Browsing by Author "Rodrigues, Carina"
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- Impact of UGT1A1 gene variants on total bilirubin levels in Gilbert syndrome patients and in healthy subjectsPublication . Rodrigues, Carina; Vieira, Emília; Santos, Rosário; Carvalho, João de; Santos-Silva, Alice; Costa, Elísio; Bronze-da-Rocha, ElsaThe Gilbert syndrome is a benign form of unconjugated hyperbilirubinemia, mainly associated with alterations in UGT1A1 gene. This work investigated the effect of UGT1A1 variants on total bilirubin levels in Gilbert patients (n = 45) and healthy controls (n = 161). Total bilirubin levels were determined using a colorimetric method; molecular analysis of exons 1–5 and two UGT1A1 promoter regions were performed by direct sequencing and automatic analysis of fragments. Five in silico methods predicted the effect of new identified variants. A significant different allelic distribution, in Gilbert patients and in controls, was found for two promoter polymorphisms. Among patients, 82.2% were homozygous and 17.8% heterozygous for the c.− 41_ − 40dupTA allele; in control group, 9.9% were homozygous and 43.5% heterozygous for this promoter variant, while 46.6% (n = 75) presented the [A(TA)6TAA]. For the T>G transition at c.− 3279 promoter region, in patients, 86.7% were homozygous and 13.3% heterozygous; in control group, 33.5% were homozygous for the wild type allele, 44.1% were heterozygous and 22.4% homozygous for the mutated allele. The two polymorphisms were in Hardy–Weinberg equilibrium in both groups. Sequencing of UGT1A1 coding region identified nine novel variants, five in patients and four in controls. In silico analysis of these amino acids replacements predicted four of them as benign and three as damaging. In conclusion, we demonstrated that total bilirubin levels are mainly determined by the TA duplication in the TATA-box promoter and by the c.− 3279T>G variant. Alterations in the UGT1A1 coding region seem to be associated with increased bilirubin levels, and, therefore, with Gilbert syndrome.
- Quality of maternal and newborn care around the time of childbirth for migrant versus nonmigrant women during the COVID-19 pandemic: results of the IMAgiNE EURO study in 11 countries of the WHO European regionPublication . the IMAgiNE EURO study group; Costa, Raquel; Rodrigues, Carina; Dias, Heloísa; Covi, Benedetta; Mariani, Ilaria; Valente, Emanuelle Pessa; Zaigham, Mehreen; Vik, Eline Skirnisdottir; Grylka-Baeschlin, Susanne; Arendt, Maryse; Santos, Teresa; Wandschneider, Lisa; Drglin, Zalka; Drandić, Daniela; Radetic, Jelena; Rozée, Virginie; Elden, Helen; Mueller, Antonia N.; Barata, Catarina; Miani, Céline; Bohinec, Anja; Ruzicic, Jovana; de La Rochebrochard, Elise; Linden, Karolina; Geremia, Sara; de Labrusse, Claire; Batram-Zantvoort, Stephanie; Ponikvar, Barbara Mihevc; Sacks, Emma; Lazzerini, MarziaObjective: To describe the perception of quality of maternal and newborn care (QMNC) around the time of childbirth among migrant and nonmigrant women in Europe. Methods: Women who gave birth at a health facility in 11 countries of the WHO European Region from March 2020 to July 2021 were invited to answer an online questionnaire including demographics and childbirth experience. Data were analyzed and compared for 1781 migrant and 20 653 nonmigrant women. Results: Migrant women who experienced labor perceived slightly more difficulties in attending routine antenatal visits (41.2% vs 39.4%; P = 0.001), more barriers in accessing facilities (32.9% vs 29.9%; P = 0.001), lack of timely care (14.7% vs 13.0%; P = 0.025), inadequate room comfort and equipment (9.2% vs 8.5%; P = 0.004), inadequate number of women per room (9.4% vs 8.6%; P = 0.039), being prevented from staying with their baby as they wished (7.8% vs 6.9%; P = 0.011), or suffering abuse (14.5% vs 12.7%; P = 0.022) compared with nonmigrant women. For women who had a prelabor cesarean, migrant women were more likely not to receive pain relief after birth (16.8% vs.13.5%; P = 0.039) and less likely to provide informal payment (1.8% vs 4.4%; P = 0.005) compared with nonmigrant women. Overall, the QMNC index was not significantly different for migrant compared with nonmigrant women. Conclusion: Gaps in overall QMNC were reported by both migrant and nonmigrant women, with improvements to healthcare necessary for all.
- Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: results of the IMAgiNE EURO study in 16 countriesPublication . IMAgiNE EURO study group; Lazzerini, Marzia; Valente, Emanuelle Pessa; Covi, Benedetta; Rozée, Virginie; Costa, Raquel; Otelea, Marina Ruxandra; Abderhalden-Zellweger, Alessia; Węgrzynowska, Maria; Linden, Karolina; Arendt, Maryse; Brigidi, Serena; Miani, Céline; Pumpure, Elizabete; Radetic, Jelena; Drandic, Daniela; Cerimagic, Amira; Nedberg, Ingvild Hersoug; Liepinaitienė, Alina; Rodrigues, Carina; de Labrusse, Claire; Baranowska, Barbara; Zaigham, Mehreen; Castañeda, Lara Martín; Batram-Zantvoort, Stephanie; Jakovicka, Dārta; Ruzicic, Jovana; Juciūtė, Simona; Santos, Teresa; Gemperle, Michael; Tataj-Puzyna, Urszula; Elden, Helen; Mizgaitienė, Marija; Lincetto, Ornella; Sacks, Emma; Mariani, IlariaObjective: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. Methods: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities. Results: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52–1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65–2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14–1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone. Conclusion: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution. ClinicalTrials.gov Identifier: NCT04847336.
- Regional differences in the quality of maternal and neonatal care during the COVID-19 pandemic in Portugal: results from the IMAgiNE EURO studyPublication . IMAgiNE EURO study group; Costa, Raquel; Barata, Catarina; Dias, Heloísa; Rodrigues, Carina; Santos, Teresa; Mariani, Ilaria; Covi, Benedetta; Valente, Emanuelle Pessa; Lazzerini, Marzia; Ćerimagić, Amira; Drandić, Daniela; Kurbanović, Magdalena; Virginie, Rozée; de La Rochebrochard, Elise; Löfgren, Kristina; Miani, Céline; Batram-Zantvoort, Stephanie; Wandschneider, Lisa; Morano, Sandra; Chertok, Ilana; Hefer, Emek; Artzi-Medvedik, Rada; Pumpure, Elizabete; Rezeberga, Dace; Jansone-Šantare, Gita; Jakovicka, Dārta; Knoka, Anna Regīna; Vilcāne, Katrīna Paula; Liepinaitienė, Alina; Kondrakova, Andželika; Mizgaitienė, Marija; Juciūtė, Simona; Arendt, Maryse; Tasch, Barbara; Nedberg, Ingvild Hersoug; Kongslien, Sigrun; Vik, Eline Skirnisdottir; Baranowska, Barbara; Tataj-Puzyna, Urszula; Węgrzynowska, Maria; Otelea, Marina RuxandraObjective: To compare women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth across Nomenclature of Territorial Units for Statistics 2 (NUTS-II) regions in Portugal during the COVID-19 pandemic. Methods: Women participating in the cross-sectional IMAgiNE EURO study who gave birth in Portugal from March 1, 2020, to October 28, 2021, completed a structured questionnaire with 40 key WHO standards-based quality measures. Four domains of QMNC were assessed: (1) provision of care; (2) experience of care; (3) availability of human and physical resources; and (4) reorganizational changes due to the COVID-19 pandemic. Frequencies for each quality measure within each QMNC domain were computed overall and by region. Results: Out of 1845 participants, one-third (33.7%) had a cesarean. Examples of high-quality care included: low frequencies of lack of early breastfeeding and rooming-in (8.0% and 7.7%, respectively) and informal payment (0.7%); adequate staff professionalism (94.6%); adequate room comfort and equipment (95.2%). However, substandard practices with large heterogeneity across regions were also reported. Among women who experienced labor, the percentage of instrumental vaginal births ranged from 22.3% in the Algarve to 33.5% in Center; among these, fundal pressure ranged from 34.8% in Lisbon to 66.7% in Center. Episiotomy was performed in 39.3% of noninstrumental vaginal births with variations between 31.8% in the North to 59.8% in Center. One in four women reported inadequate breastfeeding support (26.1%, ranging from 19.4% in Algarve to 31.5% in Lisbon). One in five reported no exclusive breastfeeding at discharge (22.1%; 19.5% in Lisbon to 28.2% in Algarve). Conclusion: Urgent actions are needed to harmonize QMNC and reduce inequities across regions in Portugal.