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Wassie ST, Ejigu AG, Tilahun AG, Lambyo SHM. The impact of intimate partner violence on adverse birth outcomes in public health facilities. A prospective cohort study. Midwifery 2023; 126:103815. [PMID: 37717345 DOI: 10.1016/j.midw.2023.103815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/04/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND During pregnancy, intimate partner violence (IPV) is a health problem associated with severe adverse birth outcomes. The Ethiopian Demographic Health Survey showed that more than one-third of married women faced IPV. Therefore, this study aimed to investigate the effects of IPV during pregnancy on adverse birth outcomes. METHODS A prospective cohort study was conducted from September 1st, 2021 to April 30th, 2022. Using a systematic random sampling technique, participants were enrolled from 20 to 24 weeks of gestation at antenatal visits at the selected public health institutions. The validated and modified standards of the World Health Organization Domestic Violence Questionnaire were used to screen for IPV. Bivariate and multivariate logistic regression models were used in this study. The relative risk was also calculated to predict the occurrence of adverse birth outcomes. RESULTS Overall, 701 pregnant women were followed from 20 to 24 weeks of gestation until delivery in a 1:2 ratio (244 exposed to 457 non-exposed). Preterm birth increased by 1.02 times (RR=1.02, 95 CI; 0.979-1.047), low birth weight with RR= 2.023, 95% CI; 1.201-3.407 and stillbirth (RR= 1.124, 95%CI; 0.43-3.055). Among the exposed groups, 167(23.8%), 83 (11.8%), and 51 (7.3%) had emotional, physical, and sexual violence, respectively. The odds of developing adverse birth outcomes from IPV exposure were [AOR=1.63,95% CI: [1.23, 3.75], emotional violence [AOR= 1.70:95% CI: [1.24, 4.24], and physical violence [AOR= 3.99:95% CI: [1.51, 10.52] times higher than those of their counterparts. No significant association was observed between sexual violence and adverse birth outcomes. Being unsupported by the husband and having previous adverse birth outcomes increased IPV by nearly four-fold [AOR=3.80:95% CI; 1.19, 12.09] and [AOR= 3.70:95% CI:1.49, 9.17], respectively. The odds of mothers with a 2nd visit MUAC measurement of < 23 cm were [AOR=2.81:95% CI; 1.20, 6.61]. CONCLUSION The incidence of adverse birth outcomes was significantly higher in the physically IPV-exposed group than in the non-exposed group. Therefore, pregnant women should be screened for IPV during their antenatal period. Thus, IPV-exposed pregnant women should be counseled and closely followed up.
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Affiliation(s)
| | - Amare Genetu Ejigu
- Department of Midwifery, Injibara University, P.O. Box:40, Injibara, Ethiopia
| | - Abel Girma Tilahun
- School of Public Health, Mizan-Tepi University, P. O. Box: 260, Mizan-Tapi, Ethiopia
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Marques ES, Faus DP, Levy RB, Leite MA, Eisner MP, Peres MFT. Relationship between polyvictimization and overweight among adolescents from São Paulo city, Brazil. Prev Med 2023; 170:107492. [PMID: 37001605 DOI: 10.1016/j.ypmed.2023.107492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
This study is to identify victimization patterns and analyze the association between the experience of polyvictimization and overweight or obesity among adolescent girls and boys. The sample consisted of 2680 Brazilian ninth-graders enrolled in public and private schools, taken from the São Paulo Project for the social development of children and adolescents (SP-PROSO). Victimization was explored in two ways: (i) as per Finkelhor and (ii) by latent class analysis (LCA). The interest outcomes were overweight and obesity. Multinomial logistic regression models were used to study the relationship between victimization and overweight or obesity, controlling for confounders. LCA grouped boys and girls adolescents into three classes. These classes received the same labels, but the patterns differed between sexes. Class 1 was characterized by fewer types of victimization suffered and lower endorsement values in the analyzed items and was named bullying and indirect victimization (♀: 42.7%, n = 546; ♂: 21.6%, n = 293). Class 2 included more victimization types than Class 1 and less than Class 3. This class was labeled family violence and peer victimization (♀: 29.1%, n = 356; ♂: 47.9%, n = 652). Class 3 was named high polyvictimization (♀: 28.2%, n = 345; ♂: 30.5%, n = 418). According to Finkelhor, polyvictimization was not associated with overweight or obesity in both sexes. Only the class of high polyvictimization was associated with being overweight (ORadj: 1.60, 95%CI: 1.01-2.54) in girls. In this study, polyvictimization was associated with being overweight only among adolescent girls. Longitudinal studies in different contexts and populations are needed to understand this relationship.
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Affiliation(s)
- Emanuele Souza Marques
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Daniela Porto Faus
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria Alvim Leite
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Manuel P Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
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Dutta S, Deshmukh P. Association of Eating Disorders in Prenatal and Perinatal Women and Its Complications in Their Offspring. Cureus 2022; 14:e31429. [PMID: 36523672 PMCID: PMC9745253 DOI: 10.7759/cureus.31429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/12/2022] [Indexed: 11/15/2022] Open
Abstract
Numerous studies revealed that women in the first trimester of pregnancy (prenatal) and 6-12 months after delivery of a newborn (postnatal) suffer from eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder. Pregnancy may increase or decrease the symptoms of eating disorders. It varies from person to person. The mother faces many complications during this period which may also affect the newborn child. Weight loss is an essential symptom of eating disorders, which may cause extreme anxiety and depression during and after pregnancy. Stress is another symptom that is associated with binge eating disorders. The main aim of this narrative review article is to critically analyze and discuss the association of prenatal and postnatal factors that lead to different eating disorders in the mother and child. A total of 38 published and standard articles were selected for this review. The studies under consideration showed numerous methodological shortcomings, necessitating additional investigation to explain these discrepancies. The evidence points to a connection between prenatal and perinatal variables, and the children of these women also develop eating disorders. Earlier research focused on linking pregnancy and eating disorders, mainly emphasizing anorexia nervosa and bulimia nervosa. However, any significant correlation between binge eating disorder and pregnancy is yet to be found. In the first half of pregnancy, about 33%-35% of women who had binge eating disorder before becoming pregnant no longer met the diagnostic criteria, their illness improved, and they seemed to recover. These patients with eating disorders are more likely to have pregnancy-related complications and births. Therefore, creating a multidisciplinary screening strategy and guidelines for managing and supervising this particular patient population makes sense.
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Affiliation(s)
- Sushmita Dutta
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Prasad Deshmukh
- Otolaryngology-Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Getinet W, Azale T, Getie E, Salelaw E, Amare T, Demilew D, Lemma A, Kibret D, Aklilu A, Tensae T, Srahbzu M, Shumet S. Intimate partner violence among reproductive-age women in central Gondar zone, Northwest, Ethiopia: a population-based study. BMC Womens Health 2022; 22:109. [PMID: 35397559 PMCID: PMC8994176 DOI: 10.1186/s12905-022-01685-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/29/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49). METHODS Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant. RESULT Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI . CONCLUSION Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.
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Affiliation(s)
- Wondale Getinet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eskedar Getie
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Endalamaw Salelaw
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemu Lemma
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Destaw Kibret
- Central Gondar Zonal Health Office, Gondar, Ethiopia
| | - Abayneh Aklilu
- School of Midwifery College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techalo Tensae
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Segoviano-Lorenzo MDC, Trigo-Esteban E, Gyorkos TW, St-Denis K, Guzmán FMD, Casapía-Morales M. Prevalence of malnutrition, anemia, and soil-transmitted helminthiasis in preschool-age children living in peri-urban populations in the Peruvian Amazon. CAD SAUDE PUBLICA 2022; 38:e00248221. [DOI: 10.1590/0102-311xen248221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 10/06/2022] [Indexed: 12/23/2022] Open
Abstract
Stunting, anemia, and soil-transmitted helminth (STH) infections are major health concerns for children in extremely poor regions of the world, especially rural and periurban ones. This study aimed to determine the prevalence of these three cooccurring conditions in preschool-age children in an extremely poor district on the outskirts of Iquitos, in the Peruvian Amazon, to inform public health actions. Malnutrition was assessed by standard World Health Organization-recommended metrics; anemia, by hemoglobin levels; and STH, by the Kato-Katz technique. Logistic regression analyses were performed to identify the risk factors for our three outcomes of interest. A total of 572 children aged 6-59 months were recruited in March 2019. We found a 31.3% stunting, 47.2% anemia, and 34.1% STH prevalence. Stunting and anemia figures exceeded both regional and national estimates for 2019. Having more children was a risk factor for stunting, whereas married mothers were associated with a lower risk. Risk factors for anemia included younger age and the male sex, whereas those for STH, older age, incomplete vaccination, and a lower socioeconomic status. Mothers’ employment outside the home was also associated with a lower STH risk. This recent evidence highlights the need for prompt and integrated clinical attention and public health actions to address both short- and long-term health consequences in this vulnerable child age group. The integration of a monitoring and evaluation framework is important to effectively manage these conditions, optimize resources and accountability, and show their impact.
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Affiliation(s)
| | | | | | - Kariane St-Denis
- Research Institute of the McGill University Health Centre, Canada
| | | | - Martín Casapía-Morales
- Asociación Civil Selva Amazónica, Perú; Universidad Nacional de la Amazonia Peruana, Peru
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Dias FMV, Oliveira AS, Júnior CSD, Franco GC, Teixeira AL, Nunes PT, Oliveira PDS, Ribeiro AM. Social vulnerability: The connection between psychiatric disorders and thiamine deficiency in pregnant women. Psychiatry Res 2020; 293:113362. [PMID: 32861095 DOI: 10.1016/j.psychres.2020.113362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 07/20/2020] [Accepted: 08/02/2020] [Indexed: 11/26/2022]
Abstract
The evaluation of thiamine and its derivative phosphate esters levels in pregnant women in rural communities can contribute not only for understanding the specific characteristics of this population regarding nutritional aspects, but also for clarifying the relations of psychiatric manifestations and a vitamin deficit. In the present work we assessed sociodemographic variables, psychiatric parameters and thiamine and its derivative in the whole blood of women in a rural, low-income community in Brazil. A case-control study was done. 94 women were divided in groups using the trimesters of pregnancy as a criterion: each trimester, 1st, 2nd and 3rd had 17, 37 and 38 women, respectively. A control group of non-pregnant women (n-39) was also included. Symptoms of anxiety and depression were assessed using the HAMA Scale and Beck Inventory, respectively. The thiamine and its phosphorylated derivatives concentrations were determined in whole blood samples using the HPLC method. The results suggest that physiological mechanisms linked to the metabolic pathways of thiamine may play a role in some neurobiological substrate involved in the regulation of emotional state. Thus, social vulnerability is identified as an important factor to be considered in the evaluation of the mental health of pregnant women living in rural communities.
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Affiliation(s)
- Fernando Machado Vilhena Dias
- Graduate program in Neurosciences, Laboratorio of Molecular and Behavioural Neuroscience, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | - Cláudio S Dias Júnior
- Department of Sociology and Anthropology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Glaura C Franco
- Department of Statistics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Antônio L Teixeira
- Graduate program in Neurosciences, Neuropsychiatry Research Group, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Poliana Toledo Nunes
- Graduate program in Neurosciences, Laboratorio of Molecular and Behavioural Neuroscience, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Patricia da Silva Oliveira
- Graduate program in Neurosciences, Laboratorio of Molecular and Behavioural Neuroscience, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Angela Maria Ribeiro
- Graduate program in Neurosciences, Laboratorio of Molecular and Behavioural Neuroscience, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Carrilho TRB, Farias DR, Batalha MA, Costa NCF, Rasmussen KM, Reichenheim ME, Ohuma EO, Hutcheon JA, Kac G. Brazilian Maternal and Child Nutrition Consortium: establishment, data harmonization and basic characteristics. Sci Rep 2020; 10:14869. [PMID: 32913200 PMCID: PMC7483530 DOI: 10.1038/s41598-020-71612-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
Pooled data analysis in the field of maternal and child nutrition rarely incorporates data from low- and middle-income countries and existing studies lack a description of the methods used to harmonize the data and to assess heterogeneity. We describe the creation of the Brazilian Maternal and Child Nutrition Consortium dataset, from multiple pooled longitudinal studies, having gestational weight gain (GWG) as an example. Investigators of the eligible studies published from 1990 to 2018 were invited to participate. We conducted consistency analysis, identified outliers, and assessed heterogeneity for GWG. Outliers identification considered the longitudinal nature of the data. Heterogeneity was performed adjusting multilevel models. We identified 68 studies and invited 59 for this initiative. Data from 29 studies were received, 21 were retained for analysis, resulting in a final sample of 17,344 women with 72,616 weight measurements. Fewer than 1% of all weight measurements were flagged as outliers. Women with pre-pregnancy obesity had lower values for GWG throughout pregnancy. GWG, birth length and weight were similar across the studies and remarkably similar to a Brazilian nationwide study. Pooled data analyses can increase the potential of addressing important questions regarding maternal and child health, especially in countries where research investment is limited.
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Affiliation(s)
- Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Mônica Araújo Batalha
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia Cristina Freitas Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Kathleen M Rasmussen
- Division of Nutritional Sciences, Cornell University, 227 Savage Hall, Ithaca, NY, 14850, USA
| | - Michael E Reichenheim
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7 andar, Bloco D, Sala 7018, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research (PMB), South Parks Road, Oxford, OX1 3SY, UK
| | - Jennifer A Hutcheon
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, BC, V6Z 2K8, Canada
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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Caprara GL, Bernardi JR, Bosa VL, da Silva CH, Goldani MZ. Does domestic violence during pregnancy influence the beginning of complementary feeding? BMC Pregnancy Childbirth 2020; 20:447. [PMID: 32758170 PMCID: PMC7404913 DOI: 10.1186/s12884-020-03144-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigate the influence of domestic violence against pregnant women on early complementary feeding and associated factors. METHODS A longitudinal observational study was conducted with a convenience sample recruited from three public hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Data on maternal age, education, marital status, breastfeeding, introduction of complementary feeding and domestic violence during pregnancy were investigated at four follow-ups points. Data on domestic violence was collected through a self-report questionnaire based on the Abuse Assessment Screen. The early introduction of complementary feeding, characterized as occurring before or at 3 months of life, was verified through a questionnaire prepared by the research group. Data analysis involved Student's t-test, the chi-square test and Cox regression and was carried out in Statistical Package for the Social Sciences program. The significance level was set at 5%. RESULTS A total of 232 mother-infant pairs participated in the analyses, and 15.1% of the mothers reported suffering some form of violence. Domestic violence was directly associated with maternal education, marital status, and health status during pregnancy. Domestic violence was not associated with maternal age or breastfeeding at 3 months after delivery. In the univariate analysis, domestic violence during pregnancy was associated with early complementary feeding (RR = 1.74; CI: 1.01-2.98). This effect disappeared after the model was adjusted in multivariate analysis. CONCLUSIONS There was no relationship between domestic violence during pregnancy and early complementary feeding.
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Affiliation(s)
- Gabriele Luiza Caprara
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Juliana Rombaldi Bernardi
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Vera Lúcia Bosa
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Clécio Homrich da Silva
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Marcelo Zubaran Goldani
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
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Martínez-Olcina M, Rubio-Arias JA, Reche-García C, Leyva-Vela B, Hernández-García M, Hernández-Morante JJ, Martínez-Rodríguez A. Eating Disorders in Pregnant and Breastfeeding Women: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E352. [PMID: 32679923 PMCID: PMC7404459 DOI: 10.3390/medicina56070352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
Background: Pregnancy is a stage associated with various biopsychosocial changes. These changes, along with concerns about keeping an adequate weight, can modulate an individual's risk for psychological disorders, especially eating disorders (EDs). The aim of this review was to investigate the prevalence, associated risks, and consequences of eating disorders in pregnancy and in breastfeeding mothers. Materials and Methods: A systematic review was carried out following the PRISMA guidelines in the scientific databases: PubMed, Web of Science, Scopus, and PsycINFO. Search terms related to EDs, pregnancy, and breastfeeding were used. The evaluation of the methodological quality of the studies was carried out using different scales; CASP (Checklist for Cohort Study), NICE (Methodology Checklist for Cohort Study), ARHQ (Methodology Checklist for Cross-Sectional), and NOS (Newcastle-Ottawa Scale for Cohort). Results: From 2920 studies, 16 were selected to study EDs in pregnant women and 2 studies in nursing mothers. Most of the studies used questionnaires and scales as tools for the diagnosis of EDs. Binge eating, anxiety, and depression were the most common comorbidities of EDs, accompanied in most cases by excessive concern about weight gain. The consequences of EDs are diverse. The prevalence of EDs in this population is estimated to be 1 out of 20. Conclusions: Eating disorders are related to anxiety and depression and have negative consequences for both mothers and fetuses (cesarean, miscarriages, premature births). More research on the field to determine the risk factors for EDs in the population of pregnant and lactating women is needed.
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Affiliation(s)
- María Martínez-Olcina
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | - Jacobo A. Rubio-Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Polytechnic University of Madrid, 28040 Madrid, Spain;
| | | | - Belén Leyva-Vela
- Department of Health, Vinalopó University Hospital, 03293 Elche, Spain;
| | - María Hernández-García
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | | | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
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Epstein A, Bendavid E, Nash D, Charlebois ED, Weiser SD. Drought and intimate partner violence towards women in 19 countries in sub-Saharan Africa during 2011-2018: A population-based study. PLoS Med 2020; 17:e1003064. [PMID: 32191701 PMCID: PMC7081984 DOI: 10.1371/journal.pmed.1003064] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/21/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries. METHODS AND FINDINGS We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15-49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations. CONCLUSIONS Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.
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Affiliation(s)
- Adrienne Epstein
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Eran Bendavid
- Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Denis Nash
- Institute for Implementation Science in Population Health, City University of New York, New York, New York, United States of America
| | - Edwin D. Charlebois
- Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Sheri D. Weiser
- Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America
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Diamond-Smith N, Conroy AA, Tsai AC, Nekkanti M, Weiser SD. Food insecurity and intimate partner violence among married women in Nepal. J Glob Health 2019; 9:010412. [PMID: 30774941 PMCID: PMC6359930 DOI: 10.7189/jogh.09.010412] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Intimate Partner Violence (IPV) is an important public health concern globally, including in Nepal. Food insecurity (being without reliable access to a sufficient quantity of affordable, nutritious food) has been associated with IPV, but no known studies have explored this relationship in South Asia, or Nepal specifically. Women’s level of empowerment is an important factor to consider when understanding the relationship between food insecurity and IPV. Methods Using data from the 2011 Nepal Demographic and Health Survey, we explore the relationship between different levels of food insecurity (none, mild, moderate, severe) and three types of IPV: physical, sexual and emotional. In a second set of models we adjust for indicators of women’s empowerment. We use multi-variable logistic regression to test for an association between these factors, adjusting for individual and household level demographic variables. Findings About half of married women in our sample experience food insecurity and approximately 10% of women experienced each of the three different types of IPV in the past 12 months: emotional, sexual and physical. Food insecurity is significantly associated with increased odds of experiencing emotional (odds ratio OR = 1.75 95% confidence interval CI = 1.06-2.77 for severe food insecurity) or physical (OR = 2.48, 95% CI = 1.52-4.04 for severe food insecurity) IPV, but not sexual IPV, after adjusting for individual and household level demographic variables. After adjusting for empowerment related factors, this relationship still holds, although it is somewhat attenuated. Women’s level of household decision-making power is significantly associated with higher odds of emotional, sexual and physical IPV, and whether she lives with her in-laws is protective against emotional IPV. Conclusions Among married women in Nepal, being food insecure is associated with higher odds of some types of IPV, specifically emotional and physical IPV. Accounting for women’s level of empowerment explains some of the relationship between food insecurity and IPV. It is essential that interventions to prevent IPV address household stressors such as food insecurity among married, Nepalese women, perhaps through cross-sectoral approaches. Such structural interventions are likely to reduce IPV for married women across South Asia who live in a similar levels of gender discrimination and food insecurity.
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Affiliation(s)
| | - Amy A Conroy
- University of California, San Francisco, California, USA
| | | | - Manali Nekkanti
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sheri D Weiser
- University of California, San Francisco, California, USA
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Teague S, Youssef GJ, Macdonald JA, Sciberras E, Shatte A, Fuller-Tyszkiewicz M, Greenwood C, McIntosh J, Olsson CA, Hutchinson D. Retention strategies in longitudinal cohort studies: a systematic review and meta-analysis. BMC Med Res Methodol 2018; 18:151. [PMID: 30477443 PMCID: PMC6258319 DOI: 10.1186/s12874-018-0586-7] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participant retention strategies that minimise attrition in longitudinal cohort studies have evolved considerably in recent years. This study aimed to assess, via systematic review and meta-analysis, the effectiveness of both traditional strategies and contemporary innovations for retention adopted by longitudinal cohort studies in the past decade. METHODS Health research databases were searched for retention strategies used within longitudinal cohort studies published in the 10-years prior, with 143 eligible longitudinal cohort studies identified (141 articles; sample size range: 30 to 61,895). Details on retention strategies and rates, research designs, and participant demographics were extracted. Meta-analyses of retained proportions were performed to examine the association between cohort retention rate and individual and thematically grouped retention strategies. RESULTS Results identified 95 retention strategies, broadly classed as either: barrier-reduction, community-building, follow-up/reminder, or tracing strategies. Forty-four of these strategies had not been identified in previous reviews. Meta-regressions indicated that studies using barrier-reduction strategies retained 10% more of their sample (95%CI [0.13 to 1.08]; p = .01); however, studies using follow-up/reminder strategies lost an additional 10% of their sample (95%CI [- 1.19 to - 0.21]; p = .02). The overall number of strategies employed was not associated with retention. CONCLUSIONS Employing a larger number of retention strategies may not be associated with improved retention in longitudinal cohort studies, contrary to earlier narrative reviews. Results suggest that strategies that aim to reduce participant burden (e.g., flexibility in data collection methods) might be most effective in maximising cohort retention.
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Affiliation(s)
- Samantha Teague
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Adrian Shatte
- School of Engineering & Information Technology, Faculty of Science & Technology, Federation University, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Chris Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia
| | - Jennifer McIntosh
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia.,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Burwood, Geelong, Victoria, 3125, Australia. .,Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia. .,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Melbourne, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Khajehei M, Doherty M. Women's experience of their sexual function during pregnancy and after childbirth: a qualitative survey. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.5.318] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marjan Khajehei
- Clinical midwifery consultant, women's health research, Westmead Hospital, Australia Conjoint senior lecturer, University of New South Wales, Sydney, Australia Senior research fellow, University of Sydney
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Paskulin JTA, Drehmer M, Olinto MT, Hoffmann JF, Pinheiro AP, Schmidt MI, Nunes MA. Association between dietary patterns and mental disorders in pregnant women in Southern Brazil. ACTA ACUST UNITED AC 2017; 39:208-215. [PMID: 28355346 PMCID: PMC7111387 DOI: 10.1590/1516-4446-2016-2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. Methods: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants’ mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). Results: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). Conclusions: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.
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Affiliation(s)
- Jéssica T A Paskulin
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Michele Drehmer
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Maria T Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil.,Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Juliana F Hoffmann
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Andréa P Pinheiro
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria I Schmidt
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria A Nunes
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Khajehei M, Doherty M. Exploring postnatal depression, sexual dysfunction and relationship dissatisfaction in Australian women. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjom.2017.25.3.162] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Marjan Khajehei
- Clinical midwifery consultant – women's health research, Westmead Hospital, Westmead, Sydney, Australia
| | - Maryanne Doherty
- Associate professor, Curtin University, Perth, Western Australia
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DREHMER M, MELERE C, REINHEIMER SM, CAMEY SA. Agreement of dietary fiber and calorie intake values according to the choice of nutrient composition and household measure tables. REV NUTR 2017. [DOI: 10.1590/1678-98652017000200008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: To analyze the variations in the daily intake of dietary fiber and calories according to the different nutrient composition and homemade measure tables. Methods: Five different methods based on different nutrient composition and household measure tables were used to calculate daily calorie and fiber intake, measured using a food frequency questionnaire, of 633 pregnant women receiving care in primary health care units in the Southern region of Brazil; they were selected to participate in a cohort study. The agreement between the five methods was evaluated using the Kappa and weighted Kappa coefficients. The Nutritional Support Table, a Brazilian traditional food composition table and the Brazilian household expenditure survey were used in Method 1. Brazilian Food Composition Table and the Table for the Assessment of Household Measures (Pinheiro) were used in Methods 2 and 3. The average values of all subtypes of food listed in the Brazilian Food Composition Table for each corresponding item in the food frequency questionnaire were calculated in the method 3. The United States Department of Agriculture Food Composition Table and the table complied by Pinheiro were used in Method 4. The Brazilian Food Composition Table and the Brazilian household expenditure survey were used in Method 5. Results: The highest agreement of calorie intake values were found between Methods 2 and 3 (Kappa=0.94; 0.92-0.95), and the lowest agreement was found between Methods 4 and 5 (Kappa=0.46; 0.42-0.50). As for the fiber intake, the highest agreement was found between Methods 2 and 5 (Kappa=0.87; 0.82-0.90), and the lowest agreement was observed between Methods 1 and 4 (Kappa=0.36; 0.3-0.43). Conclusion: Considerable differences were found between the nutritional composition tables. Therefore, the choice of the table can influence the comparability between studies.
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Athié K, Menezes ALDA, da Silva AM, Campos M, Delgado PG, Fortes S, Dowrick C. Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study. BMC Health Serv Res 2016; 16:532. [PMID: 27716299 PMCID: PMC5045579 DOI: 10.1186/s12913-016-1740-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 09/06/2016] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. METHOD In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. RESULTS Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. CONCLUSION There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.
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Affiliation(s)
- Karen Athié
- Programa de Pós Graduação em Ciências Médicas/ Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alice Lopes do Amaral Menezes
- Laboratório Interdisciplinar em Atenção Primária à Saúde/LIPAPS/Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angela Machado da Silva
- Laboratório Interdisciplinar em Atenção Primária à Saúde/LIPAPS/Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monica Campos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Pedro Gabriel Delgado
- Núcleo de Pesquisas em Políticas Públicas de Saúde Mental/ Instituto de Psiquiatria da Universidade do Brasil, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Fortes
- Laboratório Interdisciplinar em Atenção Primária à Saúde/LIPAPS/Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christopher Dowrick
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
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INTIMATE PARTNER VIOLENCE AND UNINTENDED PREGNANCY AMONG ADOLESCENT AND YOUNG ADULT MARRIED WOMEN IN SOUTH ASIA. J Biosoc Sci 2016; 49:206-221. [PMID: 27324924 DOI: 10.1017/s0021932016000286] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005-2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15-24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.
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Abdollahi F, Abhari FR, Delavar MA, Charati JY. Physical violence against pregnant women by an intimate partner, and adverse pregnancy outcomes in Mazandaran Province, Iran. J Family Community Med 2015; 22:13-8. [PMID: 25657606 PMCID: PMC4317989 DOI: 10.4103/2230-8229.149577] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and Aim: Violence against women during pregnancy is linked to poor outcome of pregnancy, which is reported to have widespread in Iran. The aim of this study was to determine the prevalence of physical violence against women by an intimate partner during pregnancy, and to assess the impact of this physical violence on pregnancy outcomes. Materials and Methods: A prospective cohort study was conducted on the characteristics of pregnant women in urban areas and related violence. The modified standard World Health Organization Domestic Violence Questionnaire was used to classify pregnant women and domestic violence. A total of 1461 pregnant women were selected using cluster sampling. The association between sociodemographic with intimate partner violence (IPV) and IPV with pregnancy outcomes was determined using logistic regression. Results: Of these, 206 (14.1%) (confidence interval = 12.3-15.9) reported physical IPV during pregnancy. The adjusted odds ratio for IPV in illiterate women or those with primary level of education (0.001), secondary level education (0.003), and in low income households (0.0001) were significantly higher than in those women with university level education and in higher income households. After adjusting for suspected confounding factors, the women with a history of violence by partners had 1.9 fold risk of premature rupture of membranes, and a 2.9 fold risk of low birth weight compared to women who did not experience any violence from their partners. Conclusion: The results of this research indicated that the prevalence of IPV was high among pregnant women. Therefore, it is necessary to emphasize the screening of pregnant women at Primary Health Centers to prevent physical abuse.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farrideh R Abhari
- Department of Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mouloud A Delavar
- Department of Midwifery, Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Ganjafroz, Babol, Iran
| | - Jamshid Y Charati
- Department of Statistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Camey SA, Torman VBL, Hirakata VN, Cortes RX, Vigo A. Bias of using odds ratio estimates in multinomial logistic regressions to estimate relative risk or prevalence ratio and alternatives. CAD SAUDE PUBLICA 2014; 30:21-9. [PMID: 24627010 DOI: 10.1590/0102-311x00077313] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 09/02/2013] [Indexed: 11/22/2022] Open
Abstract
Recent studies have emphasized that there is no justification for using the odds ratio (OR) as an approximation of the relative risk (RR) or prevalence ratio (PR). Erroneous interpretations of the OR as RR or PR must be avoided, as several studies have shown that the OR is not a good approximation for these measures when the outcome is common (> 10%). For multinomial outcomes it is usual to use the multinomial logistic regression. In this context, there are no studies showing the impact of the approximation of the OR in the estimates of RR or PR. This study aimed to present and discuss alternative methods to multinomial logistic regression based upon robust Poisson regression and the log-binomial model. The approaches were compared by simulating various possible scenarios. The results showed that the proposed models have more precise and accurate estimates for the RR or PR than the multinomial logistic regression, as in the case of the binary outcome. Thus also for multinomial outcomes the OR must not be used as an approximation of the RR or PR, since this may lead to incorrect conclusions.
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de Carvalho Padilha P, Barros DC, Campos ABF, Ayeta AC, Queiróz JA, Saunders C. Performance of an anthropometric assessment method as a predictor of low birthweight and being small for gestational age. J Hum Nutr Diet 2014; 28:292-9. [DOI: 10.1111/jhn.12235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P. de Carvalho Padilha
- Department of Nutrition and Dietetics; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - D. C. Barros
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Food and Nutrition Collaboration Center - Southeast Region; Osvaldo Cruz Foundation; National School of Public Health; Rio de Janeiro Brazil
| | - A. B. F. Campos
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - A. C. Ayeta
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - J. A. Queiróz
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - C. Saunders
- Department of Nutrition and Dietetics; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- Research Group on Maternal and Child Health; Josué de Castro Nutrition Institute; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
- UFRJ Maternidade Escola; Rio de Janeiro Brazil
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Nunes MA, Pinheiro AP, Hoffmann JF, Schmidt MI. Eating disorders symptoms in pregnancy and postpartum: a prospective study in a disadvantaged population in Brazil. Int J Eat Disord 2014; 47:426-30. [PMID: 24338624 DOI: 10.1002/eat.22236] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 11/22/2013] [Accepted: 11/30/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess eating disorder symptoms (EDS) from prepregancy through postpartum. METHOD Seven hundred and twelve women with gestational age ranging from 16th to 36th week completed the eating disorder examination questionnaire (EDE-Q). A shortened version of the EDE-Q was used to assess, retrospectively, EDS during the last 28 days of the pregestational period. Follow up assessment occurred at the 4th-5th month postpartum (n = 427). Generalized structural equation models were used to estimate risk of EDS in pregestation, gestation, and postpartum. RESULTS Women who did not participate in follow up (n = 285) were not significantly different in sociodemographic characteristics. In postpartum, a higher number of women referred shape (RR = 1.65; 95% CI 1.19-2.30) and weight concerns (RR = 1.64; 95% CI 1.16-2.31) than in pregestation. Binge eating (BE) and self-induced vomiting diminished during pregnancy (RR = 0.70, 95% CI 0.57-0.85; RR = 0.21, 95% CI 0.10-0.44, respectively) and postpartum (RR = 0.62, 95% CI 0.48-0.80; RR = 0.38, 95% CI 0.19-0.76, respectively) compared with pregestation DISCUSSION Shape and weight concerns are highly prevalent in postpartum and may confer risk for the development of inappropriate eating behaviors. Health professionals should be trained on how to recognize these symptoms.
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Affiliation(s)
- Maria Angélica Nunes
- Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Brazil
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Perumal V. Reproductive risk factors assessment for anaemia among pregnant women in India using a multinomial logistic regression model. Trop Med Int Health 2014; 19:841-51. [PMID: 24708308 DOI: 10.1111/tmi.12312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess reproductive risk factors for anaemia among pregnant women in urban and rural areas of India. METHOD The International Institute of Population Sciences, India, carried out third National Family Health Survey in 2005-2006 to estimate a key indicator from a sample of ever-married women in the reproductive age group 15-49 years. Data on various dimensions were collected using a structured questionnaire, and anaemia was measured using a portable HemoCue instrument. Anaemia prevalence among pregnant women was compared between rural and urban areas using chi-square test and odds ratio. Multinomial logistic regression analysis was used to determine risk factors. RESULTS Anaemia prevalence was assessed among 3355 pregnant women from rural areas and 1962 pregnant women from urban areas. Moderate-to-severe anaemia in rural areas (32.4%) is significantly more common than in urban areas (27.3%) with an excess risk of 30%. Gestational age specific prevalence of anaemia significantly increases in rural areas after 6 months. Pregnancy duration is a significant risk factor in both urban and rural areas. In rural areas, increasing age at marriage and mass media exposure are significant protective factors of anaemia. However, more births in the last five years, alcohol consumption and smoking habits are significant risk factors. CONCLUSION In rural areas, various reproductive factors and lifestyle characteristics constitute significant risk factors for moderate-to-severe anaemia. Therefore, intensive health education on reproductive practices and the impact of lifestyle characteristics are warranted to reduce anaemia prevalence.
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Affiliation(s)
- Vanamail Perumal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
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Melere C, Hoffmann JF, Nunes MAA, Drehmer M, Buss C, Ozcariz SGI, Soares RM, Manzolli PP, Duncan BB, Camey SA. Healthy eating index for pregnancy: adaptation for use in pregnant women in Brazil. Rev Saude Publica 2014; 47:20-8. [PMID: 23703126 DOI: 10.1590/s0034-89102013000100004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 07/08/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate dietary quality in a sample of pregnant women based on one simple and objective parameter. METHODS Pregnant women (n = 712), between 16 and 36 weeks, attending primary care clinics in Porto Alegre and Bento Gonçalves, Southern Brazil, in 2010 were recruited to take part. The Healthy Eating Index for Brazilian Pregnancy (HEIP-B) was created, derived from the American instrument called Alternate Healthy Eating Index for Pregnancy (AHEI-P). Questionnaires on frequency of consumption and on socio-demographic factors were completed. Focused principal component analysis (ACPF) was used to assess the relationship between the index and nutrients relevant to pregnancy. RESULTS The median (interquartile range) of AHEI-P and HEIP-B were 66.6 (57.8-72.4) and 67.4 (60.0-73.4), respectively. The HEIP-B showed a good positive correlation with nutrients which are specifically recommended for pregnancy: folate (r = 0.8; p < 0.001), calcium (r = 0.6; p < 0.001) and iron (r = 0.7; p < 0.001). CONCLUSIONS The quality of the diet of the pregnant women in this study was classified as within the "improvements needed" cut off point, which demonstrates the need for more specific education on nutrition for this stage of life. The index showed good correlations and, thus, may be considered an effective tool for assessing the quality of nutrition during pregnancy.
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Affiliation(s)
- Cristiane Melere
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
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Hoffmann JF, Nunes MAA, Schmidt MI, Olinto MTA, Melere C, Ozcariz SGI, Buss C, Drhemer M, Manzolli P, Soares RM, Pinheiro AP, Camey S. Dietary patterns during pregnancy and the association with sociodemographic characteristics among women attending general practices in southern Brazil: the ECCAGe Study. CAD SAUDE PUBLICA 2013. [DOI: 10.1590/s0102-311x2013000500014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The assessment of the relationship between food intake and sociodemographic factors is crucial for developing effective public health policies. The present study aimed to examine dietary patterns in pregnant women and the association between these patterns and sociodemographic characteristics. Pregnant women attending general practices in southern Brazil (n = 712) answered a questionnaire and a food-frequency questionnaire with 88 items. Three dietary patterns were identified using cluster analysis. The association between the dietary patterns and sociodemographic variables was analyzed using the chi-square test and adjusted standardized residuals (p < 0,05). The restricted pattern was associated with lower maternal age, not living with a partner and being a non-working student. The varied pattern was associated with older maternal age, living with a partner, being employed and higher levels of education and income. The common-Brazilian dietary pattern included traditional Brazilian food items and was associated with lower levels of education and income, being unemployed and being a non-student.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Suzi Camey
- Universidade Federal do Rio Grande do Sul, Brasil
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Nunes MAA, Pinheiro AP, Camey SA, Schmidt MI. Binge eating during pregnancy and birth outcomes: a cohort study in a disadvantaged population in Brazil. Int J Eat Disord 2012; 45:827-31. [PMID: 22531873 DOI: 10.1002/eat.22024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the impact of binge eating behavior (BE) during pregnancy on birth outcomes among 697 Brazilian women who attended primary care. METHOD Pregnant women answered a questionnaire on sociodemographic data, obstetric history, and The Eating Disorder Examination Questionnaire (EDE-Q). Perinatal outcomes were obtained from birth records. Birth weight, prematurity, caesarean delivery, being small or large for gestational age were compared among women reporting BE (N = 119) and those without BE (N = 578). Poisson regression was used to estimate the association between BE during pregnancy and birth outcomes. RESULTS BE during pregnancy was not significantly associated with the birth outcomes analyzed. Gestational weight gain was significantly higher among those who reported BE. DISCUSSION Binge eating behavior during pregnancy may not influence birth outcomes as binge eating disorder does but affects gestational weight gain. Women reporting binge eating during pregnancy should undergo a diagnostic assessment for eating disorders.
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Affiliation(s)
- Maria Angélica Antunes Nunes
- Department of Social Medicine, Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Brazil.
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Almeida MSD, Nunes MA, Camey S, Pinheiro AP, Schmidt MI. [Mental disorders in a sample of pregnant women receiving primary health care in Southern Brazil]. CAD SAUDE PUBLICA 2012; 28:385-93. [PMID: 22331164 DOI: 10.1590/s0102-311x2012000200017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 10/03/2011] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to examine the prevalence of probable psychiatric disorders diagnosed during pregnancy and related sociodemographic causative factors among 712 women between the 16th and 36th week of pregnancy receiving prenatal care in 18 basic health units in Porto Alegre and Bento Gonçalves in southern Brazil. PRIME-MD was used to assess mental disorders. The prevalence of probable mental disorder occurred in 41.7% of the women. The most prevalent diagnosis was major depressive disorder (21.6%), followed by generalized anxiety disorder (19.8%). A multivariate analysis showed that the factors most significantly associated with a probable psychiatric disorder were: the fact that the pregnant woman did not work or study: PR = 1.25 (95%CI: 1.04-1.51);the fact that the pregnant woman did not live with her spouse: PR = 1.24 (95%CI: 1.01-1.52);the fact that the pregnant woman had two or more children: PR = 1.21 (95%CI: 1.01-1.46). A high prevalence of probable mental disorder was observed. The increased search for health care by pregnant women provides an opportunity for screening, diagnosing and treating these disorders under the primary health care system.
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Abstract
AbstractObjectiveTo evaluate the effect of fibre intake on the evolution of maternal BMI from pregnancy to postpartum and to identify dietary patterns associated with fibre intake.DesignCohort study. Food intake was obtained using an FFQ. Focused principal component analysis was used focusing on the variables: postpartum weight retention and total dietary fibre intake. Poisson regression models with robust variance were built in order to measure the effect of fibre intake during the postpartum period on obesity risk.SettingPrimary care clinics in southern Brazil.SubjectsPregnant women (n370) were followed until the 5th month postpartum.ResultsThe highest contribution to fibre intake came from the consumption of beans. Consumption of bread and rice indicated a common Brazilian food pattern along with beans. Participants retained a median of 4·4 (interquartile range 0·6, 7·9) kg of weight gained during pregnancy. Obesity risk, defined as an unfavourable evolution of BMI during pregnancy and postpartum, was present in 189 (55·1 %) women. Individual food items did not have an important effect on weight retention. In Poisson regression adjusting for maternal age, pre-pregnancy BMI and total gestational weight gain, inadequate postpartum fibre intake increased obesity risk by 24 % (relative risk = 1·24; 95 % CI 1·05, 1·47).ConclusionsImportant maternal weight retention occurred in these women. Adequate fibre intake may reduce obesity risk in the period following childbirth.
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Manzolli P, Nunes MA, Schmidt MI, Ferri CP. Abuse against women, depression, and infant morbidity: a primary care cohort study in Brazil. Am J Prev Med 2012; 43:188-95. [PMID: 22813684 DOI: 10.1016/j.amepre.2012.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 02/17/2012] [Accepted: 04/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The relationship between abuse against women and maternal depression as risk factors for infant morbidity is unclear. PURPOSE To describe the association of prenatal and postnatal abuse against women on infant physical morbidity and examine the potential mediating effect of maternal depression on these associations. METHODS Prospective cohort study of 375 women from pregnancy (16th-36th week) to the fifth month postpartum, who attended 18 primary care units in Southern Brazil between 2006 and 2008. Abuse and depression were measured at the prenatal and postnatal interviews using standardized instruments. Infant outcomes were diarrhea and respiratory infection during the first 5 months after birth. Analyses were conducted in 2010. RESULTS Overall, 35% of participants reported having suffered abuse during pregnancy and/or in the postnatal period. In addition, 10.1% reported infant diarrhea and 20.5% respiratory infection. Infants of mothers abused at the postnatal period were at increased risk for diarrhea (adjusted relative risk [RR]=2.20, 95% CI=1.15, 4.19) and for respiratory infection (adjusted RR=1.68, 95% CI=1.12, 2.52). There was no mediating effect of depression for either outcome. CONCLUSIONS Postnatal abuse against women is associated with risk of infant diarrhea and respiratory infection. The current findings highlight the importance of getting abuse against women into the public health agenda.
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Affiliation(s)
- Patricia Manzolli
- Graduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Bernardi JR, Ferreira CF, Nunes M, da Silva CH, Bosa VL, Silveira PP, Goldani MZ. Impact of Perinatal Different Intrauterine Environments on Child Growth and Development in the First Six Months of Life--IVAPSA Birth Cohort: rationale, design, and methods. BMC Pregnancy Childbirth 2012; 12:25. [PMID: 22471837 PMCID: PMC3378440 DOI: 10.1186/1471-2393-12-25] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 04/02/2012] [Indexed: 11/23/2022] Open
Abstract
Background In the last twenty years, retrospective studies have shown that perinatal events may impact the individual health in the medium and long term. However, only a few prospective studies were designed to address this phenomenon. This study aims to describe the design and methods of the Impact of Perinatal Environmental Variations in the First Six Months of Life - the IVAPSA Birth Cohort. Method/Design This is a clinical study and involves the recruitment of a birth cohort from hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Mothers from different clinical backgrounds (hypertensive, diabetics, smokers, having an intrauterine growth restricted child for idiopathic reasons, and controls) will be invited to join the study twenty-four hours after the birth of their child. Data on economic, social, and maternal health care, feeding practices, anthropometric measures, physical activity, and neuropsychological evaluation will be obtained in interviews at postpartum, 7 and 15 days, 1, 3 and 6 months of life. Discussion To our knowledge, this is the first thematic cohort focused on the effects of intrauterine growth restriction to prospectively enroll mothers from different clinical backgrounds. The IVAPSA Birth Cohort is a promising research platform that can contribute to the knowledge on the relationship between perinatal events and their consequences on the children's early life.
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Affiliation(s)
- Juliana Rombaldi Bernardi
- Núcleo de Estudos da Saúde da Criança e do Adolescente - Hospital de Clínicas de Porto Alegre - Faculdade de Medicina - Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, CEP 90035-903 - Porto Alegre/RS - Brazil
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