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Fernandes JDKB, de Sousa FS, Alves CMC, Ribeiro CCC, Simões VMF, Saraiva MDCP, Thomaz EBAF. Small for gestational age and early childhood caries: the BRISA cohort study. Sci Rep 2023; 13:14343. [PMID: 37658113 PMCID: PMC10474029 DOI: 10.1038/s41598-023-41411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
This study tests the hypothesis that children 12-30 months born small for gestational age (SGA) aged are more susceptible to severe early childhood caries (S-ECC). We used data on 865 children aged 12-30 months from a prospective cohort study conducted in a city in the northeast of Brazil. The study outcome was S-ECC, defined based on the proportion of decayed tooth surfaces (cavitated or not). The main exposure variable was SGA, defined according to the Kramer criterion and the INTERGROWTH-21st standard. Direct (SGA → S-ECC) and indirect effects were estimated using structural equation modeling, calculating standardized factor loadings (SFL) and P-values (alpha = 5%). The final models showed a good fit. SGA influenced S-ECC in the direct and indirect paths. In the group of SGA children with 12 or more erupted teeth defined according to the Kramer criterion, the direct effect was positive (SFL = 0.163; P = 0.019); while among all SGA children defined according to the INTERGROWTH-21st standard, the direct effect was negative (SFL = - 0.711; P < 0.001). Age and number of erupted teeth may influence the occurrence of S-ECC in SGA children, as the number of teeth affects the time of exposure to disease risk factors.
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Affiliation(s)
- Juliana de Kássia Braga Fernandes
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brazil
- Departamento de Odontologia, Universidade CEUMA, São Luís, MA, Brazil
| | - Francenilde Silva de Sousa
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brazil.
- Departamento de Saúde Pública, Universidade Federal do Maranhão (UFMA), Rua Barão de Itapari, 155 - Centro, São Luís, Maranhão, 65020-070, Brazil.
| | - Cláudia Maria Coelho Alves
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brazil
- Programa de Pós-graduação em Odontologia, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Cecília Cláudia Costa Ribeiro
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brazil
- Programa de Pós-graduação em Odontologia, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | | | | | - Erika Barbara Abreu Fonseca Thomaz
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Maranhão, São Luís, MA, Brazil
- Programa de Pós-graduação em Odontologia, Universidade Federal do Maranhão, São Luís, MA, Brazil
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Costa EM, Pinho JRO, Saraiva MDCP, Ribeiro CCC, Batista RFL, Coêlho Alves CM, Simões VMF, Bettiol H, Barbieri MA, de Carvalho Cavalli R, Thomaz EBAF. RANTES and developmental defects of enamel in children: A Brazilian prenatal cohort (BRISA). PLoS One 2023; 18:e0284606. [PMID: 37498839 PMCID: PMC10374131 DOI: 10.1371/journal.pone.0284606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/04/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Little is known about the effect of maternal immunological factors on the etiology of developmental defects of enamel (DDE). RANTES (Regulated on Activation Normal T Cell Expressed and Secreted) is a chemokine produced by fibroblasts, lymphoid and epithelial mucosa cells in response to various external stimuli. Despite its importance for embryogenesis, RANTES expression has been demonstrated in multiple diseases characterized by inflammation, tumor and immune response, and wound healing. We hypothesized that altered levels of RANTES during pregnancy are associated with the immune and inflammatory response in women, which could lead to the occurrence of DDE in utero (DDE-iu), directly or mediated by preterm birth. Therefore, this study aimed to evaluate the direct and indirect effects of serum levels of RANTES in pregnant women in the occurrence of DDE-iu in children. METHODS This is a longitudinal case-control study. The mothers and their children (327) were evaluated in three moments: prenatal care, post childbirth, and when the child was between 12.3 and 36 months of age. The analysis was performed with structural equation modeling, estimating the standardized coefficient (SC), adopting α = 5%. RESULTS There was a direct and negative effect of RANTES on the outcome (SC = -0.137; p = 0.022). This association was not mediated by preterm birth (SC = 0.007; P = 0.551). When considering the specific types of DDE-iu, RANTES had a direct effect on hypoplasia (SC = -0.190; p = 0.007), but not on opacity (SC = 0.343; p = 0.074). CONCLUSION Lower serum levels of RANTES may contribute to a higher number of teeth with DDE-iu, specifically hypoplasia. However, more evidence supported by clinical, laboratory and epidemiological studies is still needed.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Cecília Cláudia Costa Ribeiro
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Cláudia Maria Coêlho Alves
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão, São Paulo, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Souza LNS, Confortin SC, Aristizábal LYG, Chagas DCD, Vieira AC, Simões VMF, Alves MTSSDBE. [Do depressive symptoms, anxiety and stressful symptoms during pregnancy affect gestational weight gain?]. Cien Saude Colet 2023; 28:2087-2097. [PMID: 37436321 DOI: 10.1590/1413-81232023287.10532022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/06/2023] [Indexed: 07/13/2023] Open
Abstract
The scope of this article is to estimate the effects of symptoms of mental disorders during pregnancy (depressive symptoms, anxiety and stress) on gestational weight gain (kg). It is a longitudinal study, carried out with data from the BRISA Birth Cohort, which was launched in 2010 in São Luís, Maranhão. Gestational weight gain was classified according to the Institute of Medicine. The independent variable was a construct (latent variable) referred to as symptoms of mental disorders, made up of the depressive symptoms, anxiety and stressful symptoms variables (all on an ongoing basis). Structural equation modeling was used to investigate the association between mental health and weight gain. Regarding the association between symptoms of mental disorders and weight gain during pregnancy, no total effect was found (PC=0.043; p=0.377). Regarding indirect effects, no effect was found either through risk behaviors (PC=0.03; p=0.368) or through physical activity (PC=0.00; p=0.974). Finally, the data did not show a direct effect of symptoms of mental disorders during pregnancy such as gestational weight gain (PC=0.050; p=0.404). Gestational weight gain had no direct, indirect or total effect on symptoms of mental disorders in pregnant women.
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Affiliation(s)
- Larissa Nogueira Silva Souza
- Faculdade de Medicina, Universidade Federal do Maranhão (UFMA). Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
| | | | | | | | - Ana Cleide Vieira
- Programa de Pós- Graduação em Saúde da Família, UFMA. São Luís MA Brasil
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Aristizábal LYG, Rocha PRH, Confortin SC, Simões VMF, Bettiol H, Barbieri MA, da Silva AAM. Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA). BMC Pediatr 2023; 23:125. [PMID: 36932378 PMCID: PMC10024445 DOI: 10.1186/s12887-023-03897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/07/2023] [Indexed: 03/19/2023] Open
Abstract
AIM To analyze the association between neonatal near miss and infant development at two years. METHODS Data from two birth cohorts, one conducted in Ribeirão Preto (RP)/São Paulo and the other in São Luís (SL)/Maranhão, were used. The cognitive, motor and communication development of children was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The following criteria were used for the definition of NNM: birth weight < 1,500 g, 5-min Apgar score < 7, gestational age < 32 weeks, and report of congenital malformations. The relationship between neonatal near miss and development was assessed using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). A directed acyclic graph was built to select the adjustment variables. RESULTS A total of 1,050 mother-newborn dyads were evaluated in SL and 1,840 in RP. Regarding outcomes in SL and RP, respectively, 2.4% and 17.3% of the children were not competent in the cognitive domain, 12.1% and 13.3% in the receptive communication domain, 39.2% and 47.1% in the expressive communication domain, 20.7% and 12.6% in the fine motor domain, and 14.3% and 13.8% in the gross motor domain. The prevalence of neonatal near miss was 5.4% in SL and 4.3% in RP. Unadjusted analysis showed an association of neonatal near miss with fine motor development in SL and RP and with the cognitive, receptive communication, expressive communication, and gross motor domains only in RP. These associations remained after adjusted analysis. CONCLUSION Neonatal near miss is a risk factor for developmental delays.
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Affiliation(s)
- Liliana Yanet Gómez Aristizábal
- Federal University of Maranhão (UFMA). Graduate Program in Collective Health, Rua Barão de Itapary, 155, Maranhão, 65020-070, São Luís, Brazil.
| | | | - Susana Cararo Confortin
- Federal University of Maranhão (UFMA). Graduate Program in Collective Health, Rua Barão de Itapary, 155, Maranhão, 65020-070, São Luís, Brazil
| | - Vanda Maria Ferreira Simões
- Federal University of Maranhão (UFMA). Graduate Program in Collective Health, Rua Barão de Itapary, 155, Maranhão, 65020-070, São Luís, Brazil
| | - Heloisa Bettiol
- Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antonio Barbieri
- Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Federal University of Maranhão (UFMA). Graduate Program in Collective Health, Rua Barão de Itapary, 155, Maranhão, 65020-070, São Luís, Brazil
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Araújo AP, Barbosa JMA, Carvalho CAD, Viola PCDAF, Ribeiro CCC, Batista RFL, Simões VMF. Peso ao nascer e densidade mineral óssea aos 18–19 anos: coorte de nascimentos 1997–1998. Rev Saude Publica 2023; 57:9. [PMID: 37075393 PMCID: PMC10118403 DOI: 10.11606/s1518-8787.2023057004179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/28/2022] [Indexed: 04/08/2023] Open
Abstract
OBJETIVO: Analisar a associação entre o peso ao nascer e a densidade mineral óssea (DMO) na adolescência. MÉTODOS: Estudo de coorte de nascimentos em São Luís, Maranhão, utilizando dados de dois momentos: ao nascimento e aos 18–19 anos. A exposição foi o peso ao nascer em gramas, analisado de forma contínua. O desfecho foi a DMO, utilizando o índice Z-escore (corpo inteiro) medido pela densitometria por dupla emissão de raios X (DEXA). Foi construído modelo teórico em gráficos acíclicos direcionados para identificar o conjunto mínimo de variáveis de ajuste – renda familiar, a mãe saber ler e escrever à época do nascimento, realização de pré-natal, tabagismo durante a gestação e paridade – para avaliar a associação entre o peso ao nascer e a densidade mineral óssea na adolescência. Utilizou-se regressão linear múltipla no software Stata 14.0. O nível de significância adotado foi de 5%. RESULTADOS: Dos 2.112 adolescentes, 8,2% apresentaram baixo peso ao nascer e 2,8% apresentaram DMO considerada baixa para a idade. O Z-escore médio de corpo inteiro foi de 0,19 (± 1,00). O maior peso ao nascer foi associado de forma linear e direta aos valores de DMO na adolescência (Coef.: 0,10; IC95% 0,02–0,18), mesmo após ajuste para as variáveis renda familiar (Coef.: -0,33; IC95% 0,66–0,03) e a mãe saber ler e escrever (Coef.: 0,23; IC95% 0,03–0,43). CONCLUSÕES: Apesar de a associação ter sido atenuada após ajuste das variáveis, o peso ao nascer está associado de forma positiva e linear à DMO na adolescência.
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Affiliation(s)
- Allanne Pereira Araújo
- Universidade Federal do Maranhão. Programa de Pós Graduação em Saúde Coletiva. São Luís, MA, Brasil
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Lima ABS, Martins Neto C, Ferraro AA, Barbieri MA, Simões VMF. Nascer de cesariana e associação com quociente de inteligência em adolescentes: contribuição do Consórcio de Coortes RPS (Ribeirão Preto, Pelotas e São Luís), Brasil. CAD SAUDE PUBLICA 2023; 39:e00064422. [PMID: 37018773 DOI: 10.1590/0102-311xpt064422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/09/2023] [Indexed: 04/05/2023] Open
Abstract
O objetivo do estudo foi avaliar a associação entre a cesariana e o quociente de inteligência (QI) em adolescentes do Município de São Luís, Maranhão, Brasil. Trata-se de um estudo longitudinal utilizando dados da coorte de nascimento em São Luís, iniciado no ano de 1997. A abordagem ocorreu na terceira fase da coorte, em 2016, com adolescente aos 18 e 19 anos de idade. A variável de exposição foi a via de nascimento e a variável de desfecho foi o QI, mensurada a partir da aplicação da terceira versão da Escala de Inteligência Wechsler para Adultos (WAIS-III). Na análise dos dados verificou-se a média do QI segundo as covariáveis e utilizou-se a regressão linear multivariada. Para controlar os fatores de confundimento foi elaborado um modelo teórico utilizando o gráfico acíclico dirigido. As variáveis confundidoras foram as socioeconômicas no momento do nascimento e as variáveis perinatais. A média do QI dos adolescentes foi 101,4. Na análise bruta, o QI dos adolescentes nascidos de cesariana foi 5,8 pontos maior em relação aos nascidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), com significância estatística. Na análise multivariada, o valor reduziu para 1,9 (IC95%: -0,5; 3,6, p = 0,141), sem significância estatística. O resultado do estudo mostrou que a cesariana não está associada ao QI dos adolescentes nessa amostra e reflete que as diferenças encontradas podem ser explicadas por outros fatores, como aspectos socioeconômicos e perinatais.
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Araújo AP, Carvalho CAD, Ribeiro CCC, Barbosa JMA, Viola PCDAF, Simões VMF. Association between prepregnancy and newborn body mass index. Rev Bras Saude Mater Infant 2022. [DOI: 10.1590/1806-9304202200040013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Abstract Objectives: to investigate the association between prepregnancy body mass index (BMI) and newborns’ (NB) BMI. Methods: cohort study with 1,365 pregnant women and their newborns from the BRISA survey (Brazilian Ribeirão Preto and São Luís Birth Cohort Studies) in São Luís-MA. Prepregnancy BMI was self-reported, and newborns’ BMI was estimated using the weight and length measured at birth. A directed acyclic graph (DAG) was developed to identify the adjustment variables. The association between the prepregnancy BMI and newborns’ BMI were analyzed using multiple linear and Poisson regression with robust variance estimation. Results: NBs had 13.4±1.7kg/m2 average BMI at birth. In the linear analysis, we observed that as the prepregnancy BMI increases, the NBs BMI also increases (ß=0.07; CI95%=0.05–0.09;p<0.001). Newborns of mothers with prepregnancy overweight were 3.58 times more likely to be overweight. Conclusion: prepregnancy BMI can affect newborn’s BMI early. Thus, women planning to become pregnant should consider conducting nutritional planning to maintain or obtain a healthy weight to minimize the risk of overweight for the newborn.
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Gómez Aristizábal LY, Confortin SC, Batista RFL, de Britto e Alves MTSS, Simões VMF, da Silva AAM. Association between violence and depression during pregnancy with perinatal outcomes: a moderated mediation analysis. BMC Pregnancy Childbirth 2022; 22:801. [PMID: 36319959 PMCID: PMC9623969 DOI: 10.1186/s12884-022-05106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the direct, indirect, and total effects of violence during pregnancy on perinatal outcomes, and to evaluate the effect of violence as a moderator of the mediated relationship of depression with perinatal outcomes. METHODS Data was collected from the prenatal study and follow-ups of the BRISA cohort, São Luís, Maranhão, Brazil. The perinatal outcomes investigated were: birth weight (BW), intrauterine growth restriction (IUGR) and gestational age (GA). Violence against women was evaluated using the World Health Organization Violence against Women instrument (Violence during pregnancy - regardless of the type of violence; Physical violence during pregnancy; Psychological violence during pregnancy). Depressive symptoms during pregnancy were evaluated as a mediating variable. Moderated mediation analysis was performed to estimate the effects of violence and depression on perinatal outcomes. RESULTS Three types of violence analyzed by depression had an indirect effect in BW and GA. None of the types of violence showed an association with IUGR. All types of violence analyzed showed a moderated mediation effect with BW and GA. Only among women who experienced violence were birth weight and gestational age lower the higher the values of depressive symptoms. CONCLUSION Violence and depression are only associated with lower BW and GA when they occur simultaneously.
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Affiliation(s)
- Liliana Yanet Gómez Aristizábal
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Susana Cararo Confortin
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Rosângela Fernandes Lucena Batista
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | | | - Vanda Maria Ferreira Simões
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Antônio Augusto Moura da Silva
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
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Confortin SC, Aristizábal LYG, Bragança MLBM, Cavalcante LC, Alves JDDA, Batista RFL, Simões VMF, Viola PCDAF, Barbosa AR, da Silva AAM. Are Fat Mass and Lean Mass Associated with Grip Strength in Adolescents? Nutrients 2022; 14:nu14163259. [PMID: 36014765 PMCID: PMC9416332 DOI: 10.3390/nu14163259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/02/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The interaction between lean body mass (LBM) and fat mass index (FMI) with grip strength (GS) has not been explored in the same analysis model in adolescents. This study thus aims to analyze the association between FMI and LBM with GS. Methods: This cross-sectional study was conducted with data from the 2016 follow-up of the 1997/98 Birth Cohort of São Luís. Grip strength was assessed by the Jamar Plus + dynamometer. The LBM and FMI indexes were assessed [ratio of the mass (lean or fat-kg) to height (m2)]. The confounding variables identified for the relationship between FMI and LBM with GS in the same analysis model, by directed acyclic graph (DAG), were sex, age, race, work, alcohol consumption, smoking, physical activity, and consumption of ultra-processed foods and culinary preparations, used in the adjusted analysis. Results: A total of 2339 adolescents (52.5% girls) were analyzed. The boys have a higher GS than the girls. In the adjusted analysis, with each increase of 1 kg/m2 in the FMI, GS was reduced by 0.72 kgf for boys and 0.35 kgf for girls. At each increase of 1 kg/m2 in the LBM, GS increased by 2.18 kgf for boys and 1.26 kgf for girls. Conclusions: FMI was associated with lower GS regardless of the LBM. LBM was associated with higher GS regardless of the FMI.
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Affiliation(s)
- Susana Cararo Confortin
- Department of Collective Health, Federal University of Maranhão, São Luís 65020-905, Maranhão, Brazil
- Correspondence: ; Tel.: +55-48-996634007
| | | | | | - Luciana Costa Cavalcante
- Department of Collective Health, Federal University of Maranhão, São Luís 65020-905, Maranhão, Brazil
| | | | | | | | | | - Aline Rodrigues Barbosa
- School of Sports, Federal University of Santa Catarina, Florianópolis 88040-900, Santa Catarina, Brazil
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Rocha PRH, Bettiol H, Confortin SC, Bazo G, Aristizábal LYG, Simões VMF, Matijasevich A, Santos IS, Silveira MFD, Cavalli RDC, Silva AAMD, Barbieri MA. Factors associated with neonatal-near miss: birth cohorts in three Brazilian cities - Ribeirão Preto, Pelotas and São Luís, Brazil. Cien Saude Colet 2022; 27:2729-2740. [PMID: 35730842 DOI: 10.1590/1413-81232022277.20932021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/13/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate the association of sociodemographic factors, lifestyle, maternal reproductive profile and prenatal and childbirth care with neonatal near miss (NNM) morbidity in four birth cohorts. This study involved four population-based birth cohorts: Ribeirão Preto (RP) and São Luís (SL) (2010), Pelotas 2004 (PEL04) and 2015 (PEL15). NNM was defined when one or more of the following conditions were present: birthweight <1,500 g, 5-minute Apgar score <7, gestational age <32 weeks, and report of congenital malformations. The covariates were obtained with questionnaires applied to the puerperal women. Some particularities between cohorts were identified. In the RP and SL cohorts, factors of the more distal levels (sociodemographic, lifestyle, and reproductive profile) were associated with NNM. On the other hand, proximal factors related to healthcare were more significant for the occurrence of NNM in PEL. Only the absence of prenatal care was associated with NNM in all cohorts: RP (OR=4.27, 95%CI 2.16-8.45), SL (OR=2.32, 95%CI 1.09-4.94), PEL04 (OR=4.79, 95%CI 1.59-14.46), and PEL15 (OR=5.10, 95%CI 2.60-9.97).
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Affiliation(s)
- Paulo Ricardo Higassiaraguti Rocha
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP). Av. Bandeirantes 3900, Campus da USP. 14049-900 Ribeirão Preto SP Brasil.
| | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP). Av. Bandeirantes 3900, Campus da USP. 14049-900 Ribeirão Preto SP Brasil.
| | - Susana Cararo Confortin
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. São Luís MA Brasil
| | - Gabriel Bazo
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP). Av. Bandeirantes 3900, Campus da USP. 14049-900 Ribeirão Preto SP Brasil.
| | | | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP. São Paulo SP Brasil
| | - Iná S Santos
- Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
| | | | - Ricardo de Carvalho Cavalli
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP). Av. Bandeirantes 3900, Campus da USP. 14049-900 Ribeirão Preto SP Brasil.
| | | | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP). Av. Bandeirantes 3900, Campus da USP. 14049-900 Ribeirão Preto SP Brasil.
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Cavalcante LFP, Carvalho CAD, Padilha LL, Viola PCDAF, Silva AAMD, Simões VMF. Cesarean section and body mass index in children: is there a causal effect? CAD SAUDE PUBLICA 2022; 38:e00344020. [PMID: 35442262 DOI: 10.1590/0102-311x00344020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 10/01/2021] [Indexed: 11/21/2022] Open
Abstract
Obesity is considered a global public health problem. Cesarean section has been associated with high body mass index (BMI) and increased obesity throughout life. However, this association has been challenged by some studies. This study aims to assess the causal effect of cesarean section on the BMI of children aged 1-3 years. This is a cohort study of 2,181 children aged 1-3 years, born in 2010, obtained from the BRISA Birth Cohort, in São Luís, state of Maranhão, Brazil. Sociodemographic variables, maternal characteristics, type of childbirth, morbidity, anthropometric measurements, and BMI were assessed. Marginal structural models with a counterfactual approach were used to check the causal effect of the type of childbirth on obesity, weighted by the inverse probability of selection and exposure. Out of the 2,181 children assessed (52% female), 50.6% were born by cesarean section, 5.9% of the newborn infants were large for gestational age, and 10.7% of them had excess weight. No causal effect of cesarean section on BMI was observed (coefficient = -0.004; 95%CI: -0.136; 0.127; p = 0.948). Cesarean section did not have a causal effect on the BMI of children aged 1-3 years.
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Affiliation(s)
| | | | - Luana Lopes Padilha
- Instituto Federal de Educação, Ciência e Tecnologia do Maranhão, São Luís, Brasil
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Serra SC, Carvalho CAD, Batista RFL, Thomaz EBAF, Viola PCDAF, Silva AAMD, Simões VMF. Factors associated with perinatal mortality in a Brazilian Northeastern capital. Cien Saude Colet 2022; 27:1513-1524. [PMID: 35475831 DOI: 10.1590/1413-81232022274.07882021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
This study investigated factors associated with perinatal mortality in São Luís, Maranhão, Northeastern Brazil. Data on perinatal mortality were obtained from the BRISA birth cohort and from the Mortality Information System, including records of 5,236 births, 70 of which referred to fetal deaths and 36 to early neonatal deaths. Factors associated with mortality were investigated using a hierarchical logistic regression model, resulting in a perinatal mortality coefficient equal to 20.2 per thousand births. Mothers with low education level and without a partner were associated with an increased risk of perinatal death. Moreover, children of mothers who did not have at least six antenatal appointments and with multiple pregnancies (OR= 9.15; 95%CI:4.08-20.53) were more likely to have perinatal death. Perinatal death was also associated with the presence of congenital malformations (OR= 4.13; 95%CI:1.23-13.82), preterm birth (OR= 3.36; 95%CI:1.56-7.22), and low birth weight (OR=11.87; 95%CI:5.46-25.82). In turn, families headed by other family members (OR= 0.29; 95%CI: 0.12 - 0.67) comprised a protective factor for such condition. Thus, the results indicate an association between perinatal mortality and social vulnerability, non-compliance with the recommended number of prenatal appointments, congenital malformations, preterm birth, and low birthweight.
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Affiliation(s)
- Sara Costa Serra
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
| | - Carolina Abreu de Carvalho
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
| | - Rosangela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
| | - Erika Bárbara Abreu Fonseca Thomaz
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
| | | | - Antônio Augusto Moura da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
| | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro, 65020-070. São Luís MA Brasil.
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Confortin SC, Batista RFL, Barbosa AR, Wendt A, Crochemore-Silva I, Alves MTSSDBE, Simões VMF, Silva AAMD. Is sleep time associated with handgrip strength in adolescents from the 1997/1998 São Luís Birth Cohort? Cien Saude Colet 2022; 27:1147-1155. [PMID: 35293451 DOI: 10.1590/1413-81232022273.03132021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/17/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to analyze the association between sleep time and handgrip strength in adolescents belonging to the 1997/1998 São Luís Birth Cohort. This was a cross-sectional study nested in a birth cohort study. One thousand two hundred sixty-nine individuals (18 and 19 years) wore an Actigraph® GTX3+ accelerometer on their wrist 24 hr/day for 7 consecutive days. Handgrip strength was measured using a digital hand dynamometer. We used directed acyclic graphs (DAG) to identify confounding variables. This sample of adolescents was mostly composed of men, with brown skin color, economic class C, which did not work, did not consume alcohol, did not smoke, and never used drugs. The mean value of handgrip strength was 28.2 (±9.3) kgf, and the mean of sleep time was 6 (±1.0) hours per day. The crude analysis showed an association between sleep time and muscle strength. An increase of one hour of sleep reduced the handgrip strength by 1.95 kgf (95%CI:-2.51;-1.39). However, after adjustment for confounders, the association was not maintained (β:-0.07; 95%CI:-0.48;0.36). Sleep time is not associated with handgrip strength in adolescents in São Luís.
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Affiliation(s)
- Susana Cararo Confortin
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | - Rosângela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | | | - Andrea Wendt
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Inácio Crochemore-Silva
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | | | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | - Antônio Augusto Moura da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
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Takahasi EHM, Alves MTSSDBE, Ribeiro MRC, Santos AMD, Campos MAG, Simões VMF, Amaral GA, Sousa PDS, Miranda-Filho DDB, Silva AAMD. Decline in head circumference growth and associated factors in congenital Zika syndrome. CAD SAUDE PUBLICA 2022; 38:e00296021. [DOI: 10.1590/0102-311xen296021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/16/2022] [Indexed: 12/23/2022] Open
Abstract
Little is known about the evolution of head circumference (HC) in children with congenital Zika syndrome (CZS). This study aims to evaluate HC growth in children with CZS in the first three years of life and identify associated factors. HC data obtained at birth and in neuropediatric consultations from 74 children with CZS were collected from the Child’s Health Handbook, parents’ reports, and medical records. Predictors of HC z-score were investigated using different mixed-effects models; Akaike’s information criterion was used for model selection. The HC z-score decreased from -2.7 ± 1.6 at birth to -5.5 ± 2.2 at 3 months of age, remaining relatively stable thereafter. In the selected adjusted model, the presence of severe brain parenchymal atrophy and maternal symptoms of infection in the first trimester of pregnancy were associated with a more pronounced reduction in the HC z-score in the first three years of life. The decrease of HC z-score in CZS children over the first three months demonstrated a reduced potential for growth and development of the central nervous system of these children. The prognosis of head growth in the first 3 years of life is worse when maternal infection occurs in the first gestational trimester and in children who have severe brain parenchymal atrophy.
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Barbosa JMA, Ribeiro CCC, Batista RFL, Brondani MA, Simões VMF, Bettiol H, Barbieri MA, Coelho SJDDDAC, Silva AAMD. Behavioral risk factors for noncommunicable diseases associated with depression and suicide risk in adolescence. CAD SAUDE PUBLICA 2022; 38:e00055621. [DOI: 10.1590/0102-311x00055621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/24/2021] [Indexed: 11/22/2022] Open
Abstract
Noncommunicable diseases (NCDs) and mental disorders cooccur in adulthood, which is why their determinants and common risk factors should be addressed at an early age. Therefore, we estimated the association of the major risk factors for NCDs with depression and suicide risk by structural equation modeling considering pathways triggered by social vulnerability or mediated by obesity. This population-based study included 2,515 Brazilian adolescents. The following exposures were the major risk factors for NCDs: substance use behaviors (variable deduced from alcohol, tobacco, and drug use), physical inactivity, and components of unhealthy eating markers (added sugar and saturated fat). Obesity was assessed using the fat mass index. The outcomes were depression and suicide risk. Depression was associated with substance use behaviors (SC = 0.304; p < 0.001), added sugar (SC = 0.094; p = 0.005), and females (SC = 0.310; p < 0.001). Suicide risk was also associated with substance use behaviors (SC = 0.356; p < 0.001), added sugar (SC = 0.100; p = 0.012), and females (SC = 0.207; p < 0.001). In adolescents, these associations may help explain the cluster of NCDs and mental disorders in adulthood.
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Pinto DAS, Nascimento JXPT, Padilha LL, da Conceição SIO, França AKTDC, Simões VMF, Batista RFL, Barbieri MA, Ribeiro CCC. High sugar content and body mass index: modelling pathways around the first 1000 d of life, BRISA cohort. Public Health Nutr 2021; 24:4997-5005. [PMID: 33517949 DOI: 10.1017/s136898002000525x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life. DESIGN BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life. SETTING A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling. PARTICIPANTS Data of pregnant women (n 1136) and their offspring. RESULTS Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time. CONCLUSIONS Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life.
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Affiliation(s)
- Dâmaris Alves Silva Pinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | | | - Luana Lopes Padilha
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | | | | | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | - Rosângela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Cecilia Claudia Costa Ribeiro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary-Centro, São Luís, MA 65020-070, Brasil
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Barbieri MA, Ferraro AA, Simões VMF, Goldani MZ, Cardoso VC, Moura da Silva AA, Bettiol H. Cohort Profile: The 1978-79 Ribeirao Preto (Brazil) birth cohort study. Int J Epidemiol 2021; 51:27-28g. [PMID: 34564724 DOI: 10.1093/ije/dyab190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Marco Antônio Barbieri
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Marcelo Zubaran Goldani
- Department of Pediatrics, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Heloisa Bettiol
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Machado PMA, Campelo CL, de Oliveira JVP, Batista RFL, Simões VMF, dos Santos AM. Analysis of the AUDIT factor structure in adolescents between 18 and 19 years. Rev Saude Publica 2021; 55:27. [PMID: 34037139 PMCID: PMC8139847 DOI: 10.11606/s1518-8787.2021055002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years. METHODS Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, "was injured or someone else was injured due to drinking." Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments. CONCLUSION The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol.
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Affiliation(s)
- Patrícia Maria Abreu Machado
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Ciências da SaúdeSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Ciências da Saúde. São Luís, MA. Brasil
| | - Cleber Lopes Campelo
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - João Victor Pimentel de Oliveira
- Universidade Federal do MaranhãoFaculdade de MedicinaSão LuísMABrasilUniversidade Federal do Maranhão. Faculdade de Medicina. São Luís, MA, Brasil
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Farias-Antunez S, Simões VMF, Cardoso VC, Silveira MFD. Sociodemographic profile of primiparous mothers from nine birth cohorts in three Brazilian cities. CAD SAUDE PUBLICA 2021; 37:e00057520. [PMID: 34008734 DOI: 10.1590/0102-311x00057520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/09/2020] [Indexed: 11/21/2022] Open
Abstract
Fertility reduction is a phenomenon observed in demographic transition. The demographic changes noted in female fertility represent a need for adjustment on health services regarding female health and family planning support. Thus, this study aimed to perform a descriptive analysis by tracing the sociodemographic profile of primiparous mothers belonging to nine Brazilian birth cohorts, in three cities from different states. Standardized questionnaires were applied to assess reproductive characteristics and covariables. Primiparous mothers were defined as women whose child included in birth cohorts was their firstborn child. Sample description was performed using analysis of variance (continuous variables) and chi-square (categorical variables). In total, 44,615 women were included in the analyses and 41.8% (95%CI: 41.3; 42.2) were categorized as primiparous. The primiparity rates were the lowest in Ribeirão Preto (São Paulo State) 1978 (32%; 95%CI: 30.9; 33.1) and the highest in most recent cohorts, reaching up to 50% of the participants (São Luís - Maranhão State 2010: 47.2%; 95%CI: 45.8; 48.6; Ribeirão Preto 2010: 50.2%; 95%CI: 49.1; 51.4); Pelotas (Rio Grande do Sul State) 2015: 49.4% (95%CI: 47.9; 50.9). Primiparous mothers' age and schooling increased over the years in all cohorts. Maternal age at the first childbirth behaved similarly in the three studied cities. There was an increase in the proportion of first-time mothers that were older, higher educated and belonged to richer income groups. Also, the proportion of teenage mothers (aged 15 years or younger) increased until the early 2000's and started decreasing around the years 2010, especially among women in the poorer income groups.
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Affiliation(s)
- Simone Farias-Antunez
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Confortin SC, Ribeiro MRC, Barros AJD, Menezes AMB, Horta BL, Victora CG, Barros FC, Gonçalves H, Bettiol H, Santos ISD, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Silveira MFD, Domingues MR, Lima NP, Rocha PRH, Cavalli RC, Batista RFL, Cardoso VC, Simões VMF, Silva AAMD. RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. CAD SAUDE PUBLICA 2021; 37:e00093320. [PMID: 33950086 DOI: 10.1590/0102-311x00093320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/20/2020] [Indexed: 01/11/2023] Open
Abstract
This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.
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Barbieri MR, Fontes AM, Barbieri MA, Saraiva MCP, Simões VMF, Silva AAMD, Abraham KJ, Bettiol H. Effects of FTO and PPARγ variants on intrauterine growth restriction in a Brazilian birth cohort. ACTA ACUST UNITED AC 2021; 54:e10465. [PMID: 33729310 PMCID: PMC7945878 DOI: 10.1590/1414-431x202010465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/02/2021] [Indexed: 01/18/2023]
Abstract
Intrauterine growth restriction (IUGR) is related to a higher risk of neonatal mortality, minor cognitive deficit, metabolic syndrome, and cardiovascular disease in adulthood. In previous studies, genetic variants in the FTO (fat mass and obesity-associated) and PPARγ (peroxisome proliferator-activated receptor-gamma) genes have been associated with metabolic disease, body mass index, and obesity among other outcomes. We studied the association of selected FTO (rs1421085, rs55682395, rs17817449, rs8043757, rs9926289, and rs9939609) and PPARγ (rs10865710, rs17036263, rs35206526, rs1801282, rs28763894, rs41516544, rs62243567, rs3856806, and rs1805151) single-nucleotide polymorphisms (SNPs) with IUGR, through a case-control study in a cohort of live births that occurred from June 1978 to May 1979 in a Brazilian city. We selected 280 IUGR cases and 256 controls for analysis. Logistic regression was used to jointly analyze the SNPs as well as factors such as maternal smoking, age, and schooling. We found that the PPARγ rs41516544 increased the risk of IUGR for male offspring (OR 27.83, 95%CI 3.65-212.32) as well as for female offspring (OR=8.94, 95%CI: 1.96-40.88). The FTO rs9939609 TA genotype resulted in a reduced susceptibility to IUGR for male offspring only (OR=0.47, 95%CI: 0.26-0.86). In conclusion, we demonstrated that PPARγ SNP had a positive effect and FTO SNP had a negative effect on IUGR occurrence, and these effects were gender-specific.
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Affiliation(s)
- M R Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A M Fontes
- Departamento de Genética, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A M da Silva
- Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - K J Abraham
- Departamento de Economia, Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Cavalcante TB, Ribeiro MRC, Sousa PDS, Costa EDPF, Alves MTSSDBE, Simões VMF, Batista RFL, Takahasi EHM, Amaral GA, Khouri R, Branco MDRFC, Mendes AKT, Costa LC, Campos MAG, Silva AAMD. Congenital Zika syndrome: Growth, clinical, and motor development outcomes up to 36 months of age and differences according to microcephaly at birth. Int J Infect Dis 2021; 105:399-408. [PMID: 33610784 DOI: 10.1016/j.ijid.2021.02.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Little is known regarding the developmental consequences of congenital Zika syndrome (CZS) without microcephaly at birth. Most previously published clinical series were descriptive and they had small sample sizes. STUDY DESIGN We conducted a cohort study to compare the growth, clinical, and motor development outcomes for 110 children with CZS born with and without microcephaly up to their third birthday. Ninety-three had their head circumference (HC) at birth abstracted and they did not have hypertensive hydrocephalus at birth, where 61 were born with microcephaly and 32 without. RESULTS The HC z-scores decreased steeply from birth to six months of age, i.e., from -3.77 to -6.39 among those with microcephaly at birth and from -1.03 to -3.84 among those without. Thus, at 6 months of age, the mean HC z-scores for children born without microcephaly were nearly the same as those for children born with microcephaly. Children born without microcephaly were less likely to have brain damage, ophthalmic abnormalities, and drug-resistant epilepsy, but the differences in many conditions were not statistically significant. CONCLUSIONS Children born without microcephaly were only slightly less likely to present severe neurologic impairment and to develop postnatal-onset microcephaly, and some of the original differences between the groups tended to dissipate with age.
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Affiliation(s)
| | | | - Patrícia da Silva Sousa
- Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children/NINAR - Health Secretariat of the State of Maranhão, São Luís, Maranhão, Brazil
| | | | | | | | | | - Eliana Harumi Morioka Takahasi
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil; Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil
| | | | - Ricardo Khouri
- Laboratory of Vector-Borne Infectious Diseases, Gonçalo Moniz Institute, Fiocruz-Bahia, and Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
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Takahasi EHM, Alves MTSSDB, Ribeiro MRC, Souza VFP, Simões VMF, Borges MCR, Amaral GA, Gomes LN, Khouri R, da Silva Sousa P, Silva AAMD. Gross Motor Function in Children with Congenital Zika Syndrome. Neuropediatrics 2021; 52:34-43. [PMID: 33111304 DOI: 10.1055/s-0040-1718919] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little information on gross motor function of congenital Zika syndrome (CZS) children is available. OBJECTIVES To evaluate gross motor function in CZS children aged up to 3 years, and its associated factors and changes in a minimum interval of 6 months. METHODS One hundred children with CZS and cerebral palsy (36 with confirmed and 64 with presumed CZS) were evaluated with the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM-88/GMFM-66). Forty-six were reevaluated. Wilcoxon tests, Wilcoxon tests for paired samples, percentile scores, and score changes were performed. RESULTS Clinical and socioeconomic characteristics (except maternal age), GMFM scores and GMFCS classification of confirmed and probable cases, which were analyzed together, were similar. The mean age was 25.6 months (±5.5); the median GMFM-88 score was 8.0 (5.4-10.8); and the median GMFM-66 score was 20.5 (14.8-23.1); 89% were classified as GMFCS level V. Low economic class, microcephaly at birth, epilepsy, and brain parenchymal volume loss were associated with low GMFM-66 scores. The median GMFM-66 percentile score was 40 (20-55). On the second assessment, the GMFM-66 scores in two GMFCS level I children and one GMFCS level IV child improved significantly. In one GMFCS level III child, one GMFCS level IV child, and the group of GMFCS level V children, no significant changes were observed. CONCLUSIONS Almost all CZS children had severe cerebral palsy; in the third year of life, most presented no improvement in gross motor function and were likely approaching their maximal gross motor function potential.
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Affiliation(s)
- Eliana Harumi Morioka Takahasi
- Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil.,Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Valéria Ferreira Pereira Souza
- Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children - NINAR, State Department of Health of the State of Maranhão, São Luís, Maranhão, Brazil
| | | | | | | | - Lillian Nunes Gomes
- Laboratory of Immunology Human, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Ricardo Khouri
- Laboratory of Vector-Borne Infectious Diseases, Gonçalo Moniz Institute, Salvador, Bahia, Brazil.,Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Patricia da Silva Sousa
- Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children - NINAR, State Department of Health of the State of Maranhão, São Luís, Maranhão, Brazil
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24
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Negrão MEA, Rocha PRH, Saraiva MCP, Barbieri MA, Simões VMF, Batista RFL, Ferraro AA, Bettiol H. Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort. ACTA ACUST UNITED AC 2020; 54:10252-0. [PMID: 33338100 PMCID: PMC7780373 DOI: 10.1590/1414-431x202010252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/28/2020] [Indexed: 01/13/2023]
Abstract
Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities.
However, little is currently known about the association of the separate or
concomitant use of alcohol and tobacco with infant motor and cognitive
development. Thus, the objective of the present study was to investigate the
association between maternal consumption of alcohol and/or tobacco during
pregnancy and the motor and cognitive development of children starting from the
second year of life. The study included 1006 children of a cohort started during
the prenatal period (22-25 weeks of pregnancy), evaluated at birth and
reevaluated during the second year of life in 2011/2013. The children were
divided into four groups according to the alcohol and/or tobacco consumption
reported by their mothers at childbirth: no consumption (NC), separate alcohol
consumption (AC), separate tobacco consumption (TC), and concomitant use of both
(ACTC). The Bayley Scale of Infant and Toddler Development Third Edition
screening tool was used for the assessment of motor and cognitive development.
Adjusted Poisson regression models were used to determine the association
between groups and delayed development. The results indicated that only the ACTC
group showed a higher risk of motor delay, specifically regarding fine motor
skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol
or tobacco consumption was not associated with delayed gross motor or cognitive
development. However, the concomitant use of the two substances increased the
risk of delayed acquisition of fine motor skills.
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Affiliation(s)
- M E A Negrão
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P R H Rocha
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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da Silva AAM, Lima-Neto LG, de Azevedo CDMPES, da Costa LMM, Bragança MLBM, Barros AKD, Wittlin BB, de Souza BF, de Oliveira BLCA, de Carvalho CA, Thomaz EBAF, Simões-Neto EA, Leite JF, Cosme LMSS, Campos MAG, Queiroz RCDS, Costa SS, de Carvalho VA, Simões VMF, Alves MTSSDBE, dos Santos AM. Population-based seroprevalence of SARS-CoV-2 and the herd immunity threshold in Maranhão. Rev Saude Publica 2020; 54:131. [PMID: 33331525 PMCID: PMC7703539 DOI: 10.11606/s1518-8787.2020054003278] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.
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Affiliation(s)
- Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Lídio Gonçalves Lima-Neto
- Laboratório Central do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Laboratório Central do Maranhão. São Luís, MA, Brasil
- Universidade CEUMASão LuísMABrasilUniversidade CEUMA. São Luís, MA, Brasil
| | - Conceição de Maria Pedrozo e Silva de Azevedo
- Universidade Federal do MaranhãoDepartamento de Medicina ISão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Medicina I. São Luís, MA, Brasil
- Saúde do Estado do MaranhãoHospital Presidente VargasSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Hospital Presidente Vargas. São Luís, MA, Brasil
| | - Léa Márcia Melo da Costa
- Saúde do Estado do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Assessoria. São Luís, MA, Brasil
| | - Maylla Luanna Barbosa Martins Bragança
- Universidade Federal do MaranhãoDepartamento de Ciências FisiológicasSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Ciências Fisiológicas. São Luís, MA, Brasil
| | - Allan Kardec Duailibe Barros
- Universidade Federal do MaranhãoDepartamento de Engenharia ElétricaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia Elétrica. São Luís, MA, Brasil
| | - Bernardo Bastos Wittlin
- Saúde do Estado do MaranhãoHospital Presidente VargasSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Hospital Presidente Vargas. São Luís, MA, Brasil
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilUniversidade Federal do Maranhão. Hospital Universitário. São Luís, MA, Brasil
| | - Bruno Feres de Souza
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | | | - Carolina Abreu de Carvalho
- Universidade Federal do MaranhãoCurso de MedicinaPinheiroMABrasilUniversidade Federal do Maranhão. Curso de Medicina. Pinheiro, MA, Brasil
| | - Erika Barbara Abreu Fonseca Thomaz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Eudes Alves Simões-Neto
- Universidade Federal do MaranhãoHospital UniversitárioSão LuísMABrasilUniversidade Federal do Maranhão. Hospital Universitário. São Luís, MA, Brasil
- Secretaria Municipal de SaúdeSão LuísMABrasilSecretaria Municipal de Saúde. São Luís, MA, Brasil
| | - Jamesson Ferreira Leite
- Saúde do Estado do MaranhãoCentro de Informações Estratégicas de Vigilância em SaúdeSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Centro de Informações Estratégicas de Vigilância em Saúde. São Luís, MA, Brasil
| | - Lécia Maria Sousa Santos Cosme
- Laboratório Central do MaranhãoSão LuísMABrasilSecretaria de Saúde do Estado do Maranhão. Laboratório Central do Maranhão. São Luís, MA, Brasil
| | - Marcos Adriano Garcia Campos
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Sérgio Souza Costa
- Universidade Federal do MaranhãoDepartamento de Engenharia da ComputaçãoSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil
| | - Vitória Abreu de Carvalho
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | | | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Trombe KSD, Rodrigues LS, Nascente LMP, Simões VMF, Batista RFL, Cavalli RC, Grandi C, Cardoso VC. Is birth weight associated with pregestational maternal BMI? BRISA Cohort, Ribeirão Preto, Brazil. ACTA ACUST UNITED AC 2020; 54:e10037. [PMID: 33295534 PMCID: PMC7727099 DOI: 10.1590/1414-431x202010037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 10/09/2020] [Indexed: 01/01/2023]
Abstract
Given the increase of women with excess weight or obesity and its possible effects on birth weight, the present study aimed to investigate the association between pregestational maternal body mass index (BMI) and birth weight in a birth cohort from Ribeirão Preto, SP, Brazil. This was a prospective study conducted on 1362 mother-child pairs involving singleton births. The women were evaluated using standardized questionnaires during the second trimester of pregnancy and at the time of childbirth. Information about the newborns was obtained from their medical records. The dependent variable was birth weight, categorized as low, adequate, or high. The independent variable was pregestational maternal BMI, categorized as malnutrition, adequate weight, overweight, and obesity. A multinomial regression model was used to estimate the crude and adjusted relative risk (RR) of low and high birth weight. A high frequency of pregestational excess weight (39.6%) was detected and found to be independently associated with high birth weight (RR=2.13, 95%CI: 1.19-3.80 for overweight and RR=3.34, 95%CI: 1.80-6.19 for obese pregnant women). There was no association between pregestational malnutrition and low birth weight (RR=1.70; 95%CI: 0.81-3.55). The present data showed a high rate of women with excess pregestational weight, supporting the hypothesis that pregestational BMI may contribute to high birth weight babies and indicating the need for actions aiming to prevent excessive weight in women at reproductive age.
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Affiliation(s)
- K S D Trombe
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L S Rodrigues
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L M P Nascente
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C Grandi
- Research Committee, Argentine Society of Pediatrics, Buenos Aires, Argentina
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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27
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Soares Filho LC, Batista RFL, Cardoso VC, Simões VMF, Santos AM, Coelho SJDDAC, Silva AAM. Body image dissatisfaction and symptoms of depression disorder in adolescents. ACTA ACUST UNITED AC 2020; 54:e10397. [PMID: 33295537 PMCID: PMC7727113 DOI: 10.1590/1414-431x202010397] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/10/2020] [Indexed: 01/18/2023]
Abstract
The objective of this study was to evaluate the effect of body image dissatisfaction on symptoms of depressive disorder in adolescents. This is a cross-sectional study that included 2,162 adolescents ages 18-19 born in São Luís, Maranhão, Brazil, which was part of the joint RPS cohort (Brazilian birth cohorts of Ribeirão Preto-SP, Pelotas-RS, and São Luís-MA). Socioeconomic characteristics, nutritional status, mental health, and body image characteristics were evaluated. Body image was assessed by Stunkard’s silhouettes scale. The presence of symptoms indicative of depressive disorder was investigated through a diagnostic interview MINI (Mini International Neuropsychiatric Interview). A theoretical model was built in a Directed Acyclic Graph (DAG) in order to investigate the relationship between the variables of the study. The relationship was estimated weighting the inverse probability of selection for the variables of adjustment: sex and nutritional status. Among the dissatisfied adolescents due to overweight, 66.54% were girls, 32.85% were overweight, and 11.99% were obese (P<0.01). There was a significant association between dissatisfaction due to overweight and symptoms of depressive disorder (P=0.01), and there was no evidence of the same association with dissatisfaction due to thinness. Therefore, only dissatisfaction due to overweight was associated with the symptoms of depressive disorder in the evaluated adolescents.
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Affiliation(s)
- L C Soares Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A M Santos
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - S J D D A C Coelho
- Departamento de Medicina I, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A M Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
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Rodrigues IC, Grandi C, Simões VMF, Batista RFL, Rodrigues LS, Cardoso VC. Metabolic profile during pregnancy in BRISA birth cohorts of Ribeirão Preto and São Luís, Brazil. ACTA ACUST UNITED AC 2020; 54:e10253. [PMID: 33295536 PMCID: PMC7727101 DOI: 10.1590/1414-431x202010253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
During pregnancy, metabolic changes that develop in women may increase the risk of diseases and conditions that may also harm the life of the growing fetus. The aim of the present study was to identify and compare the metabolic profile (MP) during pregnancy in two birth cohorts in 2010 in the cities of Ribeirão Preto (RP) and São Luís (SL), Brazil. Pregnant women (1393 in RP and 1413 in SL) were studied; information was obtained through questionnaires in addition to anthropometric, biochemical, and blood pressure measurements. Data are presented as means and proportions. To compare the characteristics of pregnant women in both cities, chi-squared and Student's t-tests were applied, with 5% significance level. Ribeirão Preto presented higher mean values than SL for pre-gestational body mass index (24.5 vs 23 kg/m2, P<0.001), systolic (108.4 vs 102.8 mmHg, P<0.001) and diastolic (65.9 vs 61.8 mmHg, P<0.001) blood pressure, total cholesterol (226.3 vs 213.7 mg/dL, P<0.001) and fractions, and glycemia (84.5 vs 80.2 mg/dL, P<0.001), except for triglycerides (P=0.135). Women from RP also showed higher rates of pre-gestational overweight and obesity compared with SL (40.1 vs 25.8%). In the present study, pregnant women in RP had a worse gestational metabolic profile than those in SL, with higher pre-gestational excess weight, indicating that nutritional transition was more advanced in the more developed city.
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Affiliation(s)
- I C Rodrigues
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C Grandi
- Argentine Society of Pediatrics, Buenos Aires, Argentina
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - L S Rodrigues
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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29
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Lima RJCP, Batista RFL, Ribeiro CCC, Simões VMF, Lima Neto PM, Bettiol H, Silva AAMD. Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís - MA. Rev Saude Publica 2020; 54:113. [PMID: 33237171 PMCID: PMC7664845 DOI: 10.11606/s1518-8787.2020054002229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the effects of early determinants on adolescent fat-free mass. METHODS A cohort study with 579 adolescents evaluated at birth and adolescence in a birth cohort in São Luís, Maranhão. In the proposed model, estimated by structural equation modeling, socioeconomic status (SES) at birth, maternal age, pregestational body mass index (BMI), gestational smoking, gestational weight gain, type of delivery, gestational age, sex of the newborn, length and weight at birth, adolescent socioeconomic status, "neither study/nor work" generation, adolescent physical activity level and alcohol consumption were tested as early determinants of adolescent fat-free mass (FFM). RESULTS A higher pregestational BMI resulted in higher FFM in adolescence (Standardized Coefficient, SC = 0.152; p < 0.001). Being female implied a lower FFM in adolescence (SC = -0.633; p < 0.001). The negative effect of gender on FFM was direct (SC = -0.523; p < 0.001), but there was an indirect negative effect via physical activity level (SC = -0.085; p < 0.001). Women were less active (p < 0.001). An increase of 0.5 kg (1 Standard Deviation, SD) in birth weight led to a gain of 0.25 kg/m2 (0.106 SD) in adolescent FFM index (p = 0.034). Not studying or working had a negative effect on the adolescent's FFM (SC = -0.106; p = 0.015). Elevation of 1 SD in the adolescent's physical activity level represented an increase of 0.5 kg/m2 (0.207 SD) in FFM index (p < 0.001). CONCLUSIONS The early determinants with the greatest effects on adolescent FFM are gender, adolescent physical activity level, pregestational BMI, birth weight and belonging to the "neither-nor" generation.
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Affiliation(s)
| | | | - Cecília Claudia Costa Ribeiro
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Odontologia II. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Pedro Martins Lima Neto
- Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil
| | - Heloisa Bettiol
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Puericultura e Pediatria. Ribeirão Preto, SP, Brasil
| | - Antônio Augusto Moura da Silva
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
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Martins LAB, Veiga ECA, Ribeiro CCC, Simões VMF, Cardoso VC, Bettiol H, Barbieri MA, Cavalli RC. Uterine vascular resistance and other maternal factors associated with the risk of developing hypertension during pregnancy. ACTA ACUST UNITED AC 2020; 54:e10118. [PMID: 33237124 PMCID: PMC7679108 DOI: 10.1590/1414-431x202010118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Gestational hypertension and pre-eclampsia are important causes of perinatal morbidity. The objective of the present study was to determine the increase in relative risk for developing hypertensive disorders of pregnancy based on the evaluation of pregnant women between 20 and 25 weeks of gestation, and to correlate the findings at this period with the outcome of pregnancy. We conducted a prospective cohort study, with a convenience sample of 1417 patients evaluated at this gestational age, of which 1306 were contacted at childbirth. We detected an increased relative risk of 2.69 (95%CI: 1.86 to 3.89) associated with pulsatility index of the uterine arteries, a 2.8 increase (95%CI: 1.58 to 5.03) in relative risk attributed to maternal age above 35 years, a 1.68 increase (95%CI: 1.17 to 2.40) attributed to parity greater than or equal to 3, and a 5.35 increase (95%CI: 4.18 to 6.85) attributed to chronic hypertension and obesity, with a progressive increase in relative risk according to the degree of overweight, i.e., grades 1, 2, 3, and morbid obesity (2.58, 3.06, 5.84, and 7.28, respectively).
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Affiliation(s)
- L A B Martins
- Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, SP, Brasil
| | - E C A Veiga
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C C C Ribeiro
- Departamento de Odontologia II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Silva FDS, Queiroz RCDS, Branco MDRFC, Simões VMF, Barbosa YC, Rodrigues MAFRDA, Barbieri MA, Bettiol H, Saraiva MDCP, Scorzafave LG, Habenschus MIAT, Silva AAMD. Bolsa Família program and incomplete childhood vaccination in two Brazilian cohorts. Rev Saude Publica 2020; 54:98. [PMID: 33175031 PMCID: PMC7575218 DOI: 10.11606/s1518-8787.2020054001774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/25/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE: To estimate the effect of being a beneficiary of the Bolsa Família Program (BFP) in the vaccination of children aged 13 to 35 months. METHODS: Our study was based on all birth records of residents of Ribeirão Preto (SP) and probabilistic sampling with 1/3 of the births of residents of São Luís (MA), selecting low-income children, born in 2010, belonging to the cohorts Brazilian Ribeirão Preto and São Luís Birth Cohort Studies and eligible for the Bolsa Família program. The information of Cadastro Único (CadÚnico – Single Registry) was used to categorize the receipt of benefit from the BFP (yes or no). The final sample consisted of 532 children in Ribeirão Preto and 1,229 in São Luís. The outcome variable was a childhood vaccine regimen, constructed with BCG, tetravalent, triple viral, hepatitis B, poliomyelitis, rotavirus and yellow fever vaccines. The adjustment variables were: economic class, mother's schooling and mother's skin color. Children with monthly per capita family income of up to R$ 280.00 and/or economic class D/E were considered eligible for the benefit of the BFP. A theoretical model was constructed using a directed acyclic graph to estimate the effect of being a beneficiary of the BFP in the vaccination of low-income children. In the statistical analyses, weighing was used by the inverse of the probability of exposure and pairing by propensity score. RESULTS: Considering a monthly per capita family income of up to R$ 280.00, being a beneficiary of the BFP had no effect on the childhood vaccination schedule, according to weighing by the inverse of the probability of exposure (SL-coefficient: −0.01; 95%CI −0.07 to 0.04; p = 0.725 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.244) and pairing by propensity score (SL-coefficient: −0.01; 95%CI −0.07 to 0.05; p = 0.744 and RP-coefficient: 0.04; 95%CI −0.02 to 0.10; p = 0.231). CONCLUSIONS: The receipt of the benefit of the BFP did not influence childhood vaccination, which is one of the conditionalities of the program. This may indicate that this conditionality is not being adequately monitored.
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Affiliation(s)
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do Maranhão. Departamento de Saúde Pública. Programa de Pós-Graduação em Saúde Coletiva. São Luís, Maranhão, MA, Brasil
| | | | - Vanda Maria Ferreira Simões
- Universidade Federal do Maranhão. Departamento de Saúde Pública. Programa de Pós-Graduação em Saúde Coletiva. São Luís, Maranhão, MA, Brasil
| | - Yonna Costa Barbosa
- Universidade Federal do Maranhão. Hospital Universitário Presidente Dutra. São Luís, Maranhão, MA, Brasil
| | | | - Marco Antonio Barbieri
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Programa de Pós-Graduação em Saúde da Criança e do Adolescente. Ribeirão Preto, São Paulo, Brasil
| | - Heloísa Bettiol
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Programa de Pós-Graduação em Saúde da Criança e do Adolescente. Ribeirão Preto, São Paulo, Brasil
| | - Maria da Conceição Pereira Saraiva
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Programa de Pós-Graduação em Saúde da Criança e do Adolescente. Ribeirão Preto, São Paulo, Brasil
| | - Luiz Guilherme Scorzafave
- Universidade de São Paulo. Faculdade de Economia. Departamento de Economia. Programa de Pós-Graduação em Economia Aplicada. Ribeirão Preto, São Paulo, Brasil
| | | | - Antônio Augusto Moura da Silva
- Universidade Federal do Maranhão. Departamento de Saúde Pública. Programa de Pós-Graduação em Saúde Coletiva. São Luís, Maranhão, MA, Brasil
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Alves MTSSDBE, Chagas DCD, Santos AMD, Simões VMF, Ayres BVDS, Santos GLD, Silva AAMD. Racial inequality in obstetric good practices and interventions in labor and birth care in Rede Cegonha. Cien Saude Colet 2020; 26:837-846. [PMID: 33729340 DOI: 10.1590/1413-81232021263.38982020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/26/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the racial inequality on childbirth care at the Rede Cegonha (Stork Network) using obstetric good practice and interventions indicators. Racial inequality, measured by the total effect of ethnicity/skin color in the crude model, was seen in many indicators. After adjusting for mediators, such as age, schooling, parity, high-risk hospital, and geographic macro-regions, the persistent direct effect suggests racial discrimination against black women with lower partograph completion (PR 0.88; 95% CI 0.80-0.95). Black women stayed less in lithotomy (PR 0.93; 95% CI 0.89-0.98), performed less episiotomy (PR 0.81; 95% CI 0.68 - 0.96), and had less episiotomy suturing pain (PR 0.66; 95% CI 0.51 - 0.87) when compared to white women, suggesting more good practice applied to black women. However, according to the interventionist care model still adopted by many professionals, these practices are routine, and lower achievement in black women would be better interpreted as evidence of racial discrimination against these women. For other outcomes, the ethnicity/skin color effect disappeared after adjusting for mediators, suggesting mitigation or disappearance of the skin color effect in some practices/interventions in childbirth.
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Affiliation(s)
| | - Deysianne Costa das Chagas
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | - Alcione Miranda Dos Santos
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | - Vanda Maria Ferreira Simões
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
| | | | | | - Antônio Augusto Moura da Silva
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. R. Barão de Itapary 155, Centro. 65020-070 São Luís MA Brasil.
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Ribeiro MRC, Batista RFL, Schraiber LB, Pinheiro FS, Santos AMD, Simões VMF, Confortin SC, Aristizabal LYG, Yokokura AVCP, Silva AAMD. Recurrent Violence, Violence with Complications, and Intimate Partner Violence Against Pregnant Women and Breastfeeding Duration. J Womens Health (Larchmt) 2020; 30:979-989. [PMID: 32936043 DOI: 10.1089/jwh.2020.8378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Few studies have investigated the association between violence against pregnant women in terms of recurrence, complications, and perpetrators of violence, and breastfeeding duration. This study verifies whether recurrent violence, violence with pregnancy complications, and intimate partner violence (IPV) against pregnant women are associated with shorter exclusive breastfeeding up to the infant's 6th month and breastfeeding up to the 12th month of life. Materials and Methods: A cohort study with a convenience sample of 1,146 pregnant women was performed. Follow-up assessments were conducted at birth, and at 12-36 months. Survival analysis was used to verify whether recurrent violence, violence with pregnancy complications, and IPV were associated with reduced duration of exclusive breastfeeding and breastfeeding. Results: The adjusted Cox regression revealed no difference regarding exclusive breastfeeding duration among mothers exposed or not exposed to violence and according to who perpetrated the violence. The risk of an infant not being breastfed within the first 12 months of life increased in cases of violence before/during pregnancy (95% confidence interval [CI] = 1.03-1.88), recurrent psychological/physical/sexual violence during pregnancy (95% CI = 1.11-1.92), recurrent psychological violence (95% CI = 1.05-1.96), and recurrent physical/sexual violence (95% CI = 1.01-2.39). Violence with pregnancy complications (95% CI = 0.94-2.22) was not associated with breastfeeding interruption. Similar risks of breastfeeding interruption were observed for IPV (95% CI = 0.96-1.87) and violence perpetrated by other family members (95% CI = 0.83-1.89). Conclusions: We observed a shorter breastfeeding duration up to 12 months of life in cases of recurrent violence.
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Affiliation(s)
| | | | | | | | | | | | - Susana Cararo Confortin
- Postgraduation Program in Collective Health, Federal University of Maranhão, São Luís, Brazil
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Rodrigues LDS, Santos AMD, Lima MIS, Simões VMF, Pereira SR. Association between the FTO gene polymorphism and obesity in Brazilian adolescents from the Northeast region. J Pediatr (Rio J) 2020; 96:630-637. [PMID: 31374206 PMCID: PMC9432123 DOI: 10.1016/j.jped.2019.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To investigate the association between the FTO gene polymorphism with obesity in Brazilian adolescents from the Northeast region. METHOD This was a case-control study with adolescents aged 18 to 19 years. The case group consisted of 378 obese individuals and the control group of 378 non-obese individuals. Obesity was measured by percentage of body fat using the air displacement plethysmography technique. The study variables included data on socioeconomics, demographics, lifestyle, physical activity, waist circumference, waist-to-height ratio, and body mass index. To identify the rs9939609 polymorphism of the FTO gene, blood samples were obtained for genomic DNA extraction by the real-time PCR (Polymerase Chain Reaction) technique. Categorical variables were compared between the groups by the chi-squared test. The normality of the anthropometric measurements body mass index, waist circumference, waist-to-height ratio, and percentage of body fat was evaluated by the Shapiro-Wilk test. Comparison of the anthropometric measurements, stratified by the polymorphism genotypes, was performed by the Kruskal-Wallis test. The Hardy-Weinberg equilibrium was calculated. The significance level was set at 5%. RESULTS The variables gender, age, and physical activity showed significant differences between the groups (p<0.001). The samples of obese and non-obese adolescents were in Hardy-Weinberg equilibrium (p=0.0515). There was no significant difference between the genotypic (p=0.719) and allelic frequencies (p=0.812) regarding the case and control groups. When comparing the anthropometric measurements according to the genotypes (AA, AT, and TT), no significant difference was observed for body mass index (p=0.337), waist circumference (p=0.3473), percentage of body fat (p=0.7096), and waist-to-height ratio (p=0.2584). CONCLUSION The excess adiposity of the study adolescents was not influenced by their genotype.
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Affiliation(s)
| | | | | | | | - Silma Regina Pereira
- Universidade Federal do Maranhão (UFMA), Departamento de Biologia, São Luís, MA, Brazil
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Rodrigues LDS, Santos AMD, Lima MIS, Simões VMF, Pereira SR. Association between the FTO gene polymorphism and obesity in Brazilian adolescents from the Northeast region. Jornal de Pediatria (Versão em Português) 2020. [DOI: 10.1016/j.jpedp.2019.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Miranda ECS, Rodrigues CB, Machado LG, Gomes MADSM, Augusto LCR, Simões VMF, Magluta C, Lamy-Filho F. Neonatal bed status in Brazilian maternity hospitals: an exploratory analysis. Cien Saude Colet 2020; 26:909-918. [PMID: 33729346 DOI: 10.1590/1413-81232021263.21652020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022] Open
Abstract
Neonatal units should be organized as a progressive care line, with intermediate and intensive care beds (conventional and kangaroo). The aim of this study was to evaluate the status and adequacy of neonatal beds in maternity hospitals linked to the 'Stork Network' ("Rede Cegonha"). A descriptive study was conducted in 606 maternity hospitals in all regions of Brazil. The databases used belonged to the Stork Network Evaluation Survey and the National Live Birth System. To assess the distribution of neonatal beds by typology, the parameters proposed in Ordinance N. 930/2012 of the Ministry of Health were used. Most neonatal units are not organized as a progressive care line with the three types of bed planned. Kangaroo intermediate care beds comprise the minority of implanted beds. There is a concentration of intensive and intermediate beds in the Southeast and South regions, which show a kangaroo intermediate care bed deficit. Analyzing the adequacy of beds by the number of live births, one can observe an inadequacy of Kangaroo care beds in all regions of Brazil, as well as intensive bed deficit in the North and Northeast regions, and adequacy of conventional intermediate care beds in all regions.
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Affiliation(s)
- Elaine Cristina Silva Miranda
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
| | - Camila Brito Rodrigues
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
| | | | | | | | - Vanda Maria Ferreira Simões
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
| | - Cynthia Magluta
- Instituto Fernando Figueira, Fiocruz. Rio de Janeiro RJ Brasil
| | - Fernando Lamy-Filho
- Centro de Ciências da Saúde, Universidade Federal do Maranhão. Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
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Barbosa SMML, Batista RFL, Rodrigues LDS, Bragança MLBM, Oliveira BRD, Simões VMF, Eckeli AL, Silva AAMD. Prevalence of excessive daytime sleepiness and associated factors in adolescents of the RPS cohort, in São Luís (MA), Brazil. Rev Bras Epidemiol 2020; 23:e200071. [PMID: 32667465 DOI: 10.1590/1980-549720200071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 10/31/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To estimate the prevalence and factors associated with excessive daytime sleepiness (EDS) in adolescents from the São Luís, Maranhão birth cohort. METHOD Cross-sectional study conducted with 2,514 adolescents aged 18 and 19 years old. A hierarchical approach was used, and prevalence ratios were calculated using Poisson regression with robust variance adjustment. Sociodemographic characteristics (gender, race, economic class, and occupation), lifestyle (leisure activities, smoking, alcohol, illicit drug use, coffee and energy consumption, physical activity, body adiposity, screen time, and depression), and factors related to sleep were studied. RESULTS The prevalence of EDS was 36.8%. The female gender (PR = 1.33; 95%CI 1.19 - 1.49), high risk for alcohol consumption (PR = 1.26; 95%CI 1.09 - 1.46), current major depressive episode (PR = 1.26; 95%CI 1.08 - 1.46), sleep alteration score from 10 to 18 (PR = 1.43; 95%CI 1.10 - 1.85), and sleep score from 5 to 7 of daytime dysfunction (PR = 2.51; 95%CI 2.06 - 3.07) were risk factors for EDS. Economic class D/E was a protective factor for EDS (PR = 0.47; 95%CI 0.27 - 0.85). CONCLUSION More than one-third of adolescents had EDS. Adolescents at higher risk need to improve their sleeping habits and lifestyle so that they no longer have EDS and can improve their quality of life.
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Affiliation(s)
| | | | | | | | | | | | - Alan Luiz Eckeli
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Amaral MS, Ribeiro CCC, Alves MTSDBE, Ribeiro MJS, Nascimento JXPT, Simões VMF, Ferraro AA, Barbieri MA, Silva AAMD. Modeling Pathways From the Perinatal Factors to the Vascular Risk Phenotype at the End of the Second Decade of Life: Birth Cohort, Brazil. Hypertension 2020; 76:359-365. [PMID: 32594805 DOI: 10.1161/hypertensionaha.119.14218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Risk factors act around birth increasing future vascular risk. In this study, we analysed the pathways from perinatal factors to the vascular risk phenotype (VRP) in adolescents including indirect pathways mediated by obesity in adolescence. Data from a Brazilian cohort were collected at birth and at 18 to 19 years (follow-up). A theoretical model was constructed to analyze the association between variables at birth (socioeconomic status, prepregnancy body mass index, mother's age, history of maternal hypertension, maternal smoking, gestational age at birth, birth weight, sex, delivery type) and at follow-up (smoking and excess weight) with the VRP, using structural equation modeling. VRP was a continuous latent variable, representing the shared variance of blood pressure indictors and carotid-femoral pulse wave velocity. Males had higher VRP (standardized coefficient [SC], 0.561; P<0.001). Higher prepregnancy body mass index was associated with higher VRP (SC, 0.140; P=0.032). Gestational age <34 weeks had a total (SC, 0.259; P=0.002) and direct effect (SC, 0.354; P=0.018) on VRP. Cesarean delivery had a total effect, albeit borderline, on VRP (SC, 0.159; P=0.066). Excess weight at follow-up was the main determinant of a high VRP (SC, 0.470; P<0.001). Male sex, cesarean section, gestational age <34 weeks, pregestational excess weight, and excess weight in adolescents were associated with increased VRP at 18 to 19 years of age.
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Affiliation(s)
- Marconi Satuf Amaral
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | - Cecilia Claudia Costa Ribeiro
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil.,Dentistry Department (C.C.C.R.), Federal University of Maranhão, São Luís, Brazil
| | - Maria Teresa Seabra de Britto E Alves
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | | | | | - Vanda Maria Ferreira Simões
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
| | - Alexandre Archanjo Ferraro
- Department of Pediatrics, University of São Paulo School of Medicine, University of São Paulo, Brazil (A.A.F.)
| | - Marco Antônio Barbieri
- Faculty of Medicine of Ribeirão Preto, São Paulo University, Department of Puericulture and Pediatrics, Ribeirão Preto, Brazil (M.A.B.)
| | - Antônio Augusto Moura da Silva
- From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil
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Lisboa LAS, Queiroz RCDS, Thomaz EBAF, da Silva NC, Rocha TAH, Vissoci JRN, Staton CA, Lein A, Simões VMF, Thumé E, Facchini LA. Characteristics of primary care and rates of pediatric hospitalizations in Brazil. Rev Saude Publica 2020; 54:32. [PMID: 32236383 PMCID: PMC7100948 DOI: 10.11606/s1518-8787.2020054001784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/19/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil. METHOD In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil's federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia. RESULTS In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97-0.99), structural conditions (RR: 0.98; 95%CI: 0.97-0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97-0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02-1.48), it forms (RR: 1.01, 95%CI: 1.01-1.02), and more medications (RR: 1.02, 95%CI: 1.01-1.03). CONCLUSION Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.
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Affiliation(s)
- Lívia Anniele Sousa Lisboa
- Universidade Federal do MaranhãoPrograma de Pos graduação em Saúde PúblicaSão LuísMaranhãoBrasilUniversidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. São Luís, Maranhão, Brasil.
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhãoPrograma de Pos graduação em Saúde PúblicaDepartamento de Saúde PúblicaSão LuísMaranhãoBrasilUniversidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. Departamento de Saúde Pública. São Luís, Maranhão, Brasil.
| | - Erika Bárbara Abreu Fonseca Thomaz
- Universidade Federal do MaranhãoPrograma de Pos graduação em Saúde PúblicaSão LuísMaranhãoBrasilUniversidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. São Luís, Maranhão, Brasil.
| | - Núbia Cristina da Silva
- Universidade Federal de Minas GeraisObservatório de Recursos Humanos em SaúdeBelo HorizonteMinas GeraisBrasilUniversidade Federal de Minas Gerais. Observatório de Recursos Humanos em Saúde. Belo Horizonte, Minas Gerais, Brasil.
| | - Thiago Augusto Hernandes Rocha
- Organização Pan Americana de SaúdeBrasíliaDistrito FederalBrasilOrganização Pan Americana de Saúde: OPAS/WHO - Brasília, Distrito Federal, Brasil.
| | - João Ricardo Nickenig Vissoci
- Duke UniversityDuke Global Health InstituteDurhamNorth CarolinaU.SDuke University. Duke Global Health Institute. Durham, North Carolina. U.S.
| | - Catherine Ann Staton
- Duke UniversityDuke Global Health InstituteDurhamNorth CarolinaU.SDuke University. Duke Global Health Institute. Durham, North Carolina. U.S.
| | - Adriana Lein
- Duke UniversityDuke Global Health InstituteDurhamNorth CarolinaU.SDuke University. Duke Global Health Institute. Durham, North Carolina. U.S.
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoPrograma de Pos graduação em Saúde PúblicaDepartamento de Saúde PúblicaSão LuísMaranhãoBrasilUniversidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. Departamento de Saúde Pública. São Luís, Maranhão, Brasil.
| | - Elaine Thumé
- Universidade Federal de PelotasPrograma de Pós-graduação em EnfermagemDepartmento de EnfermagemPelotasRio Grande do SulBrasilUniversidade Federal de Pelotas. Programa de Pós-graduação em Enfermagem. Departmento de Enfermagem. Pelotas, Rio Grande do Sul, Brasil.
| | - Luiz Augusto Facchini
- Universidade Federal de PelotasProgramas de Pós-graduação em Epidemiologia e EnfermagemDepartmento de Medicina SocialPelotasRio Grande do SulBrasilUniversidade Federal de Pelotas. Programas de Pós-graduação em Epidemiologia e Enfermagem. Departmento de Medicina Social. Pelotas, Rio Grande do Sul, Brasil.
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Padilha LL, Ribeiro CCC, Nascimento JXPT, Simões VMF, Vitti FP, Cardoso VC, Vianna EO, Barbieri MA, Silva AAMD, Bettiol H. Lifetime overweight and adult asthma: 1978/1979 Ribeirão Preto Birth Cohort, São Paulo, Brazil. CAD SAUDE PUBLICA 2020; 36:e00041519. [PMID: 32187287 DOI: 10.1590/0102-311x00041519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/23/2019] [Indexed: 11/22/2022] Open
Abstract
Studies focusing on obesity and asthma frequently consider the weight at a given time; thus, modeling pathways through lifetime overweight may contribute to elucidate temporal aspects in this relationship. This study modeled the pathways in the association of lifetime overweight with asthma in adult life, using data from the 1978/1979 Birth Cohort, Ribeirão Preto, São Paulo, Brazil (n = 2,063) at birth (baseline), school age (9/11 years) and adult age (23/25 years). A theoretical model was proposed to explore the effects of lifetime overweight on asthma in adult life analyzed by structural equation modeling. Parental obesity (SC - standardized coefficenttotal = 0.211, p < 0.001; SCdirect = 0.115, p = 0.007) and overweight at school age (SCtotal = 0.565, p < 0.0001; SCdirect = 0.565, p < 0.0001) were associated with overweight in adult life. Parental obesity (SCdirect = 0.105, p = 0.047) and nutritional status at birth (SCtotal = -0.124, p = 0.009; SCdirect = -0.131, p = 0.007) were associated with asthma in adult life. A higher "current adult socieconomic situation" was inversely associated to overweight (SCdirect = -0.171, p = 0.020) and to asthma in adult life (SCtotal = -0.179, p = 0.041; SCdirect = -0.182, p = 0.039). Parental obesity showed a transgenerational effect in weight, triggering to childhood and adulthood overweight. Parallel to underweight at birth, parental obesity was also a risk to asthma in adult life. While, the socioeconomic status in adult life protected from both, overweight and asthma.
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Affiliation(s)
| | | | | | | | - Fernanda Pino Vitti
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Elcio Oliveira Vianna
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Marco Antônio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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Simões VMF, Batista RFL, Alves MTSSDBE, Ribeiro CCC, Thomaz EBAF, Carvalho CAD, Silva AAMD. Saúde dos adolescentes da coorte de nascimentos de São Luís, Maranhão, Brasil, 1997/1998. CAD SAUDE PUBLICA 2020; 36:e00164519. [DOI: 10.1590/0102-311x00164519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/06/2019] [Indexed: 12/28/2022] Open
Abstract
Resumo: O objetivo foi estimar a prevalência de indicadores de saúde de adolescentes em São Luís, Maranhão, Brasil, em 2016. Foram estudadas condições sociodemográficas, hábitos de vida, composição corporal, qualidade do sono, atividade física, habilidade cognitiva e risco de suicídio de 2.515 adolescentes com 18 e 19 anos. Os adolescentes pertencem à coorte de nascimento 1997/1998 ou foram incluídos, retrospectivamente, utilizando-se o banco do SINASC (Sistema de Informações sobre Nascidos Vivos). Os adolescentes eram, principalmente, da classe econômica C (50,1%), 69,5% estudavam, 40,3% trabalhavam e 25,2% não estudavam nem trabalhavam; 60,3% já foram vítimas de assalto e 48,7% tinham pais separados. Apresentaram padrão de consumo nocivo, excessivo ou provável dependência de álcool 19,4%, 19,1% usaram ou estavam usando drogas ilícitas, 53,7% tinham qualidade de sono ruim, 40,8% referiram dor de cabeça frequente, 34,3% declararam tempo de tela por dia maior que cinco horas e 4,1% apresentaram alto risco para suicídio. A prevalência de hipertensão arterial foi de 12% e de obesidade, 6%. As meninas eram mais inativas (80,7%) e apresentaram maior percentual de gordura corporal alto (15,8%) e muito alto (21,5%), já os meninos tiveram maior prevalência de hipertensão arterial (21,2%) e menor prevalência de inatividade física (40,9%). As elevadas prevalências de fatores de risco à saúde aumentam a vulnerabilidade dos adolescentes, expondo estes indivíduos precocemente a fatores que levam ao acometimento cada vez mais cedo de doenças e agravos à saúde.
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Oliveira PSD, Lamy ZC, Guimarães CNM, Rodrigues CB, Silva AAMD, Simões VMF, Sousa PDS. [Experiences of parents of children born with microcephaly during the Zika epidemic following disclosure of the diagnosis]. CAD SAUDE PUBLICA 2019; 35:e00226618. [PMID: 31800794 DOI: 10.1590/0102-311x00226618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/06/2019] [Indexed: 11/22/2022] Open
Abstract
This article aims to understand how parents of children with microcephaly received the diagnosis. This qualitative study was conducted at State Referral Center for Children's Neurodevelopment, Care, and Rehabilitation (NINAR) in São Luís, Maranhão State, Brazil, from April 2017 to February 2018. Participants in the study included parents or guardians of children with microcephaly. Data collection included structured and semi-structured interviews with 3 couples, 16 mothers, and 1 great-grandmother, totaling 20 interviews. The sample was defined by the saturation criterion, and content analysis was performed according to the thematic modality. Eighteen interviewees reported that the diagnosis had been disclosed to them inappropriately and traumatically, sometimes linked to a sense of "end of life" and dissociated from orientation on ways to cope with the situation and care for the child. The diagnosis of microcephaly was disclosed by physicians in 15 of the 20 cases. Three other cases were disclosed as follows: one by a nurse, one by the mother-in-law (who had learned of the diagnosis from the physician), and one by a health department employee. The other two did not receive the diagnosis: one couple learned of the microcephaly from the infant's Certificate of Life Birth and the other associated the child's problem with information broadcast on the media. Three thematic lines were analyzed: omission of the diagnosis; process of disclosure of the diagnosis; and anticipation of the prognosis. The ways diagnosis of microcephaly was disclosed to families influenced how they accepted and coped with the situation.
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Affiliation(s)
| | | | | | | | | | | | - Patrícia da Silva Sousa
- Centro de Referência Estadual em Neurodesenvolvimento, Assistência e Reabilitação de Crianças, São Luís, Brasil
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Ribeiro SVO, Batista RFL, Ribeiro MRC, Pessoa KC, Simões VMF, Figueiredo FPD, Bettiol H. Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach. Rev Bras Saude Mater Infant 2019. [DOI: 10.1590/1806-93042019000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze associations among violence against pregnant women, depressive symptoms during pregnancy and maternal depression symptoms. Methods: a sample of 1,139 mothers was conducted on a prenatal cohort study in the municipality of São Luís in Brazil. Psychological and physical violence against pregnant women were measured by the World Health Organization Violence Against Woman. Depressive symptoms during pregnancy were measured by the Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) (Depression Scale for Epidemiological Studies Center) and maternal depression symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS). The conceptual model of the structural equation modeling contained socioeconomic situation, social support, psychological and physical violence and depression during pregnancy as determinants of the maternal depression symptoms. Results: maternal depression symptoms were more frequently reported by pregnant women who suffered psychological violence (Standardized Coefficient, SC=0.256; p-value, p<0.001), physical violence (SC=0.221 p<0.001) and those who presented depressive symptoms during pregnancy SC=0.322, p<0.001). Depressive symptoms during pregnancy mediated the effects on physical and psychological violence on maternal depression. Conclusions: pregnant women who were submitted to psychological and physical violence and presented depressive symptoms during pregnancy frequently reported more of having maternal depression symptoms.
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Silva FDS, Queiroz RCDS, Branco MDRFC, Habenschus MIAT, Scorzafave LG, Saraiva MDCP, Bettiol H, Barbieri MA, Rodrigues MAFR, Barbosa YC, Simões VMF, Silva AAMD. Foco e cobertura do programa Bolsa Família em crianças das coortes de nascimento BRISA, Ribeirão Preto (São Paulo) e São Luís (Maranhão), Brasil. CAD SAUDE PUBLICA 2019; 35:e00159718. [DOI: 10.1590/0102-311x00159718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 02/15/2019] [Indexed: 11/22/2022] Open
Abstract
Estudo transversal aninhado a uma coorte, que teve como objetivo descrever foco e cobertura do programa Bolsa Família em crianças de 13-35 meses de idade. Fez-se uso de dados das coortes de nascimento BRISA, em Ribeirão Preto, São Paulo, e São Luís, Maranhão, Brasil. O início das coortes ocorreu em 2010, com a inclusão de todos os nascimentos em Ribeirão Preto (7.794) e 5.236 em São Luís, abrangendo amostra aleatória de um terço. No seguimento, realizado de 2011 a 2013, retornaram 3.805 crianças em Ribeirão Preto e 3.308 em São Luís. Foram utilizados dados do momento do seguimento, e estes foram integrados às informações do Cadastro Único (CadÚnico). Consideraram-se dois critérios de elegibilidade para o benefício do Bolsa Família: renda familiar per capita mensal de até R$ 140,00 e classe econômica D/E. Estimaram-se percentuais de foco e cobertura do Bolsa Família. Realizou-se ponderação para perdas de seguimento. O foco do Bolsa Família, segundo renda familiar per capita mensal, foi de 33,8% em São Luís e 15,9% em Ribeirão Preto, e de acordo com a classe econômica foi de 33,7% em São Luís e 15,3% em Ribeirão Preto. A cobertura do Bolsa Família, de acordo com o critério de renda familiar per capita mensal, foi de 82,1% em São Luís e 71,6% em Ribeirão Preto; e segundo classe econômica foi de 68,9% em São Luís e 46,8% em Ribeirão Preto. Foram baixos os percentuais de foco e melhores os de cobertura do Bolsa Família, com estimativas destes indicadores maiores para São Luís em relação a Ribeirão Preto.
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Moraes LMVD, Simões VMF, Carvalho CDA, Batista RFL, Alves MTSSDBE, Thomaz ÉBAF, Barbieri MA, Alves CMC. [Factors associated with the involuntary pilgrimage for childbirth care in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil: a contribution from the BRISA cohort]. CAD SAUDE PUBLICA 2018; 34:e00151217. [PMID: 30427413 DOI: 10.1590/0102-311x00151217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
Abstract
The objectives of this study were to estimate the involuntary pilgrimage by women in labor in search of childbirth care and to identify factors associated with this endeavor in two Brazilian cities. This was a cross-sectional study nested in the BRISA birth cohort, whose sample consisted of 10,475 women admitted to the selected maternity hospitals for delivery in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State). Interviews were held with questionnaires that contained sociodemographic and obstetric variables. Hierarchical modeling was used, and relative risk was calculated with Poisson regression. Involuntary pilgrimage during labor was more frequent in São Luís (35.8%) than in Ribeirão Preto (5.8%). In São Luís, factors associated with pilgrimage were: first pregnancy (RR = 1.19; 95%CI: 1.08-1.31) and schooling less than 12 complete years. However, age 35 years or older (RR = 0.65; 95%CI: 0.54-0.84) was associated with less pilgrimage. In Ribeirão Preto, such trekking for obstetric care was more frequent in women with high-risk pregnancies (RR = 2.45; 95%CI: 1.81-3.32) and those with gestational age less than 37 weeks (RR = 1.93; 95%CI: 1.50-2.50). Meanwhile, delivery with gestational age equal to or greater than 42 weeks was associated with less pilgrimage (RR = 0.57; 95%CI: 0.33-0.98). In both cities, poor women had to trek more in search of childbirth care and had no guarantee of care, even for those who had received prenatal care. The study revealed the lack of guarantee of universal and equitable access and highlighted the unequal access to childbirth care between Brazil's major geographic regions.
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Lima RJCP, Batista RFL, Ribeiro MRC, Ribeiro CCC, Simões VMF, Lima Neto PM, Silva AAMD, Bettiol H. Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort. Rev Saude Publica 2018; 52:46. [PMID: 29723385 PMCID: PMC5947505 DOI: 10.11606/s1518-8787.2018052000125] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/12/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001). A 6 kg increase (1 SD) in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001). The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001), but the negative indirect effect was small (SC = -0.076, p < 0.001) and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001). The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001), with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001). Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001). CONCLUSIONS The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.
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Affiliation(s)
| | | | | | | | | | - Pedro Martins Lima Neto
- Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brasil
| | | | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Silva FDS, Barbosa YC, Batalha MA, Ribeiro MRC, Simões VMF, Branco MDRFC, Thomaz ÉBAF, Queiroz RCDS, Araújo WRM, Silva AAMD. Incomplete childhood immunization with new and old vaccines and associated factors: BRISA birth cohort, São Luís, Maranhão State, Northeast Brazil. CAD SAUDE PUBLICA 2018. [PMID: 29538497 DOI: 10.1590/0102-311x00041717] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study estimated the percentages of incomplete immunization with new vaccines and old vaccines and associated factors in children 13 to 35 months of age belonging to a birth cohort in São Luís, the capital of Maranhão State, Brazil. The sample was probabilistic, with 3,076 children born in 2010. Information on vaccination was obtained from the Child's Health Card. The new vaccines, namely those introduced in 2010, were meningococcal C and 10-valent pneumococcal, and the old vaccines, or those already on the childhood immunization schedule, were BCG, hepatitis B, human rotavirus, polio, tetravalent (diphtheria, tetanus, pertussis, Haemophilus influenzae b), yellow fever, and triple viral (measles, mumps, rubella). The study used hierarchical modeling and Poisson regression with robust variance. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. Incomplete immunization was higher with new vaccines (51.1%) than with old vaccines (33.2%). Children 25 to 35 months of age (PR = 1.27; 95%CI: 1.14-1.41) and those in economic classes D/E (PR = 1.20; 95%CI: 1.06-1.35) were only significantly associated with new vaccines; low maternal schooling (PR = 1.58; 95%CI: 1.21-2.06), unavailability of outpatient and/or hospital care for the child (PR = 1.20; 95%CI: 1.04-1.38), and unavailability of the vaccine in health services (PR: 1.28; 95%CI: 1.12-1.46) were only associated with old vaccines. Immunization strategies should consider the vulnerability of older preschool-age children and those belonging to classes D and E, especially when new vaccines are introduced, as well as children of mothers with low schooling. Strategies should also address problems with the availability of health services and vaccines.
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Affiliation(s)
| | - Yonna Costa Barbosa
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, Brasil
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Moura da Silva AA, Ganz JSS, Sousa PDS, Doriqui MJR, Ribeiro MRC, Branco MDRFC, Queiroz RCDS, Pacheco MDJT, Vieira da Costa FR, Silva FDS, Simões VMF, Pacheco MAB, Lamy-Filho F, Lamy ZC, Soares de Britto E Alves MTS. Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome. Emerg Infect Dis 2018; 22:1953-1956. [PMID: 27767931 PMCID: PMC5088045 DOI: 10.3201/eid2211.160956] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We report the early growth and neurologic findings of 48 infants in Brazil diagnosed with probable congenital Zika virus syndrome and followed to age 1-8 months. Most of these infants had microcephaly (86.7%) and craniofacial disproportion (95.8%). The clinical pattern included poor head growth with increasingly negative z-scores, pyramidal/extrapyramidal symptoms, and epilepsy.
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Cavalcante NCN, Simões VMF, Ribeiro MRC, Lamy-Filho F, Barbieri MA, Bettiol H, Silva AAMD. Maternal socioeconomic factors and adverse perinatal outcomes in two birth cohorts, 1997/98 and 2010, in São Luís, Brazil. Rev bras epidemiol 2017; 20:676-687. [DOI: 10.1590/1980-5497201700040010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 07/11/2017] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Several studies have identified social inequalities in low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR), which, in recent years, have diminished or disappeared in certain locations. Objectives: Estimate the LBW, PTB, and IUGR rates in São Luís, Maranhão, Brazil, in 2010, and check for associations between socioeconomic factors and these indicators. Methods: This study is based on a birth cohort performed in São Luís. It included 5,051 singleton hospital births in 2010. The chi-square test was used for proportion comparisons, while simple and multiple Poisson regression models with robust error variance were used to estimate relative risks. Results: LBW, PTB and IUGR rates were 7.5, 12.2, and 10.3% respectively. LBW was higher in low-income families, while PTB and IUGR were not associated with socioeconomic factors. Conclusion: The absence or weak association of these indicators with social inequality point to improvements in health care and/or in social conditions in São Luís.
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Morais AODDS, Simões VMF, Rodrigues LDS, Batista RFL, Lamy ZC, Carvalho CAD, Silva AAMD, Ribeiro MRC. [Maternal depressive symptoms and anxiety and interference in the mother/child relationship based on a prenatal cohort: an approach with structural equations modeling]. CAD SAUDE PUBLICA 2017; 33:e00032016. [PMID: 28724023 DOI: 10.1590/0102-311x00032016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the association between maternal depressive symptoms and anxiety and interference in the mother/child relationship, using structural equations modeling. Data were used from a prospective cohort study initiated during the prenatal period with 1,140 mothers in São Luís, Maranhão State, Brazil. Data were collected during prenatal care and when the children reached two years of age. Interference in the mother/child relationship was measured with the Postpartum Bonding Questionnaire - PBQ (N = 1,140). In the initial theoretical model, socioeconomic status determined the maternal demographic, psychosocial, and social support factors, which determined the outcome, i.e., the mother/child relationship. Adjustments were performed by structural equations modeling, using Mplus 7.0. The final model showed good fit (RMSEA = 0.047; CFI = 0.984; TLI = 0.981). Depressive symptoms in pregnancy and the postpartum were associated with higher PBQ scores, indicating interference in the mother/child relationship. The greatest effect was from depressive symptoms in pregnancy. Other factors associated with higher PBQ scores were lower social support, unfavorable socioeconomic status, and living without a partner, by indirect association. Anxiety symptoms and maternal age were not associated with the mother/child relationship. The results suggest that identifying and treating depression in pregnancy and postpartum can improve mother/child bonding in childhood.
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