depend on sustained financial investment, integration with vaccination efforts, and the assurance of equitable access to screening services.

Palavras-chave: Cervical cancer, HPV DNA test, Cytology, Screening, Brazil