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Biomedical subjects

C G Victora

Publications and source records attributed to C G Victora.

At least 145 records · Page 8Linked to original sources
PubMed1987

Perinatal mortality in southern Brazil: a population-based study of 7392 births.

Perinatal, fetal and early neonatal mortality rates were determined in a population of 7392 babies born in hospitals in Pelotas (total population, 260 000) during 1982. These babies represented over 99% of all births in the city in that year. The perinatal mortality rate for singletons was 31.9 per 1000 total births, the fetal mortality rate being 16.2 and the early neonatal mortality rate 15.9 per 1000 total births.The most important variable influencing perinatal mortality was birth weight; low-birth-weight babies were 17 times more likely to die in the perinatal period than those weighing 2500 g or more. Perinatal mortality was also strongly influenced by socio-economic status, which was measured by family income. Babies belonging to the poorest families were 3 times more likely to die during the perinatal period than those in families with the highest incomes. Other variables significantly associated with perinatal mortality were gestational age, maternal age, maternal weight and height, reproductive history, attendance in antenatal clinics, parity, and birth interval. Information on most of these risk factors can easily be obtained by health workers at the beginning of pregnancy and should be taken into consideration when allocating women to the proper level of care.

Adult↗
PubMed1986

Why so many caesarean sections? The need for a further policy change in Brazil.

Caesarean sections in Brazil rose from 15 per cent of all births in 1970 to over 30 per cent in 1980. A new policy was introduced by the largest medical care provider (INAMPS) which made the reimbursement fee payable to doctors the same for both vaginal and caesarean section deliveries. However, the caesarean rate has continued to rise. This study analysed the antenatal care and deliveries of over 7000 births which occurred during 1982 in the city of Pelotas in southern Brazil. The organization of health care is discussed in relation to the findings on the utilization of the different antenatal and delivery services available. Utilization is then related to the gestational risk and socio-economic status of the mothers. There were marked differentials between the low and high risk mothers and between those from high and low income families. Doctors clearly concentrated their efforts on the low risk and high income mothers, with 50 per cent of private patients having an operative delivery compared to 13 per cent of uninsured mothers. There was a large demand for tubal ligations to be carried out at the same time as the caesareans. The non-medical and financial reasons for these high rates are discussed and the high extra cost that is being incurred by patients and the insurance schemes is emphasized.

Brazil↗
PubMed1986

Breastfeeding and socioeconomic status in Southern Brazil.

Patterns of breastfeeding were studied in a cohort of 5 914 infants followed from birth in Pelotas, Southern Brazil. Overall, 92% of the babies commenced breastfeeding and 54% were still breastfed by 3 months of age. This proportion dropped to 30% by 6 months, 20% by 9 months, and 16% by 12 months. The prevalence of breastfeeding soon after birth, and at 3, 6, 9 and 12 months of age was studied according to socioeconomic status as measured by family income. Children from the poorest families were less likely to be breastfed from birth than those from the richest families (89% and 97%, respectively), and also showed lower prevalence of breastfeeding at 3 and 6 months. By the age of 12 months poor children showed the highest prevalence of breastfeeding.

Age Factors↗
PubMed1986

Risk factors for malnutrition in Brazilian children: the role of social and environmental variables.

The article reports the effects of several socioeconomic and environmental indicators on the nutritional status (stunting, underweight, and wasting) of a sample of 802 children aged 12-35.9 months in urban and rural areas of southern Brazil. Of the social variables studied, family income and father's education level were the two risk factors that showed the strongest associations with nutritional status. The mother's education level, employment status of the head of the family, number of siblings, and family's ethnic background also showed some degree of association, but these were less significant when family income was included in the analysis. Environmental variables, particularly the type of housing, degree of crowding, and type of sewage disposal, were also strongly associated with malnutrition. The effects of having access to piped or treated water were only apparent on stunting and wasting.

Anthropometry↗
PubMed1986

Birth weight and duration of breast-feeding: are the beneficial effects of human milk being overestimated?

The beneficial effects of breast-feeding on infant mortality and morbidity have been demonstrated in many studies. Few of these, however, have taken into account the possible confounding effect of birth weight. Several studies have shown that babies of low birth weight are less likely to be breast-fed. In some circumstances, this alone may account for a more than twofold excess in postperinatal infant mortality rates among non-breast-fed babies, even in the absence of any beneficial effect of breast-feeding. The association between birth weight and breast-feeding and the magnitude of the confounding effect is illustrated using data from a longitudinal study of infant mortality in Pelotas, Southern Brazil, and also using published results from other studies. It is concluded that studies designed or analyzed to relate breast-feeding to infant mortality should take the confounding effect of birth weight into account to avoid overestimating the beneficial effects of human milk.

Birth Weight↗
PubMed1985

Land tenure patterns and child health in southern Brazil: the relationship between agricultural production, malnutrition and child mortality.

The relationships between infant mortality, malnutrition, and land tenure patterns in the State of Rio Grande do Sul, Brazil, were investigated with data from demographic and agricultural censuses, vital statistics, and dietary surveys, complemented by a large nutritional survey in urban and rural areas. These studies employed a variety of analytical methods and revealed that young children in areas with large ranches, livestock-raising, and a high proportion of agricultural wage-earners presented a higher mortality and had a poorer nutritional status than children in areas with small properties, crop agriculture, and self-employed family workers. Children of landowners showed least malnutrition and the smaller risk of death compared to children of laborers, although the differential seems to have narrowed in recent years. The main conclusion is that land tenure patterns play a very important role in determining early mortality and malnutrition in this Brazilian state.

Adolescent↗
PubMed1984

Is prolonged breast-feeding associated with malnutrition?

The association between duration of breast-feeding and nutritional status was studied in a population-based sample of 802 children aged 12 to 35.9 months in Southern Brazil during 1982. The prevalence of malnutrition (low weight for age, length for age, and weight for length) was smallest in those children breast-fed for 3 to 6 months, but after this age nutritional status appeared to be worse in those breast-fed for longer. Children still being breast-fed at the time of the survey presented with a significantly higher prevalence of low weight for length than those who had been totally weaned, and those receiving breast-plus bottle-feeding presented with intermediate levels. This association could not be explained by a number of possible confounding variables using a multiple logistic regression analysis. These results are also consistent with a controlled trial on supplementary feeding in the Sudan.

Adolescent↗
PubMed1982

Statistical malpractice in drug promotion: a case-study from Brazil.

The advertising practices employed by some drug corporations in peripheral countries have been criticised on medical and ethical grounds, mainly for failing to disclose the dangers and for exaggerating the properties of the promoted products. This paper reveals how statistical and methodological fallacies have also been employed in advertisements directed at Brazilian physicians in recent years. A large fraction of such promotional materials not only fail to support with evidence the claims being made but also employ faulty experimental design, analysis and presentation of results in order to impress upon doctors the quality of the drugs being advertised. Such practices, since they are likely to influence doctors to prescribe inadequate products, may represent a hazard to their patients' recovery.

Advertising↗
PubMed1982

Drug usage in southern Brazilian hospitals.

A drug usage survey was carried out in 14 hospitals in the southernmost region of Brazil in the year 1979. The average number of drugs prescribed per patient was 8.6, and antimicrobials, followed by analgesics, vitamins and sedatives-tranquilizers were the most often employed drug categories. Among the antimicrobials, ampicillin was the first, followed by chloramphenicol, but the overall leading drug was an analgesic-antipyretic, dipyrone. Some possible distortions in drug usage are discussed.

Adolescent↗
PubMed1980

Epidemiology of infant mortality in Rio Grande do Sul, Brazil. The influence of agricultural production.

Infant mortality rates (IMRs) for the 24 districts of the State of Rio Grande do Sul, Brazil, for 1972, have been correlated to 12 variables representative of the state's agrarian structure, as well as five other socioeconomic variables, through Pearson's correlation coefficient and multiple linear regression. The IMR was found to be significantly larger in the districts characterized by large properties, cattle raising and wage earning, rather than in the districts of small properties, agriculture and large rural population. The IMR was not found to be correlated to the variables representing education, housing, medical care or availability of banks, but there was a direct association with the sanitation variable. A multiple linear regression equation was then obtained, in which the agrarian variables accounted for 70% of the variation in the IMR, while the non-agrarian ones accounted for 13%. These findings support the hypothesis that the agrarian structure of Rio Grande do Sul may influence the observed distribution of the IMR in the state, while other variables specifically related to the preservation and restoration of health do not seem to play an important role.

Agriculture↗