The Influence of Human-Milk Substitutes Marketing on Breastfeeding Intention and Practice among Native and Immigrant Brazilians

Background: The International Code of Marketing of Breast-Milk Substitutes is a global public health policy aiming to protect breastfeeding from the influence of human-milk substitutes marketing. Brazil is one of the few countries substantially implementing it. Most countries adopted selected provisions, including Portugal. Research Aim: To explore whether Brazilians’ perspectives about breastfeeding intention and practice are influenced by human-milk substitutes marketing upon migration to Portugal. Methods: A qualitative, prospective, cross-sectional survey design was conducted in Brazil and Portugal (2018–2019). Qualitative semi-structured interviews were performed with native (n = 16) and immigrant (n = 15) Brazilians. Women aged 18 or above, mothers of 0–12 month infants, and without contraindications to breastfeed, were eligible for the study. Heterogeneity sampling was employed based on socioeconomic status and infants’ age. Content analysis was conducted using NVivo. Results: Brazilian immigrants were more aware of the potential negative influence of human-milk substitutes marketing than natives. Sociocultural factors contributed to Brazilian immigrants being less permeable to the influence of human-milk substitutes marketing in the host country, where a less protective breastfeeding environment was perceived. Conclusions: Sociocultural factors including breastfeeding promotion strategies and a strong breastfeeding culture in the home country appear to play a protective role on breastfeeding intention and practice among Brazilians migrating to Portugal. © The Author(s) 2022.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is funded by FEDER funds through the Operational Programme for Competitiveness and Internationalization, and by national funding through the Foundation for Science and Technology (FCT; Portuguese Ministry of Science, Technology and Higher Education), under the scope of the project ‘‘Perinatal Health in Migrants: Barriers, Incentives and Outcomes’’ (POCI-01-0145-FEDER-016874; PTDC/DTPSAP/6384/2014), the projects UIDB/04750/2020 e LA/P/0064/2020, the PhD grant PD/BD/128082/2016 (C. L.) co-funded by the FCT and Human Potential Operating Program of the European Social Fund (POPH/FSE Program) and the contract DL57/2016/CP1336/CT0001 (C.F.). A. M. has a research scholarship from the Brazilian National Council for Scientific and Technological Development (CNPq)

Echocardiographic Findings and Their Impact on Outcomes of Critically Ill Patients with AIDS in the Era of HAART

Objective. To describe the echocardiographic findings in critically ill patients with AIDS and their impact on clinical outcome. Design. A retrospective chart review of consecutive AIDS patients over 18 years of age, who had a trans-thoracic echocardiogram performed during the course of intensive care unit stay over the course of 2 years at a tertiary care hospital. Main outcome measures. The prevalence of echocardiogram abnormalities in this population and its impact on ICU mortality, ICU length of stay, hospital mortality, hospital length of stay and 60 day survival. Results. Among 107 patients who met the inclusion criteria, an admission echocardiogram was performed in 62 (58%). The prevalence of cardiac abnormalities was 60%. The most common admission diagnosis was respiratory failure n = 27 (43%). The most common finding on echocardiogram was left ventricular (LV) dysfunction n = 31 (50%) followed by pulmonary hypertension n = 25 (40%). None of these findings had a significant impact on clinical outcomes. There was trend toward reduced 60 day survival among patients with depressed LV function. Conclusions. Although echocardiogram abnormalities were prevalent among this population none of these findings had a significant impact on ICU mortality or hospital mortality and ICU length of stay or hospital length of stay

Maternity “blues”: prevalence and risk factors

Objectives: estimate the prevalence and track the risk factors associated with, Maternity blues (MB). Methods: a transversal study was performed with 113 women, on the tenth day of puerperium. The following instruments were used: Pitt Scale (1968), Stein (1980), Inventory for stressful life events by Holmes & Rahe (1967), and a questionnaire with sociodemographic and obstetric data. Results: the prevalence of MB was 32.7% according to the Stein scale. In the univariated analysis, civil status and tobacco use were associated with MB. Legally married women and nonsmokers showed a risk approximately 4 times lower of experiencing the problem. Conclusions: MB was very prevalent in this sample. Obstetricians must be aware of this condition which may be associated with postpartum depression.Objetivos: estimar la prevalencia y rastrear los factores de riesgo asociados con la tristeza postparto (TP). Método: se realizó un estudio transversal con 113 mujeres, en el décimo día del puerperio. Se utilizaron los siguientes instrumentos: Pitt Scale (1968), Stein (1980), Inventory for Stressful Life Events de Holmes & Rahe (1967) y un cuestionario de datos sociodemográficos y obstétricos. Resultados: la prevalencia de la TP fue de un 32.7% de acuerdo con la escala Stein. En el análisis univariado, el estado civil y el consumo de tabaco se asociaron a la TP. Las mujeres casadas y las no fumadoras mostraron un riesgo aproximadamente 4 veces más bajo de sufrir el problema. Conclusiones: se encontró una alta prevalencia de la TP en la muestra. Los obstetras deberían estar alerta ante este estado, que puede asociarse con la depresión postparto

Maternal depression and offspring mental health at age 5: MINA-Brazil cohort study

OBJECTIVE: To identify longitudinal patterns of maternal depression between three months and five years after child’s birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. METHODS: We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6–8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. RESULTS: We identified four trajectories of maternal depressive symptoms: “low” (67.1%), “increasing” (11.5%), “decreasing” (17.4%), and “high-chronic” (4.0%). Women in the “high/ chronic” trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00–5.22) and 2.87 (95%CI: 1.09–7.57) times higher among children of mothers belonging to the “increasing” and “high-chronic” trajectory groups, respectively, compared with those of mothers in the “low” depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. CONCLUSIONS: We identified poorer mental health outcomes for children of mothers assigned to the “chronic/severe” and “increasing” depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups

A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes

Background: To study maternal anxiety and perinatal outcomes in pregnant women submitted to a Multidisciplinary Program for Childbirth and Motherhood Preparation (MPCM).Methods: This is a not randomized controlled trial on 67 nulliparous pregnant women divided into two groups according to participation (MPCM Group; n = 38) or not (Control Group; n = 29) in MPCM. the program consisted of 10 meetings (between the 18th and the 38th gestational week) during which educational, physiotherapeutic and interaction activities were developed. Anxiety was quantified at the beginning and at the end of the gestational period by the Trace-State Anxiety Inventory (STAI).Results: Initial maternal anxiety was equivalent between the groups. At the end of the gestational period, it was observed that anxiety levels increased in the Control Group and were maintained in the MPCM Group. A higher occurrence of vaginal deliveries (83.8%) and hospital discharge of three-day-older newborns (81.6%) as a result of MPCM was also significant. Levels of state-anxiety at the end of pregnancy showed a negative correlation with vaginal delivery, gestational age, birth weight and Apgar index at the first minute and positive correlation with the hospital period remaining of the newborns.Conclusion: in the study conditions, MPCM was associated with lower levels of maternal anxiety, a larger number of vaginal deliveries and shorter hospitalization time of newborns. It was not related to adverse perinatal outcomes.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ Estadual Paulista, Botucatu Sch Med, Dept Neurol Psychol & Psychiat, Botucatu, SP, BrazilUniv Estadual Paulista, Botucatu Sch Med, Dept Gynecol & Obstet, Botucatu, SP, BrazilUniv Sagrado Coracao, Dept Hlth Sci, Physiotherapy Sch, Bauru, BrazilSão Paulo Fed Univ Unifesp, Dept Hlth Sci, Phys Therapy Program, Santos, BrazilSão Paulo Fed Univ Unifesp, Dept Hlth Sci, Phys Therapy Program, Santos, BrazilWeb of Scienc