Vania Matos Fonseca

Deficiência de Vitamina A em mães e filhos no Estado de Pernambuco

Analisou-se a prevalencia e os fatores associados a deficiencia de vitamina A (DVA) em maes (664) e seus filhos (790) menores de cinco anos em Pernambuco/2006. Estudo transversal populacional, com amostra representativa do meio urbano e rural. A DVA foi definida como niveis de retinol serico < 20µg/dL para os dois grupos (maes e filhos). Analises bi e multivariadas foram realizadas utilizando o modelo log-log complementar como funcao de ligacao adotando-se modelo de ordenacao hierarquica explicativa da DVA para as criancas e modelo logistico para as maes. A prevalencia de DVA foi 6,9% nas maes e 16,1% em seus filhos, com ocorrencias semelhantes para cada grupo na comparacao urbano x rural. Na area urbana, o regime de ocupacao da moradia teve relacao significante com a DVA nas maes. Para criancas urbanas, apos o ajuste final do modelo, figuraram como variaveis preditivas a idade da mae; no de consultas pre-natais e peso ao nascer. No meio rural a DVA materna se associou a DVA dos filhos RP = 3,99 (IC:1,73-9,19), ao peso ao nascer e diarreia nos ultimos 15 dias. A DVA mantem-se como um problema de saude publica em Pernambuco, com marcantes diferencas de prevalencia e fatores associados em maes e filhos.The aim of this study was to assess the prevalence and associated factors of high Blood Pressure (BP) among adolescents in a Brazilian city. A cross-sectional study was conducted with 653 adolescents (57.9% female) of high school level between 14 and 19 years of age. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were measured. Social and demographic variables and lifestyle factors and body mass index were obtained. Binary logistic regression, crude and adjusted, was employed with a significance level of 5%. The mean SBP and DBP were 111.9 mmHg and 69.9 mmHg, respectively. The prevalence of high BP levels was 12.4%. The multivariable analysis revealed that males (OR: 2.37, 95% CI: 1.45, 3.90), adolescents with maternal education < 8 years (OR: 1.84, 95% CI: 1.03, 3.30) and overweight (OR: 3.79, 95% CI: 2.23, 6.43) had greater indices of high BP. The interaction term between males and overweight represented the subgroup with greater indices of high BP (OR: 6.41, 95% CI: 3.00, 13.16). High BP affects adolescents from Ponta Grossa, State of Parana, and the groups with greater indices of high BP were males, with low maternal educational level and overweight.

Consumo de folato em gestantes de um hospital público do Rio de Janeiro

Folate plays an important role in DNA and RNA synthesis, a central feature of fetal development. There is a lack of information concerning dietary folate intake during pregnancy in Brazil, and in other countries, a significant proportion of women in childbearing age have low dietary folate intake and do not use folic acid-containing supplements. Folate intake by pregnant women was examined in a public hospital in the city of Rio de Janeiro. The analysis included 285 pregnant women at the Fernandes Figueira Institute Maternity (FIOCRUZ). Food-derived folate was assessed by a semi-quantitative food frequency questionnaire, previously validated, with standardized food portions. The study collected data on demographic and socio-economic characteristics and the use of folic acid supplements throughout pregnancy. The prevalence of a deficient dietary folate intake (intake < 600 µg/day) was of 51.3%. Only 22.4% of the pregnant women used folic acid supplements. With the inclusion of supplemental folate in the dietary folate intake, the prevalence dropped to 43.8%. Low-income women reported greater intake of energy, folate and folic acid supplements. The variation of folic consumption was explained by beef, R2 =0.962 (p=0.02), and milk, R2=0.038 (p=0.007). Due to the necessity of folate supplementation during pregnancy, we suggest it is important to advise women planning to conceive to start the use of folic acid supplements, as well as the emphasis.

Fatores associados ao uso de suplementos em recém-natos em alojamento conjunto no município do Rio de Janeiro, 2009

This article presents the configuration of the social network of women living in domestic violence situations in a city in the metropolitan region of São Paulo, Brazil. Interviews were conducted with 9 women and 8 professionals, in addition to observation in three institutions which constitute the network for protection of women. The analysis was underpinned by the theoretical assumptions of social networks. Results show that violence inflicted upon women by their partners make them unable to establish and maintain social bonds, and thus face isolation and ostracism. Professionals and institutions can play a vital role for getting women out of the cycle of violence provided that care networks and services are well organized. Further studies of social networks, focusing on the nature of the links and exchanges among actors may contribute to acquiring knowledge about the relationship dynamics in situation of violence.

Lack of association between iron status at birth and growth of preterm infants

OBJECTIVE To assess the association between iron status at birth and growth of preterm infants. METHODS Ninety-five premature babies (26 to 36 weeks of gestational age) born from July 2000 to May 2001 in a public hospital in Rio de Janeiro, Southeastern Brazil, were followed up for six months, corrected by gestational age. Iron measurements at birth were available for 82 mothers and 78 children: hemoglobin, hematocrit, mean corpuscular volume and plasma iron. All children received free doses of iron supplement (2 mg/kg/day) during the follow-up period and up to two years of age. Multivariate linear regression analyses with repeated measurements were performed to assess factors associated to linear growth. RESULTS Growth was more pronounced up to 40 weeks of gestational age, increasing about 1.0 cm/week and then slowing down to 0.75 cm/week. The multivariate analysis showed growth was positively associated with birth weight (0.4 cm/100 g; p<0.001) and negatively associated with gestational age at birth (-0.5 cm/week; p<0.001). There was no association between cord iron and mother iron measurements and growth (p>0.60 for all measures). Only two children had anemia at birth, whereas 43.9% of mothers were anemic (hemoglobin <11 g/dl). Also, there was no correlation between anemia indicators of mothers and children at birth (r<0.15; p>0.20). CONCLUSIONS Maternal anemia was not associated with anemia in preterm infants and iron status of mothers and children at birth was not associated with short-term growth of preterm infants.

[Factors associated with the use of supplements among newborns in communal wards in Rio de Janeiro, 2009].

The scope of this study was to estimate the prevalence of the use of supplements among newborns and analyze the factors associated with their use. A cross-sectional study was conducted in 2009 with a representative sample of 687 mothers interviewed in 15 communal wards in hospitals of the Unified Health System in the city of Rio de Janeiro. Prevalence ratios (PR) of supplement use were obtained by Poisson Regression with robust variance, using a hierarchical model. The prevalence of supplement use was 49.8%. Factors associated with supplement use were: being submitted to the rapid HIV test (PR = 1.37; CI95%:1.18-1.58); cesarean delivery (PR = 1.57; CI95%:1.38-1.79); not being helped to breastfeed in the delivery room (PR = 1.60; CI95%:1.29-1.99); mother-child separation (PR = 1.24; CI95%:1.05-1.46); pacifier use (PR = 1.31; CI95%:1.08-1.58); maternal or neonatal interventions (PR = 1.56; CI95%:1.34-1.82); BFH certification (PR = 0.52; CI95%:0.44-0.61); and not receiving help to breastfeed in the communal ward (PR = 0.78; CI95%:0.66-0.92). Supplements to breast milk are being widely used. Hospital routines should be reviewed, so that exclusive breastfeeding becomes the norm.