ABSTRACT BACKGROUND: Few food frequency questionnaires (FFQ) have been validated for pregnant women, particularly those in small- and medium-sized cities in different regions of Brazil. OBJECTIVES: To validate and calibrate a semiquantitative FFQ for pregnant women. DESIGN AND SETTING: The study was validated with a sample of 50 pregnant women (≥ 18 years) enrolled in Brazilian prenatal services. METHODS: An FFQ and a 24-hour recall were used to evaluate dietary intake. Dietary variables were tested for normality and log-converted when asymmetrical. Pearson's Correlation Coefficient was used to validate the questionnaire. Linear regression was applied to extract calibration factors. All variables underlying the consumption analysis were adjusted for energy. RESULTS: The mean age of the pregnant women was 26 years ± 6.2 years; 58% were in their first trimester, and 30% were identified as overweight/obese. The Pearson correlation analysis results indicated that the FFQ overestimated energy and nutrient intake, whose coefficients ranged from −0.15 (monounsaturated fat) to 0.50 (carbohydrate). Adjusting for energy reduced the mean values of intake coefficients, which now ranged from −0.33 (sodium) to 0.96 (folate). The calibration analysis results indicated variation in the coefficients from −0.23 (sodium) to 1.00 (folate). Calibration produced satisfactory coefficients for the FFQ compared with the reference standard for energy, macronutrients, monounsaturated fat, cholesterol, vitamins B12/C, folate, sodium, iron, and calcium. CONCLUSIONS: After validating and calibrating tests, we observed that the FFQ was adequately accurate for assessing the food consumption of the pregnant women in this study. BACKGROUND (FFQ small mediumsized medium sized Brazil OBJECTIVES SETTING 5 ≥ ( 1 services METHODS 24hour hour 24 logconverted log converted asymmetrical Pearsons s questionnaire factors RESULTS 2 62 6 6. 58 trimester 30 overweightobese overweight obese overweight/obese 015 0 15 −0.1 fat 050 0.5 carbohydrate. carbohydrate . (carbohydrate) 033 33 −0.3 sodium (sodium 096 96 0.9 folate. folate (folate) 023 23 −0.2 100 00 1.0 macronutrients cholesterol B12C BC B12 C B B12/C iron calcium CONCLUSIONS tests 3 01 −0. 05 0. (carbohydrate 03 09 9 (folate 02 10 1. B1 −0 −

Abstract The incidence of premature birth has increased worldwide, unequally distributed by race/ethnicity. Racism generates economic inequalities, educational disparities, and differential access to health care, which increases the risk of preterm birth. Thus, this study aimed to evaluate the factors associated with preterm birth and racial and ethnic disparities in premature birth among pregnant women attending prenatal care at the Brazilian Unified Health System health units in the urban area of Santo Antônio de Jesus, Bahia, Brazil. This study used data from 938 pregnant women aged between 18 to 45 years within the NISAMI prospective cohort. Premature birth prevalence was 11.8%, with a higher prevalence among black than non-black women (12.9% versus 6.0%, respectively). Maternal age between 18 and 24 years was the only factor associated with premature birth. A higher risk of premature birth was found among black women than non-black women (RR 3.22; 95%CI 1.42-7.32). These results reveal the existence of racial and social inequalities in the occurrence of premature birth.

Resumo A incidência de parto prematuro tem aumentado em todo o mundo, distribuída de forma desigual por raça/etnia. O racismo gera desigualdades econômicas, disparidades educacionais e acesso diferenciado à saúde, o que aumenta o risco de parto prematuro. Assim, este estudo teve como objetivo avaliar os fatores associados à prematuridade e disparidades raciais e étnicas no parto prematuro entre gestantes atendidas durante o pré-natal em unidades de saúde do Sistema Único de Saúde na zona urbana de Santo Antônio de Jesus, Bahia, Brasil. Este estudo utilizou dados de 938 mulheres grávidas com idade entre 18 e 45 anos dentro da coorte prospectiva do NISAMI. A prevalência de prematuridade foi de 11,8%, sendo maior entre as negras do que entre as não negras (12,9% versus 6,0%, respectivamente). A idade materna entre 18 e 24 anos foi o único fator associado ao parto prematuro. Foi encontrado maior risco de prematuridade entre as mulheres negras do que entre as não negras (RR 3,22; IC95% 1,42-7,32). Esses resultados revelam a existência de desigualdades raciais e sociais na ocorrência do parto prematuro.

Resumo A incidência de parto prematuro tem aumentado em todo o mundo, distribuída de forma desigual por raça/etnia. O racismo gera desigualdades econômicas, disparidades educacionais e acesso diferenciado à saúde, o que aumenta o risco de parto prematuro. Assim, este estudo teve como objetivo avaliar os fatores associados à prematuridade e disparidades raciais e étnicas no parto prematuro entre gestantes atendidas durante o pré-natal em unidades de saúde do Sistema Único de Saúde na zona urbana de Santo Antônio de Jesus, Bahia, Brasil. Este estudo utilizou dados de 938 mulheres grávidas com idade entre 18 e 45 anos dentro da coorte prospectiva do NISAMI. A prevalência de prematuridade foi de 11,8%, sendo maior entre as negras do que entre as não negras (12,9% versus 6,0%, respectivamente). A idade materna entre 18 e 24 anos foi o único fator associado ao parto prematuro. Foi encontrado maior risco de prematuridade entre as mulheres negras do que entre as não negras (RR 3,22; IC95% 1,42-7,32). Esses resultados revelam a existência de desigualdades raciais e sociais na ocorrência do parto prematuro. mundo raçaetnia raça etnia raça/etnia econômicas Assim prénatal pré natal Jesus Bahia Brasil 93 1 4 NISAMI 118 11 8 11,8% 12,9% 129 12 9 (12,9 60 6 0 6,0% respectivamente. respectivamente . respectivamente) 2 RR 3,22 322 3 22 IC95 IC 1,427,32. 142732 1,42 7,32 42 7 32 1,42-7,32) 11,8 12,9 (12, 6,0 3,2 IC9 427 1,427,32 14273 142 1,4 732 7,3 1,42-7,32 11, 12, (12 6, 3, 1,427,3 1427 14 1, 73 7, 1,42-7,3 (1 1,427, 1,42-7, ( 1,427 1,42-7 1,42-

Abstract The incidence of premature birth has increased worldwide, unequally distributed by race/ethnicity. Racism generates economic inequalities, educational disparities, and differential access to health care, which increases the risk of preterm birth. Thus, this study aimed to evaluate the factors associated with preterm birth and racial and ethnic disparities in premature birth among pregnant women attending prenatal care at the Brazilian Unified Health System health units in the urban area of Santo Antônio de Jesus, Bahia, Brazil. This study used data from 938 pregnant women aged between 18 to 45 years within the NISAMI prospective cohort. Premature birth prevalence was 11.8%, with a higher prevalence among black than non-black women (12.9% versus 6.0%, respectively). Maternal age between 18 and 24 years was the only factor associated with premature birth. A higher risk of premature birth was found among black women than non-black women (RR 3.22; 95%CI 1.42-7.32). These results reveal the existence of racial and social inequalities in the occurrence of premature birth. worldwide raceethnicity race ethnicity race/ethnicity Thus Jesus Bahia Brazil 93 1 4 cohort 118 11 8 11.8% nonblack non 12.9% 129 12 9 (12.9 60 6 0 6.0% respectively. respectively . respectively) 2 RR 3.22 322 3 22 95CI CI 95 1.427.32. 142732 1.42 7.32 42 7 32 1.42-7.32) 11.8 12.9 (12. 6.0 3.2 427 1.427.32 14273 142 1.4 732 7.3 1.42-7.32 11. 12. (12 6. 3. 1.427.3 1427 14 1. 73 7. 1.42-7.3 (1 1.427. 1.42-7. ( 1.427 1.42-7 1.42-

ABSTRACT BACKGROUND: Weight retention during the post-partum period is associated with excessive weight gain. OBJECTIVES: To investigate factors associated with maternal weight retention at six months post-partum (PPWR). DESIGN AND SETTING: A prospective cohort study was conducted with 127 women monitored using prenatal services. METHODS: The outcome variable was represented by post-partum maternal weight retention and calculated as the difference between the mother’s weight at sixth month post-partum and her pregestational weight. RESULTS: The mean age of the pregnant women was 26.7 ± 5.25 years old, and the post-partum maternal weight retention was 46.5%. The proximal determinants showed a direct association with PPWR after adjusting for the distal and intermediate variables: excessive gestational weight gain (odds ratio [OR]:3.34; confidence interval [CI]:1.16–9.59), greater adhesion to dietary intake pattern 2 (composed of red meats and derivatives, eggs, industrialized foods, and coffee) (OR:2.70; CI:1.16–6.32), and the absence of exclusive maternal breastfeeding in the first month (OR:3.40; CI:1.27–9.12), as well as primiparity (OR:2.36; CI:1.00–5.55), an intermediate determinant. Insufficient weight gain in pregnancy was inversely associated with the outcome (OR:0.35; CI:0.31–0.93). CONCLUSIONS: Among the hierarchical determinants, proximal factors were interrelated with maternal weight retention, indicating that excessive total weight gain, an inadequate dietary intake pattern, and the absence of exclusive maternal breastfeeding in the first month of life work as dampeners of the return to pre-gestational weight. Prepartum and post-partum care interventions can contribute to reducing excess weight in women. BACKGROUND postpartum post partum OBJECTIVES PPWR. . (PPWR) SETTING 12 services METHODS mothers mother s RESULTS 267 26 7 26. 525 5 25 5.2 old 465 46 46.5% variables odds OR3.34 OR334 OR 3.34 3 34 [OR]:3.34 CI1.16–9.59, CI116959 CI 1.16–9.59 , 1 16 9 59 [CI]:1.16–9.59) composed derivatives eggs foods coffee OR2.70 OR270 2.70 70 (OR:2.70 CI1.16–6.32, CI116632 1.16–6.32 6 32 CI:1.16–6.32) OR3.40 OR340 3.40 40 (OR:3.40 CI1.27–9.12, CI127912 1.27–9.12 27 CI:1.27–9.12) OR2.36 OR236 2.36 36 (OR:2.36 CI1.00–5.55, CI100555 1.00–5.55 00 55 CI:1.00–5.55) determinant OR0.35 OR035 0.35 0 35 (OR:0.35 CI0.31–0.93. CI031093 0.31–0.93 31 93 CI:0.31–0.93) CONCLUSIONS pre (PPWR 52 5. 4 46.5 OR3 OR3.3 OR33 334 3.3 [OR]:3.3 CI1 CI1.16–9.59 CI11695 116959 1.16–9.5 [CI]:1.16–9.59 OR2 OR2.7 OR27 270 2.7 (OR:2.7 CI1.16–6.32 CI11663 116632 1.16–6.3 CI:1.16–6.32 OR3.4 OR34 340 3.4 (OR:3.4 CI1.27–9.12 CI12791 127912 1.27–9.1 CI:1.27–9.12 OR2.3 OR23 236 2.3 (OR:2.3 CI1.00–5.55 CI10055 100555 1.00–5.5 CI:1.00–5.55 OR0 OR0.3 OR03 035 0.3 (OR:0.3 CI0 CI0.31–0.93 CI03109 031093 0.31–0.9 CI:0.31–0.93 46. OR3. 33 3. [OR]:3. CI1.16–9.5 CI1169 11695 1.16–9. [CI]:1.16–9.5 OR2. 2. (OR:2. CI1.16–6.3 CI1166 11663 1.16–6. CI:1.16–6.3 (OR:3. CI1.27–9.1 CI1279 12791 1.27–9. CI:1.27–9.1 23 CI1.00–5.5 CI1005 10055 1.00–5. CI:1.00–5.5 OR0. 03 0. (OR:0. CI0.31–0.9 CI0310 03109 0.31–0. CI:0.31–0.9 [OR]:3 CI1.16–9. CI116 1169 1.16–9 [CI]:1.16–9. (OR:2 CI1.16–6. 1166 1.16–6 CI:1.16–6. (OR:3 CI1.27–9. CI127 1279 1.27–9 CI:1.27–9. CI1.00–5. CI100 1005 1.00–5 CI:1.00–5. (OR:0 CI0.31–0. CI031 0310 0.31–0 CI:0.31–0. [OR]: CI1.16–9 CI11 116 1.16– [CI]:1.16–9 (OR: CI1.16–6 CI:1.16–6 CI1.27–9 CI12 1.27– CI:1.27–9 CI1.00–5 CI10 100 1.00– CI:1.00–5 CI0.31–0 CI03 031 0.31– CI:0.31–0 [OR] CI1.16– 11 1.16 [CI]:1.16– (OR CI:1.16– CI1.27– 1.27 CI:1.27– CI1.00– 10 1.00 CI:1.00– CI0.31– 0.31 CI:0.31– [OR CI1.16 1.1 [CI]:1.16 CI:1.16 CI1.27 1.2 CI:1.27 CI1.00 1.0 CI:1.00 CI0.31 CI:0.31 CI1.1 1. [CI]:1.1 CI:1.1 CI1.2 CI:1.2 CI1.0 CI:1.0 CI0.3 CI:0.3 CI1. [CI]:1. CI:1. CI0. CI:0. [CI]:1 CI:1 CI:0 [CI]: CI: [CI] [CI

Resumo Investigar o impacto dos programas de tranferência de renda (CTs) nos desfechos ao nascer, incluindo peso ao nascer, baixo peso ao nascer e prematuridade, e crescimento físico infantil, avaliado pelos índices antropométricos de crianças menores de cinco anos. Revisão sistemática realizada nas bases de dados PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus e Web of Science. Foram incluídos estudos quantitativos observacionais, experimentais e quasi-experimentais, com um total de 11 estudos na revisão. A maioria (81,8%) foi realizada em países de baixa e média rendas. Também na modalidade CT condicionais (63,6%). Quatro eram ensaios clínicos, e sete observacionais. Os CT condicionais estiveram associados a uma redução nos índices de altura-para-idade (-0,14; IC95% -0,27, -0,02); (OR 0,85; IC95% 0,77-0,94); (OR = 0,44; IC95% 0,19-0,98), redução significativa na chance de baixo peso-para-idade (OR = 0,16; IC95% -0,11-0,43), baixo peso-para-altura (OR = -0,68; IC95% -1,14, -0,21), e redução de peso para idade (OR = 0,27; IC95% 0,10; 0,71). CTs não condicionais foram associados à redução do baixo peso as nascer (RR = 0,71; IC95% 0,63-0,81; p < 0,0001), e de prematuros (RR = 0,76; IC95% 0,69-0,84; p < 0,0001). Os CTs condicionais podem influenciar positivamente os desfechos ao nascer e o crescimento infantil. (CTs prematuridade infantil anos PubMedMedline PubMed Medline PubMed/Medline Embase LILACS Library Science observacionais quasiexperimentais, quasiexperimentais quasi experimentais, quasi-experimentais 1 revisão 81,8% 818 81 8 (81,8% rendas 63,6%. 636 63,6% . 63 6 (63,6%) clínicos alturaparaidade altura 0,14 014 0 14 (-0,14 IC95 IC 0,27, 027 27 -0,27 0,02 002 02 -0,02) OR 0,85 085 85 0,770,94 077094 0,77 0,94 77 94 0,77-0,94) 0,44 044 44 0,190,98, 019098 0,19 0,98 , 19 98 0,19-0,98) pesoparaidade 0,16 016 16 0,110,43, 011043 0,11 0,43 43 -0,11-0,43) pesoparaaltura 0,68 068 68 -0,68 1,14, 114 -1,14 0,21, 021 0,21 21 -0,21) 0,27 0,10 010 10 0,71. 071 0,71 71 0,71) RR 0,630,81 063081 0,63 0,81 0,63-0,81 0,0001, 00001 0,0001 0001 0,0001) 0,76 076 76 0,690,84 069084 0,69 0,84 69 84 0,69-0,84 0,0001. 81,8 (81,8 63,6 (63,6% 0,1 01 (-0,1 IC9 2 -0,2 0,0 00 -0,02 0,8 08 770 0,770,9 07709 077 0,7 094 0,9 7 9 0,77-0,94 0,4 04 4 190 0,190,98 01909 019 098 0,19-0,98 110 0,110,43 01104 011 043 -0,11-0,43 0,6 06 -0,6 1,14 -1,1 0,2 -0,21 07 630 0,630,8 06308 063 081 0,63-0,8 0000 0,000 000 690 0,690,8 06908 069 084 0,69-0,8 81, (81, 63, (63,6 0, (-0, -0, -0,0 0,770, 0770 09 0,77-0,9 0,190,9 0190 0,19-0,9 0,110,4 0110 -0,11-0,4 1,1 -1, 0,630, 0630 0,63-0, 0,00 0,690, 0690 0,69-0, (81 (63, (-0 -0 0,770 0,77-0, 0,190, 0,19-0, 0,110, -0,11-0, 1, -1 0,630 0,63-0 0,690 0,69-0 (8 (63 (- - 0,77-0 0,190 0,19-0 0,110 -0,11-0 0,63- 0,69- ( (6 0,77- 0,19- -0,11- -0,11 -0,1

Abstract To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth. (CTs prematurity age PubMedMedline PubMed Medline PubMed/Medline Embase LILACS Library databases quasiexperimental. quasiexperimental quasi experimental. quasi-experimental review 81.8% 818 81 8 (81.8% lowand middleincome middle income 63.6%. 636 63.6% . 63 6 (63.6%) heightforage height for 0.14 014 0 14 (-0.14 95CI CI 95 0.27, 027 27 -0.27 0.02 002 02 -0.02) OR 0.85 085 85 0.770.94 077094 0.77 0.94 77 94 0.77-0.94) 0.44 044 44 0.190.98, 019098 0.19 0.98 , 19 98 0.19-0.98) weightforage 0.16 016 16 0.110.43, 011043 0.11 0.43 11 43 -0.11-0.43) weightforheight 0.68 068 68 -0.68 1.14, 114 1 -1.14 0.21, 021 0.21 21 -0.21) 0.27 0.10 010 10 0.71. 071 0.71 71 0.71) RR 0.630.81 063081 0.63 0.81 0.63-0.81 0.0001 00001 0001 0.76 076 76 0.690.84 069084 0.69 0.84 69 84 0.69-0.84 0.0001. 81.8 (81.8 63.6 (63.6% 0.1 01 (-0.1 9 2 -0.2 0.0 00 -0.02 0.8 08 770 0.770.9 07709 077 0.7 094 0.9 7 0.77-0.94 0.4 04 4 190 0.190.98 01909 019 098 0.19-0.98 110 0.110.43 01104 011 043 -0.11-0.43 0.6 06 -0.6 1.14 -1.1 0.2 -0.21 07 630 0.630.8 06308 063 081 0.63-0.8 0.000 0000 000 690 0.690.8 06908 069 084 0.69-0.8 81. (81. 63. (63.6 0. (-0. -0. -0.0 0.770. 0770 09 0.77-0.9 0.190.9 0190 0.19-0.9 0.110.4 0110 -0.11-0.4 1.1 -1. 0.630. 0630 0.63-0. 0.00 0.690. 0690 0.69-0. (81 (63. (-0 -0 0.770 0.77-0. 0.190. 0.19-0. 0.110. -0.11-0. 1. -1 0.630 0.63-0 0.690 0.69-0 (8 (63 (- - 0.77-0 0.190 0.19-0 0.110 -0.11-0 0.63- 0.69- ( (6 0.77- 0.19- -0.11- -0.11 -0.1

RESUMEN Objetivo: analizar la tendencia temporal de la mortalidad materna y correlacionarla con la cobertura prenatal, entre adolescentes y adultas jóvenes, en el estado de Bahía, período 2000-2020. Métodos: estudio ecológico de series temporales y correlación entre muertes maternas y atención prenatal, en grupos de edad de 10-19 y 20-24, utilizando el Sistema de Información de Mortalidad. Analizó la tendencia mediante regresión de Prais-Winsten, según raza/color de piel, causas y hora de muerte; para correlación, el coeficiente de Spearman. Resultados: en el período se registraron 418 muertes de adolescentes y 574 de adultas jóvenes; razón de mortalidad materna de 59,7 y 63,2 muertes/100.000 nacidos vivos, con importante tendencia a la baja (-2,2%; -2,9%, respectivamente). Se observó correlación inversa entre el mayor número de consultas y la mortalidad materna en grupos. Conclusión: la mortalidad materna mostró tendencia descendente en el período, pero con altas proporciones de muertes. Hubo una correlación significativa entre la cobertura prenatal y la mortalidad materna, adolescente y adulta joven. Objetivo jóvenes Bahía 20002020. 20002020 2000 2020. 2020 2000-2020 Métodos 1019 10 19 10-1 2024, 2024 20 24, 24 20-24 Mortalidad PraisWinsten, PraisWinsten Prais Winsten, Winsten Prais-Winsten razacolor raza color piel muerte Spearman Resultados 41 57 597 59 7 59, 632 63 2 63, muertes100000 100 000 muertes/100.00 vivos 2,2% 22 (-2,2% 2,9%, 29 9 -2,9% respectivamente. respectivamente . respectivamente) Conclusión joven 2000202 200 202 2000-202 101 1 10- 20-2 4 5 6 muertes10000 00 muertes/100.0 2,2 (-2,2 2,9% -2,9 200020 2000-20 20- muertes1000 0 muertes/100. 2, (-2, 2,9 -2, 20002 2000-2 muertes100 muertes/100 (-2 -2 2000- muertes10 muertes/10 (- - muertes1 muertes/1 ( muertes/

ABSTRACT Objective: to analyze the temporal trend of maternal mortality and correlate it with prenatal care coverage among adolescents and young adults, state of Bahia, Brazil, 2000-2020. Methods: this was an ecological time-series study and correlation between maternal deaths and prenatal care visits in 10-19 and 20-24 age groups, using the Mortality Information System; the trend analysis was performed by means of Prais-Winsten regression, according to race/skin color, timing and causes of death; and Spearman coefficient was used for correlation. Results: in the study period, 418 deaths among adolescents and 574 among young adults were recorded; maternal mortality ratio was 59.7 and 63.2 deaths/100,000 live births, with a significant decreasing trend (-2.2% and -2.9% respectively); it could be seen an inverse correlation between a higher number of prenatal care visits and maternal mortality in the age groups. Conclusion: maternal mortality showed a decreasing trend in the study period, but with high proportions of death; there was a significant correlation between prenatal care coverage and maternal mortality among adolescents and young adults. Objective Bahia Brazil 20002020. 20002020 2000 2020. 2020 2000-2020 Methods timeseries time series 1019 10 19 10-1 2024 20 24 20-2 groups System PraisWinsten Prais Winsten regression raceskin race skin color death Results period 41 57 recorded 597 59 7 59. 632 63 2 63. deaths100000 100 000 deaths/100,00 births 2.2% 22 (-2.2 2.9% 29 9 -2.9 respectively respectively) Conclusion 2000202 200 202 2000-202 101 1 10- 20- 4 5 6 deaths10000 00 deaths/100,0 2.2 (-2. 2.9 -2. 200020 2000-20 deaths1000 0 deaths/100, 2. (-2 -2 20002 2000-2 deaths100 deaths/100 (- - 2000- deaths10 deaths/10 ( deaths1 deaths/1 deaths/

RESUMO Objetivo: analisar a tendência temporal da mortalidade materna e correlacioná-la com a cobertura pré-natal entre adolescentes e adultas jovens, Bahia, Brasil, 2000-2020. Métodos: estudo ecológico de série temporal e correlação entre óbitos maternos e consulta de pré-natal aos 10-19 e 20-24 anos, utilizando-se o Sistema de Informações sobre Mortalidade; a tendência foi analisada pela regressão de Prais-Winsten, segundo raça/cor da pele, causas e momento do óbito; para a correlação, utilizou-se o coeficiente de Spearman. Resultados: no período, foram registrados 418 óbitos de adolescentes e 574 de adultas jovens; razão de mortalidade materna de 59,7 e 63,2 óbitos/100 mil nascidos vivos, com tendência decrescente significante (-2,2% e -2,9% respectivamente); observou-se correlação inversa entre maior número de consultas e mortalidade materna, nos grupos etários. Conclusão: a mortalidade materna apresentou tendência de redução no período, porém com altas proporções de óbito; houve correlação significante entre cobertura pré-natal e mortalidade materna, entre adolescentes e adultas jovens. Objetivo correlacionála correlacioná la prénatal pré natal jovens Bahia Brasil 20002020. 20002020 2000 2020. 2020 2000-2020 Métodos 1019 10 19 10-1 2024 20 24 20-2 anos utilizandose utilizando se Mortalidade PraisWinsten, PraisWinsten Prais Winsten, Winsten Prais-Winsten raçacor raça cor pele óbito utilizouse utilizou Spearman Resultados período 41 57 597 59 7 59, 632 63 2 63, óbitos100 100 óbitos/10 vivos 2,2% 22 (-2,2 2,9% 29 9 -2,9 respectivamente respectivamente) observouse observou etários Conclusão 2000202 200 202 2000-202 101 1 10- 20- 4 5 6 óbitos10 óbitos/1 2,2 (-2, 2,9 -2, 200020 2000-20 óbitos1 óbitos/ 2, (-2 -2 20002 2000-2 (- - 2000- (

Resumo Investigar o impacto dos programas de tranferência de renda (CTs) nos desfechos ao nascer, incluindo peso ao nascer, baixo peso ao nascer e prematuridade, e crescimento físico infantil, avaliado pelos índices antropométricos de crianças menores de cinco anos. Revisão sistemática realizada nas bases de dados PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus e Web of Science. Foram incluídos estudos quantitativos observacionais, experimentais e quasi-experimentais, com um total de 11 estudos na revisão. A maioria (81,8%) foi realizada em países de baixa e média rendas. Também na modalidade CT condicionais (63,6%). Quatro eram ensaios clínicos, e sete observacionais. Os CT condicionais estiveram associados a uma redução nos índices de altura-para-idade (-0,14; IC95% -0,27, -0,02); (OR 0,85; IC95% 0,77-0,94); (OR = 0,44; IC95% 0,19-0,98), redução significativa na chance de baixo peso-para-idade (OR = 0,16; IC95% -0,11-0,43), baixo peso-para-altura (OR = -0,68; IC95% -1,14, -0,21), e redução de peso para idade (OR = 0,27; IC95% 0,10; 0,71). CTs não condicionais foram associados à redução do baixo peso as nascer (RR = 0,71; IC95% 0,63-0,81; p < 0,0001), e de prematuros (RR = 0,76; IC95% 0,69-0,84; p < 0,0001). Os CTs condicionais podem influenciar positivamente os desfechos ao nascer e o crescimento infantil.

Abstract To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.

RESUMO Objetivo: analisar a tendência temporal da mortalidade materna e correlacioná-la com a cobertura pré-natal entre adolescentes e adultas jovens, Bahia, Brasil, 2000-2020. Métodos: estudo ecológico de série temporal e correlação entre óbitos maternos e consulta de pré-natal aos 10-19 e 20-24 anos, utilizando-se o Sistema de Informações sobre Mortalidade; a tendência foi analisada pela regressão de Prais-Winsten, segundo raça/cor da pele, causas e momento do óbito; para a correlação, utilizou-se o coeficiente de Spearman. Resultados: no período, foram registrados 418 óbitos de adolescentes e 574 de adultas jovens; razão de mortalidade materna de 59,7 e 63,2 óbitos/100 mil nascidos vivos, com tendência decrescente significante (-2,2% e -2,9% respectivamente); observou-se correlação inversa entre maior número de consultas e mortalidade materna, nos grupos etários. Conclusão: a mortalidade materna apresentou tendência de redução no período, porém com altas proporções de óbito; houve correlação significante entre cobertura pré-natal e mortalidade materna, entre adolescentes e adultas jovens.

RESUMEN Objetivo: analizar la tendencia temporal de la mortalidad materna y correlacionarla con la cobertura prenatal, entre adolescentes y adultas jóvenes, en el estado de Bahía, período 2000-2020. Métodos: estudio ecológico de series temporales y correlación entre muertes maternas y atención prenatal, en grupos de edad de 10-19 y 20-24, utilizando el Sistema de Información de Mortalidad. Analizó la tendencia mediante regresión de Prais-Winsten, según raza/color de piel, causas y hora de muerte; para correlación, el coeficiente de Spearman. Resultados: en el período se registraron 418 muertes de adolescentes y 574 de adultas jóvenes; razón de mortalidad materna de 59,7 y 63,2 muertes/100.000 nacidos vivos, con importante tendencia a la baja (-2,2%; -2,9%, respectivamente). Se observó correlación inversa entre el mayor número de consultas y la mortalidad materna en grupos. Conclusión: la mortalidad materna mostró tendencia descendente en el período, pero con altas proporciones de muertes. Hubo una correlación significativa entre la cobertura prenatal y la mortalidad materna, adolescente y adulta joven.

ABSTRACT Objective: to analyze the temporal trend of maternal mortality and correlate it with prenatal care coverage among adolescents and young adults, state of Bahia, Brazil, 2000-2020. Methods: this was an ecological time-series study and correlation between maternal deaths and prenatal care visits in 10-19 and 20-24 age groups, using the Mortality Information System; the trend analysis was performed by means of Prais-Winsten regression, according to race/skin color, timing and causes of death; and Spearman coefficient was used for correlation. Results: in the study period, 418 deaths among adolescents and 574 among young adults were recorded; maternal mortality ratio was 59.7 and 63.2 deaths/100,000 live births, with a significant decreasing trend (-2.2% and -2.9% respectively); it could be seen an inverse correlation between a higher number of prenatal care visits and maternal mortality in the age groups. Conclusion: maternal mortality showed a decreasing trend in the study period, but with high proportions of death; there was a significant correlation between prenatal care coverage and maternal mortality among adolescents and young adults.

ABSTRACT BACKGROUND: There are few studies on the influence of a cash transfer program on nutritional outcomes from pregnancy. OBJECTIVES: To analyze how a Brazilian conditional cash transfer program (Bolsa Familia Program, BFP) was associated with changes in body mass index (BMI) and food consumption among pregnant women. DESIGN AND SETTING: Cohort study on 250 pregnant women (≥ 18 years of age) in Brazilian prenatal services. METHODS: A food frequency questionnaire was used to evaluate dietary intake. Weight was measured in each gestational trimester. Generalized estimation equations and structural equation modeling were used for statistical analyses. Correlations were analyzed using standardized coefficients (SCs). RESULTS: Women benefitting from the BFP were of greater age and had lower education. The BFP exerted a direct negative effect on the pregnant women’s consumption choices regarding refined grains, regional foods, vegetable oil, sausages, salted meats and snacks (SC = -0.10) and on maternal BMI (SC = -0.12). Among the intermediate variables, we observed that the time elapsed since pregnancy and the month of prenatal onset had direct negative effects; and that the number of visits to doctors, family income and number of years of education had direct positive effects. CONCLUSIONS: Beneficiaries were less likely to increase their BMI outside of the recommended standards and had a greater tendency to receive prenatal care. Participation in the BFP had a direct negative effect on adherence to unhealthy diets.

Abstract Objectives: To contribute to a better understanding of the maternal genetic mechanisms that influence obstetric outcomes and that are involved in maternal and child health, this study aimed to evaluate the association between maternal genetic variants and the offspring birth weight by analyzing single-nucleotide polymorphisms (SNPs) in genes related to glucose homeostasis. Methods: Three polymorphisms were analyzed (GCK rs1799884, TCF7L2 rs7903146 and LEPR rs1137101) in 250 pregnant women who participated in a Brazilian prospective cohort study. Genotyping was performed by Real-Time Polymerase Chain Reaction (qPCR) using pre-designed TaqMan® SNP genotyping assays. Vitamin D dosage was performed by chemiluminescence. Variance, Pearson's chi-square test and multiple linear regression were used for the statistical analysis. Results: It was possible to verify a significant association between birth weight and maternal GCK rs1799884 when obstetric outcomes, clinical and anthropometric characteristics were taken into consideration. The children of homozygous women for the minor allele GCK rs1799884 presented lower birth weight (β = -335.25, 95% CI = -669.39; -1.17, p = 0.04). Furthermore, a direct link between a leptin receptor variant and gestational duration was found (p = 0.037). Conclusion: The variant GCK rs1799884 (mm) was associated with a reduction in newborn weight in the miscegenated Brazilian population.

Resumo Objetivou-se avaliar os fatores socioeconômicos e de assistência nutricional de gestantes beneficiárias do Programa Bolsa Família que foram atendidas em serviço de pré-natal em município do Recôncavo da Bahia. Estudo transversal realizado com 250 gestantes do serviço de pré-natal em 16 Unidades de Saúde da Família, de agosto de 2013 a dezembro de 2014. Para a coleta de dados, utilizou-se questionário fechado envolvendo informações socioeconômicas, antropométricas e de saúde da gestante. Identificou-se que a média de idade das gestantes foi de 28,3 anos, das quais 85,2% estudaram até o ensino médio, 72,4% das gestantes afirmaram possuir renda menor ou igual a dois salários mínimos, com uma média de 1.036,3 reais, e 26,8% declararam receber o benefício. Observou-se que 40% encontravam-se com Índice de Massa Corporal pré-gestacional de excesso de peso, 38% apresentaram um ganho de peso adequado para Idade Gestacional; 90,57% realizaram mais de 7 consultas, e 75,6% relataram que fizeram uso de bebida alcoólica ou pararam na gestação. O Programa Bolsa Família, enquanto uma estratégia integrada de inclusão social e de desenvolvimento econômico, parece exercer efeito protetor na saúde nutricional das gestantes do município.

Abstract The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

Resumo Objetivou-se avaliar os fatores socioeconômicos e de assistência nutricional de gestantes beneficiárias do Programa Bolsa Família que foram atendidas em serviço de pré-natal em município do Recôncavo da Bahia. Estudo transversal realizado com 250 gestantes do serviço de pré-natal em 16 Unidades de Saúde da Família, de agosto de 2013 a dezembro de 2014. Para a coleta de dados, utilizou-se questionário fechado envolvendo informações socioeconômicas, antropométricas e de saúde da gestante. Identificou-se que a média de idade das gestantes foi de 28,3 anos, das quais 85,2% estudaram até o ensino médio, 72,4% das gestantes afirmaram possuir renda menor ou igual a dois salários mínimos, com uma média de 1.036,3 reais, e 26,8% declararam receber o benefício. Observou-se que 40% encontravam-se com Índice de Massa Corporal pré-gestacional de excesso de peso, 38% apresentaram um ganho de peso adequado para Idade Gestacional; 90,57% realizaram mais de 7 consultas, e 75,6% relataram que fizeram uso de bebida alcoólica ou pararam na gestação. O Programa Bolsa Família, enquanto uma estratégia integrada de inclusão social e de desenvolvimento econômico, parece exercer efeito protetor na saúde nutricional das gestantes do município.

Abstract The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

Resumo Objetivou-se realizar uma revisão sistemática para identificar e avaliar a prevalência da prescrição de medicamentos potencialmente inapropriados (MPI), segundo os Critérios de Beers, em idosos hospitalizados com ≥65 anos. Foram consultadas cinco bases de dados: BVS, Cochrane Library, CINAHL, MEDLINE e Web of Science. Foram identificados 19 artigos, selecionados a partir de critérios de elegibilidade. A média de idade foi 78,2 anos e o critério mais utilizado para a identificação dos MPI para idosos foi o de Beers 2015 (57,9%). Um total de 221.879 idosos recebeu prescrição inapropriada, a prevalência média foi de 65.0%, com destaque para o sistema gastrointestinal (15,3%) e os inibidores da bomba de prótons (27,7%) como a principal classe de medicamento prescrita. Conclui-se que os Critérios de Beers possibilitaram a identificação da alta prevalência na prescrição dos MPI. Os resultados desta revisão poderão auxiliar na tomada de decisão dos profissionais de saúde, no intuito de se evitar a administração dos MPI e propor melhores práticas que garantam a segurança do idoso hospitalizado.

Abstract The study aimed to perform a systematic review to identify and evaluate the prevalence of potentially inappropriate medicines (PIM) prescriptions for the elderly, according to Beers Criteria, in hospitalized elderly individuals aged 65 years or older. Five databases consulted: VHL; Cochrane Library; CINAHL; MEDLINE and Web of Science. Nineteen articles identified, selected based on eligibility criteria. The mean age was 78.2 years and the most used criterion for the identification of PIM for the elderly was Beers 2015 (57.9%). A total of 221,879 elderly received a prescription for PIM, the mean prevalence was 65.0%, for the gastrointestinal system (15.3%) and proton-pump inhibitors (27.7%) highlighted as the main class of medicine prescribed. It concluded that the Beers Criteria have made it possible to identify the high prevalence in the prescription of PIM. The results of this review may help in the decision making of health professionals, to avoid the administration of PIM and to propose best practices to ensure the safety of the elderly hospitalized.

Objective: To identify in the scientific literature the clinical overview of the pediatric population that tested positive for SARS-CoV-2 and care recommendations and recommendations among children who tested positive for SARS-CoV-2 in the scientific literature.Method: Rapid review based on the guidelines of the Joana Briggs Institute: elaboration of the research question, structured search of the literature in April 2020, in nine databases, selection and critical analysis of the eighteen primary studies (using two instruments to assess methodological quality), elaboration of the synthesis, incorporation of suggestions and dissemination.Result: The most frequent clinical overview was respiratory, gastrointestinal symptoms and fever. The images showed irregular frosted glass opacification. It is recommended to screen the pediatric population and family members who show signs and symptoms and to adopt isolation for more than fourteen days.Conclusion: The clinical overview in pediatric population is varied, not exclusively with respiratory symptoms, and a significant number of asymptomatic patients. The importance of new investigations is highlighted, such as randomized clinical trial or cohort studies, identifying their participation in the transmission of COVID-19.

Objetivo: Identificar en la literatura científica el estado clínico de la población pediátrica que probó positivo para el SARS-CoV-2 y las recomendaciones de atención.Método: Revisión rápida basada en las directrices del Instituto Joana Briggs: elaboración de la pregunta de investigación, búsqueda estructurada de la literatura en abril de 2020, en nueve bases de datos, selección y análisis crítico de los dieciocho estudios primarios (utilizando dos instrumentos para evaluar la calidad metodológica), elaboración de la síntesis, incorporación de sugerencias y difusión.Resultado: El cuadro clínico más frecuente fue respiratorio, síntomas gastrointestinales y fiebre. Las imágenes mostraron opacificación irregular de vidrio esmerilado. Se recomienda evaluar a población pediátrica y familiares que muestran signos y síntomas y adoptar aislamiento durante más de catorce días.Conclusiones: El cuadro clínico en la población pediátrica es variado, no exclusivamente con síntomas respiratorios, y un número importante de pacientes asintomáticos. Se destaca la importancia de nuevas investigaciones, como ensayos clínicos aleatorizados o estudios de cohorte, identificando su participación en la transmisión del COVID-19.

Objetivo: Identificar, na literatura científica, o quadro clínico da população pediátrica que testou positivo para SARS-CoV-2 e recomendações de cuidados.Método: Revisão rápida baseada nas diretrizes da Joana Briggs Institute: elaboração da pergunta de investigação, busca estruturada da literatura no mês de abril de 2020, em nove bases de dados, seleção e análise crítica dos dezoito estudos primários (utilizando dois instrumentos para avaliação da qualidade metodológica), elaboração da síntese, incorporação das sugestões e divulgação.Resultado: O quadro clínico mais frequente foi sintomas respiratórios, gastrointestinais e febre. As imagens demonstraram opacificação irregular de vidro fosco. Recomenda-se triagem da população pediátrica e familiares que apresentam sinais e sintomas e adotar isolamento por período superior a quatorze dias.Conclusão: Quadro clínico na população pediátrica é variado, não exclusivamente com sintomas respiratórios, e número significativo de assintomáticos. Destaca-se importância de novas investigações, como ensaios clínicos randomizados ou estudos de coorte, identificando a participação dessas na transmissão da COVID-19.

ABSTRACT BACKGROUND: Physician and patient-related characteristics can influence prescription of medications to older patients within primary healthcare. Use of Brazilian criteria may indicate the real prevalence of prescription of potentially inappropriate medications to this population. OBJECTIVES: To evaluate prescription of potentially inappropriate medications to older patients within primary care and identify patient-related and prescribing physician-related factors. DESIGN AND SETTING: This cross-sectional study was conducted in 22 public primary care facilities in Brazil, among older people (≥ 60 years) who were waiting for medical consultations. METHODS: Interviews were conducted before and after the medical consultations. If the patient received a medical prescription at the consultation, all the drugs prescribed and the physician's medical council registration number were recorded. Prevalence ratios were estimated to ascertain the magnitude of prescription of potentially inappropriate medications, along with patient and physician-related factors associated with such prescription. RESULTS: In total, 417 older patients were included; 45.3% had received ≥ 1 potentially inappropriate medication, and 86.8% out of 53 physicians involved had prescribed ≥ 1 potentially inappropriate medication. The strongest patient-related factor associated with higher prevalence of prescription of potentially inappropriate medications was polypharmacy. Among physician-related factors, the number of patients attended, number of prescriptions and length of medical practice < 10 years were positively associated with prescription of potentially inappropriate medications. CONCLUSIONS: High prevalence of prescription of potentially inappropriate medications was observed. Physician-related characteristics can influence prescription of medications to older people within primary healthcare. This suggests that there is a need for interventions among all physicians, especially younger physicians.