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1.
Rev Saude Publica ; 55: 50, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34406319

RESUMO

OBJECTIVES: To describe the evolution of care during pregnancy and childbirth among postpartum women living in the municipality of Rio Grande, Southern Brazil, using data from surveys carried out every three years between 2007 and 2019. METHODS: Within 48 hours after delivery, a single, standardized questionnaire was applied to all mothers who had children in local hospitals and met the inclusion criteria. Demographic and reproductive characteristics, lifestyle habits, socioeconomic level of the family, and care received during pregnancy and childbirth were investigated. In the analysis, the chi-square test for linear trend was used to assess the distribution of indicators per survey. RESULTS: A total of 12,645 parturients were interviewed (98% of the women eligible to participate in the surveys). In the period evaluated, the proportion of births fell 35% among adolescents and increased 25% among women aged 35 years and over. Mothers gained, on average, two years of schooling, and their families experienced an important economic improvement, followed by loss of income in the last survey. Maternal smoking, before and during pregnancy, fell by half. The rate of mothers who started prenatal care in the first trimester and the number of consultations and laboratory tests increased. Almost 60% of prenatal consultations and 80% of births took place in the Brazilian Unified Health System. In 2019, vaginal delivery was once again the most common. The rates of low birth weight (9%) and prematurity (17%) virtually remained unchanged. CONCLUSIONS: We found an important change in the reproductive profile and increased coverage of various prenatal care and delivery services. Children continue to be born well, but low birth weight and prematurity remain endemic.


Assuntos
Parto , Cuidado Pré-Natal , Adolescente , Brasil , Criança , Escolaridade , Feminino , Humanos , Gravidez , Fatores Socioeconômicos
3.
Braz J Psychiatry ; 43(4): 402-406, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33605399

RESUMO

OBJECTIVE: To describe and compare measures of maternal depression, anxiety, and posttraumatic stress symptoms before and during the coronavirus disease 2019 (COVID-19) pandemic in a Brazilian birth cohort. METHODS: All hospital births occurring in the municipality of Rio Grande (southern Brazil) during 2019 were identified. Mothers were invited to complete a standardized questionnaire on sociodemographic and health-related characteristics. Between May and July 2020, we tried to contact all cohort mothers of singletons, living in urban areas, to answer a standardized web-based questionnaire. They completed the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder 7-item (GAD-7) in both follow-ups, and the Impact of Event Scale (IES) in the online follow-up. RESULTS: We located 1,136 eligible mothers (n=2,051). Of those, 40.5% had moderate to severe stress due to the current pandemic, 29.3% had depression, and 25.9% had GAD. Mothers reporting loss of income during the pandemic (57.2%) had the highest proportions of mental health problems. Compared to baseline, the prevalence of depression increased 5.7 fold and that of anxiety increased 2.4-fold during the pandemic (both p < 0.001). CONCLUSION: We found a high prevalence of personal distress due to the ongoing COVID-19 pandemic, and a clear rise in both maternal depression and anxiety.


Assuntos
COVID-19 , Pandemias , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental , SARS-CoV-2
4.
Prev Med ; 145: 106432, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33485999

RESUMO

We described prenatal care quality for four indicators over a 12-years period among puerperae living in Southern Brazil. Five surveys including all women giving birth between 01/01 to 31/12 in 2007, 2010, 2013, 2016, and 2019 were conducted in Rio Grande, Rio Grande do Sul state, Brazil. A single standardized questionnaire was applied within 48 h after delivery in all the city's maternity hospitals. Outcomes included the followings proportion of pregnant women who started prenatal care in the first trimester and performed at least six medical visits, completed at least two HIV, two syphilis and two qualitative urine tests. These indicators were stratified according to quartiles of household income. Absolute and relative measures of inequalities were calculated. A total of 12,645 (98% of the total) of the 12,914 mothers eligible in the five surveys were successfully interviewed. Coverage for all indicators increased substantially, especially in the poorest quartile for six prenatal care visits starting in the first trimester, and for HIV and qualitative urine tests. The slope index (SII) and the concentration index (CIX) of inequality showed clear disadvantage among the poorest for prenatal visits starting in the first trimester and performing two or more urine tests. There was a substantial increase in coverage for all variables studied in the period. The reduced inequity, mainly for the beginning of the first trimester and for visits and urine tests, was due to the higher coverage achieved in the poorest quartile.


Assuntos
Cuidado Pré-Natal , Sífilis , Brasil , Feminino , Humanos , Pobreza , Gravidez , Fatores Socioeconômicos
6.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1289982

RESUMO

ABSTRACT OBJECTIVES To describe the evolution of care during pregnancy and childbirth among postpartum women living in the municipality of Rio Grande, Southern Brazil, using data from surveys carried out every three years between 2007 and 2019. METHODS Within 48 hours after delivery, a single, standardized questionnaire was applied to all mothers who had children in local hospitals and met the inclusion criteria. Demographic and reproductive characteristics, lifestyle habits, socioeconomic level of the family, and care received during pregnancy and childbirth were investigated. In the analysis, the chi-square test for linear trend was used to assess the distribution of indicators per survey. RESULTS A total of 12,645 parturients were interviewed (98% of the women eligible to participate in the surveys). In the period evaluated, the proportion of births fell 35% among adolescents and increased 25% among women aged 35 years and over. Mothers gained, on average, two years of schooling, and their families experienced an important economic improvement, followed by loss of income in the last survey. Maternal smoking, before and during pregnancy, fell by half. The rate of mothers who started prenatal care in the first trimester and the number of consultations and laboratory tests increased. Almost 60% of prenatal consultations and 80% of births took place in the Brazilian Unified Health System. In 2019, vaginal delivery was once again the most common. The rates of low birth weight (9%) and prematurity (17%) virtually remained unchanged. CONCLUSIONS We found an important change in the reproductive profile and increased coverage of various prenatal care and delivery services. Children continue to be born well, but low birth weight and prematurity remain endemic.


RESUMO OBJETIVO Descrever a evolução da assistência à gestação e ao parto entre puérperas residentes no município de Rio Grande (RS) utilizando dados de inquéritos realizados a cada três anos, entre 2007 e 2019. MÉTODOS Em até 48 horas após o parto foi aplicado questionário único, padronizado, a todas as mães que tiveram filhos nos hospitais locais e cumpriram os critérios de inclusão. Foram investigadas características demográficas e reprodutivas, hábitos de vida, nível socioeconômico da família e cuidados recebidos durante a gestação e o parto. Na análise, utilizou-se o teste qui-quadrado de tendência linear para avaliar a distribuição dos indicadores por inquérito. RESULTADOS Ao todo, 12.645 parturientes foram entrevistadas (98% do total de mulheres aptas a participar da pesquisa). No período avaliado, a proporção de partos caiu 35% entre adolescentes e aumentou 25% entre mulheres com 35 anos ou mais. As mães ganharam, em média, dois anos de escolaridade, e suas famílias tiveram importante melhora econômica, seguida, porém, de perda de renda no último inquérito. O tabagismo materno, antes e durante a gravidez, caiu à metade. Houve aumento na taxa de mães que iniciaram o pré-natal no primeiro trimestre, e aumentou também o número de consultas e de testes laboratoriais. Quase 60% das consultas de pré-natal e 80% dos partos ocorreram no Sistema Único de Saúde. Em 2019, o parto vaginal voltou a ser o mais comum. As taxas de baixo peso ao nascer (9%) e prematuridade (17%) praticamente não se modificaram. CONCLUSÕES Houve mudança importante no perfil reprodutivo e aumento da cobertura de diversos serviços de assistência pré-natal e parto. As crianças seguem nascendo bem, mas o baixo peso ao nascer e a prematuridade continuam endêmicos.


Assuntos
Humanos , Masculino , Gravidez , Criança , Adolescente , Cuidado Pré-Natal , Parto , Fatores Socioeconômicos , Brasil , Escolaridade
7.
PLoS One ; 15(6): e0234338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511254

RESUMO

Urinary incontinence (UI) is a common condition that causes significant harm to the well-being and quality of life of pregnant women. This cross-sectional population-based study aimed to estimate the prevalence and identify factors associated with the occurrence of UI during pregnancy in women living in the municipality of Rio Grande (RS), Southern Brazil, between January 1 and December 31 of 2016, and included all puerperae living in this municipality that had a child in one of the two local maternity hospitals. The previously trained interviewers used a single standardized questionnaire, within 48 hours after delivery to retrieve information on maternal demographic, behavioral and reproductive/obstetric history, as well as socioeconomic status of the household and care received during pregnancy and childbirth. The multivariate analysis followed a previously defined hierarchical model using Poisson regression with robust variance adjustment and prevalence ratio (PR) as a measure of effect. As a result, 2,716 puerperae were identified, of which 2,694 (99.2%) participated in this study. The prevalence of urinary incontinence in the gestational period was 14.7% (95%CI: 13.4%-16.1%). After adjusted analysis, the likelihood of UI occurring varied significantly as per women's characteristics. For example, the PR for the occurrence of UI among women over 30 years of age was 2.05 (95% CI: 1.39-3.01) compared to adolescents. In two other groups of women who had their first pregnancy before the age of 20 or after the age of 30, the PR for UI was 1.36 (95% CI: 1.04-1.76) and 1.59 (95% CI: 1.01-2.51), respectively, when compared to those who became pregnant for the first time between 20 and 29 years of age. Finally, in two other groups of women, namely, those who reached 90 kg and over at the end of pregnancy and those who performed regular physical exercise and reported frequent urinary urgency, the PR was 2.49 (95% CI: 1.74-3.57), and 2.90 (95% CI: 2.10-4.00) compared to those who did not exercise and did not report urinary urgency, respectively. The authors concluded that UI showed a high prevalence in the study population. The identified risk factors can be well administered at primary health care level. The recommendation of regular physical exercise in pregnancy must be reviewed and better investigated with more robust designs because of possible facilitators for the occurrence of UI in this period.


Assuntos
Complicações na Gravidez/epidemiologia , Incontinência Urinária/complicações , Incontinência Urinária/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Idade Materna , Análise Multivariada , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
8.
Rev Saude Publica ; 53: 40, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31066818

RESUMO

OBJECTIVE: To estimate coverage, examine trend and assess the disparity reduction regarding household income during prenatal care between mothers living in Rio Grande, state of Rio Grande do Sul, in 2007, 2010, 2013 and 2016. METHODS: This study included all recent mothers living in this municipality, between 1/1 and 12/31 of those years, who had a child weighing more than 500 grams or 20 weeks of gestational age in one of the only two local maternity hospitals. Trained interviewers applied, still in the hospital and up to 48 hours after delivery, a unique and standardized questionnaire, seeking to investigate maternal demographic and reproductive characteristics, the socioeconomic conditions of the family and the assistance received during pregnancy and childbirth. To assess the adequacy of prenatal care, the criteria proposed by Takeda were used, which considers only the number of prenatal appointments and gestational age at initiation, and by Silveira et al., who in addition to these two variables, considers the achievement of some laboratory tests. Chi-square tests were used to compare proportions and assess the linear trend. RESULTS: The total of 10,669 recent mothers were included in this survey (96.8% of the total). Prenatal coverage substantially increased between 2007 and 2016. According to Takeda, it rose from 69% to 80%, while for Silveira et al., it increased from 21% to 55%. This improvement occurred for all income groups (p < 0.01). The disparity between the extreme categories of income reduced, according to Takeda, and increased according to Silveira et al. CONCLUSIONS: The provision of prenatal care, considering only the number of appointments and the early start, occurred in greater proportion among the poorest. However, only the richest recent mothers were contemplated with more elaborate care, such as laboratory tests, which increased the disparities in the provision of prenatal care.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/tendências , Cuidado Pré-Natal/estatística & dados numéricos , Cuidado Pré-Natal/tendências , Adolescente , Adulto , Brasil , Criança , Características da Família , Feminino , Humanos , Idade Materna , Gravidez , Valores de Referência , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
9.
Int J Health Care Qual Assur ; 32(1): 224-232, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30859876

RESUMO

PURPOSE: The purpose of this paper is to measure the prevalence, evaluate the trend and identify the factors associated with the non-performance of qualitative urine test (QUT) among pregnant women living in the extreme south of Brazil between 2007 and 2016. DESIGN/METHODOLOGY/APPROACH: All births occurred in the local maternity wards from January 1 to December 31 of 2007, 2010, 2013 and 2016. Mothers were interviewed within 48h after delivery. The outcome was the non-performance of QUT during pregnancy. χ2 test was used to compare proportions and Poisson regression with robust variance adjustment for the multivariate analysis. The effect measure used was the prevalence ratio. FINDINGS: Of the 10,331 new mothers identified, 10,004 (96.8 percent) performed at least one prenatal visit. The prevalence of non-performance of QUT was 3.3 percent (95% CI 2.9-3.7 percent), ranging from 1.5 percent in 2007 to 5.3 percent in 2016 ( p<0.001). The analysis showed that not living with a companion, having under four years of schooling, living with seven or more people in the household, having five or more children, having had one to three prenatal visits and not having been supplemented with ferrous sulfate during pregnancy showed a significantly higher prevalence rate to the non-performance of QUT. ORIGINALITY/VALUE: The rate of non-performance of this test among pregnant women has clearly increased. Mothers at higher risk of unfavorable outcomes in pregnancy were the ones with the highest probability of not performing QUT. Increasing the number of prenatal visits is a high-impact measure toward the performance of this test.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/métodos , Urinálise/métodos , Urinálise/estatística & dados numéricos , Infecções Urinárias/diagnóstico , Adolescente , Adulto , Brasil , Estudos de Coortes , Feminino , Humanos , Incidência , Saúde Materna , Determinação de Necessidades de Cuidados de Saúde , Cuidado Pós-Natal/métodos , Gravidez , Qualidade da Assistência à Saúde , Estudos Retrospectivos , Medição de Risco , População Rural , Infecções Urinárias/urina , Adulto Jovem
10.
Rev. saúde pública (Online) ; 53: 40, jan. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1004514

RESUMO

ABSTRACT OBJECTIVE To estimate coverage, examine trend and assess the disparity reduction regarding household income during prenatal care between mothers living in Rio Grande, state of Rio Grande do Sul, in 2007, 2010, 2013 and 2016. METHODS This study included all recent mothers living in this municipality, between 1/1 and 12/31 of those years, who had a child weighing more than 500 grams or 20 weeks of gestational age in one of the only two local maternity hospitals. Trained interviewers applied, still in the hospital and up to 48 hours after delivery, a unique and standardized questionnaire, seeking to investigate maternal demographic and reproductive characteristics, the socioeconomic conditions of the family and the assistance received during pregnancy and childbirth. To assess the adequacy of prenatal care, the criteria proposed by Takeda were used, which considers only the number of prenatal appointments and gestational age at initiation, and by Silveira et al., who in addition to these two variables, considers the achievement of some laboratory tests. Chi-square tests were used to compare proportions and assess the linear trend. RESULTS The total of 10,669 recent mothers were included in this survey (96.8% of the total). Prenatal coverage substantially increased between 2007 and 2016. According to Takeda, it rose from 69% to 80%, while for Silveira et al., it increased from 21% to 55%. This improvement occurred for all income groups (p < 0.01). The disparity between the extreme categories of income reduced, according to Takeda, and increased according to Silveira et al. CONCLUSIONS The provision of prenatal care, considering only the number of appointments and the early start, occurred in greater proportion among the poorest. However, only the richest recent mothers were contemplated with more elaborate care, such as laboratory tests, which increased the disparities in the provision of prenatal care.


RESUMO OBJETIVO Estimar a cobertura, examinar a tendência e avaliar se houve redução da disparidade em relação à renda familiar na realização de pré-natal adequado entre puérperas residentes em Rio Grande, RS, nos anos de 2007, 2010, 2013 e 2016. MÉTODOS Foram incluídas neste estudo todas as puérperas residentes nesse município que, entre 1/1 a 31/12 desses anos, tiveram filho com peso superior a 500 gramas ou 20 semanas de idade gestacional em alguma das duas únicas maternidades locais. Entrevistadoras treinadas aplicaram, ainda no hospital e em até 48 horas após o parto, questionário único e padronizado, buscando investigar as características demográficas e reprodutivas maternas, as condições socioeconômicas da família e a assistência recebida durante a gestação e parto. Para avaliação da adequação do pré-natal, foram utilizados os critérios propostos por Takeda, que considera apenas o número de consultas pré-natais e a idade gestacional de início, e de Silveira et al., que além dessas duas variáveis, leva em conta a realização de alguns testes laboratoriais. Foram utilizados os testes qui-quadrado para comparar proporções e avaliar tendência linear. RESULTADOS Foram incluídas neste inquérito 10.669 puérperas (96,8% do total). Verificou-se substancial aumento na cobertura de pré-natal adequado entre 2007 e 2016. Segundo Takeda, passou de 69% para 80%, enquanto para Silveira et al. aumentou de 21% para 55%. Essa melhora no período ocorreu para todos os grupos de renda (p < 0,01). Houve redução na disparidade entre as categorias extremas de renda segundo Takeda e aumento acentuado segundo Silveira et al. CONCLUSÕES A oferta de pré-natal, considerando apenas o número de consultas e o início precoce, ocorreu em maior proporção entre as mais pobres. No entanto, ao oferecer cuidados mais elaborados, como exames laboratoriais, estes alcançaram principalmente as puérperas mais ricas, aumentando assim as disparidades na oferta da assistência pré-natal.


Assuntos
Humanos , Feminino , Gravidez , Criança , Adolescente , Adulto , Adulto Jovem , Cuidado Pré-Natal/tendências , Cuidado Pré-Natal/estatística & dados numéricos , Disparidades em Assistência à Saúde/tendências , Disparidades em Assistência à Saúde/estatística & dados numéricos , Valores de Referência , Fatores Socioeconômicos , Fatores de Tempo , Brasil , Características da Família , Inquéritos e Questionários , Idade Materna
11.
Matern Child Health J ; 23(2): 183-190, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30105515

RESUMO

Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/normas , Mães/psicologia , Posicionamento do Paciente/normas , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Recém-Nascido , Mães/educação , Análise Multivariada , Posicionamento do Paciente/métodos , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/prevenção & controle , Inquéritos e Questionários
12.
Cad Saude Publica ; 34(11): e00040718, 2018 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-30484558

RESUMO

Lower socioeconomic level is positively related to multimorbidity and it is possible that the clustering of health conditions carries the same association. The aim of this study was to identify prevalence of multimorbidity and clusters of health conditions among elderly, as well the underlying socioeconomic inequalities. This was a cross-sectional population-based study carried out with 60-year-old individuals. Multimorbidity was defined as the presence of 2+, 3+, 4+ or 5+ health conditions in the same individual. Schooling levels and the National Economic Index were used to investigate inequalities in the prevalence of multimorbidities among elderly. Slope and concentration indexes of inequality were used to evaluate absolute and relative differences. A factorial analysis was performed to identify disease clusters. In every ten older adults, about nine, eight, seven and six presented, respectvely, 2+, 3+, 4+ and 5+ health conditions. Three clusters of health conditions were found, involving musculoskeletal/mental/functional disorders, cardiometabolic, and respiratory factors. Higher inequalities were found the higher amount of health conditions (5+), when considering economic level, and for 3+, 4+ and 5+, when considering educational level. These findings show high multimorbidity prevalence among elderly, highlighting the persistence of health inequalities in Southern Brazil. Strategies by the health services need to focus on elderly at lower socioeconomic levels.


Assuntos
Disparidades nos Níveis de Saúde , Multimorbidade , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Doença Crônica/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos
13.
Cad. Saúde Pública (Online) ; 34(11): e00040718, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-974596

RESUMO

Lower socioeconomic level is positively related to multimorbidity and it is possible that the clustering of health conditions carries the same association. The aim of this study was to identify prevalence of multimorbidity and clusters of health conditions among elderly, as well the underlying socioeconomic inequalities. This was a cross-sectional population-based study carried out with 60-year-old individuals. Multimorbidity was defined as the presence of 2+, 3+, 4+ or 5+ health conditions in the same individual. Schooling levels and the National Economic Index were used to investigate inequalities in the prevalence of multimorbidities among elderly. Slope and concentration indexes of inequality were used to evaluate absolute and relative differences. A factorial analysis was performed to identify disease clusters. In every ten older adults, about nine, eight, seven and six presented, respectvely, 2+, 3+, 4+ and 5+ health conditions. Three clusters of health conditions were found, involving musculoskeletal/mental/functional disorders, cardiometabolic, and respiratory factors. Higher inequalities were found the higher amount of health conditions (5+), when considering economic level, and for 3+, 4+ and 5+, when considering educational level. These findings show high multimorbidity prevalence among elderly, highlighting the persistence of health inequalities in Southern Brazil. Strategies by the health services need to focus on elderly at lower socioeconomic levels.


O nível socioeconômico baixo está relacionado diretamente à multimorbidade, e é possível que a aglomeração de morbidades apresente a mesma associação. O estudo teve como objetivo identificar a prevalência da multimorbidade e de clusters de morbidades entre idosos, além das desigualdades socioeconômicas subjacentes. Este foi um estudo transversal de base populacional em indivíduos com 60 anos ou mais. Multimorbidade foi definida como a presença de 2+, 3+, 4+ ou 5+ condições de saúde no mesmo indíviduo. O nível de escolaridade e o Índice Econômico Nacional foram usados para medir desigualdades na prevalência de multimorbidade entre idosos. Foram utilizados os índices de desigualdades slope e concentration para avaliar as diferenças absolutas e relativas. A análise fatorial foi realizada para identificar clusters de doenças. Em cada dez idosos, nove, oito, sete e seis apresentavam 2+, 3+, 4+ e 5+ condições de saúde, respectivamente. Foram identificados três clusters de morbidades, correspondendo aos transtornos musculoesqueléticos/mentais/funcionais e doenças cardiometabólicas e respiratórias. Maiores desigualdades foram encontradas para o maior número de condições de saúde (5+), considerando nível economômico, e para 3+, 4+ e 5+, considerando nível de escolaridade. Os achados revelam a alta prevalência de multimorbidade entre idosos, destacando a persistência de desigualdades de saúde no Sul do Brasil. As estratégias dos serviços de saúde devem priorizar os idosos de nível socioeconômico mais baixo.


Un nivel socioeconómico más bajo está positivamente relacionado con la multimorbilidad y es posible que la acumulación de estos problemas de salud provenga de esta misma asociación. El objetivo de este estudio fue identificar la prevalencia de multimorbilidad y los grupos de afecciones de salud entre ancianos, así como sus inequidades socioeconómicas subyacentes. Se trata de un estudio transversal, basado en población, que se llevó a cabo con personas de 60 años. Multimorbilidad se definió como la presencia de 2+, 3+, 4+ ó 5+ condiciones de salud en el mismo individuo. Los niveles de escolaridad y el Índice Económico Nacional fueron utilizados para investigar inequidades en la prevalencia de multimorbilidad entre ancianos. Los índices de inequidad slope y concentration se usaron para evaluar las diferencias absolutas y relativas. Se realizó un análisis factorial para identificar los grupos de enfermedades. En cada diez ancianos, nueve, ocho, siete y seis tenían 2+, 3+, 4+ y 5+ condiciones de salud, respectivamente. Se encontraron tres grupos de afecciones de salud, que conllevaban enfermedades musculoesquelético/mental/funcionales, cardiometabólicas, además de factores respiratorios. Se encontraron mayores desigualdades para el mayor número de condiciones de salud (5+), cuando se consideraba el nivel económico, y para 3+, 4+ y 5+, cuando se tenía en consideración el nivel educativo. Estos hallazgos mostraron una alta prevalencia de multimorbilidad entre adultos de avanzada edad, resaltando la persistencia de inequidades de salud en el sur de Brasil. Las estrategias por parte de los servicios de salud necesitan centrarse en ancianos con niveles socioeconómicos más bajos.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Disparidades nos Níveis de Saúde , Multimorbidade , Fatores Socioeconômicos , Brasil/epidemiologia , Análise por Conglomerados , Doença Crônica/epidemiologia , Prevalência , Estudos Transversais , Fatores de Risco , Fatores Etários , Distribuição por Sexo , Distribuição por Idade
14.
Cad Saude Publica ; 31(5): 1003-14, 2015 May.
Artigo em Português | MEDLINE | ID: mdl-26083175

RESUMO

This study measured the prevalence of inadequate prenatal care and identified associated factors using different criteria in postpartum women in Rio Grande, Rio Grande do Sul State, Brazil, in 2010. A standardized questionnaire was applied within 24 hours after delivery to all mothers of children born in the two local hospitals. We used the chi-square test to compare proportions and Poisson regression with robust variance in the multivariate analysis. The study interviewed 2,395 mothers (97.2% of the total). The rates of inadequate prenatal care were 28%, 27%, and 58% according to the criteria proposed by Takeda, Coimbra et al., and Silveira et al., respectively, with large differences across categories. Poor mothers showed the highest prevalence ratio for inadequate prenatal care. After adjustment, nearly all the model's variables were significantly associated with inadequate care according to the Takeda and Coimbra et al. criteria, but few were associated when the Silveira et al. criteria were used. The study showed that the criteria proposed by Silveira et al. were more robust, and that it is necessary to improve quality of prenatal care, especially for poor mothers.


Assuntos
Cuidado Pré-Natal/normas , Avaliação de Processos em Cuidados de Saúde , Adolescente , Adulto , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Atenção Primária à Saúde , Qualidade da Assistência à Saúde , Fatores Socioeconômicos , Adulto Jovem
15.
Biomed Res Int ; 2015: 345430, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26075231

RESUMO

OBJECTIVE: To examine time trends in prevalence of smoking and smoking cessation during pregnancy by family income, maternal level of education, skin color, and age. METHODS: We conducted three population-based surveys in 2007, 2010, and 2013 with newly delivered mothers living in the municipality of Rio Grande, Southern Brazil. Data were collected using questionnaires administered after delivery in all (two) maternity units in the city, at Dr. Miguel Riet Corrêa Júnior Hospital and at Santa Casa de Misericórdia. Time trends were analyzed using chi-square test for linear trend. RESULTS: Data of 7,572 women showed that the prevalence of smoking before pregnancy decreased from 28% (26.2-29.7) in 2007 to 22% (20.8-24.0) in 2013 (P < 0.001). Prevalence of smoking during pregnancy decreased from 22% (20.4-23.7) in 2007 to 18% (16.6-19.5) in 2013 (P < 0.001). This reduction varied across income ranging from 17% (poorest) to 35% (richest) (P < 0.001). The lower the income, the higher the smoking prevalence during pregnancy. Smoking cessation was more prevalent among women of higher level of education and income. CONCLUSIONS: Smoking before and during pregnancy is still highly prevalent and the prevalence of cessation is low pointing to a need to strengthen actions targeting low-income, less educated, black pregnant women.


Assuntos
Abandono do Hábito de Fumar , Fumar/epidemiologia , Inquéritos e Questionários , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Gravidez , Prevalência , Fumar/terapia , Fatores Socioeconômicos
16.
Cad. saúde pública ; 31(5): 1003-1014, 05/2015. tab, graf
Artigo em Português | LILACS | ID: lil-749067

RESUMO

Este estudo mediu a prevalência e identificou fatores associados à inadequação do pré-natal conforme diferentes critérios entre puérperas residentes no Município de Rio Grande, Rio Grande do Sul, Brasil, em 2010. Aplicou-se questionário padrão em até 24 horas após o parto a todas as mães que tiveram filho nas duas maternidades do município. Utilizou-se teste do qui- quadrado para comparar proporções e regressão de Poisson com ajuste robusto da variância na análise multivariável. Foram entrevistadas 2.395 mães (97,2% do total). Os índices de inadequação do pré-natal foram 28%, 27% e 58% segundo Takeda, Coimbra et al. e Silveira et al., respectivamente, com enormes disparidades entre categorias. A razão de prevalências à realização de pré-natal inadequado foi maior entre mães mais pobres. Após ajuste, quase todas as variáveis do modelo mostraram-se significativamente associadas à inadequação do pré-natal para Takeda e Coimbra et al., mas poucas em relação a Silveira et al. Este trabalho mostrou que o índice proposto por Silveira et al. é mais robusto e que é necessário melhorar a qualidade do pré-natal, sobretudo para as mais mães mais pobres.


This study measured the prevalence of inadequate prenatal care and identified associated factors using different criteria in postpartum women in Rio Grande, Rio Grande do Sul State, Brazil, in 2010. A standardized questionnaire was applied within 24 hours after delivery to all mothers of children born in the two local hospitals. We used the chi-square test to compare proportions and Poisson regression with robust variance in the multivariate analysis. The study interviewed 2,395 mothers (97.2% of the total). The rates of inadequate prenatal care were 28%, 27%, and 58% according to the criteria proposed by Takeda, Coimbra et al., and Silveira et al., respectively, with large differences across categories. Poor mothers showed the highest prevalence ratio for inadequate prenatal care. After adjustment, nearly all the model’s variables were significantly associated with inadequate care according to the Takeda and Coimbra et al. criteria, but few were associated when the Silveira et al. criteria were used. The study showed that the criteria proposed by Silveira et al. were more robust, and that it is necessary to improve quality of prenatal care, especially for poor mothers.


Este estudio midió la prevalencia e identificó los factores asociados a la inadecuación del cuidado prenatal, conforme diferentes criterios entre puérperas residentes en municipio de Río Grande, Río Grande do Sul, Brasil, en 2010. Se aplicó un cuestionario patrón, hasta 24 horas después del parto, a todas las madres que tuvieran un hijo en cualquiera de las dos maternidades locales. Se utilizó el test de chi-cuadrado para comparar proporciones y la regresión de Poisson con ajuste robusto de la variancia en el análisis multivariable. Se entrevistaron a 2.395 madres (97,2% del total). Los índices de inadecuación del cuidado prenatal fueron 28%, 27% y 58%, según Takeda, Coimbra et al. y Silveira et al., respectivamente. La razón de prevalencias, respecto a la realización de cuidado prenatal inadecuado, fue mayor entre las madres pobres. Tras el ajuste, casi todas las variables del modelo se mostraron significativamente asociadas a la inadecuación del cuidado prenatal para Takeda y Coimbra et al., en contraste con Silveira et al. Se observó la necesidad de mejorar la calidad del cuidado prenatal y que el índice propuesto por Silveira et al. es más robusto.


Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Adulto Jovem , Avaliação de Processos em Cuidados de Saúde , Cuidado Pré-Natal/normas , Brasil , Estudos Transversais , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Atenção Primária à Saúde , Cuidado Pré-Natal/estatística & dados numéricos , Qualidade da Assistência à Saúde , Fatores Socioeconômicos
17.
J. pediatr. (Rio J.) ; 91(2): 175-182, Mar-Apr/2015. tab
Artigo em Inglês | LILACS | ID: lil-745947

RESUMO

OBJECTIVE: To analyze the prevalence of excess weight and low height, and identify associated factors among children younger than five years. METHODS: Cross-census study. A total of 1,640 children from two municipalities in Piauí, Brazil were included. RESULTS: The prevalence of low height was 10.9% (95% CI: 9.3 to 12.4), inversely associated with mother's younger age and low level of education, lower socioeconomic status, mothers who had fewer than six prenatal consultations, and households that had more than one child younger than 5 years. Excess weight prevalence was 19.1% (95% CI: 17.2 to 21.0), and remained inversely associated with lower maternal age, low maternal education, and cesarean delivery. Stunting was greater in children aged between 12 and 23 months, while excess weight decreased with age. CONCLUSIONS: It is noteworthy that the stunting rate, although decreasing, is still high, while the prevalence of excess weight, even in this very poor area, already exceeds the expected percentage for a population with better socioeconomic level. .


OBJETIVO: Analisar a prevalência de excesso de peso e déficit de altura e identificar fatores associados entre menores de cinco anos. MÉTODOS: Estudo censitário transversal. Foram incluídas 1.640 crianças de dois municípios do Piauí, Brasil. RESULTADOS: A prevalência de déficit de altura foi 10,9% (IC95%: 9,3-12,4), inversamente associado com menor idade e escolaridade materna, menor condição socioeconômica, mães que fizeram menos de seis consultas pré-natal e se nessas casas havia mais de uma criança menor de cinco anos. O excesso de peso teve prevalência de 19,1% (IC95%: 17,2-21,0) e manteve-se inversamente associado com menor idade da mãe, baixa escolaridade materna e parto cesáreo. O déficit de altura foi maior para crianças entre 12 e 23 meses, enquanto o excesso de peso diminuiu com a idade. CONCLUSÕES: Destaca-se que o déficit de altura, embora esteja diminuindo, ainda é elevado, enquanto a prevalência de excesso de peso, mesmo nessa área muito pobre, já supera o percentual esperado para uma população com melhores condições socioeconômicas. .


Assuntos
Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Densidade Óssea , Metilação de DNA , Regiões Promotoras Genéticas , Receptor X Retinoide alfa/genética , Ilhas de CpG , Ensaio de Desvio de Mobilidade Eletroforética , Estudos Prospectivos , Vitamina D/análogos & derivados , Vitamina D/sangue
18.
J Pediatr (Rio J) ; 91(2): 175-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25449789

RESUMO

OBJECTIVE: To analyze the prevalence of excess weight and low height, and identify associated factors among children younger than five years. METHODS: Cross-census study. A total of 1,640 children from two municipalities in Piauí, Brazil were included. RESULTS: The prevalence of low height was 10.9% (95% CI: 9.3 to 12.4), inversely associated with mother's younger age and low level of education, lower socioeconomic status, mothers who had fewer than six prenatal consultations, and households that had more than one child younger than 5 years. Excess weight prevalence was 19.1% (95% CI: 17.2 to 21.0), and remained inversely associated with lower maternal age, low maternal education, and cesarean delivery. Stunting was greater in children aged between 12 and 23 months, while excess weight decreased with age. CONCLUSIONS: It is noteworthy that the stunting rate, although decreasing, is still high, while the prevalence of excess weight, even in this very poor area, already exceeds the expected percentage for a population with better socioeconomic level.


Assuntos
Estatura/fisiologia , Peso Corporal/fisiologia , Transtornos do Crescimento/epidemiologia , Mães/estatística & dados numéricos , Sobrepeso/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Censos , Cesárea/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/etiologia , Humanos , Lactente , Masculino , Estado Nutricional/fisiologia , Gravidez , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
Cad Saude Publica ; 29(11): 2297-306, 2013 Nov.
Artigo em Português | MEDLINE | ID: mdl-24233044

RESUMO

This study aimed to determine the prevalence of lack of knowledge on condoms and to identify associated factors among teenagers in two municipalities (counties) in Piauí State, Brazil, in mid-2008. Standardized home interviews were conducted by trained interviewers with all the teenagers (13-19 years of age). The study investigated demographic and socioeconomic characteristics and knowledge on contraception and sexually transmitted diseases (STDs). The outcome variable was lack of knowledge on male condoms. The multivariate analysis used Poisson regression with robust variance. Of the 2,241 adolescents, 18.8% claimed ignorance of male condoms. Among individuals with at least 9 years of schooling, only 4% lacked knowledge on condoms. Meanwhile, among individuals who lacked knowledge on STDs, 74% lacked knowledge on condoms. In the adjusted analysis, female gender, younger age, low schooling, not having a girlfriend, and lack of knowledge on oral contraception and STDs increased the likelihood of lack of knowledge on condoms. The data showed the urgent need for awareness-raising interventions on condom use among adolescents in these municipalities.


Assuntos
Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Comportamento do Adolescente , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
20.
Cad. saúde pública ; 29(11): 2297-2306, Nov. 2013. tab
Artigo em Português | LILACS | ID: lil-690764

RESUMO

Buscou-se determinar a prevalência e identificar fatores associados ao não conhecimento de preservativo masculino entre adolescentes, em dois municípios do semiárido piauiense, Brasil, em meados de 2008. Entrevistadores treinados aplicaram questionário padronizado a todos adolescentes (13-19 anos), nos domicílios. Investigaram-se características demográficas, socioeconômicas e conhecimento sobre contracepção e doenças de transmissão sexual (DST). O desfecho foi o não conhecimento de preservativo masculino. Na análise multivariada, utilizou-se regressão de Poisson com ajuste robusto da variância. Dos 2.241 adolescentes, 18,8% disseram não conhecer preservativo. A prevalência de não conhecimento variou de 4% para os com nove anos ou mais de escolaridade a 74% entre os que não conheciam DST. Na análise ajustada, ser do sexo feminino, ter pouca idade, baixa escolaridade, não ter namorada, desconhecer contracepção oral e DST aumentava a probabilidade de não conhecer preservativo em relação às demais categorias. Os dados mostram a urgente necessidade de intervenção entre adolescentes desses municípios.


This study aimed to determine the prevalence of lack of knowledge on condoms and to identify associated factors among teenagers in two municipalities (counties) in Piauí State, Brazil, in mid-2008. Standardized home interviews were conducted by trained interviewers with all the teenagers (13-19 years of age). The study investigated demographic and socioeconomic characteristics and knowledge on contraception and sexually transmitted diseases (STDs). The outcome variable was lack of knowledge on male condoms. The multivariate analysis used Poisson regression with robust variance. Of the 2,241 adolescents, 18.8% claimed ignorance of male condoms. Among individuals with at least 9 years of schooling, only 4% lacked knowledge on condoms. Meanwhile, among individuals who lacked knowledge on STDs, 74% lacked knowledge on condoms. In the adjusted analysis, female gender, younger age, low schooling, not having a girlfriend, and lack of knowledge on oral contraception and STDs increased the likelihood of lack of knowledge on condoms. The data showed the urgent need for awareness-raising interventions on condom use among adolescents in these municipalities.


Se buscó determinar la prevalencia y factores de riesgo asociados a la falta de conocimiento sobre preservativos entre los adolescentes en dos municipios de la región semiárida de Piauí, Brasil, a mediados de 2008. Entrevistadores formados aplicaron un cuestionario estandarizado a todos los adolescentes (13-19 años) en sus hogares. Se investigaron factores como el demográfico, socioeconómico y el conocimiento sobre anticoncepción y enfermedades de transmisión sexual (ETS). El resultado es que no conocían los preservativos. En el análisis multivariante se utilizó la regresión de Poisson con ajuste robusto de la varianza. De los 2.241 adolescentes, un 18,8% dijo que no conocía los preservativos. La prevalencia de la falta de conocimiento osciló entre un 4% y los 9 años de escolaridad o más, al 74% entre los que no saben acerca de las ETS. En el análisis ajustado, ser mujer, tener poca edad, bajo nivel educativo, carecer de pareja, conocer la anticoncepción oral y las ETS aumenta el riesgo de no conocer los preservativos en relación con otras categorías. Las cifras indican la urgencia de la intervención para los adolescentes de estos municipios.


Assuntos
Adolescente , Feminino , Humanos , Masculino , Adulto Jovem , Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Comportamento do Adolescente , Brasil , Estudos Transversais , Fatores Socioeconômicos , Inquéritos e Questionários , Comportamento Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle
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