Effects of the immediate postpartum insertion of the etonogestrel implant on the development of breastfed infants: Results from a randomized controlled trial Mariane Nunes de Nadai, Maria Beatriz Martins Linhares, Juliana Cunha de Lima Rodrigues Sisdeli, Lilian Sheila de Melo Pereira do Carmo, Giordana Campos Braga, et al. International Journal of Gynecology and Obstetrics, 2025 ObjectivesTo evaluate motor, cognitive, language, and social–emotional development in breastfed infants whose mothers received the etonogestrel (ENG) implant either immediately postpartum or at 6 weeks postpartum.MethodsThis was a secondary analysis from a randomized controlled trial involving 100 postpartum women and their infants. Postpartum women were block‐randomized to receive the ENG implant either within 48 h of delivery (early insertion group, n = 50) or at 6 weeks postpartum (delayed insertion group, n = 50). We focused on infant development assessed at 6–8 months and 12–15 months using the Bayley‐III Scales of Infant and Toddler Development (BSID‐III). The study was conducted at the University Hospital of Ribeirão Preto Medical School, Brazil. Sociodemographic and clinical characteristics were compared using t tests and χ2 tests. BSID‐III composite scores were analyzed using mixed‐effects linear regression.ResultsA total of 79 infants completed at least one developmental assessment. No significant differences in baseline sociodemographic and clinical characteristics were observed between groups. At 6–8 months, BSID‐III composite scores across all domains were similar between groups. At 12–15 months, the early insertion group had a significantly higher mean motor score compared with the delayed group (108 ± 11 vs. 99 ± 14, P = 0.003), but no significant differences were found in the other domains.ConclusionImmediate postpartum ENG implant insertion did not negatively impact infant development up to 12–15 months.Clinical trial registrationThis study was registered on https://clinicaltrials.gov/, registration number NCT02469454, Link: https://www.clinicaltrials.gov/study/NCT02469454?term=NCT02469454%20&rank=1#study‐overview; date of registration: June 9, 2015.
Trends in advanced maternal age pregnancies in Brazil: a time-series study (2011–2021) Enzo Bogucheski Ribeiro Machado, Ricardo Pinal de Mello, Thais Francielle de Souza, Ariane Giansante Souza, Mariane Nunes de Nadai, et al. Revista Da Associacao Medica Brasileira, 2025 SUMMARY OBJECTIVE: The aim of the study was to assess national trends in advanced maternal age pregnancies in Brazil between 2011 and 2021 and discuss their implications for maternal health care planning. METHODS: This ecological time-series study analyzed data from the Brazilian Live Birth Information System between 2011 and 2021. Births among women aged ≥35 years were identified, and temporal trends were evaluated using segmented regression models (joinpoint regression) to estimate Annual Percent Change and Average Annual Percent Change, both nationally and across the five Brazilian macro-regions. RESULTS: A sustained increase in pregnancies among women of advanced maternal age was observed nationwide. From 2011 to 2019, the Annual Percent Change in Brazil was 5.3%, followed by a slower rise from 2019 to 2021 (Annual Percent Change=2.4%). The most pronounced growth was seen among women aged ≥45 years after 2016 (Annual Percent Change=6.4%). Regionally, the highest Average Annual Percent Changes were observed in the Central-West (5.5%), Northeast (5.2%), and North (5.0%), reflecting geographic variations in the pace and timing of this demographic shift. The overall Average Annual Percent Change for Brazil was 4.7%, confirming a consistent upward trend over the study period. CONCLUSION: The rising prevalence of advanced maternal age in Brazil reflects broader demographic and social trends. Public health strategies must adapt to this reality, strengthening prenatal care and risk management protocols for older mothers.
Rib myelolipoma: a case report André Amate Neto, Felipe Ramos Camargo Preto, Amanda Tollini de Moraes, Sarah Lopes Salomão, Thiago Barreto Frederigue, et al. Journal of Medical Case Reports, 2024 Background Myelolipoma is an uncommon benign tumor composed of mature adipose tissue and hematopoietic elements. These tumors generally affect the adrenal glands, with anomalous presentations being rare and with few cases described in the literature. Most myelolipomas are asymptomatic and discovered incidentally, either through imaging tests or at autopsies. However, depending on the location and size of the lesion, myelolipomas can cause symptoms of mass effect. This article aims to report a very rare presentation of a symptomatic primary myelolipoma affecting the ribs. Case presentation A 21-year-old white female patient presented with a complaint of burning chest pain over 3 months, with gradual worsening in intensity, accompanied by a progressively growing bulge in the right thoracic wall. The patient underwent thoracotomy of the fifth and sixth ribs with complete excision of the lesion with a safety margin. Thoracic wall reconstruction was performed using a polypropylene mesh. The patient had a good postoperative course and was discharged on postoperative day 3. Histopathological examination revealed a histological image consistent with myelolipoma. Conclusions This report underscores the importance of considering a myelolipoma diagnosis for tumor masses in the ribs.
Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study Ênio Luis Damaso, Heloisa Bettiol, Viviane Cunha Cardoso, Mariane Nunes de Nadai, Elaine Christine Dantas Moisés, et al. Revista Brasileira De Ginecologia E Obstetricia Revista Da Federacao Brasileira Das Sociedades De Ginecologia E Obstetricia, 2024 Objective: To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life. Methods: Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated. Results: The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied. Conclusion: Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.
Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study Ênio Luis Damaso, Heloisa Bettiol, Viviane Cunha Cardoso, Mariane Nunes de Nadai, Elaine Christine Dantas Moisés, et al. Revista Brasileira De Ginecologia E Obstetricia, 2024 Objective: To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life. Methods: Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated. Results: The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied. Conclusion: Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.
Fear of Childbirth: It is Time to Talk about It! Cibele Santini de Oliveira Imakawa, Mariane Nunes de Nadai, Monica Iassana dos Reis, Silvana Maria Quintana, Elaine Christine Dantas Moises Revista Brasileira De Ginecologia E Obstetricia, 2022
