Impact of cash transfer programs on birth and child growth outcomes: systematic review.

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

Estado nutricional e consumo alimentar de idosos residentes em uma instituição asilar de Feira de Santana- Bahia / Nutritional status and food intake of elderly residents of a nursing home in Feira de Santana - Bahia

O Estado Nutricional (EN) exerce grande influência na morbimortalidade de idosos institucionalizados, e a sua avaliação permite definir uma intervenção nutricional individualizada. Esse estudo objetivou avaliar o estado nutricional e o consumo alimentar de idosos residentes de uma instituição de longa permanência. Trata-se de um estudo transversal, realizado com 37 idosos institucionalizados residentes, no ano de 2019. O EN foi avaliado pelo questionário da Mini Avaliação Nutricional (MAN). O consumo alimentar foi obtido através da pesagem total dos alimentos, verificando sua adequação de acordo com as recomendações para idade. As diferenças entre variáveis foram testadas por meio do teste t de Student e o teste de Mann-Whitney. As associações entre variáveis foram investigadas com auxílio dos coeficientes de correlação de Pearson e Spearman. As prevalências de desnutrição e risco de desnutrição nos idosos foram de 21,6% e 73%, respectivamente. O Índice de Massa Corporal (IMC) demonstrou predominância de baixo peso nos homens (38,9%) e sobrepeso nas mulheres (47,4%). Foi encontrado consumo excessivo de carboidratos e proteínas na população, sendo que, a ingestão de energia, proteínas e lipídios foi superior entre o grupo masculino. A circunferência do braço (p= 0,007), necessidade energética estimada (p= 0,049) e IMC (p <0,001) foram associados positivamente com a MAN. Os resultados demonstraram que, esses idosos são caracterizados por alto risco nutricional associado a alterações na composição corporal, e inadequações nutricionais. Sugerindo que, independente do consumo alimentar estar adequado em quantidade, não foi suficiente para prevenir o quadro de desnutrição nos idosos institucionalizados.(AU)

The Nutritional Status (NS) has a great influence on the morbidity and mortality of institutionalized elderly, and its evaluation allows to define of an individualized nutritional intervention. This study aimed to assess the nutritional status and food consumption of elderly residents of a long-term institution. This is a cross-sectional study carried out with 37 institutionalized elderly residents in 2019. The NS was assessed by the Mini Nutritional Assessment (MNA) questionnaire. Dietary intake was obtained through total weighing of the food, checking its adequacy according to the recommendations for age. Differences between variables were tested using the Student's t-test and the Mann-Whitney test. Associations between variables were investigated with the aid of Pearson and Spearman correlation coefficients. The prevalence of malnutrition and risk of malnutrition in the elderly was 21.6% and 73%, respectively. The Body Mass Index (BMI) showed a predominance of low weight in men (38.9%) and overweight in women (47.4%). Excessive consumption of carbohydrates and proteins was found in the population, and the intake of energy, proteins, and lipids was higher among the male group. Arm circumference (p = 0.007), estimated energy requirement (p = 0.049) and BMI (p <0.001) were positively associated with MAN. The results demonstrate that these elderly people are characterized by the high nutritional risk associated with changes in body composition, and nutritional inadequacies. Suggesting that, regardless of whether food intake was adequate in quantity, it was not enough to prevent malnutrition in institutionalized elderly.(AU)

Impact of cash transfer programs on birth and child growth outcomes: systematic review / Impacto dos programas de transferência de renda nos desfechos de nascimento e crescimento infantil: revisão sistemática

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

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

Deduplicating records in systematic reviews: there are free, accurate automated ways to do so.

OBJECTIVE: Here, we examined the accuracy measures of a set of automated deduplication tools to identify duplicate in the eligibility process of systematic reviews. STUDY DESIGN AND SETTING: A planned search strategy was carried out on seven electronic databases until May 31, 2021. Using manual search as the reference standard, we assessed sensibility, specificity, negative predictive value, and positive predictive value (PPV). RESULTS: Specificity ranged from 0.96 to 1.00. Rayyan, Mendeley, and Systematic Review Accelerator (SRA) presented high sensibility (0.98 [95% CI = 0.94-1.00]; 0.93 [95% CI = 0.88-0.97] and 0.90 [95% CI = 0.84-0.95], respectively), whereas EndNote X9 and Zotero had only fair sensitivity (0.73 [95% CI = 0.65-0.80] and 0.74 [95% CI = 0.66-0.81], respectively). Negative predictive value ranged from 0.99 to 1.00. Mendeley and SRA had good PPV (0.93 [95% CI = 0.88-0.97] and 0.99 [95% CI = 0.96-1.00], respectively). PPV was fair for EndNote X9 (0.61 [95% CI = 0.54-0.69]) and Zotero (0.62 [95% CI = 0.54-0.69]) and poor for Rayyan (0.41 [95% CI = 0.36-0.47]). CONCLUSION: Choosing the most suitable tool depends on its interface's characteristics, the algorithm to identify and exclude duplicates, and the transparency of the process. Therefore, Rayyan, Mendeley, and SRA proved to be accurate enough for the systematic reviews' deduplication step.

Influence of conditional cash transfer program on prenatal care and nutrition during pregnancy: NISAMI cohort study.

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

Influence of conditional cash transfer program on prenatal care and nutrition during pregnancy: NISAMI cohort study

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

Bolsa Familia Program and Perinatal Outcomes: NISAMI Cohort.

This study aimed to assess the impact of the Bolsa Familia Program on perinatal outcomes of pregnant women. A cohort study was conducted with pregnant women supported by prenatal services at 17 Family Health Units in Bahia, Brazil. A previously tested structured questionnaire, which has sociodemographic, economic, prenatal care, lifestyle, and nutritional variables, has been used to collect data. The outcomes included premature birth and low birth weight. A hierarchical conceptual model was constructed, and logistic regression analysis was performed. From a total of 1173 pregnant women, the identified average age was 25.44 years and 34.10% had pre-gestational overweight. The non-beneficiary pregnant women presented a 1.54 (95% CI = 0.46-5.09) times higher chance of giving birth to children with low weight and a 1.03 (95% CI = 95% CI = 0.53-2.00) times chance of premature birth when compared to the beneficiary group. In the multilevel model, some variables were statistically significant, such as age between 18 and 24 years (p = 0.003), age greater than or equal to 35 years (p = 0.025), family income (p = 0.008), employment status (p = 0.010), and maternal height (p = 0.009). The Bolsa Familia Program, as an integrated strategy of social inclusion and economic development, is suggested to exert a protective effect on the health of mother-concept binomial.

Evaluating the effect of Bolsa Familia, Brazil's conditional cash transfer programme, on maternal and child health: A study protocol.

BACKGROUND: Conditional Cash Transfer Programs have been developed in Latin America in response to poverty and marked social inequalities on the continent. In Brazil, the Bolsa Familia Program (BFP) was implemented to alleviate poverty and improve living conditions, health, and education for socioeconomically vulnerable populations. However, the effect of this intervention on maternal and child health is not well understood. METHODS: We will evaluate the effect of BFP on maternal and child outcomes: 1. Birth weight; 2. Preterm birth; 3. Maternal mortality; and 4. Child growth. Dynamic retrospective cohort data from the 100 Million Brazilian Cohort (2001 to 2015) will be linked to three different databases: Live Birth Information System (2004 to 2015); Mortality Information System (2011 to 2015); and Food and Nutritional Surveillance System (2008 to 2017). The definition of exposure to the BFP varies according to the outcome studied. Those who never received the benefit until the outcome or until the end of the follow-up will be defined as not exposed. The effects of BFP on maternal and child outcomes will be estimated by a combination of propensity score-based methods and weighted logistic regressions. The analyses will be further stratified to reflect changes in the benefit entitlement before and after 2012. DISCUSSION: Harnessing a large linked administrative cohort allows us to assess the effect of the BFP on maternal and child health, while considering a wide range of explanatory and confounding variables.

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI.

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

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI / Aspectos socioeconômicos e nutricionais de gestantes do Programa Bolsa Família: coorte NISAMI

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

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

Estado antropométrico pré-gestacional e peso ao nascer: Coorte NISAMI / Pre-gestational anthropometric status and birth weight: NISAMI cohort

O objetivo do estudo foi analisar a relação entre o Índice de Massa Corporal pré-gestacional (IMCpg) e peso do recém-nascido no município de Santo Antônio de Jesus-BA. Estudo de coorte prospectivo, com 185 gestantes e seus respectivos recém-nascidos, atendidas nas Unidades Básicas de Saúde, de abril de 2012 a novembro de 2013. O IMC pré-gestacional foi realizado com dados do peso referido e estatura aferida no dia da aplicação do questionário. O teste de Kolmogorov­ Smirnov foi realizado para análise da normalidade dos dados. Estimou-se a associação entre o estado nutricional pré-gestacional e os desfechos perinatais, por meio do Risco Relativo e intervalo de confiança de 95%. Das 185 mulheres, 44,9% iniciaram a gestação com algum desvio ponderal. As mulheres com baixo peso e sobrepeso apresentaram associação positiva para peso insuficiente ao nascer (<3000g), sendo as com baixo peso (RR=2,2; IC95%=0,5-9,5) e sobrepeso (RR=1,1; IC95%=0,5-2,6), enquanto as obesas apresentaram associação negativa (RR=0,8; IC95%=0,3-2,7). Apenas as mulheres com baixo peso apresentaram risco para baixo peso ao nascer (RR=3,1; IC95%=0,3-30,7). Esses dados revelam que o estado antropométrico pré-gestacional influencia no desenvolvimento da gestação e as inadequações nutricionais configuradas em períodos anteriores à concepção são considerados fatores determinantes para o peso da criança. Os desvios ponderais pré-gestacionais apresentaram associação positiva com o peso inadequado ao nascer, o que sugere a necessidade de cuidados nutricionais pré-concepcionais. Assistência à saúde a mulheres em idade fértil poderá auxiliar em melhores desfechos gestacionais.

The aim of this study was to analyze the relationship between the pre-gestational Body Mass Index (BMIpg) and the newborn's weight in the municipality of Santo Antônio de Jesus, BA. This was a prospective cohort study, with 185 pregnant women and their respective newborns, attended at the Basic Health Units, from April 2012 to November 2013. The pre-gestational BMI was performed with data of their referred weight and height measured on the day of application of the questionnaire. The Kolmogorov ­ Smirnov test was performed to analyze the normality of the data. The association between pre-pregnancy nutritional status and perinatal outcomes was estimated through the Relative Risk and 95% confidence interval. Of the 185 women, 44.9% started the pregnancy with some weight deviation. Underweight (RR = 2.2; 95% CI = 0.5-9.5) and overweight (RR = 1, 1; 95% CI = 0.5-2.6) women showed a positive association with insufficient birth weight (<3000g), while obese women presented a negative association (RR = 0.8; 95% CI = 0.3-2.7). Only underweight women were at risk for low birth weight (RR = 3.1; 95% CI = 0.3-30.7). These data reveal that the pre-gestational anthropometric status influences the development of pregnancy and the nutritional inadequacies configured in periods prior to conception are considered determining factors for the child's weight. Pre-pregnancy weight deviations were positively associated with inadequate birth weight, which suggests the need for preconception nutritional care. Health care for women of childbearing age may assist in better pregnancy outcomes.

Influência da anemia em gestantes sobre o peso ao nascer: um estudo da Coorte Nisami / Influence of anemia in pregnancy on weight at birth: a coordination study / Influencia de anemia en gestantes sobre el peso al nacer: un estudio de cohorte

Este trabalho tem como objetivos avaliar a prevalência de anemia durante a gestação e sua influência em relação ao peso da criança ao nascer no município de Santo Antônio de Jesus, Bahia. Trata-se de um estudo de coorte prospectivo, realizado com gestantes cadastradas no pré-natal em 16 Unidades Básica de Saúde, de janeiro a dezembro de 2012, no município de Santo Antônio de Jesus. A amostra foi composta por 315 gestantes clinicamente saudáveis. A coleta de dados ocorreu de janeiro a junho de 2012 e utilizou questionário estruturado previamente testado como instrumento. A segunda etapa aconteceu de julho a dezembro de 2012 e compreendeu a coleta dos dados referentes ao desfecho gestacional (peso ao nascer). A digitação foi feita no programa EpiInfo 6.04 b e analisados no Stata, versão 12. A prevalência de anemia materna foi de 16,8%, com valor médio de hemoglobina de 10,1 ± 0,78g /dL. A incidência de baixo peso ao nascer foi de 4,7%, com média de 2131 g, 11 ± 526,74 g. Foi possível identificar associação positiva não significativa entre a anemia e o baixo peso ao nascer, expressa por risco relativo = 2,53 (IC95%: 0,60-10,69). A prevalência de anemia entre as gestantes avaliadas foi similiar à observada no Brasil, sendo considerada um problema de saúde moderado. Além disso, verificou-se relação positiva não significativa entre a anemia e o peso da criança ao nascer no município do estudo.

This study seeks to evaluate the prevalence of anemia during pregnancy and its influence on the weight of the child at birth in the municipality of Santo Antônio de Jesus, state of Bahia, Brazil. This is a prospective cohort study conducted with pregnant women registered for prenatal care in 16 Basic Health Units from January to December 2012, in the municipality of Santo Antônio de Jesus. The sample consisted of 315 clinically healthy pregnant women. Data was collected from January to June 2012 using a structured questionnaire previously tested as an instrument. The second stage occurred from July to December 2012 and included data collection regarding the gestational outcome (birth weight). Data were typed in the EpiInfo 6.04 b program and analyzed in STATA, version 12. The prevalence of maternal anemia was 16.8%, with a mean hemoglobin value of 10.1 ± 0.78 g/dL. The incidence of low birth weight (LBW) was 4.7% in the studied infants with a mean of 2131g, 11 ± 526.74 g. The study identified a non-significant positive association between anemia and low birth weight expressed by relative risk = 2.53 (95% CI: 0.60-10.69). The prevalence of anemia among pregnant women of the city was similar to that observed in Brazil and considered a moderate health problem. Moreover, a non-significant relationship was observed between anemia and the weight of the child at birth in the study municipality.

Este trabajo tuvo como objetivo evaluar la prevalencia de anemia durante la gestación y su influencia en relación al peso del niño al nacer en el municipio de Santo Antônio de Jesus, Bahía (Brasil). Este es un estudio prospectivo de cohorte realizado con mujeres embarazadas registradas para atención prenatal en 16 Unidades Básicas de Salud en el período de enero a diciembre de 2012, en el municipio de Santo Antônio de Jesus. La muestra fue compuesta por 315 mujeres gestantes clínicamente sanas. La recopilación de datos ocurrió de enero a junio de 2012 y utilizó un cuestionario estructurado previamente probado como instrumento. La segunda etapa ocurrió de julio a diciembre de 2012 y comprendió la recopilación de datos referentes al desenlace gestacional (peso al nacer). Para digitalizar los datos se utilizó el programa EpiInfo 6.04 b, y para analizarlos el Stata, versión 12. La prevalencia de anemia materna fue del 16,8%, con un valor promedio de hemoglobina de 10,1 ± 0,78 g/dl. La incidencia de bajo peso al nacer fue del 4,7% en los recién nacidos estudiados con promedio de 2131 g, 11 ± 526,74 g. Hubo una asociación positiva no significativa entre anemia y bajo peso al nacer, con riesgo relativo = 2,53 (IC 95%: 0,60-10,69). La prevalencia de anemia entre las gestantes evaluadas fue similar a la observada en Brasil por lo que se considera un problema de salud moderado, además se verificó una relación positiva no significativa entre la anemia y el peso del niño al nacer en el municipio del estudio.

Qualidade microbiológica de refrescos armazenados em garrafas PET e refresqueiras comercializados em um município do Recôncavo da Bahia

Este trabalho teve por objetivo avaliar as características higienicossanitárias dos refrescos armazenados em garrafas tipo PET e em refresqueiras comercializados em estabelecimentos de um município do Recôncavo da Bahia. Foram analisadas, quanto à presença de bolores, leveduras e coliformes termotolerantes, 10 amostras de refrescos, acondicionadas em garrafas PET e refresqueiras. Das cinco amostras analisadas, duas (40%) armazenadas em garrafas PET, e uma (20%) armazenada em refresqueiras, apresentou-se em desacordo com os padrões estabelecidos pela legislação vigente. Na análise de bolores e leveduras, encontrou-se elevado crescimento destes micro-organismos em quatro amostras (80%) armazenadas em garrafas PET e em cinco amostras (100%) armazenadas em refresqueiras. As informações obtidas nessa pesquisa demonstraram que os refrescos coletados estavam em condições higienicossanitárias insatisfatórias, podendo representar causas de infecções de origem alimentar aos consumidores.

The objective of this study was to evaluate the hygienic-sanitary characteristics of refreshment stored in PET bottles and in refreshments marketed in establishments in a municipality in the Recôncavo da Bahia. For the presence of molds, yeasts and thermotolerant coliforms, 10 samples of refreshment, packed in PET bottles and coolers, were analyzed. Of the five samples analyzed, two (40%) stored in PET bottles, and one (20%) stored in refrigerators, were in disagreement with the standards established by current legislation. When analyzing molds and yeasts, a high growth of these microorganisms was found in four samples (80%) stored in PET bottles and in five samples (J 00%) stored in coolants. The information obtained in this research showed that the refreshments collected were in unsatisfactory hygienic-sanitary conditions, and may represent causes of food-borne infections to consumers.

Qualidade microbiológica de refrescos armazenados em garrafas pet e refresqueiras comercializados em um munícipio do recôncavo da Bahia / Microbiological quality of soft drinks stored in pet bottles marketed in a municipality of the Bahia state

Este trabalho teve por objetivo avaliar as características higienicossanitárias dos refrescos armazenados em garrafas tipo PET e em refresqueiras comercializados em estabelecimentos de um município do Recôncavo da Bahia. Foram analisadas, quanto à presença de bolores, leveduras e coliformes termotolerantes, 10 amostras de refrescos, acondicionadas em garrafas PET e refresqueiras. Das cinco amostras analisadas, duas (40%) armazenadas em garrafas PET, e uma (20%) armazenada em refresqueiras, apresentou-se em desacordo com os padrões estabelecidos pela legislação vigente. Na análise de bolores e leveduras, encontrou-se elevado crescimento destes micro- -organismos em quatro amostras (80%) armazenadas em garrafas PET e em cinco amostras (100%) armazenadas em refresqueiras. As informações obtidas nessa pesquisa demonstraram que os refrescos coletados estavam em condições higienicossanitárias insatisfatórias, podendo representar causas de infecções de origem alimentar aos consumidores.(AU)

The objective of this study was to evaluate the hygienic-sanitary characteristics of refreshment stored in PET bottles and in refreshments marketed in establishments in a municipality in the Recôncavo da Bahia. For the presence of molds, yeasts and thermotolerant coliforms, 10 samples of refreshment, packed in PET bottles and coolers, were analyzed. Of the five samples analyzed, two (40%) stored in PET bottles, and one (20%) stored in refrigerators, were in disagreement with the standards established by current legislation. When analyzing molds and yeasts, a high growth of these microorganisms was found in four samples (80%) stored in PET bottles and in five samples (100%) stored in coolants. The information obtained in this research showed that the refreshments collected were in unsatisfactory hygienic-sanitary conditions, and may represent causes of food-borne infections to consumers.

Consumo de nutrientes no primeiro e terceiro trimestres gestacionais e peso ao nascer: coorte nisami / Consumption of nutrients in the 1st and 3rd gestational quarters and weight at birth: coorte nisami / Consumo de nutrientes en el primer y tercer trimestre gestacional y peso al nacimiento: coorte nisami

A inadequação no consumo de nutrientes pode comprometer o crescimento fetal e resultar em baixo peso ao nascer ou em macrossomia fetal. Busca-se aqui identificar a relação entre consumo de energia, macronutrientes e micronutrientes no primeiro e terceiro trimestre gestacional e o peso ao nascer. Trata-se de estudo transversal aninhado em coorte prospectiva longitudinal com 166 gestantes do serviço público entrevistadas, no período de abril de 2012 a novembro de 2013. Para comparar as médias de consumo alimentar no primeiro e terceiro trimestre com o peso ao nascer foi utilizado o Test T de Student, com nível de significância estatística com valores de p < 0,05. Foi observado que as crianças com peso ao nascer inadequado (< 3.000 g) apresentaram consumo médio mais elevado de calorias (p = 0,02) e carboidratos (p = 0,04) no primeiro trimestre. E no terceiro trimestre identificaram-se diferenças nas médias de consumo de proteína (p = 0,02) segundo as categorias de peso ao nascer, já que mulheres que tiveram crianças com peso adequado (≥ 3.000 g) apresentaram consumo médio maior de proteína (médias = 72,66 g). O consumo alimentar de gestantes tem influência sobre a situação nutricional do concepto, especialmente no terceiro trimestre de gestação, momento em que a ingestão proteica materna teve maior relevância para o peso ao nascer.

Inadequate nutrient intake may compromise fetal growth and result in low birth weight or fetal macrosomia. This paper identified the relation between energy consumption, macronutrients, and micronutrients in the first and third gestational trimesters and birth weight. This cross-sectional study nested in a prospective longitudinal cohort involving 166 pregnant women in public service interviewed from April 2012 to November 2013. To compare the means of food consumption in the first and third trimesters with the birth weight, Student's T-Test was used. The level of statistical significance adopted was p<0.05. The results show that children with inadequate birth weight (<3.000 g) presented higher mean intake of calories (p=0.02) and carbohydrates (p=0.04) during the first trimester. In the third trimester, differences in the mean intake of protein (p=0.02) were observed according to the categories of birth weight, where women who had children of adequate weight (≥3.000 g) had a higher mean protein intake (averages = 72.66 g). The dietary intake of pregnant women was shown to influence the nutritional status of the conceptus, especially during the third trimester of gestation in which maternal protein intake was more relevant according to birth weight.

La inadecuación en el consumo de nutrientes puede afectar el crecimiento fetal y resultar en bajo peso al nacer o en macrosomía fetal. Se objetivó identificar la relación entre consumo de energía, macronutrientes y micronutrientes en el primer y tercer trimestre gestacional y el peso al nacer. Es un estudio transversal anidado en una cohorte prospectiva longitudinal con 166 gestantes entrevistadas en el servicio público, en el período de abril de 2012 a noviembre de 2013. Para la comparación entre las medias de consumo alimentario en el primer y tercer trimestre con el peso al nacer, se utilizó el Test T de Student, con nivel de significancia estadística de p < 0,05. Se observó que los niños con peso inadecuado al nacer (< 3.000 g) presentaron un consumo medio más alto de calorías (p = 0,02) y carbohidratos (p = 0,04) en el primer trimestre. En el tercer trimestre se identificaron diferencias en las medias de consumo de proteína (p = 0,02) según las categorías de peso al nacer, puesto que las mujeres que tuvieron niños con peso adecuado (≥ 3.000 g) presentaron un consumo medio mayor de proteína (promedios = 72,66 g). Se concluye que el consumo alimentario de gestantes tiene influencia sobre la situación nutricional del concepto, especialmente en el tercer trimestre de gestación momento en que la ingestión proteica materna tuvo mayor relevancia para el peso al nacer.

Prevalence and associated factors for early interruption of exclusive breastfeeding: meta-analysis on Brazilian epidemiological studies / Prevalência e fatores associados à interrupção precoce do aleitamento materno exclusivo: metanálise de estudos epidemiológicos brasileiros

Abstract Objectives: to summarize Brazilian studies that analyzed the risk factors for Exclusive Breastfeeding (EBF) interruption before the child's six months of life. Methods: systematic review and meta-analysis indexed articles from Bireme, Scielo and Pubmed databases published in the period of January 2000 to December 2015. Results: 22 articles were included in the meta-analysis. The factors related to newborns were observed, such as birth weight (OR= 1.17; CI 95%: 1.05-1.29), female gender (OR= 1,09; CI 95%: 1.04-1.13) and the use of pacifier (OR= 2.29; CI 95%: 1.68-2.91) were the main factors responsible for the increase in the occurrence of EBF interruption. The factors were related to the mother, maternal age below twenty years old (OR= 1.22; CI 95%: 1.12-1.33) low schooling level (OR=1.28; CI 95%: 1.11-1.45), primiparity (OR= 1.17; CI 95%: 1.02-1.32) maternal employment during the postpartum period (OR= 1.26; CI 95%: 1.11-1.41), and low family income (OR= 1.22; CI 95%: 1.08-1.37) contributed significantly to the EBF interruption . Conclusions: the meta-analysis of Brazilian epidemiological studies demonstrated evidences to conclude that below the age of twenty, low schooling, primiparity, maternal employment in the postpartum period and low family income are associated to the interruption of exclusive breastfeeding until 6 months of age. Children with low birth weight, female gender and used a pacifier had greater vulnerability to not be exclusively breastfed. In conclusion, most of these factors can be modified through appropriate public policies throughout the adequate prenatal period to promote exclusive breastfeeding.

Resumo Objetivos: sumarizar estudos brasileiros que analisaram os fatores de risco para interrupção do aleitamento materno exclusivo (AME) antes dos seis meses de vida da criança. Métodos: revisão sistemática e metanálise de artigos indexados na base de dados Bireme, Scielo e Pubmed, publicados no período de janeiro 2000 a dezembro de 2015. Resultados: 22 artigos foram incluídos na metanálise. Observou-se que os fatores relacionados ao recém-nascido como o baixo peso ao nascer (OR= 1,17; IC95%: 1,05-1,29), sexo feminino (OR= 1,09; IC95%: 1,04-1,13) e uso de chupeta (OR= 2,29; IC95%: 1,68- 2,91) foram os principais fatores de exposição responsável pelo aumento da ocorrência de interrupção do AME. No que se refere aos fatores de exposição relacionados à mãe, a idade materna inferior a vinte anos (OR= 1,22; IC95%: 1,12-1,33), a baixa escolaridade (OR=1.28; CI 95%: 1,11-1,45), a primiparidade (OR= 1,17; IC95%: 1,02-1,32), o trabalho materno no puerpério (OR= 1,26; IC95%: 1,11-1,41) e a baixa renda familiar (OR= 1,22; IC95%: 1,08-1,37) contribuíram significativamente para ocorrência de interrupção do AME. Conclusões: a metanálise de estudos epidemiológicos brasileiros registrou evidências para concluir que a idade inferior a vinte anos, baixa escolaridade, primiparidade, trabalho materno no puerpério e a baixa renda familiar estão associados com a interrupção do aleitamento materno exclusivo até os seis meses de idade. Crianças com baixo peso ao nascer, do sexo feminino e que usaram chupeta tiveram maior vulnerabilidade de não serem amamentadas exclusivamente. Conclui-se, que a maioria deste fatores podem ser modificados por meio de políticas públicas de acompanhamento adequado durante todo o pré-natal,com ações de promoção do aleitamento materno exclusivo.