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da Silva HBM, de Cássia Ribeiro-Silva R, Junior EPP, Barreto ML, Paixão ES, Ichihara MY. Syphilis in pregnancy and adverse birth outcomes: A nationwide longitudinal study in Brazil. Int J Gynaecol Obstet 2024. [PMID: 38706411 DOI: 10.1002/ijgo.15561] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE The present study aimed to evaluate the association between syphilis in pregnancy and low birth weight, small for gestational age, and preterm birth. METHODS This longitudinal study used Brazilian National Information System for livebirths (SINASC) linked to the gestational syphilis cases from Notifiable Diseases Information System (SINAN) from 2011 to 2017. Descriptive statistics and logistic regression were used to compare the birth outcomes of pregnant women with and without syphilis. The study protocol was approved by the Research Ethics Committee of the Institute of Collective Health of the Federal University of Bahia (CAAE: registration no. 18022319.4.0000.5030). RESULTS A total of 17 930 817 live births were included in the study. Of these, 155 214 (8.7/1000) were exposed to syphilis during pregnancy. Maternal syphilis increased the odds of low birth weight (aOR 1.88, 95% CI: 1.85-1.91), small for gestational age (aOR 1.53, 95% CI: 1.51-1.56), and preterm birth (aOR 1.35, 95% CI: 1.33-1.37). Higher odds were observed for pregnant women with VDRL titer ≥64 and untreated maternal syphilis when compared to mothers without syphilis. Analysis stratified by prenatal care showed higher odds for all adverse birth outcomes for mothers attending ≤6 prenatal appointments. CONCLUSION Our findings showed a strong association between gestational syphilis and adverse birth outcomes with increased odds observed among women with higher VDRL titers, lack of treatment, and fewer prenatal appointments. These results highlight the need for adequate screening and treatment for gestational syphilis during pregnancy to mitigate the risk of adverse birth outcomes.
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Affiliation(s)
- Helena Benes Matos da Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Elzo Pereira Pinto Junior
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixão
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
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Santiago-Vieira C, Velasquez-Melendez G, de Cássia Ribeiro-Silva R, de Jesus Pinto E, Barreto ML, Li L. Recent changes in growth trajectories: a population-based cohort study of over 5 million Brazilian children born between 2001 and 2014. Lancet Reg Health Am 2024; 32:100721. [PMID: 38629028 PMCID: PMC11019368 DOI: 10.1016/j.lana.2024.100721] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024]
Abstract
Background There is limited evidence on recent trends in childhood growth trajectories in Low-/middle-income countries. We investigated how age-trajectories for height and Body Mass Index (BMI) have changed among Brazilian children born in two different time periods after 2000. Methods We used a population-based cohort (part of the "Cohort of 100-Million Brazilians") created by the linkage of three Brazilian administrative databases: the Cadastro Único of the Federal Government, the National System of Live Births and the National Nutritional and Food Surveillance System. We included longitudinal data on 5,750,214 children who were 3 to <10 years of age and born between 2001 and 2014 (20,209,133 observations). We applied fractional polynomial models with random-effects to estimate mean height and BMI trajectories for children. Findings Compared to children born in 2001-2007, the cohort born in 2008-2014 were on average taller, by a z-score of 0.15 in boys and 0.12 in girls. Their height trajectories shifted upwards, by approximately 1 cm in both sexes. Levels of BMI increased little, by a z-score of 0.06 (boys) and 0.04 (girls). Mean BMI trajectories also changed little. However, the prevalence of overweight/obesity increased between cohorts, e.g., from 26.8% to 30% in boys and 23.9%-26.6% in girls aged between 5 and <10 years. Interpretation An increase of 1 cm in mean height of Brazilian children during a short period indicates the improvement in maternal and child health, especially those from low-income families due to the new health and welfare policies in Brazil. Although mean BMI changed little, the prevalence of child overweight/obesity slightly increased and remained high. Funding This work was supported by National Council for Scientific and Technological Development - CNPq; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES; National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre; Society for the Study of Human Biology; Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde - Decit/SECTICS/MS. The study also used resources from the Centre for Data and Knowledge Integration for Health (CIDACS), which receives funding from the Bill & Melinda Gates Foundation, the Wellcome Trust, the Health Surveillance Secretariat of the Ministry of Health and the Secretariat of Science and Technology of the State of Bahia (SECTI-BA).
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Affiliation(s)
- Carolina Santiago-Vieira
- School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Brazil
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK
| | | | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Brazil
| | - Elizabete de Jesus Pinto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Brazil
- Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
| | - Maurício L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz Bahia, Salvador, Brazil
| | - Leah Li
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK
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Ortelan N, de Almeida MF, Pinto Júnior EP, Bispo N, Fiaccone RL, Falcão IR, Rocha ADS, Ramos D, Paixão ES, de Cássia Ribeiro-Silva R, Rodrigues LC, Barreto ML, Ichihara MYT. Evaluating the relationship between conditional cash transfer programme on preterm births: a retrospective longitudinal study using the 100 million Brazilian cohort. BMC Public Health 2024; 24:713. [PMID: 38443875 PMCID: PMC10916064 DOI: 10.1186/s12889-024-18152-2] [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: 04/14/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births, including their severity categories, and explored how this association differs according to prenatal care and the quality of Bolsa Familia Programme management. METHODS A retrospective cohort study was performed involving the first live singleton births to mothersenrolled in the 100 Million Brazilian Cohort from 2004 to 2015, who had at least one child before cohort enrollment. Only the first birth during the cohort period was included, but born from 2012 onward. A deterministic linkage with the Bolsa Familia Programme payroll dataset and a similarity linkage with the Brazilian Live Birth Information System were performed. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age < 37 weeks: (i) all preterm births, (ii) moderate-to-late (32-36), (iii) severe (28-31), and (iv) extreme (< 28) preterm births compared to at-term newborns. We combined propensity score-based methods and weighted logistic regressions to compare newborns to mothers who did and did not receive Bolsa Familia, controlling for socioeconomic conditions. We also estimated these effects separately, according to the adequacy of prenatal care and the index of quality of Bolsa Familia Programme management. RESULTS 1,031,053 infants were analyzed; 65.9% of the mothers were beneficiaries. Bolsa Familia Programme was not associated with all sets of preterm births, moderate-to-late, and severe preterm births, but was associated with a reduction in extreme preterm births (weighted OR: 0.69; 95%CI: 0.63-0.76). This reduction can also be observed among mothers receiving adequate prenatal care (weighted OR: 0.66; 95%CI: 0.59-0.74) and living in better Bolsa Familia management municipalities (weighted OR: 0.56; 95%CI: 0.43-0.74). CONCLUSIONS An income transfer programme for pregnant women of low-socioeconomic status, conditional to attending prenatal care appointments, has been associated with a reduction in extremely preterm births. These programmes could be essential in achieving Sustainable Development Goals.
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Affiliation(s)
- Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation. Edifício Tecnocentro, Rua Mundo, 121, Trobogy, Salvador, Bahia, 41745-715, Brazil.
| | | | - Elzo Pereira Pinto Júnior
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
| | - Nivea Bispo
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Institute of Mathematics and Statistics, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Institute of Mathematics and Statistics, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
| | - Aline Dos Santos Rocha
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
| | - Dandara Ramos
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Collective Health Institute, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Enny S Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rita de Cássia Ribeiro-Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- School of Nutrition, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Collective Health Institute, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil
| | - Maria Yury T Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
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de Mello E Silva JF, de Jesus Silva N, Carrilho TRB, Jesus Pinto ED, Rocha AS, Pedroso J, Silva SA, Spaniol AM, da Costa Santin de Andrade R, Bortolini GA, Paixão E, Kac G, de Cássia Ribeiro-Silva R, Barreto ML. Identifying biologically implausible values in big longitudinal data: an example applied to child growth data from the Brazilian food and nutrition surveillance system. BMC Med Res Methodol 2024; 24:38. [PMID: 38360575 PMCID: PMC10868032 DOI: 10.1186/s12874-024-02161-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Several strategies for identifying biologically implausible values in longitudinal anthropometric data have recently been proposed, but the suitability of these strategies for large population datasets needs to be better understood. This study evaluated the impact of removing population outliers and the additional value of identifying and removing longitudinal outliers on the trajectories of length/height and weight and on the prevalence of child growth indicators in a large longitudinal dataset of child growth data. METHODS Length/height and weight measurements of children aged 0 to 59 months from the Brazilian Food and Nutrition Surveillance System were analyzed. Population outliers were identified using z-scores from the World Health Organization (WHO) growth charts. After identifying and removing population outliers, residuals from linear mixed-effects models were used to flag longitudinal outliers. The following cutoffs for residuals were tested to flag those: -3/+3, -4/+4, -5/+5, -6/+6. The selected child growth indicators included length/height-for-age z-scores and weight-for-age z-scores, classified according to the WHO charts. RESULTS The dataset included 50,154,738 records from 10,775,496 children. Boys and girls had 5.74% and 5.31% of length/height and 5.19% and 4.74% of weight values flagged as population outliers, respectively. After removing those, the percentage of longitudinal outliers varied from 0.02% (<-6/>+6) to 1.47% (<-3/>+3) for length/height and from 0.07 to 1.44% for weight in boys. In girls, the percentage of longitudinal outliers varied from 0.01 to 1.50% for length/height and from 0.08 to 1.45% for weight. The initial removal of population outliers played the most substantial role in the growth trajectories as it was the first step in the cleaning process, while the additional removal of longitudinal outliers had lower influence on those, regardless of the cutoff adopted. The prevalence of the selected indicators were also affected by both population and longitudinal (to a lesser extent) outliers. CONCLUSIONS Although both population and longitudinal outliers can detect biologically implausible values in child growth data, removing population outliers seemed more relevant in this large administrative dataset, especially in calculating summary statistics. However, both types of outliers need to be identified and removed for the proper evaluation of trajectories.
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Affiliation(s)
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- ISGlobal, Hospital Clínic. Universitat de Barcelona, Barcelona, Spain
| | - Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Elizabete de Jesus Pinto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil
| | - Aline Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Jéssica Pedroso
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Sara Araújo Silva
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Ana Maria Spaniol
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | | | | | - Enny Paixão
- London School of Hygiene & Tropical Medicine, London, UK
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil.
- School of Nutrition, Federal University of Bahia, Av. Araújo Pinho, nº 32, Canela, Salvador, Bahia, CEP: 40.110-150, BA, Brazil.
| | - Maurício L Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
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Benes Matos da Silva H, Ribeiro-Silva RDC, Freitas de Mello E Silva J, Chis Ster I, Rebouças P, Goes E, Ichihara MY, Ferreira A, M Pescarini J, Leovigildo Fiaccone R, S Paixão E, L Barreto M. Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children. BMC Pediatr 2024; 24:103. [PMID: 38341551 PMCID: PMC10858530 DOI: 10.1186/s12887-024-04550-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life. OBJECTIVE We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. METHODS A population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother's age, educational level, and marital status. RESULTS A total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children's weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth. CONCLUSION We observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.
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Affiliation(s)
- Helena Benes Matos da Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Juliana Freitas de Mello E Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Irina Chis Ster
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Poliana Rebouças
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Emanuelle Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Andrêa Ferreira
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Julia M Pescarini
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Enny S Paixão
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
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Tedde JGG, Cerqueira-Silva T, Lagrosa Garcia SA, Amira BV, Rodrigues LC, Barreto ML, Rocha AS, de Cássia Ribeiro-Silva R, Falcão IR, Paixao ES. Association of interpregnancy interval with adverse pregnancy outcomes according to the outcomes of the preceding pregnancy: a longitudinal study with 4.7 million live births from Brazil. Lancet Reg Health Am 2024; 30:100687. [PMID: 38332936 PMCID: PMC10850771 DOI: 10.1016/j.lana.2024.100687] [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] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
Background Earlier studies have proposed a link between the Interpregnancy Interval (IPI) and unfavorable birth outcomes. However, it remains unclear if the outcomes of previous births could affect this relationship. We aimed to investigate whether the occurrence of adverse outcomes-small for gestational age (SGA), preterm birth (PTB), and low birth weight (LBW)-at the immediately preceding pregnancy could alter the association between IPI and the same outcomes at the subsequent pregnancy. Methods We used a population-based linked cohort from Brazil (2001-2015). IPI was measured as the difference, in months, between the preceding birth and subsequent conception. Outcomes included SGA (<10th birthweight percentile for gestational age and sex), LBW (<2500 g), and PTB (gestational age <37 weeks). We calculated risk ratios (RRs), using the IPI of 18-22 months as the reference IPI category, we also stratified by the number of adverse birth outcomes at the preceding pregnancy. Findings Among 4,788,279 births from 3,804,152 mothers, absolute risks for subsequent SGA, PTB, and LBW were higher for women with more adverse outcomes in the preceding delivery. The RR of SGA and LBW for IPIs <6 months were greater for women without previous adverse outcomes (SGA: 1.44 [95% Confidence Interval (CI): 1.41-1.46]; LBW: 1.49 [1.45-1.52]) compared to those with three previous adverse outcomes (SGA: 1.20 [1.10-1.29]; LBW: 1.24 [1.15-1.33]). IPIs ≥120 months were associated with greater increases in risk for LBW and PTB among women without previous birth outcomes (LBW: 1.59; [1.53-1.65]; PTB: 2.45 [2.39-2.52]) compared to women with three adverse outcomes at the index birth (LBW: 0.92 [0.78-1.06]; PTB: 1.66 [1.44-1.88]). Interpretation Our study suggests that women with prior adverse outcomes may have higher risks for adverse birth outcomes in subsequent pregnancies. However, risk changes due to differences in IPI length seem to have a lesser impact compared to women without a prior event. Considering maternal obstetric history is essential in birth spacing counseling. Funding Wellcome Trust225925/Z/22/Z.
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Affiliation(s)
| | - Thiago Cerqueira-Silva
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Brenda V. Amira
- Faculty of Medicine of São José do Rio Preto (FAMERP), Children's Hospital, São Paulo, Brazil
| | - Laura C. Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Aline S. Rocha
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | | | - Ila R. Falcão
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S. Paixao
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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7
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Rocha AS, Ribeiro-Silva RDC, Silva JFM, Pinto EJ, Silva NJ, Paixao ES, Fiaccone RL, Kac G, Rodrigues LC, Anderson C, Barreto ML. Postnatal growth in small vulnerable newborns: a longitudinal study of 2 million Brazilians using routine register-based linked data. Am J Clin Nutr 2024; 119:444-455. [PMID: 38128734 PMCID: PMC10884605 DOI: 10.1016/j.ajcnut.2023.12.009] [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: 08/07/2023] [Revised: 11/21/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Preterm, low-birth weight (LBW) and small-for-gestational age (SGA) newborns have a higher frequency of adverse health outcomes, including linear and ponderal growth impairment. OBJECTIVE To describe the growth trajectories and to estimate catch-up growth during the first 5 y of life of small newborns according to 3 vulnerability phenotypes (preterm, LBW, SGA). METHODS Longitudinal study using linked data from the 100 Million Brazilian Cohort baseline, the Brazilian National Live Birth System (SINASC), and the Food and Nutrition Surveillance System (SISVAN) from 2011 to 2017. We estimated the length/height-for-age (L/HAZ) and weight-for-age z-score (WAZ) trajectories from children of 6-59 mo using the linear mixed model for each vulnerable newborn phenotype. Growth velocity for both L/HAZ and WAZ was calculated considering the change (Δ) in the mean z-score between 2 time points. Catch-up growth was defined as a change in z-score > 0.67 at any time during follow-up. RESULTS We analyzed 2,021,998 live born children and 8,726,599 observations. The prevalence of at least one of the vulnerable phenotypes was 16.7% and 0.6% were simultaneously preterm, LBW, and SGA. For those born at term, all phenotypes had a period of growth recovery from 12 mo. For preterm infants, the onset of L/HAZ growth recovery started later at 24 mo and the growth trajectories appear to be lower than those born at term, a condition aggravated among children with the 3 phenotypes. Preterm and female infants seem to experience slower growth recovery than those born at term and males. The catch-up growth occurs at 24-59 mo for males preterm: preterm + AGA + NBW (Δ = 0.80), preterm + AGA + LBW (Δ = 0.88), and preterm + SGA + LBW (Δ = 1.08); and among females: term + SGA + NBW (Δ = 0.69), term + AGA + LBW (Δ = 0.72), term + SGA + LBW (Δ = 0.77), preterm + AGA + LBW (Δ = 0.68), and preterm + SGA + LBW (Δ = 0.83). CONCLUSIONS Children born preterm seem to reach L/HAZ and WAZ growth trajectories lower than those attained by children born at term, a condition aggravated among the most vulnerable.
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Affiliation(s)
- Aline S Rocha
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil; Institute of Collective Health, Federal University of Bahia (ISC/UFBA), Salvador, Brazil
| | - Juliana F M Silva
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Elizabete J Pinto
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
| | - Natanael J Silva
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; ISGlobal, Hospital Clínic. Universitat de Barcelona, Barcelona, Spain
| | - Enny S Paixao
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Rosemeire L Fiaccone
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; Department of Statistics, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura C Rodrigues
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Craig Anderson
- School of Mathematics and Statistics, University of Glasgow, Scotland, United Kingdom
| | - Mauricio L Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil; Institute of Collective Health, Federal University of Bahia (ISC/UFBA), Salvador, Brazil
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8
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Falcão IR, Ribeiro-Silva RDC, Fiaccone RL, Alves FJO, Rocha ADS, Ortelan N, Silva NJ, Rebouças P, Pinto Júnior EP, de Almeida MF, Paixao ES, Pescarini JM, Rodrigues LC, Ichihara MY, Barreto ML. Participation in Conditional Cash Transfer Program During Pregnancy and Birth Weight-Related Outcomes. JAMA Netw Open 2023; 6:e2344691. [PMID: 38015506 PMCID: PMC10685879 DOI: 10.1001/jamanetworkopen.2023.44691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 11/29/2023] Open
Abstract
Importance There is limited evidence of the association of conditional cash transfers, an important strategy to reduce poverty, with prevention of adverse birth-related outcomes. Objective To investigate the association between receiving benefits from the Bolsa Família Program (BFP) and birth weight indicators. Design, Setting, and Participants This cohort study used a linked data resource, the Centro de Integracao de Dados e Conhecimentos Para Saude (CIDACS) birth cohort. All live-born singleton infants born to mothers registered in the cohort between January 2012 and December 2015 were included. Each analysis was conducted for the overall population and separately by level of education, self-reported maternal race, and number of prenatal appointments. Data were analyzed from January 3 to April 24, 2023. Exposure Live births of mothers who had received BFP until delivery (for a minimum of 9 months) were classified as exposed and compared with live births from mothers who did not receive the benefit prior to delivery. Main Outcomes and Measures Low birth weight (LBW), birth weight in grams, and small for gestational age (SGA) were evaluated. Analytical methods used included propensity score estimation, kernel matching, and weighted logistic and linear regressions. Race categories included Parda, which translates from Portuguese as "brown" and is used to denote individuals whose racial background is predominantly Black and those with multiracial or multiethnic ancestry, including European, African, and Indigenous origins. Results A total of 4 277 523 live births (2 085 737 females [48.8%]; 15 207 among Asian [0.4%], 334 225 among Black [7.8%], 29 115 among Indigenous [0.7%], 2 588 363 among Parda [60.5%], and 1 310 613 among White [30.6%] mothers) were assessed. BFP was associated with an increase of 17.76 g (95% CI, 16.52-19.01 g) in birth weight. Beneficiaries had an 11% lower chance of LBW (odds ratio [OR], 0.89; 95% CI, 0.88-0.90). BFP was associated with a greater decrease in odds of LBW among subgroups of mothers who attended fewer than 7 appointments (OR, 0.85; 95% CI, 0.84-0.87), were Indigenous (OR, 0.73; 95% CI, 0.61-0.88), and had 3 or less years of education (OR, 0.76; 95% CI, 0.72-0.81). There was no association between BFP and SGA, except among less educated mothers, who had a reduced risk of SGA (OR, 0.83; 95% CI, 0.79-0.88). Conclusions and Relevance This study found that BFP was associated with increased birth weight and reduced odds of LBW, with a greater decrease in odds of LBW among higher-risk groups. These findings suggest the importance of maintaining financial support for mothers at increased risk of birth weight-related outcomes.
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Affiliation(s)
- Ila R. Falcão
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Rosemeire L. Fiaccone
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Naiá Ortelan
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Natanael J. Silva
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Barcelona, Spain
| | - Poliana Rebouças
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | | | | | - Enny S. Paixao
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Júlia M. Pescarini
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura C. Rodrigues
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mauricio L. Barreto
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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9
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Silva NDJ, Silva JFDME, Carrilho TRB, Pinto EDJ, de Andrade RDCS, Silva SA, Pedroso J, Spaniol AM, Bortolini GA, Fagundes A, Nilson EAF, Fiaccone RL, Kac G, Barreto ML, Ribeiro-Silva RDC. Quality of child anthropometric data from SISVAN, Brazil, 2008-2017. Rev Saude Publica 2023; 57:62. [PMID: 37878848 PMCID: PMC10519688 DOI: 10.11606/s1518-8787.2023057004655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 12/19/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.
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Affiliation(s)
- Natanael de Jesus Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universitat de BarcelonaInstituto de Salud Global de BarcelonaBarcelonaEspaña Universitat de Barcelona. Instituto de Salud Global de Barcelona. Barcelona, España.
| | - Juliana Freitas de Mello e Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
| | - Thaís Rangel Bousquet Carrilho
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroObservatório de Epidemiologia NutricionalRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Observatório de Epidemiologia Nutricional. Rio de Janeiro, RJ, Brasil.
| | - Elizabete de Jesus Pinto
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal do Recôncavo da BahiaSanto Antônio de JesusBABrasil Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus, BA, Brasil.
| | - Rafaella da Costa Santin de Andrade
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Sara Araújo Silva
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Jéssica Pedroso
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Ana Maria Spaniol
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Gisele Ane Bortolini
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Andhressa Fagundes
- Universidade Federal de SergipeDepartamento de NutriçãoSão CristóvãSEBrasil Universidade Federal de Sergipe. Departamento de Nutrição. São Cristóvão, SE, Brasil.
| | - Eduardo Augusto Fernandes Nilson
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaInstituto de Matemática e EstatísticaSalvadorBABrasil Universidade Federal da Bahia. Instituto de Matemática e Estatística. Salvador, BA, Brasil.
| | - Gilberto Kac
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroObservatório de Epidemiologia NutricionalRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Observatório de Epidemiologia Nutricional. Rio de Janeiro, RJ, Brasil.
| | - Maurício Lima Barreto
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Rita de Cássia Ribeiro-Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaEscola de NutriçãoSalvadorBABrasil Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, Brasil.
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Facina VB, Fonseca RDR, da Conceição-Machado MEP, Ribeiro-Silva RDC, dos Santos SMC, de Santana MLP. Association between Socioeconomic Factors, Food Insecurity, and Dietary Patterns of Adolescents: A Latent Class Analysis. Nutrients 2023; 15:4344. [PMID: 37892419 PMCID: PMC10610405 DOI: 10.3390/nu15204344] [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: 09/09/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Socioeconomic factors and food insecurity play a fundamental role in the food choices of adolescents, and in addition to influencing access to food, they also have significant effects on dietary patterns. The objectives of this study were to identify the dietary patterns of adolescents through the application of latent class analysis and to evaluate their association with socioeconomic variables and food insecurity. This cross-sectional study was conducted with adolescents aged between 11 and 17 years from public schools. Latent class analysis was used to identify the dietary patterns. Associations between socioeconomic factors, food insecurity and dietary patterns were assessed using multinomial logistic regression (odds ratio (OR); 95% confidence interval (CI)). Among the 1215 participants in the study, four dietary patterns were identified: "Mixed", "Low consumption", "Prudent" and "Diverse". A "Diverse" dietary pattern was associated with a lower economic stratum (OR:2.02; CI:1.26-3.24). There was no association between food insecurity and identified dietary patterns. These results highlight the importance of promoting healthy eating in this age group at all socioeconomic levels, especially the lowest level.
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Affiliation(s)
- Vanessa Barbosa Facina
- Postgraduate Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Salvador 40170-110, Brazil
- Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antonio de Jesus 44574-490, Brazil
| | - Rosemary da Rocha Fonseca
- Nutrition Science Department, School of Nutrition, Federal University of Bahia, Salvador 40170-110, Brazil
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11
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Ribeiro-Silva RDC, Costa PRDF, da Conceição MEP, de Oliveira LPM, Araújo MDPN, de Santana MLP, dos Santos NS, dos Santos SMC, Queiroz VADO, de Oliveira N, de Lira PIC, Barreto ML. Academic trajectory of Prof. Ana Marlúcia Oliveira: contributions to the field of food and nutrition in Brazil. Rev Bras Epidemiol 2023; 26:e230042. [PMID: 37820192 PMCID: PMC10566569 DOI: 10.1590/1980-549720230042.2] [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: 06/18/2023] [Accepted: 06/23/2023] [Indexed: 10/13/2023] Open
Abstract
It will be presented the main academic contributions of Professor Ana Marlúcia Oliveira (AMO) (in memoriam), nutritionist, professor at the School of Nutrition at the Federal University of Bahia, Ph.D. in epidemiology and CNPQ Researcher level A, from 1980 to 2021. Professor Ana accumulated, throughout her academic career, scientific articles published in national and international journals; book and book chapters authored by her; papers presented at scientific events, in addition to guiding scientific projects, dissertations and theses. She has coordinated several research projects in the field of food and nutrition in public health, with a focus on nutritional epidemiology. The scope of the subjects addressed in her scientific production expressed the concern that mobilized her around the production of knowledge to face the complex health and nutrition problems in Brazil. Her way of being in the world, welcoming and caring for people who approached her seeking qualification opportunities, her example, words and teachings influenced, and still influence, the trajectory and training of nutritionists, professors and researchers at ENUFBA and other national and international institutions. She was a Brazilian researcher and intellectual committed to the health of the most vulnerable populations and the fight against malnutrition and hunger in our country. Her wide and fruitful work left us a legacy to be remembered and continued. Some of her friends, colleagues and collaborators pay this tribute to her memory, to her example and to the legacy she left for all of us and future generations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Nilce de Oliveira
- Universidade Federal da Bahia, Escola de Nutrição – Salvador (BA), Brasil
| | - Pedro Israel Cabral de Lira
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Departamento de Nutrição – Recife (PE), Brasil
| | - Mauricio Lima Barreto
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Centro de Integração de Dados e Conhecimentos para Saúde – Salvador (BA), Brasil
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12
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de Souza GR, Ribeiro-Silva RDC, Felisbino-Mendes MS, Silva NDJ, de Andrade RDCS, Pedroso J, Spaniol AM, Bortolini GA, Nilson EAF, da Silva SA, Lourenço BH, Rocha ADS, Falcão IR, Ichihara MYT, Farias DR, Barreto ML. Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil's Food and Nutrition Surveillance System, 2008-2019. Public Health Nutr 2023; 26:1731-1742. [PMID: 37231823 PMCID: PMC10478053 DOI: 10.1017/s1368980023001039] [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: 08/10/2022] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). DESIGN This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008-2019. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Totally, 911 735 Brazilian children under 2 years old. RESULTS Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8-52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5-40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7-80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7-70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. CONCLUSIONS Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most.
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Affiliation(s)
- Giesy Ribeiro de Souza
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Santos Felisbino-Mendes
- School of Nursing, Department of Mother-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | | | - Jéssica Pedroso
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Ana Maria Spaniol
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Food, Nutrition and Culture Program (PALIN), Brasília Regional Management, Oswaldo Cruz Foundation, Federal District, Brasília, Brazil
| | - Sara Araújo da Silva
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Maria Yury Travassos Ichihara
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maurício Lima Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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13
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Rocha AS, Paixao ES, Alves FJO, Falcão IR, Silva NJ, Teixeira CSS, Ortelan N, Fiaccone RL, Rodrigues LC, Ichihara MY, Barreto ML, de Almeida MF, de Cássia Ribeiro-Silva R. Cesarean sections and early-term births according to Robson classification: a population-based study with more than 17 million births in Brazil. BMC Pregnancy Childbirth 2023; 23:562. [PMID: 37537549 PMCID: PMC10399022 DOI: 10.1186/s12884-023-05807-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 06/22/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Cesarean section (CS) rates are increasing worldwide and are associated with negative maternal and child health outcomes when performed without medical indication. However, there is still limited knowledge about the association between high CS rates and early-term births. This study explored the association between CSs and early-term births according to the Robson classification. METHODS A population-based, cross-sectional study was performed with routine registration data of live births in Brazil between 2012 and 2019. We used the Robson classification system to compare groups with expected high and low CS rates. We used propensity scores to compare CSs to vaginal deliveries (1:1) and estimated associations with early-term births using logistic regression. RESULTS A total of 17,081,685 live births were included. Births via CS had higher odds of early-term birth (OR 1.32; 95% CI 1.32-1.32) compared to vaginal deliveries. Births by CS to women in Group 2 (OR 1.50; 95% CI 1.49-1.51) and 4 (OR 1.57; 95% CI 1.56-1.58) showed the highest odds of early-term birth, compared to vaginal deliveries. Increased odds of an early-term birth were also observed among births by CS to women in Group 3 (OR 1.30, 95% CI 1.29-1.31), compared to vaginal deliveries. In addition, live births by CS to women with a previous CS (Group 5 - OR 1.36, 95% CI 1.35-1.37), a single breech pregnancy (Group 6 - OR 1.16; 95% CI 1.11-1.21, and Group 7 - OR 1.19; 95% CI 1.16-1.23), and multiple pregnancies (Group 8 - OR 1.46; 95% CI 1.40-1.52) had high odds of an early-term birth, compared to live births by vaginal delivery. CONCLUSIONS CSs were associated with increased odds of early-term births. The highest odds of early-term birth were observed among those births by CS in Robson Groups 2 and 4.
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Affiliation(s)
- Aline S Rocha
- School of Nutrition, Federal University of Bahia (UFBA), Araújo Pinho - No. 32, Canela, Salvador, Bahia, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Flavia Jôse O Alves
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (ISC/UFBA), Salvador, Brazil
| | - Ila R Falcão
- School of Nutrition, Federal University of Bahia (UFBA), Araújo Pinho - No. 32, Canela, Salvador, Bahia, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Natanael J Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Barcelona Institute for Global Health, Hospital Clínic, Barcelona, Spain
| | - Camila S S Teixeira
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (ISC/UFBA), Salvador, Brazil
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (ISC/UFBA), Salvador, Brazil
| | | | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia (UFBA), Araújo Pinho - No. 32, Canela, Salvador, Bahia, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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14
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Lisboa CS, Guimarães NS, Ferreira AJF, Silva KBBD, Alves FJO, Rocha ADS, Ortelan N, Texeira CSS, Falcão IR, Silva NDJ, Ribeiro-Silva RDC, Barbosa D, Barreto ML. Impact of cash transfer programs on birth and child growth outcomes: systematic review. Cien Saude Colet 2023; 28:2417-2432. [PMID: 37531548 DOI: 10.1590/1413-81232023288.14082022] [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: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 08/04/2023] Open
Abstract
To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.
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Affiliation(s)
- Cinthia Soares Lisboa
- Universidade Estadual de Feira de Santana, Programa de Pós-Graduação em Saúde Coletiva. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | | | | | - Karine Brito Beck da Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Aline Dos Santos Rocha
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Naiá Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Camila Silveira Silva Texeira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Ila Rocha Falcão
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | | | - Rita de Cássia Ribeiro-Silva
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Djanilson Barbosa
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | - Mauricio Lima Barreto
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
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15
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Alves FJO, Ramos D, Paixão ES, Falcão IR, de Cássia Ribeiro-Silva R, Fiaccone R, Rasella D, Teixeira C, Machado DB, Rocha A, de Almeida MF, Goes EF, Rodrigues LC, Ichihara MY, Aquino EML, Barreto ML. Association of Conditional Cash Transfers With Maternal Mortality Using the 100 Million Brazilian Cohort. JAMA Netw Open 2023; 6:e230070. [PMID: 36821115 PMCID: PMC9951038 DOI: 10.1001/jamanetworkopen.2023.0070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
IMPORTANCE Conditional cash transfers (CCTs) have been consistently associated with improvements to the determinants of maternal health, but there have been insufficient investigations regarding their effects on maternal mortality. OBJECTIVE To evaluate the association between being a Bolsa Família program (BFP) beneficiary and maternal mortality and to examine how this association differs by duration of BFP receipt, maternal race, living in rural or urban areas, the Municipal Human Development Index (MHDI), and municipal primary health care coverage. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis was nested within the 100 Million Brazilian Cohort. Girls and women aged 10 to 49 years (hereinafter referred to as women) who had at least 1 live birth were included, using data from Brazilian national health databases linked to the 100 Million Brazilian Cohort (January 1, 2004, to December 31, 2015). Propensity score kernel weighting was applied to control for sociodemographic and economic confounders in the association between BFP receipt and maternal mortality, overall and stratified by different subgroups (race, urban or rural area, and MHDI), and duration of BFP receipt. Data were analyzed from July 12, 2019, to December 31, 2022. MAIN OUTCOME(S) AND MEASURES Maternal death. RESULTS A total of 6 677 273 women aged 10 to 49 years were included in the analysis, 4056 of whom had died from pregnancy-related causes. The risk of maternal death was 18% lower in women who received BFP (weighted odds ratio [OR], 0.82 [95% CI, 0.71-0.93]). A longer duration receiving BFP was associated with an increased reduction in maternal mortality (OR for 1-4 years, 0.85 [95% CI, 0.75-0.97]; OR for 5-8 years, 0.70 [95% CI, 0.60-0.82]; OR for ≥9 years, 0.69 [95% CI, 0.53-0.88]). Receiving BFP was also associated with substantial increases in the number of prenatal appointments and interbirth intervals. The reduction was more pronounced in the most vulnerable groups. CONCLUSIONS AND RELEVANCE This cross-sectional analysis nested within the 100 Million Brazilian Cohort found an association between BFP receipt and maternal mortality. This association was of greater magnitude in women with longer exposure to BFP and in the most vulnerable groups. These findings reinforce evidence that programs such as BFP, which have already proven effective in poverty reduction, have great potential to improve maternal survival.
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Affiliation(s)
- Flávia Jôse O. Alves
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Dandara Ramos
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Iyaleta Research Association, Salvador, Brazil
| | - Enny S. Paixão
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Infectious Disease Department, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ila R. Falcão
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Rosemeire Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Davide Rasella
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Camila Teixeira
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Daiane Borges Machado
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - Aline Rocha
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | | | - Emanuelle F. Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Iyaleta Research Association, Salvador, Brazil
| | - Laura C. Rodrigues
- Infectious Disease Department, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Yury Ichihara
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Estela M. L. Aquino
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Maurício L. Barreto
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
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16
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Rocha ADS, Falcão IR, Teixeira CSS, Alves FJO, Ferreira AJF, Silva NDJ, Almeida MFD, Ribeiro-Silva RDC. Determinants of preterm birth: proposal for a hierarchical theoretical model. Ciênc saúde coletiva 2022. [DOI: 10.1590/1413-81232022278.03232022en] [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: 11/22/2022] Open
Abstract
Abstract Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.
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Affiliation(s)
| | - Ila Rocha Falcão
- Universidade Federal da Bahia, Brazil; Fundação Oswaldo Cruz, Brazil
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17
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Rocha ADS, Falcão IR, Teixeira CSS, Alves FJO, Ferreira AJF, Silva NDJ, Almeida MFD, Ribeiro-Silva RDC. Determinants of preterm birth: proposal for a hierarchical theoretical model. Cien Saude Colet 2022; 27:3139-3152. [PMID: 35894325 DOI: 10.1590/1413-81232022278.03232022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/05/2022] [Indexed: 11/22/2022] Open
Abstract
Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.
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Affiliation(s)
- Aline Dos Santos Rocha
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
| | - Ila Rocha Falcão
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
| | - Camila Silveira Silva Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Andrêa Jacqueline Fortes Ferreira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Natanael de Jesus Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Global de Barcelona, Hospital Clínic. Barcelona Espanha
| | | | - Rita de Cássia Ribeiro-Silva
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
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18
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Barreto ML, Ichihara MY, Pescarini JM, Ali MS, Borges GL, Fiaccone RL, Ribeiro-Silva RDC, Teles CA, Almeida D, Sena S, Carreiro RP, Cabral L, Almeida BA, Barbosa GCG, Pita R, Barreto ME, Mendes AAF, Ramos DO, Brickley EB, Bispo N, Machado DB, Paixao ES, Rodrigues LC, Smeeth L. Cohort Profile: The 100 Million Brazilian Cohort. Int J Epidemiol 2022; 51:e27-e38. [PMID: 34922344 PMCID: PMC9082797 DOI: 10.1093/ije/dyab213] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mauricio L Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Julia M Pescarini
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - M Sanni Ali
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Center for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Gabriela L Borges
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Rosemeire L Fiaccone
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Carlos A Teles
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Daniela Almeida
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Samila Sena
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Roberto P Carreiro
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Liliana Cabral
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Bethania A Almeida
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - George C G Barbosa
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Robespierre Pita
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Marcos E Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Statistics, London School of Economics and Political Science, London, UK
| | - Andre A F Mendes
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Dandara O Ramos
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Elizabeth B Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Nivea Bispo
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Daiane B Machado
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
| | - Enny S Paixao
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura C Rodrigues
- Centre for Data and Knowledge Integration for Health (CIDACS), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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19
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Lisboa CS, da Mota Santana J, de Cássia Ribeiro-Silva R, de Araújo EM, Lima da Silva CA, Barreto ML, Pereira M, dos Santos DB. Bolsa Familia Program and Perinatal Outcomes: NISAMI Cohort. Int J Environ Res Public Health 2022; 19:5345. [PMID: 35564740 PMCID: PMC9105772 DOI: 10.3390/ijerph19095345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022]
Abstract
This study aimed to assess the impact of the Bolsa Familia Program on perinatal outcomes of pregnant women. A cohort study was conducted with pregnant women supported by prenatal services at 17 Family Health Units in Bahia, Brazil. A previously tested structured questionnaire, which has sociodemographic, economic, prenatal care, lifestyle, and nutritional variables, has been used to collect data. The outcomes included premature birth and low birth weight. A hierarchical conceptual model was constructed, and logistic regression analysis was performed. From a total of 1173 pregnant women, the identified average age was 25.44 years and 34.10% had pre-gestational overweight. The non-beneficiary pregnant women presented a 1.54 (95% CI = 0.46-5.09) times higher chance of giving birth to children with low weight and a 1.03 (95% CI = 95% CI = 0.53-2.00) times chance of premature birth when compared to the beneficiary group. In the multilevel model, some variables were statistically significant, such as age between 18 and 24 years (p = 0.003), age greater than or equal to 35 years (p = 0.025), family income (p = 0.008), employment status (p = 0.010), and maternal height (p = 0.009). The Bolsa Familia Program, as an integrated strategy of social inclusion and economic development, is suggested to exert a protective effect on the health of mother-concept binomial.
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Affiliation(s)
- Cinthia Soares Lisboa
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Jerusa da Mota Santana
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus 44574-490, BA, Brazil;
| | | | - Edna Maria de Araújo
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Carlos Alberto Lima da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
| | - Mauricio Lima Barreto
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador 40110-040, BA, Brazil;
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador 41745-715, BA, Brazil
| | - Marcos Pereira
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador 40110-040, BA, Brazil;
| | - Djanilson Barbosa dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Feira de Santana State University, Av. Transnordestina, s/n, Feira de Santana, Novo Horizonte 44036-900, BA, Brazil; (E.M.d.A.); (C.A.L.d.S.)
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus 44574-490, BA, Brazil;
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20
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Rocha AS, de Cássia Ribeiro-Silva R, Fiaccone RL, Paixao ES, Falcão IR, Alves FJO, Silva NJ, Ortelan N, Rodrigues LC, Ichihara MY, de Almeida MF, Barreto ML. Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort. BMC Med 2022; 20:111. [PMID: 35392917 PMCID: PMC8991880 DOI: 10.1186/s12916-022-02313-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. METHODS We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. RESULTS A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (Pdifference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed-OR 1.04) and (indigenous-OR 1.34)], young maternal age (14 to 19 years-OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit-OR 2.56 vs OR 2.16) and (1 to 3 visits-OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months-OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35-49 years-OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB. CONCLUSIONS The risk factors for PTB in the second pregnancy differed according to women's first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy.
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Affiliation(s)
- Aline S Rocha
- School of Nutrition, Federal University of Bahia, Salvador, Brazil. .,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ila R Falcão
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Flavia Jôse O Alves
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Natanael J Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Barcelona Institute for Global Health, Hospital Clínic, Barcelona, Spain
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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21
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Ribeiro-Silva RDC, Pereira M, Aragão É, Guimarães JMDM, Ferreira AJF, Rocha ADS, Silva NDJ, Teixeira CSS, Falcão IR, Paixao ES, Barreto ML. COVID-19, Food Insecurity and Malnutrition: A Multiple Burden for Brazil. Front Nutr 2022; 8:751715. [PMID: 34977114 PMCID: PMC8716012 DOI: 10.3389/fnut.2021.751715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Érika Aragão
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | | | - Andrêa J F Ferreira
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Aline Dos Santos Rocha
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Natanael de Jesus Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Camila Silveira Silva Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia - Salvador, Bahia, Brazil.,Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil
| | - Enny Santos Paixao
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mauricio Lima Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Fundação Oswaldo Cruz - FIOCRUZ, Salvador, Bahia, Brazil.,Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia - Salvador, Bahia, Brazil
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22
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Ribeiro-Silva RDC, Silva NDJ, Felisbino-Mendes MS, Falcão IR, de Andrade RDCS, Silva SA, Nilson EAF, Spaniol AM, Fiaccone RL, Paixão E, Ichihara MYT, Velasquez-Melendez G, Barreto ML. Time trends and social inequalities in child malnutrition: nationwide estimates from Brazil's food and nutrition surveillance system, 2009-2017. Public Health Nutr 2021; 25:1-11. [PMID: 34915949 PMCID: PMC9991727 DOI: 10.1017/s1368980021004882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In Brazil, national estimates of childhood malnutrition have not been updated since 2006. The use of health information systems is an important complementary data source for analysing time trends on health and nutrition. This study aimed to examine temporal trends and socio-demographic inequalities in the prevalence of malnutrition in children attending primary health care services between 2009 and 2017. DESIGN Time trends study based on data from Brazil's Food and Nutrition Surveillance System. Malnutrition prevalence (stunting, wasting, overweight and double burden) was annually estimated by socio-demographic variables. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Children under 5 years old. RESULTS In total, 15,239,753 children were included. An increase in the prevalence of overweight (APC = 3·4 %; P = 0·015) and a decline in the prevalence of wasting (-6·2 %; P = 0·002) were observed. The prevalence of stunting (-3·2 %, P = 0·359) and double burden (-1·4 %, P = 0·630) had discrete and non-significant reductions. Despite the significant reduction in the prevalence of undernutrition among children in the most vulnerable subgroups (black, conditional cash transfer's recipients and residents of poorest and less developed areas), high prevalence of stunting and wasting persist alongside a disproportionate increase in the prevalence of overweight in these groups. CONCLUSIONS The observed pattern in stunting (high and persistent prevalence) and increase in overweight elucidate setbacks in advances already observed in previous periods and stresses the need for social and political strategies to address multiple forms of malnutrition.
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Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Av. Araújo Pinho, nº 32, Canela, CEP 40.110-150, Salvador, BA, Brazil
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Natanael de Jesus Silva
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Mariana Santos Felisbino-Mendes
- Department of Maternal and Child Nursing and Public Health, Nursing School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ila Rocha Falcão
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | | | - Sara Araújo Silva
- General-Coordination Office for Food and Nutrition Policy, Ministry of Health, Brasília, DF, Brazil
| | | | - Ana Maria Spaniol
- General-Coordination Office for Food and Nutrition Policy, Ministry of Health, Brasília, DF, Brazil
| | - Rosemeire Leovigildo Fiaccone
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Mathematics and Statistics, Federal University of Bahia, Salvador, BA, Brazil
| | - Enny Paixão
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Nursing School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maurício Lima Barreto
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
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23
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Pescarini JM, Teixeira CSS, Cruz EP, Ortelan N, Pinto PFPS, Ferreira AJF, Alves FJO, Pinto Junior EP, Falcão IR, Rocha ADS, Silva NBD, Ortiz RF, Saavedra RDC, Oliveira VDA, Ribeiro-Silva RDC, Ichihara MYT, Boaventura V, Barral Netto M, Kerr LRFS, Werneck GL, Barreto ML. Methods to evaluate COVID-19 vaccine effectiveness, with an emphasis on quasi-experimental approaches. Cien Saude Colet 2021; 26:5599-5614. [PMID: 34852093 DOI: 10.1590/1413-812320212611.18622021] [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: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.
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Affiliation(s)
- Julia Moreira Pescarini
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Camila Silveira Silva Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Enny Paixão Cruz
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Naia Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Priscila Fernanda Porto Scaff Pinto
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Andrêa Jacqueline Fortes Ferreira
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Flavia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Elzo Pereira Pinto Junior
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Ila Rocha Falcão
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Aline Dos Santos Rocha
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Nivea Bispo da Silva
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Renzo Flores Ortiz
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | | | | | - Rita de Cássia Ribeiro-Silva
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Maria Yury Travassos Ichihara
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Viviane Boaventura
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | - Manoel Barral Netto
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
| | | | | | - Mauricio L Barreto
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Muniz, Fundação Oswaldo Cruz. Rua Waldemar Falcão 121, Candeal. 40296-710 Salvador BA Brasil.
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24
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Rocha AS, de Cássia Ribeiro-Silva R, Paixao ES, Falcão IR, Alves FJO, Ortelan N, de Almeida MF, Fiaccone RL, Rodrigues LC, Ichihara MY, Barreto ML. Recurrence of preterm births: A population-based linkage with 3.5 million live births from the CIDACS Birth Cohort. Int J Gynaecol Obstet 2021; 158:605-612. [PMID: 34854081 PMCID: PMC7613286 DOI: 10.1002/ijgo.14053] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the recurrence of preterm birth (PTB) among the poorest half of the Brazilian population. METHODS A population-based retrospective study was conducted in Brazil with the live births of multiparous women extracted from the CIDACS Birth Cohort between 2001 and 2015. We used multivariate logistic regression to estimate the odds of recurrent PTB in second and third births. RESULTS A total of 3 528 050 live births from 1 764 025 multiparous women were analyzed. The adjusted odds for the occurrence of a PTB given a previous PTB was 2.58 (95% confidence interval [CI] 2.53-2.62). Lower gestational age increased the odds of a subsequent PTB (<28 weeks: adjusted OR [aOR] 3.61, 95% CI 3.41-3.83; 28-31 weeks: aOR 3.34, 95% CI 3.19-3.49; and 32-36 weeks: aOR 2.42, 95% CI 2.38-2.47). Women who had two previous PTBs were at high risk of having a third (aOR 4.98, 95% CI 4.70-5.27). Recurrence of PTB was more likely when the inter-birth interval was less than 12 months. CONCLUSION In Brazil, a middle-income country, women with a previous PTB had an increased risk of a subsequent one. This association was affected by gestational age, the number of PTBs, severity of previous PTBs, and a short interval between births.
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Affiliation(s)
- Aline S Rocha
- School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ila R Falcão
- School of Nutrition, Federal University of Bahia (UFBA), Salvador, Brazil.,Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Flavia Jôse O Alves
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Laura C Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.,Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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25
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Silva NDJ, Ribeiro-Silva RDC, Ferreira AJF, Teixeira CSS, Rocha AS, Alves FJO, Falcão IR, Pinto EDJ, Santos CADST, Fiaccone RL, Ichihara MYT, Paixão ES, Barreto ML. Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients. BMJ Open 2021; 11:e050739. [PMID: 34373311 PMCID: PMC8354760 DOI: 10.1136/bmjopen-2021-050739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/21/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. DESIGN Cross-sectional study based on registry data from Brazil's influenza surveillance system. SETTING Public and private hospitals across Brazil. PARTICIPANTS Eligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020. MAIN OUTCOME MEASURES Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. RESULTS A sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33). CONCLUSIONS The combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults.
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Affiliation(s)
- Natanael de Jesus Silva
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
| | - Andrêa Jacqueline Fortes Ferreira
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
| | - Camila Silveira Silva Teixeira
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
| | - Aline Santos Rocha
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
| | - Flávia Jôse Oliveira Alves
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
| | - Ila Rocha Falcão
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Elizabete de Jesus Pinto
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Center for Health Sciences, Federal University of Reconcavo da Bahia, Santo Antônio de Jesus, BA, Brazil
| | - Carlos Antônio de Souza Teles Santos
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Department of Exact Sciences, State University of Feira de Santana, Feira de Santana, BA, Brazil
| | - Rosemeire Leovigildo Fiaccone
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Mathematics and Statistics, Federal University of Bahia, Salvador, BA, Brazil
| | - Maria Yury Travassos Ichihara
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Enny S Paixão
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mauricio L Barreto
- Rede CoVida, Salvador, BA, Brazil
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
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Falcão IR, Ribeiro-Silva RDC, de Almeida MF, Fiaccone RL, Silva NJ, Paixao ES, Ichihara MY, Rodrigues LC, Barreto ML. Factors associated with small- and large-for-gestational-age in socioeconomically vulnerable individuals in the 100 Million Brazilian Cohort. Am J Clin Nutr 2021; 114:109-116. [PMID: 33826704 PMCID: PMC8246620 DOI: 10.1093/ajcn/nqab033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/29/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. OBJECTIVES To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. METHODS The study population consisted of women of reproductive age (14-49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. RESULTS Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14-20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35-49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1-3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1-3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). CONCLUSIONS In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.
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Affiliation(s)
| | - Rita de Cássia Ribeiro-Silva
- The School of Nutrition, Federal University of Bahia, Salvador, Brazil,Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Rosemeire L Fiaccone
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Natanael J Silva
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixao
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Laura C Rodrigues
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mauricio L Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Falcão IR, Ribeiro-Silva RDC, de Almeida MF, Fiaccone RL, Dos S Rocha A, Ortelan N, Silva NJ, Paixao ES, Ichihara MY, Rodrigues LC, Barreto ML. Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth 2020; 20:536. [PMID: 32928144 PMCID: PMC7491100 DOI: 10.1186/s12884-020-03226-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women. METHODS Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW. RESULTS Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47-1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18-1.22), had a low educational level (OR: 1.57; 95% CI: 1.53-1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43-1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42-2.54) and were primiparous (OR: 1.62; 95% CI: 1.60-1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South. CONCLUSION Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children.
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Affiliation(s)
- Ila R Falcão
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Institute of Mathematics, Federal University of Bahia, Salvador, Brazil
| | - Aline Dos S Rocha
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Natanael J Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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Ribeiro-Silva RDC, Pereira M, Campello T, Aragão É, Guimarães JMDM, Ferreira AJ, Barreto ML, Santos SMCD. Covid-19 pandemic implications for food and nutrition security in Brazil. Cien Saude Colet 2020; 25:3421-3430. [PMID: 32876253 DOI: 10.1590/1413-81232020259.22152020] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 01/19/2023] Open
Abstract
The emergence of COVID-19 in Brazil further explained the massive discrepancy between different social realities coexisting in the country, rekindling the discussions about food and nutrition security, similarly to what has been happening in other countries facing the same pandemic situation. In this paper, we argue that the risks to hunger and food security in Brazil have been present since 2016 and are now being exacerbated due to the emergence of the COVID-19 epidemic. This situation requires knowing the extent and magnitude of the issue and articulation of measures in the three governmental spheres(federal, municipal and state) to ensure access to adequate and healthy food and reduce the disease's adverse effectson the diet, health, and nutrition among the most vulnerable people. Thus, this work aims to contribute to the debate on the measures to be adopted by governments and society to promote and ensure food and nutrition security and prevent insecurity and the expansion of hunger during and after the social and health crisis created by the pandemic.
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Affiliation(s)
| | - Marcos Pereira
- Rede CoVida Ciência, Informação e Solidariedade, Salvador, BA, Brazil
| | | | - Érica Aragão
- Rede CoVida Ciência, Informação e Solidariedade, Salvador, BA, Brazil
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Uzêda JCO, Ribeiro-Silva RDC, Silva NDJ, Fiaccone RL, Malta DC, Ortelan N, Barreto ML. Correction: Factors associated with the double burden of malnutrition among adolescents, National Adolescent School-Based Health Survey (PENSE 2009 and 2015). PLoS One 2019; 14:e0219315. [PMID: 31247043 PMCID: PMC6597194 DOI: 10.1371/journal.pone.0219315] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Uzêda JCO, Ribeiro-Silva RDC, Silva NDJ, Fiaccone RL, Malta DC, Ortelan N, Barrato ML. Factors associated with the double burden of malnutrition among adolescents, National Adolescent School-Based Health Survey (PENSE 2009 and 2015). PLoS One 2019; 14:e0218566. [PMID: 31199844 PMCID: PMC6570028 DOI: 10.1371/journal.pone.0218566] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/04/2019] [Indexed: 12/27/2022] Open
Abstract
Objective To assess the sociodemographic factors associated with the double burden of malnutrition (DBM) among Brazilian adolescents. Methods This was a descriptive study based on data from 59,637 and 10,770 students who participated in the National Adolescent School-Based Health Survey (PeNSE), 2009 and 2015 editions, respectively. Weight and height measurements were obtained to evaluate nutritional status. DBM was classified as follows: adolescents with high BMI-for-age and low height-for-age (BMI/A: Z-score > +1 and H/A: Z-score < -2). Sociodemographic data on the participants were also collected. A multinomial logistic regression analysis was used to detect associations of interest. Results The prevalence of DBM in the 2009 and 2015 editions of the PeNSE was 0.4% and 0.3%, respectively. In the 2009 edition, the chance of DBM was lower among boys (OR = 0.60; 95% CI = 0.45–0.81) and higher among those over 14 years old (OR = 2.40; 95% CI = 1.80–3.20), living in the country’s north and northeast regions (OR = 2.01; 95% CI = 1.49–2.84), and from families with a low maternal education level (OR = 1.48; 95% CI = 1.07–2.04). In the 2015 edition, no significant associations were found regarding the DBM outcome. Conclusion The results indicate the presence of socioeconomic inequalities in the occurrence of DBM in the 2009 edition of the PeNSE. Simultaneous interventions in the area of equity are necessary to prevent the advancement of nutrition-related problems.
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Affiliation(s)
- Júlia Caffé Oliveira Uzêda
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Rita de Cássia Ribeiro-Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brasil
- * E-mail:
| | | | | | - Débora C. Malta
- Universidade Federal de Minas Gerais – Escola de Enfermagem, Belo Horizonte (MG), Brasil
| | - Naiá Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Instituto Gonçalo Moniz. Fundação Oswaldo Cruz – FIOCRUZ, Salvador, Bahia, Brasil
| | - Maurício L. Barrato
- Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia, Salvador, Bahia, Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Instituto Gonçalo Moniz. Fundação Oswaldo Cruz – FIOCRUZ, Salvador, Bahia, Brasil
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Brito Beck da Silva K, Ortelan N, Giardini Murta S, Sartori I, Couto RD, Leovigildo Fiaccone R, Lima Barreto M, Jones Bell M, Barr Taylor C, Ribeiro-Silva RDC. Evaluation of the Computer-Based Intervention Program Stayingfit Brazil to Promote Healthy Eating Habits: The Results from a School Cluster-Randomized Controlled Trial. Int J Environ Res Public Health 2019; 16:ijerph16101674. [PMID: 31091683 PMCID: PMC6572183 DOI: 10.3390/ijerph16101674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/04/2019] [Accepted: 05/05/2019] [Indexed: 12/16/2022]
Abstract
Abstract Interventions via the Internet are promising regarding the promotion of healthy habits among youth. The objective of this study was to evaluate the effect of an adapted version of StayingFit to promote healthy eating habits and the measurement adequacy of anthropometric markers among adolescents. A web school-based 12-month cluster-randomized controlled trial examining 7th to 9th grade students was conducted in twelve schools in Salvador, Bahia, Brazil. The schools’ students were randomly distributed into the intervention and control groups. The intervention group participated in StayingFit, an online program designed to encourage and guide healthy eating habits and control body weight. Data on food consumption, anthropometry, physical activity level, and sedentary behavior were collected from all of the students at the beginning of and after the 12-month study. Demographic and socioeconomic data were collected at baseline. The baseline data indicated high rates of overweight (14.4% overweight and 8.5% obese), insufficiently active (87.6%), and sedentary (63.7%). Furthermore, few adolescents regularly consumed fruits (18.8%) and vegetables/legumes (16.4%). Generalized estimating equations (GEEs) were used to evaluate the effect of the intervention. At the end of the follow-up period, students in the intervention group had a 43% increased chance of regularly consuming beans (OR = 1.43, 95% CIs = 1.10–1.86) and a 35% decreased chance of regularly consuming soft drinks (OR = 0.65, 95% CIs = 0.50–0.84). No differences were found between the groups studied with regard to the anthropometric parameters. Despite these modest results, the implementation of a web intervention can be beneficial and help promote positive changes in adolescent eating habits. Trial Registration Brazilian Registry of Clinical Trials RBR-7qgnbn.
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Affiliation(s)
- Karine Brito Beck da Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, Salvador, BA 40.110-150, Brazil.
| | - Naiá Ortelan
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
| | - Sheila Giardini Murta
- Departamento de Psicologia Clínica, Instituto de Psicologia, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, DF 70910-900, Brazil.
| | - Isabel Sartori
- Programa de Engenharia Industrial, PROTEC. Escola Politécnica-PEI, Universidade Federal da Bahia, Rua Aristídes Novis, 02, 6o andar, Federação, Salvador, BA 40210630, Brazil.
| | - Ricardo David Couto
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia 40.170-115, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
- Instituto de Matemática, Universidade Federal da Bahia, Av. Adhemar de Barros, s/n, Ondina, Salvador, BA 40.170-110, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, Salvador, BA 40.110-040, Brazil.
| | - Maurício Lima Barreto
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal, Salvador, BA 40.296-710, Brazil.
| | - Megan Jones Bell
- Headspace, Inc. 2415 Michigan Avenue, Santa Monica, CA 90404, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Craig Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Rita de Cássia Ribeiro-Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, Salvador, BA 40.110-150, Brazil.
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Ribeiro-Silva RDC, Barreto ML, Ramos D, Cruz AA, Oliveira-Campos M, Malta DC. Asthma trend in adolescence in Brazil: results of the National Adolescent School-based Health Survey (PeNSE 2012-2015). Rev Bras Epidemiol 2018; 21:e180017. [PMID: 30517468 DOI: 10.1590/1980-549720180017.supl.1] [Citation(s) in RCA: 3] [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: 10/24/2017] [Accepted: 12/20/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the evolution of asthma indicators in the editions of the National School Health Survey (PeNSE 2012 and 2015). METHODS Cross-sectional study including Brazilian 9th grade students from public and private schools. Wheezing was assessed through the question: "In the past 12 months, did you have wheezing (or chirping) chest? (yes/no)", and to assess lifetime presence of asthma, the question was "Have you ever had asthma? (yes/no)". RESULTS Of the students, 23,52% reported wheezing or chirping chest in the past 12 months, with prevalences ranging from 16,80% (in Salvador, Bahia) to 27,43% (in Porto Alegre, Rio Grande do Sul). Lifetime presence of asthma was reported by 17,92% of the students, ranging from 13,98% (in Campo Grande, Mato Grosso do Sul) to 30,35% (in Porto Alegre, Rio Grande do Sul). There was also a decrease in the prevalence of self-report of wheezing/chirping chest in the last 12 months between the two editions of the survey (2012/2015) in 20 of the 27 Brazilian state capitals, especially in Belo Horizonte, Florianópolis, Cuiabá and Goiânia. However, prevalence of lifetime diagnostic of asthma increased from 2012 to 2015 in 26 of the 27 Brazilian state capitals. CONCLUSION There was a decrease in the prevalence of self-report of asthma symptoms and an increase of self-reported lifetime presence of asthma. Certainly, monitoring indicators of asthma prevalence is of high importance for health knowledge and the development of public policies.
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Affiliation(s)
| | - Maurício Lima Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia - Salvador (BA), Brasil.,Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz - Salvador (BA), Brasil
| | - Dandara Ramos
- Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz - Salvador (BA), Brasil
| | - Alvaro Augusto Cruz
- Núcleo de Excelência em Asma, Universidade Federal da Bahia - Salvador (BA), Brasil
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Dos Santos Rocha A, de Cássia Ribeiro-Silva R, Nunes de Oliveira Costa G, Alexandrina Figueiredo C, Cunha Rodrigues L, Maria Alvim Matos S, Leovigildo Fiaccone R, Oliveira PR, Alves-Santos NH, Blanton RE, Lima Barreto M. Food Consumption as a Modifier of the Association between LEPR Gene Variants and Excess Body Weight in Children and Adolescents: A Study of the SCAALA Cohort. Nutrients 2018; 10:E1117. [PMID: 30126176 PMCID: PMC6116060 DOI: 10.3390/nu10081117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/04/2018] [Accepted: 08/08/2018] [Indexed: 01/13/2023] Open
Abstract
No studies showing that food consumption is a modifier of the association of variants of the leptin receptor gene (LEPR) with body weight have involved a Brazilian population. The aim of this study was to evaluate the modifying effect of dietary intake on the association between the LEPR gene and excess weight. In this study, 1211 children and adolescents aged 4⁻11 years were assessed. Participants were genotyped for 112 single-nucleotide variants of the LEPR gene. Anthropometric measurements were performed, and dietary data were obtained. Logistic regressions were used to study the associations of interest. Of the participants, 13.4% were overweight/obese. The risk allele (G) of the rs1137100 variant was associated with excess weight in individuals with fat consumption below the median (odds ratio OR = 1.92; 95% confidence interval CI = 1.18⁻3.14), with daily frequency of consumption of drink/artificial juice (OR = 2.15; 95% CI = 1.26⁻3.68) and refined cereals (OR = 2.17; 95% CI = 1.31⁻3.62) above the median. The risk allele (G) of variant rs1177681 was also associated with excess weight (OR = 2.74; 95% CI = 1.65⁻4.57) in subjects with a daily frequency of refined cereal consumption above the median. The association between LEPR and excess weight can be modulated by the type and distribution of dietary fatty acids, sugary drinks, and refined cereals.
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Affiliation(s)
- Aline Dos Santos Rocha
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40.110-150, Salvador, BA Brasil.
| | - Rita de Cássia Ribeiro-Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40.110-150, Salvador, BA Brasil.
| | - Gustavo Nunes de Oliveira Costa
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- UNIFACS-Universidade Salvador, Laureate International Universities, Rua Doutor José Peroba, 251, Edf. Civil Empresarial, Sobreloja, STIEP, CEP: 41770-235, Salvador, BA, Brasil.
| | - Camila Alexandrina Figueiredo
- Departamento de Ciências da Biorregulação, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Av. Reitor Miguel Calmon. s/n, Vale do Canela, CEP: 40110-100, Salvador, BA, Brasil.
| | - Laura Cunha Rodrigues
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT UK.
| | - Sheila Maria Alvim Matos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, CEP:40.110-040, Salvador, BA, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, CEP:40.110-040, Salvador, BA, Brasil.
- Instituto de Matemática, Universidade Federal da Bahia-Av. Adhemar de Barros, s/n-Ondina, CEP: 40.170-110, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
| | - Pablo Rafael Oliveira
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
| | - Nadya Helena Alves-Santos
- Observatório de Epidemiologia Nutricional, Departamento de Nutrição Aplicada e Social, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro-UERJ. CEP: 21941-590, Rio de Janeiro, RJ, Brasil.
| | - Ronald E Blanton
- Center for Global Health & Diseases, Biomedical Research Building (BRB), Room 425, Case Western Reserve University, 2109 Adelbert Rd, Cleveland, OH 44106, USA.
| | - Maurício Lima Barreto
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal-Salvador/BA, CEP: 40296-710, Salvador, BA, Brasil.
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituo Gonçalo Muniz, Fundação Owaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador, BA, Brasil.
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Ribeiro-Silva RDC, Fiaccone RL, Conceição-Machado MEPD, Ruiz AS, Barreto ML, Santana MLP. Body image dissatisfaction and dietary patterns according to nutritional status in adolescents. J Pediatr (Rio J) 2018; 94:155-161. [PMID: 28801145 DOI: 10.1016/j.jped.2017.05.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 09/26/2016] [Revised: 02/18/2017] [Accepted: 03/08/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There is a lack of data on the association between body self-perception and eating patterns in Brazil. Thus, this study aimed to explore the relationship between body image dissatisfaction and eating patterns by the anthropometric status in adolescents. METHODS A cross-sectional study of 1496 adolescents was conducted. The participants completed the Body Shape Questionnaire. Demographic, anthropometric, and socioeconomic data were collected, as well as information regarding the pubertal development and dietary intake. Logistic regression was performed to evaluate the associations of interest. RESULTS Body image dissatisfaction was identified in 19.5% of the adolescents. Three dietary patterns were identified: (1) the Western pattern was composed of sweets and sugars, soft drinks, typical dishes, pastries, fast food, beef, milk, and dairy products; (2) the Traditional pattern was composed of oils, chicken, fish, eggs, processed meat products, cereals (rice, cassava flour, pasta, etc.), baked beans, and bread; and (3) the Restrictive pattern was composed of granola, roots, vegetables, and fruit. Among overweight/obese adolescents, the data indicated a negative association of slight body image dissatisfaction (OR: 0.240 [0.100; 0.576]) and moderate body image dissatisfaction (OR: 0.235 [0.086; 0.645]) with the Western dietary pattern. Additionally, in this group, there was a positive association between high body image dissatisfaction and the Restrictive pattern (OR: 2.794 [1.178; 6.630]). CONCLUSION Amongst overweight/obese adolescents, those with slight and moderate body image dissatisfaction were less likely to follow a Western-like dietary pattern when compared with those satisfied with their body image. Additionally, in this group, adolescents with high body image dissatisfaction was more likely to follow a restrictive pattern.
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Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- Universidade Federal da Bahia (UFBA), Escola de Nutrição, Departamento Ciência da Nutrição, Salvador, BA, Brazil.
| | | | | | - Ana Santos Ruiz
- Universidad de Alicante, Departamento de Psicología de la Salud, Alicante, Spain
| | - Maurício Lima Barreto
- Fundação Oswaldo Cruz (Fiocruz), Instituto Gonçalo Moniz (IGM), Salvador, BA, Brazil; Universidade Federal da Bahia (UFBA), Instituto de Saúde Coletiva, Salvador, BA, Brazil
| | - Mônica Leila Portela Santana
- Universidade Federal da Bahia (UFBA), Escola de Nutrição, Departamento Ciência da Nutrição, Salvador, BA, Brazil
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Barreto ML, Ribeiro-Silva RDC, Malta DC, Oliveira-Campos M, Andreazzi MA, Cruz AA. Prevalence of asthma symptoms among adolescents in Brazil: National Adolescent School-based Health Survey (PeNSE 2012). Rev Bras Epidemiol 2016; 17 Suppl 1:106-15. [PMID: 25054257 DOI: 10.1590/1809-4503201400050009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 02/12/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aims to describe the prevalence rates of asthma symptoms in Brazil, its Regions and State capitals, according to data from the National Adolescent School-based Health Survey, 2012. Furthermore, it aims to compare the prevalence of asthma in the capitals evaluated by PeNSE 2012 with previous results of the International Study of Asthma and Allergies in Childhood (ISAAC). METHODS Cross sectional study of 9th grade students at public and private schools of all Brazilian states and the Federal District (Brasília). A self reported questionnaire containing items from the ISAAC was applied in order to identify the presence of asthma symptoms. RESULTS The results of PeNSE indicate a high prevalence of asthma symptoms (23.2%) and of reports of a previous medical diagnosis of asthma (12.4%). Of the five state capitals in which the PeNSE results were compared to the ISAAC, São Paulo, Curitiba and Porto Alegre presented an increase in the prevalence of asthma symptoms. In Salvador, there was a reduction. CONCLUSION Brazil is among the countries with the highest prevalence of asthma in the world, and the prevalence is still growing.
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Affiliation(s)
| | | | - Deborah Carvalho Malta
- Departament of Disease and Non-Communicable Condition Surveillance and Health Promotion, Ministry of Health, Brasília, DF, Brazil
| | - Maryane Oliveira-Campos
- Departament of Disease and Non-Communicable Condition Surveillance and Health Promotion, Ministry of Health, Brasília, DF, Brazil
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Brito Beck da Silva K, Leovigildo Fiaccone R, Couto RD, Ribeiro-Silva RDC. EVALUATION OF THE EFFECTS OF A PROGRAMME PROMOTING ADEQUATE AND HEALTHY EATING ON ADOLESCENT HEALTH MARKERS: AN INTERVENTIONAL STUDY. NUTR HOSP 2015; 32:1582-90. [PMID: 26545521 DOI: 10.3305/nh.2015.32.4.9512] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIM to evaluate the effects of a protocol promoting adequate and healthy eating on adolescent health parameters. METHODS this controlled intervention study was conducted for 9 months, with the participation of adolescents enrolled in two schools (intervention/control) located in a poor neighbourhood in the city of Salvador (Bahia), Brazil. For the intervention school, activities promoting adequate and healthy eating were designed based on the Food Guide for the Brazilian Population (Guia Alimentar para a População Brasileira). Students underwent biochemical, sexual maturation and anthropometric tests at baseline and at the end of the 9-month period. In addition, students answered a questionnaire on food consumption, physical activity and sedentary behaviour. Information on the socioeconomic status of their family was also obtained. Generalized Estimating Equation (GEE) analysis was chosen to evaluate the associations of interest. RESULTS students under intervention presented decreases of 7.64 mg/dL in mean total cholesterol (TC) (p = 0.009) and 7.77 mg/dL in mean low-density lipoprotein cholesterol (LDLc) (p = 0.003) and increases of 18% in legume consumption (odds ratio [OR] = 1.18; 95% confidence interval [CI] 1.03-1.37) and 17% in vegetable consumption (OR = 1.17; 95%CI 1.01-1.35) compared with students who did not undergo intervention. No differences were observed in the anthropometric parameters analysed. CONCLUSION the results showed a positive effect of activities promoting adequate and healthy eating on reducing TC and LDLc and on increasing the consumption of vegetables and legumes, evidencing that the intervention model was able to prevent and/or treat cardiovascular risk factors in adolescents.
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Affiliation(s)
| | | | - Ricardo David Couto
- Departamento de Análises Clínicas e Toxicológicas. Universidade Federal da Bahia - Faculdade de Farmácia, Salvador, Bahia. Brasil..
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Bittencourt LDS, Santos SMCD, Pinto EDJ, Aliaga MA, Ribeiro-Silva RDC. Factors Associated with Food Insecurity in Households of Public School Students of Salvador City, Bahia, Brazil. J Health Popul Nutr 2014. [DOI: 10.3329/jhpn.v31i4.20002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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de Cássia Ribeiro-Silva R, Fiaccone RL, Barreto ML, da Silva LA, Santos LFP, Alcantara-Neves NM. The prevalence of wheezing and its association with serum zinc concentration in children and adolescents in Brazil. J Trace Elem Med Biol 2014; 28:293-7. [PMID: 24686116 DOI: 10.1016/j.jtemb.2014.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/26/2014] [Accepted: 02/28/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To assess the influence of zinc serum status on the prevalence of wheezing in a sample of children and adolescents in Northeastern Brazil. RESEARCH METHODS AND PROCEDURES This is a cross-sectional study which included 592 students of 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeastern Brazil. Report of wheezing in the past 12 months was collected using a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. The determination of serum Zn levels was performed using a flame atomic absorption spectrometer. Data on anthropometric status, level of physical activity, pubertal development and socioeconomic information, for each participant were obtained. Multivariate logistic regression analyses were used to assess the associations of interest. RESULTS Of the students, 8.6% (95% CI 6.30-10.9) reported having wheezing. The mean (SD) serum zinc level was 114 (22.9 μg/dL). The results of the multiple logistic regression analysis showed, after adjustments, positive and significant association between low serum zinc levels and wheezing. Students categorized as being below the median for serum Zn concentration presented an almost 1.9-fold increase in the wheezing prevalence ratio (OR=1.9; 95% CI 1.03-3.53). CONCLUSION The main findings of this study suggest that the level of zinc may influence the risk of wheezing in late childhood on the study population.
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Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil.
| | - Rosemeire Leovigildo Fiaccone
- Instituto de Matemática, Universidade Federal da Bahia, Av. Adhemar de Barros, s/n, Ondina, CEP: 40170-110 Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Campus Universitário Canela, CEP: 40110-040 Salvador, Bahia, Brazil
| | - Luce Alves da Silva
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil
| | - Luis Fernandes Pereira Santos
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, CEP: 40110-150 Salvador, Bahia, Brazil
| | - Neuza Maria Alcantara-Neves
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Av. Reitor Miguel Calmon, s/n, CEP: 40110-100 Salvador, Bahia, Brazil
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Ribeiro-Silva RDC, Florence TCM, Conceição-Machado MEPD, Fernandes GB, Couto RD. Indicadores antropométricos na predição de síndrome metabólica em crianças e adolescentes: um estudo de base populacional. Rev Bras Saude Mater Infant 2014. [DOI: 10.1590/s1519-38292014000200007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: avaliar a capacidade dos indicadores antropométricos e pontos de corte na predição da síndrome metabólica (SM) em crianças e adolescentes. Métodos: estudo transversal, envolvendo amostra probabilística de 879 crianças e adolescentes de ambos os sexos. Dados metabólicos, antropométricos e sociodemográficos foram coletados. Para diagnóstico da SM, foi utilizada a definição modificada do National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III). A capacidade dos indicadores antropométricos na predição do SM foi avaliada por meio da curva Receiver Operating Characteristic (ROC). Resultados: a prevalência de SM foi de 6,6%. Na predição da SM, a área sob a curva ROC foi de 0,79 (0,72; 0,85) para índice de massa corporal (IMC), de 0,79 (0,73; 0,85) para circunferência da cintura (CC) e de 0,83 (0,78; 0,89) para circunferência da cintura corrigida pela estatura (RCE). O ponto de corte identificado para RCE na predição da SM foi de 0,448 (ambos os gêneros). Conclusões: todos os indicadores antropométricos utilizados, com pequena superioridade da RCE, foram bons preditores da SM. O ponto de corte identificado para RCE na predição da SM aproxima-se daquele proposto por alguns autores como universal. Sugere-se o uso deste índice dado a sua simples operacionalidade em estudos clínicos e epidemiológicos como preditor da SM.
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Ribeiro-Silva RDC, Oliveira-Assis AM, Junqueira SB, Fiaccone RL, dos Santos SMC, Barreto ML, de Jesus Pinto E, da Silva LA, Rodrigues LC, Alcantara-Neves NM. Food and nutrition insecurity: a marker of vulnerability to asthma symptoms. Public Health Nutr 2014; 17:14-9. [PMID: 23332100 PMCID: PMC10282459 DOI: 10.1017/s1368980012005551] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 11/01/2012] [Accepted: 11/09/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the association between food and nutrition insecurity and asthma in children from Latin America. DESIGN Cross-sectional study. SETTING São Francisco do Conde, Bahia, north-eastern Brazil. SUBJECTS The study included 1307 children aged 6-12 years from public elementary schools. Asthma symptoms were collected using a questionnaire that was translated and adapted from the International Study of Asthma and Allergies in Childhood, phase III. The diagnosis of asthma was determined based on reports of wheezing in the previous 12 months. The Brazilian Food Insecurity Scale was used to identify food insecurity. We also obtained demographic, socio-economic and anthropometric information for each participant. We used multivariate logistic regression analyses to assess the associations of interest. RESULTS Of the children surveyed, 10·4% had a history of wheezing and 64·5% had some degree of food and nutrition insecurity. We found a positive dose-response relationship and statistically significant associations of asthma with moderate (OR = 1·71, 95% CI 1·01, 2·89) and severe (OR = 2·51, 95% CI 1·28, 4·93) food and nutrition insecurity. CONCLUSIONS The results show that moderate and severe food and nutrition insecurity are markers of vulnerability to wheezing. It is important to note that the results of studies in this field have potential implications for social policies that promote food security. Further studies to identify the mechanisms involved in the relationship between food and nutrition insecurity and asthma are needed.
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Affiliation(s)
| | - Ana Marlúcia Oliveira-Assis
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Samuel Badaró Junqueira
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | | | | | | | - Elizabete de Jesus Pinto
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Luce Alves da Silva
- Departamento Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - Laura Cunha Rodrigues
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Neuza Maria Alcantara-Neves
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brasil
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de Souza Bittencourt L, Chaves dos Santos SM, de Jesus Pinto E, Aliaga MA, de Cássia Ribeiro-Silva R. Factors associated with food insecurity in households of public school students of Salvador City, Bahia, Brazil. J Health Popul Nutr 2013; 31:471-479. [PMID: 24592588 PMCID: PMC3905641] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This cross-sectional study was conducted to find out the factors associated with food insecurity (FI) in households of the students aged 6-12 years in public schools of Salvador city, Bahia, Brazil. The study included 1,101 households. Food and nutritional insecurity was measured using the Brazilian Food Insecurity Scale (BFIS). Data on socioeconomic and demographic characteristics as well as environmental and housing conditions were collected during the interviews conducted with the reference persons. Multivariate polytomous logistic regression was used in assessing factors associated with food insecurity. We detected prevalence of food insecurity in 71.3% of the households. Severe and moderate forms of FI were diagnosed in 37.1% of the households and were associated with: (i) female gender of the reference person in the households (OR 2.21, 95% CI 1.47-3.31); (ii) a monthly per-capita income below one-fourth of the minimum wage (US$ 191.73) (OR 2.63, 95% CI 1.68-4.08); (iii) number of residents per bedroom below 3 persons (OR 1.91, 95% CI 1.23-2.96); and (iv) inadequate housing conditions (OR 1.84, 95% CI 1.12-4.49). Socioeconomic inequalities determine the factors associated with FI of households in Salvador, Bahia. Identifying vulnerabilities is necessary to support public policies in reducing food insecurity in the country. The results of the present study may be used in re-evaluating strategies that may limit the inequalities in school environment.
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Affiliation(s)
- Liliane de Souza Bittencourt
- Escola de Nutrição da Universidade Federal da Bahia. Av. Araújo Pinho 32, Canela. CEP 40.110-150 Salvador, Bahia, Brazil
| | - Sandra Maria Chaves dos Santos
- Escola de Nutrição da Universidade Federal da Bahia. Av. Araújo Pinho 32, Canela. CEP 40.110-150 Salvador, Bahia, Brazil
| | - Elizabete de Jesus Pinto
- Escola de Nutrição da Universidade Federal da Bahia. Av. Araújo Pinho 32, Canela. CEP 40.110-150 Salvador, Bahia, Brazil
| | - Marie Agnes Aliaga
- Escola de Nutrição da Universidade Federal da Bahia. Av. Araújo Pinho 32, Canela. CEP 40.110-150 Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Escola de Nutrição da Universidade Federal da Bahia. Av. Araújo Pinho 32, Canela. CEP 40.110-150 Salvador, Bahia, Brazil
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