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Penteado MP, Grandi C, Rodrigues LDS, Cardoso VC. Association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from the 2010/2011 BRISA birth cohort. J Pediatr (Rio J) 2024:S0021-7557(24)00007-X. [PMID: 38346677 DOI: 10.1016/j.jped.2023.11.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort. METHOD This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data. RESULTS 723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05-7.57), stunting (OR 2.23; 95 % CI 1.07-4.65), and wasting (OR 8.22; 95 % CI 1.96-34.37). No relationship was found between LGA and placental efficiency. CONCLUSIONS Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities.
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Affiliation(s)
- Marina Papa Penteado
- Universidade de São Paulo (USP), Hospital das Clínicas de Ribeirão Preto (HCRP), HC Criança, Ribeirão Preto, SP, Brazil.
| | - Carlos Grandi
- Sociedade Argentina de Pediatria, Comissão de Pesquisa, Buenos Aires, Argentina
| | | | - Viviane Cunha Cardoso
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
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Teixeira JH, Rocha PRH, Veiga ECDA, Salomão KB, Barbieri MR, de Oliveira MM, Cardoso VC, Cavalli RDC, Barbieri MA, Saraiva MDCP, Bettiol H. Sociodemographic and economic characteristics of families and health and education conditions of children in the BRISA cohort during the COVID-19 pandemic. Rev Bras Epidemiol 2023; 26:e230036. [PMID: 37646733 PMCID: PMC10470252 DOI: 10.1590/1980-549720230036] [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: 12/15/2022] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To describe changes in sociodemographic, economic and variables related to the characterization of family, health and education during the COVID-19 pandemic in a birth cohort evaluated at 10-11 years of age. METHODS Cross-sectional study involving 1,033 children from a cohort of children born in 2010/2011, in the city of Ribeirão Preto, SP, Brazil. Data were collected from July to October 2021 by telephone or video interview held with the person responsible for the child. The questionnaires discussed family organization, child behavior and health, school attendance, socioeconomic assessment and occurrence of COVID-19 during the period of social isolation due to the pandemic. Descriptive statistics were used to describe the data. The chi-square test was used to verify group differences by minimum wages (MW). RESULTS Of the respondents, 47.6% reported worsening of their financial situation during the pandemic, which was more frequent in the group with a household income <3 MW compared to the group with >6 MW (59.1 vs. 15.7%; p<0.001). According to the respondents, 62% of the children exhibited behavioral changes during the period and anxiety was the most frequently reported condition. In addition, 61.4% of the children had learning difficulties and these problems were more prevalent among children from households with lower incomes compared to those with higher incomes (74.7 vs. 45.1%; p<0.001). CONCLUSION The COVID-19 pandemic has changed different economic aspects of families, as well as educational, health and behavioral indicators of children. Lower-income families were the most affected both economically and in terms of other indicators.
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Affiliation(s)
- Julia Hannah Teixeira
- Universidade de São Paulo, Ribeirão Preto School of Nursing –
Ribeirão Preto (SP), Brazil
| | | | | | - Karina Bezerra Salomão
- Universidade de São Paulo, Faculty of Medicine of Ribeirão
Preto – Ribeirão Preto (SP), Brazil
| | - Manuela Ramos Barbieri
- Universidade de São Paulo, Faculty of Medicine of Ribeirão
Preto – Ribeirão Preto (SP), Brazil
| | | | - Viviane Cunha Cardoso
- Universidade de São Paulo, Faculty of Medicine of Ribeirão
Preto – Ribeirão Preto (SP), Brazil
| | | | - Marco Antonio Barbieri
- Universidade de São Paulo, Faculty of Medicine of Ribeirão
Preto – Ribeirão Preto (SP), Brazil
| | | | - Heloisa Bettiol
- Universidade de São Paulo, Faculty of Medicine of Ribeirão
Preto – Ribeirão Preto (SP), Brazil
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de Oliveira BR, Magalhães EIDS, Bragança MLBM, Coelho CCNDS, Lima NP, Bettiol H, Barbieri MA, Cardoso VC, dos Santos AM, Horta BL, da Silva AAM. Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults. Nutrients 2023; 15:2974. [PMID: 37447300 PMCID: PMC10346298 DOI: 10.3390/nu15132974] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Maylla Luanna Barbosa Martins Bragança
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Carla Cristine Nascimento da Silva Coelho
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Marco Antônio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Antônio Augusto Moura da Silva
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
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Damaso ÊL, Bettiol H, Cardoso VC, Vieira CS, Moisés ECD, Cavalli RC. Sociodemographic and reproductive risk factors associated with obesity in a population of brazilian women from the city of Ribeirão Preto: a cross-sectional study. BMC Public Health 2023; 23:1222. [PMID: 37353820 PMCID: PMC10288772 DOI: 10.1186/s12889-023-16056-1] [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: 08/04/2022] [Accepted: 06/05/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Obesity is a highly prevalent chronic disease that is associated with the development of other metabolic comorbidities. Its etiology is complex and multiple risk factors have been reported. In women, weight gain during pregnancy and the effect of pregnancy on subsequent weight gain are important events in women's history. Both pregnancy and postpartum are critical periods for the development of obesity. OBJECTIVES To identify sociodemographic and reproductive risk factors associated with obesity in women in their fourth decade of life. METHODS Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of obesity and the adjusted relative risk (RR) was calculated. RESULTS The cohort included 916 women and 309 (33.7%) of them were obese. Obesity was associated with low educational level (RR 1.77, 95%CI 1.33-2.35) and teenage pregnancy (RR 1.46, 95%CI 1.10-1.93). There was no association of obesity with the other covariates studied. CONCLUSION Obesity is associated with years of schooling and teenage pregnancy.
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Affiliation(s)
- Ênio Luis Damaso
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
| | - Heloisa Bettiol
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Carolina Sales Vieira
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Elaine Christine Dantas Moisés
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Ricardo Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Turra SE, Damaso ÊL, Veiga ECDA, Cardoso VC, Bettiol H, Cavalli RC. Serum cytokines in second trimester pregnancy and their relationship with spontaneous preterm births in the Ribeirão Preto and São Luiz cohorts. BMC Pregnancy Childbirth 2023; 23:460. [PMID: 37344822 DOI: 10.1186/s12884-023-05791-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/15/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE To evaluate the association between second trimester plasma cytokine levels in asymptomatic pregnant women and preterm births (PTB) in an attempt to identify a possible predictor of preterm birth. METHODS The study design was a nested case-control study including women with singleton a gestational age between 20-25(+ 6) weeks from two Brazilian cities. The patients were interviewed, Venous blood samples were collected. The participants were again evaluated at birth. A total of 197 women with PTB comprised the case group. The control group was selected among term births (426 patients). Forty-one cytokines were compared between groups. RESULTS When only spontaneous PTB were analyzed, GRO, sCD40L and MCP-1 levels were lower in the case group (p < 0.05). Logarithmic transformation was performed for cytokines with discrepant results, which showed increased levels of IL-2 in the group of spontaneous PTB (p < 0.05). In both analyses, the incidence of maternal smoking and of a history of preterm delivery differed significantly between the case and control groups. In multivariate analysis, only serum GRO levels differed between the case and control groups. CONCLUSION Lower second trimester serum levels of GRO in asymptomatic women are associated with a larger number of PTB. This finding may reflect a deficient maternal inflammatory response.
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Affiliation(s)
- Suzana Eggers Turra
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Ênio Luis Damaso
- Department of Pediatric Dentistry, Orthodontics and Collective Health, Faculty of Dentistry of Bauru, University of São Paulo, Bauru, SP, Brazil
| | - Eduardo Carvalho de Arruda Veiga
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida: Bandeirantes, 3900, Sao Paulo, CEP: 14049-900, Brazil.
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Ricardo Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Okido MM, Cavalli RDC, Cardoso VC, Marcolin AC. Prediction of Perinatal and Neurodevelopmental Outcomes in Newborns with a Birth Weight below the 3rd Percentile: Performance of Two International Curves - Prospective Cohort from a Brazilian City. Rev Bras Ginecol Obstet 2023; 45:225-234. [PMID: 37339641 PMCID: PMC10281769 DOI: 10.1055/s-0043-1770131] [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] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVES To evaluate the performance of Intergrowth-21 st (INT) and Fetal Medicine Foundation (FMF) curves in predicting perinatal and neurodevelopmental outcomes in newborns weighing below the 3rd percentile. METHODS Pregnant women with a single fetus aged less than 20 weeks from a general population in non-hospital health units were included. Their children were evaluated at birth and in the second or third years of life. Newborns (NB) had their weight percentiles calculated for both curves. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and area under the ROC curve (ROC-AUC) for perinatal outcomes and neurodevelopmental delay were calculated using birth weight < 3rd percentile as the cutoff. RESULTS A total of 967 children were evaluated. Gestational age at birth was 39.3 (±3.6) weeks and birth weight was 3,215.0 (±588.0) g. INT and FMF classified 19 (2.4%) and 49 (5.7%) newborns below the 3rd percentile, respectively. The prevalence of preterm birth, tracheal intubation >24 hours in the first three months of life, 5th minute Apgar <7, admission to a neonatal care unit (NICU admission), cesarean section rate, and the neurodevelopmental delay was 9.3%, 3.3%, 1.3%, 5.9%, 38.9%, and 7.3% respectively. In general, the 3rd percentile of both curves showed low sensitivity and PPV and high specificity and NPV. The 3rd percentile of FMF showed superior sensitivity for preterm birth, NICU admission, and cesarean section rate. INT was more specific for all outcomes and presented a higher PPV for the neurodevelopmental delay. However, except for a slight difference in the prediction of preterm birth in favor of INT, the ROC curves showed no differences in the prediction of perinatal and neurodevelopmental outcomes. CONCLUSION Birth weight below the 3rd percentile according to INT or FMF alone was insufficient for a good diagnostic performance of perinatal and neurodevelopmental outcomes. The analyzes performed could not show that one curve is better than the other in our population. INT may have an advantage in resource contingency scenarios as it discriminates fewer NB below the 3rd percentile without increasing adverse outcomes.
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Affiliation(s)
- Marcos Masaru Okido
- Department of Obstetrics and Gynecology, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
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Bragança MLBM, Bogea EG, de Almeida Fonseca Viola PC, dos Santos Vaz J, Confortin SC, Menezes AMB, Gonçalves H, Bettiol H, Barbieri MA, Cardoso VC, da Silva AAM. High Consumption of Sugar-Sweetened Beverages Is Associated with Low Bone Mineral Density in Young People: The Brazilian Birth Cohort Consortium. Nutrients 2023; 15:324. [PMID: 36678194 PMCID: PMC9867470 DOI: 10.3390/nu15020324] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18-23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm2), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1-16.7 times/day) was associated with a lower lumbar spine BMD (β = -0.009; 95% CI: -0.017; -0.001; standardized β = -0.03). This association persisted after adjustment for confounders (β = -0.008; 95% CI: -0.016; -0.001; standardized β = -0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.
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Affiliation(s)
| | - Eduarda Gomes Bogea
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Maranhão, Brazil
| | | | - Juliana dos Santos Vaz
- Postgraduate Programme in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas 96010-610, Rio Grande do Sul, Brazil
| | - Susana Cararo Confortin
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Maranhão, Brazil
| | - Ana Maria Baptista Menezes
- Postgraduate Programme in Epidemiology, Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas 96020-220, Rio Grande do Sul, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas 96020-220, Rio Grande do Sul, Brazil
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
| | - Marco Antonio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
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Confortin SC, Santos IDS, Batista RFL, Eckeli AL, Tovo-Rodrigues L, Del-Ponte B, Menezes AMB, Wehrmeister FC, Gonçalves H, Cardoso VC, Barbieri MA, Bettiol H, Silva AAMD. Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium. Rev Bras Epidemiol 2023; 26:e230027. [PMID: 37162069 PMCID: PMC10168628 DOI: 10.1590/1980-549720230027] [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: 05/10/2022] [Accepted: 03/03/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics. METHODS Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex. RESULTS Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes. CONCLUSION Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Graduate Program in Collective Health - São Luís (MA), Brazil
| | - Iná da Silva Santos
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Luciana Tovo-Rodrigues
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Bianca Del-Ponte
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | | | - Helen Gonçalves
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Viviane Cunha Cardoso
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Marco Antonio Barbieri
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
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Cardoso VC, Grandi C, Silveira RC, Duarte JLB, Viana MCFB, Ferreira DMDLM, Alves JMS, Embrizi LF, Gimenes CB, de Mello E Silva NM, Melo FPDG, Venzon PS, Gomez DB, Vale MSD, Bentlin MR, Barros MCDM, Cardoso LEMB, Diniz EMDA, Luz JH, Marba STM, Almeida JHCLD, Aragon DC, Carmona F. Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH. J Pediatr (Rio J) 2023; 99:86-93. [PMID: 36049561 PMCID: PMC9875266 DOI: 10.1016/j.jped.2022.07.007] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). METHOD Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. OUTCOME the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. RESULTS 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92-2.31)/1.60 (1.27-2.02) for SGA; 0.90 (0.55-1.47)/1.05 (0.55-1.99) for LGA; 1.65 (1.08-2.51)/1.58 (1.28-1.96) for stunting; and 1.48 (1.02-2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. CONCLUSION The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.
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Affiliation(s)
- Viviane Cunha Cardoso
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, São Paulo, SP, Brazil.
| | - Carlos Grandi
- Sociedad Argentina de Pediatria, Subcomissión de Investigación, Buenos Aires, Argentina
| | - Rita C Silveira
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - José Luiz Bandeira Duarte
- Universidade do Estado do Rio de Janeiro, Hospital Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil
| | | | | | - José Mariano Sales Alves
- Faculdade de Ciências Médicas de Minas Gerais, Maternidade Escola Hilda Brandão, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Paulyne Stadler Venzon
- Universidade Federal do Paraná, Departamento de Pediatria, Curitiba, PR, Brazil; Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil
| | - Dafne Barcala Gomez
- Universidade Federal do Maranhão, Hospital Universitário, São Luís, MA, Brazil
| | - Marynéa Silva do Vale
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil
| | - Maria Regina Bentlin
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil
| | | | | | | | - Jorge Hecker Luz
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brazil
| | - Sérgio Tadeu Martins Marba
- Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira, Rio de Janeiro, RJ, Brazil
| | | | - Davi Casale Aragon
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, São Paulo, SP, Brazil
| | - Fabio Carmona
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, São Paulo, SP, Brazil
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Muniz AKOA, Ribeiro CCC, Vianna EO, Serra HCOA, Nascimento JXPT, Cardoso VC, Barbieri MA, da Silva AAM, Bettiol H. Factors associated with allergy traits around the 2nd year of life: a brazilian cohort study. BMC Pediatr 2022; 22:703. [PMID: 36482361 PMCID: PMC9733343 DOI: 10.1186/s12887-022-03772-7] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Allergic status has been strongly influenced by early exposures; however, allergic diseases are hard to measure in early life. Thus, this study proposed a latent variable allergy traits around the second year of life and analyzed pre- and perinatal factors associated with this phenomenon. METHODS The study used data from the BRISA birth cohort, Ribeirão Preto, Brazil (n = 3644). The theoretical model included: family allergy (history of allergic rhinitis, atopic dermatitis, and asthma); gestational period variables (socioeconomic status, mother's skin color, pregestational body mass index - BMI, smoking, gestational diabetes, and hypertension); birth variables (gestational age, 5-minute Apgar score, birth weight, type of delivery), and early life factor (exclusive breast feeding). The outcome was allergy traits around the 2nd year of life, a latent variable deduced from the shared variance among medical diagnosis of allergic rhinitis, atopic dermatitis, and food allergy. The model was analyzed by structural equation modeling. RESULTS Higher socioeconomic status (SC = 0.256; p < 0.001) and higher family allergy values (SC = 1.224; p < 0.001) were associated with higher allergy trait values. Hypertension during pregnancy was associated with higher values (SC = 0.170; p = 0.022) and exclusive breast feeding (SC = -0.192; p < 0.001) with low allergy trait values. CONCLUSION Although socioeconomic and environmental factors were associated with allergy traits around the 2nd year of life, the family component of allergy was the exposure that best explained this outcome.
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Affiliation(s)
| | - Cecilia Claudia Costa Ribeiro
- grid.411204.20000 0001 2165 7632Department of Public Health, Federal University of Maranhão – UFMA, São Luís, Maranhão Brazil
| | - Elcio Oliveira Vianna
- grid.11899.380000 0004 1937 0722Ribeirão Preto Medical School, University of São Paulo – USP, Ribeirão Preto, São Paulo Brazil
| | | | | | - Viviane Cunha Cardoso
- grid.11899.380000 0004 1937 0722Ribeirão Preto Medical School, University of São Paulo – USP, Ribeirão Preto, São Paulo Brazil
| | - Marco Antonio Barbieri
- grid.11899.380000 0004 1937 0722Ribeirão Preto Medical School, University of São Paulo – USP, Ribeirão Preto, São Paulo Brazil
| | - Antonio Augusto Moura da Silva
- grid.411204.20000 0001 2165 7632Department of Public Health, Federal University of Maranhão – UFMA, São Luís, Maranhão Brazil
| | - Heloisa Bettiol
- grid.11899.380000 0004 1937 0722Ribeirão Preto Medical School, University of São Paulo – USP, Ribeirão Preto, São Paulo Brazil
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11
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Urquia ML, Batista R, Grandi C, Cardoso VC, Orozco F, Fafard St. Germain AA. Associations between child and adolescent marriage and reproductive outcomes in Brazil, Ecuador, the United States and Canada. BMC Public Health 2022; 22:1410. [PMID: 35871000 PMCID: PMC9308908 DOI: 10.1186/s12889-022-13766-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although marriage is associated with favourable reproductive outcomes among adult women, it is not known whether the marriage advantage applies to girls (< 18 years). The contribution of girl child marriage (< 18 years) to perinatal health is understudied in the Americas. Methods National singleton birth registrations were used to estimate the prevalence of girl child marriage among mothers in Brazil (2011–2018, N = 23,117,661), Ecuador (2014–2018, N = 1,519,168), the USA (2014–2018, N = 18,618,283) and Canada (2008–2018, N = 3,907,610). The joint associations between marital status and maternal age groups (< 18, 18–19 and 20–24 years) with preterm birth (< 37 weeks), small-for-gestational age (SGA < 10 percentile) and repeat birth were assessed with logistic regression. Results The proportion of births to < 18-year-old mothers was 9.9% in Ecuador, 8.9% in Brazil, 1.5% in the United States and 0.9% in Canada, and marriage prevalence among < 18-year-old mothers was 3.0%, 4.8%, 3.7% and 1.7%, respectively. In fully-adjusted models, marriage was associated with lower odds of preterm birth and SGA among 20–24-year-old mothers in the four countries. Compared to unmarried 20–24-year-old women, married and unmarried < 18-year-old girls had higher odds of preterm birth in the four countries, and slightly higher odds of SGA in Brazil and Ecuador but not in the USA and Canada. In comparisons within age groups, the odds of repeat birth among < 18-year-old married mothers exceeded that of their unmarried counterparts in Ecuador [AOR: 1.99, 95%CI: 1.82, 2.18], the USA [AOR: 2.96, 95%CI: 2.79, 3.14], and Canada [AOR: 2.17, 95%CI: 1.67, 2.82], although minimally in Brazil [AOR: 1.09, 95%CI: 1.07, 1.11]. Conclusions The prevalence of births to < 18-year-old mothers varies considerably in the Americas. Girl child marriage was differentially associated with perinatal health indicators across countries, suggesting context-specific mechanisms.
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Rudakoff LCS, Magalhães EIDS, Viola PCDAF, de Oliveira BR, da Silva Coelho CCN, Bragança MLBM, Arruda SPM, Cardoso VC, Bettiol H, Barbieri MA, Levy RB, da Silva AAM. Ultra-processed food consumption is associated with increase in fat mass and decrease in lean mass in Brazilian women: A cohort study. Front Nutr 2022; 9:1006018. [PMID: 36313106 PMCID: PMC9615037 DOI: 10.3389/fnut.2022.1006018] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the association between ultra-processed food consumption at 23–25 years of age and measurements of body composition–fat mass, fat mass distribution and lean mass at 37–39 years of age in Brazilian adults. Methods 1978/1979 birth cohort study conducted with healthy adults from Ribeirão Preto, São Paulo, Brazil. A total of 1,021 individuals participated in the fat mass analysis (measured by air displacement plethysmography) and 815 in the lean mass analysis and fat mass distribution (assessed by dual energy X-ray absorptiometry). Food consumption was evaluated by a food frequency questionnaire. Food items were grouped according to the level of processing as per the NOVA classification. Ultra-processed food consumption was expressed as a percentage of total daily intake (g/day). Linear regression models were used to estimate the effect of ultra-processed food consumption (g/day) on body mass index, body fat percentage, fat mass index, android fat, gynoid fat, android-gynoid fat ratio, lean mass percentage, lean mass index and appendicular lean mass index. Marginal plots were produced to visualize interactions. Results The mean daily ultra-processed food consumption in grams was 35.8% (813.3 g). There was an association between ultra-processed food consumption and increase in body mass index, body fat percentage, fat mass index, android fat and gynoid fat and decrease in lean mass percentage, only in women. Conclusion A high ultra-processed food consumption is associated with a long-term increase in fat mass and a decrease in lean mass in adult women.
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Affiliation(s)
- Lívia Carolina Sobrinho Rudakoff
- Post-Graduate Program in Collective Health, Public Health Department, Federal University of Maranhão, São Luís, Brazil,*Correspondence: Lívia Carolina Sobrinho Rudakoff
| | - Elma Izze da Silva Magalhães
- Post-Graduate Program in Collective Health, Public Health Department, Federal University of Maranhão, São Luís, Brazil
| | | | - Bianca Rodrigues de Oliveira
- Post-Graduate Program in Collective Health, Public Health Department, Federal University of Maranhão, São Luís, Brazil
| | | | | | | | - Viviane Cunha Cardoso
- Post-Graduate Program in Child and Adolescent Health, University of São Paulo, Ribeirão Preto, Brazil
| | - Heloisa Bettiol
- Post-Graduate Program in Child and Adolescent Health, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Barbieri
- Post-Graduate Program in Child and Adolescent Health, University of São Paulo, Ribeirão Preto, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Confortin SC, Rocha PRH, Silva BGCD, Menezes AMB, Horta BL, Gonçalves H, Bettiol H, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Batista RFL, Cardoso VC, Silva ICMD, Silva AAMD. Physical activity in birth cohorts of three Brazilian cities (Ribeirão Preto, Pelotas, and São Luís): A cross-sectional study. Rev Bras Epidemiol 2022; 25:e220024. [PMID: 36074452 DOI: 10.1590/1980-549720220024] [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: 04/05/2022] [Accepted: 07/19/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the prevalence of physical activity among subjects from birth cohorts of three cities located in different regions of Brazil according to sociodemographic characteristics and sex, comparing the relationships within and between cohorts. METHODS Cross-sectional study involving 12,724 adolescents and young adults who participated in five birth cohorts: Ribeirão Preto [1978/79 (37/39 years old in 2016) and 1994 (22 years in 2016)]; Pelotas [1982 (30 years in 2012) and 1993 (22 years in 2015)], and São Luís [1997/98 (18/19 years in 2016)]. Leisure-time physical activity was evaluated with questionnaires (insufficiently active: <150 min/week and active: ≥150 min/week) and moderate and vigorous physical activity (MVPA) was objectively measured by accelerometry. Those, in each city, were evaluated accordingly to skin color, socioeconomic classification, and study/work activities. RESULTS The prevalence of leisure-time physical activity ranged from 29.2% at 30 years old in Pelotas to 54.6% among adolescents from São Luís. The prevalence of leisure-time physical activity was higher among younger people (54.6% in São Luís 1997), while the same was not observed for total physical activity. MVPA (3rd tercile) was higher in the cohorts from Pelotas and São Luís. The prevalence of leisure-time physical activity and MVPA was higher in men. The data showed that the variation in physical activity was associated with sex and sociodemographic conditions in all cohorts. CONCLUSION Sociodemographic characteristics should be considered when promoting leisure-time physical activity and actions aimed at young people, and adults who are more socioeconomically vulnerable should be encouraged.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Collective Health Postgraduate Program - São Luís (MA), Brazil
| | | | | | | | - Bernardo Lessa Horta
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Helen Gonçalves
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
| | | | | | | | | | - Viviane Cunha Cardoso
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
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Urquia ML, Batista RF, Cunha Cardoso V, Grandi C, Fafard St Germain AA. The perinatal epidemiology of child and adolescent marriage in Brazil, 2011–2018. SSM Popul Health 2022; 18:101093. [PMID: 35464613 PMCID: PMC9018448 DOI: 10.1016/j.ssmph.2022.101093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 10/28/2022] Open
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Dornelas ACVDR, Rodrigues LDS, Penteado MP, Batista RFL, Bettiol H, Cavalli RDC, Grandi C, Cardoso VC. Abuse, disrespect and mistreatment during childbirth care: contribution of the Ribeirão Preto cohorts, Brazil. Ciênc saúde coletiva 2022; 27:535-544. [DOI: 10.1590/1413-81232022272.01672021] [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: 09/16/2020] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
Abstract This study aimed to estimate the perception and frequency of abuse, disrespect and mistreatment (ADM) situations during childbirth care of 745 women from the Ribeirão Preto birt cohorts. Confidential questionnaires containing one question regarding perceived abuse during childbirth care and other questions addressing exposure to ADM situations were applied. The chi-squared test was used to compare the situations presented between women who did and did not report mistreatment using the Stata 14.0 software. Among the 745 women evaluated, 66.2% were exposed to some situation of ADM and 8.3% reported having perceived ADM. The most frequent situations were that the woman could not eat or drink (30.5%), the woman had her belly squeezed to help the child be born (27.5%), and the woman could not stay with a companion of her choice (25.5%). Women who reported to have suffered maltreatment more frequently responded positively to all situations of ADM when compared to the other participants, except for the following statements: “I was not allowed to eat or drink anything” (p = 0.975) and “I was forced to have a cesarean delivery against my will” (p = 0.073). Although most women of the Ribeirão Preto cohorts reported exposure to ADM situations during childbirth care, a minority perceived disrespect or mistreatment.
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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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Carvalho CAD, Magalhães EIDS, Bettiol H, Barbieri MA, Cardoso VC, Matijasevich A, Menezes AMB, Horta BL, Wehrmeister FC, Gonçalves H, Santos IS, Lima NP, França AKTDC, Silva AAMD. Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís). CAD SAUDE PUBLICA 2021; 37:e00237020. [PMID: 34008736 DOI: 10.1590/0102-311x00237020] [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: 08/10/2020] [Accepted: 01/04/2021] [Indexed: 11/21/2022] Open
Abstract
Our objective was to estimate the prevalence of excess weight and obesity, according to sex and income in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas, and São Luís). Participants in the Ribeirão Preto (1978/1979 and 1994), Pelotas (1982, 1993 and 2004) and São Luís (1997/1998) birth cohorts were included in different follow-ups from 7 years old onwards. Excess weight (overweight and obesity) were assessed by body mass index. The highest prevalences were observed in Ribeirão Preto (excess weight: 27.7% at 9-11 and 47.1% at 22-23 years; obesity: 8.6% at 9-11 and 19.8% at 22-23 years) while the smallest was in São Luís (excess weight: 5.4 to 7-9 and 17.2% at 18-19 years; obesity: 1.8% at 7-9 and 3.6% at 18-19 years). The younger the cohort, the greater the prevalence of excess weight and obesity when comparing similar age groups. Increases in obesity prevalence were greater than in excess weight prevalence. Women had lower excess weight prevalence in older cohorts and higher obesity prevalence in younger cohorts. Higher excess weight and obesity prevalence were observed in higher income children and adolescents, and in poorer adults. Differences in the prevalence of excess weight and obesity evidenced that individuals from younger cohorts are more exposed to this morbidity, as well as those who were born in the most developed city, low-income adults as well as children and adolescents belonging to families of the highest income tertile. Therefore, the results of this study indicate the need to prioritize actions aimed at younger individuals.
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Affiliation(s)
| | | | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | | | | | | | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Iná S Santos
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, 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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de Arruda Veiga EC, Rocha PRH, Caviola LL, Cardoso VC, da Silva Costa F, da Conceição Pereira Saraiva M, Barbieri MA, Bettiol H, Cavalli RC. Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis. Clinics (Sao Paulo) 2021; 76:e1999. [PMID: 33503177 PMCID: PMC7798130 DOI: 10.6061/clinics/2021/e1999] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/24/2020] [Indexed: 11/18/2022] Open
Abstract
Preeclampsia is a multifactorial disease. Among these factors, untreated hypertension during pregnancy can result in high morbidity and mortality rates and may also be related to the future development of cardiovascular diseases.Therefore, this systematic review aimed to determine the association of previous preeclampsia with the future development of cardiovascular diseases. Studies on the association between preeclampsia and future cardiovascular diseases published in the last 10 years (2009-2019) were identified from the PubMed/Medline (207 articles), Embase (nine articles), and Cochrane (three articles) databases using the keywords "preeclampsia" and "future cardiovascular diseases", "preeclampsia" and "future heart attack", and "preeclampsia" and "future cardiac disease". After applying the inclusion and exclusion criteria, 15 articles were analyzed by systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis and the determination of the quality of the articles were conducted using RevMan software, version 5.3. Statistically significant differences were observed between the control and previous preeclampsia groups with respect to systolic blood pressure (mean difference [MD] 4.32; 95% confidence interval [95%CI] 3.65, 4.99; p<0.001), diastolic blood pressure (MD): 2.11; 95%CI: 1.68, 2.55; p<0.0001), and insulin level (MD: 2.80; 95% CI: 0.50, 5.11; p<0.001). Body mass index (MD: 2.57, 95%CI: 2.06, 3.07; p=0.0001), total cholesterol (MD: 10.39; 95%CI: 8.91, 11.87; p=0.0001), HDL (MD: 2.83; 95%CI: 2.20, 3.46; p=0.0001), and LDL (MD: 1.77; 95%CI: 0.42, 3.13; p=0.0001) also differed significantly between groups. Thus, the results of the present study showed that women with a history of preeclampsia were more likely to develop cardiovascular disease.
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Affiliation(s)
- Eduardo Carvalho de Arruda Veiga
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | | | - Leonardo L. Caviola
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Viviane Cunha Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Fabricio da Silva Costa
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Maria da Conceição Pereira Saraiva
- Departamento de Odontologia Pediatrica, Escola de Odontologia de Ribeirao Preto, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Marco Antonio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Ricardo Carvalho Cavalli
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
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Coelho CCNDS, Bragança MLBM, de Oliveira BR, Bettiol H, Barbieri MA, Cardoso VC, Silva AAMD. Incidence of metabolic syndrome in adults with healthy weight, normal weight obesity, and overweight/obesity. Nutrition 2020; 85:111134. [PMID: 33578242 DOI: 10.1016/j.nut.2020.111134] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/01/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to estimate the incidence of metabolic syndrome (MetS) in individuals with a healthy weight (HWI), normal weight obesity (NWO), or overweight/obesity (OWO). METHODS In all, 787 adults belonging to a 1978/1979 birth cohort from Ribeirão Preto were placed into one of three groups: HWI (body mass index [BMI] ≥18.5 and <25 kg/m2 + ∑skinfolds ≤90th percentile); NWO (BMI ≥18.5 and <25 kg/m2 +∑skinfolds >90th percentile); and OWO (BMI ≥25 kg/m2 +∑skinfolds >90th percentile). Those diagnosed with MetS at the 23 to 25 y of age were excluded according to Joint Interim Statement criteria. The incidence of MetS and its components in individuals 37 to 39 y of age was evaluated by Poisson regression with robust estimation of variance, which was adjusted for family income; physical activity level; and daily intake of calories, lipids, and added sugar. RESULTS MetS was detected in 279 adults at 37 to 39 y of age. NWO and OWO individuals showed higher risk ratios (RRs) for the development of MetS (RR,1.87; 95% confidence interval [CI], 1.36-2.57; RR, 1.61; 95% CI, 1.29-2.03), increased blood glucose levels (RR, 1.77; 95% CI, 1.12-2.79; RR, 1.51; 95% CI, 1.12-2.04), and increased waist circumferences (RR, 1.46; 95% CI, 1.32-1.61; RR, 1.50; 95% CI, 1.38-1.62). There was a higher risk for increased blood pressure (RR, 1.72; 95% CI, 1.35-2.19) among OWO individuals, but not among those with NWO. CONCLUSION Individuals with NWO have a risk ratio for MetS similar to individuals with OWO. This demonstrates the need to assess body fat percentages, even in BMI-designated normal weight individuals, both for prevention and management of obesity.
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Affiliation(s)
| | | | - Bianca Rodrigues de Oliveira
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Bernardo FMM, Veiga ECA, Quintana SM, Camayo FJA, Batista RFL, Alves MTSSB, Bettiol H, Barbieri MA, Cardoso VC, Cavalli RC. Association of genitourinary infections and cervical length with preterm childbirth. ACTA ACUST UNITED AC 2020; 54:e10235. [PMID: 33338099 PMCID: PMC7747871 DOI: 10.1590/1414-431x202010235] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/28/2020] [Indexed: 11/21/2022]
Abstract
A prospective cohort study was conducted on a convenience sample of 1370 pregnant
women with a gestational age of 20 to 25 weeks in the city of Ribeirão Preto.
Data on obstetrical history, maternal age, parity, smoking habit, and a history
of preterm delivery was collected with the application of a sociodemographic
questionnaire. Cervical length was determined by endovaginal ultrasound, and
urine and vaginal content samples were obtained to determine urinary tract
infection (UTI) and bacterial vaginosis (BV), respectively. The aim of this
study was to verify the association of cervical length and genitourinary
infections with preterm birth (PTB). Ultrasound showed no association of UTI or
BV with short cervical length. PTB rate was 9.63%. Among the women with PTB, 15
showed UTI (RR: 1.55, 95%CI: 0.93–2.58), 19 had BV (RR: 1.22, 95%CI: 0.77–1.94),
and one had both UTI and BV (RR: 0.85, 95%CI: 0.13–5.62). Nineteen (14.4%) PTB
occurred in women with a cervical length ≤2.5 cm (RR: 2.89, 95%CI: 1.89–4.43).
Among the 75 patients with PTB stratified as spontaneous, 10 showed UTI (RR:
2.02, 95%CI: 1.05–3.86) and 14 had a diagnosis of BV (RR: 1.72, 95%CI:
0.97–3.04). A short cervical length between 20 and 25 weeks of pregnancy was
associated with PTB, whereas UTI and BV determined at this age were not
associated with short cervical length or with PTB, although UTI, even if
asymptomatic, was related to spontaneous PTB.
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Affiliation(s)
- F M M Bernardo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 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
| | - S M Quintana
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F J A Camayo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M T S S B Alves
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, 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
| | - V C Cardoso
- 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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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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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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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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Vieira CS, Braga GC, Cruz Lugarinho PT, Stifani BM, Bettiol H, Barbieri MA, Cardoso VC, de Carvalho Cavalli R. Sociodemographic factors and prenatal care behaviors associated with unplanned pregnancy in a Brazilian birth cohort study. Int J Gynaecol Obstet 2020; 151:237-243. [PMID: 32652559 DOI: 10.1002/ijgo.13305] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/23/2020] [Accepted: 07/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify the sociodemographic factors and prenatal behavior characteristics associated with unplanned pregnancy. METHODS A cross-sectional survey was conducted of mothers of newborns enrolled in a birth cohort in Ribeirão Preto, Brazil. Questionnaires were administered to postpartum women. Multiple logistic regression was used to identify sociodemographic predictors of unplanned pregnancy and to evaluate the association with adherence to prenatal care recommendations. RESULTS The cohort included 7608 mothers: 7541 (99.1%) answered the interview and 4056 (53.8%) had an unplanned pregnancy. Adolescents were more likely to have an unplanned pregnancy (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.50-2.34) as were women over 40 (OR 1.74; 95% CI 1.22-2.47). Pregnancy during adolescence (OR 1.27; 95% CI 1.09-1.48), being single (OR 7.56; 95% CI 5.98-9.56), having two or more previous births (OR 1.73; 95% CI 1.52-1.97), and being of a lower socioeconomic status were also predictors. Lack or late initiation of prenatal care, attendance at less than six prenatal visits, drinking alcohol, and smoking during pregnancy were associated with unplanned pregnancy. CONCLUSION Unplanned pregnancies disproportionately affect women at extremes of age, single, and of low socioeconomic status. These women are less likely to adhere to prenatal care.
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Affiliation(s)
- Carolina Sales Vieira
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Giordana Campos Braga
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Bianca Maria Stifani
- Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Heloisa Bettiol
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Pimenta JRR, Grandi C, Aragon DC, Cardoso VC. Comparison of birth weight, length, and head circumference between the BRISA-RP and Intergrowth-21st cohorts. J Pediatr (Rio J) 2020; 96:511-519. [PMID: 31026416 PMCID: PMC9432049 DOI: 10.1016/j.jped.2019.03.003] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES (a) To determine the 3rd, 50th, and 97th percentiles of weight, length, and head circumference of newborns from the Ribeirão Preto BRISA cohort, according to gender and gestational age, and compare them with the Intergrowth-21st standard; (b) To estimate the small for gestational age (<3rd percentile), large for gestational age (>97th percentile), stunting (length<3rd percentile), and wasting (body mass index<3rd percentile). METHODS Observational study of a cohort of 7702 newborns between 01/01/2010 and 12/31/2010 in the city of Ribeirão Preto, SP, Brazil. The 3rd, 50th, and 97th percentiles were determined for the anthropometric measurements using fractional polynomial regression. RESULTS The weight difference between Ribeirão Preto and Intergrowth-21st was small, being more pronounced in preterm infants (mean difference between the two populations of +266g); for full-term newborns, there was a mean difference of +66g, and for post-term infants, of -113g. For length, the mean variation was always <1cm; whereas for head circumference, preterm newborns showed a variation >1cm, and full-term and post-term newborns showed a variation of <1cm. The small and large for gestational age detection rates were 2.9% and 4.3%, respectively. Stunting affected 6.5% of all newborns and wasting, 1.5%, with a predominance in girls and in full-term pregnancies; both conditions were present in 0.4% of the sample. CONCLUSIONS Newborns from Ribeirão Preto, when compared to the Intergrowth-21 standard, are heavier, longer, and have a larger head circumference until they reach full-term.
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Affiliation(s)
- João Roberto R Pimenta
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Farmacologia, Ribeirão Preto, SP, Brazil
| | - Carlos Grandi
- Sociedade Argentina de Pediatria, Comissão de Pesquisa, Buenos Aires, Argentina
| | - Davi C Aragon
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Viviane Cunha Cardoso
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil.
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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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Silva FACCD, Bragança MLBM, Bettiol H, Cardoso VC, Barbieri MA, Silva AAMD. Socioeconomic status and cardiovascular risk factors in young adults: a cross-sectional analysis of a Brazilian birth cohort. Rev Bras Epidemiol 2020; 23:e200001. [PMID: 32130390 DOI: 10.1590/1980-549720200001] [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: 08/28/2018] [Accepted: 01/26/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. OBJECTIVE To evaluate the association between family income and cardiovascular risk factors in young adults. METHODS A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance. RESULTS High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. CONCLUSION Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.
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Affiliation(s)
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Marco Antonio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Universidade Federal do Maranhão - São Luís (MA), Brazil
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Nascente LMDP, Grandi C, Aragon DC, Cardoso VC. Placental measurements and their association with birth weight in a Brazilian cohort. Rev Bras Epidemiol 2020; 23:e200004. [PMID: 32130393 DOI: 10.1590/1980-549720200004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/13/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Epidemiological studies have shown associations between placental measurements and perinatal and later life outcomes. OBJECTIVES To report placental measurements and evaluate their association with birth weight in a Brazilian birth cohort. METHODS Retrospective cohort study with 958 mothers, placentas, and newborns delivered at the Ribeirão Preto Medical School Hospital, Universidade de São Paulo, Brazil, in 2010 and 2011. The information was collected from interviews, medical records, and pathology reports. The placental measurements were: weight, largest and smallest diameters, eccentricity, thickness, shape, area, and birth weight/placental weight and placental weight/birth weight ratios. We analyzed the associations between birth weight and placental measurements using multiple linear regression. RESULTS Placental weight alone accounted for 48% of birth weight variability (p < 0.001), whereas placental measurements combined (placental weight, largest and smallest diameters, and thickness) were responsible for 50% (p < 0.001). When adjusted for maternal and neonatal characteristics, placental measurements explained 74% of birth weight variability (p < 0.001). CONCLUSION Placental measurements are powerful independent predictors of birth weight. Placental weight is the most predictive of them, followed by the smallest diameter.
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Affiliation(s)
| | - Carlos Grandi
- Department of Pediatrics, Sardá Maternity Hospital, Universidad de Buenos Aires - Buenos Aires, Argentina
| | - Davi Casale Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo - São Paulo (SP), Brazil
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Loret de Mola C, Cardoso VC, Batista R, Gonçalves H, Saraiva MCP, Menezes AMB, Santos IS, Domingues MR, da Silva AAM, Bettiol H, de Britto e Alves MTSS, Barbieri MA, Barros A, Horta BL. Maternal pregnancy smoking in three Brazilian cities: trends and differences according to education, income, and age. Int J Public Health 2020; 65:207-215. [DOI: 10.1007/s00038-019-01328-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/18/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022] Open
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Orellana JDY, Ribeiro MRC, Barbieri MA, Saraiva MDC, Cardoso VC, Bettiol H, Silva AAMD, Barros FC, Gonçalves H, Wehrmeister FC, Menezes AMB, Del-Ben CM, Horta BL. Mental disorders in adolescents, youth, and adults in the RPS Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil. CAD SAUDE PUBLICA 2020; 36:e00154319. [PMID: 32022176 DOI: 10.1590/0102-311x00154319] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/21/2019] [Indexed: 01/14/2023] Open
Abstract
Although depression and anxiety are known to result in disabilities and workplace and health system losses, population-based studies on this problem are rare in Brazil. The current study assessed the prevalence of mental disorders in adolescents, youth, and adults and the relationship to sociodemographic characteristics in five birth cohorts (RPS) in Ribeirão Preto (São Paulo State), Pelotas (Rio Grande do Sul State), and São Luís (Maranhão State), Brazil. Major depressive episode, suicide risk, social phobia, and generalized anxiety disorder were assessed with the Mini International Neuropsychiatric Interview. Bootstrap confidence intervals were estimated and prevalence rates were stratified by sex and socioeconomic status in the R program. The study included 12,350 participants from the cohorts. Current major depressive episode was more prevalent in adolescents in São Luís (15.8%; 95%CI: 14.8-16.8) and adults in Ribeirão Preto (12.9%; 95%CI: 12.0-13.9). The highest prevalence rates for suicide risk were in adults in Ribeirão Preto (13.7%; 95%CI: 12.7-14.7), and the highest rates for social phobia and generalized anxiety were in youth in Pelotas, with 7% (95%CI: 6.3-7.7) and 16.5% (95%CI: 15.4-17.5), respectively. The lowest prevalence rates of suicide risk were in youth in Pelotas (8.8%; 95%CI: 8.0-9.6), social phobia in youth in Ribeirão Preto (1.8%; 95%CI: 1.5-2.2), and generalized anxiety in adolescents in São Luís (3.5%; 95%CI: 3.0-4.0). Mental disorders in general were more prevalent in women and in individuals with lower socioeconomic status, independently of the city and age, emphasizing the need for more investment in mental health in Brazil, including gender and socioeconomic determinants.
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Affiliation(s)
| | | | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Fernando C Barros
- Faculdade de Medicina, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | - Cristina Marta Del-Ben
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Okido MM, Bettiol H, Barbieri MA, Marcolin AC, Quintana SM, Cardoso VC, Del-Ben CM, Cavalli RC. Can increased resistance to uterine artery flow be a risk factor for adverse neurodevelopmental outcomes in childhood? A prospective cohort study. J OBSTET GYNAECOL 2019; 40:784-791. [PMID: 31790313 DOI: 10.1080/01443615.2019.1666094] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A prospective cohort study was conducted to determine whether an increased uterine artery pulsatility index (UtA-PI) in the second trimester of pregnancy is a risk factor for neurodevelopmental outcomes in children 2-3 years of age. A group of pregnant women with a UtA-PI below the 90th percentile (P90) and a second group with a UtA-PI ≥ P90 in the second trimester were included in this study. The children of these women were evaluated during their second or third year of life using the Bayley III Screening Test. A total of 858 pregnancies with UtA-PI < P90 and 96 pregnancies with UtA-PI ≥ 90 were studied. The differences between the groups related to UtA-PI ≥ 90 were detected in relation to the variables of the Caucasian ethnicity, hypertension, newborn weight and stay in the intensive care unit after birth. However, adjusted neurodevelopmental outcomes did not differ between the groups: OR 0.53 (95% CI 0.27-1.04%). This study failed to demonstrate that the UtA-PI is a risk factor for adverse neurodevelopment in children.Impact statementWhat is already known on this subject? Early interventions in children at high risk for neurodevelopmental deficiency have proved to be beneficial. The complications associated with gestation and delivery negatively influence neurodevelopment. Several studies have shown that some adverse pregnancy outcomes such as preeclampsia, foetal growth restriction and foetal death can be predicted by increased resistance to flow in the uterine artery in the second trimester. However, there are no studies evaluating the association of the uterine artery with neurodevelopmental results.What do the results of this study add? This study concludes that neurodevelopment is influenced by multiple environmental and intrinsic factors and cannot be predicted by only one variable, such as the uterine artery blood flow. The brain has repair mechanisms to attenuate insults that occur during gestation and delivery.What are the implications of these findings for clinical practice and/or further research? This study was unable to demonstrate that blood flow in the uterine artery is a risk factor for neurodevelopment. Different, larger studies should be conducted by combining other factors with the uterine artery in an algorithm to allow the early identification of children at risk for neurodevelopmental impairment.
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Affiliation(s)
- M M Okido
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - H Bettiol
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - M A Barbieri
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - A C Marcolin
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - S M Quintana
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
| | - V C Cardoso
- Department of Puericulture and Pediatrics, University of São Paulo, Ribeirão Preto, Brazil
| | - C M Del-Ben
- Department of Neurology, Psychiatry and Medical Psychology, University of São Paulo, Ribeirão Preto, Brazil
| | - R C Cavalli
- Department of Obstetrics and Gynaecology, University of São Paulo, Ribeirão Preto, Brazil
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Ferraro AA, Barbieri MA, da Silva AAM, Goldani MZ, Fernandes MTB, Cardoso VC, Stein AD, Bettiol H. Cesarean Delivery and Hypertension in Early Adulthood. Am J Epidemiol 2019; 188:1296-1303. [PMID: 31111861 DOI: 10.1093/aje/kwz096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/15/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 12/17/2022] Open
Abstract
The rate of cesarean delivery (CD) is high in many parts of the world. Birth via CD has been associated with adverse later health outcomes, such as obesity, asthma, and type 1 diabetes mellitus. Few studies have focused on hypertension. We investigated the associations of CD with hypertension, systolic blood pressure (BP), and diastolic BP and tested whether body mass index (BMI; weight (kg)/height (m)2) was a mediator of these associations in a birth cohort (n = 2,020) assembled in 1978-1979 and followed up in 2002-2004 in Ribeirão Preto, Brazil. The CD rate was 32.0%. Hypertension was present in 11.7% of persons born via CD and 7.7% of those born vaginally. Being born by CD increased the odds of hypertension by 51% (odds ratio = 1.51, 95% confidence interval (CI): 1.10, 2.07). After adjustment for confounders, this estimate changed little (odds ratio = 1.49, 95% CI: 1.07, 2.06). In a mediation analysis, odds ratios for the indirect and direct effects were 1.18 (95% CI: 1.11, 1.25) and 1.31 (95% CI: 0.97, 1.65), respectively. CD also had indirect effects on both systolic and diastolic BP via BMI. Our findings suggest that CD is associated with young-adult hypertension and that this association is at least partially mediated by BMI. This has implications for countries struggling with the burden of noncommunicable diseases and where CD rates are high.
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Affiliation(s)
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Marcelo Zubaran Goldani
- Department of Pediatrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Viviane Cunha Cardoso
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aryeh David Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Sandrim VC, Machado J, Bettiol H, Barbieri MA, Cardoso VC, Palei AC, Cavalli RC. Circulating Tissue Inhibitor of Metalloproteinase-4 levels are not a Predictor of Preeclampsia in the period between 20 and 25 Weeks of Gestation. Rev Bras Ginecol Obstet 2018; 40:757-762. [PMID: 30536270 PMCID: PMC10316924 DOI: 10.1055/s-0038-1676056] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/02/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To evaluate whether the circulating level of tissue inhibitor of metalloproteinase-4 (TIMP-4) in the period between 20 and 25 weeks of gestation is a predictor of preeclampsia. METHODS We have performed a case-control study, nested in a prospective study cohort in Ribeirão Preto, in the state of São Paulo, Brazil. Of the 1,400 pregnant women evaluated between 20 and 25 weeks of gestation, 460 delivered in hospitals outside of our institution. Of the 940 pregnant women who completed the protocol, 30 developed preeclampsia. Healthy pregnant women (controls, n = 90) were randomly selected from the remaining 910 participants. From blood samples collected between 20 and 25 weeks of gestation, we performed a screening of 55 angiogenesis-related proteins in 4 cases and 4 controls. The protein TIMP-4 was the most differentially expressed between cases and controls. Therefore, we measured this protein in all cases (n = 30) and controls selected (n = 90). RESULTS There were no differences in the plasma TIMP-4 levels of cases compared with controls (1,144 ± 263 versus 1,160 ± 362 pg/mL, respectively; p > 0.05). CONCLUSION Plasma TIMP-4 levels were not altered at 20 to 25 weeks of gestation, before the manifestation of clinical symptoms; therefore, they are not good predictors of the development of preeclampsia.
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Ferraro AA, Barbieri MA, da Silva AAM, Grandi C, Cardoso VC, Stein AD, Bettiol H. Contributions of relative linear growth and adiposity accretion from birth to adulthood to adult hypertension. Sci Rep 2017; 7:8928. [PMID: 28827571 PMCID: PMC5566373 DOI: 10.1038/s41598-017-09027-1] [Citation(s) in RCA: 2] [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: 04/11/2017] [Accepted: 07/20/2017] [Indexed: 12/03/2022] Open
Abstract
While birth weight and weight gain have been associated with hypertension (HT), the association of linear growth, independently of weight gains, has been less well studied. We assessed the independent association of body mass index (BMI) and length at birth and changes in BMI and height during the first two decades of life with adult blood pressure (BP). A birth cohort (n = 1141) was assembled in 1978–79, and followed up at school-age and adulthood. We used conditional length and BMI measures. BMI at birth was inversely associated with HT; c-BMI from school age to adulthood and c-height from birth to school age were positively associated with hypertension. Early adiposity accretion from birth to 9 years and late linear growth from 9 to 24 years were not associated with increased HT. Regarding BP, systolic and diastolic BP presented similar partterns: the lower the BMI at birth the higher the adult BP; the higher the BMI gains in the first 2 decades of life the higher the adult BP; linear accretion only in the first decade of life was associated with adult BP. Linear growth in the first decade of life and fat accretion in the second decade are associated with adults HT.
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Affiliation(s)
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Carlos Grandi
- Department of Pediatrics, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Viviane Cunha Cardoso
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Rêgo AS, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Bettiol H, Cardoso VC, Barbieri MA, Loureiro FHF, Silva AAMD. Physical activity in pregnancy and adverse birth outcomes. CAD SAUDE PUBLICA 2016; 32:e00086915. [PMID: 27925023 DOI: 10.1590/0102-311x00086915] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 01/05/2016] [Indexed: 11/22/2022] Open
Abstract
This study focused on the association between physical activity in the second trimester of pregnancy and adverse perinatal outcomes: low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR). The study used a sample from the BRISA cohort, São Luís, Maranhão State, Brazil, which included women with singleton pregnancy, gestational age from 22 to 25 weeks confirmed by obstetric ultrasound performed at < 20 weeks, and re-interviewed in the first 24 hours postpartum (n = 1,380). Level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ), short version, categorized as high, moderate, and low. A directed acyclic graph (DAG) was used to identify minimum adjustment to control confounding. High physical activity was not associated with LBW (RR = 0.94; 95%CI: 0.54-1.63), PTB (RR = 0.86; 95%CI: 0.48-1.54), or IUGR (RR = 0.80; 95%CI: 0.55-1.15). The results support the hypothesis that physical activity during pregnancy does not result in adverse perinatal outcomes.
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Affiliation(s)
| | | | | | | | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Sbrana M, Grandi C, Brazan M, Junquera N, Nascimento MS, Barbieri MA, Bettiol H, Cardoso VC. Alcohol consumption during pregnancy and perinatal results: a cohort study. SAO PAULO MED J 2016; 134:146-52. [PMID: 27007799 PMCID: PMC10496540 DOI: 10.1590/1516-3180.2015.02040211] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 10/29/2015] [Revised: 10/07/2015] [Accepted: 11/02/2015] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Alcohol consumption during pregnancy is a significant social problem that may be associated with adverse perinatal outcomes. The aim of this study was to describe alcohol consumption during pregnancy and to study its association with low birth weight, newborns small for gestational age and preterm birth. DESIGN AND SETTING Nested cohort study, in the city of Ribeirão Preto, São Paulo, Brazil. METHODS 1,370 women and their newborns were evaluated. A standardized questionnaire on health and lifestyle habits was applied to the mothers. Anthropometry was performed on the newborns. Alcohol consumption was defined as low, moderate or high, as defined by the World Health Organization. Adjusted logistic regression analysis was used. RESULTS 23% of the women consumed alcohol during pregnancy. Consumption mainly occurred in the first trimester (14.8%) and decreased as the pregnancy progressed. The median alcohol intake was 3.89 g (interquartile range, IQR = 8 g) per day. In the unadjusted analysis, alcohol consumption increased the risk of low birth weight almost twofold (odds ratio, OR 1.91; 95% confidence interval, CI: 1.25-2.92). The risk was lower in the adjusted analysis (OR 1.62; 95% CI: 1.03-2.54). Alcohol consumption did not show associations with small for gestational age or preterm birth. There was greater risk of low birth weight and newborns small for gestational age and preterm birth among mothers who were both smokers and drinkers. CONCLUSIONS The alcohol consumption rate during pregnancy was 23% and was independently associated with low birth weight, but there was no risk of newborns small for gestational age or preterm birth.
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Affiliation(s)
- Mariana Sbrana
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Carlos Grandi
- MD, PhD. Postdoctoral Student, Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Murilo Brazan
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Natacha Junquera
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Marina Stevaux Nascimento
- MD. Medical Resident, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Marco Antonio Barbieri
- MD, PhD. Senior Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Heloisa Bettiol
- MD, PhD. Associate Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
| | - Viviane Cunha Cardoso
- MD, PhD. Adjunct Professor, Department of Pediatrics, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
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Silva AAMD, Batista RFL, Simões VMF, Thomaz EBAF, Ribeiro CCC, Lamy-Filho F, Lamy ZC, Alves MTSSDBE, Loureiro FHF, Cardoso VC, Bettiol H, Barbieri MA. Changes in perinatal health in two birth cohorts (1997/1998 and 2010) in São Luís, Maranhão State, Brazil. CAD SAUDE PUBLICA 2016; 31:1437-50. [PMID: 26248099 DOI: 10.1590/0102-311x00100314] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/10/2014] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze changes in perinatal health in two birth cohorts started in 1997/1998 and 2010, respectively, in São Luís, Maranhão State, Brazil. A total of 2,493 live born infants were included in 1997/1998 and 5,166 in 2010. Low birth weight (LBW) rate did not change (8.5% in 1997/1998 and 8.6% in 2010). Preterm birth (PTB) rate also remained stable (13.2% in 1997/1998 and 13% in 2010). Teenage deliveries and births to single mothers decreased. Maternal schooling and prenatal care coverage increased. Intrauterine growth restriction (IUGR) decreased from 13.3% to 10.6% (p < 0.001). The perinatal mortality rate decreased from 36.6 to 20.7 per 1,000 (p < 0.001) and the infant mortality rate (IMR) dropped from 28.5 to 12.8 per 1,000 (p < 0.001). The cesarean rate increased from 34.1% to 47.5% (p < 0.001). In conclusion, despite favorable changes in socio-demographic, behavioral, and health service factors and decreasing rates of IUGR and perinatal and infant mortality, LBW and PTB remained stable, while the cesarean rate increased.
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Affiliation(s)
| | | | | | | | | | - Fernando Lamy-Filho
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil
| | - Zeni Carvalho Lamy
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil
| | | | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Thomaz ÉBAF, Alves CMC, Ribeiro CCC, Batista RFL, Simões VMF, Cavalli R, Saraiva MDC, Cardoso VC, Bettiol H, Barbieri MA, Silva AAMD. Desfechos perinatais e alterações na cavidade bucal: coortes brasileiras de Ribeirão Preto e São Luís. Rev bras epidemiol 2015; 18:966-70. [DOI: 10.1590/1980-5497201500040023] [Citation(s) in RCA: 4] [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: 03/13/2014] [Accepted: 03/15/2014] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Estudos vêm mostrando uma possível associação das doenças bucais no período gestacional com o nascimento pré-termo (NPT) e o baixo peso ao nascer (BPN). Esses desfechos perinatais parecem se associar com defeitos de desenvolvimento do esmalte (DDE) na dentição decídua, que, por sua vez, parecem predispor ao desenvolvimento futuro de lesões de cárie nas crianças. Assim, é relevante a inclusão de variáveis de saúde bucal do binômio mãe/filho nos estudos de coorte para a compreensão de como esses fatores se associam. Os objetivos deste estudo são: 1) verificar se existe associação entre doenças da cavidade bucal da gestante e o NPT; 2) testar a hipótese de associação entre desfechos perinatais e defeitos de esmalte/cárie dentária nas crianças; 3) analisar se existem associações entre desfechos perinatais e distúrbios de erupção dentária nas crianças; 4) construir modelos teóricos para estudo das iniquidades sociais como fator comum entre os desfechos perinatais e condições bucais. Utilizou-se abordagem integrada e colaborativa entre duas cidades brasileiras com condições socioeconômicas contrastantes: São Luís, MA; e Ribeirão Preto, SP - estudo BRISA (Brazilian Birth Cohort Studies, Ribeirão Preto-São Luís ). Duas coortes foram avaliadas: uma iniciada ao nascimento, representativa da população de nascidos vivos; e outra iniciada no pré-natal. Os participantes foram reavaliados a partir do início do segundo ano de vida. Espera-se que estas coortes contribuam para fomentar o desenvolvimento e consolidação de pesquisas de seguimento, de base populacional, no Brasil.
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Medeiros MNL, Cavalcante NCN, Mesquita FJA, Batista RLF, Simões VMF, Cavalli RDC, Cardoso VC, Bettiol H, Barbieri MA, Silva AAMD. Validity of pre and post-term birth rates based on the date of last menstrual period compared to early obstetric ultrasonography. CAD SAUDE PUBLICA 2015; 31:885-90. [PMID: 25945996 DOI: 10.1590/0102-311x00121514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/21/2015] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the validity of the last menstrual period (LMP) estimate in determining pre and post-term birth rates, in a prenatal cohort from two Brazilian cities, São Luís and Ribeirão Preto. Pregnant women with a single fetus and less than 20 weeks' gestation by obstetric ultrasonography who received prenatal care in 2010 and 2011 were included. The LMP was obtained on two occasions (at 22-25 weeks gestation and after birth). The sensitivity of LMP obtained prenatally to estimate the preterm birth rate was 65.6% in São Luís and 78.7% in Ribeirão Preto and the positive predictive value was 57.3% in São Luís and 73.3% in Ribeirão Preto. LMP errors in identifying preterm birth were lower in the more developed city, Ribeirão Preto. The sensitivity and positive predictive value of LMP for the estimate of the post-term birth rate was very low and tended to overestimate it. LMP can be used with some errors to identify the preterm birth rate when obstetric ultrasonography is not available, but is not suitable for predicting post-term birth.
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Figueiredo FPD, Parada AP, Cardoso VC, Batista RFL, Silva AAMD, Barbieri MA, Cavalli RDC, Bettiol H, Del-Ben CM. Postpartum depression screening by telephone: a good alternative for public health and research. Arch Womens Ment Health 2015; 18:547-53. [PMID: 25380783 DOI: 10.1007/s00737-014-0480-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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] [Received: 06/19/2014] [Accepted: 10/18/2014] [Indexed: 11/24/2022]
Abstract
This study verified the reliability and validity of the Edinburg Postpartum Depression Scale (EPDS) administered by telephone interviews. In a cross-sectional study of a cohort from Brazil (BRISA), the EPDS was administered by telephone to 1,083 women within 12 months postpartum, and 257 (23.7 %) participants had an EPDS score ≥10. At 67 ± 48 days after their telephone interview, 199 (EPDS ≥10 = 96; EPDS <10 = 103) participants were interviewed face-to-face using the Structured Clinical Interview for DSM-IV (SCID) and completed the EPDS again by self-report. In 90 participants, the diagnosis of major depressive episode was confirmed by the SCID (EPDS ≥10 = 65; EPDS <10 = 25). The Cronbach's alpha coefficient was 0.861. The Spearman's correlation between the EPDS administered by telephone and the self-reported EPDS was 0.69 (p < 0.001). The receiver-operating characteristic (ROC) curve for the EPDS administered by telephone was 0.78 (95 % confidence interval (CI) = 0.72 to 0.84). Scores ≥10 showed a sensitivity of 72.2 %, a specificity of 71.6 %, and a positive predictive value of 67.7 %. The application of the EPDS by telephone is a suitable alternative for clinical practice and research and represents a method to optimize the diagnosis of postpartum depression.
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Affiliation(s)
- Felipe Pinheiro de Figueiredo
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, Av. dos Bandeirantes 3900, Ribeirao Preto, SP, 14048-900, Brazil,
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de Melo AS, Dias SV, Cavalli RDC, Cardoso VC, Bettiol H, Barbieri MA, Ferriani RA, Vieira CS. Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause. Reproduction 2015; 150:R11-24. [PMID: 25835506 DOI: 10.1530/rep-14-0499] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 04/02/2015] [Indexed: 01/19/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a multifactorial disorder that arises from interactions between genetic, environmental and intra-uterine factors. Small-for-gestational-age (SGA) babies and the daughters of mothers with PCOS represent possible postnatal clinical targets for developmental programming by steroid excess. The presence of excess glucocorticoids and/or androgens during foetal organogenesis and growth might promote changes in gene expression, and these changes might be related to an increase in the risk of PCOS-like reproductive and metabolic disorders in postnatal life, such as rapid growth and weight gain during the first 2 years of life (only in SGA babies), hyperinsulinaemia, adipocyte dysfunction and childhood visceral obesity, premature pubarche and adrenarche (only in SGA babies) and PCOS. In the fourth decade of life, women who have PCOS may be at higher risk for type 2 diabetes mellitus, dyslipidaemia and systemic arterial hypertension, which suggests that these women are also at higher risk for cardiovascular disease during menopause. However, PCOS can also occur in women who were born at appropriate weight for GA or in newborns of women without PCOS, which suggests that genetic variation and environmental factors play important roles in the development and maintenance of PCOS in a population. Genome-wide association studies based on adequate population samples have shown a higher frequency of genetic polymorphisms of the LHCGR, THADA and DENND1A genes in women with PCOS. Genetic studies of PCOS have also included analyses of structural changes in the chromosome based on an assessment of telomere length in single, cross-sectional evaluations, and these studies have produced controversial results. The present narrative review assesses the multifactorial origins of PCOS (including environmental, genetic and intra-uterine factors) and the development of conditions associated with this disorder. It is concluded that although PCOS might originate in the intra-uterine environment through developmental programming by steroid excess, the interaction between genetic and environmental factors is crucial for its appearance. Follow-up studies should be conducted to assess the same populations over their entire lifespans while taking into account different aspects of the pathogenesis of PCOS.
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Affiliation(s)
- Anderson Sanches de Melo
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Sabrine Vilan Dias
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo de Carvalho Cavalli
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Heloisa Bettiol
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antonio Barbieri
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Rui Alberto Ferriani
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Sales Vieira
- Unit of Human Reproduction and Gynecological EndocrinologyDepartment of Gynecology and ObstetricsDepartment of PaediatricsMedical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, São Paulo, Brazil
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da Silva AAM, Simões VMF, Barbieri MA, Cardoso VC, Alves CMC, Thomaz EBAF, de Sousa Queiroz RC, Cavalli RC, Batista RFL, Bettiol H. A protocol to identify non-classical risk factors for preterm births: the Brazilian Ribeirão Preto and São Luís prenatal cohort (BRISA). Reprod Health 2014; 11:79. [PMID: 25410690 PMCID: PMC4246428 DOI: 10.1186/1742-4755-11-79] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 11/07/2014] [Indexed: 11/10/2022] Open
Abstract
Background Preterm birth is the main cause of morbidity and mortality during the perinatal period. Classical risk factors are held responsible for only 1/3 of preterm births and no current intervention has produced an appreciable reduction of this event. It is necessary to explore new hypotheses and mechanisms of causality by using an integrated approach, collaboration among research groups and less fragmented theoretical-methodological approaches in order to detect new risk factors and to formulate more effective intervention strategies. Methods The study will be conducted on a convenience cohort of Brazilian pregnant women recruited at public and private prenatal health services. A total of 1500 pregnant women in São Luís, and 1500 in Ribeirão Preto, will be invited for an interview and for the collection of biological specimens from the 22nd to the 25th week of gestational age (GA). At the time of delivery they will be reinterviewed. GA will be determined using an algorithm based on two criteria: date of last menstruation (DLM) and obstetric ultrasound (OUS) performed at less than 20 weeks of GA. Illicit drug consumption during pregnancy will be determined using a self-applied questionnaire and the following instruments will be used: perceived stress scale, Beck anxiety scale, screening for depression of the Center of Epidemiological Studies (CES-D), experiences of racial discrimination, social network and social support scale of the Medical Outcomes Study and violence (Abuse Assessment Screening and violence questionnaire of the WHO). Bacterial vaginosis, urinary tract infection and periodontal disease will also be identified. Neuroendocrine, immunoinflammatory and medical intervention hypotheses will be tested. The occurrence of elective cesarean section in the absence of labor will be used as a marker of medical intervention. Conclusion Psychosocial, genetic and infectious mechanisms will be selected, since there are indications that they influence preterm birth (PTB). The studies will be conducted in two Brazilian cities with discrepant socioeconomic conditions. The expectation is to identify risk factors for PTB having a greater predictive power than classically studied factors. The final objective is to propose more effective interventions for the reduction of PTB, which, after being tested, might subsidize health policies. Electronic supplementary material The online version of this article (doi:10.1186/1742-4755-11-79) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão (UFMA), Rua Barão de Itapary, 155 Centro, 65020-070 São Luís, Maranhão, Brasil.
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Melo ASD, Bettiol H, Silva AAMD, Rosa-e-Silva ACJS, Cardoso VC, Reis RMD, Ferriani RA, Barbieri MA, Vieira CS. Small for gestational age babies are not related to changes in markers of adipose tissue dysfunction during reproductive age. Early Hum Dev 2014; 90:231-5. [PMID: 24602474 DOI: 10.1016/j.earlhumdev.2014.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/18/2013] [Accepted: 02/06/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Small for gestational age (SGA) birth has been associated with adipocyte dysfunction during later phases of life. Because SGA women are at a higher risk of developing polycystic ovary syndrome (PCOS), adipocyte dysfunction detected in patients with PCOS may be associated with SGA birth. AIMS To determine whether SGA birth is related to altered serum markers of adipose tissue dysfunction during the third decade of life in Brazilian women. A secondary objective was to relate the presence of PCOS with serum markers of adipose tissue dysfunction. STUDY DESIGN Prospective cohort observational study. SUBJECTS A total of 384 women born at 37 to 42weeks of gestation from June 1, 1978 to May 31, 1979 in Ribeirão Preto, State of São Paulo, Brazil. After exclusion, 165 women participated in the study. Of these women, 43 were in the SGA group and 122 were in the adequate for gestational age group based on birth weight determined from cohort files. OUTCOME MEASURES Body mass index (BMI), arterial systolic and diastolic pressures, abdominal circumference and serum concentrations of total testosterone, fasting glucose and insulin, lipid profile, adiponectin, leptin and necrosis factor alpha tumor (TNFα). RESULTS BMI was an independent predictor of lower adiponectin (adjusted coefficient=-0.02, p=0.01) and higher leptin (adjusted coefficient=0.06, p=0.01) concentrations. The serum insulin concentration was associated with higher leptin (adjusted coefficient=0.03, p=0.02) and TNF-α (adjusted coefficient=0.01, p=0.03) concentrations. Having PCOS or being born SGA did not predict any markers of adipocyte dysfunction.
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Affiliation(s)
- Anderson Sanches de Melo
- Department of Gynecology and Obstetrics, University Hospital, Faculty of Medicine of Ribeirão Preto, FMRP-USP, Ribeirão Preto, SP, Brazil.
| | - Heloisa Bettiol
- Department of Pediatrics, University Hospital, FMRP-USP, Ribeirão Preto, SP, Brazil
| | | | | | | | - Rosana Maria dos Reis
- Department of Gynecology and Obstetrics, University Hospital, FMRP-USP, Ribeirão Preto, SP, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, University Hospital, FMRP-USP, Ribeirão Preto, SP, Brazil
| | | | - Carolina Sales Vieira
- Department of Gynecology and Obstetrics, University Hospital, FMRP-USP, Ribeirão Preto, SP, Brazil
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Cardoso VC, Meritano J, Silva AAMD, Bettiol H, Barbieri MA, Grandi C. Size at birth and blood pressure in young adults: findings from a Brazilian birth cohort study. Rev Saude Publica 2012; 46:978-87. [DOI: 10.1590/s0034-89102013005000009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 05/14/2012] [Indexed: 11/21/2022] Open
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Simões VMF, Barbieri MA, Silva AAMD, Batista RFL, Alves MTSSDBE, Cardoso VC, Veloso HJF, Bettiol H. Perinatal and early adulthood factors associated with adiposity. CAD SAUDE PUBLICA 2012; 28:1381-93. [DOI: 10.1590/s0102-311x2012000700016] [Citation(s) in RCA: 3] [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: 07/24/2011] [Accepted: 03/15/2012] [Indexed: 11/22/2022] Open
Abstract
We used body mass index (BMI) and waist circumference (WC) as fat indicators to assess whether perinatal and early adulthood factors are associated with adiposity in early adulthood. We hypothesized that risk factors differ between men and women and are also different when WC is used for measuring adiposity as opposed to BMI. We conducted a longitudinal study based on a sample of 2,063 adults from the 1978/1979 Ribeirão Preto birth cohort. Adjustment was performed using four sequential multiple linear regression models stratified by sex. Both perinatal and early adulthood variables influenced adulthood BMI and WC. The associations differed between men and women and depending on the measure of abdominal adiposity (BMI or WC). Living with a partner, for both men and women, and high fat and alcohol intake in men were factors that were consistently associated with higher adulthood BMI and WC levels. The differences observed between sexes may point to different lifestyles of men and women, suggesting that prevention policies should consider gender specific strategies.
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Aitsi-Selmi A, Batty GD, Barbieri MA, Silva AAM, Cardoso VC, Goldani MZ, Marmot MG, Bettiol H. Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study. Int J Obes (Lond) 2012; 37:439-47. [PMID: 22565421 PMCID: PMC3595466 DOI: 10.1038/ijo.2012.64] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil. Methods: We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23–25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low–low, low–high, high–low, high–high), and the adiposity measures was examined using linear regression. Results: There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: −1.49 (−2.29,−0.69); WC: −3.85 (−5.73,−1.97); WHR: −0.03 (−0.04,−0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,−1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (−0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men. Conclusion: In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women.
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Affiliation(s)
- A Aitsi-Selmi
- Department of Epidemiology and Public Health, University College London, London, UK.
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Ferraz E, Garcia CA, Bettiol H, Caldeira RD, Cardoso VC, Arruda LK, Barbieri MA, Vianna EO. Atopy risk factors at birth and in adulthood. J Pediatr (Rio J) 2011; 87:336-42. [PMID: 21842111 DOI: 10.2223/jped.2114] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 05/25/2011] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To study the association between atopy and variables such as weight, length, and socioeconomic level at birth and in young adulthood. METHODS A total of 2,063 subjects were investigated in a prospective birth cohort study of individuals born in Ribeirão Preto, Brazil, in 1978/1979, and examined at the age of 23-25 years. Skin prick tests (SPT) for eight common allergens in Brazil were performed. Subjects with a wheal reaction ≥ 3 mm to one or more of the eight allergens tested were considered to be atopic. We used the log-binomial model (generalized linear model) in order to assess the association between atopy and birth or adult variables. RESULTS The prevalence of positive SPT was 47.6%. Male gender was associated with an increased risk of atopy (relative risk [RR] = 1.18; 95% confidence interval [95%CI] 1.07-1.30). Low level of schooling was a protective factor against atopy, with a RR = 0.74; 95%CI 0.62-0.89. Living with a smoker in childhood was also associated with lower risk of atopy (RR = 0.87; 95%CI 0.79-0.96). Birth weight, length and order, maternal age, and intrauterine growth restriction were not associated with positive SPT. CONCLUSIONS This study showed that male gender was associated with an increased risk of atopy. Low socioeconomic status, assessed by low level of schooling, was a protective factor against atopy. These data agree with the hygiene hypothesis.
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Affiliation(s)
- Erica Ferraz
- Departamento de Clínica Médica, Universidade de São Paulo (USP), Av. Bandeirantes 3900 – Monte Alegre, Ribeirão Preto, SP, Brazil
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