Introduction Prematurity is an urgent public health problem worldwide. Recent studies associate maternal hypovitaminosis D during pregnancy with an increased risk of prematurity. However, the evidence on this association remains inconclusive, and there is lack of consensus in the literature. The exact mechanism by which low vitamin D levels may increase the risk of preterm birth is not yet fully understood. Nevertheless, it is known that vitamin D may play a role in maintaining a healthy pregnancy by regulating inflammation and immunomodulation by acting on the maternal and fetal immune systems. Inflammation and immune dysregulation are both associated with preterm birth, and low vitamin D levels may exacerbate these processes. The results of this review may have important implications for clinical practice and public health policy, particularly regarding vitamin D supplementation during pregnancy. Methods and analysis A systematic review of the literature will be conducted. The search will be performed in electronic databases: CINAHL; MEDLINE; Cochrane Central Register of Controlled Trials; Cochrane Library; Academic Search Complete; Information Science and Technology Abstracts; MedicLatina; SCOPUS; PubMed; and Google Scholar, with the chronological range of January 2018 to November 2022. The search strategy will include the following Medical Subject Headings or similar terms: ‘Vitamin D’; ‘25-hydroxyvitamin D’; ‘Hypovitaminosis D’; ‘Pregnancy’; ‘Pregnant women’; ‘Expectant mother’; ‘Prematurity’; ‘Premature birth’; ‘Premature delivery’; ‘Preterm birth’; and ‘Preterm labour’. This review will include quantitative primary studies, both experimental (clinical trials) and observational (cohort, cross-sectional, and case–control). The quality of each selected study and the results obtained will be assessed by two reviewers separately, using the Cochrane risk of bias tool for evaluating randomised clinical trials or the Newcastle Ottawa Scale for non-randomised studies, following the respective checklist. In case of disagreement, a third reviewer will be consulted. Ethics and dissemination This study does not involve human subjects and therefore does not require ethics approval. The results will be disseminated through publication in a peer-reviewed scientific journal and through conference presentations. All changes made to the protocol will be registered in PROSPERO, with information on the nature and justification for the changes made. PROSPERO registration number CRD42022303901.

Objetivo: Identificar a tendência de artigos publicados por enfermeiros em base de dados, sobre os benefícios do brincar terapêutico em crianças hospitalizadas. Metodologia: Foi utilizado o método PI[C]O na elaboração da questão orientadora e na definição dos critérios de inclusão e exclusão para a seleção dos artigos. As palavras-chave foram organizadas com a adição do booleano AND: Hospitalized Child; AND Play Therapy; AND Benefits e suas combinações na língua portuguesa e espanhola. O estudo realizado consiste numa pesquisa bibliográfica integrativa, com abordagem qualitativa, sendo a pesquisa realizada nas plataformas de bases de dados eletrónicas EBSCO e B-ON, com o friso cronológico de 2009-2013. Foram selecionados 15 artigos que se enquadravam com o objetivo deste estudo. Elaboramos um instrumento de recolha de dados com as variáveis consideradas mais relevantes. Os dados foram analisados segundo Bradin e Minayo. Resultados: Após a análise procedeu-se à categorização dos estudos: 1) Significado do brinquedo terapêutico; 2) Formas de brincar/brinquedo terapêutico; 3) Importância/benefícios da utilização do brinquedo terapêutico. Conclusões: Evidencia-se pelos resultados encontrados, os benefícios do brincar terapêutico em todos os artigos analisados. Torna-se assim essencial a inserção do brinquedo terapêutico no plano de assistência de enfermagem pediátrica para um cuidado integral e de qualidade. Descritores: Criança hospitalizada; brincar terapêutico; benefícios. Abstract Objective: To identify the trend of articles published by nurses in database, on the benefits of play therapy in hospitalized child. Methods: We used the PI[C]O method, in drafting the guiding question and the definition of inclusion and exclusion criteria for the selection of items. The keywords were organized with the addition of the AND Boolean: Hospitalized Child; AND Play Therapy; AND Benefits and there combinations in Portuguese and Spanish. The study is an integrative literature review, with a qualitative approach, with the survey on the platforms of electronic databases EBSCO and B-ON, with the timeline 2009-2013. Were selected 15 articles that fit with the objective of this study. We developed a data collection instrument with the variables considered most relevant. Data were analyzed according Bradin and Minayo. Results: After the analysis proceeded to the categorization of the studies: 1) Meaning of play therapy; 2) Forms of play therapy; 3) the importance / benefits of using play therapy. Conclusions: We can see the results found in this review the benefits of play therapy in all the analyzed articles. Therefore essential becomes the insertion of play therapy in pediatric nursing for a comprehensive and quality care. Descriptors: Hospitalized Child; Play Therapy; Benefits.

Background: Numerous studies have shown that hypovitaminosis D is linked to adverse maternal and infant health outcomes, such as intrauterine growth restriction, preeclampsia, cholestasis, hypertension, and gestational diabetes, all of which are potential causes of prematurity. Recognizing the significance of this issue and its impact on maternal–infant health, the VitDTracking research project was designed and registered on 4 March 2024, in the ClinicalTrials.gov database (Identifier: NCT06292195). The project includes a large-scale multicenter observational study, targeting a minimum initial sample size of 1800 participants. This paper describes the pilot study aimed at assessing the feasibility of the full-scale study. Methods: A multicenter observational pilot study was conducted in public health organizations in the Alentejo region, adhering to the research protocol. Data collection included 67 parameters: 37 obtained from a questionnaire and 30 from clinical records, with particular focus on maternal 25(OH)D levels and maternal–infant health outcomes. Feasibility was assessed through predefined outcome indicators and success criteria. Results: The pilot study enrolled 30 pregnant women and successfully met all feasibility criteria. The global recruitment rate was 73.17%, with an eligible recruitment rate of 88.2%. The refusal rate was low (11%), and adherence, retention, and completion rates were all 100%, indicating strong participant engagement. The questionnaire comprehension rate was 86.6%. Participating centers demonstrated the capacity to implement the study, adhering to the protocol with a compliance rate exceeding 90%. The study also highlighted a concerning prevalence of hypovitaminosis D and identified cases of premature birth and miscarriage. Conclusions: The pilot study confirmed the feasibility of recruitment methodologies and procedures, supporting the implementation of the large-scale observational study. The planned study will recruit approximately 1800 pregnant women to achieve an eligible cohort of 1000 samples, and a statistically significant final sample of 100 cases meeting the prematurity criterion.