Programa de Pós-Graduação em Ciências Aplicadas à Saúde da Mulher
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Master Thesis Desenvolvimento motor, neurológico e cognitivo de recémnascido pré-termo durante a transição hospital-casa: coorte prospectiva(Universidade Federal do Rio Grande do Norte, 2026-02-10) Silva, Roseany Cavalcante da; Pereira, Silvana Alves; Alvarez, Carolina Daniel de Lima; https://orcid.org/0000-0002-2126-2937; http://lattes.cnpq.br/4144337339534625; https://orcid.org/0000-0002-6226-2837; http://lattes.cnpq.br/3640379319601363; https://orcid.org/0009-0004-3012-3228; http://lattes.cnpq.br/5446028553918521; Fonseca Filho, Gentil Gomes da; http://lattes.cnpq.br/7093066731971896; Sanada, Luciana Sayuri; https://orcid.org/0000-0002-6530-6831; http://lattes.cnpq.br/2982273061513669The first thousand days of life constitute a crucial phase for child development, marked by intense brain plasticity and considered a window of opportunity. During this period, early experiences directly influence the formation of motor, cognitive, and socioemotional skills. In this context, preterm birth represents a developmental challenge, as the immaturity of physiological systems—particularly the neurological system—exposes the newborn to greater risks of developmental alterations. The hospital-to-home transition represents a sensitive and determining moment for these infants, requiring continuous follow-up and care strategies that promote their overall development. Therefore, this study aimed to monitor the neurological, motor, and cognitive development of preterm newborns during the hospital-to-home transition. This was a prospective cohort study conducted between April 2024 and June 2025 at the Januário Cicco Maternity School/RN. A total of 68 preterm newborns with gestational age <34 weeks were included. Assessments were performed using validated instruments (TIMP, HINE, Bayley III, and the Perceived Stress Scale) at hospital discharge and at 3 and 4 months of corrected gestational age (CGA). The results showed that at 3 months of CGA, 87.8% of the preterm infants assessed by the HINE did not present a risk for neurological alterations, with a mean score of 64.1±7.6. Although 68.8% of the infants demonstrated motor performance within the average range for age at hospital discharge, this proportion decreased at the 3rd and 4th months of CGA, indicating a worsening trajectory of motor development over time (p = 0.01). In addition, maternal perceived stress showed a negative association with motor development (p = 0.047). These findings reinforce the importance of early monitoring strategies and adequate family support in the face of the challenges imposed by prematurity, in order to promote integral development during the first 1,000 days of life.Master Thesis Suplementação de vitamina E em gestantes de risco habitual e com pré-eclâmpsia grave: existe impacto bioquímico e clínico na díade mãe-filho?(Universidade Federal do Rio Grande do Norte, 2026-03-01) Carneiro, Byanca Rodrigues; Rodrigues, Karla Danielly da Silva Ribeiro; https://orcid.org/0000-0002-2251-5967; http://lattes.cnpq.br/5658288179573297; https://orcid.org/0000-0001-6474-9393; http://lattes.cnpq.br/3716353180788974; Maia, Carla Soraya Costa; https://orcid.org/0000-0003-1535-6686; http://lattes.cnpq.br/2879750916488596; Bezerra, Danielle Soares; http://lattes.cnpq.br/4545867903131219Vitamin E is a fat-soluble antioxidant essential for maternal–fetal protection against oxidative stress and has been widely investigated in inflammatory conditions such as preeclampsia (PE). In this context, this study evaluated maternal oral vitamin E supplementation and its effects on maternal–fetal health through two study designs: (1) a systematic review (SR) investigating the effects of supplementation on the mother–child dyad, and (2) a randomized clinical trial (RCT) involving pregnant women with severe PE, aiming to analyze the impact of vitamin E supplementation on the nutritional status of this micronutrient and health outcomes in the maternal– infant dyad. The SR followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with a protocol registered in PROSPERO (CRD42024529048), including RCTs identified in PubMed, Scopus, Web of Science, EMBASE, LILACS, and the Cochrane Library. Study selection, data extraction, and risk of bias assessment were conducted independently using the Cochrane Risk of Bias 2.0 tool. Statistical analysis was performed using RevMan software (version 5.4), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. After screening 1,212 studies, six were included. Supplementation significantly increased serum alpha-tocopherol (α-TOH) concentrations (SMD = 4.89; 95% CI: 2.89–6.89; p < 0.001), with no effects on gestational age (SMD = 0.04 weeks; 95% CI: −0.03– 0.11; I² = 0%; p = 0.29) or birth weight (SMD = −0.02 g; 95% CI: −0.09–0.04; I² = 62%; p = 0.49). The included studies showed low risk of bias and low to moderate certainty of evidence. The double-blind, placebo-controlled RCT was approved by the Research Ethics Committee (approval no. 6,985,999) and registered in the Brazilian Clinical Trials Registry (RBR-99h2qmf). A total of 42 pregnant women with severe PE were randomized, with 22 allocated to the intervention group (daily supplementation with 400 IU of dl-α-TOH) and 20 to the placebo group (soybean oil), and followed until the immediate postpartum period. Obstetric, neonatal, socioeconomic, and nutritional data were collected, as well as blood samples at two time points: baseline and immediate postpartum. Serum α-TOH concentrations were determined using ultra-high-performance liquid chromatography, with deficiency defined as values ≤ 30 μmol/L. Data were analyzed using the Statistical Package for the Social Sciences. Linear regression models were applied to assess the effect of supplementation on maternal nutritional status. At baseline, all participants presented low serum vitamin E levels (4.68 ± 2.12 µmol/L) and inadequate dietary intake (6.06 ± 2.49 mg/day). Supplementation significantly increased serum α-TOH concentrations in the intervention group during the immediate postpartum period (4.29 ± 2.06 vs. 31.70 ± 14.66 µmol/L; p = 0.001), with no association with maternal or neonatal variables. Linear regression analysis indicated a positive, although non-significant, association between supplementation duration and increased serum concentrations. Vitamin E supplementation increased serum α-TOH levels and corrected maternal deficiency; however, it did not result in significant clinical benefits in maternal–infant outcomes, suggesting that it may be an effective intervention strategy to address maternal vitamin E deficiency.Master Thesis Acurácia do mRNA HPV E6/E7 para rastreio de câncer cervical usando amostras autocoletadas: uma revisão sistemática e meta-análise(Universidade Federal do Rio Grande do Norte, 2025-02-27) Gomes, Kayonaria Kardenia Alves da Costa; Freitas, Janaina Cristiana de Oliveira Crispim; Sarmento, Ayane Cristine Alves; https://orcid.org/0000-0001-9131-1952; http://lattes.cnpq.br/6145665770763582; https://orcid.org/0000-0002-1344-0078; http://lattes.cnpq.br/2644540835478572; http://lattes.cnpq.br/8149742665775407; Oliveira, Ana Katherine da Silveira Gonçalves de; https://orcid.org/0000-0002-8351-5119; http://lattes.cnpq.br/3436756337251449; Medeiros, Kleyton Santos de; https://orcid.org/0000-0002-4105-7535; http://lattes.cnpq.br/3723750550570434Introduction: Cervical cancer is the fourth most common cancer among women worldwide and is associated with high-risk Human Papillomavirus (HPV) types. HPV DNA tests have been developed for cervical cancer screening, particularly in resourcelimited settings. Meanwhile, mRNA tests identify active infections, increasing diagnostic specificity. Self-sampling for HPV is an innovative screening method, allowing patients to collect their own samples for analysis. Detecting the mRNA of HPV oncoproteins E6/E7 in self-collected samples reduces unnecessary referrals for invasive and costly examinations while expanding cervical cancer screening coverage. Objective: To evaluate the accuracy of mRNA testing for HPV oncoproteins E6/E7 in self-collected cervical samples compared to the reference standard. Methods: A systematic review was conducted following the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy (DTA). Study selection and data extraction were performed in a paired and independent manner. Cross-sectional studies evaluating the accuracy of E6/E7 HPV mRNA testing in self-collected cervical samples were included. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the risk of bias. A meta-analysis was conducted to evaluate the diagnostic accuracy of tests through the systematic synthesis of data from multiple studies. All analyses were performed using R Statistical Software (version 4.1.0), incorporating the “meta” and “mada” packages. Results: Most of the included studies showed a low risk of bias, with only one study presenting a high risk—mainly due to patient selection methods and the conduct of the index test. After the selection process, five studies were included in the review, and two were eligible for the meta-analysis. The meta-analysis demonstrated high diagnostic accuracy of the evaluated test, with pooled sensitivity and specificity indicating excellent ability to distinguish between individuals with and without the disease. The diagnostic odds ratio (DOR) revealed that patients with the disease were approximately 16 times more likely to test positive compared to those without the disease, confirming the strong discriminatory performance of the test. Conclusion: These findings indicate that detecting HPV oncoproteins E6 and E7 mRNA through selfsampling has good accuracy and may be a viable and effective method to enhance cervical cancer screening in hard-to-reach populations and resource-limited settings.Master Thesis Avaliação dos músculos do assoalho pélvico antes e após cirurgia de prolapso de órgãos pélvicos isolada e associada à correção da incontência urinária(Universidade Federal do Rio Grande do Norte, 2025-02-28) Guerra, Cazuy Alves Uchoa; Micussi, Maria Thereza Albuquerque Barbosa Cabral; Soares, Gustavo Mafaldo; http://lattes.cnpq.br/3613539053191568; https://orcid.org/0000-0003-4140-5568; http://lattes.cnpq.br/2360845979410206; http://lattes.cnpq.br/7606209125142665; Gouveia, Guilherme Pertinni de Morais; https://orcid.org/0000-0001-6470-2341; http://lattes.cnpq.br/4485485225731789The objective of this study was to evaluate pelvic floor muscle (PFM) function and the impact of pelvic floor symptoms in women who underwent pelvic organ prolapse (POP) repair surgery, either isolated or associated with urinary incontinence (UI), over a three- and 12-month follow-up. A prospective cohort study was conducted with 100 participants divided into two groups: women undergoing isolated POP repair (POPg, n=47) and women with POP associated with UI (UI+POPg, n=53). All participants were evaluated preoperatively (T0) and at three (T1) and 12 months (T2) postoperatively. The evaluation included a sociodemographic form, functional PFM assessment (vaginal manometry), and the Pelvic Floor Distress Inventory (PFDI) with its subscales: Urogenital Distress Inventory (UDI), Pelvic Organ Prolapse Distress Inventory (POPDI), and Colorectal-Anal Distress Inventory (CRADI). Descriptive statistics were expressed as mean, standard deviation, median, and interquartile ranges (25th and 75th). Absolute and relative frequencies were also calculated. The unpaired Student's t-test and the chi-square test were used to compare sociodemographic and clinical variables between groups. A mixed model with Bonferroni post-hoc correction was used to compare times, groups, and the time * group interaction. At baseline, the POPg group was older and had a higher prevalence of constipation and smoking. After surgery, there was a significant increase in manometric pressure (p < 0.001) and an improvement in prolapse symptoms (POPDI) (p=0.001) over the 12 months in both groups. The improvement in urinary (UDI) and colorectal (CRADI) symptoms did not reach statistical significance in the longitudinal analysis. The progression of functional and symptomatic improvement was similar between the groups, with no significant time*group interactions for any of the variables. The results of this study demonstrate an improvement in pelvic floor function and a reduction in the impact of pelvic floor symptoms on patients' quality of life over time. However, no significant differences were observed in the time * group interaction for vaginal manometry, UDI, POPDI, and CRADI. These findings indicate that the surgical repair of POP, with or without concomitant UI surgery, not only addresses the anatomical symptoms of prolapse but also contributes to the improvement of pelvic floor muscle function.Master Thesis Eficácia das terapias não farmacológicas na dor pélvica crônica da endometriose(Universidade Federal do Rio Grande do Norte, 2025-02-10) Dantas, Hégila da Silva; Micussi, Maria Thereza Albuquerque Barbosa Cabral; https://orcid.org/0000-0003-4140-5568; http://lattes.cnpq.br/2360845979410206; http://lattes.cnpq.br/5104103804205296; Sarmento, Ayane Cristine Alves; https://orcid.org/0000-0001-9131-1952; http://lattes.cnpq.br/6145665770763582; Correia, Grasiela Nascimento; http://lattes.cnpq.br/8878717048564522Introduction: Endometriosis is a complex condition characterized by significant symptoms and complications, such as chronic pelvic pain (CPP) and infertility. Current therapeutic options, including medications and surgical procedures, often fail to provide complete relief and may lead to undesirable side effects. Objective: To evaluate the efficacy of non-pharmacological therapies in alleviating chronic pelvic pain compared to control therapies in women with endometriosis. Methods: This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (CRD42023455704). Database searches were performed in Web of Science, PubMed, Scielo, Embase, and PEDro from June to September 2024. Randomized clinical trials employing non-pharmacological therapies and assessing pain as the primary outcome were included. Quality of life was considered a secondary outcome. Studies comparing non-pharmacological therapies with pharmacological therapy were excluded. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the quality of evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Nine studies, involving 432 women aged 13 to 50 years, were included. The interventions analyzed were acupuncture, yoga, integrative psychotherapy, aerobic exercise, cardiorespiratory training, telerehabilitation, and virtual reality. All studies assessed the primary outcome of pain using different measurement tools, such as the Visual Analog Scale (VAS) from 0 to 10 or 0 to 100 mm and the Numeric Rating Scale (NRS) from 0 to 10. The intervention group demonstrated greater efficacy in pain reduction compared to the control group, except in one study. Meta-analysis of pain outcomes was conducted with five studies, showing the intervention to be superior to the control in reducing pain (mean difference = -1.69; confidence interval: 95% -3.38, -0.00). Quality of life, a secondary outcome, was assessed in seven studies, four of which were included in the meta-analysis. The intervention group showed greater improvement than the control group (mean difference = -1.57; 95% CI: -2.04, -1.10). GRADE assessment revealed very low-quality evidence for pain and quality of life outcomes. Five studies presented a high risk of bias, while four showed a low risk of bias. Conclusion: The analyzed studies indicate improvements in pain and quality of life in women with endometriosis through non-pharmacological therapies. However, the studies present very low confidence in the evidence, underscoring the need for further high-quality methodological research to confirm the efficacy of nonpharmacological interventions in reducing pain associated with endometriosis.Master Thesis Intervenções para o tratamento das neoplasias intraepiteliais vulvares de tipo usual: uma revisão sistemática e meta-análise(Universidade Federal do Rio Grande do Norte, 2025-02-07) Simões, Ana Carolina Zimmermann; Oliveira, Ana Katherine da Silveira Gonçalves de; Sarmento, Ayane Cristine Alves; https://orcid.org/0000-0002-8351-5119; http://lattes.cnpq.br/3436756337251449; http://lattes.cnpq.br/9556027921708423; Freitas, Janaina Cristiana de Oliveira Crispim; Medeiros, Kleyton Santos deVulvar intraepithelial neoplasia (VIN) is a term used to describe squamous epithelial changes of the vulva. This study aimed to evaluate the efficacy of treatments for usual-type vulvar intraepithelial neoplasia (uVIN). This review followed PRISMA guidelines, searching PubMed, Embase, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, PsycINFO, and Clinical Trial Databases in July 2024. Clinical trials comparing treatments for uVIN to placebo or other treatments were included. Risk of bias was assessed using the Cochrane Risk of Bias (RoB 2.0) tool, and the strength of evidence was evaluated using the GRADE approach. Out of 10,306 studies, eight met the inclusion criteria. A meta-analysis of two studies comparing imiquimod 5% to placebo found that 55.3% of women in the imiquimod group experienced total lesion resolution, compared to 0% in the placebo group (RR 18.21, 95% CI 2.60–127.69). Cidofovir 1% had a complete response rate of 41%, while imiquimod 5% showed a 42% response. Imiquimod 5% was well-tolerated and showed a trend toward non-inferiority to surgical treatments. Ultrasonic surgical aspiration caused less scarring than CO2 laser vaporization, with similar efficacy. Sinecatechins 10% showed lesion improvement in the best observed clinical response compared to those in the placebo group (P = 0.002), while indole-3-carbinol and Omiganan were ineffective despite adherence to treatment protocols. Imiquimod 5% is an effective treatment for uVIN with comparable results to surgery. Cidofovir 1% is another effective option. Less invasive treatments are beneficial for multifocal or extensive lesions, but combining medical and surgical approaches has not been studied.Master Thesis Impacto das síndromes hipertensivas gestacionais nos desfechos nutricionais e clínicos em recém-nascidos pré-termo: uma coorte prospectiva(Universidade Federal do Rio Grande do Norte, 2025-02-27) Mendes, Thayanne Gurgel de Medeiros; Lopes, Márcia Marilia Gomes Dantas; Dametto, Juliana Fernandes dos Santos; https://orcid.org/0000-0002-0011-576X; http://lattes.cnpq.br/0512077912732473; http://lattes.cnpq.br/0075923536894629; Saunders, Cláudia; Arrais, Nivia Maria RodriguesHypertensive syndromes in pregnancy (HGS) are characterized by changes in blood pressure levels during the gestational period. For children of women with HGS, premature birth is one of the main consequences, which can impact neonatal outcomes. The objective of this research was to compare the nutritional outcomes of preterm newborns (PTNB) born to women with HGS to children of normotensive women. This was a prospective cohort study with a quantitative approach. The study participants were PTNBs born at the Januário Cicco School Maternity Hospital, in Natal-RN, from October 2021 to November 2023 who were hospitalized in the neonatal intensive care unit (NICU). PTNBs with gestational age between ≥23 and <37 weeks and weight less than 2500g were included, and neonates diagnosed with severe congenital malformation, inborn errors of metabolism and water restriction were excluded. The preterm infants were divided into 2 groups according to exposure to GHS. Data collection was performed using electronic medical records, considering anthropometric and dietary variables for the newborn and maternal comorbidities. Significant results were those with p < 0.05. Of the 220 pregnant women monitored, half had GHS. There was a statistically significant association between GHS and maternal age > 35 years (p = 0.013) and cesarean delivery (p < 0.01). Preterm infants born to women with GHS had a greater need for parenteral nutrition (p = 0.017) and a higher risk of inadequate full enteral nutrition (p = 0.020), had a higher prevalence of being classified as small for gestational age at birth (p < 0.001) and, at discharge from the NICU, with extrauterine growth restriction (p = 0.018), when compared to children of normotensive women. The results confirm that GHS are associated with unfavorable nutritional outcomes in preterm infants. Children of women with GHS had difficulty maintaining adequate nutritional status, having lower Z-scores at birth and at discharge from the NICU. Considering this, these preterm infants require differentiated care, prioritizing early and individualized nutritional interventions in order to improve their nutritional status during their stay in the NICU.Master Thesis Ferramenta gatilho para a otimização do seguimento farmacoterapêutico em gestantes de alto risco: desenvolvimento e validação(Universidade Federal do Rio Grande do Norte, 2023-10-25) Fonseca, Andreia Suelle Moura; Martins, Rand Randall; http://lattes.cnpq.br/8062199269259772; http://lattes.cnpq.br/3094434749098767; Diniz, Rodrigo dos Santos; Moreira, Francisca Sueli MonteIntroduction: Clinical pharmacy is the area of pharmacy concerned with the science and practice of rational drug use, in which pharmacists provide patient care to optimize pharmacotherapy, promote health and well-being, and prevent disease using strategies and tools for this purpose. However, as far as we know, there are no behavioral trigger tools for the detection of Drug-Related Problems in hospitalized pregnant women. Objective: to develop and validate a trigger tool to optimize the identification of Drug-Related Problems in hospitalized high-risk pregnant women. Methods: observational, prospective, descriptive and longitudinal study, developed in a Brazilian maternity hospital from September 2019 to July 2022. Based on the profile and frequency of prescription, the main parameters for monitoring effectiveness and safety were used to develop a triggers. The trigger tool was validated with a sample of 150 pregnant women evaluated concurrently using the SOAP method in two groups: test group (only applied the SOAP method if at least one positive trigger) and standard group (all patients evaluated). The investigation involved identification and characterization of Drug-Related Problems via PCNE v. 9.0. The tool was characterized in terms of accuracy, sensitivity, specificity and predictive values, in addition to using the Brier method for validation. Results: The trigger tool showed a sensitivity of 74.1% (CI95% 67.7 - 81.1), specificity of 70.7% (CI95%63.4 - 78.0) and accuracy of 73.2% (CI95% 65.3 - 79.7). Internal validation showed a Brier score of 0.269. Conclusion: The evaluated tool showed a moderate sensitivity and an acceptable positive predictive value, making it a useful tool in the initial screening and identification of possible Drug-Related Problems in hospitalized high-risk pregnant women.Master Thesis Perfil sociodemográfico de gestantes com diabetes e sua relação com mecanismos de morte celular(Universidade Federal do Rio Grande do Norte, 2024-10-25) Neves, Maria Carolina Dantas Campelo; Salha, Daniella Regina Arantes Martins; Aguiar, Carolina de Oliveira Mendes; http://lattes.cnpq.br/3980490175965712; https://orcid.org/0000-0002-1350-5919; http://lattes.cnpq.br/3695151190501921; https://orcid.org/0000-0003-2509-1685; http://lattes.cnpq.br/4741467832748483; Kluczynik, Caroline Evelin Nascimento; Bacellar, Maria Olivia Amado RamosIntroduction: The gestational period is marked by complex physiological changes that seek to meet the demands between mother and baby. A pregnancy accompanied by Diabetes Mellitus potentiates oxidative stress mediated by the inflammatory response that culminates in the production of reactive oxygen and nitrogen species, generating a maternal and placental imbalance causing cellular damage. Objective: To analyze the sociodemographic profile and cell death along with the inflammatory process of Diabetes Mellitus during pregnancy. Materials and methods: This is an observational and descriptive study, with a quantitative approach, operationalized in two stages: cross-sectional study and case-control study. In the first, 240 diabetic and 12 nondiabetic pregnant women were characterized sociodemographically. In the second study, among the 240 diabetic pregnant women, 23 of them and 12 pregnant women without comorbidities had whole blood samples collected for analysis of the cell death profile by flow cytometry, in the populations of lymphocytes, monocytes and granulocytes of whole blood, through labeling with annexin V FIT-C and/or propidium iodide. Results: Of the population studied, 46.25% were between 30 and 39 years old, 57.08% were brown, 50% had a salary income ≤ 01 minimum wage, 57.08% had high school education. Regarding housing, 62.92% of the pregnant women lived in rural areas; 65.83% had sanitation, 97.92% had electricity and 71.25% lived on paved streets. Clinically, 67.74% of pregnant women did not notice symptoms of diabetes before diagnosis, 77.41% were diagnosed during pregnancy, 57.14% had a family history of diabetes and 67.86% had a family history of hypertension. Regarding the diabetes condition, among the 240 pregnant women studied, 79.17%, 5.83% and 15.00% had gestational diabetes, type 1 diabetes mellitus and type 2 diabetes mellitus, respectively. Cellular analysis showed greater cell viability in lymphocytes and granulocytes in the control population (p = 0.001) than in pregnant women with gestational diabetes mellitus (p = 0.04) and in pregnant women with type 1 and 2 diabetes (p = 0.04). Furthermore, a significant difference was observed regarding the degree of recent and late apoptosis in the lymphocyte population of pregnant women with gestational diabetes and control (p = 0.006). Likewise, there was a statistical difference when comparing the same cellular stages in the group of pregnant women with type 1 and 2 diabetes with the control group (p=0.03). Necrosis was more significant in the control group (p=0.03). In the monocyte population, no significant difference was observed between the groups of pregnant women analyzed. The gestational age of the participants was between the 12th and 38th weeks, with apoptosis levels present in all of them. Final considerations: Almost half of the pregnant women were over 32 years old, an age at which the risks of pregnancy such as preeclampsia and other aggravating factors must be taken into account. However, it is possible to have a healthy pregnancy at this age, paying attention to the necessary care. The cellular viability of lymphocytes and granulocytes was better identified in the group of women without diabetes (control group). Between the groups of women with only Gestational Diabetes Mellitus and the group of women with type 1 or 2 diabetes, no difference was observed in the level of apoptosis, suggesting that, regardless of the type of diabetes, the pregnant woman suffered cell loss during pregnancy, showing that Diabetes, especially gestational diabetes, can increase the level of oxidative stress and inflammation, causing excessive apoptosis, causing harm to mothers and babies.Master Thesis Caracterização do perfil Th1, Th2 E Th17 em mulheres com infertilidade submetidas à fertilização in vitro antes e após protocolo de estimulação ovariana(Universidade Federal do Rio Grande do Norte, 2023-10-30) Martins, Marcela Queiroz Lopes de Melo; Freitas, Janaina Cristiana de Oliveira Crispim; https://orcid.org/0000-0002-1344-0078; http://lattes.cnpq.br/2644540835478572; http://lattes.cnpq.br/5544212725472459; Lanza, Daniel Carlos Ferreira; Lovato, Juliana MeolaThe search for biomarkers that have a predictive and prognostic value in the pathophysiology of the infertility process between couples is one of the objectives of reproductive immunobiology studies. It is known that immunoregulatory molecules and expression of pro/anti-inflammatory mediators have a contribution in reproductive medicine. However, the role of these molecules in the physio pathogenesis of infertility is still unknown. This study aims to evaluate the protein expression of the cytokine axis of Th1, Th2 and Th17 responses in women who present infertility before and after ovarian stimulation protocol. A prospective cohort study was conducted with 20 women followed by the assisted reproduction outpatient clinic from September 2021 to September 2022 at a University Hospital. As an inclusion criterion, we selected women over 18 years of age diagnosed with infertility due to different etiologies and causes with clinical indication for the treatment of in vitro fertilization (IVF). Women with autoimmune diseases, immunodeficiencies, chronic diseases and genetic syndromes linked to sex chromosomes were excluded at this study. 4ml of whole blood was collected by venous puncture for the quantification of cytokines by flow cytometry at two different times: Time 0: Before the start of the ovarian stimulation protocol (without medication) and at time 1: On the day of ovarian puncture for collection of oocytes (after medication for ovarian stimulation). For statistical analysis, Spearman correlation with p<0.05 values was performed. We observed a negative correlation between the fertilization rate and the production of TNF-α (p0.041) and between IL 6 and pregnancy, independent of the Th17 response. In this context, we observed a modulation of the pro-inflammatory response (activation of the innate imune response) in women with infertility.