ROSSANA PULCINELI VIEIRA FRANCISCO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Dietary Pattern Influences Gestational Weight Gain: Results from the ProcriAr Cohort Study-Sao Paulo, Brazil(2022) SALDIVA, Silvia Regina Dias Medici; NETA, Adelia da Costa Pereira De Arruda; TEIXEIRA, Juliana Araujo; PERES, Stela Verzinhasse; MARCHIONI, Dirce Maria Lobo; CARVALHO, Mariana Azevedo; VIEIRA, Sandra Elisabete; FRANCISCO, Rossana Pulcineli VieiraThe maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in Sao Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit (<14 weeks) was used as a proxy for pre-pregnancy weight. Food consumption was assessed using the 24HR method, administered twice at each gestational trimester, and dietary patterns were identified by principal component analysis. Three dietary patterns were identified: ""Vegetables and Fruits,"" ""Western,"" and ""Brazilian Traditional."" Descriptive data analysis was performed using absolute and relative frequencies for each independent variable and multilevel mixed-effects logistic regression was used to analyze excessive gestational gain weight (EGWG) and dietary patterns (DP). The Brazilian Traditional dietary pattern showed a protective effect on EGWG (p = 0.04) and age > 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child's health.
- Placental pathological findings in coronavirus disease 2019: Perinatal outcomes(2022) ARCOS JUNIOR, Gelson Farias; FRANCISCO, Rossana Pulcineli Vieira; KILL, Beatriz; PERES, Stela Verzinhasse; GIBELLI, Maria Augusta B. C.; IBIDI, Silvia Maria; CARVALHO, Werther Brunow de; SIMOES, Angelica Braz; BRIZOT, Maria de Lourdes; SCHULTZ, Regina; CARVALHO, Mariana AzevedoIntroduction: Placental alterations caused by severe acute respiratory coronavirus-2 (SARS-CoV-2) infection have already been described, but most studies used small sample groups and the difference according to the severity of the disease has not been verified. Our objective was to describe placental alterations in patients with coronavirus disease 2019 (COVID-19) and analyze the association of pathological placental findings with the clinical pa-rameters of COVID-19 and perinatal results.Methods: This was a nested study within a prospective cohort study involving 109 symptomatic pregnant women with COVID-19. The prevalence of observed placental alterations was described, and the associations of path-ological findings with the clinical parameters of COVID-19 severity and with perinatal outcomes were assessed.Results: The frequency of types of placental features was poor maternal vascular perfusion in 45% of cases, poor fetal vascular perfusion in 33.9%, hematogenous origin infection in 32.1%, and morphological changes corre-sponding to ascending infection in 21.1%. Hematogenous infection differed significantly according to COVID-19 severity (p = 0.008), with a prevalence ratio (PR) of 1.74 (95% confidence interval, 1.02-2.98) in the moderate COVID-19 group compared to the mild COVID-19 group. Among the perinatal outcomes, there was an unex-pected inverse association between prematurity and placental infection of hematogenous origin, with lower rates of prematurity among cases with inflammation of hematogenous origin (p = 0.029).Discussion: Moderate SARS-Cov-2 infection presented a higher prevalence of placental pathological findings. There was no association of placental findings with adverse perinatal outcomes.
- Post-Viral Fatigue Following SARS-CoV-2 Infection during Pregnancy: A Longitudinal Comparative Study(2022) OLIVEIRA, Ana Maria da Silva Sousa; CARVALHO, Mariana Azevedo; NACUL, Luis; CABAR, Fabio Roberto; FABRI, Amanda Wictky; PERES, Stela Verzinhasse; ZACCARA, Tatiana Assuncao; O'BOYLE, Shennae; ALEXANDER, Neal; TAKIUTI, Nilton Hideto; MAYAUD, Philippe; BRIZOT, Maria de Lourdes; FRANCISCO, Rossana Pulcineli VieiraStudies reported post-COVID-19 fatigue in the general population, but not among pregnant women. Our objectives were to determine prevalence, duration, and risk factors of post-viral fatigue among pregnant women with SARS-CoV-2. This study involved 588 pregnant women with SARS-CoV-2 during pregnancy or delivery in Brazil. Three groups were investigated: G1 (n = 259, symptomatic infection during pregnancy); G2 (n = 131, positive serology at delivery); G3 (n = 198, negative serology at delivery). We applied questionnaires investigating fatigue at determined timepoints after infection for G1, and after delivery for all groups; fatigue prevalence was then determined. Cox regression was used to estimate hazard ratio (HR) and 95% CI of the risk of remaining with fatigue in G1. Overall fatigue prevalence in G1 at six weeks, three months and six months were 40.6%, 33.6%, and 27.8%, respectively. Cumulative risk of remaining with fatigue increased over time, with HR of 1.69 (95% CI: 0.89-3.20) and 2.43 (95% CI: 1.49-3.95) for women with moderate and severe symptoms, respectively. Multivariate analysis showed cough and myalgia as independent risk factors in G1. Fatigue prevalence was significantly higher in G1 compared to G2 and G3. Post-viral fatigue prevalence is higher in women infected during pregnancy; fatigue's risk and duration increased with the severity of infection.