Evolução intergeracional da estatura no Estado de Pernambuco, Brasil, entre 1945 e 2006: 2 - aspectos analíticos

Linear growth of children attending public daycare centers in the municipality of Campina Grande, Paraíba, Brazil

OBJECTIVE

To identify variables predictors of linear growth in preschool children attending public child day care centers of Campina Grande, Paraíba.

METHODS

A cross-sectional study on a probabilistic sample of 335 children attending child day care centers. Were obtained information about socioeconomic, maternal and children's characteristics. The height/age (Z-score) was analyzed as continuous dependent variable. Anthropometric data were obtained in compliance with the recommendations of the World Health Organization. The Multicentre Growth Reference Study was used as the reference population. The data were subjected to multiple linear regression analysis using the hierarchical model.

RESULTS

Children who slept in rooms with at least two people, households without garbage collection, households with no refrigerator, rural zone, illiterate mothers, mothers of short stature, low birth weight and stay in child day care center at part time were the conditions associated with worse height/age of children.

CONCLUSION

There is a clear difference in linear growth with multicausal characteristic in which the low birth weight, as an expression of adverse history, and the socioeconomic conditions, as an expression of health inequities, profiling the genetic potential of growth.

[Risk factors of stunting in preschool children: a case-control study]

This article seeks to establish risk factors for mild and moderate stunting among preschool children attending public daycare centers. It involves a case-control study with 67 pairs of children. Cases defined as children with height/age between -1 and -2 Z-scores were paired with controls between -1 Z-score and the median, while cases with height/age < -2 Z-scores were paired with controls with height/age > median to +1 Z-score. The sex and age of the child was used for pairing purposes. The final model of hierarchical multivariate analysis indicated a greater chance of stunting in the following groups of preschoolers: family income < 1/2 Minimum Wage, squatted/courtesy house, number of individuals in the household ≥ 6, maternal age at child's birth < 20 years, low maternal stature, incomplete immunization program, low birth weight. Stunting is determined by adverse socioeconomic conditions and the characteristics of children reflecting health care (maternal height and child variables).

Factors associated with the nutritional status of children less than 5 years of age

OBJECTIVE To analyze if the nutritional status of children aged less than five years is related to the biological conditions of their mothers, environmental and socioeconomic factors, and access to health services and social programs.METHODS This cross-sectional population-based study analyzed 664 mothers and 790 children using canonical correlation analysis. Dependent variables were characteristics of the children (weight/age, height/age, BMI/age, hemoglobin, and retinol serum levels). Independent variables were those related to the mothers' nutritional status (BMI, hemoglobin, and retinol serum levels), age, environmental and socioeconomic factors and access to health service and social programs. A < 0.05 significance level was adopted to select the interpreted canonical functions (CF) and ± 0.40 as canonical load value of the analyzed variables.RESULTS Three canonical functions were selected, concentrating 89.9% of the variability of the relationship among the groups. In the first canonical function, weight/age (-0.73) and height/age (-0.99) of the children were directly related to the mother's height (-0.82), prenatal appointments (-0.43), geographical area of the residence (-0.41), and household incomeper capita (-0.42). Inverse relationship between the variables related to the children and people/room (0.44) showed that the larger the number of people/room, the poorer their nutritional status. Rural residents were found to have the worse nutritional conditions. In the second canonical function, the BMI of the mother (-0.48) was related to BMI/age and retinol of the children, indicating that as women gained weight so did their children. Underweight women tended to have children with vitamin A deficiency. In the third canonical function, hemoglobin (-0.72) and retinol serum levels (-0.40) of the children were directly related to the mother's hemoglobin levels (-0.43).CONCLUSIONS Mothers and children were associated concerning anemia, vitamin A deficiency and anthropometric markers. Living in rural areas is a determining factor for the families health status.

Evolução do excesso de peso e fatores associados em mulheres de 10 a 49 anos em Pernambuco, Nordeste, Brasil

OBJETIVO: Este estudo tem como objetivo verificar a evolução do excesso do peso e fatores a ele associados, em mulheres de 10 a 49 anos, no Estado de Pernambuco, em pesquisas realizadas em 1997 e em 2006. MÉTODOS: Trata-se de estudo transversal, de base populacional, com amostra probabilística representativa dos meios urbano e rural de Pernambuco, abrangendo 1 . 105 mulheres em 1997, e 1 . 464 em 2006. Para mulheres entre 10 e 19 anos, foi utilizada a relação índice de massa corporal/idade, observados os seguintes parâmetros: déficit de peso: valores abaixo de -2 escores-Z; peso adequado: entre -2 e <1 escores-Z; sobrepeso: >1 e <2 escores-Z; obesidade: >2 escore-Z. Para mulheres com idade superior a 19 anos, consideraram-se os seguintes valores: déficit de peso: índice de massa corporal <18,5; normal: índice de massa corporal >18,5 e <24,9; sobrepeso: índice de massa corporal >25,0 e <29,9; obesidade: índice de massa corporal >30 kg/m2. A análise de regressão de Poisson foi utilizada para avaliar a associação entre o excesso de peso e as variáveis explanatórias. RESULTADOS: Em relação ao estado nutricional no período compreendido entre 1997 e 2006, houve um aumento significativo no sobrepeso e obesidade, com estabilização na prevalência de déficit de peso. O excesso de peso aumentou de 32,8% em 1997 para 41,7% em 2006, representando um incremento de 27,1%. As mulheres da Região Metropolitana do Recife, do Interior Urbano e Rural apresentaram um aumento de excesso de peso de 40,2%, 6,8% e 45,2%, respectivamente. Na avaliação dos fatores associados a esse agravo, em 2006, permaneceram significantes, após ajuste, baixa escolaridade (quatro ou menos anos de estudo), a posse de três ou mais bens de uso doméstico, idade e maior número de gestações, em contraste com o estudo de 1997, que apontava sobrepeso associado à idade e ao maior número de gestações. CONCLUSÃO: O excesso de peso em mulheres em idade fértil, no Estado de Pernambuco, aumentou significativamente, observando-se menor ritmo no Interior Urbano. Evidencia-se nas categorias de condições socioeconômicas e microambientais mais favoráveis uma clara desaceleração no incremento temporal do excesso ponderal.