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Objective: To describe the impact of the Koala project (Actively Controlling Target Oxygen) on clinical outcomes in patients born with less than 36 weeks of gestation, in two maternity hospitals, comparing before and after the strategy implementation. Methods: This is an intervention study with 100 preterm infants with gestational age ≤36 weeks, who used oxygen in two maternity hospitals between January 2020 and August 2021. One of the hospitals was a private institution and the other was philanthropic. The goal for the target oxygen saturation with this project was 91–95%. Comparisons between the two stages (before and after the implementation of the project) were made evaluating the outcomes of retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, and deaths. The continuous variables were described using mean, median, standard deviation and interquartile interval. The significance level adopted was 5% and the software used was R Core Team 2021 (version 4.1.0). Results: After oxygen control use according to the Koala protocol, there was a significant reduction in the cases of retinopathy of prematurity (p

Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage. RESUMO Objetivo: Inquérito nacional de cobertura vacinal aos 12 e 24 meses de idade foi realizado para investigar as quedas nas coberturas a partir de 2016. Métodos: Amostra de 37.836 nascidos vivos das coortes de 2017 e 2018 residentes nas capitais, Distrito Federal (DF) e 12 cidades com mais de 100 mil habitantes, acompanhados nos primeiros 24 meses por registros nas cadernetas de vacinação. Setores censitários foram estratificados segundo condições socioeconômicas, e o mesmo número de crianças foi incluído para cada estrato. Calcularem-se coberturas vacinais de cada vacina e coberturas completas aos 12 e 24 meses, doses aplicadas, válidas e oportunas. Fatores familiares, maternos e da criança associados à cobertura foram pesquisados. Os motivos para não vacinar analisados foram: contraindicações médicas, dificuldades de acesso, problemas no funcionamento do programa e hesitação vacinal. Resultados: Os resultados preliminares mostram que menos de 1% das crianças não foram vacinadas, as coberturas pelo esquema completo são menores que 75% em todas as capitais e no DF, as vacinas com mais de uma dose perdem cobertura progressivamente, há diferenças entre os estratos socioeconômicos, favoráveis aos estratos mais altos em algumas cidades e aos estratos mais baixos em outras. Conclusão: Houve realmente redução da cobertura vacinal em todas as capitais e no DF para as crianças nascidas em 2017 e 2018, denotando piora na execução do Programa Nacional de Imunizações durante os anos de 2017 a 2019. O inquérito realizado não mensurou os impactos da pandemia de COVID-19 que podem ter reduzido ainda mais as coberturas vacinais.

INTRODUCTION: Stillbirth has an estimation of more than 2.5 million cases across the world. A great percentage of the cause of stillbirths is reported as unknown or unexplained. The aim of this study was the identification of the causes, incidence and profile of the fetal and also the mothers in a maternity hospital in the State of Sergipe. METHODS: This was an observational and cross-sectional study in which all stillbirths of the maternal hospital in the State of Sergipe from June 2020 to May 2021 were included. Fetal death investigation forms were analyzed and some women were interviewed through telephone calls. The interview was based on the SAMPLE VA questionnaire 1 from the WHO Verbal autopsy instrument and an additional list to assess the maternal, pregnancy and labor history, and also history of signs and symptoms of COVID-19 infection. RESULTS: A total of 10375 births were delivered at the hospital and the months with highest births were May and March of 2021. We found 64 cases of stillbirth. Forty-two cases of neonatal deaths were also registered. Only 11 women with cases of stillbirth were interviewed in our study. The major participants were married or living with a partner (60%) and finished secondary education (63.63%). There were 5 cases of women with gestational age at 37 weeks or greater. Antenatal care was completed by 90.9%(n=10) of women. The majority (54.5%) had Unknown or unexplained causes of death. The remaining categories also showed relevant results. CONCLUSION: Fetal deaths were responsible for approximately 60% of perinatal deaths, in which the most reported cause in our interview were unexplained or unknown. The total number of deaths when neonatal deaths were added almost duplicated the percentage of the mortality rate at the maternity hospital. All women went into labor with less than 42 weeks of gestational age and greater or equal to 22 and most were healthy and had no diagnosed diseases.

This clinical trial aimed to evaluated the effects of a 5-minutes SBT and a 10-minutes SBT on successful extubation rates of very low birth weight (VLBW) infants compared to clinical judgment alone. A double-blind randomized controlled trial was conducted in two NICU in Alagoas, Brazil, including 88 VLBW infants allocated in three groups: control group, 5-minutes SBT and 10-minutes SBT. SBT was performed under endotracheal CPAP mode with 5 cmH2O positive end-expiratory pressure, inspiratory flow 10 L/min and FiO2 of 30%. The primary outcome was successful extubation rate, defined as no need for reintubation within 7 days after extubation. There was no difference among the three groups in relation to the proportion of successful extubation rate (p =0.644), bronchopulmonary dysplasia (BPD) (p =0.790) and hospital length stay (p = 0.175). To have passed the 5-minutes or the 10-minutes SBT did not improve successful extubation rates in VLBW infants compared to clinical judgment alone or made difference in BDP occurrence and hospital stay length. Designing a predictor test of extubation readiness in preterm infants remains a challenging in respiratory management. El objetivo de este estudio fue evaluar los efectos de una Prueba de ventilación espontánea (PVE) de 5 y 10 minutos en las tasas de extubación exitosa de los recién nacidos de muy bajo peso (RNMBP) en comparación con el juicio clínico solo. Se realizó un ensayo controlado aleatorio doble ciego en dos Unidades de Cuidados Intensivos Neonatales de Alagoas, Brasil, que incluyó 88 RNMBP asignados en tres grupos: grupo de control, PVE de 5 minutos y PVE de 10 minutos. El PVE se realizó con el modo ventilatorio ET-CPAP con PEEP de 5 cmH2O, flujo inspiratorio de 10 L/min y FiO2 del 30%. El resultado primario fue la tasa de extubación exitosa, definida como la ausencia de necesidad de reintubación en los 7 días siguientes a la extubación. No hubo diferencias significativas entre los tres grupos en cuanto a la proporción de tasas de extubación exitosa (p = 0,644), la displasia broncopulmonar (DBP) (p = 0,790) y la duración de la estancia hospitalaria (p = 0,175). Superar la PVE de 5 minutos o la de 10 minutos no mejoró las tasas de extubación exitosa en los RNMBP en comparación con el juicio clínico por sí solo ni supuso una diferencia en la aparición de DBP ni en la duración de la estancia hospitalaria. El desarrollo de una prueba de predicción de la preparación para la extubación sigue siendo un reto en el manejo ventilatorio de la población neonatal. Este estudo teve como objetivo avaliar os efeitos de um Teste de Respiração Espontânea (TRE) de 5 minutos e de 10 minutos nas taxas de sucesso na extubação de recém-nascidos muito baixo peso (RNMBP) comparado ao julgamento clínico isolado. Foi realizado um ensaio clínico randomizado controlado duplo-cego em duas Unidades de Terapia Intensiva Neonatal em Alagoas, Brasil, incluindo 88 RNMBP alocados em três grupos: grupo controle, TRE de 5 minutos e TRE de 10 minutos. O TRE foi realizado com o modo ventilatório ET-CPAP com PEEP de 5 cmH2O, fluxo inspiratório de 10 L/min e FiO2 de 30%. O desfecho primário foi a taxa de sucesso na extubação, definida como a não necessidade de reintubar em até sete dias após a extubação. Não houve diferença significante entre os três grupos em relação à proporção da taxa de sucesso na extubação (p =0,644), displasia broncopulmonar (DPB) (p =0,790) e internamento hospitalar (p = 0,175). Passar em um TRE com 5 ou 10 minutos não melhorou as taxas de sucesso na extubação de RNMBP em comparação com o julgamento clínico isolado ou fez diferença na ocorrência de DBP e no tempo de internamento hospitalar. O desenvolvimento de um teste de prontidão para extubação continua sendo um desafio no manejo ventilatório da população neonatal.

BACKGROUND\ud COVID-19 pandemic has disrupted health services, including vaccination demand. We describe the impact of the COVID-19 pandemic on routine pediatric vaccination in Brazil.\ud METHODS\ud We conducted a retrospective analysis of all vaccine doses provided to children aged 0-6 years from January 2019 to December 2020. We obtained data stratified by age group (0 to 2 years and >2 to 6 years) and Brazilian region. Difference-in-difference (DiD) analyses were performed to compare vaccine uptake in the pre-pandemic (January-February), stay-at-home (March-June), and reopening (July-December) periods.\ud RESULTS\ud The number of vaccine doses administered declined in the stay-at-home period. For children aged 0 to 2 years, the highest reductions were recorded in the North (-25.3%), Northeast (-16.8%) and Central-West (-10.2%) regions. For children aged >2 to 6 years, the highest decline was observed in the North (DiD = -27.2%) and South (DiD = -14.0%) regions. The number of vaccine doses administered in the reopening period has slightly increased in all regions.\ud CONCLUSIONS\ud Vaccination decreased during the COVID-19 pandemic. Although the number of doses recovered in part during the reopening phase, additional strategies, such as increased public awareness and vaccination booster campaigns are required.

The sequelae of microcephaly vary according to the severity of the lesion, however, there are few reports of food function in children with microcephaly caused by Zika virus. Objective: to evaluate the food function in children with Zika virus microcephaly. Forty-three children diagnosed with SCZ microcephaly were evaluated, divided into three groups, according to the age range of the children, understood as follows: Age Range 1 (FE1) aged between 0 and 6 months; Age group 2(FE2) aged between 6 months and 1 day to 36 months; Age group 3(FE3) aged between 36 months and 1 day to 48 months. Specific aspects of the child's feeding and eating behavior were analyzed, as well as speech therapy assessment. The evaluations were defined by the protocol created by the clinical service, given the absence of validated protocols for the studied sample. For the analysis, the results were presented in simple and absolute percentage distribution. Signs suggestive of aspiration were more frequent in FE2, while in FE1 and 3 there was a lower incidence of children with this sign of impairment in swallowing. In the evaluation of swallowing with pasty food was observed during food uptake, altered lip occlusion in FE2 and 3. in 45.5% of children in age group 2 and 45.8% in age group 3. Presence of extraoral escape, time of oral transit, coughing, post-swallowing residues, laryngeal elevation and, with a lower incidence, the suggestive signs of aspiration in FE2 and 3. It was possible to conclude that there were important alterations in the functions of sucking and swallowing. These findings indicate that this population should be kept under multidisciplinary follow-up. Como sequelas da microcefalia são variáveis ​​de acordo com a gravidade da lesão, no entanto, poucos são os relatos da função alimentar em crianças com microcefalia por Zika vírus. Objetivo: avaliar una função alimentar em crianças microcefalia por Zika vírus. Foram avaliadas 43 crianças con diagnóstico de microcefalia por SCZ, divididas em três grupos, de acordo con faixa etária das crianças compreendida da seguinte maneira: Faixa Etária 1 (FE1) com idade entre 0 a 6 meses; Faixa Etária 2 (FE2) com idade entre 6 meses y 1 día a 36 meses; Faixa Etária 3 (FE3) com idade entre 36 meses y 1 día a 48 meses. Foram analisados ​​aspectos específicos de la alimentación y el comportamiento alimentar da criança, além de avaliação fonoaudiológica. Como avaliações foram definidas pelo protocolo criado pelo serviço clínico, frente à ausência de protocolos validados para amostra estudada. Para un análisis, os resultados de apresentados em distribuição percentual simples e absoluta. Os sinais sugestivos de aspiração estiveram com maior frequência na FE2, enquanto que nas FE1 e 3 houve menor incidência de crianças com este sinal de comprometimento na deglutição. N avaliação da deglutição com alimento pastoso foi observada durante a captação do alimento, oclusão labial alterada nas FE2 e 3. em 45,5% das crianças da faixa etária 2 e 45,8% da faixa etária 3. Presença de escape extraoral, tempo de tránsito oral, tosse, resíduos pós-deglutição, elevação laríngea e com menor incidência, os sinais sugestivos de aspiração nas FE2 e 3. Foi possível concluir que ocorreram importantes alteraciones nas funções de sucção e deglutição. Estes achados indicam que esta população deve ser mantida em acompanhamento multidisciplinar. As sequelas da microcefalia são variáveis de acordo com a gravidade da lesão, no entanto, poucos são os relatos da função alimentar em crianças com microcefalia por Zika vírus. Objetivo: avaliar a função alimentar em crianças microcefalia por Zika vírus. Foram avaliadas 43 crianças com diagnóstico de microcefalia por SCZ, divididas em três grupos, de acordo com a faixa etária das crianças compreendida da seguinte maneira: Faixa Etária 1(FE1) com idade entre 0 a 6 meses; Faixa Etária 2(FE2) com idade entre 6 meses e 1 dia a 36 meses; Faixa Etária 3(FE3) com idade entre 36 meses e 1 dia a 48 meses. Foram analisados aspectos específicos da alimentação e comportamento alimentar da criança, além de avaliação fonoaudiológica. As avaliações foram definidas pelo protocolo criado pelo serviço clínico, frente à ausência de protocolos validados para a amostra estudada. Para a análise, os resultados foram apresentados em distribuição percentual simples e absoluta. Os sinais sugestivos de aspiração estiveram com maior frequência na FE2, enquanto que nas FE1 e 3 houve menor incidência de crianças com este sinal de comprometimento na deglutição. N avaliação da deglutição com alimento pastoso foi observada durante a captação do alimento, oclusão labial alterada nas FE2 e 3. em 45,5% das crianças da faixa etária 2 e 45,8% da faixa etária 3. Presença de escape extraoral, tempo de trânsito oral, tosse, resíduos pós-deglutição, elevação laríngea e com menor incidência, os sinais sugestivos de aspiração nas FE2 e 3. Foi possível concluir que ocorreram importantes alterações nas funções de sucção e deglutição. Estes achados indicam que esta população deve ser mantida em acompanhamento multidisciplinar.

Objective: Investigating the epidemiological profile of families living in the coastal cities in northeastern Brazil, considering that the are registered in the Brazilian Cash Transfer Program (CTP). Methods: Cross-sectional study involving a probabilistic sample of 1,444 representative families of the region. A previously tested semi-structured questionnaire was used, containing questions about socioeconomic, demographic, anthropometric and health variables, and also the situation of food and nutritional security during the home visits. The family’s characteristics were simultaneously benefited and not benefited by the PSF that was compared. The results were expressed in proportions (%), with the respective prevalence ratio of 95% confidence interval as a measure of association, using Poisson regression analysis with robust adjustment of variance. Results: There were 729 (50.5%) families registered with the PSF. The variables that best discriminated the families benefited by the program were: homemaker's education

The study aimed to characterize the gross motor performance and motor stimulation opportunities present in the home environment of infants with microcephaly by Zika virus (ZIKV), comparing them with infants without microcephaly from public health institutions in Northeast Brazil, and to verify the impact of microcephaly and associated factors on the outcomes assessed. Case-control study that used infants' birth, gestational, and maternal sociodemographic data, and the tests: Gross Motor Function Measure (GMFM), Affordances in the Home Environment for Motor Development (AHEMD), and Gross Motor Function Classification System (GMFCS). Multiple linear regression was used to analyze the impact of microcephaly on tests associated with sociodemographic or clinical factors. Forty infants with microcephaly due to ZIKV, mean age 15.3 (3.1) months, and 40 infants without involvement, mean age 14.8 (4.4) months participated. 85% of the infants with microcephaly due to ZIKV classified in level V of the GMFCS. Significant differences (p

RESUMO Objetivo investigar a forma de oferta de dieta, conforme os diversos métodos de alimentação, e descrever o ganho de peso em recém-nascidos com microcefalia relacionada ao Zika Vírus, comparando-os com recém-nascidos sem microcefalia. Método estudo de coorte retrospectivo com caso controle aninhado. Informações sobre idade gestacional, peso e métodos de alimentação (seio materno, sonda nasogástrica/orogástrica, mamadeira e copo) foram coletadas em prontuários de 43 recém-nascidos com microcefalia por Zika Vírus, equiparados conforme idade gestacional com 43 recém-nascidos sem acometimentos (grupo controle), em uma maternidade de referência no Nordeste do Brasil. Os dados foram coletados desde o nascimento até a alta hospitalar. As medidas de desfecho foram pesos (ao nascer e na alta), velocidade de ganho de peso, tempo de internação e métodos de alimentação. Resultados O grupo com microcefalia apresentou menores pesos ao nascer (D=-1,67; p

Despite great advances in our knowledge of the consequences of Zika virus to human health, many questions remain unanswered, and results are often inconsistent. The small sample size of individual studies has limited inference about the spectrum of congenital Zika manifestations and the prognosis of affected children. The Brazilian Zika Cohorts Consortium addresses these limitations by bringing together and harmonizing epidemiological data from a series of prospective cohort studies of pregnant women with rash and of children with microcephaly and/or other manifestations of congenital Zika. The objective is to estimate the absolute risk of congenital Zika manifestations and to characterize the full spectrum and natural history of the manifestations of congenital Zika in children with and without microcephaly. This protocol describes the assembly of the Consortium and protocol for the Individual Participant Data Meta-analyses (IPD Meta-analyses). The findings will address knowledge gaps and inform public policies related to Zika virus. The large harmonized dataset and joint analyses will facilitate more precise estimates of the absolute risk of congenital Zika manifestations among Zika virus-infected pregnancies and more complete descriptions of its full spectrum, including rare manifestations. It will enable sensitivity analyses using different definitions of exposure and outcomes, and the investigation of the sources of heterogeneity between studies and regions.

EXCLI Journal; 20:Doc1009; ISSN 1611-2156

Diagnosing cases of coronavirus disease (COVID-19) with only non-respiratory symptoms has been challenging. We reported the diagnosis of a child who tested positive for COVID-19 with abdominal pain/diarrhea and tracked his family cluster. One member of the family tested positive for COVID-19 on real-time reverse-transcription polymerase chain reaction assay and three other family members had anti-SARS-CoV-2 antibodies.

OBJECTIVE To analyze the maternal characteristics and type of prenatal care associated with peregrination before childbirth among pregnant women in a northeastern Brazilian state. METHODS Quantitative and transversal study, with descriptive and analytical approaches, part of the Nascer em Sergipe research held between June 2015 and April 2016. A total of 768 puerperal women proportionally distributed across all maternities of the state (n = 11) were evaluated. Data were collected in interviews and from prenatal records. The associations between antepartum peregrination and the exposure variables were described in absolute and relative frequencies, crude and adjusted odds ratios and their respective confidence intervals. RESULTS Antepartum peregrination was reported by 29.4% (n = 226) of the interviewees, most of whom sought care in a single service before the current one (87.6%; n = 198). It should be noted that antepartum peregrination was less frequent among women aged ≥ 20 years old (OR = 0.50; 95%CI 0.34–0.71), with high education level (OR = 0.42; 95%CI 0.31–0.59) and a paid job (adjusted OR = 0.59; 95%CI 0.41–0.82), who had been instructed during prenatal care about the referral maternity for childbirth (adjusted OR = 0.88; 95%CI 0.42–0.92), and who used the private service to receive prenatal (adjusted OR = 0.44; 95%CI 0.18–0.86) or childbirth (adjusted OR = 0.96; 95%CI 0.66–0.98) care. No statistical evidence of associations between gestational characteristics and the occurrence of peregrination was observed. CONCLUSIONS Antepartum peregrination suffers interference from the mother’s socioeconomic characteristics, the type of prenatal care received and the source of funding for childbirth. RESUMO OBJETIVO Analisar as características maternas e da assistência pré-natal associadas à peregrinação no anteparto entre gestantes de um estado do Nordeste brasileiro. MÉTODOS Estudo quantitativo e transversal, com abordagens descritiva e analítica, vinculado à pesquisa Nascer em Sergipe, realizada entre junho de 2015 e abril de 2016. Foram avaliadas 768 puérperas proporcionalmente distribuídas entre todas as maternidades do estado (n = 11). Os dados foram coletados por meio de entrevistas e consultas aos cartões de pré-natal. As associações entre a peregrinação no anteparto e as variáveis de exposição foram descritas em frequências absoluta e relativa, razões de chances brutas e ajustadas e seus respectivos intervalos de confiança. RESULTADOS A peregrinação no anteparto foi referida por 29,4% (n = 226) das entrevistadas, a maioria das quais procurou atendimento em apenas um serviço antes do atual (87,6%; n = 198). Ressalta-se que a peregrinação no anteparto foi menos frequente entre as mulheres com idade ≥ 20 anos (OR = 0,50; IC95% 0,34–0,71), com alta escolaridade (OR = 0,42; IC95% 0,31–0,59), com trabalho remunerado (OR ajustada = 0,59; IC95% 0,41–0,82), orientadas durante o pré-natal sobre a maternidade de referência para o parto (OR ajustada = 0,88; IC95% 0,42–0,92) e que utilizaram o serviço privado para realização do pré-natal (OR ajustada = 0,44; IC95% 0,18–0,86) ou do parto (OR ajustada = 0,96; IC95% 0,66–0,98). Não foi observada evidência estatística de associação entre as características gestacionais e a ocorrência da peregrinação. CONCLUSÕES A peregrinação no anteparto sofre interferência das características socioeconômicas maternas, da assistência pré-natal e do tipo de financiamento para o parto.

Objective: To describe the structure and the processes of care for pregnant women/newborn infants, including the Essential Newborn Care (ENC), in maternity hospitals in Sergipe State, Brazil. Methods: A cross-sectional study carried out between June 2015 and April 2016 in all maternity hospitals of Sergipe with more than 500 deliveries/year (n=11). A questionnaire on the existing structure and work processes was administered to the managers. Subsequently, a representative number of postpartum women from these hospitals were interviewed (n=768). Their medical records, as well as newborn infants’ records, were also analyzed. Results: Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 beds of Intermediate Care Unit (IMCU) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for high-risk parturient care. Regarding the ENC components, only 41% (n=315) of the women had early skin-to-skin contact with their babies, 33.1% (n=254) breastfed in the first hour of life, and 18% (n=138) had a companion always during birth. Conclusions: The distribution of NICU beds between capital city and other cities of the State is adequate, considering Brazilian guidelines. However, there was a low adherence to the protocols for hypertensive and hemorrhagic emergencies, and a low coverage of humanization policies, pregnancy risk classification and ENC practices, especially breastfeeding in the first hour of life, and companion always during birth. RESUMO Objetivo: Descrever a estrutura e os processos de atendimento a gestante/recém-nascido, incluindo os componentes do Essential Newborn Care (ENC), das maternidades de Sergipe, Brasil. Métodos: Estudo transversal realizado entre junho de 2015 e abril de 2016 em todas as maternidades de Sergipe (n=11) com mais de 500 partos/ano. Foi aplicado um questionário aos gestores sobre a estrutura e os processos de trabalhos existentes. Posteriormente, um número representativo de puérperas desses hospitais foi entrevistado (n=768) e seus prontuários, bem como o dos recém-nascidos, foram analisados. Resultados: Sergipe conta com 78 leitos de Unidade de Terapia Intensiva Neonatal (UTIN) e 90 de Unidade Intermediária (UI) para atendimento da demanda espontânea e programada. Somente seis maternidades (54,5%) realizam a classificação de risco e quatro (36,3%) possuem protocolos para atendimento das parturientes de alto risco. No que se refere aos componentes do ENC, apenas 41% (n=315) das mulheres tiveram contato pele a pele precoce com seu filho, 33,1% (n=254) amamentaram na primeira hora de vida e 18% (n=138) tiveram a presença do acompanhante em todos os momentos do parto. Conclusões: A distribuição de leitos de UTIN entre capital/interior é adequada no Estado, levando-se em consideração a legislação vigente no país. Entretanto, houve baixa adesão aos protocolos das emergências hipertensivas e hemorrágicas, e baixa cobertura das políticas de humanização, da classificação de risco para a gestante e das práticas do ENC, principalmente quanto à amamentação na primeira hora de vida e à presença do acompanhante na parturição.

Objective: To assess the relationship of post-traumatic stress symptoms and the perception of social support in women submitted to Severe Maternal Morbidity (SMM). Method: A prospective cohort study, with 549 women from public hospitals. The Impact of Events and Social Support scales were used. Results: Women with SMM were from the State countryside (p=0.046), with low schooling (p=0.039) and did not work (p