[Association between ultra-processed food consumption and lipid parameters among adolescents]. / Associação entre o consumo de alimentos ultraprocessados e parâmetros lipídicos em adolescentes.

The scope of this study was to analyze the association between ultra-processed food (UPF) consumption and lipid parameters. It was a cross-sectional study performed with high school adolescents. Food consumption was analyzed by means of a 24-hour food recall form, where UPF were identified in line with the NOVA system of food classification. The total cholesterol levels, HDL-c and triglycerides were determined by enzymatic colorimetry and the LDL-c fraction estimated by formula. The Student's t-test or Mann-Whitney was used to compare averages, and linear regression to make associations among the variables. The results show that UPF consumption was more frequent in female adolescents between 17 and 19 years of age, with a family income above two minimum wages and from private schools. It was observed that individuals in the upper third of UPF consumption had a higher energetic, carbohydrate and sodium intake, with a lower intake of proteins and fibers. Moreover, it was found that a higher UPF intake was negatively associated with HDL-c levels and positively associated with triglyceride levels and dyslipidemia. Therefore, UPF is associated with a worsening of the nutritional profile of the diet and contributes to negative changes in the lipid parameters of young individuals.

O objetivo do estudo foi analisar a associação entre o consumo de alimentos ultraprocessados (AUP) e parâmetros lipídicos. Estudo transversal realizado com adolescentes de ensino médio. O consumo alimentar foi analisado por meio de recordatório alimentar de 24h, sendo os AUP identificados de acordo com a NOVA classificação de alimentos. Os níveis de colesterol total, HDL-c e triglicérides, foram determinados por colorimetria enzimática e a fração de LDL-c estimada por fórmula. Utilizou-se o teste t de Student ou Mann-Whitney para comparação de médias e regressão linear para realizar associações entre as variáveis. Os resultados mostram que o consumo de AUP foi mais frequente nas adolescentes do sexo feminino, entre a faixa etária 17 a 19 anos, com renda familiar superior a dois salários mínimos e de escolas particulares. Nota-se que os indivíduos no maior tercil de consumo de AUP apresentaram maior ingestão energética, de carboidratos e de sódio, com menor ingestão de proteínas e de fibras. Observou-se, ainda, que o maior consumo de AUP foi associado negativamente aos níveis de HDL-c e positivamente aos níveis de triglicerídeos e dislipidemia. Portanto, os AUP estão associados a uma piora no perfil nutricional da dieta e alterações negativas nos parâmetros lipídicos de jovens.

Associação entre o consumo de alimentos ultraprocessados e parâmetros lipídicos em adolescentes / Association between ultra-processed food consumption and lipid parameters among adolescents

Resumo O objetivo do estudo foi analisar a associação entre o consumo de alimentos ultraprocessados (AUP) e parâmetros lipídicos. Estudo transversal realizado com adolescentes de ensino médio. O consumo alimentar foi analisado por meio de recordatório alimentar de 24h, sendo os AUP identificados de acordo com a NOVA classificação de alimentos. Os níveis de colesterol total, HDL-c e triglicérides, foram determinados por colorimetria enzimática e a fração de LDL-c estimada por fórmula. Utilizou-se o teste t de Student ou Mann-Whitney para comparação de médias e regressão linear para realizar associações entre as variáveis. Os resultados mostram que o consumo de AUP foi mais frequente nas adolescentes do sexo feminino, entre a faixa etária 17 a 19 anos, com renda familiar superior a dois salários mínimos e de escolas particulares. Nota-se que os indivíduos no maior tercil de consumo de AUP apresentaram maior ingestão energética, de carboidratos e de sódio, com menor ingestão de proteínas e de fibras. Observou-se, ainda, que o maior consumo de AUP foi associado negativamente aos níveis de HDL-c e positivamente aos níveis de triglicerídeos e dislipidemia. Portanto, os AUP estão associados a uma piora no perfil nutricional da dieta e alterações negativas nos parâmetros lipídicos de jovens.

Abstract The scope of this study was to analyze the association between ultra-processed food (UPF) consumption and lipid parameters. It was a cross-sectional study performed with high school adolescents. Food consumption was analyzed by means of a 24-hour food recall form, where UPF were identified in line with the NOVA system of food classification. The total cholesterol levels, HDL-c and triglycerides were determined by enzymatic colorimetry and the LDL-c fraction estimated by formula. The Student's t-test or Mann-Whitney was used to compare averages, and linear regression to make associations among the variables. The results show that UPF consumption was more frequent in female adolescents between 17 and 19 years of age, with a family income above two minimum wages and from private schools. It was observed that individuals in the upper third of UPF consumption had a higher energetic, carbohydrate and sodium intake, with a lower intake of proteins and fibers. Moreover, it was found that a higher UPF intake was negatively associated with HDL-c levels and positively associated with triglyceride levels and dyslipidemia. Therefore, UPF is associated with a worsening of the nutritional profile of the diet and contributes to negative changes in the lipid parameters of young individuals.

Impacto da intenção de engravidar sobre a amamentação na primeira hora pós-parto / Impact of intention to become pregnant on breastfeeding in the first postpartum hour

Resumo Objetivou-se analisar o impacto da intenção de engravidar sobre a amamentação na primeira hora pós-parto. Trata-se de estudo transversal, recorte da pesquisa "Nascer no Brasil: inquérito nacional sobre parto e nascimento" realizada pela Fundação Oswaldo Cruz. Participaram do estudo 5.563 puérperas e seus conceptos. Utilizou-se Regressão Logística Múltipla para análise dos dados. Apresentaram menor propensão para início da amamentação na primeira hora de vida: puérperas que não queriam engravidar (OR = 0,85; IC: 0,73-0,98) e se declararam insatisfeitas ao tomarem conhecimento da gravidez (OR = 0,72; IC: 0,61-0,83). A intencionalidade da gravidez afetou o comportamento materno quanto à amamentação, sendo que mulheres com gestações não intencionais apresentaram menor propensão a iniciarem a amamentação na primeira hora pós-parto, evidenciando que falhas no planejamento familiar podem impactar negativamente, de forma indireta, a amamentação. Logo, há de se melhorar a qualidade dos serviços de planejamento familiar, a fim de reduzirem-se gestações não intencionais e prevenir desfechos desfavoráveis para a saúde materno-infantil, como o início tardio da amamentação.

Abstract This study aimed to analyze the impact of the intention to become pregnant on breastfeeding within the first hour after delivery. This is a cross-sectional study nested in the research "Birth in Brazil: national survey into labor and birth" carried out by the Oswaldo Cruz Foundation. Multiple logistic regression was used to analyze the data of 5,563 puerperae and their newborns who participated in the study. The following women evidenced a lower propensity to begin breastfeeding in the first hour of life: puerperae who did not wish to become pregnant (OR = 0.85; CI: 0.73-0.98) and who were dissatisfied upon learning that they had become pregnant (OR = 0.72; CI: 0.61-0.83). The intentionality of pregnancy affected maternal breastfeeding behavior so that women with unintended pregnancies were less likely to initiate breastfeeding in the first hour postpartum, thus evidencing that inadequate family planning may indirectly harm breastfeeding. Therefore, the quality of family planning services should be improved to reduce unintended pregnancies and prevent unfavorable outcomes for mother-and-child health, such as the late onset of breastfeeding.

Impact of intention to become pregnant on breastfeeding in the first postpartum hour. / Impacto da intenção de engravidar sobre a amamentação na primeira hora pós-parto.

This study aimed to analyze the impact of the intention to become pregnant on breastfeeding within the first hour after delivery. This is a cross-sectional study nested in the research "Birth in Brazil: national survey into labor and birth" carried out by the Oswaldo Cruz Foundation. Multiple logistic regression was used to analyze the data of 5,563 puerperae and their newborns who participated in the study. The following women evidenced a lower propensity to begin breastfeeding in the first hour of life: puerperae who did not wish to become pregnant (OR = 0.85; CI: 0.73-0.98) and who were dissatisfied upon learning that they had become pregnant (OR = 0.72; CI: 0.61-0.83). The intentionality of pregnancy affected maternal breastfeeding behavior so that women with unintended pregnancies were less likely to initiate breastfeeding in the first hour postpartum, thus evidencing that inadequate family planning may indirectly harm breastfeeding. Therefore, the quality of family planning services should be improved to reduce unintended pregnancies and prevent unfavorable outcomes for mother-and-child health, such as the late onset of breastfeeding.

Objetivou-se analisar o impacto da intenção de engravidar sobre a amamentação na primeira hora pós-parto. Trata-se de estudo transversal, recorte da pesquisa "Nascer no Brasil: inquérito nacional sobre parto e nascimento" realizada pela Fundação Oswaldo Cruz. Participaram do estudo 5.563 puérperas e seus conceptos. Utilizou-se Regressão Logística Múltipla para análise dos dados. Apresentaram menor propensão para início da amamentação na primeira hora de vida: puérperas que não queriam engravidar (OR = 0,85; IC: 0,73-0,98) e se declararam insatisfeitas ao tomarem conhecimento da gravidez (OR = 0,72; IC: 0,61-0,83). A intencionalidade da gravidez afetou o comportamento materno quanto à amamentação, sendo que mulheres com gestações não intencionais apresentaram menor propensão a iniciarem a amamentação na primeira hora pós-parto, evidenciando que falhas no planejamento familiar podem impactar negativamente, de forma indireta, a amamentação. Logo, há de se melhorar a qualidade dos serviços de planejamento familiar, a fim de reduzirem-se gestações não intencionais e prevenir desfechos desfavoráveis para a saúde materno-infantil, como o início tardio da amamentação.

Prevalence and factors associated with violence against high school teachers in Teresina, Piauí, 2016: a cross-sectional study. / Prevalência e fatores associados à violência contra professores em escolas do ensino médio em Teresina, Piauí, 2016: estudo transversal.

OBJECTIVE: to analyze prevalence of violence against high school teachers and associated factors in Teresina, Piauí, Brazil. METHODS: this was a cross-sectional study using convenience sampling. Data was collected in 2016 in public and private high schools, using a self-administered questionnaire. Prevalence ratios (PR) using Poisson regression and 95% confidence intervals (95%CI) were calculated. RESULTS: 279 teachers participated, of whom 54.8% (95%CI 48.8;60.7) reported having suffered at least one type of violence. Verbal insults were most prevalent (39.4%; 95%CI 33.7;45.4), positively associated with public schools (PR=1.45; 95%CI 1.00;2.11) and with schools in the city's Eastern region (PR=1.85; 95%CI 1.17;2.93) and Southern region (PR=1.59; 95%CI 1.05;2.41). Sexual harassment was associated with males (PR=2.38; 95%CI 2.02;2.71). CONCLUSION: violence against teachers was higher in public schools in poorer outskirt regions and regions with high indicators of urban violence.

Suicidal ideation and associated factors among high school adolescents.

OBJECTIVE: To analyze the prevalence of suicidal ideation and its associated factors in school adolescents. METHODS: Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26-4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80-6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence. CONCLUSION: The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.

Prevalência e fatores associados à violência contra professores em escolas do ensino médio em Teresina, Piauí, 2016: estudo transversal / Prevalencia y factores asociados a la violencia contra profesores en escuelas de enseñanza secundaria en Teresina, Piauí, 2016: estudio transversal / Prevalence and factors associated with violence against high school teachers in Teresina, Piauí, 2016: a cross-sectional study

Resumo Objetivo: analisar a prevalência de violência contra professores do ensino médio e fatores associados em Teresina, Piauí. Métodos: estudo transversal com amostragem por conveniência. Os dados foram coletados em 2016, em escolas públicas e privadas do ensino médio, utilizando-se questionário autoaplicável. Calcularam-se as razões de prevalência (RP) por regressão de Poisson e intervalos de confiança de 95% (IC95%). Resultados: participaram da pesquisa 279 professores, dos quais 54,8% (IC95% 48,8; 60,7) relataram ter sofrido pelo menos um tipo de violência. Houve maior prevalência de insultos verbais (39,4%; IC95% 33,7;45,4), associados positivamente às escolas públicas (RP=1,45; IC95%1,00;2,11) e às escolas das regiões Leste (RP=1,85; IC95% 1,17;2,93) e Sul (RP=1,59; IC95% 1,05;2,41). Assédio sexual foi associado ao sexo masculino (RP=2,38; IC95% 2,02;2,71). Conclusão: a violência contra docentes foi maior em escolas públicas, localizadas em regiões periféricas e com elevados indicadores de violência urbana.

Resumen Objetivo: analizar la prevalencia de violencia contra docentes de secundaria y factores asociados en Teresina, Piauí. Métodos: estudio transversal con muestreo de conveniencia. Se recolectaron los datos, en 2016, utilizando un cuestionario autoadministrado, en escuelas públicas y privadas de enseñanza secundaria. Se calcularon las razones de prevalencia (RP) por la regresión de Poisson y los intervalos de confianza de 95% (IC95%). Resultados: participaron 279 profesores, de los cuales un 54.8% (IC95% 48.8;60.7) relató haber sufrido al menos un tipo de violencia. Hubo mayor prevalencia de insultos verbales (39.4%; IC95% 33.7;45.4), positivamente asociados a las escuelas públicas (RP=1.45; IC95% 1.00;2.11) y en las regiones Este (RP=1.85; IC95% 1.17;2.93) y Sur (RP=1.59; IC95% 1.05;2.41). El acoso sexual se asoció al sexo masculino (RP=2,38; IC95%: 2,02;2,71). Conclusión: la violencia fue mayor en las escuelas públicas de las regiones periféricas más violentas.

Abstract Objective: to analyze prevalence of violence against high school teachers and associated factors in Teresina, Piauí, Brazil. Methods: this was a cross-sectional study using convenience sampling. Data was collected in 2016 in public and private high schools, using a self-administered questionnaire. Prevalence ratios (PR) using Poisson regression and 95% confidence intervals (95%CI) were calculated. Results: 279 teachers participated, of whom 54.8% (95%CI 48.8;60.7) reported having suffered at least one type of violence. Verbal insults were most prevalent (39.4%; 95%CI 33.7;45.4), positively associated with public schools (PR=1.45; 95%CI 1.00;2.11) and with schools in the city's Eastern region (PR=1.85; 95%CI 1.17;2.93) and Southern region (PR=1.59; 95%CI 1.05;2.41). Sexual harassment was associated with males (PR=2.38; 95%CI 2.02;2.71). Conclusion: violence against teachers was higher in public schools in poorer outskirt regions and regions with high indicators of urban violence.

Suicidal ideation and associated factors among high school adolescents / Ideação suicida e fatores associados entre escolares adolescentes

ABSTRACT OBJECTIVE To analyze the prevalence of suicidal ideation and its associated factors in school adolescents. METHODS Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26-4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80-6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence. CONCLUSION The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.

RESUMO OBJETIVO Analisar a prevalência de ideação suicida e fatores associados em adolescentes escolares. MÉTODOS Estudo transversal de base escolar com 674 estudantes de escolas públicas e privadas em Teresina, Piauí, em 2016. Realizou-se análise bivariada com o teste do qui-quadrado e análise múltipla pelo modelo de regressão de Poisson para estimar as razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). RESULTADOS Os participantes do estudo foram em sua maioria estudantes do sexo feminino (56,7%), negros (77,4%), que moravam com os pais (85%), cujas mães apresentavam escolaridade maior ou igual a 8 anos de estudo (68,8%), com renda familiar maior que um salário mínimo (58,3%), praticantes de alguma religião (86,8%) e procedentes de escola pública (64,7%). A prevalência de ideação suicida foi de 7,9%. Maior frequência de ideação suicida foi relatada entre estudantes do sexo feminino (10,2%). Ideação suicida foi associada estatisticamente aos alunos que referiram não residir com os pais (RP ajustada = 2,27; IC95% 1,26-4,10; p < 0,05) e àqueles que informaram ter sofrido violência sexual por outros alunos, professores ou funcionários da escola (RP ajustada = 3,40; IC95% 1,80-6,44; p < 0,05), entre os quais a prevalência de ideação suicida foi mais de três vezes a observada entre aqueles que não referiram esse tipo de violência. CONCLUSÃO A prevalência de ideação suicida em adolescentes escolares foi associada ao sexo feminino, não residir com os pais e ter sido vítima de violência sexual na escola. Recomenda-se alertar a comunidade escolar e profissionais de saúde para identificarem sinais do comportamento suicida, em especial naqueles com suspeita ou comprovação da ocorrência de violência sexual na escola.

Prevalência de Síndrome Metabólica e associação com estado nutricional em adolescentes / Prevalence of Metabolic Syndrome and associations with nutritional status in adolescents

Resumo Introdução A síndrome metabólica é uma desordem multifatorial relacionada, principalmente, com a deposição de gordura abdominal e as alterações da homeostase da glicose e/ou resistência à insulina. Estudos demonstram associações entre o excesso de peso na infância e as taxas de morbimortalidade elevadas na vida adulta; portanto, a presença de alterações metabólicas na infância e/ou na adolescência pode contribuir para um perfil de saúde desfavorável ao futuro dos indivíduos. Objetivo Determinar a prevalência de síndrome metabólica e verificar sua associação com estado nutricional em adolescentes. Método Estudo transversal com adolescentes entre 14 e 19 anos de escolas públicas e particulares. Realizou-se avaliação antropométrica, incluindo o índice de massa corporal e o perímetro da cintura, e foram determinados os parâmetros bioquímicos e a pressão arterial. Para o diagnóstico da síndrome metabólica, utilizou-se de critérios da National Cholesterol Education Program's Adult Treatment Panel III (NCEP/ATP III). As características antropométricas e bioquímicas foram expressas como média e desvios-padrão e comparadas entre os sexos pelo teste t de Student, enquanto, para análise de risco, utilizou-se da regressão logística binária. Resultados Dos 327 adolescentes investigados, 59,9% eram meninas e 65,7% estudavam em escola pública. A prevalência de síndrome metabólica foi de 7%, enquanto a presença de pelo menos um critério diagnóstico da síndrome esteve presente em 90,8% da amostra. Ainda, observou-se associação significativa entre a obesidade e a síndrome metabólica, apontando um maior risco. Conclusão Os adolescentes tiveram uma importante prevalência de síndrome metabólica, apresentando precocemente componentes dessa patologia. Além disso, foi observada associação com a obesidade, evidenciando um maior risco para aqueles que possuem essa condição; portanto, intervenções nutricionais direcionadas à população jovem devem ser promovidas no intuito de melhorar os hábitos alimentares e o estilo de vida.

Abstract Background Metabolic syndrome is a multifactorial disorder mainly related to abdominal fat deposition and changes in glucose homeostasis and / or insulin resistance. Studies show associations between childhood overweight and high morbidity and mortality rates in adulthood, so the presence of metabolic changes in childhood and / or adolescence may contribute to an unfavorable health profile to the future health of individuals. Objective To determine the prevalence of metabolic syndrome and to check its association with nutritional status in adolescents. Method Cross-sectional study with adolescents from public and private schools with ages ranging from 14 to 19 years was carried out. It was performed an anthropometric assessment, including the determination of Body Mass Index and Waist Circumference, besides that the determination of biochemical parameters and blood pressure was also collected. In order to diagnose Metabolic Syndrome, it was used the National Cholesterol Education Program's Adult Treatment Panel III (NCEP/ATP III) criteria. The anthropometric and biochemical characteristics were expressed as average and standard deviations, and compared between the genders by the Student's t-test, while for the analysis of risk was used binary logistic regression. Results Of total 327 interviewed adolescents, 59.9% of them were female, 65.7% were studying in public schools. The prevalence of metabolic syndrome was 7%, while the presence of at least one diagnostic criterion of this syndrome was present in 90.8% of the sample. Moreover, obesity was significantly associated with metabolic syndrome, indicating a greater risk. Conclusion Adolescents have a high prevalence of metabolic syndrome, showing early components of this pathology, which is still associated with obesity, highlighting a greater risk for those who present this condition. Therefore, nutritional interventions directed at the young population should be promoted, with the purpose of improving eating habits and lifestyle.

The impact of consumption of ultra-processed foods on the nutritional status of adolescents / Impacto del consumo de alimentos ultraprocesados en el estado nutricional de adolescentes

ABSTRACT Because of its composition, ultra-processed foods can contribute to excess weight. The objective of the study was to verify the association between the consumption of ultra-processed foods and overweight in adolescents. We conducted a cross-sectional study with 617 adolescents. Sociodemographic, anthropometric and food consumption data were evaluated. Linear regression analyses were used to verify the association. Ultra-processed foods presented higher proportions of carbohydrates, lipids and saturated fat in relation to the total diet consumed. However, this food group had a lower proportion of proteins and fibers. Intake of ultra-processed foods was more frequent in females and being overweight was positively associated with the ingestion of ultra-processed foods. The high consumption of ultra-processed foods can contribute to weight gain. Therefore, the reduction of consumption of ultra-processed foods should be encouraged to improve eating habits.

RESUMEN Debido a su composición, los alimentos ultraprocesados pueden contribuir al exceso de peso. El objetivo del estudio fue verificar la asociación entre el consumo de alimentos ultraprocesados y el sobrepeso en adolescentes. Estudio transversal con 617 adolescentes. Se evaluaron los datos sociodemográficos, antropométricos y de consumo de alimentos. Se usaron análisis de regresión lineal para verificar la asociación. Los alimentos ultraprocesados presentaron mayores proporciones de carbohidratos, lípidos y grasas saturadas en relación con la dieta total consumida. Sin embargo, este grupo de alimentos tenía una menor proporción de proteínas y fibras. La ingesta de ultraprocesados fue más frecuente en las mujeres y el sobrepeso se asoció positivamente con la ingestión de alimentos ultraprocesados. El alto consumo de alimentos ultraprocesados puede contribuir al aumento de peso. Por lo tanto, se debe fomentar la reducción del consumo de alimentos ultraprocesados para mejorar los hábitos alimenticios.

Factors associated with the lipid profile of adolescents / Factores asociados con el perfil lipídico de adolescentes

ABSTRACT There is a high prevalence of dyslipidemia in adolescence. The aim of this study was to determine the lipid profile of adolescents and associated factors. We conducted a cross-sectional study with male and female adolescents from public and private schools in Teresina, aged 14 to 19 years. Body mass index (BMI) z-score was obtained and adjusted for age, in addition to waist circumference (WC) percentile values. Lipid profile was determined by enzymatic colorimetric method; LDL-C was calculated. The statistical tests Mann-Whitney U, Student's t, and odds ratio were used. The sample was comprised of 327 adolescents with a mean age of 16.5 years, 59.6% were female and 65.7% from public schools. The prevalence of dyslipidemia was 85.6%, especially hypoalphalipoproteinemia. TG levels were significantly higher and HDL levels were lower among participants who attended public schools (P< 0.05). BMI and WC were associated with dyslipidemia; a higher mean BMI and overweight was observed in girls with dyslipidemia. In the adjusted regression, being from a public school increased the odds for low HDL-C and dyslipidemia, while overall higher BMI and abdominal excess weight represented a risk for higher triglycerides. Thus, overweight increased the chances of hypertriglyceridemia and studying in a public school increased the odds for dyslipidemia and hypoalphalipoproteinemia.

RESUMEN Las dislipidemias tienen una elevada prevalencia en la adolescencia. Nuestro objetivo fue determinar el perfil lipídico de adolescentes y sus factores asociados. Realizamos un estudio transversal que abarcó adolescentes de escuelas públicas y privadas de Teresina, con edad entre 14 y 19 años, de los dos sexos. El índice de masa corporal (escore-z, IMC-Z) se obtuvo conforme a la edad, y la circunferencia de la cintura (CC) en percentil. La determinación del perfil lipídico se realizó por método enzimático colorimétrico; LDL-C fue calculado. Las pruebas estadísticas Mann-Whitney U, T de Student y odds ratio fueran utilizadas. La muestra comprendió 327 adolescentes con edad media de 16,5 años, siendo 59,6% del sexo femenino y el 65,7% de escuelas públicas. La prevalencia de dislipidemia fue 85,6%, destacándose la hipo-alfa-lipoproteinemia. Los niveles de TC fueron significativamente mayores y los de HDL menores en las escuelas públicas (P< 0,05). Al asociar IMC y CC con dislipidemia, se observó mayores valores medios de IMC en las niñas con dislipidemia y sobrepeso. En la regresión ajustada, ser de escuela pública aumentó las posibilidades de bajo HDL-C y dislipidemia, mientras que el exceso de peso global y abdominal fueron factores de riesgo de cambios en los triglicéridos. Así, el exceso de peso elevó las posibilidades de hipertrigliceridemia, y estudiar en escuela pública elevó las posibilidades de dislipidemia e hipo-alfa-lipoproteinemia.

Análise da situação de saúde no ensino médio: metodologia / Analysis of the health situation in high school: methodology / Análisis de la situación de salud en la educación media: metodología

Justificativa e Objetivos: Em tempos de escassez de financiamento para pesquisas no Brasil, o estudo transversal ganha importância por suas vantagens. O objetivo é analisar o delineamento de estudo sobre a situação de saúde de estudantes do ensino médio e analisar o currículo escolar quanto à abordagem de promoção de saúde. Métodos: Estudo transversal realizado em 24 escolas de Teresina-PI, das quais 12 públicas e 12 particulares. Os dados foram coletados no primeiro semestre de 2016 de 674 estudantes e 281 professores e dos projetos políticos pedagógicos das escolas. O município foi dividido em quatro áreas geográficas para distribuição das escolas elegíveis ao estudo, que foram organizadas em três portes, de modo a evitar aglomeração da amostra numa mesma área e porte. Seis escolas foram sorteadas para cada área, com uma de cada porte e tipo de gestão (pública e particular). Os dados de alunos e docentes foram coletados por questionários pré-testados. Também foram realizadas medidas antropométricas e de pressão arterial, colheita de sangue periférico e digital dos alunos. Resultados: Após recusa de 11 (1,61%) alunos, 434 alunos de escolas públicas e 240 de escolas particulares participaram do estudo; e 281 docentes. Conclusões: O delineamento transversal e as estratégias utilizadas se mostraram adequadas, gerando dados que permitirão o conhecimento de vários aspectos da situação de saúde de estudantes do ensino médio e da abordagem curricular sobre promoção da saúde nesse nível de ensino.(AU)

Background and Objectives: In times of shortage of funding for research in Brazil, the cross-sectional study gains importance due to its advantages. The aim of this study is to analyze the study design on the health situation of secondary school students and analyze the school curriculum regarding the health promotion approach. Methods: This is a cross-sectional study. It was conducted in 24 schools (12 public and 12 private) of Teresina-PI, Brazil. Data were collected in the first semester of 2016 from 674 students, 281 teachers, and from political pedagogical projects of the schools. The municipality was divided into four geographic areas for the distribution of eligible schools for the study. They were sorted in three sizes in order to avoid sample crowding in the same area and size. A draw was made of six schools for each area with one of each size and type of management (public and private). Data from both students and teachers were collected through pre-tested questionnaires. Anthropometric and blood pressure measurements were taken from students, and were performed peripheral blood draw and finger prick blood sampling. Results: after refusal of 11 (1.61%) students, 434 students from public schools and 240 from private schools participated in the study; 281 teachers participated in the study. Conclusion: The cross-sectional design and strategies were adequate to the study, and was generated data that will allow the knowledge of several aspects of the health situation of secondary school students and the curricular approach on health promotion at this level of education.(AU)

Justificación y Objetivos: En tiempos de escasez de financiamiento para investigaciones en Brasil, el estudio transversal gana importancia debido a sus ventajas. El objetivo del estudio es analizar el delineamiento de estudio sobre la situación de salud de estudiantes de la educación media y analizar el currículo escolar en cuanto al abordaje de promoción de salud. Métodos: Estudio transversal realizado en 24 escuelas de Teresina-PI, de las cuales 12 públicas y 12 privadas. En el primer semestre de 2016, los datos fueron recogidos de 674 estudiantes, 281 profesores y de los proyectos políticos pedagógicos de las escuelas. El municipio fue dividido en cuatro áreas geográficas para la distribución de las escuelas elegibles al estudio, que se organizaron en tres portes para evitar la aglomeración de la muestra en una misma área y porte. Seis escuelas fueron sorteadas para cada área, con una de cada porte y tipo de gestión (pública y privada). Los datos de alumnos y docentes fueron recolectados por cuestionarios pre-testados. También se realizaron medidas antropométricas y de presión arterial, y recolección de muestra de sangre periférica y digital de los alumnos. Resultados: Participaron del estudio 434 alumnos de escuelas públicas y 240 de escuelas privadas, después de rechazo de 11 (1,61%) alumnos. Participaron del estudio 281 docentes. Conclusión: El delineamiento transversal y las estrategias utilizadas se mostraron apropiados al estudio, generando datos que permitirán el conocimiento de varios aspectos de la situación de salud de estudiantes de la enseñanza media y del abordaje curricular sobre promoción de la salud en ese nivel de enseñanza.(AU)

Fatores preditores da evasão escolar entre adolescentes com experiência de gravidez / School evasion predictive factors among adolescents with pregnancy experience

Resumo Objetivo Analisar os fatores preditores da evasão escolar entre adolescentes com experiência de gravidez em Teresina, Piauí. Método Estudo transversal, com amostragem acidental, realizado com jovens que finalizaram uma gravidez no primeiro quadrimestre de 2006, quando tinham entre 15 e 19 anos de idade. Foi realizada análise multivariada por meio de regressão logística binomial para cálculo de Odds Ratio ajustado (ORaj), com intervalo de confiança de 95% (IC 95%). Resultados 94,4% das jovens afirmaram ter interrompido os estudos em algum momento da vida, das quais 54,4% abandonaram os estudos. As jovens que trabalhavam e tiveram gravidez recorrente foram as mais propensas a abandonar os estudos. Além disso, conviver com uma renda f amiliar de até um salário mínimo aumentou suas chances em três vezes. O tempo em que parou de estudar se apresentou como fator de proteção. Conclusão O abando escolar de jovens mães está fortemente associado a fatores socioeconômicos desfavoráveis, por isso são imprescindíveis políticas que incentivem a continuidade dos estudos e, consequentemente, a inserção no mercado de trabalho, favorecendo melhor renda, menor dependência financeira, menos gravidez precoce e não planejadas.

ABSTRACT: Background Formal education is considered a protective factor because of the social inclusion it promotes and because the permanence of the young in school reduces the risk of early motherhood, which leads to associate adolescent gestation to school dropout. Objective Analyze the predictive factors of school dropout among adolescents with pregnancy experience in Teresina, Piaui state, Brazil. Method Cross-sectional study with convenience sampling conducted with young women who completed pregnancy in the first four months of 2006, when they were between 15 and 19 years of age. Data were assessed by multivariate analysis using binomial logistic regression to calculate adjusted Odds Ratio (ORaj) and 95% confidence intervals (95% CI). Results 94.4% of the adolescents reported having interrupted their studies some time in their lives, with 54.4% of them being definite dropouts. Young women who had recurrent pregnancies and had a job were more likely to drop out, and living with a family income of up to one minimum wage increased their chances of dropping out in three times. The dropout period was presented as a protection factor. Conclusion School dropout rate among young mothers is strongly associated with unfavorable socioeconomic factors, and policies that encourage continuity of education and consequent insertion in the labor market are considered essential, favoring better income, less financial dependence, and fewer early and unplanned pregnancies.

Intenção de engravidar e amamentação: revisão integrativa / Intención de quedarse embarazada y amamantar: revisión integrativa / Intention of getting pregnant and breastfeeding: an integrative review

Objetivo: Analisar a relação entre a intenção de engravidar e a prática da amamentação. Métodos: Realizou-se revisão integrativa da literatura por meio de busca nas bases de dados PubMed e LILACS, segundo recomendações do protocolo Preferred Reporting Itens for Systematic Reviews and Meta-Analyses (PRISMA). Dois pesquisadores independentes utilizaram a seguinte combinação dos descritores: Pregnancy (Unplanned OR Unwanted) AND Breastfeeding, em junho de 2016, sem restringir período de publicação. Após aplicação dos critérios preestabelecidos e avaliação qualitativa, seis artigos foram incluídos no estudo. Resultados: Verificou-se associação entre gravidez não planejada e baixos índices de amamentação, sendo que gravidezes indesejadas associaram-se a piores resultados comparadas às inoportunas. Circunstâncias socioeconômicas e culturais afetaram essa relação. Conclusão: Diante da predisposição de mulheres com gravidezes não planejadas a comportamentos desfavoráveis quanto ao estabelecimento e continuidade da amamentação, é necessário o fortalecimento da atenção pré-natal de modo a promover e apoiar o aleitamento materno como estratégia de promoção da saúde materno-infantil, principalmente quando a gravidez for indesejada. (AU)

Objective: To analyze the relationship between the intention of getting pregnant and breastfeeding. Methods: An integrative review of the literature was carried out by searching the PubMed and LILACS databases following the recommendations of the Preferred Reporting Itens for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Two independent researchers used the combination of the descriptors Pregnancy (Unplanned OR Unwanted) AND Breastfeeding in June 2016 without restricting the publication period. After applying the pre-established criteria and the qualitative evaluation, six articles were included in the study. Results: There was an association between unplanned pregnancy and low breastfeeding rates, with unwanted pregnancies associated with worse outcomes compared with untimely pregnancies. Socioeconomic and cultural circumstances affected this relationship. Conclusion: Given the predisposition of women with unplanned pregnancies to unfavorable behaviors regarding the establishment and continuity of breastfeeding, it is necessary to strengthen prenatal care to promote and support breastfeeding as a strategy to promote maternal and child health, especially when pregnancy is unwanted. (AU)

Objetivo: Analizar la relación entre la intención de quedarse embarazada y la práctica de amamantamiento. Métodos: Se realizó una revisión integrativa de la literatura a través de una búsqueda en las bases de datos PubMed y LILACS según las recomendaciones del protocolo Preferred Reporting Itens for Systematic Reviews and Meta-Analyses (PRISMA). Dos investigadores distintos utilizaron la siguiente combinación para los descriptores: embarazo (no planeado OR no deseado) AND amamantamiento, en junio de 2016 sin limitarse al periodo de publicación. Se incluyeron seis artículos en el estudio después de la aplicación de los criterios preestablecidos y la evaluación cualitativa. Resultados: Se verificó la asociación entre el embarazo no planeado y los bajos índices de amamantamiento y los embarazos no deseados se asociaron con los peores resultados al comparar con los embarazos inoportunos. Las circunstancias socioeconómicas y de la cultura afectaron esa relación. Conclusión: Ante la predisposición para conductas desfavorables sobre el establecimiento y el seguimiento del amamantamiento de parte de las mujeres con embarazos no planeados, se hace necesario el fortalecimiento de la atención prenatal de modo a promocionar y apoyar el amamantamiento como estrategia para la promoción de la salud materno-infantil, en especial cuando el embarazo no es deseado. (AU)

Association between the consumption of antioxidant nutrients with lipid alterations and cardiometabolic risk in adolescents / Associação entre o consumo de nutrientes antioxidantes com alterações lipídicas e risco cardiometabólico em adolescentes

ABSTRACT Objective This study aimed at validating the associations between the consumption of antioxidant nutrients as well as lipid alterations and cardiometabolic risks in adolescents. Methods This cross-sectional study included 327 adolescents aged 14-19 years. Sociodemographic and dietary information, anthropometric and blood pressure measurements, and biochemical data were obtained. Cardiometabolic risk was calculated by aggregating the risk factors, which were expressed as the sum of Z-scores. Poisson regression was performed to estimate the prevalence ratios. Results In boys, low intake of zinc was associated with elevated total cholesterol and triglyceride levels, whereas it was associated with low high-density lipoprotein cholesterol levels and high low-density lipoprotein cholesterol and total cholesterol levels in girls, thus indicating a cardiometabolic risk. Furthermore, low intake of copper was associated with high triglyceride levels and cardiometabolic risk in girls. The high prevalence ratios of high low-density lipoprotein cholesterol and total cholesterol levels and cardiometabolic risk were higher in those with low intake of vitamin A. Among girls, associations were also observed between lower intake of vitamin A and high triglyceride levels. Low intake of vitamin C among boys was associated with elevated high low-density lipoprotein cholesterol and triglyceride levels. Among girls, the intake of this vitamin was associated with lower low high-density lipoprotein cholesterol levels. In girls, low intake of vitamin E was associated with low low high-density lipoprotein cholesterol levels and high total cholesterol levels. Conclusion The associations between antioxidant micronutrients as well as lipid alterations and cardiometabolic risk emphasize the importance of encouraging the consumption of foods that are rich in these nutrients to modulate lipid alterations and cardiometabolic risk.

RESUMO Objetivo Esta pesquisa teve como objetivo verificar as associações entre o consumo de nutrientes antioxidantes e as alterações lipídicas e o risco cardiometabólico em adolescentes. Métodos Trata-se de estudo transversal com 327 adolescentes de 14 a 19 anos de idade. Investigaram-se dados sociodemográficos, antropométricos, pressóricos, bioquímicos e de consumo alimentar. O risco cardiometabólico foi calculado por meio da agregação dos fatores de risco, expressa pela soma dos escores Z. Realizou-se a regressão de Poisson para estimar as razões de prevalência. Resultados O baixo consumo de zinco associou-se a elevados níveis de CT e triglicérides para os meninos, e a níveis baixos de HDL-c e elevados de LDL-c e CT para as meninas, demonstrando risco. Além disso, a baixa ingestão de cobre associou-se a altos níveis de triglicérides e risco cardiometabólico para as meninas. A razão de prevalência nos níveis elevados de LDL-c, CT e risco cardiometabólico foi maior entre os adolescentes que apresentavam baixa ingestão de vitamina A. Foram observadas também associações, no sexo feminino, da menor ingestão de vitamina A com altos níveis de triglicérides. A baixa ingestão de vitamina C nos meninos mostrou associações com LDL-c e triglicérides elevado, enquanto nas meninas essa vitamina associou-se com menores níveis de HDL-c. O baixo consumo de vitamina E, para as meninas, apresentou associações com níveis baixos de HDL-c e elevados de CT. Conclusão As associações entre os micronutrientes antioxidantes e as alterações lipídicas e risco cardiometabólico ressaltam a importância de estimular o consumo de alimentos que sejam fonte desses nutrientes, com o objetivo de modular as alterações lipídicas e o risco cardiometabólico.

Impact of first sexual intercourse on the sexual and reproductive life of young people in a capital city of the Brazilian Northeast. / Repercussão da iniciação sexual na vida sexual e reprodutiva de jovens de capital do Nordeste brasileiro.

This study aimed to analyze the repercussion of first sexual intercourse on the number of pregnancies and partners of teenagers with obstetric history in Teresina (PI), Brazil. This is a cross-sectional study with 464 young women selected by accidental sampling who gave birth at 15-19 years of age in the first four months of 2006 in six maternity hospitals of the municipality. Primary data was collected from May to December 2008 at the participants' homes after tracking them in the hospital medical records. The univariate and bivariate analysis were performed by descriptive statistics and Pearson's Correlation Coefficient Test or T-test, respectively. Tukey's post hoc test was used as post hoc test and significant variables on the bivariate analysis (p < 0.05) were also included in the multifactor analysis of variance model. Schooling (p < 0,001) and menarche's age (p < 0,001) influenced the age of first sexual intercourse and this, in turn, showed significant negative correlation (p < 0.01) with the number of partners and pregnancies of young women. Thus, the earlier the young women start sexual activity, the higher the number of pregnancies and sexual partners until the moment of their reproductive life. Thus, early first sexual intercourse had a negative repercussion on these variables.

Objetivou-se analisar a repercussão da iniciação sexual de jovens com antecedentes obstétricos no número de gestações e de parceiros, em Teresina (PI). Trata-se de estudo seccional, realizado com 464 jovens selecionadas por amostragem acidental, que finalizaram uma gravidez quando tinham idade de 15 a 19 anos, no primeiro quadrimestre de 2006, em seis maternidades do município. A coleta dos dados primários ocorreu de maio a dezembro de 2008, no domicílio das jovens, após sua localização nos registros hospitalares. As análises univariada e bivariada se deram por meio de estatística descritiva e Coeficiente de Correlação de Pearson ou Teste t, respectivamente. Empregouse ainda o Teste post hoc de Tukey e as variáveis significativas na análise bivariada (p < 0,05) foram incluídas no modelo de Análise de Variância Multifatorial. A escolaridade (p < 0,001) e a idade da menarca (p < 0,001) influenciaram a idade da iniciação sexual e, esta, por sua vez, apresentou correlação negativa significativa (p < 0,01) com o número de parceiros e de gestações das jovens. Assim, quanto mais cedo ela iniciou-se sexualmente, mais gestações teve até o momento de sua vida reprodutiva, bem como maior número de parceiros sexuais. Portanto, a iniciação sexual precoce repercutiu negativamente sobre estas variáveis.

Repercussão da iniciação sexual na vida sexual e reprodutiva de jovens de capital do Nordeste brasileiro / Impact of first sexual intercourse on the sexual and reproductive life of young people in a capital city of the Brazilian Northeast

Resumo Objetivou-se analisar a repercussão da iniciação sexual de jovens com antecedentes obstétricos no número de gestações e de parceiros, em Teresina (PI). Trata-se de estudo seccional, realizado com 464 jovens selecionadas por amostragem acidental, que finalizaram uma gravidez quando tinham idade de 15 a 19 anos, no primeiro quadrimestre de 2006, em seis maternidades do município. A coleta dos dados primários ocorreu de maio a dezembro de 2008, no domicílio das jovens, após sua localização nos registros hospitalares. As análises univariada e bivariada se deram por meio de estatística descritiva e Coeficiente de Correlação de Pearson ou Teste t, respectivamente. Empregouse ainda o Teste post hoc de Tukey e as variáveis significativas na análise bivariada (p < 0,05) foram incluídas no modelo de Análise de Variância Multifatorial. A escolaridade (p < 0,001) e a idade da menarca (p < 0,001) influenciaram a idade da iniciação sexual e, esta, por sua vez, apresentou correlação negativa significativa (p < 0,01) com o número de parceiros e de gestações das jovens. Assim, quanto mais cedo ela iniciou-se sexualmente, mais gestações teve até o momento de sua vida reprodutiva, bem como maior número de parceiros sexuais. Portanto, a iniciação sexual precoce repercutiu negativamente sobre estas variáveis.

Abstract This study aimed to analyze the repercussion of first sexual intercourse on the number of pregnancies and partners of teenagers with obstetric history in Teresina (PI), Brazil. This is a cross-sectional study with 464 young women selected by accidental sampling who gave birth at 15-19 years of age in the first four months of 2006 in six maternity hospitals of the municipality. Primary data was collected from May to December 2008 at the participants' homes after tracking them in the hospital medical records. The univariate and bivariate analysis were performed by descriptive statistics and Pearson's Correlation Coefficient Test or T-test, respectively. Tukey's post hoc test was used as post hoc test and significant variables on the bivariate analysis (p < 0.05) were also included in the multifactor analysis of variance model. Schooling (p < 0,001) and menarche's age (p < 0,001) influenced the age of first sexual intercourse and this, in turn, showed significant negative correlation (p < 0.01) with the number of partners and pregnancies of young women. Thus, the earlier the young women start sexual activity, the higher the number of pregnancies and sexual partners until the moment of their reproductive life. Thus, early first sexual intercourse had a negative repercussion on these variables.

Predictive factors of abortion among teenagers with obstetric experience. / Fatores preditores do abortamento entre jovens com experiência obstétrica.

OBJECTIVE:: To analyze the predictive factors of abortion among teenagers with gestational history. METHODS:: Cross-sectional study carried out with 464 teenagers aged between 15 and 19 years, from Teresina, Piauí, who completed a pregnancy in the first quarter of 2006 in six city maternity hospitals. Data were collected from May to December 2008, at the teenagers' home, after their identification in the hospital records. For the univariate analysis of data, descriptive statistics was used, and for bivariate analysis, Pearson's χ2-test and Z-test were applied. Multivariate analysis was performed by means of the Multiple logistic regression (MLR), with significance level of 5%. RESULTS:: Teenagers who had more than one pregnancy were almost nine times more likely to have an abortion when compared to those who had only one pregnancy (p = 0.002). Furthermore, the teenagers who reported being pressured by the partner to have an abortion were four times and a half more likely to do it, when compared to those pressured by relatives and friends (p = 0.007). CONCLUSION:: The teenagers who had two or more pregnancies and were pressured by the partner to have an abortion were more prone to do it. Thus, it is necessary that programs of Family Planning include the teenagers more effectively, aiming at avoiding unwanted pregnancies among this population and, consequently, abortion induced in poor conditions.

Fatores preditores do abortamento entre jovens com experiência obstétrica / Predictive factors of abortion among teenagers with obstetric experience

RESUMO: Objetivo: Analisar os fatores preditores do abortamento entre jovens com antecedentes gestacionais. Métodos: Estudo seccional realizado com 464 jovens de Teresina, Piauí, que finalizaram uma gravidez no primeiro quadrimestre de 2006 em seis maternidades do município, com faixa etária entre 15 e 19 anos. Os dados foram coletados de maio a dezembro de 2008, no domicílio das jovens após sua identificação nos registros das maternidades. Para a análise univariada dos dados, utilizou-se a estatística descritiva, e para a análise bivariada empregou-se o teste do χ2 de Pearson e o teste Z. A análise multivariada se deu por meio da Regressão Logística Múltipla (RLM), sendo empregado um nível de significância de 5%. Resultados: As jovens que tiveram mais de uma gestação foram quase nove vezes mais propensas a abortar quando comparadas àquelas que haviam vivenciado apenas uma gestação (p = 0,002). Além disso, as jovens que referiram ter sido pressionadas pelo parceiro a abortar eram quatro vezes e meia mais propensas a consumar o ato quando comparadas aos casos em que a pressão advinha de parentes e amigos do casal (p = 0,007). Conclusão: As jovens que vivenciaram duas ou mais gestações, e que sofreram pressão do companheiro para abortar, eram mais propensas a praticar o aborto. Assim, faz-se necessário que programas de Planejamento Familiar incluam, com maior profundidade, o público adolescente, com vistas a evitar gestações indesejadas nesta população e, consequentemente, o aborto induzido sob condições precárias.

ABSTRACT: Objective: To analyze the predictive factors of abortion among teenagers with gestational history. Methods: Cross-sectional study carried out with 464 teenagers aged between 15 and 19 years, from Teresina, Piauí, who completed a pregnancy in the first quarter of 2006 in six city maternity hospitals. Data were collected from May to December 2008, at the teenagers' home, after their identification in the hospital records. For the univariate analysis of data, descriptive statistics was used, and for bivariate analysis, Pearson's χ2-test and Z-test were applied. Multivariate analysis was performed by means of the Multiple logistic regression (MLR), with significance level of 5%. Results: Teenagers who had more than one pregnancy were almost nine times more likely to have an abortion when compared to those who had only one pregnancy (p = 0.002). Furthermore, the teenagers who reported being pressured by the partner to have an abortion were four times and a half more likely to do it, when compared to those pressured by relatives and friends (p = 0.007). Conclusion: The teenagers who had two or more pregnancies and were pressured by the partner to have an abortion were more prone to do it. Thus, it is necessary that programs of Family Planning include the teenagers more effectively, aiming at avoiding unwanted pregnancies among this population and, consequently, abortion induced in poor conditions.

Access to childbirth care by adolescents and young people in the Northeastern region of Brazil.

OBJECTIVE: To identify the factors that interfere with the access of adolescents and young people to childbirth care for in the Northeast region of Brazil. METHODS: Cross-sectional study with 3,014 adolescents and young people admitted to the selected maternity wards to give birth in the Northeast region of Brazil. The sample design was probabilistic, in two stages: the first corresponded to the health establishments and the second to women who had recently given birth and their babies. The data was collected by means of interviews and consulting the hospital records, from pre-tested electronic form. Descriptive statistics were used for the univariate analysis, Pearson's Chi-square test for the bivariate analysis and multiple logistic regressions for the multivariate analysis. Sociodemographic variables, obstetrical history, and birth care were analyzed. RESULTS: Half of the adolescents and young people interviewed had not been given guidance on the location that they should go to when in labor, and among those who had, 23.5% did not give birth in the indicated health service. Furthermore, one third (33.3%) had to travel in search of assisted birth, and the majority (66.7%) of the postpartum women came to maternity by their own means. In the bivariate analysis, the variables marital status, paid work, health insurance, number of previous pregnancies, parity, city location, and type of health establishment showed a significant association (p < 0.20) with inadequate access to childbirth care. The multivariate analysis showed that married adolescents and young people (p < 0.015), with no health insurance (p < 0.002) and from the countryside (p < 0.001) were more likely to have inadequate access to childbirth care. CONCLUSIONS: Adolescents and young women, married, without health insurance, and from the countryside are more likely to have inadequate access to birth care. The articulation between outpatient care and birth care can improve this access and, consequently, minimize the maternal and fetal risks that arise from a lack of systematic hospitalization planning.