Revista Paulista de Pediatria (English Edition)最新文献_第6页

Socioeconomic status indicators, physical activity, and overweight/obesity in Brazilian children 巴西儿童的社会经济地位指标、身体活动和超重/肥胖

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2015.08.018

Victor Keihan Rodrigues Matsudo , Gerson Luis de Moraes Ferrari , Timóteo Leandro Araújo , Luis Carlos Oliveira , Emily Mire , Tiago V. Barreira , Catrine Tudor-Locke , Peter Katzmarzyk

Objective

To analyze the associations between socioeconomic status (SES) indicators and physical activity and overweight/obesity in children.

Methods

485 children wore accelerometers for 7 days. Variables included time in sedentary behavior and moderate-to-vigorous physical activity (MVPA), and steps/day. Children were further categorized as meeting or not meeting guidelines of ≥60min/day MVPA and ≥12,000 steps/day. Body mass index (BMI) and body fat percentage (BF%) were measured using bioelectrical impedance. Overweight/obesity was defined as BMI >+1 SD and BF% ≥85th percentile. Parents answered questionnaires that questioned total annual household income, parental education level, parental employment status and automobile ownership.

Results

Children averaged 59.5min/day in MVPA (44.1% met MVPA guidelines), and 9639 steps/day (18.4% met steps/day guidelines). 45.4% and 33% were overweight/obese classified by BMI and BF% respectively. Higher relative total annual household income level (Odds Ratio 0.31; 95% confidence interval=0.15–0.65), and relatively higher maternal (OR=0.38; 95%CI=0.20–0.72) and paternal (OR=0.36; 95%CI=0.17–0.75) education levels were associated with lower odds of children meeting MVPA guidelines. Household automobile ownership was associated with lower odds of children meeting MVPA (OR=0.48; 95%CI=0.31–0.75) and steps/day guidelines (OR=0.44; 95%CI=0.26–0.74).

Conclusions

SES indicators were not associated with overweight/obesity, but higher SES was associated with lower odds of children meeting MVPA guidelines.

目的分析儿童社会经济地位(SES)指标与身体活动和超重/肥胖的关系。方法485例儿童佩戴加速度计7 d。变量包括久坐行为的时间、中等到剧烈的身体活动(MVPA)和每天的步数。儿童进一步被分类为符合或不符合≥60min/day MVPA和≥12,000步/day指南。采用生物电阻抗法测定体质量指数(BMI)和体脂率(BF%)。超重/肥胖定义为BMI >+1 SD和BF%≥85百分位。家长们回答了有关家庭年收入总额、父母受教育程度、父母就业状况和汽车拥有量的问卷。结果儿童MVPA平均59.5min/d(44.1%符合MVPA指南)，9639步/天(18.4%符合MVPA指南)。按BMI和BF%分类的超重/肥胖分别为45.4%和33%。较高的家庭年总收入水平(优势比0.31;95%可信区间= 0.15-0.65)，且母体相对较高(OR=0.38;95%CI= 0.20-0.72)和父系(OR=0.36;95%CI= 0.17-0.75)教育水平与儿童符合MVPA指南的几率较低相关。家庭拥有汽车与儿童达到MVPA的几率较低相关(OR=0.48;95%CI= 0.31-0.75)和每日步数指南(OR=0.44;95% ci = 0.26 - -0.74)。结论SES指标与超重/肥胖无关，但较高的SES与较低的符合MVPA指南的几率相关。

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引用次数: 10

Experiences of adolescents seropositive for HIV/AIDS: a qualitative study 艾滋病毒/艾滋病血清阳性青少年的经历:一项定性研究

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2015.08.019

Eliana Galano , Egberto Ribeiro Turato , Philippe Delmas , José Côté , Aida de Fátima Thomé Barbosa Gouvea , Regina Célia de Menezes Succi , Daisy Maria Machado

Objective

Explore the meanings attributed by young individuals about “living as an adolescent with HIV” in a group of patients that acquired the infection at birth and the elements involved with the adherence to antiretroviral treatment.

Methods

Qualitative study, involving 20 subjects (aged 13–20 years), followed at services specialized in the treatment of pediatric AIDS in São Paulo, Brazil. Semi-structured interviews were carried out of which script consisted of questions about their personal histories, experiences and difficulties they must face while living with HIV/AIDS.

Results

Being “normal” and “different” were central issues voiced by the participants. However, a normal life situation is guaranteed by being responsible with one's health, the condition that the diagnosis be kept secret and concerns about HIV transmission and dissemination to a sexual partner. The answers about treatment show that adherence is a dynamic process and involves moments of greater or lesser interest in relation to care for one's health. The adolescents have plans and projects and although HIV is considered a stressor, positive perspectives for the future prevailed.

Conclusions

To live as an adolescent with HIV involves subtle dimensions that need to be recognized and legitimized by professionals who follow the trajectory of these young individuals. It is necessary to allow a space in which the adolescents can reflect and find support regarding issues related to the construction of their sexuality and care of one's own body.

目的探讨在一组出生时感染艾滋病毒的患者中，年轻人对“青少年艾滋病毒感染者生活”的理解及其坚持抗逆转录病毒治疗的因素。方法采用定性研究方法，对巴西圣保罗圣保罗市儿童艾滋病专业治疗机构的20名受试者(年龄13-20岁)进行随访。进行了半结构化访谈，其中脚本包括他们的个人历史，经历和他们在感染艾滋病毒/艾滋病时必须面对的困难。结果“正常”和“不同”是参与者表达的中心问题。但是，通过对自己的健康负责、对诊断结果保密的条件以及对艾滋病毒传染和传播给性伴侣的担忧，可以保证正常的生活状况。关于治疗的回答表明，坚持治疗是一个动态过程，涉及到与个人健康护理或多或少相关的时刻。青少年有计划和项目，虽然艾滋病毒被认为是一个压力源，但对未来的积极看法占了上风。作为一名感染艾滋病毒的青少年，其生活涉及一些微妙的方面，这些方面需要被跟踪这些年轻人轨迹的专业人士认识到并合法化。有必要给青少年提供一个空间，使他们能够在与他们的性取向和照顾自己的身体有关的问题上进行反思和寻求支持。

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引用次数: 9

Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique 呼气流量增加技术对早产儿呼吸治疗期间脑血流量的评估

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.02.007

Mariana Almada Bassani , Jamil Pedro Siqueira Caldas , Abimael Aranha Netto , Sérgio Tadeu Martins Marba

Objective

To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns.

Methods

This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8–15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5min. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed.

Results

Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time.

Conclusions

The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.

目的探讨呼气流量增加技术呼吸治疗对早产儿脑血流动力学的影响。方法本研究是一项干预研究，纳入40例8-15天的早产儿(≤34周)，在环境空气或氧导管使用下临床稳定。排除有心脏缺陷、诊断为脑损伤和/或使用血管活性药物的儿童。经颅多普勒血流仪在呼气流量增加之前、期间和之后进行超声评估，持续5min。观察胼胝体周围动脉血流速度、阻力及脉搏指数。结果呼吸物理治疗对心脏收缩期峰值血流速度(p=0.50)、舒张末期血流速度(p=0.17)、平均血流速度(p=0.07)、阻力指数(p=0.41)和脉搏指数(p=0.67)随时间的变化无显著影响。结论呼气流量增加术对临床稳定的早产儿脑血流量无影响。

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引用次数: 3

Otitis media with effusion in children younger than 1 year 1岁以下儿童中耳炎伴积液

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.01.003

Renata Cantisani Di Francesco , Vivian Boschesi Barros , Rafael Ramos

Objective

To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors.

Methods

Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis.

Results

25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion.

Conclusions

Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

目的了解1岁以下儿童积液性中耳炎的患病率及其与季节、人工喂养、环境和围产期因素的关系。方法对184例随机纳入的982例健康婴儿进行听力筛查试验的病历进行回顾性研究。中耳炎伴积液的诊断基于耳镜检查(琥珀金色、液面、锤骨位置把手)、B型鼓室测量曲线和无耳声发射。不完整的医疗记录或评估当日或最近3个月内描述急性中耳炎、上呼吸道感染、神经病变和颅面异常的记录均被排除在外。通过似然检验和多因素分析，比较了有中耳炎伴双侧积液患儿与无中耳炎伴双侧积液患儿的胎龄、出生体重、Apgar评分、喂养方式、日托出日率等数据。9.2%为单侧。在中耳炎婴儿中，观察到以下情况:实足年龄9.6±1.7个月;胎龄38周的占43.4%，出生体重2500克的占48.4%。中耳炎伴积液与冬季/秋季、人工喂养、Apgar评分<7和日托出勤有关。多因素分析显示，人工喂养是导致中耳炎积液的最常见因素。结论1岁以下儿童中膜炎伴积液发生率约为1 / 3，主要与人工喂养有关。

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引用次数: 2

Atypical presentation of intra-abdominal extralobar pulmonary sequestration detected in prenatal care: a case report 产前护理中发现的腹内肺叶外肺隔离的不典型表现:1例报告

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.02.008

Márcio Rodrigues Costa, Théo Rodrigues Costa, Mauricio Sérgio Brasil Leite, Fernandes Rodrigues de Souza Filho, Alexandre Magno Bahia Reis, Bruno Paiva Pereira, Arthur Magalhães de Oliveira

Objective

To describe an unusual clinical presentation of intra-abdominal extralobar pulmonary sequestration in a 2-year, 9 month-old patient and assess diagnostic and treatment aspects of this pathology.

Case description

An undefined intra-abdominal mass was identified in the right adrenal region in a male fetus. Postnatal evaluation with ultrasound images, computed tomography, magnetic resonance imaging and laboratory testing was insufficient to determine the nature of the lesion. After two years, laparoscopic resection of the mass and histopathological examination of the surgical specimen allowed to establish the diagnosis of intra-abdominal extralobar pulmonary sequestration.

Comments

This malformation can be monitored clinically; however, surgical excision is often performed, probably due to the impossibility of attaining diagnosis with non-invasive methods, such as in the present case, in which the lesion appeared in an unusual position for intra-abdominal extralobar pulmonary sequestration. Therefore, the surgical approach seems to be the key to attain the diagnosis and establish the conduct for this type of congenital malformation.

目的描述一名2岁9个月大的腹内肺叶外肺隔离患者的临床表现，并评估该病理的诊断和治疗方面。病例描述:在男性胎儿的右肾上腺区发现一不明腹内肿块。产后超声图像、计算机断层扫描、磁共振成像和实验室检查不足以确定病变的性质。两年后，腹腔镜切除肿块并对手术标本进行组织病理学检查，确定了腹内肺叶外肺隔离的诊断。该畸形可在临床上监测;然而，手术切除往往是由于无法获得诊断的非侵入性方法，如在本病例中，病变出现在一个不寻常的位置，腹内肺叶外肺隔离。因此，手术入路似乎是获得诊断和建立这类先天性畸形行为的关键。

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引用次数: 6

Characterization of anthropometric assessment studies of Brazilian children attending daycare centers 巴西日托中心儿童人体测量学评估研究的特征

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.01.002

Dixis Figueroa Pedraza, Tarciana Nobre de Menezes

Objective

To obtain an overview of available information on the anthropometric assessment of Brazilian children attending daycare centers.

Data source

A literature search was carried out in the PubMed, LILACS and SciELO databases of studies published from 1990 to 2013 in Portuguese and English languages. The following search strategy was used: (nutritional status OR anthropometrics OR malnutrition OR overweight) AND daycare centers, as well as the equivalent terms in Portuguese. In the case of MEDLINE search, the descriptor Brazil was also used.

Data synthesis

It was verified that the 33 studies included in the review were comparable from a methodological point of view. The studies, in general, were characterized by their restrictive nature, geographical concentration and dispersion of results in relation to time. Considering the studies published from 2010 onwards, low prevalence of acute malnutrition and significant rates of stunting and overweight were observed.

Conclusions

Despite the limitations, considering the most recent studies that used the WHO growth curves (2006), it is suggested that the anthropometric profile of Brazilian children attending daycare centers is characterized by a nutritional transition process, with significant prevalence of overweight and short stature. We emphasize the need to develop a multicenter survey that will more accurately define the current anthropometric nutritional status of Brazilian children attending daycare centers.

目的对巴西日托中心儿童的人体测量学评估进行综述。数据来源对PubMed、LILACS和SciELO数据库中1990 - 2013年葡萄牙语和英语发表的研究进行文献检索。使用以下搜索策略:(营养状况或人体测量或营养不良或超重)和日托中心，以及葡萄牙语的等效术语。在MEDLINE搜索的情况下，还使用了描述符Brazil。经证实，从方法学的角度来看，纳入综述的33项研究具有可比性。总的来说，这些研究的特点是限制性、地理上的集中和结果在时间上的分散。考虑到2010年以来发表的研究，观察到急性营养不良的发生率较低，发育迟缓和超重的发生率很高。尽管存在局限性，但考虑到最近使用世卫组织生长曲线(2006年)的研究，我们认为，在日托中心就读的巴西儿童的人体测量特征是一个营养过渡过程，超重和身材矮小的患病率很高。我们强调需要开展一项多中心调查，以更准确地定义目前在日托中心就读的巴西儿童的人体营养状况。

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引用次数: 4

Identification of cutoff points for Homeostatic Model Assessment for Insulin Resistance index in adolescents: systematic review 确定青少年胰岛素抵抗指数的稳态模型评估的截止点:系统综述

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.01.004

Maria Izabel Siqueira de Andrade, Juliana Souza Oliveira, Vanessa Sá Leal, Niedja Maria Silva da Lima, Emília Chagas Costa, Nathalia Barbosa de Aquino, Pedro Israel Cabral de Lira

Objective

To identify cutoff points of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index established for adolescents and discuss their applicability for the diagnosis of insulin resistance in Brazilian adolescents.

Data source

A systematic review was performed in the PubMed, Lilacs and SciELO databases, using the following descriptors: “adolescents”, “insulin resistance” and “Receiver Operating Characteristics Curve”. Original articles carried out with adolescents published between 2005 and 2015 in Portuguese, English or Spanish languages, which included the statistical analysis using Receiver Operating Characteristics Curve to determine the index cutoff (HOMA-IR) were included.

Data synthesis

A total of 184 articles were identified and after the study phases were applied, seven articles were selected for the review. All selected studies established their cutoffs using a Receiver Operating Characteristics Curve, with the lowest observed cutoff of 1.65 for girls and 1.95 for boys and the highest of 3.82 for girls and 5.22 for boys. Of the studies analyzed, one proposed external validity, recommending the use of the HOMA-IR cutoff>2.5 for both genders.

Conclusions

The HOMA-IR index constitutes a reliable method for the detection of insulin resistance in adolescents, as long as it uses cutoffs that are more adequate for the reality of the study population, allowing early diagnosis of insulin resistance and enabling multidisciplinary interventions aiming at health promotion of this population.

目的确定青少年胰岛素抵抗稳态模型评估(HOMA-IR)指数的截止点，探讨其在巴西青少年胰岛素抵抗诊断中的适用性。在PubMed、Lilacs和SciELO数据库中进行系统评价，使用以下描述符:“青少年”、“胰岛素抵抗”和“受试者工作特征曲线”。纳入2005年至2015年间以葡萄牙语、英语或西班牙语发表的青少年原创文章，其中包括使用受试者工作特征曲线进行统计分析以确定指数截止点(HOMA-IR)。数据综合共识别184篇文章，在应用研究阶段后，选择7篇文章进行综述。所有选定的研究都使用接受者工作特征曲线建立了它们的截止点，最低的观察截止点为女孩1.65，男孩1.95，最高的观察截止点为女孩3.82，男孩5.22。在分析的研究中，一项研究提出了外部有效性，建议男女均使用HOMA-IR临界值2.5。结论HOMA-IR指数是一种检测青少年胰岛素抵抗的可靠方法，只要它使用的截止点更适合研究人群的实际情况，可以早期诊断胰岛素抵抗，并进行旨在促进该人群健康的多学科干预。

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引用次数: 15

Practice of martial arts and bone mineral density in adolescents of both sexes 青少年男女武术练习与骨密度的关系

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2015.09.003

Igor Hideki Ito , Alessandra Madia Mantovani , Ricardo Ribeiro Agostinete , Paulo Costa Junior , Edner Fernando Zanuto , Diego Giulliano Destro Christofaro , Luis Pedro Ribeiro , Rômulo Araújo Fernandes

Objective

The purpose of this study was to analyze the relationship between martial arts practice (judo, karate and kung-fu) and bone mineral density in adolescents.

Methods

The study was composed of 138 (48 martial arts practitioners and 90 non-practitioners) adolescents of both sexes, with an average age of 12.6 years. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry in arms, legs, spine, trunk, pelvis and total. Weekly training load and previous time of engagement in the sport modality were reported by the coach. Partial correlation tested the association between weekly training load and bone mineral density, controlled by sex, chronological age, previous practice and somatic maturation. Analysis of covariance was used to compare bone mineral density values according to control and martial arts groups, controlled by sex, chronological age, previous practice and somatic maturation. Significant relationships between bone mineral density and muscle mass were inserted into a multivariate model and the slopes of the models were compared using the Student t test (control versus martial art).

Results

Adolescents engaged in judo practice presented higher values of bone mineral density than the control individuals (p-value=0.042; Medium Effect size [Eta-squared=0.063]), while the relationship between quantity of weekly training and bone mineral density was significant among adolescents engaged in judo (arms [r=0.308] and legs [r=0.223]) and kung-fu (arms [r=0.248] and spine [r=0.228]).

Conclusions

Different modalities of martial arts are related to higher bone mineral density in different body regions among adolescents.

目的分析青少年武术练习(柔道、空手道和功夫)与骨密度的关系。方法研究对象为138名青少年，平均年龄12.6岁，其中武术练习者48名，非武术练习者90名。采用双能x线骨密度仪测量手臂、腿部、脊柱、躯干、骨盆和全身的骨密度。每周的训练负荷和以前参与运动模式的时间由教练报告。偏相关测试了每周训练负荷和骨密度之间的关系，由性别、实足年龄、以前的训练和身体成熟度控制。采用协方差分析比较对照组和武术组的骨密度值，以性别、实足年龄、既往练习和体细胞成熟度为控制因素。骨密度和肌肉质量之间的显著关系被插入到一个多变量模型中，模型的斜率使用学生t检验(对照与武术)进行比较。结果参加柔道训练的青少年骨密度高于对照组(p值=0.042;中等效应量[Eta-squared=0.063])，而在柔道(手臂[r=0.308]和腿部[r=0.223])和功夫(手臂[r=0.248]和脊柱[r=0.228])青少年中，每周训练量与骨密度的关系显著。结论不同武术形式与青少年不同身体部位较高的骨密度有关。

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引用次数: 7

Short stature in children of Karapotó ethnic background, São Sebastião, Alagoas, Brazil 身高矮小的Karapotó种族背景的儿童，<s:1> o塞巴斯蒂安<e:1>，阿拉戈斯，巴西

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.02.006

Samara Bomfim Gomes Campos , Risia Cristina Egito de Menezes , Maria Alice Araújo Oliveira , Danielle Alice Vieira da Silva , Giovana Longo-Silva , Juliana Souza Oliveira , Leiko Asakura , Emília Chagas Costa , Vanessa Sá Leal

Objective

To describe the prevalence of short stature among children of Karapotó ethnic background.

Methods

Cross-sectional, population-based study that included children between 6 and 59 months of age from the Plak-Ô native village and the Terra Nova settlement, São Sebastião, Alagoas, carried out between 2008 and 2009. Short stature was evaluated by the Height/Ageindex, using as cutoff z score≤−2. The prevalence of short stature was determined by compa-ring simple and relative frequencies. The population growth curves were compared to the WHO reference curves. Data analysis included the outcome variable: Height/Age and the predictor variables: place of residence, gender, age, anemia, birth weight, family income, maternal literacy. The chi-square test was used to compare the categorical variables, where as the chi-square test with Yates correction was used for dichotomous variables, considering as statistically significant p-values≤0.05.

Results

The prevalence of short stature was 15.6% for children from the Terra Nova settlement and 9.1% for those from Plak-Ô native village. The prevalence of short stature among the Karapotó ethnicity was 13.4%. The variables: maternal literacy, family income and low birth weight were statistically associated with short stature.

Conclusions

The observed short stature prevalence rates are significant, being characterized as a public health problem. Among the associated factors, the following are noteworthy: unfavorable conditions of maternal literacy, family income and low birth weight. The planning of strategies to reverse the situation must take such factors into consideration.

目的了解Karapotó民族背景儿童身材矮小的流行情况。方法以人口为基础的横断面研究，包括2008年至2009年在阿拉各斯州 o sebasti o村的Plak-Ô土著村庄和Terra Nova定居点进行的6至59个月大的儿童。身高用身高/年龄指数评价，截点z值≤- 2。矮小的患病率是通过比较简单频率和相对频率来确定的。将人口增长曲线与WHO参考曲线进行比较。数据分析包括结局变量:身高/年龄和预测变量:居住地、性别、年龄、贫血、出生体重、家庭收入、孕产妇文化程度。分类变量的比较采用卡方检验，二分类变量的比较采用Yates校正的卡方检验，认为p值≤0.05具有统计学意义。结果特拉诺瓦居民点儿童身材矮小率为15.6%，普拉克-Ô村儿童身材矮小率为9.1%。Karapotó人种中身材矮小的患病率为13.4%。这些变量包括:母亲文化程度、家庭收入和低出生体重在统计上与身材矮小有关。结论观察到的身材矮小患病率显著，已成为一个公共卫生问题。在相关因素中，以下是值得注意的:不利条件的母亲识字，家庭收入和低出生体重。扭转局势的战略规划必须考虑到这些因素。

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引用次数: 3

Duration of breastfeeding in preterm infants followed at a secondary referral service 在二级转诊服务跟踪早产儿母乳喂养的持续时间

Revista Paulista de Pediatria (English Edition)

Pub Date : 2016-06-01 DOI: 10.1016/j.rppede.2016.02.010

Brunnella Alcantara Chagas de Freitas , Luciana Moreira Lima , Carla Fernanda Lisboa Valente Carlos , Silvia Eloiza Priore , Sylvia do Carmo Castro Franceschini

Objective

Identify and analyze variables associated with shorter duration of breastfeeding in preterm infants.

Methods

Retrospective cohort of premature infants followed up at secondary referral service in the period of 2010–2015. Inclusion: first appointment in the first month of corrected age and have undergone three or more consultations. Exclusion: diseases that impaired oral feeding. Outcome: duration of breastfeeding. A total of 103 preterm infants were evaluated, accounting for 28.8% of the preterm infants born in the municipality in that period, with a power of study of 80%. Descriptive analysis, t-test, chi-square test, Kaplan–Meier curves and Cox regression were used. p-values <0.05 were considered significant.

Results

The median duration of breastfeeding among preterm infants was 5.0 months. The risk of breastfeeding discontinuation among preterm infants with gestational age <32 weeks was 2.6-fold higher than for those born at 32 weeks or more and the risk of breastfeeding interruption in preterm infants who were receiving breastfeeding supplementation in the first outpatient visit was 3-fold higher when compared to those who were exclusively breastfed in the first consultation.

Conclusions

The median duration of breastfeeding in preterm infants was below the recommended one and discontinuation was associated with gestational <32 weeks and the fact that the infant was no longer receiving exclusive breastfeeding in the first outpatient visit. When these two variables were associated, their negative effect on the median duration of breastfeeding was potentiated.

目的确定并分析与早产儿母乳喂养时间较短相关的变量。方法对2010-2015年在二级转诊机构随访的早产儿进行回顾性队列调查。包括:在矫正年龄的第一个月首次就诊，并进行了三次或以上的咨询。排除:损害口腔喂养的疾病。结果:母乳喂养持续时间。共评估103例早产儿，占同期全市早产儿总数的28.8%，研究权为80%。采用描述性分析、t检验、卡方检验、Kaplan-Meier曲线和Cox回归。p值<0.05被认为是显著的。结果早产儿母乳喂养时间中位数为5.0个月。胎龄32周的早产儿停止母乳喂养的风险比32周或以上出生的早产儿高2.6倍，在第一次门诊就诊时接受母乳喂养补充的早产儿母乳喂养中断的风险比第一次咨询时纯母乳喂养的早产儿高3倍。结论:早产婴儿母乳喂养的中位持续时间低于推荐时间，中止母乳喂养与妊娠32周和婴儿在第一次门诊时不再接受纯母乳喂养有关。当这两个变量相关联时，它们对母乳喂养中位数持续时间的负面影响被增强了。

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引用次数: 35