Luciano Lima Correia

Características sócio-demográficas, reprodutivas e médicas de mulheres admitidas por aborto em hospital da Região Sul do Brasil

No Brasil, a inducao do aborto e legalmente permitida somente quando necessaria para salvar a vida da mulher ou quando a concepcao ocorreu de estupro. Apesar das restricoes legais, morais e religiosas, a inducao do aborto e amplamente praticada. Com o objetivo de identificar as caracteristicas do aborto incompleto nas mulheres admitidas na maternidade publica de Florianopolis, foram entrevistadas 620 mulheres, entre 1o de julho de 1993 e 30 de junho de 1994. Com base em dados coletados por meio de questionario estruturado, sao apresentadas caracteristicas socio-demograficas, reprodutivas e medicas dos abortos, classificados como certamente provocados, possivelmente provocados e espontâneos. Entre os 141 casos de aborto provocado, cerca de 50% das mulheres reportaram uso isolado do Cytotec® (misoprostol), ou deste associado a outro metodo abortivo. Os resultados revelam que na populacao estudada a inducao do aborto e pratica comum entre mulheres jovens, solteiras ou sem parceiro estavel, de bom nivel de escolaridade e nao usuarias de metodos anticonceptivos. Foi tambem registrada uma reducao do numero de complicacoes graves relacionadas ao aborto provocado admitido ao hospital.

Determinantes do aborto provocado entre mulheres admitidas em hospitais em localidade da região Nordeste do Brasil

Com o objetivo de identificar os determinantes do aborto provocado entre mulheres admitidas por complicacoes decorrentes dos abortos, nos hospitais-maternidades publicos em Fortaleza, CE (Brasil) foram entrevistadas 4.359 pacientes entre 1o de outubro de 1992 e 30 de setembro de 1993. Os dados foram coletados atraves de questionario estruturado. Sao apresentados os determinantes dos abortos provocados em 2.084 (48%) mulheres classificadas como tendo induzido aborto. Dois tercos (66%) das mulheres relataram a inducao do aborto com o uso isolado do Cytotec(R) (misoprostol) ou associado a outro meio abortivo. Os resultados indicam que, na populacao estudada, a inducao do aborto e pratica comum entre jovens, solteiras (ou que vivem sem um parceiro estavel), de baixa paridade, com escolaridade incipiente e nao-usuarias de metodos contraceptivos. Recomenda-se a realizacao de estudos que investiguem os conhecimentos relacionados a percepcoes, conceitos culturais do aborto, e as razoes por que mulheres pobres fracassam na adocao de metodos de planejamento familiar.

Prevalência e determinantes de obesidade e sobrepeso em mulheres em idade reprodutiva residentes na região semiárida do Brasil

O estudo estimou a prevalencia e identificou fatores determinantes do sobrepeso e obesidade em mulheres em idade fertil na regiao semiarida do Brasil. Na amostra por conglomerados de oito mil domicilios do estado do Ceara, foram pesquisadas 6.845 mulheres. Sobrepeso e obesidade foram medidos pelo Indice de Massa Corporal, utilizando-se a analise multivariada para a identificacao dos fatores determinantes. As prevalencias de sobrepeso e obesidade foram de 32,6% e 16,1%, respectivamente. Na analise ajustada, a obesidade esteve positivamente associada a: idade >30 anos (RP=1,55), estado civil casada (RP=1,36), escolaridade fundamental (RP=1,40), idade na menarca 1 filho (RP=1,65), uso de contraceptivos (RP=1,31). Os fatores relacionados a saude e a nutricao, referentes a obesidade morbida, foram: hipertensao arterial (RP=3,11), diabetes (RP=2,08), insatisfacao com a imagem corporal (RP=4,26) e procedimentos para perder peso (RP=2,73). Sobrepeso e obesidade sao altamente prevalentes na regiao semiarida. A educacao foi o unico fator socioeconomico passivel de ser modificado. Os fatores reprodutivos identificados apontam para a necessidade de mobilizacao dos servicos de pre-natal, pos-parto e planejamento familiar na prevencao e no controle da obesidade.

Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil

OBJETIVO : Analisar tendencias na prevalencia e determinantes da desnutricao em criancas na regiao semiarida do Brasil. METODOS : Foram analisados dados de duas pesquisas transversais domiciliares de base populacional que utilizaram a mesma metodologia. A amostragem por conglomerados foi utilizada para coletar os dados de 8.000 familias, do estado do Ceara, Nordeste do Brasil, para os anos de 1987 e 2007. A desnutricao aguda foi calculada como peso/idade < -2 desvios padrao; nanismo como altura/idade < -2 desvios padrao; e emaciacao como peso/altura < -2 desvios padrao. Os dados sobre os determinantes biologicos e sociodemograficos foram analisados por meio de analises multivariadas com base em um modelo teorico hierarquizado. RESULTADOS : Amostras de 4.513 e 1.533 criancas menores de tres anos de idade, em 1987 e 2007, respectivamente, foram incluidas nas analises. A prevalencia de desnutricao aguda foi reduzida em 60,0%, passando de 12,6% em 1987, para 4,7% em 2007, enquanto a prevalencia de nanismo foi reduzida em 50,0%, passando de 27,0% em 1987 para 13,0% em 2007. A prevalencia de emaciacao teve pouca alteracao no periodo. Em 1987, as caracteristicas socioeconomicas e biologicas (renda familiar, escolaridade da mae, disponibilidade de latrina e agua potavel, consulta medica e hospitalizacao da crianca, idade, sexo e peso ao nascer) foram fatores significativamente associados a desnutricao, ao nanismo e a emaciacao. Em 2007, os determinantes da desnutricao ficaram restritos as caracteristicas biologicas (idade, sexo e peso ao nascer). Apenas uma caracteristica socioeconomica, a disponibilidade de latrina, permaneceu significantemente associada ao nanismo. CONCLUSOES : O desenvolvimento socioeconomico, alem de intervencoes de saude, parecem ter efetivamente contribuido para a melhoria do estado nutricional das criancas. Peso ao nascer, especialmente o peso extremamente baixo (< 1.500 g), aparece como o fator de risco mais importante para a desnutricao na primeira infância.OBJECTIVE To analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil. METHODS Data were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model. RESULTS A sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting. CONCLUSIONS Socioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.

Uso da aspiração manual a vácuo na redução do custo e duração de internamentos por aborto incompleto em Fortaleza, CE, Brasil

INTRODUCAO: O uso de aspiracao a vacuo (AV) no tratamento do aborto incompleto e pratica bastante difundida em paises desenvolvidos. Varios estudos nesses paises indicam que o uso da tecnica de aspiracao manual a vacuo (AMV) pode conservar recursos do sistema de saude e melhorar a qualidade do tratamento do aborto. No Brasil, o uso da AMV e procedimento de rotina nos hospitais e clinicas privados. Entretanto, na maioria dos hospitais da rede publica e utilizada somente a tecnica de dilatacao e curetagem (D&C). METODOLOGIA: Foram utilizados metodos de avaliacao rapida para estimar a variacao do custo medio do tratamento e duracao da estadia hospitalar, em um grupo de 30 pacientes admitidas com aborto incompleto em hospital publico de Fortaleza, CE (Brasil). Participantes foram alocadas, randomicamente, em um dos dois grupos de tratamento investigados (AMV ou D&C). RESULTADOS E CONCLUSOES: Os resultados sugerem que o uso da AMV, em substituicao a D&C, no tratamento do aborto incompleto, pode reduzir em ate 41% o custo medio do tratamento e em 77% o tempo medio de hospitalizacao. Recomenda-se a realizacao de estudos confirmatorios, como tambem que se aprofunde os conhecimentos sobre a percepcao do aborto e seu tratamento por parte do pessoal de saude e da populacao feminina.INTRODUCAO: O uso de aspiracao a vacuo (AV) no tratamento do aborto incompleto e pratica bastante difundida em paises desenvolvidos. Varios estudos nesses paises indicam que o uso da tecnica de aspiracao manual a vacuo (AMV) pode conservar recursos do sistema de saude e melhorar a qualidade do tratamento do aborto. No Brasil, o uso da AMV e procedimento de rotina nos hospitais e clinicas privados. Entretanto, na maioria dos hospitais da rede publica e utilizada somente a tecnica de dilatacao e curetagem (D&C). METODOLOGIA: Foram utilizados metodos de avaliacao rapida para estimar a variacao do custo medio do tratamento e duracao da estadia hospitalar, em um grupo de 30 pacientes admitidas com aborto incompleto em hospital publico de Fortaleza, CE (Brasil). Participantes foram alocadas, randomicamente, em um dos dois grupos de tratamento investigados (AMV ou D&C). RESULTADOS E CONCLUSOES: Os resultados sugerem que o uso da AMV, em substituicao a D&C, no tratamento do aborto incompleto, pode reduzir em ate 41% o custo medio do tratamento e em 77% o tempo medio de hospitalizacao. Recomenda-se a realizacao de estudos confirmatorios, como tambem que se aprofunde os conhecimentos sobre a percepcao do aborto e seu tratamento por parte do pessoal de saude e da populacao feminina.INTRODUCTION In most developed countries vacuum aspiration has been shown to be safer and less costly than sharp curettage (SC) for uterine evacuation. In many of the developing countries, including Brazil, sharp curettage (SC) is the most commonly used technique for treating cases of incomplete abortion admitted to hospital. The procedure often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. Two hypotheses are examined: the first, that the use of manual vacuum aspiration (MVA)--a variation of the vacuum aspiration, would be less costly than SC for the treatment of cases of incomplete abortion admitted to hospital; and the second, that the treatment of incomplete abortion with MVA would substantially reduce the length of hospital stay. METHODOLOGY Thirty women with diagnosis of first trimester incomplete abortion were randomly allocated to the SC or MVA group. Rapid-assessment data collection techniques were used to identify factors that contributed to cost reduction and hospital stay. RESULTS AND CONCLUSION The results of the study show that, overall, patients treated for incomplete abortion with MVA spent 77% less time in the hospital and consumed 41% fewer resources than similarly diagnosed patients treated with SC. Recommendations are made as to the need of certain changes in patient management. Particularly necessary is information regarding cultural perception and concepts of abortion treatment.INTRODUCTION: In most developed countries vacuum aspiration has been shown to be safer and less costly than sharp curettage (SC) for uterine evacuation. In many of the developing countries, including Brazil, sharp curettage (SC) is the most commonly used technique for treating cases of incomplete abortion admitted to hospital. The procedure often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. Two hypotheses are examined: the first, that the use of manual vacuum aspiration (MVA) - a variation of the vacuum aspiration, would be less costly than SC for the treatment of cases of incomplete abortion admitted to hospital; and the second, that the treatment of incomplete abortion with MVA would substantially reduce the length of hospital stay. METHODOLOGY: Thirty women with diagnosis of first trimester incomplete abortion were randomly allocated to the SC or MVA group. Rapid-assessment data collection techniques were used to identify factors that contributed to cost reduction and hospital stay. RESULTS AND CONCLUSION: The results of the study show that, overall, patients treated for incomplete abortion with MVA spent 77% less time in the hospital and consumed 41% fewer resources than similarly diagnosed patients treated with SC. Recommendations are made as to the need of certain changes in patient management. Particularly necessary is information regarding cultural perception and concepts of abortion treatment.

[Risk factors of stillbirths in Fortaleza-Brazil: a case-control study].

Stillbirths are a common event in areas where reproductive health care is poorly delivered, such as the Northeast region of Brazil. This case-control study aimed to identify risk factors associated to foetal deaths occurred in a major obstetric facility of Fortaleza, 1.7 million inhabitants, Northeastern Brazil. 125 stillborn foetus over 20 weeks of gestation (cases) were compared to 250 healthy newborns (controls), in relation to socioeconomic, reproductive, behavioral and morbidity characteristics of their mothers. Crude and adjusted Odds Ratios were then calculated. After adjustment for confounders, the following characteristics of the mother remained as risk factors for stillbirths, with OR statistically significant at the 95% level: attending <5 antenatal consultations during pregnancy (OR=3.30; CI=1.92 - 5.07 ), illiterate mother (OR=3.30; CI=1.84 - 5.92 ), mothers age above 19 (OR=2.73; CI=1.42 - 5.24 ), monthly family income of 1 minimum wage or less (OR=2.12; CI=1.03 - 4.35 ) and severe illnesses or complication during pregnancy (OR=1.75; CI=1.01 - 3.03 ). Inadequate attendance to antenatal care consultations was the risk factor most strongly associated to stillbirths. Similarly, it was the condition most amenable to change in a short term, among those identified as risk factors.

Factors associated with non-vaccination against measles in northeastern Brazil: Clues about causes of the 2015 outbreak

Measles is a highly contagious disease that can be effectively prevented through vaccination. The recent increase in vaccination coverage was successful in reducing the mortality globally of the disease by 74%. As a whole, the Americas have been considered a disease-free zone. However, it is known that if an immunization programs fails, there will be an accumulation of susceptible people that can lead to disease outbreaks. Recently, both the United States and Brazil faced outbreaks of measles. The present study aims to identify the determining factors of non-vaccination in Brazil in two different vaccination coverage moments, to provide clues as to the causes of current outbreaks. Data were drawn from five population-based cross-sectional studies that surveyed a representative sample of preschool children from 1987 to 2007 (9585 children in total). To assess childrens vaccination status, two different information sources were used: information provided by mothers and information from childrens health cards. Multivariate analyses with logistic binary regression models were conducted. After adjustment for confounding factors, it was observed that in 1987, with 48.2% vaccination coverage, socioeconomic, maternal, nutritional factors and access to health facilities were important, while in 2007 (96.7% coverage), nutritional and maternal factors were important. Distinct patterns of determinants of non-vaccination were also found. In addition, the low coverage in 1987 resulted in a current pool of adults who were not immunized as children; this may have contributed to the beginning of the current Brazilian outbreak. Globally, there are two standards of vaccination coverage (low and high). Therefore, discussion of the determinants of non-vaccination is important. Our findings suggest vulnerable groups should receive special attention to ensure they are protected. It is also important to consider the possible impact of pools of adults not immunized.

Metodologia das Pesquisas Populacionais de Saúde Materno-Infantil: uma série transversal realizada no Estado do Ceará de 1987 a 2007

Objective: to describe the methods used in mother-child health studies (PESMIC), over a period of 20 years in Ceara. Methods: a series of studies carried out over a twenty-year period were examined with regard to the following aspects: a) population-based cross-sectional series studies, with a representative sample of 8000 families; b) questionnaires and anthropo-metric measurements were used, studying the levels and causes of infant mortality, the prevalence of mother and child malnutrition, the duration of breastfeeding, vaccination coverage, the prevalence and management of diarrhea and access to mother-child health services; c) the results obtained were outcome variables (mainly infant mortality) and various determining factors relating to the child and the mother and social and economic conditions. Results: the response rate was nearly 100% for the five studies (1986-2007) and there were important changes in socio-demographic and health indicators, an 81% reduction in the infant mortality rate, a 43% increase in breastfeeding an immunization rate of 95%. There was also a 243% increase in overweight. In total the five studies covered 177,132 residents, 47,508 women and 13,049 children. Conclusion: it is recommended that these studies should be continued using the same methodology, making it possible to analyze variations over time.

Adoption of manual vacuum aspiration for treatment of incomplete abortion reduces costs and duration of patient's hospital stay in an urban area of Northeastern Brazil

INTRODUCAO: O uso de aspiracao a vacuo (AV) no tratamento do aborto incompleto e pratica bastante difundida em paises desenvolvidos. Varios estudos nesses paises indicam que o uso da tecnica de aspiracao manual a vacuo (AMV) pode conservar recursos do sistema de saude e melhorar a qualidade do tratamento do aborto. No Brasil, o uso da AMV e procedimento de rotina nos hospitais e clinicas privados. Entretanto, na maioria dos hospitais da rede publica e utilizada somente a tecnica de dilatacao e curetagem (D&C). METODOLOGIA: Foram utilizados metodos de avaliacao rapida para estimar a variacao do custo medio do tratamento e duracao da estadia hospitalar, em um grupo de 30 pacientes admitidas com aborto incompleto em hospital publico de Fortaleza, CE (Brasil). Participantes foram alocadas, randomicamente, em um dos dois grupos de tratamento investigados (AMV ou D&C). RESULTADOS E CONCLUSOES: Os resultados sugerem que o uso da AMV, em substituicao a D&C, no tratamento do aborto incompleto, pode reduzir em ate 41% o custo medio do tratamento e em 77% o tempo medio de hospitalizacao. Recomenda-se a realizacao de estudos confirmatorios, como tambem que se aprofunde os conhecimentos sobre a percepcao do aborto e seu tratamento por parte do pessoal de saude e da populacao feminina.INTRODUCAO: O uso de aspiracao a vacuo (AV) no tratamento do aborto incompleto e pratica bastante difundida em paises desenvolvidos. Varios estudos nesses paises indicam que o uso da tecnica de aspiracao manual a vacuo (AMV) pode conservar recursos do sistema de saude e melhorar a qualidade do tratamento do aborto. No Brasil, o uso da AMV e procedimento de rotina nos hospitais e clinicas privados. Entretanto, na maioria dos hospitais da rede publica e utilizada somente a tecnica de dilatacao e curetagem (D&C). METODOLOGIA: Foram utilizados metodos de avaliacao rapida para estimar a variacao do custo medio do tratamento e duracao da estadia hospitalar, em um grupo de 30 pacientes admitidas com aborto incompleto em hospital publico de Fortaleza, CE (Brasil). Participantes foram alocadas, randomicamente, em um dos dois grupos de tratamento investigados (AMV ou D&C). RESULTADOS E CONCLUSOES: Os resultados sugerem que o uso da AMV, em substituicao a D&C, no tratamento do aborto incompleto, pode reduzir em ate 41% o custo medio do tratamento e em 77% o tempo medio de hospitalizacao. Recomenda-se a realizacao de estudos confirmatorios, como tambem que se aprofunde os conhecimentos sobre a percepcao do aborto e seu tratamento por parte do pessoal de saude e da populacao feminina.INTRODUCTION In most developed countries vacuum aspiration has been shown to be safer and less costly than sharp curettage (SC) for uterine evacuation. In many of the developing countries, including Brazil, sharp curettage (SC) is the most commonly used technique for treating cases of incomplete abortion admitted to hospital. The procedure often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. Two hypotheses are examined: the first, that the use of manual vacuum aspiration (MVA)--a variation of the vacuum aspiration, would be less costly than SC for the treatment of cases of incomplete abortion admitted to hospital; and the second, that the treatment of incomplete abortion with MVA would substantially reduce the length of hospital stay. METHODOLOGY Thirty women with diagnosis of first trimester incomplete abortion were randomly allocated to the SC or MVA group. Rapid-assessment data collection techniques were used to identify factors that contributed to cost reduction and hospital stay. RESULTS AND CONCLUSION The results of the study show that, overall, patients treated for incomplete abortion with MVA spent 77% less time in the hospital and consumed 41% fewer resources than similarly diagnosed patients treated with SC. Recommendations are made as to the need of certain changes in patient management. Particularly necessary is information regarding cultural perception and concepts of abortion treatment.INTRODUCTION: In most developed countries vacuum aspiration has been shown to be safer and less costly than sharp curettage (SC) for uterine evacuation. In many of the developing countries, including Brazil, sharp curettage (SC) is the most commonly used technique for treating cases of incomplete abortion admitted to hospital. The procedure often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. Two hypotheses are examined: the first, that the use of manual vacuum aspiration (MVA) - a variation of the vacuum aspiration, would be less costly than SC for the treatment of cases of incomplete abortion admitted to hospital; and the second, that the treatment of incomplete abortion with MVA would substantially reduce the length of hospital stay. METHODOLOGY: Thirty women with diagnosis of first trimester incomplete abortion were randomly allocated to the SC or MVA group. Rapid-assessment data collection techniques were used to identify factors that contributed to cost reduction and hospital stay. RESULTS AND CONCLUSION: The results of the study show that, overall, patients treated for incomplete abortion with MVA spent 77% less time in the hospital and consumed 41% fewer resources than similarly diagnosed patients treated with SC. Recommendations are made as to the need of certain changes in patient management. Particularly necessary is information regarding cultural perception and concepts of abortion treatment.

Prevalência e determinantes da desnutrição infantil no semiárido do Brasil

OBJETIVO : Analisar tendencias na prevalencia e determinantes da desnutricao em criancas na regiao semiarida do Brasil. METODOS : Foram analisados dados de duas pesquisas transversais domiciliares de base populacional que utilizaram a mesma metodologia. A amostragem por conglomerados foi utilizada para coletar os dados de 8.000 familias, do estado do Ceara, Nordeste do Brasil, para os anos de 1987 e 2007. A desnutricao aguda foi calculada como peso/idade < -2 desvios padrao; nanismo como altura/idade < -2 desvios padrao; e emaciacao como peso/altura < -2 desvios padrao. Os dados sobre os determinantes biologicos e sociodemograficos foram analisados por meio de analises multivariadas com base em um modelo teorico hierarquizado. RESULTADOS : Amostras de 4.513 e 1.533 criancas menores de tres anos de idade, em 1987 e 2007, respectivamente, foram incluidas nas analises. A prevalencia de desnutricao aguda foi reduzida em 60,0%, passando de 12,6% em 1987, para 4,7% em 2007, enquanto a prevalencia de nanismo foi reduzida em 50,0%, passando de 27,0% em 1987 para 13,0% em 2007. A prevalencia de emaciacao teve pouca alteracao no periodo. Em 1987, as caracteristicas socioeconomicas e biologicas (renda familiar, escolaridade da mae, disponibilidade de latrina e agua potavel, consulta medica e hospitalizacao da crianca, idade, sexo e peso ao nascer) foram fatores significativamente associados a desnutricao, ao nanismo e a emaciacao. Em 2007, os determinantes da desnutricao ficaram restritos as caracteristicas biologicas (idade, sexo e peso ao nascer). Apenas uma caracteristica socioeconomica, a disponibilidade de latrina, permaneceu significantemente associada ao nanismo. CONCLUSOES : O desenvolvimento socioeconomico, alem de intervencoes de saude, parecem ter efetivamente contribuido para a melhoria do estado nutricional das criancas. Peso ao nascer, especialmente o peso extremamente baixo (< 1.500 g), aparece como o fator de risco mais importante para a desnutricao na primeira infância.OBJECTIVE To analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil. METHODS Data were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model. RESULTS A sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting. CONCLUSIONS Socioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.