Although maternal nutrition has an impact on fetal development and gestational outcome, tracking maternal nutrition in outpatient practice is still complex and involves proper technical capacitation in this area. Nevertheless, the association between nutritional variables may broaden the ability to predict the occurrence of gestational disorders and prevention management. We aimed to identify factors that could indicate the probability of adverse outcomes in mid-pregnancy. From a cohort of 1165 nulliparous pregnant women without any previous disease, the nutritional status was assessed by body mass index (BMI) and mid-upper arm circumference (MUAC), associated with dietary patterns and sociodemographic characteristics. Two predictive models with nutritional status for screening the occurrence of adverse outcomes of preterm birth, gestational diabetes mellitus, small-for-gestational-age newborns and preeclampsia were developed. The odds of adverse outcomes were higher in non-white (p < 0.05) obese women and with high protein consumption. There was no significant difference between the models, with an overall accuracy of 63% for both models and a probability of success in predicting adverse outcomes (BMI = 61%, MUAC = 52%). This study of Brazilian pregnant nulliparous women offers two possible options for early tracking of adverse gestational outcomes that should be further externally validated.

Background: Preterm birth is the leading cause of mortality and disability in newborn and infants. Having a short cervix increases the risk of preterm birth, which can be accessed by a transvaginal ultrasound scan during the second trimester. In women with a short cervix, vaginal progesterone and pessary can both reduce this risk, which progesterone more established than cervical pessary. The aim of this study is to compare the use of vaginal progesterone alone versus the association of progesterone plus pessary to prevent preterm birth in women with a short cervix. Methods: This is a pragmatic open-label randomized controlled trial that will take place in 17 health facilities in Brazil. Pregnant women will be screened for a short cervix with a transvaginal ultrasound between 18 ^0/7 until 22 ^6/7 weeks of gestational age. Women with a cervical length below or equal to 30 mm will be randomized to the combination of progesterone (200 mg) and pessary or progesterone (200 mg) alone until 36 + 0 weeks. The primary outcome will be a composite of neonatal adverse events, to be collected at 10 weeks after birth. The analysis will be by intention to treat. The sample size is 936 women, and a prespecified subgroup analysis is planned for cervical length (= < or > 25 mm). Categorical variables will be expressed as a percentage and continuous variables as mean with standard deviation. Time to delivery will be assessed with Kaplan-Meier analysis and Cox proportional hazard analysis. Discussion: In clinical practice, the combination of progesterone and pessary is common however, few studies have studied this association. The combination of treatment might act in both the biochemical and mechanical routes related to the onset of preterm birth. Trial registration: Brazilian Clinical Trial Registry (ReBec) RBR-3t8prz, UTN: U1111–1164-2636, 2014/11/18.

The principal aim of this study was to understand how communication between parents and health professionals concerning prematurity occurs, from delivery to admission to the neonatal Intensive Care Unit. This is an exploratory, descriptive study with a qualitative methodology. Data were collected using tape-recorded and Focal Groups technique interview with mothers of premature newborns and health professionals involved in caring for preterm infants, at southeast Brazil. The word “premature” was not said or heard during prenatal care. From the narratives, it was observed that there was a lack of information available to pregnant women about preterm birth, failure in medical care regarding signs and symptoms reported by pregnant women, and lack of communication between the medical teams, mothers and family during delivery and Neonatal Intensive Care Unit (NICU) admission. There is a fine line between born too soon and die too soon, that increases stress, fear and distance impacting negatively over communication between mothers and health professionals during antenatal care, childbirth and NICU admission.

Error in figureIn the published article, there was an error in Figure 7 as published. Figure 7 (titled 2008) was inadvertently duplicated from Figure 8 (titled 2018). All numerical values, legends, and captions for Figures 7 and 8 are correct. *Only the image in Figure 7 should be replaced with the correct version corresponding to data from 2008.*The original caption of Figure 7 is correct and should remain unchanged.

Introduction: Planetary health is a comprehensive approach that reveals the complex interconnections between sustainable human and environmental balance. This concept is rooted in the understanding that the health and progress of human civilization depend on thriving natural systems and their preservation. However, the profound impact of plant-based foods on both human and planetary health remains underestimated. Diet has the power to shape present health and compromise the future of entire generations.Methods: This study analyzed 48 years (1974–2022) of trends in Brazilian agricultural production, focusing on plant-based foods and their potential risks to the environment and the health of women of reproductive age—a particularly vulnerable population. Using national databases, we explored associations between food production and consumption patterns within this demographic.Results: Although rice and beans are traditionally central to Brazilian diets, production data suggest that the dominant crops available to women of reproductive age are soy and sugarcane. These crops are associated with numerous pesticide authorizations, suggesting high levels of contamination by toxic chemical residues.Discussion: Our findings suggest that plant-based diets represent a disruptive concept that requires careful revision, given the high contamination by toxic chemical residues in food, water, and humans. Beyond nutrient-based public policies, food management—from field to plate—must integrate food security to ensure a healthy and sustainable food system.