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Lima JFDB, Lima RJCP, Batalha MA, da Silva AAM, Ribeiro MRC, Batista RFL. Do childhood depressive symptoms interfere with intelligence in adulthood? Rev Saude Publica 2023; 57:64. [PMID: 37878850 PMCID: PMC10519686 DOI: 10.11606/s1518-8787.2023057004918] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/19/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To investigate the effects of depressive symptoms in childhood on the intellectual development of young adults. METHODS Study conducted with a birth cohort of São Luís, Maranhão, Brazil, composed of 339 participants evaluated between 7 and 9 years and between 18 and 19 years. Structural equation modeling (young adult education, sex, race/color) and childhood variables (nutritional status, depressive symptoms, cognitive function, head of household's and mother's education, family income) were used. In addition, head of household's occupation, mother's age, and presence of partner were tested as determinants of adults' intelligence quotient (IQ). RESULTS Presence of depressive symptoms in childhood triggered a reduction of 0.342 in standard deviation (SD) and -3.83 points in the average IQ of adults (p-value < 0.001). Cognitive function in childhood had a total and direct positive effect (standardized coefficient [SC] = 0.701; p-value < 0.001) on IQ, increasing 7.84 points with each increase in level. A positive indirect effect of child nutritional status (SC = 0.194; p-value = 0.045), head of household's (SC = 0.162; p-value = 0.036), and mother's education was identified, the latter mediated by cognitive function in childhood (SC = 0.215; p-value = 0.012) on the IQ of young people. CONCLUSION Presence of depressive symptoms in childhood triggered a long-term negative effect on intelligence, reducing the IQ score in adulthood.
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Affiliation(s)
- Janielle Ferreira de Brito Lima
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Raina Jansen Cutrim Propp Lima
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Mônica Araújo Batalha
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Marizélia Rodrigues Costa Ribeiro
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrazil Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil. São Luís, MA, Brazil.
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Lima RJCP, Batalha MA, Ribeiro CCC, Lima PM, da Silva AAM, Batista RFL. Modifiable behavioral risk factors for NCDs and sleep in Brazilian adolescents. Rev Saude Publica 2023; 57:60. [PMID: 37878846 PMCID: PMC10519685 DOI: 10.11606/s1518-8787.2023057004957] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/09/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To analyze the association between modifiable behavioral risk factors for non-communicable diseases and sleep parameters in Brazilian adolescents. METHODS This was a cross-sectional study that used data from the RPS Cohort Consortium, São Luís, Brazil for the follow-up of adolescents aged 18-19 years (n = 2,515). The outcomes were excessive daytime sleepiness (Epworth Sleepiness Scale - ESS) and sleep quality (Pittsburgh Sleep Quality Index - PSQI). The exposures of interest were the behavioral risk factors for non-communicable diseases (NCDs): screen time, physical inactivity, alcohol, smoking, illicit drugs, caffeine intake, and consumption of sugar-sweetened beverages. Excess weight was considered a possible mediator of this association between the exposures of interest and the outcomes. The models were analyzed by modeling with structural equations. RESULTS Physical inactivity (standardized coefficient, SC = 0.112; p = 0.001), higher consumption of alcohol (SC = 0.168; p = 0.019) and of sugar-sweetened beverages (SC = 0.128; p < 0.001) were associated with excessive daytime sleepiness in adolescents; better socioeconomic status was also associated with this outcome (SC = 0.128; p < 0.001). Physical inactivity (SC = 0.147; p < 0.001) and higher consumption of sugar-sweetened beverages (SC = 0.089; p = 0.003) were also associated with poor sleep quality. Overweight was neither a mediator nor associated with sleep quality or excessive daytime sleepiness. CONCLUSIONS The main modifiable behavioral risk factors for NCDs are associated with worse sleep parameters already in adolescence, which serves as a warning toward the accumulation of risks for sleep disorders in the future.
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Affiliation(s)
- Raina Jansen Cutrim Propp Lima
- Instituto Federal de Educação. Ciência e Tecnologia do MaranhãoDepartamento de EnsinoAçailândiaMABrasil Instituto Federal de Educação. Ciência e Tecnologia do Maranhão. Departamento de Ensino. Açailândia, MA, Brasil
| | - Mônica Araujo Batalha
- Universidade Federal do MaranhãoCentro de Ciências Biológicas e da SaúdeDepartamento de Saúde PúblicaSão LuísMABrasil Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Cecília Cláudia Costa Ribeiro
- Universidade Federal do MaranhãoCentro de Ciências Biológicas e da SaúdeDepartamento de Odontologia IISão LuísMABrasil Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Odontologia II. São Luís, MA, Brasil
| | - Pedro Martins Lima
- Universidade Federal do MaranhãoCentro de Ciências Sociais, Saúde e TecnologiaImperatrizMABrasil Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil
| | - Antônio Augusto Moura da Silva
- Universidade Federal do MaranhãoCentro de Ciências Biológicas e da SaúdeDepartamento de Saúde PúblicaSão LuísMABrasil Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoCentro de Ciências Biológicas e da SaúdeDepartamento de Saúde PúblicaSão LuísMABrasil Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
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Campelo CL, Batista RFL, Silveira VNDC, Figueiredo KNDRS, Machado PMA, Borgatto AF, dos Santos AM. Assessment of the Brazilian Version of the Epworth Sleepiness Scale Using Item Response Theory: A Psychometric Study. Clocks Sleep 2023; 5:581-589. [PMID: 37873839 PMCID: PMC10594512 DOI: 10.3390/clockssleep5040038] [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: 07/22/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 10/25/2023] Open
Abstract
There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima's graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item 'Sitting still in a public place', the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item 'Sitting around talking to someone' presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.
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Affiliation(s)
- Cleber Lopes Campelo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
- Higher School of Health Sciences, State University of Amazonas, Manaus 69065-001, AM, Brazil
| | - Rosângela Fernandes Lucena Batista
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Victor Nogueira da Cruz Silveira
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Kely Nayara dos Reis Silva Figueiredo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Patrícia Maria Abreu Machado
- Department of Medicine I, Directorate of Technologies in Education, Federal University of Maranhão, São Luís 65020-240, MA, Brazil;
| | - Adriano Ferreti Borgatto
- Department of IT and Statistics, Postgraduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis 88040-970, SC, Brazil;
| | - Alcione Miranda dos Santos
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
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Costa EM, Pinho JRO, Saraiva MDCP, Ribeiro CCC, Batista RFL, Coêlho Alves CM, Simões VMF, Bettiol H, Barbieri MA, de Carvalho Cavalli R, Thomaz EBAF. RANTES and developmental defects of enamel in children: A Brazilian prenatal cohort (BRISA). PLoS One 2023; 18:e0284606. [PMID: 37498839 PMCID: PMC10374131 DOI: 10.1371/journal.pone.0284606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/04/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Little is known about the effect of maternal immunological factors on the etiology of developmental defects of enamel (DDE). RANTES (Regulated on Activation Normal T Cell Expressed and Secreted) is a chemokine produced by fibroblasts, lymphoid and epithelial mucosa cells in response to various external stimuli. Despite its importance for embryogenesis, RANTES expression has been demonstrated in multiple diseases characterized by inflammation, tumor and immune response, and wound healing. We hypothesized that altered levels of RANTES during pregnancy are associated with the immune and inflammatory response in women, which could lead to the occurrence of DDE in utero (DDE-iu), directly or mediated by preterm birth. Therefore, this study aimed to evaluate the direct and indirect effects of serum levels of RANTES in pregnant women in the occurrence of DDE-iu in children. METHODS This is a longitudinal case-control study. The mothers and their children (327) were evaluated in three moments: prenatal care, post childbirth, and when the child was between 12.3 and 36 months of age. The analysis was performed with structural equation modeling, estimating the standardized coefficient (SC), adopting α = 5%. RESULTS There was a direct and negative effect of RANTES on the outcome (SC = -0.137; p = 0.022). This association was not mediated by preterm birth (SC = 0.007; P = 0.551). When considering the specific types of DDE-iu, RANTES had a direct effect on hypoplasia (SC = -0.190; p = 0.007), but not on opacity (SC = 0.343; p = 0.074). CONCLUSION Lower serum levels of RANTES may contribute to a higher number of teeth with DDE-iu, specifically hypoplasia. However, more evidence supported by clinical, laboratory and epidemiological studies is still needed.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Cecília Cláudia Costa Ribeiro
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Cláudia Maria Coêlho Alves
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão, São Paulo, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
- Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Figueredo VSL, Monteiro DLM, Batista RFL, Gama MEA, Campos ASF, Pinto AGCF. Vertical transmission of HIV to neonates in a reference hospital in Northeastern Brazil from 2013 to 2017. Rev Inst Med Trop Sao Paulo 2023; 65:e34. [PMID: 37283409 DOI: 10.1590/s1678-9946202365034] [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: 11/01/2022] [Accepted: 04/06/2023] [Indexed: 06/08/2023] Open
Abstract
The aim of this study was to estimate the rate of Mother-to-child Transmission (MTCT) of HIV to neonates in a reference university hospital in Sao Luis city, the capital of Maranhao State (MA), evaluating MTCT-associated factors. A retrospective cohort study based on data from the Notifiable Diseases Data System (SINAN) was carried out and included all HIV-exposed neonates notified from 2013 to 2017 by the university hospital. The study population comprised 725 HIV-exposed neonates, of whom 672 neonates were exposed and uninfected, and 53 were exposed and infected. The estimated rate of MTCT in the period of 2013 to 2017 was 7.3%. Most pregnant women were ≥ 20 years old (86.9%), reported ≥ 8 years of schooling (53.2%), reported full-time or independent paid work (46.9%) and were residents in other cities of the state (61.7%). Regarding healthcare, 86.3% received prenatal care, 74.6% received Antiretroviral Therapy (ART) as prophylaxis during pregnancy, 81.8% received ART prophylaxis during childbirth and 78.1% underwent cesarean section. Among the neonates, 92.8% received ART prophylaxis and 94.3% were not breastfed. Despite these variables, the 7.3% MTCT rate found in this study makes it clear that the interventions recommended by the Ministry of Health were not fully adopted.
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Affiliation(s)
- Vaneça Santos Leal Figueredo
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Denise Leite Maia Monteiro
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Centro Universitário Serra dos Órgãos, Teresópolis, Rio de Janeiro, Brazil
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Confortin SC, Santos IDS, Batista RFL, Eckeli AL, Tovo-Rodrigues L, Del-Ponte B, Menezes AMB, Wehrmeister FC, Gonçalves H, Cardoso VC, Barbieri MA, Bettiol H, Silva AAMD. Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium. Rev Bras Epidemiol 2023; 26:e230027. [PMID: 37162069 PMCID: PMC10168628 DOI: 10.1590/1980-549720230027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 03/03/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics. METHODS Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex. RESULTS Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes. CONCLUSION Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Graduate Program in Collective Health - São Luís (MA), Brazil
| | - Iná da Silva Santos
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Luciana Tovo-Rodrigues
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Bianca Del-Ponte
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | | | - Helen Gonçalves
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Viviane Cunha Cardoso
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Marco Antonio Barbieri
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
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Rodrigues CB, Thomaz EBAF, Batista RFL, Riggirozzi P, Moreira DSDO, Gonçalves LLM, Lamy ZC. Prenatal care and human rights: Addressing the gap between medical and legal frameworks and the experience of women in Brazil. PLoS One 2023; 18:e0281581. [PMID: 36787329 PMCID: PMC9928028 DOI: 10.1371/journal.pone.0281581] [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] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/26/2023] [Indexed: 02/15/2023] Open
Abstract
Access to quality and affordable healthcare is central to the fulfilment of women's reproductive and sexual health needs and rights. For this reason, the World Health Organization declared access to appropriate healthcare services during pregnancy and childbirth a fundamental women's right. Prenatal care is a recognized human right to women's health in Brazil, as declared by the 1988 Constitution and many Brazilian policies. However, implementing the rights to health in Brazil presents a fundamental performance gap between legal rights and their delivery concerning reproductive health. Through extensive fieldwork including focus groups, interviews with women and participate observation in two municipalities in northeastern Brazil, this article addresses these issues and explores women's lived experience of access to and their fulfilment of the right to health regarding prenatal healthcare. We offer and account of the experience of women regarding what they identified as barriers that trample their right to health, that is: a) limited personnel and medical equipment as a perception of neglect; b) timely delivery of services: time matters for perception and experience of rights; c) misinformation as a barrier to the exercise of health rights; and d) socioeconomic barriers. These barriers particularly affect the right of women in rural communities, with lower socioeconomic levels and education, as well as brown and black women, from an intersectionality perspective, who are already at greater health risk and inadequate prenatal care. As such, we argue there is a performance gap between what the normative and legal frameworks encourage the health system to do and what the system actually provides in terms of access, equality, respect and continuity of treatment amongst certain groups in society whose right to health are denied while their health risks increase.
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Affiliation(s)
| | | | | | - Pía Riggirozzi
- Department of Politics and International Relations, University of Southampton, Southampton, United Kingdom
| | | | | | - Zeni Carvalho Lamy
- Department of Public Health and Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Gómez Aristizábal LY, Confortin SC, Batista RFL, de Britto e Alves MTSS, Simões VMF, da Silva AAM. Association between violence and depression during pregnancy with perinatal outcomes: a moderated mediation analysis. BMC Pregnancy Childbirth 2022; 22:801. [PMID: 36319959 PMCID: PMC9623969 DOI: 10.1186/s12884-022-05106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the direct, indirect, and total effects of violence during pregnancy on perinatal outcomes, and to evaluate the effect of violence as a moderator of the mediated relationship of depression with perinatal outcomes. METHODS Data was collected from the prenatal study and follow-ups of the BRISA cohort, São Luís, Maranhão, Brazil. The perinatal outcomes investigated were: birth weight (BW), intrauterine growth restriction (IUGR) and gestational age (GA). Violence against women was evaluated using the World Health Organization Violence against Women instrument (Violence during pregnancy - regardless of the type of violence; Physical violence during pregnancy; Psychological violence during pregnancy). Depressive symptoms during pregnancy were evaluated as a mediating variable. Moderated mediation analysis was performed to estimate the effects of violence and depression on perinatal outcomes. RESULTS Three types of violence analyzed by depression had an indirect effect in BW and GA. None of the types of violence showed an association with IUGR. All types of violence analyzed showed a moderated mediation effect with BW and GA. Only among women who experienced violence were birth weight and gestational age lower the higher the values of depressive symptoms. CONCLUSION Violence and depression are only associated with lower BW and GA when they occur simultaneously.
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Affiliation(s)
- Liliana Yanet Gómez Aristizábal
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Susana Cararo Confortin
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Rosângela Fernandes Lucena Batista
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | | | - Vanda Maria Ferreira Simões
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
| | - Antônio Augusto Moura da Silva
- grid.411204.20000 0001 2165 7632Graduate Program in Collective Health, Federal University of Maranhão, Rua Barão de Itapary, 155, MA 65020-070 São Luís, Brazil
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Confortin SC, Barbosa AR, de Oliveira BR, da Silva Magalhães EI, Bragança MLBM, de Britto E Alves MTSS, Levy RB, Batista RFL, de Almeida Fonseca Viola PC, da Silva AAM. The consumption of culinary preparations and ultra-processed food is associated with handgrip strength in teenagers. Nutr J 2022; 21:66. [PMID: 36273143 PMCID: PMC9587580 DOI: 10.1186/s12937-022-00818-5] [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: 10/25/2021] [Accepted: 09/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background A nutrient-poor and hypocaloric diet may be associated with lower handgrip strength (HGS), whereas a high-quality or balanced diet may be associated with higher HGS. However, no study has used the NOVA system for classifying food by their degree of processing. Objective To analyze the association between food consumption according to the degree of food processing and HGS in Brazilian teenagers. Methods This cross-sectional study included teenagers aged 18 and 19 years old from the 1997/98 São Luís’ birth cohort, Maranhão, Brazil. HGS (kilogram-force) was measured via a Jamar Plus + dynamometer. Food consumption was assessed using a semiquantitative food frequency questionnaire. The energy intake of culinary preparations (unprocessed or minimally processed food and processed culinary ingredients), processed, and ultra-processed foods was evaluated in percentages and categorized in tertiles. The associations between each food group intake and HGS was estimated via crude and adjusted linear regression models. A directed acyclic graph was used to identify confounding factors. Results We evaluated 2,433 teenagers, 52.1% of which were girls. For boys, adjusted analysis showed an association between the highest HGS and the 3rd tertile of culinary preparation consumption (β: 1.95; 95%CI: 0.80; 3.10) and between the lowest HGS and the 3rd tertile of ultra-processed food consumption (β: -2.25; 95%CI: -3.40; -1.10). Among girls, the consumption of culinary preparations in the 3rd tertile was associated with higher HGS (β: 0.76; 95%CI: 0.05; 1.46). Conclusions Higher consumption of culinary preparations and lower consumption of ultra-processed foods can contribute to reduce the chance of lower HGS in adult life. Interventions to promote the development and preservation of muscle strength should include dietary recommendations.
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Affiliation(s)
- Susana Cararo Confortin
- Collective Health Post-Graduate Program, Federal University of Maranhão, Rua Barão de Itapari, 155, 65020-905, São Luís, Maranhão, Brazil.
| | - Aline Rodrigues Barbosa
- School of Sports, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Bianca Rodrigues de Oliveira
- Collective Health Post-Graduate Program, Federal University of Maranhão, Rua Barão de Itapari, 155, 65020-905, São Luís, Maranhão, Brazil
| | - Elma Izze da Silva Magalhães
- Collective Health Post-Graduate Program, Federal University of Maranhão, Rua Barão de Itapari, 155, 65020-905, São Luís, Maranhão, Brazil
| | | | | | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rosângela Fernandes Lucena Batista
- Collective Health Post-Graduate Program, Federal University of Maranhão, Rua Barão de Itapari, 155, 65020-905, São Luís, Maranhão, Brazil
| | | | - Antônio Augusto Moura da Silva
- Collective Health Post-Graduate Program, Federal University of Maranhão, Rua Barão de Itapari, 155, 65020-905, São Luís, Maranhão, Brazil
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Confortin SC, Rocha PRH, Silva BGCD, Menezes AMB, Horta BL, Gonçalves H, Bettiol H, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Batista RFL, Cardoso VC, Silva ICMD, Silva AAMD. Physical activity in birth cohorts of three Brazilian cities (Ribeirão Preto, Pelotas, and São Luís): A cross-sectional study. Rev Bras Epidemiol 2022; 25:e220024. [PMID: 36074452 DOI: 10.1590/1980-549720220024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/19/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the prevalence of physical activity among subjects from birth cohorts of three cities located in different regions of Brazil according to sociodemographic characteristics and sex, comparing the relationships within and between cohorts. METHODS Cross-sectional study involving 12,724 adolescents and young adults who participated in five birth cohorts: Ribeirão Preto [1978/79 (37/39 years old in 2016) and 1994 (22 years in 2016)]; Pelotas [1982 (30 years in 2012) and 1993 (22 years in 2015)], and São Luís [1997/98 (18/19 years in 2016)]. Leisure-time physical activity was evaluated with questionnaires (insufficiently active: <150 min/week and active: ≥150 min/week) and moderate and vigorous physical activity (MVPA) was objectively measured by accelerometry. Those, in each city, were evaluated accordingly to skin color, socioeconomic classification, and study/work activities. RESULTS The prevalence of leisure-time physical activity ranged from 29.2% at 30 years old in Pelotas to 54.6% among adolescents from São Luís. The prevalence of leisure-time physical activity was higher among younger people (54.6% in São Luís 1997), while the same was not observed for total physical activity. MVPA (3rd tercile) was higher in the cohorts from Pelotas and São Luís. The prevalence of leisure-time physical activity and MVPA was higher in men. The data showed that the variation in physical activity was associated with sex and sociodemographic conditions in all cohorts. CONCLUSION Sociodemographic characteristics should be considered when promoting leisure-time physical activity and actions aimed at young people, and adults who are more socioeconomically vulnerable should be encouraged.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Collective Health Postgraduate Program - São Luís (MA), Brazil
| | | | | | | | - Bernardo Lessa Horta
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Helen Gonçalves
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
| | | | | | | | | | - Viviane Cunha Cardoso
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
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Confortin SC, Aristizábal LYG, da Silva Magalhães EI, Barbosa AR, Ribeiro CCC, Batista RFL, Silva AAMD. Association between sleep duration and cardiometabolic factors in adolescents. BMC Public Health 2022; 22:686. [PMID: 35395941 PMCID: PMC8991664 DOI: 10.1186/s12889-022-13119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background The sleep reduction can change healthy people's hemodynamic control and cardiovascular regulation through increased inflammatory response and altered endothelial function. The objective the study to analyze the association between sleep duration and cardiometabolic risk factors in adolescents in the birth cohort of São Luís (1997/98). Methods This is a cross-sectional study with adolescents participating in the birth cohort of São Luís (1997/98). Sleep duration was evaluated using accelerometer data (Actigraph wGT3X-BT). Glycemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides were considered cardiometabolic factors. The Directed Acyclic Graph (DAG) was used to identify the minimum set of adjustment for confounding. Results Out of 1,268 adolescents, 50.3% of them were male. The prevalence of sleep duration of less than 6 h per day was 31.1%. The mean glycemia value was 91.8 mg/dL (± 15.9), DBP was 71.3 mmHg (± 7.5), SBP was 114.9 mmHg (± 12.3), HDL was 48.5 mg/dL (± 11.6), LDL was 89.0 mg/dL (± 25.7), the total cholesterol was 156.0 mg/dL (± 31.1), and triglycerides was 93.6 mg/dL (± 47.2). The crude analysis showed an association between sleep duration and SBP and LDL-c. In the adjusted analysis, the associations did not remain. Conclusion Our study showed no association between sleep duration and cardiometabolic outcomes in adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13119-7.
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Affiliation(s)
- Susana Cararo Confortin
- Federal University of Maranhão, Collective Health Post-Graduate Program, São Luís, Maranhão, Brazil.
| | | | | | - Aline Rodrigues Barbosa
- School of Sports, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Confortin SC, Batista RFL, Barbosa AR, Wendt A, Crochemore-Silva I, Alves MTSSDBE, Simões VMF, Silva AAMD. Is sleep time associated with handgrip strength in adolescents from the 1997/1998 São Luís Birth Cohort? Cien Saude Colet 2022; 27:1147-1155. [PMID: 35293451 DOI: 10.1590/1413-81232022273.03132021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/17/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to analyze the association between sleep time and handgrip strength in adolescents belonging to the 1997/1998 São Luís Birth Cohort. This was a cross-sectional study nested in a birth cohort study. One thousand two hundred sixty-nine individuals (18 and 19 years) wore an Actigraph® GTX3+ accelerometer on their wrist 24 hr/day for 7 consecutive days. Handgrip strength was measured using a digital hand dynamometer. We used directed acyclic graphs (DAG) to identify confounding variables. This sample of adolescents was mostly composed of men, with brown skin color, economic class C, which did not work, did not consume alcohol, did not smoke, and never used drugs. The mean value of handgrip strength was 28.2 (±9.3) kgf, and the mean of sleep time was 6 (±1.0) hours per day. The crude analysis showed an association between sleep time and muscle strength. An increase of one hour of sleep reduced the handgrip strength by 1.95 kgf (95%CI:-2.51;-1.39). However, after adjustment for confounders, the association was not maintained (β:-0.07; 95%CI:-0.48;0.36). Sleep time is not associated with handgrip strength in adolescents in São Luís.
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Affiliation(s)
- Susana Cararo Confortin
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | - Rosângela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | | | - Andrea Wendt
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Inácio Crochemore-Silva
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | | | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
| | - Antônio Augusto Moura da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão. Rua Barão de Itapary 155 Centro 65020-070 São Luís MA Brasil.
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Dornelas ACVDR, Rodrigues LDS, Penteado MP, Batista RFL, Bettiol H, Cavalli RDC, Grandi C, Cardoso VC. Abuse, disrespect and mistreatment during childbirth care: contribution of the Ribeirão Preto cohorts, Brazil. Ciênc saúde coletiva 2022; 27:535-544. [DOI: 10.1590/1413-81232022272.01672021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
Abstract This study aimed to estimate the perception and frequency of abuse, disrespect and mistreatment (ADM) situations during childbirth care of 745 women from the Ribeirão Preto birt cohorts. Confidential questionnaires containing one question regarding perceived abuse during childbirth care and other questions addressing exposure to ADM situations were applied. The chi-squared test was used to compare the situations presented between women who did and did not report mistreatment using the Stata 14.0 software. Among the 745 women evaluated, 66.2% were exposed to some situation of ADM and 8.3% reported having perceived ADM. The most frequent situations were that the woman could not eat or drink (30.5%), the woman had her belly squeezed to help the child be born (27.5%), and the woman could not stay with a companion of her choice (25.5%). Women who reported to have suffered maltreatment more frequently responded positively to all situations of ADM when compared to the other participants, except for the following statements: “I was not allowed to eat or drink anything” (p = 0.975) and “I was forced to have a cesarean delivery against my will” (p = 0.073). Although most women of the Ribeirão Preto cohorts reported exposure to ADM situations during childbirth care, a minority perceived disrespect or mistreatment.
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Portela RDA, Silva JRS, Nunes FBBDF, Lopes MLH, Batista RFL, Silva ACO. Diabetes mellitus type 2: factors related to adherence to self-care. Rev Bras Enferm 2022; 75:e20210260. [DOI: 10.1590/0034-7167-2021-0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to analyze the sociodemographic and clinical variables related to the adherence to self-care activities in people with diabetes mellitus type 2. Methods: quantitative, cross-sectional study, carried out with 270 people with diabetes from December 2019 to October 2020, in São Luís, Maranhão. Results: the adherence to self-care was greater when it comes to medications (Md=7.0) and foot care (Md= 6.0), but lower in regard to blood sugar testing (Md=1.0), exercise (Md=2,0), and diet (general) (Md=4.0). The variables age group (p=0.007), educational level (p=0.015), body mass index (p=0.035), complications with diabetes (p=0.009), and nutritional follow-up (p=0.000) had associations with self-care activities. Conclusions: identifying the factors related to the adherence to self-care was found to be essential to strengthen the line of care in chronic diseases and to direct educational actions, aiming to improve the quality of life of people with diabetes.
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Santana KDGFP, Confortin SC, Bragança MLBM, Batista RFL, Santos IDSD, Silva AAMD. Associações entre duração de sono e índices de massa gorda, muscular e corporal em adolescentes de São Luís, Maranhão, Brasil. CAD SAUDE PUBLICA 2022; 38:e00078721. [DOI: 10.1590/0102-311x00078721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022] Open
Abstract
O objetivo do estudo foi avaliar a associação entre duração de sono e composição corporal em adolescentes. Estudo transversal, com 1.269 adolescentes de 18 e 19 anos da coorte de nascimentos de 1997/1998 de São Luís, Maranhão, Brasil. A duração do sono foi avaliada a partir dos dados registrados por acelerometria. A composição corporal foi avaliada pelo o índice de massa gorda (IMG), índice de massa muscular (IMM) e índice de massa corporal (IMC). Os fatores de confusão foram identificados em gráfico acíclico direcionado no programa DAGitty 3.0. Foram realizadas análises descritivas para todas as variáveis e, posteriormente, regressão linear, com estimativa dos coeficientes de regressão brutos e ajustados, com os respectivos intervalos de 95% de confiança (IC95%). Nos adolescentes do sexo masculino, cada hora a mais de sono associou-se a reduções de 0,30kg/m2 do IMM (IC95%: -0,45; -0,15), de 0,26kg/m2 do IMG (IC95%: -0,48; -0,03) e 0,61kg/m2 do IMC (IC95%: -0,93; -0,30). Nas adolescentes, cada hora a mais de sono associou-se à redução de 0,22kg/m2 do IMM (IC95%: -0,36; -0,07). A maior duração do sono associou-se a menor IMM em ambos os sexos e menor IMG e IMC no sexo masculino, o que evidencia a importância de ter adequadas horas de sono para melhorar os índices de composição corporal.
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Pinto DAS, Nascimento JXPT, Padilha LL, da Conceição SIO, França AKTDC, Simões VMF, Batista RFL, Barbieri MA, Ribeiro CCC. High sugar content and body mass index: modelling pathways around the first 1000 d of life, BRISA cohort. Public Health Nutr 2021; 24:4997-5005. [PMID: 33517949 PMCID: PMC11082806 DOI: 10.1017/s136898002000525x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life. DESIGN BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life. SETTING A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling. PARTICIPANTS Data of pregnant women (n 1136) and their offspring. RESULTS Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time. CONCLUSIONS Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life.
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Affiliation(s)
- Dâmaris Alves Silva Pinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary–Centro, São Luís, MA 65020-070, Brasil
| | | | - Luana Lopes Padilha
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary–Centro, São Luís, MA 65020-070, Brasil
| | | | | | - Vanda Maria Ferreira Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary–Centro, São Luís, MA 65020-070, Brasil
| | - Rosângela Fernandes Lucena Batista
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary–Centro, São Luís, MA 65020-070, Brasil
| | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Cecilia Claudia Costa Ribeiro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Maranhão, 155 Barão de Itapary–Centro, São Luís, MA 65020-070, Brasil
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Silva Junior JF, Eckeli AL, Ribeiro CCC, Batista RFL, da Silva AAM, Alves CMC. Influence of excessive daily sleeping and sleep quality on BDNF and NGF serum levels in adolescents. Sleep Med 2021; 84:415-423. [PMID: 34329829 DOI: 10.1016/j.sleep.2021.06.024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The brain-derived neurotrophic factor (BDNF) and neural growth factor (NGF) are widely expressed in the brain and play an important role in neuroplasticity, neurogenesis, and increased neuronal connections. Previous studies have shown that reduced serum levels of these proteins are associated with disorders in human sleep. OBJECTIVE Current study evaluates the prevalence in adolescents of excessive daytime sleepiness (EDS) and sleep quality, and analyzes the influence of these factors on BDNF and NGF serum levels. METHODS A cross-section population-based study was conducted with data from a Brazilian birth cohort, with a sample of five hundred and thirteen 18-19-year-old adolescents. Sleep quality was assessed by the Pittsburgh Sleep Quality Index and EDS by Epworth Sleepiness Scale. Neurotrophins serum levels were measured by Luminex™ technology kits. Analysis consisted of marginal structural models which compared people who were exposed and not exposed to sleep quality and EDS. RESULTS Poor sleep quality and EDS were detected in 62.57% and 36.35% of the sample. Adolescents with poor sleep quality and EDS had -0.39 (p-value = 0.049) and -0.51 pg/ml in NGF (p-value = 0.009). Individuals with self-reported sleep disorder had lower serum levels of NGF (Coef. -0.41, p-value = 0.045). CONCLUSION High prevalence of EDS and low sleep quality in a population of adolescents were evidenced. Poor sleep quality and EDS were associated with lower NGF levels, whilst adolescents with self-reported sleep disorder had lower serum levels of NGF.
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Affiliation(s)
| | - Alan Luiz Eckeli
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Machado PMA, Campelo CL, de Oliveira JVP, Batista RFL, Simões VMF, dos Santos AM. Analysis of the AUDIT factor structure in adolescents between 18 and 19 years. Rev Saude Publica 2021; 55:27. [PMID: 34037139 PMCID: PMC8139847 DOI: 10.11606/s1518-8787.2021055002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years. METHODS Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, "was injured or someone else was injured due to drinking." Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments. CONCLUSION The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol.
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Affiliation(s)
- Patrícia Maria Abreu Machado
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Ciências da SaúdeSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Ciências da Saúde. São Luís, MA. Brasil
| | - Cleber Lopes Campelo
- Universidade Federal do MaranhãoPrograma de Pós-Graduação em Saúde ColetivaSão LuísMABrasilUniversidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil
| | - João Victor Pimentel de Oliveira
- Universidade Federal do MaranhãoFaculdade de MedicinaSão LuísMABrasilUniversidade Federal do Maranhão. Faculdade de Medicina. São Luís, MA, Brasil
| | - Rosângela Fernandes Lucena Batista
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhãoDepartamento de Saúde PúblicaSão LuísMABrasilUniversidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil
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Confortin SC, Ribeiro MRC, Barros AJD, Menezes AMB, Horta BL, Victora CG, Barros FC, Gonçalves H, Bettiol H, Santos ISD, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Silveira MFD, Domingues MR, Lima NP, Rocha PRH, Cavalli RC, Batista RFL, Cardoso VC, Simões VMF, Silva AAMD. RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. CAD SAUDE PUBLICA 2021; 37:e00093320. [PMID: 33950086 DOI: 10.1590/0102-311x00093320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/20/2020] [Indexed: 01/11/2023] Open
Abstract
This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.
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Cavalcante TB, Ribeiro MRC, Sousa PDS, Costa EDPF, Alves MTSSDBE, Simões VMF, Batista RFL, Takahasi EHM, Amaral GA, Khouri R, Branco MDRFC, Mendes AKT, Costa LC, Campos MAG, Silva AAMD. Congenital Zika syndrome: Growth, clinical, and motor development outcomes up to 36 months of age and differences according to microcephaly at birth. Int J Infect Dis 2021; 105:399-408. [PMID: 33610784 DOI: 10.1016/j.ijid.2021.02.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Little is known regarding the developmental consequences of congenital Zika syndrome (CZS) without microcephaly at birth. Most previously published clinical series were descriptive and they had small sample sizes. STUDY DESIGN We conducted a cohort study to compare the growth, clinical, and motor development outcomes for 110 children with CZS born with and without microcephaly up to their third birthday. Ninety-three had their head circumference (HC) at birth abstracted and they did not have hypertensive hydrocephalus at birth, where 61 were born with microcephaly and 32 without. RESULTS The HC z-scores decreased steeply from birth to six months of age, i.e., from -3.77 to -6.39 among those with microcephaly at birth and from -1.03 to -3.84 among those without. Thus, at 6 months of age, the mean HC z-scores for children born without microcephaly were nearly the same as those for children born with microcephaly. Children born without microcephaly were less likely to have brain damage, ophthalmic abnormalities, and drug-resistant epilepsy, but the differences in many conditions were not statistically significant. CONCLUSIONS Children born without microcephaly were only slightly less likely to present severe neurologic impairment and to develop postnatal-onset microcephaly, and some of the original differences between the groups tended to dissipate with age.
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Affiliation(s)
| | | | - Patrícia da Silva Sousa
- Reference Center on Neurodevelopment, Assistance and Rehabilitation of Children/NINAR - Health Secretariat of the State of Maranhão, São Luís, Maranhão, Brazil
| | | | | | | | | | - Eliana Harumi Morioka Takahasi
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil; Sarah Network of Neurorehabilitation Hospitals, São Luís, Maranhão, Brazil
| | | | - Ricardo Khouri
- Laboratory of Vector-Borne Infectious Diseases, Gonçalo Moniz Institute, Fiocruz-Bahia, and Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
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Bernardo FMM, Veiga ECA, Quintana SM, Camayo FJA, Batista RFL, Alves MTSSB, Bettiol H, Barbieri MA, Cardoso VC, Cavalli RC. Association of genitourinary infections and cervical length with preterm childbirth. ACTA ACUST UNITED AC 2020; 54:e10235. [PMID: 33338099 PMCID: PMC7747871 DOI: 10.1590/1414-431x202010235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/28/2020] [Indexed: 11/21/2022]
Abstract
A prospective cohort study was conducted on a convenience sample of 1370 pregnant
women with a gestational age of 20 to 25 weeks in the city of Ribeirão Preto.
Data on obstetrical history, maternal age, parity, smoking habit, and a history
of preterm delivery was collected with the application of a sociodemographic
questionnaire. Cervical length was determined by endovaginal ultrasound, and
urine and vaginal content samples were obtained to determine urinary tract
infection (UTI) and bacterial vaginosis (BV), respectively. The aim of this
study was to verify the association of cervical length and genitourinary
infections with preterm birth (PTB). Ultrasound showed no association of UTI or
BV with short cervical length. PTB rate was 9.63%. Among the women with PTB, 15
showed UTI (RR: 1.55, 95%CI: 0.93–2.58), 19 had BV (RR: 1.22, 95%CI: 0.77–1.94),
and one had both UTI and BV (RR: 0.85, 95%CI: 0.13–5.62). Nineteen (14.4%) PTB
occurred in women with a cervical length ≤2.5 cm (RR: 2.89, 95%CI: 1.89–4.43).
Among the 75 patients with PTB stratified as spontaneous, 10 showed UTI (RR:
2.02, 95%CI: 1.05–3.86) and 14 had a diagnosis of BV (RR: 1.72, 95%CI:
0.97–3.04). A short cervical length between 20 and 25 weeks of pregnancy was
associated with PTB, whereas UTI and BV determined at this age were not
associated with short cervical length or with PTB, although UTI, even if
asymptomatic, was related to spontaneous PTB.
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Affiliation(s)
- F M M Bernardo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E C A Veiga
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - S M Quintana
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F J A Camayo
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - M T S S B Alves
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Negrão MEA, Rocha PRH, Saraiva MCP, Barbieri MA, Simões VMF, Batista RFL, Ferraro AA, Bettiol H. Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort. ACTA ACUST UNITED AC 2020; 54:10252-0. [PMID: 33338100 PMCID: PMC7780373 DOI: 10.1590/1414-431x202010252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/28/2020] [Indexed: 01/13/2023]
Abstract
Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities.
However, little is currently known about the association of the separate or
concomitant use of alcohol and tobacco with infant motor and cognitive
development. Thus, the objective of the present study was to investigate the
association between maternal consumption of alcohol and/or tobacco during
pregnancy and the motor and cognitive development of children starting from the
second year of life. The study included 1006 children of a cohort started during
the prenatal period (22-25 weeks of pregnancy), evaluated at birth and
reevaluated during the second year of life in 2011/2013. The children were
divided into four groups according to the alcohol and/or tobacco consumption
reported by their mothers at childbirth: no consumption (NC), separate alcohol
consumption (AC), separate tobacco consumption (TC), and concomitant use of both
(ACTC). The Bayley Scale of Infant and Toddler Development Third Edition
screening tool was used for the assessment of motor and cognitive development.
Adjusted Poisson regression models were used to determine the association
between groups and delayed development. The results indicated that only the ACTC
group showed a higher risk of motor delay, specifically regarding fine motor
skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol
or tobacco consumption was not associated with delayed gross motor or cognitive
development. However, the concomitant use of the two substances increased the
risk of delayed acquisition of fine motor skills.
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Affiliation(s)
- M E A Negrão
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P R H Rocha
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M C P Saraiva
- Departamento de Clínica Infantil, Faculdade de Odontologia Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M A Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A Ferraro
- Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - H Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Trombe KSD, Rodrigues LS, Nascente LMP, Simões VMF, Batista RFL, Cavalli RC, Grandi C, Cardoso VC. Is birth weight associated with pregestational maternal BMI? BRISA Cohort, Ribeirão Preto, Brazil. ACTA ACUST UNITED AC 2020; 54:e10037. [PMID: 33295534 PMCID: PMC7727099 DOI: 10.1590/1414-431x202010037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 10/09/2020] [Indexed: 01/01/2023]
Abstract
Given the increase of women with excess weight or obesity and its possible effects on birth weight, the present study aimed to investigate the association between pregestational maternal body mass index (BMI) and birth weight in a birth cohort from Ribeirão Preto, SP, Brazil. This was a prospective study conducted on 1362 mother-child pairs involving singleton births. The women were evaluated using standardized questionnaires during the second trimester of pregnancy and at the time of childbirth. Information about the newborns was obtained from their medical records. The dependent variable was birth weight, categorized as low, adequate, or high. The independent variable was pregestational maternal BMI, categorized as malnutrition, adequate weight, overweight, and obesity. A multinomial regression model was used to estimate the crude and adjusted relative risk (RR) of low and high birth weight. A high frequency of pregestational excess weight (39.6%) was detected and found to be independently associated with high birth weight (RR=2.13, 95%CI: 1.19-3.80 for overweight and RR=3.34, 95%CI: 1.80-6.19 for obese pregnant women). There was no association between pregestational malnutrition and low birth weight (RR=1.70; 95%CI: 0.81-3.55). The present data showed a high rate of women with excess pregestational weight, supporting the hypothesis that pregestational BMI may contribute to high birth weight babies and indicating the need for actions aiming to prevent excessive weight in women at reproductive age.
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Affiliation(s)
- K S D Trombe
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L S Rodrigues
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - L M P Nascente
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R C Cavalli
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C Grandi
- Research Committee, Argentine Society of Pediatrics, Buenos Aires, Argentina
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Soares Filho LC, Batista RFL, Cardoso VC, Simões VMF, Santos AM, Coelho SJDDAC, Silva AAM. Body image dissatisfaction and symptoms of depression disorder in adolescents. ACTA ACUST UNITED AC 2020; 54:e10397. [PMID: 33295537 PMCID: PMC7727113 DOI: 10.1590/1414-431x202010397] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/10/2020] [Indexed: 01/18/2023]
Abstract
The objective of this study was to evaluate the effect of body image dissatisfaction on symptoms of depressive disorder in adolescents. This is a cross-sectional study that included 2,162 adolescents ages 18-19 born in São Luís, Maranhão, Brazil, which was part of the joint RPS cohort (Brazilian birth cohorts of Ribeirão Preto-SP, Pelotas-RS, and São Luís-MA). Socioeconomic characteristics, nutritional status, mental health, and body image characteristics were evaluated. Body image was assessed by Stunkard’s silhouettes scale. The presence of symptoms indicative of depressive disorder was investigated through a diagnostic interview MINI (Mini International Neuropsychiatric Interview). A theoretical model was built in a Directed Acyclic Graph (DAG) in order to investigate the relationship between the variables of the study. The relationship was estimated weighting the inverse probability of selection for the variables of adjustment: sex and nutritional status. Among the dissatisfied adolescents due to overweight, 66.54% were girls, 32.85% were overweight, and 11.99% were obese (P<0.01). There was a significant association between dissatisfaction due to overweight and symptoms of depressive disorder (P=0.01), and there was no evidence of the same association with dissatisfaction due to thinness. Therefore, only dissatisfaction due to overweight was associated with the symptoms of depressive disorder in the evaluated adolescents.
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Affiliation(s)
- L C Soares Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A M Santos
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - S J D D A C Coelho
- Departamento de Medicina I, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - A A M Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
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Rodrigues IC, Grandi C, Simões VMF, Batista RFL, Rodrigues LS, Cardoso VC. Metabolic profile during pregnancy in BRISA birth cohorts of Ribeirão Preto and São Luís, Brazil. ACTA ACUST UNITED AC 2020; 54:e10253. [PMID: 33295536 PMCID: PMC7727101 DOI: 10.1590/1414-431x202010253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
During pregnancy, metabolic changes that develop in women may increase the risk of diseases and conditions that may also harm the life of the growing fetus. The aim of the present study was to identify and compare the metabolic profile (MP) during pregnancy in two birth cohorts in 2010 in the cities of Ribeirão Preto (RP) and São Luís (SL), Brazil. Pregnant women (1393 in RP and 1413 in SL) were studied; information was obtained through questionnaires in addition to anthropometric, biochemical, and blood pressure measurements. Data are presented as means and proportions. To compare the characteristics of pregnant women in both cities, chi-squared and Student's t-tests were applied, with 5% significance level. Ribeirão Preto presented higher mean values than SL for pre-gestational body mass index (24.5 vs 23 kg/m2, P<0.001), systolic (108.4 vs 102.8 mmHg, P<0.001) and diastolic (65.9 vs 61.8 mmHg, P<0.001) blood pressure, total cholesterol (226.3 vs 213.7 mg/dL, P<0.001) and fractions, and glycemia (84.5 vs 80.2 mg/dL, P<0.001), except for triglycerides (P=0.135). Women from RP also showed higher rates of pre-gestational overweight and obesity compared with SL (40.1 vs 25.8%). In the present study, pregnant women in RP had a worse gestational metabolic profile than those in SL, with higher pre-gestational excess weight, indicating that nutritional transition was more advanced in the more developed city.
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Affiliation(s)
- I C Rodrigues
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C Grandi
- Argentine Society of Pediatrics, Buenos Aires, Argentina
| | - V M F Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - R F L Batista
- Departamento de Saúde Pública, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - L S Rodrigues
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - V C Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Lima RJCP, Batista RFL, Ribeiro CCC, Simões VMF, Lima Neto PM, Bettiol H, Silva AAMD. Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís - MA. Rev Saude Publica 2020; 54:113. [PMID: 33237171 PMCID: PMC7664845 DOI: 10.11606/s1518-8787.2020054002229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the effects of early determinants on adolescent fat-free mass. METHODS A cohort study with 579 adolescents evaluated at birth and adolescence in a birth cohort in São Luís, Maranhão. In the proposed model, estimated by structural equation modeling, socioeconomic status (SES) at birth, maternal age, pregestational body mass index (BMI), gestational smoking, gestational weight gain, type of delivery, gestational age, sex of the newborn, length and weight at birth, adolescent socioeconomic status, "neither study/nor work" generation, adolescent physical activity level and alcohol consumption were tested as early determinants of adolescent fat-free mass (FFM). RESULTS A higher pregestational BMI resulted in higher FFM in adolescence (Standardized Coefficient, SC = 0.152; p < 0.001). Being female implied a lower FFM in adolescence (SC = -0.633; p < 0.001). The negative effect of gender on FFM was direct (SC = -0.523; p < 0.001), but there was an indirect negative effect via physical activity level (SC = -0.085; p < 0.001). Women were less active (p < 0.001). An increase of 0.5 kg (1 Standard Deviation, SD) in birth weight led to a gain of 0.25 kg/m2 (0.106 SD) in adolescent FFM index (p = 0.034). Not studying or working had a negative effect on the adolescent's FFM (SC = -0.106; p = 0.015). Elevation of 1 SD in the adolescent's physical activity level represented an increase of 0.5 kg/m2 (0.207 SD) in FFM index (p < 0.001). CONCLUSIONS The early determinants with the greatest effects on adolescent FFM are gender, adolescent physical activity level, pregestational BMI, birth weight and belonging to the "neither-nor" generation.
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Affiliation(s)
| | | | - Cecília Claudia Costa Ribeiro
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Odontologia II. São Luís, MA, Brasil
| | - Vanda Maria Ferreira Simões
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
| | - Pedro Martins Lima Neto
- Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil
| | - Heloisa Bettiol
- Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Puericultura e Pediatria. Ribeirão Preto, SP, Brasil
| | - Antônio Augusto Moura da Silva
- Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil
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Mendes AKT, Ribeiro MRC, Lamy-Filho F, Amaral GA, Borges MCR, Costa LC, Cavalcante TB, Batista RFL, Sousa PDS, Silva AAMD. Congenital Zika syndrome: association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth. Rev Inst Med Trop Sao Paulo 2020; 62:e56. [PMID: 32844907 PMCID: PMC7447234 DOI: 10.1590/s1678-9946202062056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 12/25/2022] Open
Abstract
This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1st trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1st trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.
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Affiliation(s)
| | | | - Fernando Lamy-Filho
- Departamento de Medicina III, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | | | | | | | | | | | - Patrícia da Silva Sousa
- Centro de Referência em Neurodesenvolvimento, Assistência e Reabilitação de Crianças, Secretaria de Saúde do Estado do Maranhão, São Luís, Maranhão, Brazil
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Lima JFB, Silva RAR, D'Eça Júnior A, Batista RFL, Rolim ILTP. Analysis of the mortality trend in the indigenous population of Brazil, 2000-2016. Public Health 2020; 186:87-94. [PMID: 32791342 DOI: 10.1016/j.puhe.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The objective of the study is to analyze the mortality trend in indigenous peoples in Brazil. STUDY DESIGN The study design used is an ecological study. METHODS A study carried out with data from the indigenous deaths recorded on the Mortality Information System in Brazil between 2000 and 2016. The Prais Winsten regression was used to analyze the trend of overall mortality in the country and in its geopolitical regions, in addition to the trend by sex, age groups, and groups of basic causes of death. RESULTS Of all deaths, 47,806 indigenous deaths were recorded between 2000 and 2016. The majority was male (56.5%) and 27.2% in children aged younger than 5 years. The major groups of causes of death were the circulatory diseases (15.8%) and external causes (14.9%). The affections of the perinatal period (23.7%) and infectious and parasitic diseases (18.5%) were the main causes in children aged younger than 5 years. The indigenous mortality rates showed an increasing trend in the country (annual percent change [APC] = 2.37%). There was growth in both sexes and in most age ranges. Mortality from external causes (APC = 4.71%), neoplasms (APC = 4.67%), and respiratory causes (APC = 4.14%) also presented growth. The infectious and parasitic causes and genitourinary causes showed a stable trend in the studied period. CONCLUSIONS The increasing trend of mortality in the analyzed variables showed disparities between indigenous and non-indigenous peoples in Brazil, pointing to the need for greater investment in basic social sectors, such as health, education, housing, and sanitation.
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Affiliation(s)
- J F B Lima
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | - R A R Silva
- Department of Nursing, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - A D'Eça Júnior
- Department of Nursing, Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | - R F L Batista
- Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | - I L T P Rolim
- Department of Nursing, Federal University of Maranhão, São Luís, Maranhão, Brazil.
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Barbosa SMML, Batista RFL, Rodrigues LDS, Bragança MLBM, Oliveira BRD, Simões VMF, Eckeli AL, Silva AAMD. Prevalence of excessive daytime sleepiness and associated factors in adolescents of the RPS cohort, in São Luís (MA), Brazil. Rev Bras Epidemiol 2020; 23:e200071. [PMID: 32667465 DOI: 10.1590/1980-549720200071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 10/31/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To estimate the prevalence and factors associated with excessive daytime sleepiness (EDS) in adolescents from the São Luís, Maranhão birth cohort. METHOD Cross-sectional study conducted with 2,514 adolescents aged 18 and 19 years old. A hierarchical approach was used, and prevalence ratios were calculated using Poisson regression with robust variance adjustment. Sociodemographic characteristics (gender, race, economic class, and occupation), lifestyle (leisure activities, smoking, alcohol, illicit drug use, coffee and energy consumption, physical activity, body adiposity, screen time, and depression), and factors related to sleep were studied. RESULTS The prevalence of EDS was 36.8%. The female gender (PR = 1.33; 95%CI 1.19 - 1.49), high risk for alcohol consumption (PR = 1.26; 95%CI 1.09 - 1.46), current major depressive episode (PR = 1.26; 95%CI 1.08 - 1.46), sleep alteration score from 10 to 18 (PR = 1.43; 95%CI 1.10 - 1.85), and sleep score from 5 to 7 of daytime dysfunction (PR = 2.51; 95%CI 2.06 - 3.07) were risk factors for EDS. Economic class D/E was a protective factor for EDS (PR = 0.47; 95%CI 0.27 - 0.85). CONCLUSION More than one-third of adolescents had EDS. Adolescents at higher risk need to improve their sleeping habits and lifestyle so that they no longer have EDS and can improve their quality of life.
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Affiliation(s)
| | | | | | | | | | | | - Alan Luiz Eckeli
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Ribeiro MRC, Pessoa BPT, Sauaia GA, Schraiber LB, Queiroz RCDS, Batista RFL, Cruz JADS, Silva AAMD. Violence against women before and during gestation: differences in prevalence rates and perpetrators. Rev Bras Saude Mater Infant 2020. [DOI: 10.1590/1806-93042020000200010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze differences in prevalence and perpetrators of violence against women before and during pregnancy. Methods: this is a cross-sectional study with a sample of 1,446 pregnant women interviewed in 2010 and 2011 in the São Luís municipality (Brazil). Thirteen questions measured psychological, physical and sexual violence in the 12 months before and during pregnancy. Psychological/physical/sexual violence was defined as any type of violence perpetrated against the interviewees. The perpetrators were categorized into intimate partner, other family members, community members, and multiple perpetrators. Differences between violence before and during pregnancy were analyzed by the chi-square test. Results: psychological/physical/sexual and psychological violence were more prevalent during pregnancy than before gestation (p<0.001). Insults, humiliation and intimidation (p<0.05) were more frequently reported during pregnancy. An intimate partner was the most frequent perpetrator. There were no differences in the percentage of moderate and severe forms of physical violence and sexual violence, recurrence of aggressions and perpetrators in both periods (p>0.05). Conclusions: gestation did not protect users of prenatal services in São Luís municipality from psychological, physical and sexual violence. Psychological/physical/sexual and psychological violence were more commonly practiced during pregnancy. The perpetrators of violence in the year before gestation continued to abuse the interviewees during pregnancy
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Simões VMF, Batista RFL, Alves MTSSDBE, Ribeiro CCC, Thomaz EBAF, Carvalho CAD, Silva AAMD. Saúde dos adolescentes da coorte de nascimentos de São Luís, Maranhão, Brasil, 1997/1998. CAD SAUDE PUBLICA 2020; 36:e00164519. [DOI: 10.1590/0102-311x00164519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/06/2019] [Indexed: 12/28/2022] Open
Abstract
Resumo: O objetivo foi estimar a prevalência de indicadores de saúde de adolescentes em São Luís, Maranhão, Brasil, em 2016. Foram estudadas condições sociodemográficas, hábitos de vida, composição corporal, qualidade do sono, atividade física, habilidade cognitiva e risco de suicídio de 2.515 adolescentes com 18 e 19 anos. Os adolescentes pertencem à coorte de nascimento 1997/1998 ou foram incluídos, retrospectivamente, utilizando-se o banco do SINASC (Sistema de Informações sobre Nascidos Vivos). Os adolescentes eram, principalmente, da classe econômica C (50,1%), 69,5% estudavam, 40,3% trabalhavam e 25,2% não estudavam nem trabalhavam; 60,3% já foram vítimas de assalto e 48,7% tinham pais separados. Apresentaram padrão de consumo nocivo, excessivo ou provável dependência de álcool 19,4%, 19,1% usaram ou estavam usando drogas ilícitas, 53,7% tinham qualidade de sono ruim, 40,8% referiram dor de cabeça frequente, 34,3% declararam tempo de tela por dia maior que cinco horas e 4,1% apresentaram alto risco para suicídio. A prevalência de hipertensão arterial foi de 12% e de obesidade, 6%. As meninas eram mais inativas (80,7%) e apresentaram maior percentual de gordura corporal alto (15,8%) e muito alto (21,5%), já os meninos tiveram maior prevalência de hipertensão arterial (21,2%) e menor prevalência de inatividade física (40,9%). As elevadas prevalências de fatores de risco à saúde aumentam a vulnerabilidade dos adolescentes, expondo estes indivíduos precocemente a fatores que levam ao acometimento cada vez mais cedo de doenças e agravos à saúde.
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Maia JLB, Batista RFL, Rosa MB, Silva FM, Araújo HAWP, Carvalho AA, Carneiro SCDS. IDENTIFICATION OF RISKS AND PRACTICES IN THE USE OF HIGH ALERT MEDICATIONS IN A
UNIVERSITY HOSPITAL. Reme Revista Mineira de Enfermagem 2020. [DOI: 10.5935/1415-2762.20200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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D’Eça Júnior A, Rodrigues LDS, Meneses Filho EP, Costa LDLN, Rêgo ADS, Costa LC, Batista RFL. Mortalidade por suicídio na população brasileira, 1996-2015: qual é a tendência predominante? ACTA ACUST UNITED AC 2019. [DOI: 10.1590/1414-462x201900010211] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resumo Introdução O suicídio é uma das três causas de morte mais frequentes no mundo e varia conforme o sexo e a idade. Objetivo Analisar a tendência da mortalidade por suicídio nas regiões brasileiras no período de 1996 a 2015 e sua associação com o sexo e a faixa etária. Método Estudo ecológico de série temporal, utilizando os óbitos por suicídio analisados por regiões no período de 1996 a 2015 contidos no Sistema de Informações sobre Mortalidade. Para avaliação da tendência da mortalidade por suicídio, foi considerado o modelo de regressão de Prais-Winsten. Para comparar os percentuais de mortalidade por sexo e faixa etária, foi utilizado o teste qui-quadrado. Resultados Observou-se tendência crescente de óbitos por suicídio nas regiões Norte (1,73%, Coef = 0,007; p-valor < 0,001), Nordeste (2,30%, Coef = 0,010; p-valor = 0,006) e Sudeste (1,41%, Coef = 0,006; p-valor < 0,001) e decrescente no Sul (-0,57%, Coef = -0,002; p-valor = 0,001), além de predomínio de homens no percentual de óbitos (p < 0,001). Conclusão O suicídio é considerado importante problema de saúde pública, necessitando de ações para divulgação dos riscos e programas de prevenção.
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Ribeiro SVO, Batista RFL, Ribeiro MRC, Pessoa KC, Simões VMF, Figueiredo FPD, Bettiol H. Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach. Rev Bras Saude Mater Infant 2019. [DOI: 10.1590/1806-93042019000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze associations among violence against pregnant women, depressive symptoms during pregnancy and maternal depression symptoms. Methods: a sample of 1,139 mothers was conducted on a prenatal cohort study in the municipality of São Luís in Brazil. Psychological and physical violence against pregnant women were measured by the World Health Organization Violence Against Woman. Depressive symptoms during pregnancy were measured by the Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) (Depression Scale for Epidemiological Studies Center) and maternal depression symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS). The conceptual model of the structural equation modeling contained socioeconomic situation, social support, psychological and physical violence and depression during pregnancy as determinants of the maternal depression symptoms. Results: maternal depression symptoms were more frequently reported by pregnant women who suffered psychological violence (Standardized Coefficient, SC=0.256; p-value, p<0.001), physical violence (SC=0.221 p<0.001) and those who presented depressive symptoms during pregnancy SC=0.322, p<0.001). Depressive symptoms during pregnancy mediated the effects on physical and psychological violence on maternal depression. Conclusions: pregnant women who were submitted to psychological and physical violence and presented depressive symptoms during pregnancy frequently reported more of having maternal depression symptoms.
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Moraes LMVD, Simões VMF, Carvalho CDA, Batista RFL, Alves MTSSDBE, Thomaz ÉBAF, Barbieri MA, Alves CMC. [Factors associated with the involuntary pilgrimage for childbirth care in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil: a contribution from the BRISA cohort]. CAD SAUDE PUBLICA 2018; 34:e00151217. [PMID: 30427413 DOI: 10.1590/0102-311x00151217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
Abstract
The objectives of this study were to estimate the involuntary pilgrimage by women in labor in search of childbirth care and to identify factors associated with this endeavor in two Brazilian cities. This was a cross-sectional study nested in the BRISA birth cohort, whose sample consisted of 10,475 women admitted to the selected maternity hospitals for delivery in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State). Interviews were held with questionnaires that contained sociodemographic and obstetric variables. Hierarchical modeling was used, and relative risk was calculated with Poisson regression. Involuntary pilgrimage during labor was more frequent in São Luís (35.8%) than in Ribeirão Preto (5.8%). In São Luís, factors associated with pilgrimage were: first pregnancy (RR = 1.19; 95%CI: 1.08-1.31) and schooling less than 12 complete years. However, age 35 years or older (RR = 0.65; 95%CI: 0.54-0.84) was associated with less pilgrimage. In Ribeirão Preto, such trekking for obstetric care was more frequent in women with high-risk pregnancies (RR = 2.45; 95%CI: 1.81-3.32) and those with gestational age less than 37 weeks (RR = 1.93; 95%CI: 1.50-2.50). Meanwhile, delivery with gestational age equal to or greater than 42 weeks was associated with less pilgrimage (RR = 0.57; 95%CI: 0.33-0.98). In both cities, poor women had to trek more in search of childbirth care and had no guarantee of care, even for those who had received prenatal care. The study revealed the lack of guarantee of universal and equitable access and highlighted the unequal access to childbirth care between Brazil's major geographic regions.
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Lima RJCP, Batista RFL, Ribeiro MRC, Ribeiro CCC, Simões VMF, Lima Neto PM, Silva AAMD, Bettiol H. Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort. Rev Saude Publica 2018; 52:46. [PMID: 29723385 PMCID: PMC5947505 DOI: 10.11606/s1518-8787.2018052000125] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/12/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001). A 6 kg increase (1 SD) in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001). The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001), but the negative indirect effect was small (SC = -0.076, p < 0.001) and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001). The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001), with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001). Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001). CONCLUSIONS The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.
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Affiliation(s)
| | | | | | | | | | - Pedro Martins Lima Neto
- Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brasil
| | | | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Morais AODDS, Simões VMF, Rodrigues LDS, Batista RFL, Lamy ZC, Carvalho CAD, Silva AAMD, Ribeiro MRC. [Maternal depressive symptoms and anxiety and interference in the mother/child relationship based on a prenatal cohort: an approach with structural equations modeling]. CAD SAUDE PUBLICA 2017; 33:e00032016. [PMID: 28724023 DOI: 10.1590/0102-311x00032016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the association between maternal depressive symptoms and anxiety and interference in the mother/child relationship, using structural equations modeling. Data were used from a prospective cohort study initiated during the prenatal period with 1,140 mothers in São Luís, Maranhão State, Brazil. Data were collected during prenatal care and when the children reached two years of age. Interference in the mother/child relationship was measured with the Postpartum Bonding Questionnaire - PBQ (N = 1,140). In the initial theoretical model, socioeconomic status determined the maternal demographic, psychosocial, and social support factors, which determined the outcome, i.e., the mother/child relationship. Adjustments were performed by structural equations modeling, using Mplus 7.0. The final model showed good fit (RMSEA = 0.047; CFI = 0.984; TLI = 0.981). Depressive symptoms in pregnancy and the postpartum were associated with higher PBQ scores, indicating interference in the mother/child relationship. The greatest effect was from depressive symptoms in pregnancy. Other factors associated with higher PBQ scores were lower social support, unfavorable socioeconomic status, and living without a partner, by indirect association. Anxiety symptoms and maternal age were not associated with the mother/child relationship. The results suggest that identifying and treating depression in pregnancy and postpartum can improve mother/child bonding in childhood.
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Chagas DCD, Silva AAMD, Ribeiro CCC, Batista RFL, Alves MTSSDBE. [Effects of gestational weight gain and breastfeeding on postpartum weight retention among women in the BRISA cohort]. CAD SAUDE PUBLICA 2017; 33:e00007916. [PMID: 28614443 DOI: 10.1590/0102-311x00007916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/24/2016] [Indexed: 12/18/2022] Open
Abstract
This study analyzed the effects of gestational weight gain and breastfeeding on postpartum weight retention. The study followed 2,607 women from the BRISA cohort. The variables were age, socioeconomic status, parity, pre-gestational body mass index, gestational weight gain, duration of maternal breastfeeding, length of postpartum follow-up, and postpartum weight gain. Structural equation modeling was used to evaluate the total, direct, and indirect effects of the explanatory variables on postpartum weight retention. An increase of one standard deviation in gestational weight gain corresponded to a significant increase of 0.49 standard deviations in postpartum weight retention (p < 0.001). An increase of one standard deviation in duration of breastfeeding corresponded to mean decrease of 0.10 standard deviations in postpartum weight retention (p < 0.001). Independently of pre-gestational BMI, gestational weight gain is a risk factor and duration of breastfeeding is a protective factor against postpartum weight retention.
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Ribeiro MRC, da Silva AAM, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Schraiber LB, Bettiol H, Barbieri MA. Effects of Socioeconomic Status and Social Support on Violence against Pregnant Women: A Structural Equation Modeling Analysis. PLoS One 2017; 12:e0170469. [PMID: 28107428 PMCID: PMC5249246 DOI: 10.1371/journal.pone.0170469] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 05/10/2016] [Accepted: 01/05/2017] [Indexed: 11/19/2022] Open
Abstract
Few studies have used structural equation modeling to analyze the effects of variables on violence against women. The present study analyzed the effects of socioeconomic status and social support on violence against pregnant women who used prenatal services. This was a cross-sectional study based on data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA). The sample of the municipality of São Luís (Maranhão/Brazil) consisted of 1,446 pregnant women interviewed in 2010 and 2011. In the proposed model, socioeconomic status was the most distal predictor, followed by social support that determined general violence, psychological violence or physical/sexual violence, which were analyzed as latent variables. Violence was measured by the World Health Organization Violence against Women (WHO VAW) instrument. The São Luis model was estimated using structural equation modeling and validated with 1,378 pregnant women from Ribeirão Preto (São Paulo/Brazil). The proposed model showed good fit for general, psychological and physical/sexual violence for the São Luís sample. Socioeconomic status had no effect on general or psychological violence (p>0.05), but pregnant women with lower socioeconomic status reported more episodes of physical/sexual violence (standardized coefficient, SC = -0.136; p = 0.021). This effect of socioeconomic status was indirect and mediated by low social support (SC = -0.075; p<0.001). Low social support was associated with more episodes of general, psychological and physical/sexual violence (p<0.001). General and psychological violence indistinctly affected pregnant women of different socioeconomic status. Physical/sexual violence was more common for pregnant women with lower socioeconomic status and lower social support. Better social support contributed to reduction of all types of violence. Results were nearly the same for the validation sample of Ribeirão Preto except that SES was not associated with physical/sexual violence.
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Affiliation(s)
| | | | | | | | | | - Lilia Blima Schraiber
- Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Costa DCS, Ribeiro MRC, Batista RFL, Valente CM, Ribeiro JVF, Almeida LA, Costa LEM, Alves MTSSDBE, Silva AAMD. Factors associated with physical violence against pregnant women from São Luís, Maranhão State, Brazil: an approach using structural equation modeling. CAD SAUDE PUBLICA 2017; 33:e00078515. [DOI: 10.1590/0102-311x00078515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 03/22/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract: The factors associated with physical violence against pregnant women were analyzed in a cross-sectional study of 1,446 pregnant women from a prenatal cohort who were interviewed in 2010 and 2011 in São Luís, Brazil. In the initial model, socioeconomic status occupied the most distal position, determining sociodemographic factors, social support and the behavioral factors that ultimately determined physical violence, which was investigated as a latent variable. Structural equation modeling was used in the analysis. Pregnant women who were from more disadvantaged backgrounds (p = 0.027), did not reside with intimate partners (p = 0.005), had low social support (p < 0.001) and had a high number of lifetime intimate partners (p = 0.001) reported more episodes of physical violence. Low social support was the primary mediator of the effect of socioeconomic status on physical violence. The effect of marital status was mainly mediated by a high number of lifetime intimate partners.
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Rêgo AS, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Bettiol H, Cardoso VC, Barbieri MA, Loureiro FHF, Silva AAMD. Physical activity in pregnancy and adverse birth outcomes. CAD SAUDE PUBLICA 2016; 32:e00086915. [PMID: 27925023 DOI: 10.1590/0102-311x00086915] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 01/05/2016] [Indexed: 11/22/2022] Open
Abstract
This study focused on the association between physical activity in the second trimester of pregnancy and adverse perinatal outcomes: low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR). The study used a sample from the BRISA cohort, São Luís, Maranhão State, Brazil, which included women with singleton pregnancy, gestational age from 22 to 25 weeks confirmed by obstetric ultrasound performed at < 20 weeks, and re-interviewed in the first 24 hours postpartum (n = 1,380). Level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ), short version, categorized as high, moderate, and low. A directed acyclic graph (DAG) was used to identify minimum adjustment to control confounding. High physical activity was not associated with LBW (RR = 0.94; 95%CI: 0.54-1.63), PTB (RR = 0.86; 95%CI: 0.48-1.54), or IUGR (RR = 0.80; 95%CI: 0.55-1.15). The results support the hypothesis that physical activity during pregnancy does not result in adverse perinatal outcomes.
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Affiliation(s)
| | | | | | | | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Goudard MJF, Simões VMF, Batista RFL, Queiroz RCDS, Alves MTSSDBE, Coimbra LC, Martins MDG, Barbieri MA, Nathasje IF. Inadequação do conteúdo da assistência pré-natal e fatores associados em uma coorte no nordeste brasileiro. Ciênc saúde coletiva 2016; 21:1227-38. [DOI: 10.1590/1413-81232015214.12512015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 08/01/2015] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo desta pesquisa foi analisar o conteúdo da assistência pré-natal em São Luís e os fatores associados com sua inadequação. Realizou-se estudo transversal baseado em dados da coorte de nascimento de São Luís em 2010. O conteúdo da assistência pré-natal foi classificado como inadequado quando não atendeu aos critérios do Programa de Humanização no Pré-Natal e Nascimento (PHPN) que estabelece o início precoce, o número mínimo de consultas, os exames laboratoriais básicos, a vacinação antitetânica e os procedimentos obstétricos. Regressão de Poisson foi utilizada para observar associações das variáveis com o desfecho. A taxa de inadequação foi de 60,2%. O pré-natal inadequado foi associado à classe econômica C (RP = 1,39; IC = 1,26-1,55), à D/E (RP = 1,60; IC = 1,43-1,79), à ocupação da mãe não qualificada/desempregada (RP = 1,24; IC = 1,11-1,37), à escolaridade de 5-8 anos (RP = 1,12; IC = 1,06-1,19) e de 0-4 anos (RP = 1,13; IC = 1,01-1,26), a não ter religião (RP = 1,10; IC = 1,04-1,17), ao uso de álcool durante a gestação (RP = 1,13; IC = 1,06-1,20) e ao atendimento no serviço público (RP = 1,75; IC = 1,54-2,00). Os resultados demonstraram inadequação e iniquidade da assistência pré-natal, evidenciando que mulheres de pior condição socioeconômica foram as que receberam assistência de menor qualidade.
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Silva AAMD, Batista RFL, Simões VMF, Thomaz EBAF, Ribeiro CCC, Lamy-Filho F, Lamy ZC, Alves MTSSDBE, Loureiro FHF, Cardoso VC, Bettiol H, Barbieri MA. Changes in perinatal health in two birth cohorts (1997/1998 and 2010) in São Luís, Maranhão State, Brazil. CAD SAUDE PUBLICA 2016; 31:1437-50. [PMID: 26248099 DOI: 10.1590/0102-311x00100314] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/10/2014] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze changes in perinatal health in two birth cohorts started in 1997/1998 and 2010, respectively, in São Luís, Maranhão State, Brazil. A total of 2,493 live born infants were included in 1997/1998 and 5,166 in 2010. Low birth weight (LBW) rate did not change (8.5% in 1997/1998 and 8.6% in 2010). Preterm birth (PTB) rate also remained stable (13.2% in 1997/1998 and 13% in 2010). Teenage deliveries and births to single mothers decreased. Maternal schooling and prenatal care coverage increased. Intrauterine growth restriction (IUGR) decreased from 13.3% to 10.6% (p < 0.001). The perinatal mortality rate decreased from 36.6 to 20.7 per 1,000 (p < 0.001) and the infant mortality rate (IMR) dropped from 28.5 to 12.8 per 1,000 (p < 0.001). The cesarean rate increased from 34.1% to 47.5% (p < 0.001). In conclusion, despite favorable changes in socio-demographic, behavioral, and health service factors and decreasing rates of IUGR and perinatal and infant mortality, LBW and PTB remained stable, while the cesarean rate increased.
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Affiliation(s)
| | | | | | | | | | - Fernando Lamy-Filho
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil
| | - Zeni Carvalho Lamy
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís, Brasil
| | | | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Thomaz ÉBAF, Alves CMC, Ribeiro CCC, Batista RFL, Simões VMF, Cavalli R, Saraiva MDC, Cardoso VC, Bettiol H, Barbieri MA, Silva AAMD. Desfechos perinatais e alterações na cavidade bucal: coortes brasileiras de Ribeirão Preto e São Luís. Rev bras epidemiol 2015; 18:966-70. [DOI: 10.1590/1980-5497201500040023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 03/15/2014] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Estudos vêm mostrando uma possível associação das doenças bucais no período gestacional com o nascimento pré-termo (NPT) e o baixo peso ao nascer (BPN). Esses desfechos perinatais parecem se associar com defeitos de desenvolvimento do esmalte (DDE) na dentição decídua, que, por sua vez, parecem predispor ao desenvolvimento futuro de lesões de cárie nas crianças. Assim, é relevante a inclusão de variáveis de saúde bucal do binômio mãe/filho nos estudos de coorte para a compreensão de como esses fatores se associam. Os objetivos deste estudo são: 1) verificar se existe associação entre doenças da cavidade bucal da gestante e o NPT; 2) testar a hipótese de associação entre desfechos perinatais e defeitos de esmalte/cárie dentária nas crianças; 3) analisar se existem associações entre desfechos perinatais e distúrbios de erupção dentária nas crianças; 4) construir modelos teóricos para estudo das iniquidades sociais como fator comum entre os desfechos perinatais e condições bucais. Utilizou-se abordagem integrada e colaborativa entre duas cidades brasileiras com condições socioeconômicas contrastantes: São Luís, MA; e Ribeirão Preto, SP - estudo BRISA (Brazilian Birth Cohort Studies, Ribeirão Preto-São Luís ). Duas coortes foram avaliadas: uma iniciada ao nascimento, representativa da população de nascidos vivos; e outra iniciada no pré-natal. Os participantes foram reavaliados a partir do início do segundo ano de vida. Espera-se que estas coortes contribuam para fomentar o desenvolvimento e consolidação de pesquisas de seguimento, de base populacional, no Brasil.
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Figueiredo FPD, Parada AP, Cardoso VC, Batista RFL, Silva AAMD, Barbieri MA, Cavalli RDC, Bettiol H, Del-Ben CM. Postpartum depression screening by telephone: a good alternative for public health and research. Arch Womens Ment Health 2015; 18:547-53. [PMID: 25380783 DOI: 10.1007/s00737-014-0480-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/18/2014] [Indexed: 11/24/2022]
Abstract
This study verified the reliability and validity of the Edinburg Postpartum Depression Scale (EPDS) administered by telephone interviews. In a cross-sectional study of a cohort from Brazil (BRISA), the EPDS was administered by telephone to 1,083 women within 12 months postpartum, and 257 (23.7 %) participants had an EPDS score ≥10. At 67 ± 48 days after their telephone interview, 199 (EPDS ≥10 = 96; EPDS <10 = 103) participants were interviewed face-to-face using the Structured Clinical Interview for DSM-IV (SCID) and completed the EPDS again by self-report. In 90 participants, the diagnosis of major depressive episode was confirmed by the SCID (EPDS ≥10 = 65; EPDS <10 = 25). The Cronbach's alpha coefficient was 0.861. The Spearman's correlation between the EPDS administered by telephone and the self-reported EPDS was 0.69 (p < 0.001). The receiver-operating characteristic (ROC) curve for the EPDS administered by telephone was 0.78 (95 % confidence interval (CI) = 0.72 to 0.84). Scores ≥10 showed a sensitivity of 72.2 %, a specificity of 71.6 %, and a positive predictive value of 67.7 %. The application of the EPDS by telephone is a suitable alternative for clinical practice and research and represents a method to optimize the diagnosis of postpartum depression.
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Affiliation(s)
- Felipe Pinheiro de Figueiredo
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, Av. dos Bandeirantes 3900, Ribeirao Preto, SP, 14048-900, Brazil,
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Ribeiro MRC, Alves MTSSDBE, Batista RFL, Ribeiro CCC, Schraiber LB, Barbieri MA, Bettiol H, da Silva AAM. Confirmatory factor analysis of the WHO Violence Against Women instrument in pregnant women: results from the BRISA prenatal cohort. PLoS One 2014; 9:e115382. [PMID: 25531654 PMCID: PMC4274028 DOI: 10.1371/journal.pone.0115382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/21/2014] [Indexed: 11/19/2022] Open
Abstract
Background Screening for violence during pregnancy is one of the strategies for the prevention of abuse against women. Since violence is difficult to measure, it is necessary to validate questionnaires that can provide a good measure of the phenomenon. The present study analyzed the psychometric properties of the World Health Organization Violence Against Women (WHO VAW) instrument for the measurement of violence against pregnant women. Methods Data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA) were used. The sample consisted of 1,446 pregnant women from São Luís and 1,378 from Ribeirão Preto, interviewed in 2010 and 2011. Thirteen variables were selected from a self-applied questionnaire. Confirmatory factor analysis was used to investigate whether violence is a uni-or-multidimensional construct consisting of psychological, physical and sexual dimensions. The mean-and-variance-adjusted weighted least squares estimator was used. Models were fitted separately for each city and a third model combining data from the two settings was also tested. Models suggested from modification indices were tested to determine whether changes in the WHO VAW model would produce a better fit. Results The unidimensional model did not show good fit (Root mean square error of approximation [RMSEA] = 0.060, p<0.001 for the combined model). The multidimensional WHO VAW model showed good fit (RMSEA = 0.036, p = 0.999 for the combined model) and standardized factor loadings higher than 0.70, except for the sexual dimension for SL (0.65). The models suggested by the modification indices with cross loadings measuring simultaneously physical and psychological violence showed a significantly better fit compared to the original WHO model (p<0.001 for the difference between the model chi-squares). Conclusions Violence is a multidimensional second-order construct consisting of psychological, physical and sexual dimensions. The WHO VAW model and the modified models are suitable for measuring violence against pregnant women.
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Affiliation(s)
| | | | | | | | - Lilia Blima Schraiber
- Department of Preventive Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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da Silva AAM, Simões VMF, Barbieri MA, Cardoso VC, Alves CMC, Thomaz EBAF, de Sousa Queiroz RC, Cavalli RC, Batista RFL, Bettiol H. A protocol to identify non-classical risk factors for preterm births: the Brazilian Ribeirão Preto and São Luís prenatal cohort (BRISA). Reprod Health 2014; 11:79. [PMID: 25410690 PMCID: PMC4246428 DOI: 10.1186/1742-4755-11-79] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 11/07/2014] [Indexed: 11/10/2022] Open
Abstract
Background Preterm birth is the main cause of morbidity and mortality during the perinatal period. Classical risk factors are held responsible for only 1/3 of preterm births and no current intervention has produced an appreciable reduction of this event. It is necessary to explore new hypotheses and mechanisms of causality by using an integrated approach, collaboration among research groups and less fragmented theoretical-methodological approaches in order to detect new risk factors and to formulate more effective intervention strategies. Methods The study will be conducted on a convenience cohort of Brazilian pregnant women recruited at public and private prenatal health services. A total of 1500 pregnant women in São Luís, and 1500 in Ribeirão Preto, will be invited for an interview and for the collection of biological specimens from the 22nd to the 25th week of gestational age (GA). At the time of delivery they will be reinterviewed. GA will be determined using an algorithm based on two criteria: date of last menstruation (DLM) and obstetric ultrasound (OUS) performed at less than 20 weeks of GA. Illicit drug consumption during pregnancy will be determined using a self-applied questionnaire and the following instruments will be used: perceived stress scale, Beck anxiety scale, screening for depression of the Center of Epidemiological Studies (CES-D), experiences of racial discrimination, social network and social support scale of the Medical Outcomes Study and violence (Abuse Assessment Screening and violence questionnaire of the WHO). Bacterial vaginosis, urinary tract infection and periodontal disease will also be identified. Neuroendocrine, immunoinflammatory and medical intervention hypotheses will be tested. The occurrence of elective cesarean section in the absence of labor will be used as a marker of medical intervention. Conclusion Psychosocial, genetic and infectious mechanisms will be selected, since there are indications that they influence preterm birth (PTB). The studies will be conducted in two Brazilian cities with discrepant socioeconomic conditions. The expectation is to identify risk factors for PTB having a greater predictive power than classically studied factors. The final objective is to propose more effective interventions for the reduction of PTB, which, after being tested, might subsidize health policies. Electronic supplementary material The online version of this article (doi:10.1186/1742-4755-11-79) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão (UFMA), Rua Barão de Itapary, 155 Centro, 65020-070 São Luís, Maranhão, Brasil.
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Bernardes ACF, da Silva RA, Coimbra LC, Alves MTSSDB, Queiroz RCDS, Batista RFL, Bettiol H, Barbieri MA, da Silva AAM. Inadequate prenatal care utilization and associated factors in São Luís, Brazil. BMC Pregnancy Childbirth 2014; 14:266. [PMID: 25108701 PMCID: PMC4133632 DOI: 10.1186/1471-2393-14-266] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 08/05/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over the last decades there has been a reduction of social inequalities in Brazil, as well as a strong expansion of health services, including prenatal care. The objective of the present study was to estimate the rate of inadequate prenatal care utilization and its associated factors in São Luís, Brazil, in 2010 and to determine whether there was a reduction of inequity in prenatal care use by comparing the present data to those obtained from a previous cohort started in 1997/98. METHODS Data from the BRISA (Brazilian birth cohort studies of Ribeirão Preto and São Luís) population-based cohort, which started in 2010 (5067 women), were used. The outcome variable was the inadequate utilization of prenatal care, classified according to the recommendations of the Brazilian Ministry of Health. The explanatory variables were organized into three hierarchical levels based on the Andersen's behavioral model of the use of health services: predisposing, enabling and need factors. RESULTS Only 2.0% of the women did not attend at least one prenatal care visit. The rate of inadequate prenatal care utilization was 36.7%. Despite an improved adequacy of prenatal care use from 47.3% in 1997/98 to 58.2% in 2010, social inequality persisted: both low maternal schooling (prevalence ratio (PR) = 2.78; 95% confidence interval (95% CI) 2.23-3.47 for 0 to 4 years of study) and low family income, less than 0.5 monthly minimum wage per capita (PR = 1.37; 95% CI 1.22-1. 54), continued to be associated with higher rates of inadequate prenatal care utilization. Racial disparity regarding adequate utilization of prenatal services was detected, with black (PR = 1.19; 95% CI 1.04-1.36) and mulatto (PR = 1.14; 95% CI 1.02-1.26) women showing higher rates of inadequate use. On the other hand, women covered by the FHP - Family Health Program (PR = 0.92; 95% CI 0.85-0.98) showed a lower rate of inadequate prenatal care utilization. CONCLUSIONS Despite strong expansion of health services and expressive improvements in adequate prenatal care use and social indicators, inequalities in prenatal care use still persist. The FHP seems to be effective in reducing inadequate prenatal care utilization.
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Affiliation(s)
- Ariane Cristina Ferreira Bernardes
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Raimundo Antonio da Silva
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Liberata Campos Coimbra
- />Department of Nursing, Federal University of Maranhão, Brazil, Rua Viana Vaz, 230, Centro, São Luís, Maranhão 65020-660 Brazil
| | | | - Rejane Christine de Sousa Queiroz
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Rosângela Fernandes Lucena Batista
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
| | - Heloisa Bettiol
- />Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil, Avenida Bandeirantes, 3900, Hospital das Clínicas de Ribeirão Preto, Monte Alegre, Ribeirão Preto, São Paulo 14049-900 Brazil
| | - Marco Antônio Barbieri
- />Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil, Avenida Bandeirantes, 3900, Hospital das Clínicas de Ribeirão Preto, Monte Alegre, Ribeirão Preto, São Paulo 14049-900 Brazil
| | - Antônio Augusto Moura da Silva
- />Department of Public Health, Federal University of Maranhão, Brazil, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020-070 Brazil
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Rodrigues LDS, Lima RHDS, Costa LC, Batista RFL. Características das crianças nascidas com malformações congênitas no município de São Luís, Maranhão, 2002-2011. Epidemiol Serv Saúde 2014. [DOI: 10.5123/s1679-49742014000200011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Veloso HJF, da Silva AAM, Bettiol H, Goldani MZ, Filho FL, Simões VMF, Batista RFL, Barbieri MA. Low birth weight in São Luís, northeastern Brazil: trends and associated factors. BMC Pregnancy Childbirth 2014; 14:155. [PMID: 24885887 PMCID: PMC4108005 DOI: 10.1186/1471-2393-14-155] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/24/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To analyze trends in LBW (low birth weight) rate using birth registry data and identify factors associated with LBW in São Luís comparing two birth cohorts separated by a 12-year interval. METHODS 2,426 births were included in 1997/98 and 5,040 in 2010. The dependent variable was LBW (<2,500 g). Multiple logistic regression was performed to determine the association of independent variables with LBW. Data were also obtained from SINASC (Brazilian National Birth Registry) to analyze stillbirth and LBW rates trends from 1996 to 2010, using 3-year moving averages. RESULTS LBW, intrauterine growth restriction (IUGR) and preterm birth rates did not differ between the two cohorts. Despite this, birth registry data showed increasing LBW rate up to 2001, coinciding with decreasing stillbirth rate. Both stillbirth and LBW rates decreased thereafter. A significant reduction was observed in the percentage of teenage mothers, mothers with up to 4 years of education, family income up to one minimum wage and mothers who did not attend prenatal care. There was an increase in maternal age ≥35 years and schooling ≥12 years. The variables associated with LBW in 1997/98 were young maternal age (<18 years), maternal smoking during pregnancy and primiparity. Variables that remained in the adjusted model in 2010 were female gender, income <3 minimum wages, lack of prenatal care, maternal smoking during pregnancy and primiparity. CONCLUSIONS Although LBW rate did not differ between the two cohorts, this apparent stability masked an increase up to 2001 and a decrease thereafter. The rise in LBW rate paralleled reduction in the stillbirth rate, suggesting improvement in obstetrical and newborn care. Maternal, socioeconomic and demographic factors associated with LBW differed between the two cohorts, except for smoking during pregnancy and parity that were significantly associated with LBW in both cohorts.
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Affiliation(s)
- Helma Jane Ferreira Veloso
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Antônio Augusto Moura da Silva
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Heloísa Bettiol
- Departamento de Puericultura e Pediatria. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Hospital das Clínicas de Ribeirão Preto, 7°. andar. Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Marcelo Zubarán Goldani
- Departamento de Pediatria e Puericultura. Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400, Porto Alegre, RS 90035-003, Brazil
| | - Fernando Lamy Filho
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | - Vanda Maria Ferreira Simões
- Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155 Centro, São Luís, MA 65020-070, Brazil
| | | | - Marco Antônio Barbieri
- Departamento de Puericultura e Pediatria. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Hospital das Clínicas de Ribeirão Preto, 7°. andar. Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
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