Commentary : Disentangling the contributions of childhood and adult weight to cardiovascular disease risk

Non peer reviewe

Early life diarrhoea and later blood pressure in a developing country: the 1982 Pelotas (Brazil) birth cohort study

Background: It has recently been hypothesised that acute dehydration in early childhood may "programme'' increased blood pressure via salt retention. We examined whether there was an association between episodes of diarrhoea (a proxy for acute dehydration) and later measured blood pressure.Methods: In the 1982 Pelotas birth cohort study (Brazil), parents/carers reported hospital admissions for diarrhoea in the first 12 and 20 months of study members' lives. Blood pressure was subsequently measured directly in adolescence (aged 15, 18, 19 years) and early adulthood (aged 23 years).Results: We found no evidence of an association between diarrhoea in the first 12 months of life and blood pressure measured at any point in adolescence or early adulthood. These findings were unchanged after adjustment for a range of covariates. Equally null results were apparent when diarrhoea admissions in the first 20 months of life, access to home sanitation and use of piped water were the exposures of interest.Conclusions: Early life proxies for dehydration and diarrhoea were unrelated to later blood pressure in this examination, the most comprehensive to date, of the potential association

Iniqüidades sociais na saúde e nutrição de crianças em países de renda baixa e média

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.OBJETIVO: Describir el efecto de las iniquidades sociales sobre la nutrición y salud de niños de países de renta baja y media. MÉTODOS: Fueron revisadas informaciones disponibles sobre disparidades socioeconómicas intra-países, relativas al uso de servicios de salud, estado nutricional, morbilidad y mortalidad. Se adoptó un modelo conceptual con cinco categorías jerárquicas en la producción de inequidades: contexto y posición socioeconómica, diferencias en la exposición, en la vulnerabilidad, en los hechos de salud y en las consecuencias. En investigación realizada en la base PubMed, en el período de 1990-2007 fueron encontrados 244 artículos relacionados al tema. Fueron también analizados los resultados de cerca de 100 pesquisas de ámbito nacional recientes, incluyendo Pesquisas Nacionales de Demografía y Salud y Pesquisas por Conglomerados de Múltiples Indicadores, del Fondo de las Naciones Unidas para la Infancia. RESULTADOS: Niños de familias pobres, en comparación con aquellas de familias más ricas, son más susceptibles a la exposición a agentes patogénicos; una vez expuestas, tienen un riesgo aumentado de enfermar, debido a su menor resistencia y menor cobertura de medidas preventivas. Una vez que se toman enfermos, tienen menor acceso a servicios de salud, la calidad de los servicios que logran utilizar tiende a ser inferior, con menor acceso a tratamientos médicos que garanticen su sobrevivencia. Como consecuencia, niños de familias más pobres presentan mayores tasas de mortalidad y mayor riesgo de ser subnutridas. CONCLUSIONES: Excepto obesidad infantil y prácticas inadecuadas de amamantamiento, todas las otras condiciones adversas analizadas tuvieron mayor prevalencia entre los niños de familias menos favorecidas. La documentación cuidadosa de los múltiples niveles de determinantes de las inequidades socioeconómicas en salud infantil es esencial para el entendimiento de la naturaleza del problema, y para el establecimiento de intervenciones que puedan reducir estas diferencias.OBJETIVO: Descrever o efeito das iniqüidades sociais sobre a nutrição e saúde de crianças de países de renda baixa e média. MÉTODOS: Foram revisadas informações disponíveis sobre disparidades socioeconômicas intra-países, relativas a uso de serviços de saúde, estado nutricional, morbidade e mortalidade. Adotou-se um modelo conceitual com cinco categorias hierárquicas na produção de iniqüidades: contexto e posição socioeconômica, diferenças na exposição, na vulnerabilidade, nos desfechos de saúde e nas conseqüências. Em pesquisa realizada na base PubMed, no período de 1990-2007 foram encontrados 244 artigos relacionados ao tema. Foram também analisados os resultados de cerca de 100 inquéritos de âmbito nacional recentes, incluindo Pesquisas Nacionais de Demografia e Saúde e Inquéritos por Conglomerados de Múltiplos Indicadores, do Fundo das Nações Unidas para a Infância. RESULTADOS: Crianças de famílias pobres, em comparação com aquelas de famílias mais ricas, são mais suscetíveis à exposição a agentes patogênicos; uma vez expostas, têm um risco aumentado de adoecer, devido à sua menor resistência e menor cobertura de medidas preventivas. Uma vez que se tornam doentes, têm menor acesso a serviços de saúde, a qualidade dos serviços que logram utilizar tende a ser inferior, com menor acesso a tratamentos médicos que garantam sua sobrevivência. Como conseqüência, crianças de famílias mais pobres apresentam maiores taxas de mortalidade e maior risco de serem subnutridas. CONCLUSÕES: Exceto obesidade infantil e práticas inadequadas de aleitamento materno, todas as outras condições adversas analisadas tiveram maior prevalência entre as crianças de famílias menos favorecidas. A documentação cuidadosa dos múltiplos níveis de determinantes das iniqüidades socioeconômicas em saúde infantil é essencial para o entendimento da natureza do problema, e para o estabelecimento de intervenções que possam reduzir estas diferenças

Gravidezes subseqüentes: quem as tem e quem as quer? Observações em um centro urbano da região Sul do Brasil

Em um estudo de coorte de base populacional, foram estudados todos os 6.011 nascimentos hospitalares ocorridos na cidade de Pelotas, RS, em 1982. As parturientes foram entrevistadas logo após o parto, e 80% delas foram novamente contactadas em suas residências no início de 1986, em média 43 meses mais tarde. Dessas mulheres, 39% haviam engravidado novamente. Esta proporção variou inversamente em relação à idade materna, anos de escolaridade e renda familiar. Quanto à paridade, a proporção de gravidezes subsqüentes foi maior para primíparas e para multíparas. Mães cujos filhos nasceram através de cesareana também apresentaram menor fecundidade, mesmo após exclusão daquelas que, por ocasião da operação cesárea, sofreram ligadura de trompas. Análise através de regressão logística mostrou que esses fatores permaneceram significativamente associados à fecundidade mesmo após o ajuste estatístico para as demais variáveis. Das mães que engravidaram após 1982, 60% informaram que não a desejaram. A proporção das gravidezes indesejadas foi mais elevada em mulheres de maior paridade, sendo esta tendência mais marcada em mulheres de famílias de alta renda.Subsequent pregnancies in mothers of a birth cohort from Pelotas, Southern Brazil, were studied in relation to maternal and socio-economic factors. Within about 3 1/2 years of the cohort child's birth, 39% of mothers had experienced at least one further pregnancy. This proportion decreased with increasing maternal age, years of schooling and family income. A U-shaped trend was observed with respect to parity. Mothers who had delivered the cohort child by caesarean section were also less likely to have another pregnancy within that time. Logistic regression analysis showed that each of these factors remained significantly associated with further pregnancies after controlling for the remaining variables. Analysis of the first subsequent pregnancy showed that a high proportion of mothers had not wanted the pregnancy. Unwanted pregnancies were also significantly associated with older women, low educational status, higher parity and low family income

Could we find any signal of the stratosphere-ionosphere coupling in Antarctica?

An investigation searching for a possible coupling between the lower ionosphere and the middle atmosphere in Antarctica is here performed on the basis of stratospheric vertical temperature profiles and ionospheric absorption data observed at the Antarctic Italian Base of Terra Nova Bay (74.69S, 164.12E) during local summer time. The result obtained by applying a multi-regression analysis and a Superimposed Epoch Analysis (SEA) shows a statistically significant ionosphere-stratosphere interaction. In particular, by selecting stratospheric temperature maxima occurring at different heights as the referring epoch for the SEA approach, the ionospheric absorption is found to show a positive and/or negative trend (several days) around it. The tendency for an increasing/decreasing absorption is obtained for temperature maxima occurring below/above the stratospheric level of about 17-19 km, respectively

Infancy and childhood growth and physical activity in adolescence: prospective birth cohort study from Brazil.

BACKGROUND: The Developmental Origins of Health and Disease hypothesis suggests that intrauterine, infancy and early childhood variables play a key role at programming later health. However, little is known on the programming of behavioral variables, because most studies so far focused on chronic disease-related and human capital outcomes. The aim of the present study was to evaluate the effects of prenatal, infancy and childhood weight and length/height gains on objectively-measured physical activity (PA) in adolescence. METHODS: This is a prospective birth cohort study in Pelotas, Brazil, including 457 adolescents (mean age: 13.3 years) with weight and length/height data at birth, one, three and six months, one and four years of age. PA was measured using a GT1M Actigraph accelerometer, and expressed as (a) minutes per day spent on sedentary, light, moderate, vigorous and very-vigorous activities; (b) total counts per day. RESULTS: 61.3% of the adolescents accumulated 60+ minutes of moderate-to-vigorous PA per day. Weight and length/height trajectories in infancy and childhood were similar between those classified as active or inactive at 13.3 years. However, those classified as inactive were heavier and taller at all ages; differences were statistically significant only in terms of length at three, six and 12 months. CONCLUSIONS: Weight gain in infancy and childhood did not predict variability in adolescent PA, but those active in adolescence showed somewhat smaller average gains in length in infancy. These findings suggest that PA may partially be sensitive to early hormonal programming, or that genetic factors may affect both early growth and later metabolism or predisposition for PA.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Determining factors related to smoking and its abandonment during pregnancy in an urban locality in Southern Brazil

A cross-sectional study of 873 pregnant women attending a prenatal care clinic was undertaken in Pelotas (Southern Brazil), over a one-year period (1989-90) for the purpose of identifying possible risk and prognostic factors for smoking during pregnancy. The prevalence of smoking at the beginning of pregnancy was 40.8%. The smoking habits of the woman's mother and partner, as well as her educational level, were associated with smoking at the beginning of pregnancy. Smoking in the partner was associated with an approximately two-fold increase in the risk of smoking. The smoking interruption rate, until the 15th-22nd gestational week, was of 35.6%. Family income, smoking habits of woman's mother and partner, age at starting, duration and intensity of the woman's habit were all associated with the interruption during pregnancy. The above results were not affected by adjustment for confounding variables made through stratified analysis.Foi realizado um estudo transversal, com 873 gestantes que freqüentaram o pré-natal em Pelotas (RS), em 1989-90, com o objetivo de investigar possíveis fatores de risco e fatores prognósticos para o tabagismo durante a gravidez. A prevalência no início da gravidez foi de 40,8%. O hábito de fumar da mãe da gestante e do marido e a baixa escolaridade da mulher estiveram associados com o risco de fumar no início da gravidez. O tabagismo do marido esteve associado com um aumento de cerca de duas vezes nesse risco. A taxa de abandono até a 15ª-22ª semana gestacional foi de 35,6%. A renda familiar, o hábito de fumar da mãe da gestante e do companheiro, a idade de início, duração e intensidade do hábito da mulher estiveram associados com a interrupção durante a gravidez. Os resultados acima permaneceram após ajuste para fatores de confusão, através de análise estratificada