Biomedical subjects

C G Victora

Publications and source records attributed to C G Victora.

157 records · Page 9Linked to original sources

PubMedDate not supplied

Birthweight, socio-economic status and growth of Brazilian infants.

A population-based cohort of 1458 Brazilian infants was followed from birth to 9-15 months of age to investigate the effects of birthweight and family income on subsequent growth. There was a strong association between birthweight and attained weight and length, while virtually no malnutrition among children who weighed more than 3000 g at birth; Children with lower birthweights tended to put on less weight during the first year, but these differences were no longer significant after controlling for family income. As a result, infants of lower birthweights tended to remain behind those of higher birthweights. Children from the wealthiest families gained 20% more weight than low-income infants, irrespective of birthweight. Low birthweight infants from high-income families were therefore likely to approach the standard weight at one year old while those from poor families lagged behind.

Anthropometry↗

PubMedDate not supplied

Cross-cultural differences in developmental rates: a comparison between British and Brazilian children.

The Griffiths Mental Development Scales were administered to a population-based sample of 305 4-year-old children from a Brazilian city. Their performance was compared to that of 285 British children of the same age who participated in the standardization phase of this instrument. Although the mean general quotients were very similar for both groups, British children performed better than Brazilians in the fine motor and practical reasoning scales. Brazilians, on the other hand, proved to be more advanced in gross motor and speech scales. The possibility of these differences being explained in terms of cultural environment is discussed.

Brazil↗

PubMedDate not supplied

[Prenatal care in Pelotas, Rio Grande do Sul, Brazil, 1993].

All 5304 births in the hospitals of Pelotas, Rio Grande do Sul, Brazil in 1993 were studied. Neonates were examined and their mothers were interviewed regarding sociodemographic conditions, family income, reproductive health, and medical care during pregnancy. Ninety-five per cent of women received prenatal care. The mean number of physician visits during pregnancy was 7 and the majority of the women (84.7%) began visits before the fifth month of pregnancy. Women who did not receive prenatal care were from the lowest socioeconomic stratum and were mostly adolescents or over 40 years of age. Incidence of low birth weight in this group was 2.5 times that of the group with more than five visits (p>0.001). Perinatal mortality rate was 50.6/1000 in the group without prenatal care and 15.8/1000 in the group with more than five visits. With regard to utilization of health care, the study shows that twenty-five per cent of women with high gestational risk received inadequate prenatal care. The rate was less than 10% in the group of women with low gestational risk. These results suggest the need for improvement in the quality of prenatal care with special attention for mothers with high gestational risk.

Adolescent↗

PubMedDate not supplied

Caffeine intake and pregnancy outcomes: a meta-analytic review.

Epidemiological publications on the relationship of caffeine to birth weight and duration of human pregnancy, from 1966 to 1995, were searched through Medline. Each study was treated as the stratification variable, and its weight average was proportional to the inverse of its variance. Twenty-six studies were located. Among the twenty-two studies on birth weight, eleven were on mean birth weight, nine on low birth weight (LBW), and four on intrauterine growth retardation (IUGR). Combined analysis of mean birth weight study results showed a significant decrease in birth weight of nearly 43g among newborns of the heaviest caffeine-consuming mothers. LBW, IUGR, and preterm delivery displayed significant homogeneity in the test results, indicating that a pooled estimate should not be taken as na adequate measure. The high heterogeneity of the available literature on the effects of caffeine on LBW, IUGR, and preterm delivery prevents estimation of reliable pooled estimates through meta-analysis. Further assessment of caffeine intake during pregnancy is needed in future research.

Birth Weight↗

PubMedDate not supplied

[The Children's Pastoral in Criciúma, Southern Brazil: coverage and socio-demographic characteristics of participating families].

This study describes the main social, economic, biological, and demographic characteristics of children and families who participate or have participated in the Children's Pastoral as compared to the overall urban population of Criciúma (Southern Brazil). A population-based cross-sectional study with a probabilistic sample of 2208 children under three years of age was conducted; 16.7% of the mothers confirmed having participated in the Pastoral at any given time, of whom 4.8% were currently participating, while the rest had dropped out. Black children and those over 12 months old or with two or more older siblings participated more frequently in the Pastoral. The main family factors associated with participation were mother's age (over 25), mother not working outside the home, low per capita income, low parental schooling, living in the neighborhood for more than 4 years, and death of sibling before age five. Reasons most often given by mothers for dropping out were migration, lack of time, and interruption of the Pastoral's activities in the neighborhood. The conclusion was that the Pastoral should prioritize the poorest of the poor and adopt measures to reduce drop-out rates.

Adolescent↗

PubMedDate not supplied

[Association between individual and socioeconomic characteristics and work-related accidents in Pelotas, Southern Brazil].

A case-control study was conducted to study the association between individual and socioeconomic characteristics and occupational accidents. Cases were 264 workers who had suffered a "typical" occupational accident registered at the National Institute of Social Security in the city of Pelotas in 1996. Workers were interviewed in their homes with a standardized questionnaire. Two fatal accidents were excluded, as were those leading to absence from work for less than seven days. For each case, three controls were selected: a colleague from the same workplace, a neighbor, and a population control. These were matched to cases by age (+/-5 years) and sex and had not suffered a work-related accident in the preceding month. All cases and controls had formal employment contracts and were residents in the urban area. Conditional logistic regression was used in the data analyses. Schooling and monthly income were the main determinants of occupational accidents. Effects of age, skin color, smoking, alcohol dependence (CAGE questionnaire), and stressful life events disappeared after adjustment for schooling and income.

Accidents, Occupational↗

PubMedDate not supplied

[Understanding the low prevalence of weight-for-height deficit in lower-income Brazilian children: correlations among anthropometric values].

The sample for this study consisted of 386 children from six to 59 months of age. The objective was to study the association between wasting and abdominal circumference. Thirteen anthropometric measurements were taken: weight, height or length, crown-rump length, 4 circumferences, 4 skin fold thicknesses, and 2 breadths. Muscle, fat, and total upper arm areas and leg length were calculated. Indices of body proportionality were obtained by dividing the anthropometric variables by height. Height-for-age, weight-for-age, and weight-for-height deficits were 25.9%, 14.4%, and 3.5%, respectively. The smallest and lightest children were those with the highest abdominal circumferences divided by height. According to this study, abdominal circumference for Brazilian children without height-for-age deficit is, on average, 1.2 cm larger than for US children. Using this as a basis, the study calculated that prevalence of weight-for-height deficit would increase from 3.5% to 7.0% by increasing 2 cm in the abdominal circumference. The low prevalence of wasting and the high prevalence of stunting as indicated by several Brazilian studies could be explained partially by larger mean abdominal circumference values.

Age Factors↗

PubMedDate not supplied

[Adults without caries: a case-control study about knowledge, attitudes and preventive practices].

The purpose of this article was to investigate the effect of personal awareness and attitudes, the dentist's role, oral hygiene habits, and fluoride use on total absence of caries in adults, using a case-control study, matched for sex and age with undergraduate students from two private Brazilian universities. Crude analysis using conditional logistic regression failed to show any effect for the related variables regarding fluoride use and oral hygiene habits (p > 0.20). Use of dental floss was the only exception in this set. It appeared as a risk factor, since individuals who stated not flossing presented a crude odds ratio (OR) of 0.70, or 0.73 when adjusted for regular visits to the dentist. The effect for regular visits to the dentist was that of a risk. Those with a history of caries presented a crude odds ratio of 1.55; after adjusting for dental floss use, the risk was slightly higher (OR = 1.67). Oral hygiene habits, contrary to the formulated hypothesis, did not display the expected protective effect. Likewise, fluoride use was not significantly associated with absence of caries. Individuals with a history of caries were used to visiting more professionals, confirming the formulated hypothesis for this variable. Nevertheless, it is still intriguing that some people fail to develop caries, even they report not practicing measures considered ideal for oral health.

Adult↗

PubMedDate not supplied

[Hospitalization for bronchiolitis: a risk factor for recurrent wheezing].

This longitudinal study evaluated the role of hospitalization for acute bronchiolitis as a risk factor for recurrent wheezing. Participants were children from a 1993 cohort in a southern Brazilian city. Hierarchical multivariate analysis showed that previous hospitalization for bronchiolitis was the most important risk factor for recurrent wheezing, with an odds ratio of 4.9. This strong association is consistent with a casual relationship hypothesis.

Acute Disease↗

PubMedDate not supplied

[Populational study of investigation of perinatal and infant deaths: methodology, validity of diagnosis and under-registration].

OBJECTIVE: The main objectives of the present study were to evaluate the percentage of under-registration of infant mortality in 1993 and compare it with the ones found 1982; to analyze the agreement between the official death certificates and the ones made by the referees. METHODS: The infant mortality of all children born in Pelotas, in 1993, was monitored through daily visits to hospitals, as it was done in 1982; monthly, cemeteries and public registration offices were visited to detect any deaths outside the hospitals. Besides the official death certificates, two independent referees established the underlying cause of death based on information from pediatricians, case-notes, autopsies and through a home visit to the parents of the children. RESULTS: The percentage of under-registration fell substantially from 24%, in 1982, to 5.4%, in 1993. The agreement between the official death certificates and the ones made by the referees showed satisfactory Kappas, unless for ill defined diseases such as sudden infant death, where the agreement was null. CONCLUSIONS: The authors conclude that there was a significant fell of the under-registration for infant death in Pelotas, and the ill defined causes such as sudden infant death have been hidden by the diagnosis of pneumonia.

English Abstract↗

PubMedDate not supplied

[Use of pacifiers in children: patterns and determinants].

Although pacifiers are commonly used by Brazilian children and are potentially harmful, there are no studies about their patterns and determinants. These were investigated in a cross-sectional study of 354 children under two years of age living in two slum areas of Pelotas, southern Brazil. Most children (79%) were pacifiers users, 15% had never used them, and 6% had used them in the past. Among users, 38% spent most of the time sucking a pacifier. For two-thirds of the children, pacifiers were offered on the very first day of life. Pacifier use was most common among younger children,among those of low-schooling mothers and among non-breastfed infants.

English Abstract↗

PubMedDate not supplied

[Risk factors for suspicion of developmental delays at 12 months of age]

OBJECTIVE: To investigate the prevalence of positive screening test for developmental delays in a cohort of children born in Pelotas, Brazil in 1993, and their risk factors. METHODOLOGY: A sample of 20% (1,363 children) of a cohort of children born in Pelotas, Brazil, was studied at 12 months of age regarding their development. The Denver II Test was used. The children who failed in two or more items of the test were suspected of having development delay. A set of independent variables was chosen taking into account the hierarchical relations between risk factors according to the conceptual framework (socioeconomic, reproductive and environmental, birth conditions, childreńs care, nutrition and morbidity). Analyses were performed using Mantel-Haenszel X2 and multivariate technique through conditional logistic regression, to control for possible confounding. RESULTS: At 12 months of age, 34% (463) of the total of 1,363 children failed in the screening test. After adjusting for possible confounding variables, failure was associated with family lower income children (OR= 1.5), very low birth weight (OR= 4.0), gestational age less than 37 weeks (OR= 1.6), more than three siblings (OR= 1.9), and duration of breastfeeding less than three months (OR=1.6), or no breastfeeding (OR= 1.9). Children who presented weight/age at six months of age less or equal to -2 z score of the reference population presented a risk 10 times greater of having failure in the Denver II Test. CONCLUSIONS: This study reinforces the multiple etiology of development delays and the concept of cumulative risk effect. In this population those who are economically disadvantaged accumulate risk factors (social, economic and environmental) that may render to deficits in their development.

Journal Article↗

PubMedDate not supplied

[Land ownership and infant health in Rio Grande do Sul: relationship between agricultural production, malnutrition and mortality].

The relationships between infant and preschool age 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 a 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 high proportion of agricultural wage-earners presented a higher mortality and a greater prevalence of malnutrition than children in areas with small farms, crop agriculture, and self-employed family workers. Children of landowners showed better nutritional status and smaller risk of death compared to children of laborers, although the differential seems to have narrowed in recent years. The conclusion is that land tenure patterns play a very important role in determining mortality and malnutrition of children in this Brazilian State.

Agriculture↗