Inequalities in birth weight and maternal education : a time-series study from 1996 to 2013 in Brazil

Maternal education represents one of the most important social determinants of inequality in birth weight (BW) in developing countries. The present study sought to investigate secular trends in health inequality considering the diference in mean BW between extremes of maternal educational attainment in Brazil. Using a time-series design, data from 6,452,551 live births which occurred in all Brazilian state capitals from 1996 to 2013 were obtained from the Information System on Live Births. Secular trends of the diference in mean birth weight between low (<8 years of schooling) and high (≥12 years of schooling) educational attainment were analyzed. The main fnding was that diferences in mean birth weight between the two extremes of maternal educational attainment decreased over time. There was a signifcant decrease in mean BW in neonates born to mothers with higher educational attainment, and a slight increase in those born to mothers with lower educational attainment. One of the key factors involved in decreasing inequality was an increase in the number of antenatal visits. In view of these results, we conclude, that despite a slight increase of mean birth weight among mothers with low education, the reduction of inequality in pregnancy outcomes over time in Brazil is attributable to a worsening scenario for mothers who are better of rather than to improvements for the most vulnerable group of mothers

Prevalence of congenital anomaly and its relationship with maternal education and age according to local development in the extreme south of Brazil

Congenital anomalies (CA) contribute to disabilities and health conditions throughout life. Furthermore, they can cause emotional distress to the mothers and children, who may also experience limitations in individual and social development. This study investigated the prevalence of CA and the relationship with maternal education and age according to local development in the extreme south of Brazil. This is a retrospective observational study with birth data from the Live Birth Information System from 2000 to 2017. The association between age and maternal education with the presence of CA was verified using multiple Poisson regression for robust variances in models adjusted for those variables with a preliminary significant association. A total of 5131 (1.5%) had some CA identified at birth between 2000 and 2017. Only advanced age (≥36 years) was associated with CA regardless of macro-region development (p ≤ 0.001). The highest risk was observed in regions with medium development (RR = 1.60; 95% CI 1.30–1.97). Maternal education (<8 years of study) was associated with CA only in mothers from macro-regions with very high development (RR = 1.27; 95% CI 1.03–1.54). These analyses confirmed that women of advanced age are at greater risk of having children with a CA regardless of maternal education and local development, but social characteristics can also have an influence, as regions with higher development had lower prevalence of CA

Phonetic transcription of spontaneous children's speech with the aid of software : a systematic review

O objetivo do estudo foi identificar, sintetizar e classificar os softwares atualmente disponíveis que podem auxiliar na tarefa de transcrição fonética da fala espontânea de pré-escolares, para avaliar o desenvolvimento da linguagem infantil. Foi realizada uma revisão sistemática de artigos publicados, no período de 10 anos (de junho de 2010 a junho de 2020), sem restrições quanto à localização e idioma, utilizando as bases de dados Cochrane, Pubmed e Web of Science. Os termos utilizados nas estratégias de busca foram "fonológico", "fonético", "transcrição", "computador" e "software". Os estudos foram selecionados por dois revisores independentes usando estratégias de busca pré-definidas. Na busca inicial, após a exclusão de duplicatas, foram encontrados 534 artigos. Com a leitura de seus títulos e resumos, restaram 46 artigos relacionados ao tema, que foram lidos na íntegra. Após a leitura, 24 artigos foram incluídos no estudo. Os resultados revelaram um total de sete softwares disponíveis para auxiliar a transcrição fonética da fala espontânea de pré-escolares utilizados para diferentes análises: LENA e Timestamper (para balbucios e vocalizações pré-linguísticas), ELAN (para comunicação gestual, elementos extralinguísticos e contexto situacional), Phon (para análises fonéticas e fonológicas), CLAN e SALT (para aspectos morfossintáticos, gramaticais e semânticos) e Praat (para medidas acústicas). Por meio desta revisão sistemática, pode-se concluir que há vantagens no uso de software para transcrição fonética, armazenamento de amostras e análise de linguagem infantil, principalmente no que diz respeito à padronização e confiabilidade para amostras de fala espontânea. A transcrição fonética ainda depende de um transcritor humano. As ferramentas encontradas nos softwares fornecem suporte para facilitar o uso dos símbolos fonéticos, segmentação e pareamento de áudio para escrita e análises de dados de fala.The aim of the study was to identify, synthesize and classify the software currently available that can help in the task of phonetic transcription of the spontaneous speech of pre-school children to evaluate the development of children's language. A systematic review was performed for articles published, for the 10-year period (June 2010 to June 2020), without restrictions as to location and language, using the Cochrane, Pubmed and Web of Science databases. The terms used in the search strategies were "phonological", "phonetic", "transcription", "computer" and "software". The studies were selected by two independent reviewers using pre-defined search strategies. In the initial search, after the exclusion of duplicates, 534 articles were found. By reading their titles and abstracts, 46 articles related to the theme were left, which were then read in full. After reading, 24 articles were included in the study. The results revealed a total of seven software available for the phonetic transcription of spontaneous speech from preschoolers used for different analyses: LENA and Timestamper (for babbling and pre-linguistic vocalizations), ELAN (for gestural communication, extralinguistic elements and thesituational context), Phon (for phonetic and phonological analyses), CLAN and SALT (for morphosyntactic, grammatical and semantic aspects) and Praat (for acoustic measurements). Through this systematic review, it can be concluded that there are advantages to using software for phonetic transcription, sample storage, and child language analysis, especially concerning standardization and reliability for spontaneous speech samples. Phonetic transcription still relies on the ability and subjectivity of a human transcriber. The tools found in the software provide support to facilitate using phonetic symbols, audio segmentation and pairing to writing, and analysis of speech data

Does domestic violence during pregnancy influence the beginning of complementary feeding?

Background:This study investigate the influence of domestic violence against pregnant women on early complementary feeding and associated factors. Methods:A longitudinal observational study was conducted with a convenience sample recruited from threepublic hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Data on maternal age, education, marital status, breastfeeding, introduction of complementary feeding and domestic violence during pregnancy were investigatedat four follow-ups points. Data on domestic violence was collected through a self-report questionnaire based onthe Abuse Assessment Screen. The early introduction of complementary feeding, characterized as occurring beforeor at 3 months of life, was verified through a questionnaire prepared by the research group. Data analysis involvedStudent’st-test, the chi-square test and Cox regression and was carried out in Statistical Package for the SocialSciences program. The significance level was set at 5%.Results:A total of 232 mother-infant pairs participated in the analyses, and 15.1% of the mothers reported suffering some form of violence. Domestic violence was directly associated with maternal education, marital status, and healthstatus during pregnancy. Domestic violence was not associated with maternal age or breastfeeding at 3 months afterdelivery. In the univariate analysis, domestic violence during pregnancy was associated with early complementary feeding (RR = 1.74; CI: 1.01–2.98). This effect disappeared after the model was adjusted in multivariate analysis. Conclusions:There was no relationship between domestic violence during pregnancy and early complementary feeding

Maternal diet quality and associations with body composition and diet quality of preschool children : a longitudinal study

Background: Nutrition, associated with nutritional status, influences the growth of children. This study aimed to identify the association between maternal diet quality and the diet and body composition of their children. Methods: This is a prospective longitudinal study with mother-child pairs. To assess diet quality, nutritional status, and socioeconomic data, two interviews in the children's first and third months of life (2011-2016) and one interview when children were of preschool age (2017-2019) were performed. Diet quality was assessed based on daily food consumption and frequency, considering: 1) food groups, based on the Brazilian food pyramid; 2) level of processing, according to the NOVA classification (unprocessed and/or minimally processed foods, processed foods and ultra-processed foods). One-way ANOVA with Tukey post hoc and Kruskal-Wallis with Dunn's post hoc tests were used to evaluate the influence of factors on children's diet quality. Pearson and Spearman's correlations were used to evaluate the relationship between maternal and children's diet quality, maternal schooling level, and child age. Along with the nutritional assessment of children, multiple linear regression models assessed the impact of covariables on maternal and children's diet quality. Results: Eighty-three mother-child pairs participated in this study. The more frequent the maternal consumption of unprocessed and/or minimally processed foods, the higher the consumption of these foods by children (r = +0.30; p = 0.006) and the lower their subscapular skinfold (SSF) thickness (p = 0.011; β = -0.278). On the other hand, the higher the maternal consumption of ultra-processed foods, the higher the children's tricipital skinfold (TSF) thickness (p = 0.010; β = +0.274) and SSF (p = 0.043; β = +0.222). Conclusion: Maternal diet quality was associated with the diet and body composition of children

Risk factors for neonatal mortality in preterm newborns in the extreme south of Brazil

Neonatal mortality still remains a complex challenge to be addressed. In Brazil, 60% of neonatal deaths occur among preterm infants with a gestational age of 32 weeks or less (≤32w). The aim of this study was to evaluate the factors involved in the high mortality rates among newborns with a gestational age ≤32w in a socioeconomically developed southern city in Brazil. Data on retrospective births and deaths (2000–2014) were analyzed from two ofcial Brazilian national databases. The risk of neonatal death for all independent variables (mother’s age and schooling, prenatal visits, birth hospital, delivery method, gestational age, and the newborn’s sex, age, and birth year, gemelarity, congenital anomalies and birthplace) was assessed with a univariable and a multivariable model of Cox’s semiparametric proportional hazards regression (p<0.05). Data of 288,904 newborns were included, being 4,514 with a gestational age ≤32w. The proportion of these early newborns remained stable among all births, while the neonatal mortality rate for this group tended to decrease (p<0.001). The adjusted risk was signifcantly for lower birthweight infants (mean 659.13g) born from Caesarean (HR 0.58 [95% CI 0.47–0.71]), but it was signifcantly higher for heavier birth weight infants (mean 2,087.79) also born via Caesarean section (HR 3.71 [95% CI 1.5–9.15]). Newborns with lower weight seemed to beneft most from Cesarean deliveries. Efort towards reducing unacceptably high surgical deliveries must take into account cases that the operations may be lifesaving for mother and/or the baby

The relationship between the different low birth weight strata of newborns with infant mortality and the influence of the main death determinants in the extreme south of Brazil

Background: Low birth weight (LBW) newborns present different health outcomes when classified in different birth weight strata. This study evaluated the relationship of birth weight with Infant mortality (IM) through the influence of biological, social, and health care factors in a time series. Methods: Retrospective cohort study with data collected from Information Systems (Live Births and Mortality). The mortality trends were performed for each birth weight stratum: extremely low, 4000 g. Chi-square tests analyzed IM rates. Sequential Poisson regression analyzed the impact of the determinant factors. Results: A total of 277,982 newborns were included in the study and 2088 died before their first year. There was a tendency for a decrease in mortality in all strata of weight. With the exception of macrosomics, all other strata had a higher risk for IM when compared with adequate birth weight. Extremely LBW newborns presented higher risk for mortality when born in a public hospital. A higher percentage of infant deaths were associated with lower maternal age and lower schooling for all strata. Prenatal care with less than three visits demonstrated a risk for IM in low, insufficient, and adequate birth weight strata. The cesarean section was a protective factor for IM in Extremely and Very LBW strata and it was a risk factor in adequate birth weight stratum. Conclusions: LBW had a greater association with IM, especially those children of younger mothers and those born in public hospitals