Search PubMed⌕ Search

Biomedical subjects

C G Victora

Publications and source records attributed to C G Victora.

At least 127 records · Page 7Linked to original sources
PubMed1990

Do mothers overestimate breast feeding duration? An example of recall bias from a study in southern Brazil.

The problem of recall bias when reporting breast feeding duration is investigated. Data are presented from the follow-up of over 1,000 children from a birth cohort (1982) in southern Brazil, when they were on average 11, 23, and 47 months of age. Compared with the response given at 11 months of age, 24% of mothers misclassified the duration (grouped into 3-month categories) at age 23 months and 30% at age 47 months. Women who were richer and/or better educated were significantly more likely to report longer durations, while those poorer and less educated did not tend to misclassify more in one direction than in the other.

Brazil↗
PubMed1990

Caesarean section and duration of breast feeding among Brazilians.

A birth cohort study of 4912 Brazilian infants showed that the incidence and duration of breast feeding for children delivered vaginally and for those born by elective caesarean section were similar. Those delivered by emergency caesarean section, however, were not breast fed for as long. This difference persisted after adjustment for confounding variables.

Brazil↗
PubMed1990

Subsequent pregnancies: who has them and who wants them? Observations from an urban center in southern Brazil.

Subsequent pregnancies in mothers of a birth cohort from Pelotas, Southern Brazil, were studied in relation to maternal and socio-economic factors. Within about 3 1/2 years of the cohort child's birth, 39% of mothers had experienced at least one further pregnancy. This proportion decreased with increasing maternal age, years of schooling and family income. A U-shaped trend was observed with respect to parity. Mothers who had delivered the cohort child by caesarean section were also less likely to have another pregnancy within that time. Logistic regression analysis showed that each of these factors remained significantly associated with further pregnancies after controlling for the remaining variables. Analysis of the first subsequent pregnancy showed that a high proportion of mothers had not wanted the pregnancy. Unwanted pregnancies were also significantly associated with older women, low educational status, higher parity and low family income.

Birth Rate↗
PubMed1989

Risk factors for deaths due to respiratory infections among Brazilian infants.

In a population based case-control study, 127 Brazilian infants who died due to a respiratory infection were compared with 254 neighbourhood controls. The main risk factors associated with mortality were low socioeconomic status (including low levels of parental education) and--after adjustment for socioeconomic status--lack of breastfeeding, lack of supplementation with non-milk foods, crowding, the number of under-fives in the family, lack of a flush toilet, low birthweight, low weight-for-age and having a young mother. In a multivariate analysis, the variables found to be most closely associated with mortality were breastfeeding, education of the father, the number of under-fives, family income and birthweight. Having a low weight-for-age was also strongly associated with mortality but the retrospective nature of the study makes this finding difficult to interpret.

Acute Disease↗
PubMed1989

Infant feeding and deaths due to diarrhea. A case-control study.

The association between infant feeding habits and infant mortality from diarrhea was investigated in a population-based case-control study in two urban areas in southern Brazil during 1985. Each of 170 infants who died due to diarrhea was compared with two neighborhood controls. After allowance was made for confounding variables, infants who received powdered milk or cow's milk, in addition to breast milk, were at 4.2 times (95% confidence interval (CI) 1.7-10.1) the risk of death from diarrhea compared with infants who did not receive artificial milk, while the risk for infants who did not receive any breast milk was 14.2 times higher (95% CI 5.9-34.1). Similar results were obtained when infants who died from diarrhea were compared with infants who died from diseases that were presumed to be due to noninfectious causes. Each additional daily breast feed reduced the risk of diarrhea death by 20% (95% CI 2-34%), but the increase in risk associated with each bottle feed was not significant after allowance was made for the number of breast feeds. The only other consumption variable associated with diarrhea mortality was the frequency with which tea, water, or juice were drunk with each feed (increase in risk, 42% (95% CI 4-93%]. The odds ratios associated with nonbreast milk were highest in the first two months of life. Possible biases were investigated, including the interruption of breast-feeding as an early consequence of the terminal illness, but the strong protective effect of breast-feeding persisted after these adjustments.

Animals↗
PubMed1989

[Evaluation of the quality of information on the basic cause of death of infants in Rio Grande do Sul (Brazil)].

The validity of the official information on the cause of infant deaths was studied in the Brazilian cities of Porto Alegre and Pelotas in 1985. Using data collected for a population-based case-control study of infant mortality due to infectious diseases or malnutrition, a comparison was made between the causes of death reported on the death certificates and those obtained after a careful review of case-notes and a medical interview with the parents of the decreased infants. Official death certificates showed an excess of deaths attribute to bronchopneumonia (ICD 485X) and septicemia (ICD 038.9), and an underestimation of the number of deaths due to diarrheal diseases (ICD 009.1) and of sudden infant deaths (ICD 798.0). The overall rate of agreement between official and revised certificates, in terms of groups of causes of death, was only 27.9%. Lower respiratory infections, which were the leading infectious cause of infant death according to official statistics, were superseded by diarrheal diseases after this revision.

Brazil↗
PubMed1989

Better prospects for child survival.

Infant and childhood mortality rates in São Paulo fell by about 50% and 70% respectively between 1973 and 1983. However, surveys in 1973-74 and 1984-85 showed no change in the prevalence of protein-energy malnutrition, nor were there marked changes in the socioeconomic characteristics of the population. Improvements in water supply and the duration of breast-feeding possibly accounted for a 20% decrease in the infant mortality rate. It is proposed that the markedly improved coverage of health services may have played a large role in explaining the rest of the decrease. The control of malnutrition may not always be essential for lowering infant and child mortality in developing societies.

Brazil↗
PubMed1988

Water supply, sanitation and housing in relation to the risk of infant mortality from diarrhoea.

In a population-based case-control study in the metropolitan areas of Porto Alegre and Pelotas in southern Brazil children dying in infancy from diarrhoea were compared to neighbourhood controls in terms of several social and environmental variables. Factors found to be significantly associated with an increased risk of death from diarrhoea included the non-availability of piped water, the absence of a flush toilet, residence in a poorly built house and household overcrowding. When adjustment was made for confounding variables and the mutual confounding effect of the environmental variables on each other, the only association that remained statistically significant was that with the availability of piped water. The association with poor housing was almost significant (p = 0.052). Compared to those with water piped to their house, those without easy access to piped water were found to be 4.8 times more likely to suffer infant death from diarrhoea (95% confidence interval 1.7 to 13.8) and those with water piped to their plot but not to their house had a 1.5 times greater risk (95% confidence interval 0.8 to 3.0).

Brazil↗
PubMed1988

Influence of birth weight on mortality from infectious diseases: a case-control study.

The association between birth weight and infant mortality from infectious diseases was investigated in a population-based case-control study in two urban areas in southern Brazil. All deaths of children, seven to 364 days of age, occurring in a year were studied and the parents of the 357 infants dying of an infectious cause were interviewed, as were the parents of two neighborhood control infants for each case. Low birth weight infants (less than 2,500 g) were found, after allowing for confounding factors, to be 2.3 (90% confidence interval = 1.6 to 3.4) times more likely to die of an infection than those of higher birth weight. The odds ratios were 2.0 (1.1 to 3.6) for deaths due to diarrhea, 1.9 (1.0 to 3.6) for respiratory infections, and 5.0 (1.3 to 18.6) for other infections. These estimates of the risks associated with low birth weight are considerably lower than those from studies in developed countries.

Birth Weight↗
PubMed1987

Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil.

In a population-based case-control study of infant mortality in two urban areas of southern Brazil, the type of milk in an infant's diet was found to be an important risk factor for deaths from diarrhoeal and respiratory infections. Compared with infants who were breast-fed with no milk supplements, and after adjusting for confounding variables, those completely weaned had 14.2 and 3.6 times the risk of death from diarrhoea and respiratory infections, respectively. Part-weaning was associated with corresponding relative risks (RR) of 4.2 and 1.6. The risk of death from infections other than diarrhoea or respiratory infection was less clearly associated with breast-feeding (completely weaned, RR = 2.5; partly weaned, RR = 0.4). Cow's and formula milk seemed to be equally hazardous. For deaths due to diarrhoea the increased risk associated with not breast-feeding was greatest in the first two months of life (RR for completely weaned vs breast-fed without supplementary milk = 23.3).

Animals↗
PubMed1987

Hot maté drinking and precancerous lesions of the oesophagus: an endoscopic survey in southern Brazil.

Thermal injury resulting from drinking very hot beverages has been incriminated as a risk factor for oesophageal cancer, although no information is available on the lesions caused by this injury in human or experimental animals. The drinking of hot maté tea is very common in areas of moderately high incidence of oesophageal cancer in south-eastern areas of South America. This study investigated the prevalence of precancerous lesions of the oesophagus in 60 unskilled male workers, of whom half were daily maté drinkers and the remainder were non-maté drinkers. These 2 groups were matched for age, smoking and alcohol intake. Maté drinkers were 2.2 times more likely (p = 0.046) to develop histologically confirmed oesophagitis than non-maté drinkers.

Adult↗
PubMed1987

Hot beverages and oesophageal cancer in southern Brazil: a case-control study.

There is a cluster of high-incidence areas of oesophageal cancer in south-eastern South America, including Southern Brazil, Uruguay and parts of Argentina. The present case-control study investigated the hypothesis that this may be due to the drinking of maté, a traditional beverage drunk at a very high temperature, and also studied the role of other known risk factors such as alcohol and tobacco. Cases (171) and age- and sex-matched controls (342) were recruited from hospitals in the State of Rio Grande do Sul in Southern Brazil. The crude odds ratio for daily maté drinkers was 1.92 relative to those drinking less frequently than daily (p = 0.006). Other risk factors included the drinking of cachaça (a sugar cane spirit), smoking, rural residence, low fruit consumption and high intake of meats. After adjustment for these variables through conditional logistic regression, the odds ratio associated with daily maté drinking was reduced to 1.47 (90% CI = 0.87-2.50). Although the study failed to provide evidence of a strong association between maté and oesophageal cancer, the cluster of high rates could be explained by relative risks of the magnitude observed. This is due to the fact that approximately 70% of adult males and 50% of females are daily drinkers. In addition, this study revealed that alcohol, tobacco smoking and rural residence are the main risk factors for oesophageal cancer in this population and the fruit consumption confers some degree of protection.

Alcohol Drinking↗
PubMed1987

Birthweight and infant mortality: a longitudinal study of 5914 Brazilian children.

In a population-based cohort study in Southern Brazil, 87.3% of 5914 liveborn infants were followed for over 12 months. The 215 infant deaths occurring in this cohort were studied in relation to birthweight, gestational age and socioeconomic status. Causes of death were ascertained through the review of case notes and interviews with the parents. As predicted, there was a strong inverse association between birthweight and neonatal and postneonatal mortality. Preterm infants with an adequate weight for their gestational age, despite being slightly heavier than small-for-dates, showed an IMR which was twice as large as the latter. The relative risk associated with low birthweight for deaths due to respiratory infections was over twice as large as that for diarrhoea deaths, but there were only 25 deaths in each category and the estimates are therefore not very precise. There was an interaction between birthweight and socioeconomic status, with the relative risk of mortality associated with low birthweight being much larger among rich than among poor infants. Estimates of the magnitude of the reduction in infant mortality which would accompany a given improvement in the birthweight distribution, which have been mostly based on data from developed countries, may prove to be overoptimistic.

Brazil↗
PubMed1987

Infant mortality in southern Brazil: a population based study of causes of death.

The causes of 215 infant deaths occurring in a population based cohort of 5914 infants from southern Brazil were determined. Perinatal problems were responsible for 43% of these deaths and infectious diseases for 32%. In the group who died of infectious diseases, respiratory infections and diarrhoea were equally important, each accounting for 12% of all deaths. A total of 87% of the deaths occurred in the first six months of life, and this proportion remained high (77%) even after perinatal causes had been excluded. On the other hand, 53% of the infants who died were of low birth weight, as opposed to 7.9% of the survivors. This suggests that low birthweight infants need to be carefully followed by health workers at primary level, especially during the first six months. It was estimated that if the incidence of low birth weight was reduced from the present 8.8% to 5% the likely reduction in infant mortality would be 20%. This reduction would be 33% for deaths due to perinatal causes, 14% for respiratory infections, and only 5% for diarrhoea. Efforts for the prevention of infant deaths in southern Brazil are more likely to be effective if they concentrate on improving perinatal health care and environmental conditions.

Age Factors↗