RAFAELA ALKMIN DA COSTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
32 resultados
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bookPart Placenta, sistema amniótico e cordão umbilical(2020) PAGANOTI, Cristiane de Freitas; CABAR, Fábio Roberto; MIKAMI, Fernanda Cristina Ferreira; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor- Influência da amamentação nos resultados do teste oral de tolerância à glicose pós-parto de mulheres com diabetes mellitusgestacional(2015) DIJIGOW, Fernanda Borges; PAGANOTI, Cristiane de Freitas; COSTA, Rafaela Alkmin da; FRANCISCO, Rossana Pulcineli Vieira; ZUGAIB, MarceloPURPOSE: To determine the influence of breastfeeding on the results of a postpartum oral glucose tolerance test in women recently diagnosed with gestational diabetes mellitus. METHODS: The data were obtained from the electronic medical records of the Endocrinopathy Sector during pregnancy, HCMED laboratory system ofHospital das Clínicas of São Paulo , and by telephone. According to the inclusion criteria adopted, 132 patients were eligible for the study. For statistical analysis, the patients were divided into two groups according to whether or not they breastfed. The results were analyzed by the Student t-test and by the Mann-Whitney, Chi-square and Fisher's exact tests, depending on the variable analyzed, with the level of significance set at p<0.05. RESULTS: Of the 132 patients included in the study, 114 breastfed and 18 did not. Most of the patients in both groups were overweight or obese. The breastfeeding group had a lower pre-pregnancy Body Mass Index than the non-breastfeeding group (p=0.006). Insulin was introduced earlier in the group that did not breastfeed (23.21±4.33 versus 28.84±6.17; p=0.04). The group that did not breastfeed had a higher mean postpartum fasting glucose value in the oral glucose tolerance test than the group that breastfed (91.3±8.7 versus 86.5±9.3; p=0.01). Breastfeeding acted as a protective factor against the development of glucose intolerance in the postpartum oral glucose tolerance test (OR=0.27; 95%CI 0.09-0.8). By logistic regression, breastfeeding was shown to be an independent protective factor. CONCLUSION: There was a statistically significant relationship between breastfeeding and a decreased risk of developing glucose intolerance. Breastfeeding should be encouraged because it is an effective, low cost intervention easily accessible to all patients during the postpartum period.
bookPart Obesidade e gravidez(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças endócrinas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças tromboembólicas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Anatomia da pelve feminina(2020) PAGANOTI, Cristiane de Freitas; CABAR, Fábio Roberto; MIKAMI, Fernanda Cristina Ferreira; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Doenças neurológicas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli VieirabookPart Doenças dermatológicas(2020) YOSHIZAKI, Carlos Tadashi; TESTA, Carolina Burgarelli; PAGANOTI, Cristiane de Freitas; BAPTISTA, Fernanda Spadotto; OSMUNDO JUNIOR, Gilmar de Souza; LIN, Lawrence Hsu; GALLETTA, Marco Aurélio Knippel; BORTOLOTTO, Maria Rita de Figueiredo Lemos; PEREIRA, Pedro Paulo; COSTA, Rafaela Alkmin da; RIBEIRO, Renata Lopes; FRANCISCO, Rossana Pulcineli Vieira- Diet Quality Indices and Physical Activity Levels Associated with Adequacy of Gestational Weight Gain in Pregnant Women with Gestational Diabetes Mellitus(2021) ALMEIDA, Vanessa Averof Honorato de; COSTA, Rafaela Alkmin da; PAGANOTI, Cristiane de Freitas; MIKAMI, Fernanda Cristina; SOUSA, Ana Maria da Silva; PERES, Stela Verzinhasse; LOPES, Marco Antonio Borges; FRANCISCO, Rossana Pulcineli VieiraThe aim of this study was to evaluate the Diet Quality Index (DQI) and the Physical Activity (PA) levels associated with adequacy of gestational weight gain in pregnant women with gestational diabetes mellitus (GDM). A total of 172 pregnant women with a single fetus and a diagnosis of GDM participated. Food intake was self-reported on the food frequency questionnaire and DQI was quantified using the index validated and revised for Brazil (DQI-R). To assess PA, the Pregnancy Physical Activity Questionnaire was administered. Gestational weight gain was classified, following the criteria of the Institute of Medicine, into adequate (AWG), insufficient (IWG), or excessive (EWG) weight gain. A multinomial logistic regression analysis was performed, with level of significance <0.05. The participants were divided into 3 groups: AWG (33.1%), IWG (27.3%), and EWG (39.5%). The analysis indicated that if the pregnant women PA fell into tertile 1 or 2, then they had a greater chance of having IWG, whereas those with the lowest scores on the DQI-R, whose PA fell into tertile 2, and pregestational obesity women had the greatest chance of having EWG. This study has shown that low PA levels may contribute towards IWG. On the other hand, a low final DQI-R score, representing inadequate food habits, low PA levels, and pregestational obesity may increase the chance of EWG in patients with GDM.
- The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19(2022) PAGANOTI, Cristiane de Freitas; RODRIGUES, Agatha Sacramento; FRANCISCO, Rossana Pulcineli Vieira; COSTA, Rafaela Alkmin daThe SARS-CoV-2 pandemic has imposed a huge challenge on the antenatal care of pregnant women worldwide, with the maternal mortality rate being raised to alarming levels. While COVID-19 vaccines were developed, some studies highlighted a possible relationship between influenza vaccination and lower odds of COVID-19 infection. As obstetric patients belong to a high-risk group for respiratory diseases, this study evaluated whether influenza vaccination reduces the severity of COVID-19 infection and mortality among pregnant and postpartum women. We conducted a retrospective cohort study on 3370 pregnant and postpartum women from the Brazilian national database, where they were grouped according to their influenza vaccination status before the onset of COVID-19 symptoms. The intensive care unit admission and intubation rates were significantly higher among subjects in the unvaccinated group (p = 0.002 and p < 0.001, respectively). The odds of mortality risk among those who received the vaccine was 0.33, with a 95% confidence interval of 0.23-0.47. The numbers of patients who needed to be vaccinated to avoid a case of intensive care unit admission, intubation, or death due to COVID-19 were 11, 15, and 11, respectively. Influenza vaccines could confer protection against severe COVID-19 infection in pregnant and postpartum women.