Victora C G, Langer A, Barros F, Belizan J, Farnot U, Villar J
Centro de Pesquisas Epidemiologicas, Universidade Federal de Pelotas, Brazil.
Control Clin Trials. 1994 Oct;15(5):379-94. doi: 10.1016/0197-2456(94)90034-5.
This article presents the methodology and baseline findings of a large multicenter trial involving four countries from Latin America (Argentina, Brazil, Cuba, and Mexico). The study was a randomized, controlled, single-masked trial to investigate the impact of social support during pregnancy on perinatal outcomes. Pregnant women with gestational ages between 15 and 22 weeks were screened in health facilities in the four countries. Those presenting with one or more risk factors for having a low-birthweight baby were invited to join the trial. A total of 2235 women--between 500 and 600 in each country--were randomized into an intervention (n = 1110) or a control (n = 1125) group. Both groups were comparable in terms of nearly all baseline variables. The intervention group received a minimum of four visits at home by a trained health worker who provided direct emotional support, health education, and an attempt to enhance the woman's social support network. Over 90% of all women were evaluated at 36 weeks of pregnancy and soon after delivery, and 85% at the 40th day postpartum. The outcomes under study included intrauterine growth retardation, gestational age, perinatal and maternal morbidity and mortality, labor interventions, psychological distress and characteristics of the social support network, among others. This trial showed that it was possible to select, screen, randomize, visit, and evaluate a large number of women in four Latin American countries using a standardized methodology.
本文介绍了一项涉及拉丁美洲四个国家(阿根廷、巴西、古巴和墨西哥)的大型多中心试验的方法和基线研究结果。该研究是一项随机对照单盲试验,旨在调查孕期社会支持对围产期结局的影响。在这四个国家的医疗机构对孕周在15至22周之间的孕妇进行筛查。邀请那些存在一个或多个低出生体重儿风险因素的孕妇参加试验。共有2235名女性(每个国家500至600名)被随机分为干预组(n = 1110)或对照组(n = 1125)。两组在几乎所有基线变量方面具有可比性。干预组由一名经过培训的卫生工作者至少进行四次家访,提供直接的情感支持、健康教育,并尝试加强该女性的社会支持网络。超过90%的女性在妊娠36周时和分娩后不久接受了评估,85%的女性在产后第40天接受了评估。所研究的结局包括宫内生长迟缓、孕周、围产期和孕产妇发病率及死亡率、分娩干预、心理困扰以及社会支持网络的特征等。该试验表明,使用标准化方法在四个拉丁美洲国家选择、筛查、随机分组、家访和评估大量女性是可行的。