National, regional, and global estimates of low birthweight in 2020, with trends from 2000: a systematic analysis.

BACKGROUND: Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030. METHODS: For this systematic analysis, we searched population-based, nationally representative data on LBW from Jan 1, 2000, to Dec 31, 2020. Using 2042 administrative and survey datapoints from 158 countries and areas, we developed a Bayesian hierarchical regression model incorporating country-specific intercepts, time-varying covariates, non-linear time trends, and bias adjustments based on data quality. We also provided novel estimates by birthweight subgroups. FINDINGS: An estimated 19·8 million (95% credible interval 18·4-21·7 million) or 14·7% (13·7-16·1) of liveborn newborns were LBW worldwide in 2020, compared with 22·1 million (20·7-23·9 million) and 16·6% (15·5-17·9) in 2000-an absolute reduction of 1·9 percentage points between 2000 and 2020. Using 2012 as the baseline, as this is when the Global Nutrition Target began, the estimated average annual rate of reduction from 2012 to 2020 was 0·3% worldwide, 0·85% in southern Asia, and 0·59% in sub-Saharan Africa. Nearly three-quarters of LBW births in 2020 occurred in these two regions: of 19 833 900 estimated LBW births worldwide, 8 817 000 (44·5%) were in southern Asia and 5 381 300 (27·1%) were in sub-Saharan Africa. Of 945 300 estimated LBW births in northern America, Australia and New Zealand, central Asia, and Europe, approximately 35·0% (323 700) weighed less than 2000 g: 5·8% (95% CI 5·2-6·4; 54 800 [95% CI 49 400-60 800]) weighed less than 1000 g, 9·0% (8·7-9·4; 85 400 [82 000-88 900]) weighed between 1000 g and 1499 g, and 19·4% (19·0-19·8; 183 500 [180 000-187 000]) weighed between 1500 g and 1999 g. INTERPRETATION: Insufficient progress has occurred over the past two decades to meet the Global Nutrition Target of a 30% reduction in LBW between 2012 and 2030. Accelerating progress requires investments throughout the lifecycle focused on primary prevention, especially for adolescent girls and women living in the most affected countries. With increasing numbers of births in facilities and advancing electronic information systems, improvements in the quality and availability of administrative LBW data are also achievable. FUNDING: The Children's Investment Fund Foundation; the UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction; and the Bill & Melinda Gates Foundation.

Condición física de escolares tras intervención educativa para prevenir obesidad infantil en Morelos, México / Physical fitness of school age children post-implementation of an educational intervention to prevent childhood obesity in Morelos, Mexico

Resumen: Objetivo: Comparar la condición física de niños/as de ocho escuelas primarias del estado de Morelos, posimplementación de una intervención para prevenir obesidad infantil. Material y métodos: Se seleccionaron aleatoriamente 214 niños/ as (111 localidad intervención y 103 localidad control). La condición física se evaluó mediante pruebas de marcha con duración de seis minutos y de velocidad en 50 metros, así como número de pasos/día. Resultados: La mediana de tiempo en la prueba de velocidad en la localidad intervención fue de 11.3 segundos y en la localidad control 13.8 segundos (p<0.001). La mediana de la distancia recorrida en la prueba de marcha fue de 550 m en la localidad intervención y 420 m en la localidad control (p<0.001). Los niños/as de la comuni dad intervención tuvieron una mediana de 15 161 pasos/día y los de la localidad control, de 13 749 pasos/día (p<0.05). Conclusiones: Los niños/as de la localidad intervención tienen mejor condición física.

Abstract : Objective: To compare the physical fitness of children from eight elementary schools in Morelos, México after the imple mentation of an intervention to prevent childhood obesity. Materials and methods: 214 children were randomly selected (111 - intervention community and 103 - control community). Physical fitness was evaluated by the 6 minutes walking test and the 50 meters speed test, as well as the number of steps/day. Results: The median of time in the speed test at the intervention site was 11.3 seconds and 13.8 seconds at the control site (p<0.001). The median distance traveled in the walking test was 550 m in the intervention site and 420 m in the control site (p<0.001). The children of the intervention community took a median of 15 161 steps/ day and those of the control community took 13 749 steps/ day (p<0.05). Conclusions: Children from the intervention community have significantly better physical fitness.

Child dietary intake of folate and vitamin B12 and their neurodevelopment at 24 and 30 months of age / Ingesta de folato y vitamina B12 en la dieta del niño y su neurodesarrollo a los 24 y 30 meses de edad

Abstract Objective To evaluate whether child dietary intake of folate and vitamin B12, is associated with mental and psychomotor development in Mexican children, respectively, at 24 and 30 months of age. Materials and methods Information about neurodevelopment and dietary intake of folate and vitamin B12 at 24 and 30 months of age among 229 children belonging to a perinatal cohort was analyzed longitudinally. Dietary information was assessed using a semi-quantitative food frequency questionnaire, and neurodevelopment by Bayley Scale of Infant Development II. Results At 30 months of age, dietary folate intake was marginally associated with increased Mental Development Index (MDI) (β=8.33; 95%CI -0.48, 17.14; p=0.06). Non-significant positive associations of vitamin B12 with MDI were found. Psychomotor Development Index (PDI) was not associated with these nutrients. Conclusion Dietary folate intake in early childhood may benefit the mental development of children.

Resumen Objetivo Evaluar si la ingesta dietética infantil de folato y vitamina B12 se asocia con el desarrollo mental y psicomotor en niños mexicanos de 24 y 30 meses de edad. Material y métodos La información del neurodesarrollo y la ingesta dietética de folato y B12 a los 24 y 30 meses de edad de 229 niños pertenecientes a una cohorte perinantal, se analizó longitudinalmente. La información dietética se obtuvo por un cuestionario de frecuencia de alimentos semicuantitativo y el neurodesarrollo mediante la Escala de Desarrollo Infantil de Bayley II. Resultados A los 30 meses de edad, la ingesta dietética de folato se asoció marginalmente con un incremento del Índice de Desarrollo Infantil (IDM) (β=8.33; IC95% -0.48, 17.14; p=0.06). Se observaron asociaciones positivas no significativas entre la B12 y el IDM. El Índice de Desarrollo Psicomotor (IDP) no se asoció con dichos nutrientes. Conclusión La ingesta dietética infantil de folato puede beneficiar el desarrollo mental.

Análisis de algunas barreras del ambiente construido para la actividad física en la Ciudad de Cuernavaca, Morelos, México / Analysis of some environmental barriers for physical activity Cuernavaca City, Morelos, México

Introducción: La actividad física (AF) es un factor de protección ante múltiples enfermedades. Las recomendaciones mundiales para la AF están bien establecidas y son difundidas en todos los escenarios posibles, pero el ambiente construido podría presentar múltiples barreras para seguir dichas recomendaciones. Objetivo: Analizar algunas barreras del ambiente construido para la actividad física por niveles de marginación en la ciudad de Cuernavaca, México. Materiales y métodos: Empleando el programa Atlas ti 5.0, se categorizaron los datos obtenidos de 170 guías de observación. Se realizó el análisis de un acervo fotográfico de 341 imágenes de 20 AGEBS de la ciudad de Cuernavaca, utilizando un análisis de imágenes fijas connotativo, denotativo y por 3 categorías (Calzadas, tránsito y espacios deportivos). Se utilizó el programa Stata 12.0 para obtener frecuencias y porcentajes. Resultados: Se identificaron deficiencias en el diseño y uso de espacios como las banquetas, falta de señalización e inseguridad de las vías públicas. Se encontró carencia de espacios para la práctica de la actividad física. Solo hay una presencia del 10% de espacios deportivos en los 20 AGEBS estudiados. Se encontró que el 82.86% de las calles está en deficiente estado. La deficiente iluminación vial, carencia de ciclovías y grafitis con porcentajes importantes también se identificaron como barreras para la AF. Discusión: En Cuernavaca las posibilidades de acceso a espacios seguros, presentan múltiples barreras y por ende esta tendencia afecta de forma negativa la salud de los habitantes de la ciudad, además que no es congruente con las recomendaciones mundiales para la actividad física. Conclusiones: La identificación y abolición de las barreras deben estar dentro las prioridades de las políticas de salud públicas y las intervenciones deben procurar dicha transformación, de esta forma se superará la tendencia de solamente informar sobre los beneficios de la actividad física que predominan en la gran mayoría de las recomendaciones e intervenciones.

Introduction: Physical activity (PA) is a factor of protection against multiple diseases. Global recommendations for PA are well established and are spread in all possible scenarios, but the built environment could present multiple barriers to follow these recommendations. Objective: To Analyze some built environment barriers for physical activity by levels of marginalization in the city of Cuernavaca, Mexico. Material and methods: Using the software Atlas ti 5.0, data from 170 observation guides and were categorized. The analysis of a photographic collection of 341 images of 20 AGEBS of Cuernavaca was performed using an analysis connotative and denotative by 3 categories (roadways, traffic and sports areas). Stata 12.0 software was used to obtain frequencies and percentages. Results: Deficiencies in the design and use of spaces such as sidewalks, lack of signage and insecurity of public roads were identified. Lack of spaces for the practice of physical activity was found. There is only one presence of 10% of sports facilities in the 20 AGEBS studied. It was found that 82.86% of the streets are in poor condition. Poor street lighting, lack of bicycle paths and graffiti with significant percentages were also identified as barriers to PA. Discussion: In Cuernavaca the possibilities of access to safe spaces for FA have multiple barriers, this negatively affects the health of the habitants of the city, and that is not consistent with global recommendations for physical activity. Conclusions: Identifying and abolishing barriers must be within the priorities of public health policies and interventions should seek this transformation, to improve the tendency to only report on benefits of physical activity prevailing in the vast majority of programs.