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1.
Pesqui. bras. odontopediatria clín. integr ; 24: e230030, 2024. tab, graf
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1550597

RESUMEN

ABSTRACT Objective: To assess global trends in the publication of studies investigating the association between ankyloglossia and breastfeeding. Material and Methods: An electronic search was performed in the Scopus database without restrictions. Observational studies and clinical trials were included. Bibliometric indices such as publication year, authors, co-authors, journals, field of knowledge, countries, and the most cited keywords were analyzed using the VOSviewer program. Results: The search retrieved 350 studies, and 68 were selected. The first article was published in 2000 in the United States. The United States presented the highest number of publications (n=21), followed by Brazil (n=9) and the United Kingdom (n=9). An increase in publications on this theme was observed in 2013; 2021 was the year with the highest number of publications (n=14). The most common word was "frenulum". The authors with the highest number of publications were Botze and Dollbert from Israel (n=3), Ghaheri, and Mace from the United States (n=3). Among the journals, "Breastfeeding Medicine" presented the highest number of publications (n=7), followed by the "International Journal of Pediatric Otorhinolaryngology" (n=6), "CODAS" (n=5), "Journal of Human Lactation" (n=4) and "Pediatrics" (n=3); the latter published the top-cited studies, with 412 citations. Conclusion: There has been an increase in recent articles evaluating the correlation between ankyloglossia and breastfeeding, indicating the growing interest of researchers in this field.


Asunto(s)
Lactancia Materna/tendencias , Recién Nacido , Anquiloglosia , Frenillo Lingual , Bibliografías como Asunto , Bibliometría , Correlación de Datos
3.
Rev. Bras. Saúde Mater. Infant. (Online) ; 23: e20210223, 2023. tab, graf
Artículo en Inglés | LILACS, BVSAM | ID: biblio-1449159

RESUMEN

Abstract Objectives: to analyze the trend and correlation of obesity and the increase in continued breastfeeding in children aged six to 23 months in Brazil, from 2015-2019. Methods: ecological time series study with data from the Sistema de Vigilância Alimentar e Nutricional (Food and Nutritional Surveillance System). The dependent variable was the prevalence of obesity. Prais-Winsten linear regression was used to verify the trend. Spearman's correlation was used to verify the relationship between the prevalence of obesity and the increase in continued breastfeeding. Results: there was a trend towards a reduction in the prevalence of obesity in all regions in Brazil (Annual Percentage Variation [APV]: -4.14; CI95%=-4.50; -3.79). The prevalence of continued breastfeeding showed an upward trend in the North (APV=4.89; CI95%=2.92; 6.90), Southeast (APV=3.36; CI95%=2.32; 4 .41) and South (APV=2.67; CI95%=0.98; 4.38). There was a negative and significant correlation between obesity and continued breastfeeding in the North, Northeast, Southeast and South regions. Conclusion: the reduction in the prevalence of obesity and the increase in continued breastfeeding occurred only in some regions, requiring the implementation of effective strategies to be present throughout the country. Actions to promote, protect and support continued breastfeeding and healthy eating should be more prioritized to promote the child's healthy growth.


Resumo Objetivos: analisar a tendência e a correlação de obesidade e o aumento do aleitamento materno continuado em crianças de seis a 23 meses no Brasil, de 2015-2019. Métodos: estudo ecológico de série temporal com dados do Sistema de Vigilância Alimentar e Nutricional. A variável dependente foi a prevalência de obesidade. A regressão linear de Prais-Winsten foi usada para verificar a tendência. Adotou-se a correlação de Spearman para verificar a relação entre as prevalências de obesidade e o aumento do aleitamento materno continuado. Resultados: verificou-se tendência de redução da prevalência de obesidade em todas as suas regiões do Brasil (Variação Percentual Anual [VPA]: -4,14; IC95%=-4,50; -3,79). A prevalência do aleitamento materno continuado apresentou tendência de aumento nas regiões Norte (VPA=4,89; IC95%=2,92; 6,90), Sudeste (VPA=3,36; IC95%=2,32; 4,41) e Sul (VPA= 2,67; IC95%=0,98; 4,38). Houve correlação negativa e significativa entre obesidade e aleitamento materno continuado nas regiões Norte, Nordeste, Sudeste e Sul. Conclusão: a redução da prevalência da obesidade e o aumento do aleitamento materno continuado ocorreram somente em algumas regiões, requerendo implementação de estratégias eficazes para esteja presente em todo o país. Ações de promoção, proteção e apoio ao aleitamento materno continuado e a alimentação saudável devem ser mais priorizadas para promover o crescimento saudável da criança.


Asunto(s)
Humanos , Femenino , Recién Nacido , Lactante , Vigilancia Alimentaria y Nutricional , Lactancia Materna/tendencias , Nutrición del Lactante , Obesidad Pediátrica/epidemiología , Atención Primaria de Salud , Brasil/epidemiología , Estudios de Series Temporales , Estado Nutricional
6.
An. pediatr. (2003. Ed. impr.) ; 96(4): 300-308, abril 2022. tab, graf
Artículo en Español | IBECS | ID: ibc-205455

RESUMEN

IntroducciónEn 2017 se realizó una encuesta a nivel mundial sobre el cumplimiento de las prácticas que promueve la Neo-IHAN (Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia en las unidades neonatales).Objetivo: Presentar los resultados de las unidades españolas que participaron en la encuesta mundial y compararlos con los obtenidos internacionalmente.Material y métodos: Estudio transversal mediante una encuesta sobre el cumplimiento de los requisitos de la Neo-IHAN («Tres principios básicos», «Diez pasos adaptados a unidades neonatales» y el «cumplimiento del Código internacional de comercialización de sucedáneos de leche materna»). El cumplimiento se calculó como la media en cada indicador y una puntuación media final para cada unidad neonatal. Para las puntuaciones parciales y finales de cada país y a nivel internacional se utilizó la mediana. Las puntuaciones van de 0 a 100.Resultados: La tasa de respuesta en España fue del 90% de las unidades de nivel 2 y 3. El rango de la media para las unidades neonatales fue de 37 a 99, sin diferencias según el nivel asistencial. La puntuación global de España (72) está por debajo de la mediana internacional (77), así como en 8 de los 14 requisitos de la Neo-IHAN. Las unidades neonatales de hospitales con maternidades acreditadas IHAN obtuvieron una puntuación media final significativamente mayor, así como en 9 de los 14 requisitos frente a las no acreditadas.Conclusiones: Los resultados, tanto internacionales como nacionales, indican una mejora de las prácticas de la lactancia materna en las unidades neonatales. Los beneficios de la acreditación IHAN de las maternidades alcanzan a las unidades neonatales. España tiene varios puntos clave por debajo de la puntuación internacional. (AU)


Introduction: In 2017, a worldwide survey was conducted on compliance with the practices promoted by Neo-BFHI (Baby-friendly Hospital Initiative expansion to neonatal wards).Objective: Present the results of the Spanish wards that participated in the global survey and compare them with those obtained internationally.Material and methods: Cross-sectional study through a survey on compliance with the Neo-BFHI (“Three basic principles”, “Ten steps adapted to neonatal wards” and “the compliance with the International Code of Marketing of Breast-milk Substitutes” and subsequent relevant World Health Assembly resolutions). Compliance was calculated as the mean in each indicator and a final mean score for each neonatal unit. For the partial and final scores for each country and at the international level, the median was used. All score ranged between 0 and 100.Results: The response rate in Spain was 90%. The range of the national mean for neonatal wards were from 37 to 99, with no differences in the final score according to the level of care. The global score for Spain (72) is below the international median (77) and this also occurs in 8 of 14 items. The neonatal wards from BFHI designated hospitals, obtained a significantly higher mean global score, and in 9 of 14 items than the non-accredited ones.Conclusions: Both international and national results indicate an improvement in breastfeeding practices in neonatal units. The benefits of the BFHI accreditation of maternity reach neonatal wards. Spain has several key points below the international score. (AU)


Asunto(s)
Humanos , Lactancia Materna/métodos , Lactancia Materna/estadística & datos numéricos , Lactancia Materna/tendencias , Estudios Transversales , Encuestas y Cuestionarios , España
9.
Medicine (Baltimore) ; 100(44): e27118, 2021 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-34871202

RESUMEN

ABSTRACT: In addition to the maternal death indicator, Stork Network proposes the number of prenatal consultations, the gestational age of onset of prenatal care and the number of children breastfeeding.The study aims to analyze maternal health indicators representative of the actions proposed by Stork Network in Brazil, after its implementation. Therefore, this is an ecological study of maternal health indicators in Brazil from 2012 to 2017.Thus, it was found that the number of prenatal consultations per pregnant woman in Brazil from 2012 to 2017 increased >4 times between the first and the last year analyzed. The proportion of pregnant women who started prenatal care in the first trimester of pregnancy increased progressively each year in Brazil.The breastfeeding coefficient also increased progressively between 2014 and 2017 in Brazil. It was found that maternal health indicators improved between 2012 and 2017 in the Brazilian territory.


Asunto(s)
Lactancia Materna , Servicios de Salud Materna , Salud Materna , Atención Prenatal , Brasil/epidemiología , Lactancia Materna/estadística & datos numéricos , Lactancia Materna/tendencias , Niño , Femenino , Indicadores de Salud , Humanos , Servicios de Salud Materna/estadística & datos numéricos , Servicios de Salud Materna/tendencias , Mortalidad Materna , Embarazo , Atención Prenatal/estadística & datos numéricos , Atención Prenatal/tendencias , Factores de Tiempo
10.
Biomolecules ; 11(12)2021 11 23.
Artículo en Inglés | MEDLINE | ID: mdl-34944387

RESUMEN

Breastfeeding-or lactation-is a unique and defining reproductive trait of mammals that nourishes offspring by supplying nutrient-rich breast milk [...].


Asunto(s)
Factores Biológicos/química , Lactancia Materna/estadística & datos numéricos , Leche Humana/química , Factores Biológicos/inmunología , Lactancia Materna/tendencias , Desarrollo Infantil , Femenino , Homeostasis , Humanos , Sistema Inmunológico/crecimiento & desarrollo , Lactante , Leche Humana/inmunología
11.
Lancet Child Adolesc Health ; 5(9): 619-630, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34245677

RESUMEN

BACKGROUND: Previous analyses of trends in feeding indicators of children younger than 2 years have been limited to low-income and middle-income countries. We aimed to assess time trends in the consumption of different types of milk (breastmilk, formula, and animal milk) by children younger than 2 years from 2000 to 2019 at a global level. METHODS: In this time-series analysis, we combined cross-sectional data from 487 nationally representative surveys from low-income and middle-income countries and information from high-income countries to estimate seven infant and young child feeding indicators in up to 113 countries. Multilevel linear models were used in pooled analyses to estimate annual changes in feeding practices from 2000 to 2019 for country income groups and world regions. FINDINGS: For the absolute average annual changes, we found significant gains in any breastfeeding at age 6 months in high-income countries (1·29 percentage points [PPs] per year [95% CI 1·12 to 1·45]; p<0·0001) and at age 1 year in high-income countries (1·14 PPs per year [0·99 to 1·28]; p<0·0001) and upper-middle-income countries (0·53 PPs per year [0·23 to 0·82]; p<0·0001). We also found a small reduction in low-income countries for any breastfeeding at age 6 months (-0·07 PPs per year [-0·11 to -0·03]; p<0·0001) and age 1 year (-0·13 PPs per year [-0·18 to -0·09]; p<0·0001). Data on exclusive breastfeeding and consumption of formula and animal milk were only available for low-income and middle-income countries, where exclusive breastfeeding in the first 6 months of life increased by 0·70 PPs per year (0·51-0·88; p<0·0001) to reach 48·6% (41·9-55·2) in 2019. Exclusive breastfeeding increased in all world regions except for the Middle East and north Africa. Formula consumption in the first 6 months of life increased in upper-middle-income countries and in east Asia and the Pacific, Latin America and the Caribbean, the Middle East and north Africa, and eastern Europe and central Asia, whereas the rates remained below 8% in sub-Saharan Africa and south Asia. Animal milk consumption by children younger than 6 months decreased significantly (-0·41 PPs per year [-0·51 to -0·31]; p<0·0001) in low-income and middle-income countries. INTERPRETATION: We found some increases in exclusive and any breastfeeding at age 6 months in various regions and income groups, while formula consumption increased in upper-middle-income countries. To achieve the global target of 70% exclusive breastfeeding by 2030, however, rates of improvement will need to be accelerated. FUNDING: Bill & Melinda Gates Foundation, through WHO.


Asunto(s)
Lactancia Materna , Conducta Alimentaria/fisiología , Métodos de Alimentación/tendencias , Fórmulas Infantiles , Leche , Animales , Lactancia Materna/métodos , Lactancia Materna/estadística & datos numéricos , Lactancia Materna/tendencias , Estudios Transversales , Femenino , Salud Global/estadística & datos numéricos , Salud Global/tendencias , Humanos , Lactante , Fórmulas Infantiles/normas , Fórmulas Infantiles/estadística & datos numéricos , Fenómenos Fisiológicos Nutricionales del Lactante , Masculino , Leche/fisiología , Leche/normas , Leche/estadística & datos numéricos , Leche Humana/fisiología , Factores Socioeconómicos
13.
Nat Hum Behav ; 5(8): 1027-1045, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34083753

RESUMEN

Exclusive breastfeeding (EBF)-giving infants only breast-milk for the first 6 months of life-is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization's Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.


Asunto(s)
Lactancia Materna/estadística & datos numéricos , Países en Desarrollo/estadística & datos numéricos , Lactancia Materna/tendencias , Geografía , Disparidades en el Estado de Salud , Humanos , Formulación de Políticas , Prevalencia , Política Pública , Análisis Espacial
15.
Sci Rep ; 11(1): 6841, 2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33767216

RESUMEN

This research aimed to examine the efficacy of the early initiation of breastfeeding within 1 h of birth, early skin-to-skin contact, and rooming-in for the continuation of exclusive breastfeeding until 6 months postpartum. The research used data from the Japan Environment and Children's Study (JECS), a nationwide government-funded birth cohort study. A total of 80,491 mothers in Japan between January 2011 and March 2014 who succeeded or failed to exclusively breastfeed to 6 months were surveyed in JECS. Multiple logistic regression model was used to analyse the data. The percentage of mothers who succeeded in exclusively breastfeeding to 6 months is 37.4%. Adjusted odds ratios were analysed for all 35 variables. Early initiation of breastfeeding (adjusted odds ratio [AOR]: 1.455 [1.401-1.512]), early skin-to-skin contact (AOR: 1.233 [1.165-1.304]), and rooming-in (AOR: 1.567 [1.454-1.690]) affected continuation of exclusive breastfeeding. Regional social capital (AOR: 1.133 [1.061-1.210]) was also discovered to support the continuation of breastfeeding. In contrast, the most influential inhibiting factors were starting childcare (AOR: 0.126 [0.113-0.141]), smoking during pregnancy (AOR: 0.557 [0.496-0.627]), and obese body type during early pregnancy (AOR: 0.667 [0.627-0.710]).


Asunto(s)
Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Madres/psicología , Atención Posnatal/métodos , Periodo Posparto , Estrés Psicológico , Adulto , Lactancia Materna/tendencias , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Japón , Masculino , Embarazo , Encuestas y Cuestionarios
17.
J Perinat Med ; 49(4): 500-505, 2021 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-33554582

RESUMEN

OBJECTIVES: To find out if the expressed breast milk delivery rate to neonatal intensive care unit (NICU) for babies who were hospitalized for any reason other than COVID-19, and exclusive breastfeeding (EB) rates between discharge date and 30th day of life of those babies were affected by COVID-19 pandemic. METHODS: Babies who were hospitalized before the date first coronavirus case was detected in our country were included as control group (CG). The study group was divided into two groups; study group 1 (SG1): the mothers whose babies were hospitalized in the period when mother were asked not to bring breast milk to NICU, study group 2 (SG2): the mothers whose babies were hospitalized after the date we started to use the informed consent form for feeding options. The breast milk delivery rates to NICU during hospitalization and EB rates between discharge and 30th day of life were compared between groups. RESULTS: Among 154 mother-baby dyads (CG, n=50; SG1, n=46; SG2, n=58), the percentage of breast milk delivery to NICU was 100%, 79% for CG, SG2, respectively (p<0.001). The EB rate between discharge and 30th day of life did not change between groups (CG:90%, SG1:89%, SG2:75.9; p=0.075). CONCLUSIONS: If the mothers are informed about the importance of breast milk, the EB rates are not affected by the COVID-19 pandemic in short term, even if the mothers are obligatorily separated from their babies. The breast milk intake rate of the babies was lowest while our NICU protocol was uncertain, and after we prepared a protocol this rate increased.


Asunto(s)
Lactancia Materna/tendencias , COVID-19 , Unidades de Cuidado Intensivo Neonatal/tendencias , Cuidado Intensivo Neonatal/tendencias , Adulto , Lactancia Materna/psicología , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/psicología , Protocolos Clínicos , Estudios Transversales , Femenino , Promoción de la Salud , Hospitalización , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/normas , Cuidado Intensivo Neonatal/métodos , Cuidado Intensivo Neonatal/normas , Masculino , Pandemias , Relaciones Profesional-Familia , Estudios Retrospectivos , Turquia/epidemiología
18.
Physiol Rep ; 9(3): e14744, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33580917

RESUMEN

During postnatal development, colostrum and breastmilk are sequentially the first sources of nutrition with protein components and bioactive molecules that confer protection and immunostimulatory function to the gut. Caseins, whey proteins, secretory immunoglobulin A (sIgA), mucins, tryptophan, and growth factors are among milk-borne elements that are directly important in the control of mucosa development and protection. Consequently, breastfeeding is associated with the low incidence of gastrointestinal inflammation and with the decrease in respiratory diseases during postnatal period. The novel coronavirus (SARS-CoV-2) binds to angiotensin II-converting enzyme (ACE2) on the cell membrane, allowing virus entrance, replication, and host commitment. ACE2 is expressed by different cell types, which include ciliated cells in the lungs and enterocytes in the intestine. Such cells are highly active in metabolism, as they internalize molecules to be processed and used by the organism. The disruption of ACE2 impairs leads to intestinal inflammation and decreased synthesis of serotonin, affecting motility. By reviewing the effects of SARS-CoV-2 in the gastrointestinal and respiratory tracts in infants, and gut responses to breastfeeding interruption, we suggest that it is important to maintain breastfeeding during SARS-CoV-2 infection, as it might be essential to protect newborns from gastrointestinal-associated disorders and relieve disease symptoms.


Asunto(s)
Lactancia Materna/tendencias , COVID-19/metabolismo , COVID-19/prevención & control , COVID-19/transmisión , Femenino , Humanos
19.
Respir Res ; 22(1): 41, 2021 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-33549112

RESUMEN

BACKGROUND: Childhood asthma and allergic diseases are a significant global problem. There are inconsistent findings on the associations of delivery mode, the number of children in the household and breastfeeding with childhood asthma and allergic diseases. We assessed these associations and examined whether breastfeeding modified the effects of neonatal and familial risk factors on childhood asthma and allergic diseases. METHODS: A population-based cross-sectional study was conducted in Shanghai, China. A total of 17 primary schools were randomly selected from 13 districts of Shanghai in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma and allergic diseases. Multivariable logistic regression models were used to evaluate the associations between neonatal and familial factors and childhood asthma and allergic diseases, and to examine the modification effects of breastfeeding on the associations assessed. RESULTS: Of 10,464 primary school children aged 6-11 years, the overall prevalence of childhood asthma, allergic rhinitis, urticaria, food allergy and drug allergy was 13.9, 22.7, 15.3, 8.1 and 4.6%, respectively. Male sex, high socioeconomic status, cesarean section delivery, only one child in the household and having family history of allergy were associated with increased odds ratio (OR) of childhood asthma and allergic diseases while longer breastfeeding duration (> 6 months) was inversely associated with these diseases. Longer breastfeeding duration also attenuated the OR of neonatal and familial risk factors on childhood asthma and allergic diseases. For instance, the adjusted OR of childhood asthma in the group of vaginal delivery and breastfeeding duration > 6 months was lowest (0.78, 95% confidence interval: 0.66, 0.92). CONCLUSIONS: Longer breastfeeding duration was inversely associated with childhood asthma and allergic diseases, and also reduced the OR of neonatal and familial risk factors on these diseases. Giving the prevalence of childhood asthma and allergic diseases is rapidly rising across the globe, these findings may have important clinical and public health implications.


Asunto(s)
Asma/genética , Asma/prevención & control , Lactancia Materna/tendencias , Predisposición Genética a la Enfermedad/genética , Vigilancia de la Población , Asma/epidemiología , Niño , China/epidemiología , Estudios Transversales , Femenino , Predisposición Genética a la Enfermedad/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Factores de Tiempo
20.
Int J Equity Health ; 20(1): 20, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413445

RESUMEN

BACKGROUND: In low- and middle-income countries (LMICs), low levels of formal maternal educational are positively associated with breastfeeding whereas the reverse is true among women with higher levels of formal education. As such, breastfeeding has helped to reduce health equity gaps between rich and poor children. Our paper examines trends in breastfeeding and formula consumption by maternal educational in LMICs over nearly two decades. METHODS: We used 319 nationally representative surveys from 81 countries. We used WHO definitions for breastfeeding indicators and categorized maternal education into three categories: none, primary, and secondary or higher. We grouped countries according to the World Bank income groups and UNICEF regions classifications. The trend analyses were performed through multilevel linear regression to obtain average absolute annual changes in percentage points. RESULTS: Significant increases in prevalence were observed for early initiation and exclusive breastfeeding across all education categories, but more prominently in women with no formal education for early breastfeeding and in higher level educated women for exclusive breastfeeding. Small decreases in prevalence were seen mostly for women with no formal education for continued breastfeeding at 1 and 2 years. Among formula indicators, only formula consumption between 6 and 23 months decreased significantly over the period for women with primary education. Analysis by world regions demonstrated that gains in early and exclusive breastfeeding were almost universally distributed among education categories, except in the Middle East and North Africa where they decreased throughout education categories. Continued breastfeeding at 1 and 2 years increased in South Asia, Latin America and the Caribbean, and Eastern Europe and Central Asia for primary or higher education categories. Declines occurred for the group of no formal education in South Asia and nearly all education categories in the Middle East and North Africa with a decline steeper for continued breastfeeding at 2 years. With a few exceptions, the use of formula is higher among children of women at the highest education level in all regions. CONCLUSIONS: Over the course of our study, women with no formal education have worsening breastfeeding indicators compared to women with primary and secondary or higher education.


Asunto(s)
Lactancia Materna/tendencias , Países en Desarrollo/estadística & datos numéricos , Escolaridad , Madres/estadística & datos numéricos , Adulto , África del Norte/epidemiología , Asia/epidemiología , Lactancia Materna/psicología , Región del Caribe/epidemiología , Europa Oriental/epidemiología , Femenino , Humanos , Renta/estadística & datos numéricos , América Latina/epidemiología , Madres/psicología , Pobreza/estadística & datos numéricos , Prevalencia , Clase Social
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