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Maternal depressive symptoms trajectories and harsh parenting: the mediating role of maternal quality of life in the 2004 Pelotas Birth Cohort
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Matijasevich, Alicia

; Maruyama, Jessica Mayumi

; Tovo-Rodrigues, Luciana

; Santos, Iná S.

Brazilian Journal of Psychiatry

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2025, Volume 47 elocation e20243652

Abstract: En | Text: En | PDF: En

Objective: To study the impacts of maternal depressive symptoms trajectories and harsh parenting and explore if the maternal quality of life (QoL) mediates this association. Methods: We used data from the 2004 Pelotas Birth Cohort, a population-based longitudinal study from Pelotas, Brazil (n=3,285 mothers, complete cases analysis). We used the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depressive symptoms and calculated their trajectories from 3 months until the 11-year follow-up using a group-based modeling approach. Psychological and physical aggression were measured using the Parent-Child Conflict Tactics Scale (CTSPC). Maternal QoL was measured by the question “How is your quality of life?” Data were analyzed using path models in Mplus. Results: All maternal depressive symptoms trajectories increased the frequency of psychological and physical aggression at early adolescence when compared to the reference group. Mediation analysis indicated that maternal depressive symptoms led to low levels of perceived maternal QoL, which in turn was associated with increased use of harsh parenting. The proportion of total effect explained by maternal QoL ranged from 4.04% (0.00-5.58%) to 16.31% (10.88-19.10%). Conclusion: Our findings, within a longitudinal framework from a middle-income country, support existing evidence that maternal depressive symptoms are associated with harsh parenting. Our results also suggest that one mechanism underlying this association is lower perceived maternal QoL.

https://doi.org/10.47626/1516-4446-2024-3652

Lessons from 13 years of accelerometry measurements in five Brazilian cohorts: methodological aspects
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Wendt, Andrea

; Leite, Giulia Salaberry

; Contreira, Renata

; Mielke, Grégore Iven

; Horta, Bernardo Lessa

; Motta, Janaína Vieira dos Santos

; Hartwig, Fernando Pires

; Wehrmeister, Fernando César

; Menezes, Ana Maria Baptista

; Gonçalves, Helen

; Santos, Iná S.

; Matijasevich, Alicia

; Tovo-Rodrigues, Luciana

; Bertoldi, Andréa Dâmaso

; Domingues, Marlos

; Bielemann, Renata Moraes

; Ekelund, Ulf

; Hallal, Pedro C.

; Crochemore-Silva, Inácio

Cadernos de Saúde Pública

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2025, Volume 41 N. 3 elocation e00011724

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo: Este estudo descreve as principais decisões metodológicas e suas justificativas para a coleta, processamento e limpeza/análise de dados de acelerometria nas coortes de nascimento de Pelotas, Rio Grande do Sul, Brasil, exemplificando como a pesquisa usando sensores de movimento pode ser realizada em países de renda média. Trata-se de uma pesquisa descritiva utilizando dados brutos do acelerômetro obtidos de cinco coortes brasileiras de base populacional. A amostra foi composta por dados de 32.963 indivíduos. A coleta de dados (decisões de pré-processamento), processamento (critérios para executar a análise) e as decisões de pós-processamento (limpeza de dados) foram detalhadas. O pré-processamento inclui a escolha da marca/modelo do dispositivo, posicionamento do dispositivo, algoritmos/limites e o número de dias que os participantes foram solicitados a usar os dispositivos. Processamento de dados envolve a aplicação de limites dos algoritmos. Finalmente, o pós-processamento inclui a limpeza de dados. O número mínimo de dias a serem validados para estimar corretamente as médias semanais foi específico para cada idade e tipo de medida. Ao resumir e descrever as decisões metodológicas e protocolo de análise, espera-se que o presente estudo contribua para o desenho de futuros trabalhos que busquem analisar dados do acelerômetro em contextos semelhantes.

Abstract: This study describes key methodological decisions and their justifications for accelerometer data collection, processing, and cleaning/analysis in Pelotas (Rio Grande do Sul State, Brazil) cohorts, exemplifying how research using sensor monitors could be carried out in a middle-income country context. This is a descriptive methodological study using raw accelerometer data from five Brazilian population-based cohorts with 32,963 individuals. Data collection (pre-processing decisions), processing (choosing requirements to run the analysis), and post-processing decisions (data cleaning) are described in detail. Pre-processing includes choosing the device brand/model, placement of the device, algorithms/thresholds, and the number of days participants were required to wear the devices. Processing activities involve applying thresholds/algorithms to the data. Finally, post-processing includes data cleaning. The minimum number of days to be validated to correctly estimate weekly averages was specific to age and measurement. By summarizing and describing the methodological decisions and analysis protocol, we hope to contribute to the design and analysis of accelerometer data in future studies in similar research contexts.

Resumen: Este estudio describe las principales decisiones metodológicas y sus justificaciones para la recopilación, procesamiento y limpieza/análisis de datos de acelerometría en las cohortes de nacimiento de Pelotas, Rio Grande do Sul, Brasil, ejemplificando cómo la investigación que utiliza sensores de movimiento puede llevarse a cabo en países de ingresos medianos. Se trata de una investigación descriptiva que utiliza datos sin procesar del acelerómetro obtenidos de cinco cohortes brasileñas de base poblacional. La muestra consistió en datos de 32.963 individuos. Se detalló la recopilación de datos (decisiones preprocesamiento), el procesamiento (criterios para realizar el análisis) y las decisiones posprocesamiento (limpieza de datos). El preprocesamiento incluye la elección de la marca/modelo del dispositivo, el posicionamiento del dispositivo, los algoritmos/límites y la cantidad de días que se les pidió a los participantes que usaran los dispositivos. El procesamiento de datos implica la aplicación de límites de los algoritmos. Por último, el posprocesamiento incluye la limpieza de datos. El número mínimo de días de validez para estimar correctamente los promedios semanales fue específico para cada edad y tipo de medida. Al resumir y describir las decisiones metodológicas y el protocolo de análisis, se espera que este estudio contribuya a futuros trabajos que busquen analizar los datos del acelerómetro en contextos similares.

https://doi.org/10.1590/0102-311xen011724

Lessons from 13 years of accelerometry measurements in five Brazilian cohorts: methodological aspects
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Wendt, Andrea

; Leite, Giulia Salaberry

; Contreira, Renata

; Mielke, Grégore Iven

; Horta, Bernardo Lessa

; Motta, Janaína Vieira dos Santos

; Hartwig, Fernando Pires

; Wehrmeister, Fernando César

; Menezes, Ana Maria Baptista

; Gonçalves, Helen

; Santos, Iná S.

; Matijasevich, Alicia

; Tovo-Rodrigues, Luciana

; Bertoldi, Andréa Dâmaso

; Domingues, Marlos

; Bielemann, Renata Moraes

; Ekelund, Ulf

; Hallal, Pedro C.

; Crochemore-Silva, Inácio

Cadernos de Saúde Pública

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2025, Volume 41 N. 3 elocation e00011724

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311xen011724

The impact of the COVID-19 pandemic on the lives of the 2004 Pelotas (Brazil) birth cohort adolescents
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Matijasevich, Alicia

; Maruyama, Jessica Mayumi

; Santos, Iná S.

; Dalla, Alana Carolina Andrade

; Barros, Aluísio J. D.

; Tovo-Rodrigues, Luciana

Cadernos de Saúde Pública

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2025, Volume 41 N. 5 elocation e00063724

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Resumo: Conhecimentos sobre as experiências de adolescentes durante a pandemia da COVID-19 são cruciais para entender a extensão do impacto destas experiências e orientar respostas futuras a eventos desafiadores semelhantes. Este estudo tem como objetivo descrever os efeitos da pandemia em diferentes aspectos da vida dos adolescentes e examinar como esses impactos variaram de acordo com características socioeconômicas, familiares e individuais. Usamos dados de uma subamostra da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 2004 para investigar os impactos da pandemia da COVID-19 em adolescentes (N = 1.806; média de idade = 17,41, variação: 16,73-17,95). Examinamos uma série de questões e impactos resultantes da pandemia e das medidas de distanciamento social, considerando sua influência em vários aspectos da vida. Além disso, avaliamos um espectro de variáveis socioeconômicas, familiares e individuais em nossa avaliação. Os dados foram coletados por meio de entrevistas presenciais de agosto a dezembro de 2021. Aproximadamente 20% dos adolescentes relataram interrupções significativas em suas vidas devido à pandemia. Os efeitos da pandemia foram mais acentuados entre o sexo feminino, estudantes de escolas privadas, não beneficiários do Auxílio Brasil e adolescentes que reportaram estado de saúde regular ou ruim. Os adolescentes compartilharam uma infinidade de fatores de estresse e preocupações diretamente ligados à pandemia, ressaltando uma tendência notável de impactos intensificados entre as adolescentes do sexo feminino. A pandemia da COVID-19 teve consequências de longo alcance em vários aspectos da vida cotidiana dos adolescentes. Reconhecer as perspectivas dos adolescentes neste período desafiador é crucial para atender efetivamente às suas necessidades na sociedade pós-pandemia.

Resumen: El conocimiento de las experiencias de los adolescentes durante la pandemia de la COVID-19 es fundamental para comprender el alcance del impacto de estas experiencias y para orientar las respuestas futuras a eventos desafiantes similares. Este estudio tiene como objetivo describir los efectos de la pandemia en diferentes aspectos de la vida de los adolescentes y examinar cómo variaron estos impactos según las características socioeconómicas, familiares e individuales. Utilizamos datos de una submuestra de la cohorte de nacimiento en Pelotas, Rio Grande do Sul, Brasil, 2004 para investigar los impactos de la pandemia de la COVID-19 en adolescentes (N = 1.806; edad media = 17,41, rango: 16,73-17,95). Analizamos una serie de problemas e impactos resultantes de la pandemia y de las medidas de distanciamiento social desde su influencia en diversos aspectos de la vida. Además de evaluar las variables socioeconómicas, familiares e individuales. Para analizar los datos se realizaron entrevistas presenciales de agosto a diciembre de 2021. Aproximadamente el 20% de los adolescentes informaron haber sufrido significativas cambios en sus vidas debido a la pandemia. Los efectos de la pandemia fueron más frecuentes entre las mujeres, los estudiantes de escuelas privadas, los no beneficiarios del programa gubernamental Auxilio Brasil y los adolescentes que tenían un estado de salud regular o deficiente. Los adolescentes reportaron diversos factores estresantes y preocupaciones directamente relacionadas con la pandemia, lo que subraya una tendencia notable de impactos más intensificados entre las adolescentes. La pandemia de la COVID-19 ha tenido consecuencias a largo plazo en diversos aspectos de la vida cotidiana de los adolescentes. Reconocer las perspectivas de los adolescentes en este período desafiante es crucial para satisfacer eficazmente sus necesidades en la sociedad pospandemia.

Abstract: Insights into the experiences of adolescents during the COVID-19 pandemic are crucial for understanding the extent of their impact and guiding future responses to similar challenging events. This study aims to describe the effects of the pandemic on different aspects of adolescents’ lives and examine how they varied according to socioeconomic, family, and individual characteristics. We used data from a subsample of the 2004 Pelotas (Brazil) birth cohort to investigate the reported impacts of the COVID-19 pandemic on adolescents (N = 1,806; mean age = 17.41, range: 16.73-17.95). We investigated a range of issues and impacts caused by the pandemic and social distancing measures, considering their influence on various aspects of life. Additionally, we evaluated a spectrum of socioeconomic, family, and individual variables. Data were collected via in-person interviews from August to December 2021. Roughly 20% of adolescents have reported significant disruptions in their lives due to the COVID-19 pandemic. The effects of the pandemic were more pronounced among females, private school attendees, non-beneficiaries of the government cash transfer benefit (Brazil Assistance - Auxílio Brasil), and adolescents who reported having a regular or poor health status. Adolescents have shared a multitude of stressors and concerns directly linked to the pandemic, underscoring a notable trend of heightened impacts among female adolescents. The COVID-19 pandemic has had far-reaching consequences on various aspects of adolescents’ daily lives. Recognizing the perspectives of adolescents in this challenging period is crucial for effectively addressing their needs in the post-pandemic society.

https://doi.org/10.1590/0102-311xen063724

The impact of the COVID-19 pandemic on the lives of the 2004 Pelotas (Brazil) birth cohort adolescents
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Matijasevich, Alicia

; Maruyama, Jessica Mayumi

; Santos, Iná S.

; Dalla, Alana Carolina Andrade

; Barros, Aluísio J. D.

; Tovo-Rodrigues, Luciana

Cadernos de Saúde Pública

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2025, Volume 41 N. 5 elocation e00063724

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

https://doi.org/10.1590/0102-311xen063724

Changes of adolescent sleep patterns during the COVID-19 pandemic
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Xavier, Mariana Otero

; Maruyama, Jessica Mayumi

; Santos, Iná S.

; Tovo-Rodrigues, Luciana

; Barros, Aluísio J. D.

; Matijasevich, Alicia

Revista de Saúde Pública

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2024, Volume 58 elocation 24

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals’ health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. METHODS A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. RESULTS The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = −0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. CONCLUSION The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.

https://doi.org/10.11606/s1518-8787.2024058005866

Changes of adolescent sleep patterns during the COVID-19 pandemic
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Xavier, Mariana Otero

; Maruyama, Jessica Mayumi

; Santos, Iná S.

; Tovo-Rodrigues, Luciana

; Barros, Aluísio J. D.

; Matijasevich, Alicia

Revista de Saúde Pública

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2024, Volume 58 elocation 24

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2024058005866

Risk factors for executive function impairment in adolescence: an analysis of data from the 2004 Pelotas Birth Cohort study
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Rodrigues, Júlia de Souza

; Matijasevich, Alicia Tovo-Rodrigues, Luciana Munhoz, Tiago N. Santos, Iná S. Pastor-Valero, Maria

Brazilian Journal of Psychiatry

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dec 2023, Volume 45 N. 6 Pages 470 - 481

Abstract: En | Text: En | PDF: En

Objective: To investigate risk factors associated with impaired attention-related executive functions (EFs) at age 11 and working memory at age 15. Methods: Data from participants of the population-based 2004 Pelotas Birth Cohort at ages 11 (n=3,582) and 15 (n=1,950) were analyzed. The study measured attentional control, cognitive flexibility, and selective attention using the Test of Everyday Attention for Children (TEA-Ch). Spatial working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Logistic regression was employed to explore the relationship between perinatal and childhood exposures and EF impairment. Results: Low maternal education had a significant negative impact on EFs. At age 11, it was associated with decreased attentional control (OR = 3.04; 95%CI 2.09-4.43), and at age 15, it was linked to impaired spatial working memory (OR = 2.21; 95%CI 1.58-3.09). Additional risk factors included low household income, black or brown maternal skin color, high parity, prematurity, low birth weight, and multiple siblings. Breastfeeding, regardless of duration, was found to be a protective factor against impaired cognitive flexibility (OR = 0.38; 95%CI 0.22-0.65). Conclusion: This study underscores the lasting impact of perinatal exposures on EF development. Policies that mitigate the negative effects of risk factors and promote EF development, especially among vulnerable populations, are needed.

https://doi.org/10.47626/1516-4446-2023-3277

Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort
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Maruyama, Jessica Mayumi

; Tovo-Rodrigues, Luciana

; Santos, Iná S.

; Murray, Joseph

; Matijasevich, Alicia

Brazilian Journal of Psychiatry

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oct 2023, Volume 45 N. 5 Pages 389 - 396

Abstract: En | Text: En | PDF: En

Objectives: There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences. Methods: 1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents’ socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses. Results: There were significant mean increases in adolescents’ ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic. Conclusion: Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.

https://doi.org/10.47626/1516-4446-2023-3169

10.

Net Promoter Score (NPS) as a tool to assess parental satisfaction in pediatric intensive care units NPS (NPS
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Bitencourt, Victoria Noremberg

; Crestani, Francielly

; Peuckert, Marina Zanette

; Andrades, Gabriela Rupp Hanzen

; Krauzer, João Ronaldo Mafalda

; Cintra, Cíntia de Cassia

; Cunha, Mariana Lucas da Rocha

; Eckert, Guilherme Unchalo

; Girardi, Leandra

; Santos, Iná S.

; Garcia, Pedro Celiny Ramos

Jornal de Pediatria

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jun 2023, Volume 99 N. 3 Pages 296 - 301

Abstract: En | Text: En | PDF: En

Abstract Objective To verify the performance of the Net Promoter Score (NPS) as a tool to assess parental satisfaction in pediatric intensive care units (PICUs). Methods The authors conducted an observational cross-sectional multicenter study in the PICUs of 5 hospitals in Brazil. Eligible participants were all parents or legal guardians of PICU-admitted children, aged 18 years or over. The NPS was administered together with the EMpowerment of PArents in THe Intensive Care (EMPATHIC-30), used as the gold standard, and a sociodemographic questionnaire. For analysis, the results were dichotomized into values greater than or equal to the median of the tests. The associations between the 2 tools were evaluated and the distribution of their results was compared. Results The parents or legal guardians of 78 PICU-admitted children were interviewed. Of the respondents, 85% were women and 62% were in a private hospital. The median NPS was 10 (IQR, 10-10), and the median EMPATHIC-30 score was 5.7 (IQR, 5.4-5.9). Compared with the gold standard, the NPS had a sensitivity of 100% at all cutoff points, except at cutoff 10, where the sensitivity was slightly lower (97.5%). As for specificity, NPS performance was poorer, with values ranging from 0% (NPS ≥ 5) to 47.4% (NPS = 10). Conclusions NPS proved to be a sensitive tool to assess parental satisfaction, but with poor ability to identify dissatisfied users in the sample. PICUs. . (PICUs) crosssectional cross sectional Brazil PICUadmitted PICU admitted 1 over EMPATHIC30, EMPATHIC30 EMPATHIC 30 , (EMPATHIC-30) standard questionnaire analysis tests compared 7 interviewed respondents 85 62 hospital IQR, IQR (IQR 1010, 1010 10-10) EMPATHIC-3 57 5. 5.45.9. 5459 5.4 5.9 4 9 5.4-5.9) 100 points 97.5%. 975 97.5% 97 (97.5%) specificity poorer 0 474 47 47.4 10. 10) sample (PICUs EMPATHIC3 3 (EMPATHIC-30 8 6 101 10-10 EMPATHIC- 45 5.45.9 545 54 59 5.4-5.9 97.5 (97.5% 47. (EMPATHIC-3 10-1 5.45. 5.4-5. 97. (97.5 (EMPATHIC- 10- 5.45 5.4-5 (97. (EMPATHIC 5.4- (97 (9 (

https://doi.org/10.1016/j.jped.2022.11.013

11.

Prevalence of adolescent risk behaviors at 11 and 15 years of age: data from the 2004 Pelotas birth cohort 1 age 200 20 2
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Bozzini, Ana Beatriz

; Maruyama, Jessica Mayumi

; Santos, Iná S. Murray, Joseph Tovo-Rodrigues, Luciana Munhoz, Tiago N. Matijasevich, Alicia

Brazilian Journal of Psychiatry

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apr 2023, Volume 45 N. 2 Pages 102 - 111

Abstract: En | Text: En | PDF: En

Objectives: The objective of this study was to investigate the prevalence of the following risk behaviors: experimentation with cigarettes, electronic cigarettes, alcohol, substances, delinquent behavior, and sex at age 15, stratified by sex and socioeconomic position. We also investigated the prevalence of cigarette and alcohol experimentation at age 11 and the persistence and cumulative incidence of these behaviors between 11 and 15 years of age. Methods: In this cohort study, we included 3,491 11-year-olds and 1,949 15-year-olds from the 2004 Pelotas Birth Cohort. All outcomes were identified via confidential questionnaires and were analyzed as binary variables. Results: At age 11, there was a higher prevalence of cigarette experimentation among boys. At age 15, there was a higher prevalence of experimentation with alcohol, cigarettes, and substances among girls; experimentation with cigarettes and sex were more prevalent among those in a low socioeconomic position. We found a high cumulative incidence of alcohol experimentation, as well as persistent alcohol experimentation, in both boys and girls. Conclusions: Further research should clarify causal paths of the high prevalence of risk behaviors during adolescence and its increase among girls. Objectives behavior position 1 Methods 3491 3 491 3,49 11yearolds yearolds year olds 1949 949 1,94 15yearolds 200 Cohort variables Results girls Conclusions 349 49 3,4 194 94 1,9 20 34 4 3, 19 9 1, 2

https://doi.org/10.47626/1516-4446-2022-2753

12.

Avaliação do Programa Criança Feliz: um estudo randomizado em 30 municípios brasileiros
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Santos, Iná S.

; Munhoz, Tiago N.

; Barcelos, Raquel Siqueira

; Blumenberg, Cauane

; Bortolotto, Caroline Cardozo

; Matijasevich, Alicia

; Salum, Cristiane

; Santos Júnior, Hernane Guimarães dos

; Marques, Letícia

; Correia, Luciano

; Souza, Marta Rovery de

; Lira, Pedro Israel Cabral de

; Pereira, Vitor

; Victora, Cesar G.

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

dec 2022, Volume 27 N. 12 Pages 4341 - 4363

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O Programa Criança Feliz (PCF) atinge 1,4 milhão de crianças brasileiras menores de três anos com visitas domiciliares visando o desenvolvimento neuropsicomotor. Com base em modelo conceitual, avaliou-se implementação e impacto do PCF em estudo randomizado, em 30 municípios. Ao todo 3.242 crianças foram alocadas para o grupo intervenção (GI) ou controle (GC), sendo 80,0% acompanhadas prospectivamente durante três anos. O desenvolvimento foi avaliado pelo Ages and Stages Questionnaire (ASQ3). Análises por intenção de tratar mostraram escores médios de 203,3 no GI e 201,3 no GC. Análises adicionais com variáveis instrumentais e emparelhamento por escores de propensão tampouco mostraram efeito, uma vez que o número de contatos recebidos não esteve associado aos escores ASQ3. Tampouco foi observado impacto sobre estimulação, interações responsivas ou atributos psicológicos das crianças. As visitas foram interrompidas durante 12 meses devido à COVID-19, sendo substituídas por contatos virtuais. O estudo de implementação revelou baixa cobertura no GI, contaminação do GC, deficiências na gestão e baixa qualidade das visitas em muitos municípios. O estudo não demonstrou impacto do PCF implementado sob condições de rotina e fornece elementos para seu aprimoramento.

Abstract The Happy Child Program (Programa Criança Feliz - PCF, in Portuguese) reaches 1.4 million Brazilian children under three years of age with home visits aimed at promoting neuropsychomotor development. Based on a conceptual model, PCF implementation and impact were evaluated in a randomized study in 30 municipalities. A total of 3,242 children were allocated to the intervention (IG) or control (CG) group, 80.0% of whom were prospectively followed up from late 2018 to late 2021. Development was assessed by the Ages and Stages Questionnaire (ASQ3). During the three-year study period, visits were replaced by virtual contacts for an average of 12 months due to COVID-19. At the endline survey, intent-to-treat analyses showed mean scores of 203.3 in the IG and 201.3 in the CG. Additional analyses using instrumental variables and propensity scores matching also showed no effect, since the number of contacts with the program was not associated with ASQ3 scores. No impact was observed on stimulation, responsive interactions or psychological attributes of children. The implementation study revealed low coverage in the IG, contamination of the CG, deficiencies in management and low quality of visits in many municipalities. The study did not demonstrate an impact of PCF implemented under routine conditions, but provides elements for its improvement.

https://doi.org/10.1590/1413-812320222712.13472022

13.

Prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life
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Mattiello, Rita

; Kotoski, Aline

; Ayala, Camila Ospina

; Recha, Carine Lucena

; Quiroga, Carolina Villanova

; Machado, Cátia Regina

; Roxo, Cristiano de Oliveira

; Varela, Fernanda Hammes

; Couto, Giovanna Trevisan

; Cassão, Gisele

; Lopes, Jéssica Blatt

; Gonçalves, João Ismael Budelon

; Silva, Juliana Fernandes da

; Barh, Mariana Barth de

; Rocha, Natalie Duran

; Albuquerque, Nathalia Saraiva de

; Corte, Ricardo Arlindo Dalla

; Bernardes, Rossana

; Richter, Samanta Andresa

; Rossi, Tainá

; Santos, Ina S.

Jornal de Pediatria

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feb 2022, Volume 98 N. 1 Pages 39 - 45

Abstract: En | Text: En | PDF: En

Abstract Objective: To investigate the prevalence and factors associated with no intention to exclusively breastfeed for the first 6 months of life in a sample of women in the first 24 h postpartum during the hospital stay. Methods: Cross-sectional study with data from screening phase of a birth cohort. The proportion of mothers who did not intend to breastfeed exclusively for 6 months (primary outcome) derived from a negative response to the question “Would you be willing to try to breastfeed exclusively for the first 6 months?”, in an interview conducted by previously trained interviewers. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were obtained by Poisson regression with robust variance. Results: A total of 2964 postpartum women were interviewed. The overall prevalence of mothers who did not intend to breastfeed exclusively for 6 months was 17.8% (16.4–19.1%). After adjusting for maternal age and type of pregnancy (singleton or multiple), no intention to exclusively breastfeed was higher in mothers with a monthly household income < 3 minimum wages (PR, 1.64; 1.35–1.98) and in those who intended to smoke 4–7 days/week after delivery (PR, 1.42; 1.11–1.83). The presence of significant newborn morbidity (PR, 0.32; 0.19–0.54) and intention to breastfeed up to 12 months (PR, 0.46; 0.38–0.55) had a protective effect against not intending to breastfeed exclusively for 6 months. Conclusions: Approximately 1 in every 5 mothers did not intend to breastfeed exclusively for 6 months. Strategies aimed at promoting exclusive breastfeeding should focus attention on mothers from lower economic strata and smokers.

https://doi.org/10.1016/j.jped.2021.02.006

14.

Uso de antibacterianos em gestantes antes e após regulamentação no Brasil: coortes de nascimentos de Pelotas, Rio Grande do Sul, de 2004 e 2015
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Guimarães, Fernando Silva

; Cata-Preta, Bianca Oliveira

; Barros, Aluísio J. D.

; Matijasevich, Alicia

; Santos, Iná S.

; Silveira, Mariângela Freitas

; Silveira, Marysabel Pinto Telis

; Bertoldi, Andréa Dâmaso

Cadernos de Saúde Pública

Journal Metrics
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2022, Volume 38 N. 7 elocation e00168021

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

A utilização indiscriminada de antibacterianos no período gestacional pode aumentar a resistência antimicrobiana e colocar em risco a saúde da gestante e da criança. Atualmente, está em vigência no Brasil a Resolução da Diretoria Colegiada nº 20/2011, que controla a prescrição e fornecimento de antibacterianos. O objetivo deste estudo foi comparar o uso de antibacterianos pelas gestantes participantes das coortes de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 2004 e 2015, considerando a regulamentação implementada entre as duas coortes. Foram utilizados dados coletados no período perinatal dos dois estudos. O desfecho principal foi o uso de antibacterianos na gestação. As prevalências de uso foram descritas a partir de variáveis independentes e diferenças em pontos percentuais (p.p.) entre as duas coortes. A prevalência do uso de antibacterianos foi de 41,9% (IC95%: 40,4; 43,3) em 2004 e 39,2% (IC95%: 37,7; 40,6) em 2015. Considerando-se as gestantes que relataram ter infecção durante a gestação, observou-se maior redução de uso em 2015, quando comparado a 2004, nas gestantes mais pobres (-15,4p.p., IC95%: 9,59; 21,20) e naquelas que foram a menos consultas (-17,1p.p., IC95%: 2,81; 31,36). Houve redução na proporção de antibacterianos usados, considerando o total de medicamentos de 20,6% (IC95%: 19,9; 21,4) em 2004 para 12,6% (IC95%: 12,1; 13,1) em 2015. As reduções encontradas, tanto nas prevalências de uso quanto na proporção dos antibacterianos sobre o total de medicamentos utilizados, podem ser reflexo da política de regulamentação implementada em 2011.

Indiscriminate use of anti-bacterial agents during pregnancy can increase antimicrobial resistance and endanger both the mother’s and the children’s health. Currently, Brazil has the Collegiate Directive Resolution n. 20/2011, which controls prescription and dispensation of anti-bacterial agents. Given this scenario, this study compared the use of anti-bacterial agents by pregnant women participating in the 2004 and 2015 Pelotas (Brazil) birth cohorts, in Rio Grande do Sul, Brazil, considering the regulation issued between the two cohorts. Data were collected in the perinatal period of the two studies. The main outcome was the use of anti-bacterial agents during pregnancy. Prevalence scans were described based on independent variables and differences in percentage points (p.p.) between the two cohorts. The prevalence of anti-bacterial use was 41.9% (95%CI: 40.4; 43.3) in 2004 and 39.2% (95%CI: 37.7; 40.6) in 2015. Considering the pregnant women who reported having infection during pregnancy, a greater reduction in use was observed in 2015, when compared to 2004, in poor women (-15.4p.p., 95%CI: 9.59; 21.20) and in those who had less consultations (-17.1p.p., 95%CI: 2.81; 31.36). Considering total medications, the proportion of anti-bacterial used dropped from 20.6% (95%CI: 19.9; 21.4) in 2004 to 12.6% (95%CI: 12.1; 13.1) in 2015. The reductions found in both the prevalence of use and the proportion of anti-bacterial agents over total medications used may be a reflection of the regulatory policy implemented in 2011.

El uso indiscriminado de antibacterianos durante el embarazo puede aumentar la resistencia a los antimicrobianos y poner en riesgo la salud de la gestante y del niño. Actualmente, está vigente en Brasil la Resolución de la Dirección Colegiada nº 20/2011, que controla la prescripción y dispensación de antibacterianos. El objetivo de este estudio fue comparar el uso de antibacterianos por gestantes participantes de las cohortes de nacimientos de Pelotas, Rio Grande do Sul, Brasil, del 2004 y del 2015, considerando la regulación implementada entre las dos cohortes. Se utilizaron los datos recopilados en el período perinatal de los dos estudios. El resultado principal fue el uso de antibacterianos durante el embarazo. Las prevalencias de uso se describieron con base en las variables independientes y diferencias en puntos porcentuales (p.p.) entre las dos cohortes. La prevalencia de uso de antibacterianos fue del 41,9% (IC95%: 40,4; 43,3) en el 2004 y del 39,2% (IC95%: 37,7; 40,6) en el 2015. Teniendo en cuenta que las gestantes que reportaron haber tenido infección durante el embarazo, hubo una mayor reducción de uso en el 2015, en comparación con el 2004, en las gestantes más pobres (-15,4p.p., IC95%: 9,59; 21,20) y en las que consultaron menos (-17,1p.p., IC95% 2,81;31,36). Hubo una reducción en la proporción de antibacterianos usados, considerando la cantidad total de medicamentos del 20,6% (IC95%: 19,9; 21,4) en el 2004 al 12,6% (IC95%: 12,1; 13,1) en el 2015. Las reducciones encontradas, tanto en las prevalencias de uso como en la proporción de antibacterianos sobre la cantidad total de medicamentos utilizados, pueden ser reflejo de la política regulatoria implementada en el 2011.

https://doi.org/10.1590/0102-311xpt168021

15.

Fatores associados ao desenvolvimento infantil em crianças brasileiras: linha de base da avaliação do impacto do Programa Criança Feliz
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Munhoz, Tiago N.

; Santos, Iná S.

; Blumenberg, Cauane

; Barcelos, Raquel Siqueira

; Bortolotto, Caroline C.

; Matijasevich, Alicia

; Santos Júnior, Hernane G.

; Santos, Letícia Marques dos

; Correa, Luciano L.

; Souza, Marta Rovery de

; Lira, Pedro I. C.

; Altafim, Elisa Rachel Pisani

; Macana, Esmeralda Correa

; Victora, Cesar G.

Cadernos de Saúde Pública

Journal Metrics
- Sobre o periódico
- SciELO Analytics

2022, Volume 38 N. 2 elocation e00316920

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo: O objetivo deste artigo foi avaliar os fatores socioeconômicos, familiares e individuais associados ao desenvolvimento infantil no primeiro ano de vida, entre famílias em vulnerabilidade social. Trata-se de uma análise transversal, com dados da linha de base de um ensaio randomizado. O estudo incluiu 3.242 crianças < 12 meses de idade, residentes em 30 municípios de cinco regiões do Brasil. A escolha de estados e municípios foi intencional, tendo como base a implementação do Programa Criança Feliz. A amostra foi selecionada a partir de crianças elegíveis para o Programa Criança Feliz, cujo objetivo é promover a estimulação e o desenvolvimento infantil. O Ages and Stages Questionnaire (ASQ) foi utilizado para avaliação do desenvolvimento infantil. Um modelo de análise multinível em três níveis (estado, município e indivíduos), usando teste de Wald para heterogeneidade e tendência linear, estimou a média do ASQ-3 e intervalo de 95% de confiança (IC95%). Análises foram ajustadas para potenciais confundidores. Foram analisadas informações de 3.061 (94,4%) crianças com dados disponíveis para ASQ-3. Escores de desenvolvimento infantil (total e em todos os domínios) foram cerca de 12% menores em crianças nascidas pré-termo e com restrição do crescimento intrauterino (pequenas para idade gestacional). Observou-se menores escores em filhos de mães com baixa escolaridade, com sintomas de depressão, com duas ou mais crianças menores de sete anos residindo no domicílio e que não relataram autopercepção de apoio/ajuda durante a gestação. Conclui-se que características potencialmente modificáveis (escolaridade, depressão materna e prematuridade/restrição do crescimento intrauterino) apresentaram maior impacto na redução do escore de desenvolvimento em todos os domínios avaliados.

Abstract: The study aimed to assess socioeconomic, family, and individual factors associated with infant development (i.e., in the first year of life) among families with social vulnerability. This was a cross-sectional analysis of baseline data from a randomized trial. The study included 3,242 children < 12 months of age living in 30 municipalities from five regions of Brazil. The choice of states and municipalities was intentional, based on the implementation of the Brazilian Happy Child Program. The sample was selected among eligible children for the Brazilian Happy Child Program, and the objective was the promotion of infant development. The Ages and Stages Questionnaire (ASQ) was used to assess infant development. A three-level analytical model (state, municipality, and individuals), using the Wald test for heterogeneity and linear trend, estimated the mean ASQ-3 and 95% confidence interval (95%CI). The analyses were adjusted for potential confounders. Information was analyzed for 3,061 (94.4%) children with available data for ASQ-3. Infant development scores (total and in all the domains) were some 12% lower in preterm children and those with intrauterine growth restriction (small for gestational age). Lower scores were seen in children of mothers with low schooling, depressive symptoms, two or more children under seven years of age living in the household, and who did not report self-perceived support or help during the pregnancy. In conclusion, potentially modifiable characteristics (schooling, maternal depression, and prematurity/intrauterine growth restriction) showed greater impact on reducing the infant development score in all the target domains.

Resumen: El objetivo fue evaluar los factores socioeconómicos, familiares e individuales, asociados al desarrollo infantil en el primer año de vida, entre familias con vulnerabilidad social. Se trata de un análisis transversal, con datos de la base de referencia de un ensayo aleatorio. El estudio incluyó a 3.242 niños < 12 meses de edad, residentes en 30 municipios de cinco regiones de Brasil. La elección de estados y municipios fue intencional, considerando como base la implementación del Programa Niño Feliz. La muestra se seleccionó a partir de niños elegibles para el Programa Niño Feliz, cuyo objetivo es promover la estimulación y el desarrollo infantil. Se utilizó el Ages and Stages Questionnaire (ASQ) para la evaluación del desarrollo infantil. Un modelo de análisis multinivel en tres niveles (estado, municipio e individuos), usando el test de Wald para la heterogeneidad y tendencia lineal, estimó la media del ASQ-3 y el intervalo de 95% de confianza (IC95%). Los análisis se ajustaron para potenciales factores de confusión. Se analizó información de 3.061 (94,4%) niños con datos disponibles para ASQ-3. Las puntuaciones de desarrollo infantil (total y en todos los dominios) fueron cerca de un 12% menores en niños nacidos pretérmino y con restricción del crecimiento intrauterino (pequeños para la edad gestacional). Se observaron menores puntuaciones en hijos de madres con baja escolaridad, con síntomas de depresión, con dos o más niños menores de siete años residiendo en el domicilio y que no informaron autopercepción de apoyo/ayuda durante la gestación. Se concluye que las características potencialmente modificables (escolaridad, depresión materna y prematuridad/restricción del crecimiento intrauterino) presentaron un mayor impacto en la reducción de la puntuación de desarrollo en todos los dominios evaluados.

https://doi.org/10.1590/0102-311x00316920

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