HIGH-RISK PREGNANCY AND PERINATAL RISK: MEASURING PROPOSALS AND THEIR METHODOLOGICAL IMPLICATIONS OF THEORETICAL AND TECHNICAL NATURE

Authors

  • Augusta Thereza de Alvarenga

DOI:

https://doi.org/10.7322/jhgd.38139

Keywords:

high-risk pregnancy, perinatal risk, low weight, prematurity, intrauterine growth retardation, perinatal morbimortality, measurement of high risk pregnancy.

Abstract

The present paper is about lhe existing relations between the concepts of high risk pregnancy and perinatal risk, widely used both in lhe field of Medicine (specially in Obstetrics) and in the field of Maternal-Child Health, the latter seen as an arca within the Colective or Public Health field. The author tries to trace the emergence of the use of the high-risk pregnancy concept in the context of recomposition of medical practice, especially
in relation to the Community Medicine Movement that occurred during the 60’s in the USA. From then on, the typical form,adopted by the high-risk pregnancy levei measuring
proposals - known as “score systems” - is characterized. The author also presents a set of methodological issues, both theoretical and technical present in these measuring proposals.
These issues present challenges within the scope of Perinatology, not only from the point of view of the generated knowledge, but also from the point of view of the
intervention proposals inherent to that practice. Due to the importance of gravidic and perinatal risks as points of concern in the Maternal-Child area, the author considers as relevant the investment in new methodological tools capable of dealing with these concerns in non-reducing, holistic an~ multidisciplinary ways.

Author Biography

  • Augusta Thereza de Alvarenga
    Socióloga, Sanitarista, Doutora em Saúde Pública. Prof. Dr. do Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública da Universidade de São Paulo.

References

Alvarenga AT. O conceito de risco na área materno-infantil: considerações teóricas, metodológicas e de aplicação. São Paulo,1984. [Tese de Doutorado - Faculdade de Saúde Pública da USP].

Apostolakis G. Accident analysis: probability and risk assessment: the subjetivistic view point and some suggestions. Nud. Saf., 19(3): 305-15, 1978.

Areno PB. Contribuição ao estudo da antropometria do recém nascido. São Paulo,1984. [Dissertação de Mestrado – Faculdade de Saúde Pública da USP].

Arouca ASS. O dilema preventivista. Contribuição para a compreensão e critica da medicina preventiva. Campinas, 1975. [Tese de Doutoramento - Faculdade de Ciências Médicas da Universidade Estadual de Campinas].

Backett EM. et al. The risk approach in health care: with special reference to maternal and child health including family planning. Geneva. World Health Organization, 1984.

Black M. Probability. In: Edwards R et al. The enciclopaedia of philosophy. New York, Macmillan, 1972, v. 5, p. 464-79.

Breilh J, Granda E. Investigacién de lasalud en la sociedad: guia pedagogico sobreun nuevo enfoque dei método epidemiológico.Quito, Ed. CEAS, 1980.

Clifford DSH. High risk pregnancy. Prevention of prematurity the sine qua non for eduction in mental retardation and other neurologic disords. New Engl J. Med., 27(5):243-49, 1964.

Donnangelo MCF, Pereira L. Saúde e Sociedade. São Paulo, Ed. Duas Cidades,1976.

Fortney J.A, Whitehorne EW. The development of an index of high risk pregnancy. Amer. J. Obstet. Gynec., 143(5):501-8, 1982.

Laurell AC. A saúde-doença como processo social. In: Nunes ED. (org.) Medicina Social: aspectos históricos e teóricos. São Paulo, Ed. Global, 1983, p. 133-58.

Lesinski JS. High-risk pregnancy. Un resolved problems of screening, management, and prognosis. Obstet. Gynec., 46(5): 599-603,1975.

Lubchenco LO. et al. Intrauterine growt has estimated from live born birth-weight data at 24 to 42 weeks of gestation. Pediatrics, 32:793-800, 1963.

Plaut R. Analisis de riesgo, alcance y limitaciones para ei administrador de salud. Bol Of: Sanit. Panarner., 96: 296-304, 1984.

Ramos R. A integração sanitária: doutrina e prática. São Paulo, 1972. [Tese de Livre Docência - Faculdade de Saúde Pública da USP].

Roberts HV. inferência bayesiana. In: Enciclopedia Internacional de las Ciências Sociales. Madrid, Aguilar, 1974, v.5, p.781 -5.

Schwarcz R. et al. Principales causas perinatales de la mortalidad feto-neonatales yde las secuelas invalidantes en el nino , em paises latinoamericanos: algunas estrategiasy acciones para contribuir a su abatimiento. In: Feschina RH. Tecnologias perinatales: fundarnientos, desarollo y evaluación. Montevidéo, CLAP/OPAS, 1987, p. 8-21.

Siqueira AAE. Indicadores de risco de peso inadequado ao nascer. São Paulo, 1981. Tese de Livre-Docência - Faculdade de Saúde Pública da USP].

Spiers RS, Wacholder S. Association between rates of premature delivery and intra-uterine growth retardation. Dev. Med Child Neurol., 24: 808-16, 1982.

Starfield B. et al. Mortality and morbidity in infants with intrauterine growth retardation. J. Pediat., 10I: 978-83, 1982.

World Health Organization Risk approach for maternal and child health care. Geneva: WHO; 1978.

Downloads

Published

1994-12-19

Issue

Vol. 4 No. 2 (1994)

Section

Opinião/Atualização

License

CODE OF CONDUCT FOR JOURNAL  PUBLISHERS

 

Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:

 

Publishers should:

 

  • Define the relationship between publisher, editor and other parties in a contract
  • Respect privacy (for example, for research participants, for authors, for peer reviewers)
  • Protect intellectual property and copyright
  • Foster editorial independence

 

Publishers should work with journal editors to:

 

  • Set journal policies appropriately and aim to meet those policies, particularly with respect to:

–         Editorial  independence

–         Research ethics, including confidentiality, consent, and the special requirements for human and animal research

–         Authorship

–         Transparency and integrity (for example, conflicts of interest, research funding, reporting standards

–         Peer review and the role of the editorial team beyond that of the journal editor

–         Appeals and complaints

  • Communicate journal policies (for example, to authors, readers, peer reviewers)
  • Review journal policies periodically, particularly with respect to new recommendations from the COPE
  • Code of Conduct for Editors and the COPE Best Practice Guidelines
  • Maintain the integrity of the academic record
  • Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
  • Publish corrections, clarifications, and retractions
  • Publish content on a timely basis