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1.
Artigo em Inglês | MEDLINE | ID: mdl-32033282

RESUMO

Background: Medication use during pregnancy is a common practice that has been increasing in recent years. The aim of this study is to describe medication use among pregnant women from the 2015 Pelotas (Brazil) Birth Cohort Study. Methods: This paper relies on a population-based cohort study including 4270 women. Participants completed a questionnaire about the antenatal period, including information about medication use. We performed descriptive analyses of the sample and the medications used and adjusted analyses for the use of medications and self-medication. Results: The prevalence of medication use was 92.5% (95% CI 91.7-93.3), excluding iron salts, folic acid, vitamins, and other minerals. The prevalence of self-medication was 27.7% (95% CI 26.3-29.1). In the adjusted analysis, women who had three or more health problems during pregnancy demonstrated higher use of medicines. Self-medication was higher in lower income groups and among smokers and multiparous women (three pregnancies or more). Acetaminophen, scopolamine, and dimenhydrinate were the medications most commonly used. Conclusions: This study describes the pattern of drug use among pregnant women in a population-based cohort study, with a high prevalence of self-medication. Greater awareness of the risks of self-medication during pregnancy is required, focusing on groups more prone to this practice, as well as ensuring qualified multidisciplinary prenatal care.

2.
Int J Public Health ; 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32040689

RESUMO

OBJECTIVES: To estimate and assess pregnancy smoking trends since 1978, according to sociodemographic characteristics, in three Brazilian sites. METHODS: We used cross-sectional data from the perinatal studies of nine birth cohorts, located in the southeast (Ribeirão Preto-1978/1979, 1994, and 2010), south (Pelotas-1982, 1993, 2004, and 2015), and northeast (São Luís-1997/1998 and 2010) regions of Brazil. We estimated the prevalence of pregnancy smoking at each time point according to age, education, and family income, in each cohort, and evaluated smoking trends. RESULTS: We analyzed data of 17,275 women in Ribeirão Preto, 19,819 in Pelotas, and 7753 in São Luís. Smoking decreased by 59% in Ribeirão Preto (p < 0.001), 54% in Pelotas (p < 0.001), and 32% in São Luís (p < 0.001). However, among those with 0-4 years of education, smoking did not change in Ribeirão Preto (p-trend = 0.501) nor São Luís (p = 0.556) and increased in Pelotas (p-trend = 0.003). CONCLUSIONS: Pregnancy smoking has been declining during the last decades. However, among less-educated women, pregnancy smoking did not change in two sites and increased in one of them.

3.
Nutrition ; 71: 110636, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31877451

RESUMO

OBJECTIVE: The number of chronic diseases is associated with the reduction in muscle mass and strength in older people (≥60 y of age). The purpose of this study was to asses the association between multimorbidities and handgrip strength in older community-dwelling individuals from a city in southern Brazil, identifying potential differences according to sex and loss of muscle mass. METHODS: This was a cross-sectional population-based study among older individuals living in the urban area of Pelotas, Rio Grande do Sul, Brazil. Grip strength was assessed with digital dynamometers according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) to define dynapenia. Multimorbidity was defined by self-report as the presence of at least 5 diseases diagnosed by a physician. Covariates of the study were age, sex, socioeconomic status, schooling, marital status, nutritional status, alcohol consumption, and smoking habits. Statistical analyses were stratified according to the presence of myopenia (low muscle mass). RESULTS: We received completed information from 1336 individuals ≥60 y of age. Multimorbidity was 50% and 16% more prevalent, respectively, among men and women classified in the lower quartile of manual grip strength (prevalence ratio [PR], 1.50; 95% confidence interval [CI], 1.15-1.95 for men and PR, 1.16; 95% CI, 1.03-1.32 for women) compared with those from the upper quartile. Among men without myopenia, the presence of dynapenia increased the odds of having multimorbidity (PR, 1.42; 95% CI, 1.18-1.71). Among those with myopenia, there was a 10% increase in the prevalence of multimorbidity only for women with dynapenia (PR, 1.10; 95% CI, 1.00-1.21). CONCLUSION: Results from the present study indicated an association between manual grip strength and multimorbidity among this population, and the effect measures were greater in men. Manual grip strength proved to be a good marker of health in this population, especially in those who did not present with myopenia.

4.
Int J Behav Nutr Phys Act ; 16(1): 131, 2019 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842916

RESUMO

BACKGROUND: The aim of this study is to describe objectively measured physical activity (PA) and its correlates in one-year-old children. METHODS: The current study includes participants from the 2015 Pelotas (Brazil) birth cohort. At age one, PA was assessed in a 24-h protocol during 4 days with a wrist-attached accelerometer (ActiGraph, wGT3X-BT), from which two complete days of data were analyzed, with 5-s epochs. RESULTS: A total of 2974 individuals provided valid accelerometry data. Infants able to walk independently spent on average 19 h per day below 50 mg of acceleration (including sleep time), and those who could not walk spent on average 21 h in this intensity category. Girls spent approximately 10 min more than boys below 50 mg daily in both walking status categories, and less activity than boys on higher intensity categories. Boys and infants whose mothers were more physically active during pregnancy presented more acceleration, regardless of walking status. Among infants who could walk by themselves, those with mothers with one to eight schooling years; adequate length-for-age (z-score); not attending daycare; and more physically active fathers also showed higher levels of acceleration. CONCLUSIONS: Our findings demonstrate higher levels of PA among boys and those children with higher maternal PA during pregnancy, regardless of walking status. Also, among infants able to independently walk, 1-8 years of maternal schooling, adequate length-for-age (z-score), no daycare attendance and higher paternal PA are positive correlates of objectively measured PA early in life.

5.
Rev. bras. ativ. fís. saúde ; 24: 1-9, out. 2019. tab
Artigo em Português | LILACS | ID: biblio-1026750

RESUMO

O objetivo do estudo foi descrever as instalações e equipamentos para atividade física nas escolas da zona rural de Pelotas, Rio Grande do Sul. Trata-se de um estudo transversal, de base escolar, realizado no ano de 2014, em todas as 26 escolas localizadas na zona rural da cidade de Pelotas. Foi utilizado um instrumento com questões relacionadas às políticas de Educação Física e avaliação das estruturas e materiais para a prática de atividade física, elaborado a partir do Physical Activity Resource Assessment (PARA), adaptado para o ambiente escolar. Observou-se que o professor e a disciplina de Educação Física estiveram presentes em todas as escolas. Mesmo com a maior frequência de estruturas como quadras esportivas (34,6% a 65,4%), pracinha/parquinhos (76,9%) e materiais como bolas (50,0% a 84,6%), cones (80,8%), cordas (88,5%), colchonetes (80,8%) e arcos (76,9%), as condições dos atributos foram regulares (7,7% a 46,2%) e ruins (11,5% a 50,0%). Poucas instituições ofereceram instalações e equipamentos em condições adequadas para a prática de atividade física. A ausência de ginásios, quadras cobertas e materiais em melhores condições chama a atenção para a necessidade de investimentos e intervenções nesses espaços


The aim of the study was to describe the facilities and equipment for physical activity practice in rural area schools of Pelotas, Rio Grande do Sul. The design was cross-sectional, school-based, carried out in all the 26 schools located in rural areas of Pelotas Southern, Brazil. We used a survey tool to assess the policies for Physical Education and evaluate the facilities and equipment/materials for physical activity. The instrument was based on the Physical Activity Resource Assessment (PARA), adapted for the school environment. We observed that curricular Physical Education and specific teachers were present in all schools. Despite the high number of facilities, such as courts and fields (34.6% to 65.4%), playgrounds (76.9%) and materials such as balls (50.0% to 84.6%), hoops (88.5%), exercise cones (80.8%) and mats (76.9%), the condition of the facilities and apparatus/equipment were fair (7.7% to 46.2%) or poor (11.5% to 50.0%). Few institutions have provided suitable facilities and equipment for physical activity. The absence of gymnasiums, covered courts and materials in better conditions draws attention to the need for investments and interventions in these spaces


Assuntos
População Rural , Instituições Acadêmicas , Planejamento Ambiental , Políticas Públicas de Saúde , Atividade Motora
6.
PLoS One ; 14(6): e0211442, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31246953

RESUMO

BACKGROUND: Objective methods to measure physical activity (PA) can lead to better cross-cultural comparisons, monitoring temporal PA trends, and measuring the effect of interventions. However, when applying this technology in field-work, the accelerometer data processing is prone to methodological issues. One of the most challenging issues relates to standardizing total wear time to provide reliable data across participants. It is generally accepted that at least 4 complete days of accelerometer wear represent a week for adults. It is not known if this same assumption holds true for pregnant women. AIM: We assessed the optimal number of days needed to obtain reliable estimates of overall PA and moderate-to-vigorous physical activity (MVPA) during the 2nd trimester in pregnancy using a raw triaxial wrist-worn accelerometer. METHODS: Cross-sectional analyses were carried out in the antenatal wave of the 2015 Pelotas (Brazil) Birth Cohort Study. Participants wore the wrist ActiGraph wGT3X-BT accelerometer for seven consecutive days. The daily average acceleration, which indicated overall PA, was measured as milli-g (mg), and time spent in MVPA (minutes/day) was analyzed in 5-minute bouts. ANOVA and Kruskal-Wallis tests were used to compare variability across days of the week. Bland-Altman plots and the Spearman-Brown Prophecy Formula were applied to determine the reliability coefficient associated with one to seven days of measurement. RESULTS: Among 2,082 pregnant women who wore the accelerometer for seven complete days, overall and MVPA were lower on Sundays compared to other days of the week. Reliability of > = 0.80 to evaluate overall PA was reached with at least three monitoring days, whereas seven days were needed to estimate reliable measures of MVPA. CONCLUSIONS: Our findings indicate that obtaining one week of accelerometry in adults is appropriate for pregnant women, particularly to obtain differences on weekend days and reliably estimate overall PA and MVPA.

7.
J Affect Disord ; 256: 441-447, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31252237

RESUMO

BACKGROUND: This study examined the association between disrespect and abuse of women during facility-based childbirth and postpartum depression (PD) occurrence. METHODS: We used data from the 2015 Pelotas (Brazil) Birth Cohort, a population-based cohort of all live births in the city. We assessed 3065 mothers at pregnancy and 3-months after birth. Self-reported disrespect and abuse experiences included physical abuse, verbal abuse, denial of care, and undesired procedures. We estimate the occurrence of each disrespect and abuse type, one or more types and disrespect and abuse score. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PD. EPDS scores ≥13 and ≥15 indicated at least moderate PD and marked/severe. Odds ratios (OR) were calculated by logistic regression. RESULTS: The prevalence of at least moderate PD and marked/severe PD was 9.4% and 5.7%, respectively. 18% of the women experienced at least one type of disrespect and abuse. Verbal abuse increased the odds of having at least moderate PD (OR = 1.58; 95%CI 1.06-2.33) and marked/severe PD (OR = 1.69; 95%CI 1.06-2.70) and the effect among women who did not experience antenatal depressive symptoms was greater in comparison to those who did (OR = 2.51; 95%CI 1.26-5.04 and OR = 4.27; 95%CI 1.80-10.12). Physical abuse increased the odds of having marked/severe PD (OR = 2.28; 95%CI 1.26-4.12). Having experienced three or more mistreatment types increased the odds of at least moderate PD (OR = 2.90; 95%CI 1.30 - 35.74) and marked/severe PD (OR=3.86; 95%CI 1.58-9.42). LIMITATIONS: Disrespect and abuse experiences during childbirth were self-reported. CONCLUSIONS: Disrespect and abuse during childbirth increased the odds of PD three months after birth. Strategies to promote high quality and respectful maternal health care are needed to prevent mother-child adverse outcomes.

8.
Clin Biomech (Bristol, Avon) ; 67: 148-152, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31108318

RESUMO

BACKGROUND: The morphological alterations during pregnancy may affect the biomechanical loads during exercise practice. Aquatic exercises may suit pregnant women, who are recommended to exercise with low vertical ground reaction force loads. Therefore, the study aimed to determine the apparent weight reduction during immersion and the vertical ground reaction force of three specific water-based exercises in pregnant women at the third trimester. METHODS: Eleven pregnant women volunteered to take part in the study [32.0 (SD 1.3) weeks, 28.1 (SD 5.7) years, 72.5 (SD 10.1) kg]. The protocol started with the participants immersed to the xiphoid process depth for the apparent weight assessment. Then, three water-based exercises (stationary running, frontal kick and butt kick) were randomly performed at a pre-selected cadence, with 5-min interval. The vertical ground reaction force was measured in each exercise and peak, impulse, contact time and swing time were determined. Repeated measures ANOVA was used (α = 0.05). FINDINGS: The apparent weight reduction resulted a mean of 82.9 (SD 6.5)% of body weight. Peak, impulse, contact time and swing time revealed no significant difference between exercises (P > 0.05). Values of peak of vertical ground reaction force ranged from 0.67 to 0.72 units of body weight. INTERPRETATION: Pregnant women at the third trimester can benefit from the apparent weight reduction during immersion for exercising. The three water-based exercises presented similar vertical ground reaction force values, which are considered as low odds for musculoskeletal injuries. Therefore, these findings highlight the safety of the water-based exercise program during pregnancy.

9.
BMC Public Health ; 19(1): 657, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31142294

RESUMO

BACKGROUND: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. METHODS: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. DISCUSSION: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. TRIAL REGISTRATION: NCT03264443 . Registered on 29 August, 2017.


Assuntos
Promoção da Saúde/métodos , Hipertensão/prevenção & controle , Estilo de Vida , Idoso , Protocolos Clínicos , Humanos , Pessoa de Meia-Idade
10.
BMC Pediatr ; 19(1): 165, 2019 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126263

RESUMO

BACKGROUND: Non-supine infant sleep position is an important modifiable risk factor for sudden unexpected death in infancy. The aim of this study was to assess the prevalence of supine sleep position and associated factors among 3-month-old infants from a birth cohort in the city of Pelotas, southern Brazil. METHODS: The present study evaluated longitudinal data from the 2015 Pelotas Birth Cohort. Study outcome was supine infant sleep position, defined as the appropriate position, among 3-month-old children. Demographic, socioeconomic, behavioral, and health characteristics collected at birth and at the 3-month follow-up were investigated as possible associated factors. The prevalence of each associated factor was investigated, and crude and hierarchical adjusted analyses were performed using Poisson regression. RESULTS: Among the 4108 infants assessed in this study, 2274 (55.4%) slept in supine position at 3 months and only 66 (1.6%) in prone position. Maternal white skin color, higher family income and maternal schooling, advanced maternal age, maternal cohabiting with a partner, receiving counseling from health care professionals and non-bed-sharing were associated with higher prevalence of infants sleeping in supine position at 3 months. All these variables remained associated in our hierarchical adjusted analyses except maternal cohabitation with a partner. Participants with white mothers were more likely to sleep in supine position (PR: 1.23; 95%CI: 0.75-0.89) compared to participants with black mothers. Those belonging to the richest quintile were more likely to sleep in supine position (PR: 1.49; 95%CI: 1.35-1.65) compared to those who belong to the poorest. Mothers aged 31-36 years were more likely to choose supine sleep position (PR: 1.65; 95%CI: 1.42-1.92) compared to mothers younger than 19 years. CONCLUSIONS: The findings of the present study showed the influence of maternal age, socioeconomic status, and counseling on infant sleep habits as predictors of choice of infant sleep position in a Brazilian population. It is recommended to implement informative campaigns and public policies to at-risk population and to improve recommendations from health care professionals.

11.
Rev Saude Publica ; 53: 13, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30726494

RESUMO

OBJECTIVE: To assess the prevalence of successful assisted reproductive technology and to identify the associated factors. METHODS: This population-based birth cohort study was carried out with 4,333 pregnant women expected to deliver in 2015 in the urban area of Pelotas, Southern Brazil. Use of an assisted reproductive technology procedure, type of assisted reproductive technology [in vitro fertilization or intracytoplasmic sperm injection or artificial insemination], number of embryos transferred, success of embryo transfer, number of attempts, and reported reasons for seeking assisted reproductive technology were the main outcomes measured. Use of an assisted reproductive technology procedure was analyzed according to sociodemographic, nutritional, reproductive history, and behavioral characteristics. Unadjusted and adjusted analyses were performed by logistic regression. RESULTS: Among the 4,275 newborns enrolled in the Pelotas 2015 Birth Cohort Study, 18 births (0.4%) were conceived by assisted reproductive technology. Most cases of assisted reproductive technology were by in vitro fertilization (70.6%). All cycles were performed in private clinics under direct out-of-pocket payment. Even after controlling for confounders, maternal age > 35 years, nulliparity and high family monthly income were strongly associated with assisted reproductive technology. CONCLUSIONS: The use of assisted reproductive technology services was reported by only a few women in the Pelotas 2015 Birth Cohort Study. Our study highlights sociodemographic factors associated to assisted reproductive technology procedures. To better understand the patterns and barriers in overall use of assisted reproductive technology services over time, national-level trend studies in assisted reproductive technology treatments and outcomes, as well as studies exploring the characteristics of women who have sought this kind of treatment are needed in low-middle income countries.


Assuntos
Resultado da Gravidez/epidemiologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Gravidez , Prevalência , Fatores Socioeconômicos , População Urbana
12.
JAMA Netw Open ; 2(1): e186861, 2019 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-30646198

RESUMO

Importance: Interventions to reduce postpartum depression have mainly focused on enhancing screening to increase treatment rates among women. Preventive approaches are timely from a population health perspective, particularly in low- and middle-income countries where access to mental health services is limited. Objective: To assess the efficacy of regular exercise during pregnancy on the prevention of postpartum depression. Design, Setting, and Participants: This randomized clinical trial examines a prespecified secondary outcome of the Physical Activity for Mothers Enrolled in Longitudinal Analysis (PAMELA) Study, a parallel-group, randomized clinical trial. This trial was nested in the 2015 Pelotas (Brazil) Birth Cohort Study. Between August 27, 2014, and March 14, 2016, pregnant women between 16 and 20 weeks of gestation with no contraindications to exercise were randomized 1:2 to the intervention group or control group via computer-generated randomization using a block size of 9. Data were analyzed from March 7 to May 2, 2018. Interventions: Participants assigned to the intervention were engaged in a 16-week supervised exercise program including aerobic and resistance training delivered in 60-minute sessions 3 times per week. Main Outcomes and Measures: Postpartum depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale 3 months after birth. A score of 12 or greater was defined as screening positive for postpartum depression. Primary analysis was performed on a complete case basis (90% of participants who had the primary end point ascertained). Results: A total of 639 participants (mean [SD] age, 27.1 [5.1] years; mean gestational age, 16.5 [1.5] weeks) were randomly assigned to the intervention group (n = 213) or control group (n = 426). Compliance with the protocol, defined as having engaged in at least 70% of exercise sessions, was low (40.4%). There was no significant difference in mean (SD) scores for postpartum depression between the intervention group (4.8 [3.7]) and the control group (5.4 [4.1]) (mean difference, -0.6; 95% CI, -1.3 to 0.1). There was also no significant difference in rates of postpartum depression between the intervention group (12 of 192 [6.3%]) and the control group (36 of 387 [9.3%]) (odds ratio, 0.65; 95% CI, 0.33-1.28). Instrumental variable analysis indicated that noncompliance may have attenuated the effect estimates obtained in the primary analysis. Conclusions and Relevance: Moderate-intensity exercise during pregnancy did not lead to significant reductions in postpartum depression. However, noncompliance to the intervention protocol was substantial and may have led to underestimations of the possible benefits of exercise. The point estimates for this study are in the same direction as the previous randomized clinical trial on this topic. Future studies on how to promote regular exercise during pregnancy to improve compliance, particularly targeting young and less educated women, are warranted before further trials are undertaken. Trial Registration: ClinicalTrials.gov Identifier: NCT02148965.


Assuntos
Depressão Pós-Parto , Exercício/psicologia , Treinamento de Resistência/métodos , Adulto , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/fisiopatologia , Depressão Pós-Parto/prevenção & controle , Feminino , Idade Gestacional , Humanos , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Gravidez , Gestantes/psicologia , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
13.
Rev. saúde pública (Online) ; 53: 13, jan. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-985833

RESUMO

ABSTRACT OBJECTIVE: To assess the prevalence of successful assisted reproductive technology and to identify the associated factors. METHODS: This population-based birth cohort study was carried out with 4,333 pregnant women expected to deliver in 2015 in the urban area of Pelotas, Southern Brazil. Use of an assisted reproductive technology procedure, type of assisted reproductive technology [in vitro fertilization or intracytoplasmic sperm injection or artificial insemination], number of embryos transferred, success of embryo transfer, number of attempts, and reported reasons for seeking assisted reproductive technology were the main outcomes measured. Use of an assisted reproductive technology procedure was analyzed according to sociodemographic, nutritional, reproductive history, and behavioral characteristics. Unadjusted and adjusted analyses were performed by logistic regression. RESULTS: Among the 4,275 newborns enrolled in the Pelotas 2015 Birth Cohort Study, 18 births (0.4%) were conceived by assisted reproductive technology. Most cases of assisted reproductive technology were by in vitro fertilization (70.6%). All cycles were performed in private clinics under direct out-of-pocket payment. Even after controlling for confounders, maternal age > 35 years, nulliparity and high family monthly income were strongly associated with assisted reproductive technology. CONCLUSIONS: The use of assisted reproductive technology services was reported by only a few women in the Pelotas 2015 Birth Cohort Study. Our study highlights sociodemographic factors associated to assisted reproductive technology procedures. To better understand the patterns and barriers in overall use of assisted reproductive technology services over time, national-level trend studies in assisted reproductive technology treatments and outcomes, as well as studies exploring the characteristics of women who have sought this kind of treatment are needed in low-middle income countries.

14.
Reprod Health ; 15(1): 54, 2018 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-29587802

RESUMO

BACKGROUND: The disrespect and abuse of women during the process of childbirth is an emergent and global problem and only few studies have investigated this worrying issue. The objective of the present study was to describe the prevalence of disrespect and abuse of women during childbirth in Pelotas City, Brazil, and to investigate the factors involved. METHODS: This was a cross-sectional population-based study of women delivering members of the 2015 Pelotas birth cohort. Information relating to disrespect and abuse during childbirth was obtained by household interview 3 months after delivery. The information related to verbal and physical abuse, denial of care and invasive and/or inappropriate procedures. Poisson regression was used to evaluate the factors associated with one or more, and two or more, types of disrespectful treatment or abuse. RESULTS: A total of 4275 women took part in a perinatal study. During the three-month follow-up, we interviewed 4087 biological mothers with regards to disrespect and abuse. Approximately 10% of women reported having experienced verbal abuse, 6% denial of care, 6% undesirable or inappropriate procedures and 5% physical abuse. At least one type of disrespect or abuse was reported by 18.3% of mothers (95% confidence interval [CI]: 17.2-19.5); and at least two types by 5.1% (95% CI: 4.4-5.8). Women relying on the public health sector, and those whose childbirths were via cesarean section with previous labor, had the highest risk, with approximately a three- and two-fold increase in risk, respectively. CONCLUSIONS: Our study showed that the occurrence of disrespect and abuse during childbirth was high and mostly associated with payment by the public sector and labor before delivery. The efforts made by civil society, governments and international organizations are not sufficient to restrain institutional violence against women during childbirth. To eradicate this problem, it is essential to 1) implement policies and actions specific for this type of violence and 2) formulate laws to promote the equality of rights between women and men, with particular emphasis on the economic rights of women and the promotion of gender equality in terms of access to jobs and education.


Assuntos
Violência de Gênero , Assédio não Sexual , Hospitais Urbanos , Parto , Pessoalidade , Relações Profissional-Paciente , Estresse Psicológico/etiologia , Adulto , Brasil/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Violência de Gênero/economia , Violência de Gênero/ética , Violência de Gênero/etnologia , Violência de Gênero/psicologia , Assédio não Sexual/economia , Assédio não Sexual/ética , Assédio não Sexual/etnologia , Assédio não Sexual/psicologia , Preços Hospitalares , Hospitais Urbanos/economia , Hospitais Urbanos/ética , Humanos , Incidência , Erros Médicos/economia , Erros Médicos/ética , Erros Médicos/prevenção & controle , Erros Médicos/psicologia , Determinação de Necessidades de Cuidados de Saúde , Parto/etnologia , Parto/psicologia , Gravidez , Prevalência , Relações Profissional-Paciente/ética , Recusa do Médico a Tratar/ética , Risco , Autorrelato , Estresse Psicológico/epidemiologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Recursos Humanos
15.
Int J Behav Nutr Phys Act ; 14(1): 175, 2017 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-29273044

RESUMO

BACKGROUND: Women are encouraged to be physically active during pregnancy. Despite available evidence supporting antenatal physical activity to bring health benefits for both the mother and child, the most effective way to prevent some maternal and fetal outcomes is still unclear. The purpose of this study was to evaluate the efficacy of an exercise intervention to prevent negative maternal and newborn health outcomes. METHODS: A randomized controlled trial (RCT) nested into the 2015 Pelotas (Brazil) Birth Cohort Study was carried-out with 639 healthy pregnant women, 213 in the intervention group (IG) and 426 in the control (CG) group. An exercise-based intervention was conducted three times/week for 16 weeks from 16-20 to 32-36 weeks' gestation. The main outcomes were preterm birth and pre-eclampsia. Gestational age was calculated based on several parameters, including routine ultrassounds and/or last menstrual period and categorized as < 37 weeks and ≥ 37 weeks for evaluation of preterm birth. Pre-eclampsia was self-reported. Secondary outcomes were gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. Analyses were performed by intention-to-treat (ITT) and per protocol (70% of the 48 planned exercise sessions). Odds ratio were derived using unconditional logistic regression. RESULTS: The IG and CG did not differ at baseline regarding their mean age (27.2 years ± 5.3 vs. 27.1 years ± 5.7) and mean pre-pregnancy body mass index (25.1 ± 3.9 vs. 25.2 ± 4.1 kg/m2). The mean adherence to the exercise intervention was 27 ± 17.2 sessions (out of a potential 48) with 40.4% attending > = 70% of the recommended exercise sessions. A total of 594 participants (IG:198; CG: 396) were included in the ITT and 479 (IG: 83; CG: 396) were included in the per protocol analyses. There were no significant differences in the incidence of preterm birth and pre-eclampsia between groups in the ITT and per protocol analysis. There were also no differences between the two groups in mean gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. CONCLUSIONS: While the RCT did not support the benefits of exercise performed during pregnancy on preeclampsia and preterm birth, the exercise program also did not present adverse impacts on newborn health. Our findings may contribute to promote intervention strategies that motivate health providers to encourage pregnant women to be more physically active. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02148965 , registered on 22 May 2014.


Assuntos
Exercício , Pré-Eclâmpsia/epidemiologia , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Adulto , Peso ao Nascer , Índice de Massa Corporal , Brasil , Estudos de Coortes , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/prevenção & controle , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Cooperação do Paciente , Pré-Eclâmpsia/prevenção & controle , Gravidez , Nascimento Prematuro/prevenção & controle , Cuidado Pré-Natal , Tamanho da Amostra , Ganho de Peso , Adulto Jovem
16.
J. bras. psiquiatr ; 66(1): 38-44, jan.-mar. 2017. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-841296

RESUMO

RESUMO Objetivo O presente estudo analisou o nível de insatisfação corporal em mulheres frequentadoras de academias na cidade de Pelotas, Rio Grande do Sul, Brasil, avaliando como a insatisfação se distribuiu e quais seus fatores associados. Métodos Nas 26 academias sorteadas aleatoriamente foram entrevistadas 257 mulheres entre setembro de 2014 a janeiro de 2015. As participantes responderam a um questionário incluindo o desfecho insatisfação corporal (Body Shape Questionnaire – BSQ-34), qualidade de vida (WHOQOL-Bref) e características comportamentais, socioeconômicas e demográficas. Resultados Do total de mulheres entrevistadas, 21,4% (IC95% 16,5 – 26,9) apresentaram algum tipo de insatisfação corporal (escore maior ou igual a 110 pontos). O valor médio do escore BSQ foi de 85,6 (DP ±27,4). Ao todo, 67,3% das mulheres afirmaram que o principal motivo que as levou a praticar exercícios foi a estética, e 63,8% tinham a intenção de fazer cirurgia plástica. Após a análise bivariada foi realizada análise multivariável por regressão linear. Permaneceram associadas ao desfecho as variáveis: praticar exercícios por motivos estéticos (p = 0,005); índice de massa corporal (p < 0,001); autopercepção de saúde (p = 0,002); intenção de fazer cirurgia plástica (p = 0,005); e WHOQOL-Bref (p < 0,001). Conclusões Por fim, apesar de a prevalência de insatisfação corporal do presente estudo não ter apresentado valores alarmantes (21,4%), possivelmente devido à rigorosidade do instrumento utilizado, ainda é um tema atual e de crescente interesse de pesquisa. Estudos complementares se fazem necessários para melhor compreender a autopercepção da imagem corporal, especialmente entre mulheres.


ABSTRACT Objective This study examined the level of body dissatisfaction in women denizens of gyms in the city of Pelotas, Rio Grande do Sul, Brazil, evaluating how dissatisfaction was distributed and what its associated factors. Methods In the 26 academies randomly selected 257 women were interviewed between September 2014 to January 2015. The participants answered a questionnaire including body dissatisfaction outcome (Body Shape Questionnaire – BSQ-34), quality of life (WHOQOL-Bref) and behavioral characteristics, socioeconomic and demographic. Results Of all the women interviewed, 21.4% (95% CI 16.5 to 26.9) had some type of body dissatisfaction (scores greater than or equal to 110 points). The average value of BSQ score was 85.6 (SD ±27.4). In all, 67.3% of women said that the main reason which led them to practice exercises was aesthetics, and 63.8% had intended to do plastic surgery. After bivariate analysis was performed multivariate linear regression analysis. They remained associated with the outcome variables: practice exercises for aesthetic reasons (p = 0.005); body mass index (p < 0.001); self-perceived health (p = 0.002); intention to do plastic surgery (p = 0.005); and WHOQOL-Bref (p < 0.001). Conclusions Finally, despite the prevalence of body dissatisfaction of this study did not appear alarming values (21.4%), possibly due to the rigor of the instrument used, it is still a current topic of increasing interest and research, additional studies are needed to better understand the perception of body image, especially among women.

17.
BMC Public Health ; 17(1): 119, 2017 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-28122524

RESUMO

BACKGROUND: Low levels of leisure-time physical activity (LTPA) during pregnancy have been shown in studies conducted worldwide. Surveillance is extremely important to monitor the progress of physical activity patterns over time and set goals for effective interventions to decrease inactivity among pregnant women. The aim of this study was to evaluate time changes in LTPA among Brazilian pregnant women in an 11-year period (2004-2015) by comparing data from two birth cohort studies. METHODS: Two population-based birth cohort studies were carried out in the city of Pelotas, southern Brazil, in 2004 and 2015. A total of 4244 and 4271 mothers were interviewed after delivery. Weekly frequency and duration of each session of LTPA in a typical week were reported for the pre-pregnancy period and for each trimester of pregnancy. Trends in both recommended LTPA (≥150 min/week) and any LTPA (regardless of weekly amount) were analysed overtime. Changes were also calculated separately for subgroups of maternal age, schooling, family income, parity, pre-pregnancy body mass index and pre-pregnancy LTPA. RESULTS: The proportion of women engaged in recommended levels of LTPA pre-pregnancy increased from 11.2% (95%CI 10.0-12.2) in 2004 to 15.8% (95%CI 14.6-16.9) in 2015. During pregnancy, no changes were observed over the period for the first (10.6 to 10.9%) and second (8.7 to 7.9%) trimesters, whereas there was a decrease from 3.4% (95%CI 2.9-4.0) to 2.4% (95%CI 1.9-2.8) in the last trimester. Major decreases in LTPA in the last trimester were observed among women who were younger, with intermediate to high income, high schooling, primiparous, pre-pregnancy obese and, engaged in LTPA before pregnancy. Changes in any LTPA practice followed the same patterns described for recommended LTPA. CONCLUSIONS: Despite the increase in the proportion of women engaged in LTPA before pregnancy between 2004 and 2005, LTPA levels remained stable during the first and second trimesters of pregnancy and declined during the third gestational trimester over the period. Interventions to encourage the maintenance of LTPA practice throughout pregnancy are urgently needed.


Assuntos
Exercício , Atividades de Lazer , Mães/estatística & dados numéricos , Complicações na Gravidez/prevenção & controle , Adulto , Índice de Massa Corporal , Brasil , Estudos de Coortes , Feminino , Humanos , Idade Materna , Obesidade/complicações , Paridade , Gravidez , Complicações na Gravidez/etiologia , Trimestres da Gravidez/fisiologia , Fatores de Tempo , Adulto Jovem
18.
Sleep Med ; 23: 81-88, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27692281

RESUMO

OBJECTIVE: To investigate factors associated with sleep duration in adolescence. METHODS: Data are from the 1993 Pelotas Birth Cohort Study of 5249 live births. Of these individuals, 4563 were located for follow-up at 18 years of age, and 4106 agreed to be interviewed (follow-up rate 81.3%). Sleep duration was continuously assessed by survey as hours per weekday. Additional covariates were collected during the perinatal period and at the 11- and 18-year follow-ups. Linear regression models were used to estimate associations between sleep duration and its hypothesized influences. All analyses were sex-stratified. RESULTS: The average sleep duration among participants was 8.4 hours (standard deviation 1.9). Longer sleep duration at 18 years of age was associated with the following perinatal factors: low maternal schooling, low family income, maternal black skin color, and low birth weight; and with the following factors measured at 18 years of age: being out of school, low achieved schooling, low family income, absence of depressive symptoms, and high screen time. CONCLUSION: Social and demographic variables may play an important role in determining adolescents' sleep duration, but the nature of these relationships in Brazil may differ from those observed in higher-income contexts.


Assuntos
Sono , Adolescente , Brasil/epidemiologia , Estudos de Coortes , Depressão/epidemiologia , Depressão/psicologia , Escolaridade , Feminino , Humanos , Masculino , Fatores de Risco , Autorrelato , Privação do Sono/epidemiologia , Privação do Sono/etiologia , Fatores Socioeconômicos , Fatores de Tempo
19.
PLoS One ; 11(3): e0152348, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27010312

RESUMO

We aimed to estimate the association between sleep duration trajectories and body composition in adolescents. We used data from participants of the 1993 Pelotas (Brazil) Birth Cohort Study who were later followed up at age 18 years (response rate of 81.3%). At the time, 3974 adolescents had complete data on body composition, which was assessed by air displacement plethysmography. Sleep duration was self-reported by participants at ages 11 and 18 years. Analyses were sex-stratified. The mean sleep duration at 11 years was 9.7 (SD 1.4) and 8.4 (SD 1.9) at 18 years. Sleep duration was dichotomized as inadequate (<8 hours/day) or adequate (≥8 hours/day). Mean body mass, fat mass, and fat-free mass indices at 18 years were 23.4 kg/m2 (SD 4.5), 6.1 kg/m2 (SD 3.9) and 17.3 kg/m2 (SD 2.5), respectively. Girls who reported inadequate sleep duration at 11 years of age, but adequate sleep duration at 18, on average experienced an increase in body mass index (ß = 0.39 z-scores; 95% CI 0.13, 0.65), fat mass index (ß = 0.30 z-scores; 95% CI 0.07, 0.53), and fat-free mass index (ß = 0.24 z-scores; 95% CI 0.08, 0.39) compared to those who had adequate sleep duration at both time points. The results suggest that changes in sleep duration across adolescence may impact body composition in later adolescence and that this may differ by sex.


Assuntos
Composição Corporal , Sono , Adolescente , Brasil , Feminino , Humanos , Masculino , Estudos Prospectivos
20.
J Phys Act Health ; 13(3): 257-61, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26382924

RESUMO

BACKGROUND: The aim of this study was to investigate the association between lifetime physical activity and risk of lung cancer. METHODS: A case-control study was conducted in southern Brazil. Case subjects were recruited from oncology services of 4 hospitals. Control subjects were selected from the same hospitals, but from different services (traumatology and emergency). Both case subjects (n = 81) and control subjects (n = 168) were interviewed using a questionnaire about sociodemographic characteristics, anthropometric information and family history of cancer. Control subjects were matched to case subjects according to sex and age (± 5 years). Detailed information on smoking was collected. Physical activity was measured using the Lifetime Physical Activity Questionnaire. RESULTS: Of the case subjects, 89% were either current or former smokers; among control subjects, this value was 57%. Participants in the second, third, and fourth quartiles of all-domains physical activity had odds ratios of 0.54 (95% CI, 0.21-1.40), 0.25 (95% CI, 0.08-0.72), and 0.24 (95% CI, 0.07-0.83) for lung cancer, compared with the lowest quartile, after adjusting for confounding. In the fully adjusted models, leisure-time physical activity was not associated with lung cancer risk. CONCLUSION: Lifetime all-domains physical activity may reduce the risk of lung cancer.


Assuntos
Exercício , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/prevenção & controle , Atividade Motora , Fumar/epidemiologia , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Neoplasias Pulmonares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Comportamento de Redução do Risco , Fumar/efeitos adversos , Classe Social , Fatores Socioeconômicos , Inquéritos e Questionários
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