Quality of life among parents of preterm infants: a scoping review

Purpose: To synthesize the body of knowledge on the factors influencing the QoL of mothers and fathers of preterm infants. Methods: A scoping review was performed. Publications indexed in PubMed®, Web of Science™, CINAHL® and PsycINFO® were searched, targeting studies presenting original empirical data that examined parental perception on QoL after a preterm delivery. Eligibility and data extraction were conducted by two independent researchers. The main quantitative findings were synthesized and qualitative data were explored by content analysis. Results: The studies, 11 quantitative and 1 mixed methods, were derived mainly from the USA (n = 6). Heterogeneity across the studies was observed regarding the operationalization of QoL and the use of units of analysis (mothers, parents, families and caregivers). In a context where 40 out of 45 covariates were analysed by only one or two studies, results suggested that parental QoL after a preterm delivery is influenced by factors related with mother’s characteristics, family issues and health care environment rather than infants’ variables. Factors regarding fathers’ characteristics and structural levels were not addressed. Conclusions: Standardizing the operationalization of the QoL when analysing mothers and fathers of preterm infants calls for a structured questionnaire adapted to their specific needs. Further research should include both mothers and fathers, invest in mixed methods approaches and be performed in different countries and settings for allowing integration and comparison of findings.This work was supported by FEDER funding from the Operational Programme Factors of Competitiveness—COMPETE and by national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) under the project “Parenting roles and knowledge in Neonatal Intensive Care Units” (FCOMP-01-0124-FEDER-019902; Ref. FCT PTDC/CS-ECS/120750/2010) and the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013); the grants PD/BD/105830/2014 (to MA), SFRH/BPD/103562/2014 (to EA), co-funded by the FCT and the POPH/FSE Program and the FCT Investigator contract IF/01674/2015 (to SS)

Tempo de clampeamento e fatores associados à reserva de ferro de neonatos a termo

OBJETIVO : Analisar o impacto do tempo de clampeamento e parâmetros obstétricos, biológicos e socioeconômicos sobre a reserva de ferro de neonatos nascidos a termo. MÉTODOS : Estudo transversal pelo qual foram avaliados os parâmetros hematológicos de neonatos de Viçosa, MG, de outubro de 2011 a julho de 2012. Foram coletados 7 mL de sangue do cordão umbilical de 144 neonatos a termo e sem baixo peso. Os parâmetros investigados foram: hemograma completo, ferro sérico, ferritina e proteína C-reativa. O tempo de clampeamento do cordão umbilical foi mensurado utilizando cronômetro digital sem interferir nos procedimentos do parto. Os dados de nascimento foram coletados nas Declarações de Nascidos Vivos e as demais informações foram obtidas com a mãe do neonato por aplicação de questionário no primeiro mês pós-parto. Realizou-se análise de regressão linear múltipla visando a estimar a influência de variáveis obstétricas, biológicas e socioeconômicas nos níveis de ferritina ao nascer. RESULTADOS : A mediana de ferritina foi 130,3 µg/L (n = 129, mínimo de 16,4 e máximo 420,5 µg/L), a média de ferro sérico foi 137,9 μg/dL (n = 144, dp = 39,29) e de hemoglobina, 14,7 g/dL (n = 144, dp = 1,47). O tempo mediano de clampeamento do cordão foi 36 segundos, variando entre sete e 100. A análise bivariada detectou associação entre os níveis de ferritina e a cor da criança, tempo de clampeamento de 60 segundos, tipo de parto, a presença de diabetes gestacional e a renda per capita da família. Renda per capita, número de consultas pré-natais e o comprimento ao nascer contribuíram com 22,0% da variação dos níveis de ferritina na análise múltipla. CONCLUSÕES : A reserva de ferro ao nascer sofreu influência de características biológicas, obstétricas e sociais. O combate à anemia deve envolver a implementação de um critério de clampeamento tardio do cordão umbilical para as diretrizes de trabalho de parto, bem como a criação de políticas voltadas para a redução das desigualdades sociais e melhoria da qualidade do atendimento pré-natal

PROPORTION WITH CHILDREN UNDER 2 YEARS IN BRAZIL WHO HAD AN AVOIDABLE HOSPITALISATION, 2006

Universidade Federal de São Paulo, São Paulo, BrazilLondon Sch Hyg & Trop Med, London WC1, EnglandUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Prevalence And Factors Associated With Overweight Among Brazilian Children Younger Than 2 Years [prevalência E Fatores Associados Ao Excesso De Peso Em Crianças Brasileiras Menores De 2 Anos]

Objective: To describe the prevalence of overweight, analyze its progression from 1989 to 2006 and identify factors associated with it among children younger than two years in Brazil. Methods: Data for the Women and Children National Demography and Health Survey (PNDS 2006) were collected using questionnaires and anthropometric measurements. The study sample included 1,735 children aged 0 to 24 months (910 boys; 825 girls). Nutritional status was defined according to the weight-for-height index (W/H; WHO, 2006), and children were classified as overweight if their W/H z score was greater than +2. Results: Prevalence of overweight in Brazil was 6.54%. The highest prevalence of overweight was found in the southern (10.0%) and midwestern (11.1%) regions, among families with a per capita income higher than one minimum wage (11.8%), in social classes with a greater purchasing power (9.7%), among children whose birth weight was greater than 3 kg (8.04%) and whose exclusive breastfeeding lasted less than five months (7.4%). According to a fitted multiple logistic regression model, factors associated with overweight were: birth weight ≥ 3 kg [odds ratio (OR) = 5.2, 95% confidence interval (95%CI) 2.56-10.56], per capita income ≥ 1 minimum wage (OR = 2.50, 95%CI 1.20-5.21), residence in midwestern region (OR = 2.40, 95%CI 1.01-5.72). Conclusions: The comparison of the prevalence found in the 2006 survey with the 1989 and 1996 values revealed that overweight among children younger than two years tends to decrease. The risk factors identified suggest that further actions should be conducted to prevent obesity among infants living in the midwestern region of Brazil, whose birth weight was greater than 3 kg and whose families had a per capita income higher than one minimum wage. Copyright © 2012 by Sociedade Brasileira de Pediatria.886503508Waterland, R.A., Michels, K.B., Epigenetic epidemiology of the developmental origins hypothesis (2007) Annu Rev Nutr, 27, pp. 363-388Freedman, D.S., Katzmarzyk, P.T., Dietz, W.H., Srinivasan, S.R., Berenson, G.S., Relation of body mass index and skinfold thicknesses to cardiovascular disease risk factors in children: The Bogalusa Heart Study (2009) Am J Clin Nutr, 90, pp. 210-216Baker, J.L., Olsen, L.W., Sørensen, T.I., Childhood body-mass index and the risk of coronary heart disease in adulthood (2007) N Engl J Med, 357, pp. 2329-2337Freedman, D.S., Mei, Z., Srinivasan, S.R., Berenson, G.S., Dietz, W.H., Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study (2007) J Pediatr, 150, pp. 12-17Biro, F.M., Wien, M., Childhood obesity and adult morbidities (2010) Am J Clin Nutr, 91, pp. 1499S-505SDe Onis, M., Blössner, M., The World Health Organization Global Database on Child Growth and Malnutrition: Methodology and applications (2003) Int J Epidemiol, 32, pp. 518-526Habicht, J.P., Martorell, R., Yarbrough, C., Malina, R.M., Klein, R.E., Height and weight standards for preschool children. How relevant are ethnic differences in growth potential? (1974) Lancet, 1, pp. 611-614Barros, F.C., Victora, C.G., Scherpbier, R., Gwatkin, D., Socioeconomic inequities in the health and nutrition of children in low/middle income countries (2010) Rev Saude Publica, 44, pp. 1-16Secretaria de Políticas de Saúde. Departamento de Atenção Básica (2002) Saúde da Criança: Acompanhamento Do Crescimento e Desenvolvimento Infantil, p. 100. , Brasil. Ministério da Saúde. Brasília: Ministério da Saúde(Série Cadernos de Atenção Básican. 11)Instituto Brasileiro de Geografia e Estatística (IBGE) (1974) Estudo Nacional de Despesa Familiar (ENDEF), , Rio de Janeiro: IBGE;Pesquisa Nacional sobre Saúde e Nutrição (1989) Perfil de Crescimento da População Brasileira de 0 A 25 Anos - PNSN, , Instituto Nacional de Alimentação e Nutrição (INAN). Brasília: INAN(1996) Sociedade Civil Bem-Estar Familiar No Brasil, , Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa Nacional sobre Demografia e Saúde (PNDS), 1996. Rio de Janeiro: IBGETaddei, J.A., Colugnati, F.B., Rodrigues, E.M., Sigulem, D.M., Lopez, F.A., (2002) Desvios Nutricionais em Menores de 5 Anos, p. 64. , São Paulo: Universidade Federal de São Paulo (Unifesp)Departamento de Ciência e Tecnologia. Centro Brasileiro de Análise e Planejamento (CEBRAP) (2008) Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher - PNDS 2006, p. 307. , Brasil. Ministério da Saúde. Brasília: Ministério da SaúdeMonteiro, C.A., Conde, W.L., Konno, S.C., Lima, A.L., Silva, A.C., Benicio, M.H., Avaliação antropométrica do estado nutricional de mulheres em idade fértil e crianças menores de 5 anos (2009) Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher - PNDS 2006: Dimensões Do Processo Reprodutivo e da Saúde da Criança, pp. 213-230. , In: Brasil. Ministério da Saúde. Departamento de Ciência e Tecnologia. Centro Brasileiro de Análise e Planejamento (CEBRAP). Brasília: Ministério da SaúdeVictora, C.G., Nutrition in early life: A global priority (2009) Lancet, 374, pp. 1123-1125Johnson, T.P., Wislar, J.S., Response rates and nonresponse errors in surveys (2012) JAMA, 307, pp. 1805-1806Departamento de Ciência e Tecnologia. Centro Brasileiro de Análise e Planejamento (CEBRAP) (2010) Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher - PNDS 2006, , http://bvsms.saude.gov.br/bvs/pnds, Brasil. Ministério da Saúde. Acesso: 11/11(1995) Physical Status: The Use and Interpretation of Anthropometry, , World Health Organization (WHO). Geneva: World Health Organization(2006) WHO Child Growth Standards: Length/height-for-age, Weight-for-age, Weight-forlength, Weight-for-height and Body Mass Index-for-age: Methods and Development, , WHO Multicentre Growth Reference Study Group. Geneva: World Health OrganizationKepple, A.W., Segall-Corrêa, A.M., Conceptualizing and measuring food and nutrition security (2011) Cien Saude Colet, 16, pp. 187-199Critério de classificação econômica do Brasil 2009 (2011) Dados Com Base No Levantamento Sócio-econômico 2006 e 2007 - IBOPe, , www.abep.org, Associação Brasileira de Empresas de Pesquisa. Acesso: 10/10Batista Filho, M., Rissin, A., Nutritional transition in Brazil: Geographic and temporal trends (2003) Cad Saude Publica, 19, pp. S181-S191Kain, J., Vio, F., Albala, C., Obesity trends and determinant factors in Latin America (2003) Cad Saude Publica, 19, pp. S77-86Balaban, G., Silva, G.A., Efeito protetor do aleitamento materno contra a obesidade infantil (2004) J Pediatr (Rio J), 80, pp. 7-16Wang, Y., Monteiro, C., Popkin, B.M., Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia (2002) Am J Clin Nutr, 75, pp. 971-977Rossi, C.E., Albernaz, D.O., Vasconcelos, F.A., Assis, M.A., Pietro, P.F., Television influence on food intake and obesity in children and adolescents: A systematic review (2010) Rev Nutr, 23, pp. 607-620Ogden, C.L., Flegal, K.M., Carroll, M.D., Johnson, C.L., Prevalence and trends in overweight among US children and adolescents, 1999-2000 (2002) JAMA, 288, pp. 1728-1732Menezes, R.C., Lira, P.I., Oliveira, J.S., Leal, V.S., Santana, S.C., Andrade, S.L., Prevalence and determinants of overweight in preschool children (2011) J Pediatr (Rio J), 87, pp. 231-237Martins, E.B., Carvalho, M.S., Birth weight and overweight in childhood: A systematic review (2006) Cad Saude Publica, 22, pp. 2281-2300Rossi, C.E., Vasconcelos, F.A., Birth weight and obesity in children and adolescents: A systematic review (2010) Rev Bras Epidemiol, 13, pp. 246-25

Effects of a very low birth weight newborn on family: literature review Efectos del peso extremadamente bajo al nacimiento sobre la familia: revisión bibliográfica

Objective: The present study is a literature review to identify the effects of a very low birth weight newborn on family. This is an important instrument to clarify epidemiological issues and to suggest the directions for health policy efforts. Method: A three-step review was carried out using databases of journals indexed for Medline/Lilacs/Scielo/Cochrane published between 1966 and 2005 using specific criteria of inclusion. The first step selected 12 articles from 2,889 when searching for the keyword "very low birth weight infant"; the second step used the crossing of keyword "premature infant" with other pertinent keywords and terms resulting in 191 articles generating 7 more articles matching the criteria of inclusion. The third step was to analyze the references of articles in steps 1 and 2 (12 + 7 = 19), selecting 3 additional ones totalizing 22 selected articles. Result: Evidences in literature state that the families of very low birth weight newborns suffer potential negative effects on their operational dynamics, which is associated to the clinical seriousness, the age and the neuropsycomotor development of such children. It seems that the mother is the most affected member due to the situation imposed to the family, and the one who needs psychosocial support more frequently. Conclusion: The number of existing studies is still insufficient to clarify whether the effects on the family considering all their aspects are preponderantly positive or negative.Objetivo: este estudio es una revisión bibliográfica para intentar identificar los efectos que el recién nacido de peso muy bajo tiene en una familia. Este es un instrumento importante para aclarar los aspectos epidemiológicos y sugerir las directrices en los esfuerzos de políticas sanitaria. Método: se realizó una revisión en tres pasos empleando las bases de datos de las revistas indexadas en Medline/Lilacs/Scielo/Cochrane con fecha de publicación entre 1966 y 2005, utilizando criterios de inclusión específicos. El primer paso seleccionó 12 artículos de 2.899 cuando se buscó el término clave "very low birth weight infant"; el segundo paso utilizó la combinación de las palabras clave "premature infant" con otros términos clave pertinentes, lo que produjo 191 artículos que, a su vez, originaron 7 artículos más que cumplían los criterios de inclusión. El tercer paso consistió en analizar las citas de los artículos en los pasos 1 y 2 (12 + 7 = 19), seleccionando otros 3 más, con un total de 22 artículos seleccionados. Resultado: las evidencias bibliográficas afirman que las familias con recién nacidos de peso muy bajo al nacimiento sufren efectos potencialmente negativos en su dinámica operativa, lo que se asocia con la gravedad clínica, la edad y el desarrollo neuropsicomotor de tales niños. La madre parece ser el miembro más afectado dada la situación impuesta a la familia, y también aquel que requiere apoyo psicosocial con mayor frecuencia. Conclusión: el número de estudios exigentes sigue siendo insuficiente para aclarar si los efectos sobre la familia, considerando todos sus aspectos, son predominantemente positivos o negativos