SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure. OBJECTIVE METHODS 3 participants 1 72.94±4.49 7294449 72 94 4 49 (72.94±4.4 years 72.27±6.05 7227605 27 6 05 (72.27±6.0 years, , Upperlimb Upper CR CR1 scale RESULTS xaxis x axis y xaxes. xaxes axes. x-axes However stronger CONCLUSION sexes failure 72.94±4.4 729444 7 9 (72.94±4. 72.27±6.0 722760 2 0 (72.27±6. 72.94±4. 72944 (72.94±4 72.27±6. 72276 (72.27±6 72.94±4 7294 (72.94± 72.27±6 7227 (72.27± 72.94± 729 (72.94 72.27± 722 (72.27 72.94 (72.9 72.27 (72.2 72.9 (72. 72.2 72. (72 (7 (

Resumo Introdução: O confinamento imposto durante a pandemia COVID-19 pode ter afetado o estilo de vida dos indivíduos e, possivelmente, os seus níveis de atividade física (AF). O objetivo deste estudo foi avaliar o impacto destas medidas nos níveis de AF dos Portugueses. Métodos: Foi realizado um inquérito online, com base no Eurobarómetro do desporto e atividade física, a fim de recolher dados sobre os níveis de AF em Portugal antes e durante o período pandémico. A AF foi avaliada através de 3 outcomes: (i) cumprimento com as recomendações de AF aeróbia da Organização Mundial da Saúde (OMS); (ii) tempo diário sentado; (iii) tempo de caminhada semanal. Utilizaram-se modelos de regressão multinomial de forma a identificar variáveis que pudessem estar associadas a mudanças nos níveis de AF. Resultados: Obtivemos 1281 respostas (36,4% do sexo masculino). A maioria dos participantes tinha um nível académico alto (73%) e estava empregada (76,3%). O confinamento associou-se a uma redução significativa nos níveis de AF aeróbica (50,0% dos participantes cumpriam com as recomendações de AF aeróbica da OMS antes versus 38,8% durante; p<0,001), uma redução do tempo médio de caminhada semanal (97,2 versus 72,4 minutos; p<0,001), bem como um aumento do tempo diário sentado (p<0,001). Não foram identificadas variáveis associadas ao aumento ou diminuição da AF durante o confinamento. Conclusão: O confinamento imposto durante a pandemia COVID-19 associou-se a uma redução nos níveis de AF dos portugueses. Estes dados podem ser usados para melhor preparar e promover AF durante esse período em futuras vagas e/ou situações similares.

Abstract Introduction: Home lockdown enforced during COVID-19 pandemic may have affected individuals’ lifestyles and, possibly, their physical activity (PA) levels. In this study, we aimed to assess changes in Portuguese PA levels during lockdown. Methods: We conducted an online survey based on the Special eurobarometer public opinion survey on sports and physical activity in April 2020 in order to collect data about the Portuguese PA levels before and during the home confinement period. PA was assessed by three outcome variables: (i) compliance with World Health Organization (WHO) aerobic PA recommendations, (ii) daily sitting time, (iii) and weekly walking time, with pre- lockdown and during lockdown levels being compared for each. Multinomial regression models were used to identify variables that were associated to changes in PA levels. Results: We obtained 1281 responses (36.4% males). Most participants had high academic levels (73%) and were employed (76.3%). Lockdown was associated with significant decreases in aerobic PA levels (50.0% participants met WHO recommendations for aerobic PA levels before lockdown versus 38.8% during that period; p<0.001) and average weekly walking time (97.2 versus 72.4 minutes; p<0.001), as well as with increases in daily sitting time (p<0.001). We did not identify variables consistently associated with increasing or decreasing PA during lockdown. Conclusion: Home lockdown during COVID-19 pandemic is associated with a decrease in PA levels. In the likely event of another waves, when confinement may again be implemented, these data can be used to better prepare and to promote PA during that period.

RESUMO Dentre os bioestimulantes disponíveis no mercado, encontram-se aqueles compostos por extratos de algas. Já existem resultados científicos suficientes para se concluir que a aplicação destes bioestimulantes em culturas agrícolas pode afetar positivamente o crescimento e produtividade das plantas. No entanto, os resultados são discrepantes entre espécies vegetais e condições ambientais. Assim, objetivou-se avaliar os efeitos de doses e épocas de aplicação via foliar de bioestimulante à base de extrato de alga marinha ( Ecklonia maxima) na morfologia e produtividade da cultura da soja. O experimento foi conduzido em campo no município de Uberaba - MG, em Latossolo Vermelho distrófico. O delineamento experimental foi em blocos casualizados, com quatro repetições, em esquema fatorial 3 x 5, sendo três épocas de aplicação (estádios fenológicos: V4, R1 e V4+R1) e cinco doses do bioestimulante (0, 250, 500, 750 e 1000 mL ha-1) aplicadas via foliar. De modo geral, a aplicação do bioestimulante influenciou o número de ramos, nós, flores e vagens nas plantas de soja e, consequentemente, a produção da cultura. A aplicação de 607 mL ha-1 do bioestimulante propiciou a maior produtividade de grãos (5379 kg ha-1), que foi 6,1% superior à produtividade obtida sem aplicação do bioestimulante (5070 kg ha-1). A aplicação no estádio R1 proporcionou plantas com quantidade maior de flores e vagens.

ABSTRACT Biostimulants currently available on the market include those containing seaweed extract. There is sufficient scientific evidence to conclude that applying biostimulants to agricultural crops can positively impact plant growth and yield. However, results differ between plants species and environmental conditions. As such, the present study aimed to assess the effects of doses and application times of a biostimulant based on seaweed (Ecklonia maxima) extract on the morphology and yield of soybean crops. The experiment was conducted in a field in the municipality of Uberaba, Minas Gerais state (MG), Brazil, in dystrophic red latosol. A randomized block design was used, with four repetitions, in a 3 x 5 factorial scheme consisting of three application times (phenological growth stages: V4, R1 and V4+R1) and five doses of foliar -applied biostimulant (0, 250, 500, 750 and 1000 mL ha-1). In general, biostimulant application influenced the number of branches, nodes, flowers, and pods on the soybean plants and, consequently, crop yield. A dose of 607 mL ha-1 promoted a 6.1% greater grain yield (5379 kg ha-1) than that obtained without biostimulant spraying (5070 kg ha-1). Application in stage R1 resulted in plants with more flowers and pods.

RESUMO Dentre as alternativas para suprir as demandas de K das culturas, o cloreto de potássio (KCl) é a fonte mais utilizada. Porém, a alta dependência de sua importação para suprir a demanda nacional leva à necessidade de se avaliar a eficiência de outras fontes desse nutriente. Objetivou-se avaliar a eficiência agronômica de fonolito in natura e de sua mistura com uma fonte solúvel em água (KCl), para capim Paiaguás. O experimento foi conduzido em casa-de-vegetação, com Latossolo Vermelho distrófico de textura média, adotando-se delineamento inteiramente casualizado, em esquema fatorial 3 x 5, sendo três fontes (KCl, fonolito e mistura de 30 % de KCl + 70 % de fonolito) e cinco doses (0; 50; 100; 150; e 200 mg kg-1) de K, com quatro repetições. As doses de fonolito promoveram aumento linear na produção de massa seca, mas foi inferior ao KCl em todos os cortes, enquanto a mistura de KCl (30 %) e fonolito (70 %) aumentou a eficiência fertilizante, em relação ao fonolito aplicado exclusivamente, mostrando-se intermediária. A eficiência agronômica foi de 29 e 63 % para o fonolito e a mistura, respectivamente, e os níveis críticos de K no solo e na parte aérea foram, respectivamente, 1,4 mmolc dm-3 e 8,7 g kg-1.

ABSTRACT Potassium chloride (KCl) is the most widely used potassium source to meet crops requirements. However, Brazil’s dependence on imports to meet the national demand demonstrates the need to assess the efficiency of other sources of this nutrient. The present study aimed to assess the agronomic efficiency of phonolite in natura and its mixture with a water-soluble source (KCl), for Paiaguás palisadegrass. The experiment was conducted in a greenhouse, with a sandy clay loam typic Hapludox. A completely randomized block design was used, in a 3 x 5 factorial scheme, consisting of three K sources (KCl, phonolite and a 30 % of KCl + 70 % of phonolite blend) and five doses of the nutrient (0, 50, 100, 150 and 200 mg kg-1), with four replications. The phonolite doses promoted a linear increase in the dry weight production, albeit inferior to KCl for all the cuttings, whereas the KCl (30 %) and phonolite (70 %) blend showed a better fertilization efficiency than phonolite alone, which exhibited an intermediate effect. The agronomic efficiency was 29 % for the phonolite alone and 63 % for the blend, and the critical K levels in the soil and shoots were, respectively, 1.4 mmolc dm-3 and 8.7 g kg-1.

The Portuguese College of Obstetrics and Gynecology has been following the evolution of the COVID 19 pandemic since its beginning and all the impact in terms of clinical activities in different areas of the Specialty. Likewise, there has been a concern about how changes in the functioning of the Departments of Obstetrics and Gynecology have been reflected in the Specific Training Internship. This matter was discussed at one of the College Board's meetings, and an opinion document was sent to the National Council of Postgraduate Studies of the Medical College of Physicians.

Resumo Este estudo analisa as diferenças entre os casos de violência contra a mulher, formalizados em boletins de ocorrência (BO) na Delegacia de Defesa da Mulher (DDM), durante a rotina dos formalizados nas Delegacias Civis durante os plantões policiais, em um município de médio porte do interior paulista. Trata-se de um estudo transversal, com base nos BOs realizados no período de um ano (2013/2014). As ocorrências foram diferenciadas conforme o período em que foram lavrados os BOs, na rotina ou nos plantões, sendo este último tomado como variável dependente. As comparações entre os grupos foram realizadas pelo teste χ2. Foram registrados 440 boletins, sendo 373 na rotina e 67 no plantão. As ocorrências realizadas nos plantões apresentaram maior ameaça à integridade da mulher com um maior número de flagrantes do agressor, solicitação de medidas protetivas e gravidade das agressões, como hematomas, hospitalização e encaminhamento ao IML; caracterizando maior gravidade das ocorrências no período em que a DDM está fechada. Deste modo, falta às mulheres um serviço especializado de acolhimento e ampla garantia de direitos nos períodos de maior risco e vulnerabilidade.

Abstract The study analyzes the differences among cases of violence against women registered in police reports (PR) at the Women’s Protection Police Station (WPPS) during regular working hours, and those registered during after-hours, in a medium-sized city in the inland state of São Paulo, Brazil. This is a cross-sectional study based on data from PRs registered for one year (2013/2014). PRs were differentiated by period of registration, at regular working hours and after-hours (dependent variable). A chi-square test was used to compare groups. In total, 440 PRs were registered, 373 during regular working hours, and 67 during after-hours. Cases of violence registered during after-hours evidenced more significant threats to women’s integrity, as shown by the higher number of cases of perpetrators’ flagrante delicto, requests for protective measures and greater severity of assaults, such as bruises, need for hospitalization and referral to forensic medicine (IML), which characterize the greater severity of occurrences when WPPS are closed. Thus, women lack a specialized reception service and a full guarantee of rights in periods of highest risk and vulnerability.

Resumo Este estudo analisa as diferenças entre os casos de violência contra a mulher, formalizados em boletins de ocorrência (BO) na Delegacia de Defesa da Mulher (DDM), durante a rotina dos formalizados nas Delegacias Civis durante os plantões policiais, em um município de médio porte do interior paulista. Trata-se de um estudo transversal, com base nos BOs realizados no período de um ano (2013/2014). As ocorrências foram diferenciadas conforme o período em que foram lavrados os BOs, na rotina ou nos plantões, sendo este último tomado como variável dependente. As comparações entre os grupos foram realizadas pelo teste χ2. Foram registrados 440 boletins, sendo 373 na rotina e 67 no plantão. As ocorrências realizadas nos plantões apresentaram maior ameaça à integridade da mulher com um maior número de flagrantes do agressor, solicitação de medidas protetivas e gravidade das agressões, como hematomas, hospitalização e encaminhamento ao IML; caracterizando maior gravidade das ocorrências no período em que a DDM está fechada. Deste modo, falta às mulheres um serviço especializado de acolhimento e ampla garantia de direitos nos períodos de maior risco e vulnerabilidade.

Abstract The study analyzes the differences among cases of violence against women registered in police reports (PR) at the Women’s Protection Police Station (WPPS) during regular working hours, and those registered during after-hours, in a medium-sized city in the inland state of São Paulo, Brazil. This is a cross-sectional study based on data from PRs registered for one year (2013/2014). PRs were differentiated by period of registration, at regular working hours and after-hours (dependent variable). A chi-square test was used to compare groups. In total, 440 PRs were registered, 373 during regular working hours, and 67 during after-hours. Cases of violence registered during after-hours evidenced more significant threats to women’s integrity, as shown by the higher number of cases of perpetrators’ flagrante delicto, requests for protective measures and greater severity of assaults, such as bruises, need for hospitalization and referral to forensic medicine (IML), which characterize the greater severity of occurrences when WPPS are closed. Thus, women lack a specialized reception service and a full guarantee of rights in periods of highest risk and vulnerability.

Resumo Objetivos: estimar a prevalência de incontinência urinária (IU) na gestação, identificar e quantificar fatores associados à IU gestacional. Métodos: estudo transversal realizado com mulheres admitidas para o parto nas maternidades da cidade de Botucatu (São Paulo). Foi utilizado um questionário estruturado, baseado na literatura, contendo perguntas sobre a ocorrência de IU, seus tipos, fatores de riscos e momentos que ocorreram as perdas urinárias. Associações entre a ocorrência de IU e as variáveis preditoras foram analisadas por meio de modelos de regressão logística. Resultados: 950 mulheres foram entrevistadas, dessas 472 queixaram-se de perdas urinárias no período gestacional, resultando em uma prevalência de 49,68% (IC95%= 46,51 - 52,86), sendo a maioria (61,8%) classificada como IU mista. Entre as covariáveis investigadas, tabagismo (OR= 4,56), consumo drogas ilícitas (OR= 25,14), alimentos estimulantes (OR=1,84), constipação intestinal (OR= 1,99), distúrbios hipertensivos na gestação (OR=3,23), diabetes mellitus gestacional (OR= 2,89), paridade (OR=1,52) e parto cesárea (OR= 2,56) aumentaram a chance de perdas urinárias na gestação. Conclusões: houve uma alta prevalência de IU no período gestacional. Esta condição esteve fortemente associada à fatores como hábitos de vida e morbidades gestacionais. Por fim, merece destaque o achado que o parto via cesárea aumentou a chance de IU em gestação subsequente.

Abstract Objectives: to determine the prevalence of urinary incontinence (UI) during pregnancy, to identify and quantify the factors associated with gestational UI. Methods: a cross-sectional study carried out with women admitted for deliveries in all maternity wards in the city of Botucatu (São Paulo). Data were collected through a structured questionnaire, based on the literature, containing questions about the occurrence of UI, its types, risk factors and moments when urinary losses occurred. Associations between UI and the predictive variables were analyzed with logistic regression models. Results: 950 women were interviewed, out of which 472 complained of urinary losses during pregnancy, resulting in a prevalence of 49.68% (CI95%= 46.51 - 52.86). The majority (61.8%) were classified as mixed UI. Among the covariates investigated, smoking (OR= 4.56), illicit drugs use (OR= 25.14), stimulant foods (OR= 1.84), constipation (OR=1.99), hypertensive disorders during gestation (OR= 3.23), gestational diabetes mellitus (OR= 2.89), parity (OR= 1.52) and previous caesarean sections (OR= 2.56) increased the chance of urinary losses during pregnancy. Conclusions: there was a high prevalence of UI during pregnancy. This condition was strongly associated with lifestyle habits and gestational morbidities. Finally, it is worth high-lighting the fact that delivery via caesarean section increased the chance of UI in subsequent pregnancies.

Overview and Aims: Preterm labour (PTL) represents 7-8% of all Portuguese labours. Its management is marked by ongoing controversies, resulting in systematic variability in management in different institutions. We present an assessment of agreement among national and international PTL management guidelines. Methods: A search for PTL management guidelines was performed. The following contents were extracted: Definition of Threatened PTL (TPTL) or Established (EPTL), Prevention, Diagnosis, Tocolysis, Fetal Lung Maturation and Neuroprotection. An interguideline agreement analysis was performed using a consensus obtained through a modified Delphi approach. A score of 1, 0.5 or 0 was given, for "agreement" (similar clinical significance), "partial disagreement" (differences with possible clinical significance) and "disagreement" (differences with clinical significance), respectively. Median inter-guideline agreement scores (MCct) and inter-observer Proportions of Agreement were calculated. Results: Five national protocols fulfilled selection criteria. Four international guidelines were also considered: WHO, ACOG, NICE and European Association of Perinatal Medicine. Nationwide, more significant inter-guideline disagreements related to definition of EPTL, Prevention and Diagnosis, with MCct of 0,25. TPTL, Tocolysis, Fetal Pulmonary Maturation and Neuroprotection were similarly agreeing, with MCct of 0,5. In international guidelines only four clinical categories were analyzed, with Neuroprotection achieving a MCct of 0,75; EPTL and Pulmonary Maturation reaching a MCct of 0,25; and Tocolysis presenting the lowest MCct of 0,00. Discussion: There are differences among the PTL management guidelines published internationally and in Portugal that may have clinical significance. Further research is warranted to evaluate the potential for assembling a wider national consensus through more explicit health policies.

Overview and aims: Caesarean section has been considered the optimal mode of delivery for breech presentations, but in selected cases breech vaginal delivery (BVD) may be acceptable. The aim of this study was to evaluate the importance attributed by obstetricians and gynecologists (ObGyns) to a set of good prognostic factors for BVD. Study Design: Cross-sectional study Population: Specialists and residents of Obstetrics and Gynecology from two hospitals with advanced perinatal support. Methods: Fifteen good prognostic factors for BVD were scored by ObGyns, according to a 5-point Likert scale (5=maximum clinical relevance). Medians and interquartile ranges were calculated and the Mann-Whitney test was used to compare ObGyns with experience with <15 versus ≥15 BVD. Results: Of the 58 participants, 74.1% were specialists but only 34.4% had experience with ≥15 BVD. Twelve of the 15 good prognostic factors were scored with a median of 4, while two factors (>10 years of experience in BVD and training in fetal head extraction with forceps) obtained a median of 5 and one (maternal pelvis imaging evaluation) a median of 2. The main differences between more or less experienced ObGyns was in the importance given by the former to training with simulators (p=0.006) and existence of internal protocol for BVD assistance (p= 0.032). Conclusion: Most good prognostic factors for BVD were well scored by ObGyns, but it is disturbing that the two most scored ones (experience in BVD assistance and training in fetal head extraction with forceps) represent areas with reported low levels of experience among us

Abstract: This article is the result of the research carried out in intervention services with male perpetrators of domestic violence against women (HAV) in the State of Minas Gerais, Brazil. The objective was to investigate the theoretical and methodological bases of intervention policies with HAV. In each of the four organizations identified, two semi-structured interviews were conducted with the institutional managers and professionals facilitating the groups, completing eight interviews. The analysis of the conceptions and meanings attributed by the interviewees, reflected in their theoretical-explanatory lines and methodologies, revealed different theoretical-argumentative biases that operate from different scientific assumptions for the interpretation of the phenomenon of violence against women, different conceptions about HAV, and approaches used to overcome it. The proposed reflections update important debates about these assumptions, contributing to the discussion about the improvement of these works, the capacity for change of men, and the paradigmatic development alternative to traditional science.

Resumo: Este artigo é o resultado da pesquisa realizada nos serviços de intervenção junto a homens autores de violência doméstica contra mulheres (HAV) no Estado de Minas Gerais, Brasil. O objetivo foi investigar as bases teórico-metodológicas das políticas de intervenção junto a HAV. Em cada uma das quatro organizações identificadas, foram realizadas duas entrevistas semiestruturadas com os gestores institucionais e profissionais facilitadores dos grupos, sendo um total de oito entrevistas realizadas. A análise das concepções e sentidos atribuídos pelos entrevistados, refletidos em suas linhas teórico-explicativas e metodologias, revelou diferentes vieses teórico-argumentativos que operam desde distintos pressupostos da ciência para a interpretação do fenômeno da violência contra as mulheres, diferentes concepções sobre HAV e de enfoques empregados para superá-lo. As reflexões propostas atualizam importantes debates acerca desses pressupostos, contribuindo para a discussão sobre o aprimoramento desses trabalhos, para a capacidade de mudança dos homens e para o desenvolvimento paradigmático alternativo à ciência tradicional.

OBJETIVO: Avaliar a efetividade de um manual de orientação de exercícios domiciliares (MOED) para o assoalho pélvico (AP) na promoção da continência urinária em gestantes primigestas.MÉTODOS: Ensaio clínico com 87 participantes, avaliadas 6 vezes durante a gestação e divididas aleatoriamente em 3 grupos: Grupo supervisionado (Gsup), que praticou exercícios com supervisão; Grupo observado (Gobs), que praticou exercícios sem supervisão, e Grupo referência (Gref), que não praticou exercícios. Incontinência urinária (IU) (desfecho primário) e força muscular perineal (FMP) (desfecho secundário) foram avaliadas por intermédio de diário de perdas urinárias e perineometria, respectivamente. Foram utilizados o teste de Kruskal-Wallis, seguido do teste post hoc de Dunn, para variáveis contínuas, e o teste do χ2 e testes Z, com correções de Bonferroni, para proporções, com nível de significância de 5%.RESULTADOS: O Gsup e o Gobs apresentaram 6,9% de gestantes incontinentes, enquanto o Gref apresentou 96,6% de incontinentes. Quanto à FMP, o Gsup e o Gobs apresentaram valores médios de contração de 10 e 8,9 cmH2O, respectivamente, enquanto o Gref apresentou valor de 4,7 cmH2O. Ambos os resultados significantes.CONCLUSÃO: A utilização de um MOED é eficaz na promoção da continência urinária e no aumento da FMP em gestantes primigestas, independentemente de supervisão permanente.

PURPOSE: To evaluate the effectiveness of an illustrated home exercise guide targeting the pelvic floor muscles in promoting urinary continence during pregnancy.METHODS: A randomized clinical trial was performed with 87 participants, evaluated six times during pregnancy and divided into three groups: Gsup, supervised; Gobs, not supervised, and Gref, women who did not perform the home exercises program. A miction diary and perineometry were used to evaluate urinary incontinence (primary outcome) and pelvic floor muscle strength (secondary outcome), respectively. The Kruskal-Wallis test with post hoc Dunn's and chi-square and Z tests with Bonferroni correction were used for continuous variables and proportions, respectively, with the level of significance set at 5%.RESULTS: At the end of the study, 6.9% of pregnant women in the Gsup and Gobs had urinary incontinence, while 96.6% of Gref women were incontinent. Regarding pelvic floor muscle function, Gsup and Gobs had mean contractions of 10 and 8.9 cmH2O, respectively, while Gref had a value of 4.7 cmH2O. Both results were significant.CONCLUSION: An illustrated home exercise guide targeting the pelvic floor muscles is effective in promoting urinary continence during pregnancy, even without permanent supervision.

Introdução: As transformações das últimas décadas têm influenciado as circunstâncias do nascimento e a vivência da maternidade. Neste estudo, avaliaram-se as características atuais da gravidez e parto em Portugal. Métodos: Estudo quantitativo, observacional descritivo e transversal. A população-alvo foram as 96925 puérperas portuguesas do ano 2007 e a amostra composta por 2505 puérperas de 19 hospitais de todo o país que responderam a um questionário. Resultados: A média de idades das puérperas foi de 29,4 anos, tendo 16,7% mais de 35 anos. O número médio de filhos já nascidos por mulher foi de 1,56, tendo 89,5% dos partos ocorrido nas regiões do Norte, Centro e Lisboa. Em 73,4% as gravidezes foram planeadas, tendo apenas 0,2% sido não vigiadas. Ocorreram complicações em 21,3%, tais como ameaça de abortamento (4,0%) e diabetes (3,0%). Em 21,4% houve preparação para o parto, que foi realizado por médico em 53,9%, com uma idade gestacional média de 38,8 semanas, tendo sido eutócico em 54,5% e cesariana em 34,7%. Registou-se analgesia epidural em 74,7% dos casos e em 74,5% dos partos eutócicos houve acompanhante. Conclusões: Registou-se uma elevada idade da mulher ao nascimento de um filho, um número médio de filhos próximo de um e um número elevado de nascimentos fora do casamento. Mais de metade dos partos foram realizados por médicos, com uma taxa de cesarianas elevada, a par de uma boa cobertura nacional de analgesia epidural e de presença de acompanhante.

Introduction: Recent transformations have influenced the circumstances of birth and the experience of motherhood. We assessed the actual characteristics of pregnancy and birth giving in Portugal. Methods: Quantitative, observational, descriptive cross-sectional study. The studied population were the 96925 puerperal women of year 2007 and the sample the 2505 women from 19 hospitals from all over the country, who answered a questionnaire. Results: The puerperal women were on average 29.4 years old and 16.7% were over 35. The average number of children was 1.56, with 89.5% of deliveries in the North and Centre of the country and in Lisbon. 73.4% of pregnancies were planned and only 0.2% were not medically supervised. Complications occurred in 21.3% of the cases, namely miscarriage (4.0%) and diabetes (3.0%). in 21.4% of pregnancies there was training for childbirth. delivery was performed by a physician in 53.9% of cases, at 38.8 weeks average gestational age. Eutocic delivery occurred in 54.5% of cases and caesarean section in 34.7%. Epidural analgesia occurred in 74.7% of cases and 74.5% of eutocic births had the presence of a support person. Conclusions: With a late age for having children, an average number of children close to one and a high rate of births form non-married couples. More than half of the deliveries were performed by a physician with a high caesarean section rate and a wide national availability of epidural analgesia and of a support person for the mother.

OBJETIVO: Analisar comparativamente as condições de nascimento em Portugal e no Brasil, no período entre 1975 a 2007. MÉTODOS: Os indicadores de saúde materno-infantis, razão de morte materna, mortalidade neonatal, taxa de cesarianas e gastos públicos em saúde, foram retrospectivamente coletados nas bases eletrônicas de informação do Sistema Único de Saúde (DATASUS), Instituto Nacional de Estatística de Portugal (INE), entre outras. Seus valores foram analisados descritivamente quanto a sua tendência e os cenários sanitários nos quais transcorreram foram apresentados e discutidos, comparando-se, sempre que possível, as informações dos dois países. RESULTADOS: Os nascimentos em Portugal caracterizaram-se por baixa mortalidade materna (12,2x76,2/100.000) e mortalidade neonatal (2,2x14,6/1000), comparativamente ao Brasil, na média dos anos 2004 a 2007. O histórico da conquista de indicadores materno-infantis de excelência em Portugal envolveu uma fase que transcorreu paralela às expressivas melhorias socioeconômicas e ao aporte crescente de recursos públicos em saúde, seguida de outra a partir da década de 1990, simultânea ao melhor aparelhamento das unidades de assistência à saúde. No Brasil, os índices de mortalidade materna e neonatal estão em queda, mas valores satisfatórios ainda não foram conquistados. A diferença histórica no montante do gasto público em saúde foi uma discrepância importante entre os países. A despeito das disparidades nos resultados maternos e neonatais, as taxas de cesariana mostraram-se igualmente ascendentes (34,5% em Portugalx45,5% no Brasil), na média do período 2004 a 2007. CONCLUSÃO: Os indicadores da morte materna e neonatal em Portugal e no Brasil alinharam-se às diferenças sociais, econômicas e aos aportes de investimentos públicos em saúde. As crescentes taxas de cesariana não explicam as discrepâncias no resultado materno e neonatal entre os países.

PURPOSE: To analyze comparatively the conditions of birth in Portugal and Brazil from 1975 to 2007. METHODS: Indicators of maternal and child health: rates of maternal death and neonatal mortality, cesarean rate and public spending on health were retrospectively collected from electronic databases of health information from the Unified Health System (DATASUS) and the National Institute of Statistics of Portugal (INE), among others. Their values were descriptively analyzed in terms of trends and the temporal sanitary scenarios were presented and discussed, comparing, when possible, the information from the two countries. RESULTS: Births in Portugal were characterized by lower maternal mortality (12.2x76.2/100.000) and neonatal mortality (2.2x14.6/1000), compared to Brazil, considering the average of the years from 2004 to 2007. The history of the conquest of maternal and child indicators of excellence in Portugal involved a phase that paralleled the significant socio-economic improvements and the increasing contribution of public health, followed by another from the 1990s, involving better equipped health care units. In Brazil, rates of maternal and neonatal mortality are declining, but satisfactory values have not yet been achieved. The historical difference in the amount of social spending on health, both in current and historical values, was a crucial difference between countries. Despite the disparities in maternal and neonatal outcomes, cesarean section rates were equally ascendant (34.5% in Portugal and 45.5% in Brazil), considering the average for the period from 2004 to 2007. CONCLUSION: The indicators of maternal and neonatal death in Portugal and Brazil have aligned themselves to social, economic and contributions of public investments in health. The increasing rates of caesarean section do not explain the discrepancies in maternal and neonatal outcome between countries.