Associação da posição socioeconômica e da depressão materna com a saúde das crianças: avaliação da PNAD 2008, Brasil / Associating socioeconomic position and maternal depression with the health of children: an evaluation of the 2008 Brazilian household survey

Resumo O estudo analisou a associação entre posição socioeconômica (renda), depressão materna e saúde da criança no Brasil, utilizando informações da Pesquisa Nacional por Amostra de Domicílios 2008 (PNAD/IBGE). A análise considerou o delineamento amostral da pesquisa e incluiu 46.874 indivíduos com idade até 9 anos. Modelos Poisson foram estimados para três desfechos de saúde da criança: saúde reportada pelos pais ou responsáveis, restrição das atividades habituais por motivo de saúde e episódios de acamamento nas duas semanas anteriores à entrevista. Os resultados apontaram associação entre a depressão da mãe e os três desfechos, mesmo após o ajuste para posição socioeconômica, características maternas (saúde autorreferida, idade, escolaridade e tabagismo), idade, sexo e cor da pele da criança, além de região geográfica, situação censitária e número de moradores do domicílio. Constatou-se ainda que a associação entre depressão materna e saúde da criança independe da posição socioeconômica. Assim, políticas de saúde pública que objetivem atenuar os efeitos adversos da depressão materna sobre a saúde da criança, precisam considerar também os estratos mais elevados de renda da sociedade.

Abstract The study analyzed the association between socioeconomic position (income), maternal depression and the health of children in Brazil, using information from the 2008 National Household Survey (PNAD/IBGE). The analysis considered the sampling design for the research and included 46,874 individuals up to the age of nine. The Poisson models were estimated for three health outcomes for children: health as reported by the parents or the responsible person, restrictions on habitual activities for health reasons and periods when they were confined to bed two weeks before the interviews in the study. The results showed an association between the mothers' depression and the three health outcomes, even after taking into account the following: socioeconomic position, maternal characteristics (health self-referral, age, level of education and smoking), age, gender, the child's race, geographical region, the situation as noted in the census and the number of residents in a household. It was found that there still exists an association between maternal depression and children's health irrespective of socioeconomic position. Therefore public policies that aim to reduce the adverse effects of maternal depression on the health of children need to also take into account the higher income segments of society.

Frequent HTLV-1 infection in the offspring of Peruvian women with HTLV-1-associated myelopathy/tropical spastic paraparesis or strongyloidiasis

OBJECTIVES: To describe the frequency of HTLV-1 infection among offspring of mothers who had presented with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), strongyloidiasis, or asymptomatic HTLV-1 infection, and to identify factors associated with HTLV-1 infection. METHODS: In a descriptive study, records were reviewed of HTLV-1-positive women and their offspring who had been tested for HTLV infection at a public hospital in Lima, Peru, from 1989 to 2003. Sons and daughters of women who had presented with strongyloidiasis, HAM/TSP, or asymptomatic infection were eligible for this study. RESULTS: Three hundred seventy subjects were included: 279 were the offspring of 104 mothers presenting with HAM/TSP, 58 were the offspring of 22 mothers with strongyloidiasis, and 33 were the offspring of 26 asymptomatic mothers. Mean age of the offspring at the time of testing was 26 years (standard deviation 12). Nineteen percent of the offspring tested positive for HTLV-1: 6 percent (2/33) of those with asymptomatic mothers, 19 percent (52/279) among the offspring of mothers with HAM/TSP, and 31 percent (18/58) among the offspring of mothers presenting with strongyloidiasis On multiple logistic regression analysis, three factors were significantly associated with HTLV-1: (a) duration of breast-feeding (odds ratio [OR] = 15.1; [4.2-54.1] for 12 to 24 months versus less than 6 months breast-feeding); (b) clinical condition of the mother (OR = 8.3 [1.0-65.3] for HAM/TSP and OR = 11.5 [1.4-98.4] for strongyloidiasis in comparison with offspring of asymptomatic mothers); and (c) transfusion history (OR = 5.5 [2.0-15.2]). CONCLUSIONS: In addition to known risk factors for HTLV-1 transmission (duration of breast-feeding and history of blood transfusion), maternal HAM/TSP and strongyloidiasis were associated with seropositivity among offspring of HTLV-1-infected mothers.

OBJETIVOS: Describir la frecuencia de la infección por HTLV-1 en los hijos e hijas de madres diagnosticadas con mielopatía/paraparesia espástica tropical asociada con el HTLV-1 (M/PET-HTLV-1), estrongiloidiasis o infección asintomática por HTLV-1, e identificar los factores asociados con la infección por HTLV-1. MÉTODOS: Para este estudio descriptivo se revisaron los registros de mujeres positivas a HTLV-1 y de sus hijos evaluados con pruebas para la infección por HTLV en un hospital público de Lima, Perú, entre 1989 y 2003. Eran elegibles para este estudio los hijos y las hijas de las mujeres que se presentaron con estrongiloidiasis, M/PET-HTLV-1 o infección asintomática. RESULTADOS: En el estudio participaron 370 personas: 279 hijos de 104 madres con M/PET-HTLV-1, 58 hijos de 22 madres con estrongiloidiasis y 33 hijos de 26 madres asintomáticas. La edad promedio de los participantes en el momento de su prueba para HTLV era de 26 años (desviación estándar: 12 años). De las personas estudiadas, 19 por ciento resultaron positivas a la infección por HTLV-1: 6 por ciento (2/33) de los hijos de madres asintomáticas, 19 por ciento (52/279) de los hijos de madres con M/PET-HTLV-1 y 31 por ciento (18/58) de los hijos de madres con estrongiloidiasis. Según el análisis de regresión logística múltiple, tres factores se asociaron significativamente con la infección por HTLV-1: a) duración de la lactancia materna por 12_24 meses (razón de posibilidades [odds ratio, OR] = 15,1; intervalo de confianza de 95 por ciento [IC95 por ciento]: 4,2 a 54,1, frente a la lactancia materna por menos de 6 meses); b) que la madre presentara M/PET-HTLV-1 o estrongiloidiasis (OR = 8,3; IC95 por ciento: 1,0 a 65,3 y OR = 11,5; IC95 por ciento: 1,4 a 98,4, respectivamente, en comparación con los hijos de madres asintomáticas); y c) los antecedentes de haber recibido una transfusión sanguínea (OR = 5,5; IC95 por ciento: 2,0 a 15,2). CONCLUSIONES: Además de los factores...

Lifestyle changes in descendants of parents with diabetes type 2 / Cambio en los patrones de vida en descendientes de progenitores con diabetes mellitus tipo 2 del noreste de Mexico / Mudança em os padrões de vida em descendentes de progenitores com diabetes mellitus tipo 2 do nordeste do México

This study aimed to explore the disposition of diabetic parents' descendents in changing eating and physical activity patterns. It was based on the heritability concept and Prochaska's Transtheoretical Model. This is a descriptive-correlational study; participants included 30 parents, randomly selected, and 60 children. Results and conclusion: 68 percent of the children was classified as obese, 42 percent with insulin resistance, and 15 percent with carbohydrate intolerance. None of the risk factors was associated with the stages of change. The heritability factor was 1.37 percent; more people younger than 40 and women report decreasing in the consumption of fat food (Xi² = 6.04, p = .020; and 4.41, p = .040, respectively). These results suggest a high influence of environmental factors on the participants' unhealthy life styles.

El objetivo general del estudio fue explorar la disposición al cambio de patrones alimentarios y actividad física en descendientes de progenitores con diabetes mellitus tipo 2 (DMT2), aplicando un diseño descriptivo correlacional. La base teórica la constituyó el componente genético heredabilidad (h²) y el Modelo Transteorético de Prochaska; participaron 30 progenitores con DMT2 y 60 descendientes. Resultados y Conclusión: El 68 por ciento de los descendientes fueron obesos, 60 por ciento con riesgo de enfermedad cardiovascular, 42 por ciento con resistencia a la insulina (RI) y 15 por ciento intolerantes a la glucosa; ninguno de los factores de riesgo se asoció con las etapas de cambio. El componente genético para RI fue mínimo (h² = 1.37 por ciento). Una mayor proporción de menores de 40 años (p = .020) y de mujeres "contemplan" disminuir el consumo de grasas (p = .040). Estos resultados sugieren un mayor peso de factores del medio ambiente sobre el estilo de vida nocivo de los participantes.

O objetivo geral do estudo foi explorar à disposição à mudança dos padrões alimentares e atividade física nos descendentes de progenitores com diabetes mellitus tipo 2 (DMT2). Aplicou-se un desenho descritivo correlacionar. A base teórica constituiu-se pelo Componente Genético (h²) e o Modelo Transteorético de Prochaska. Participaram 30 progenitores com DMT2 e 60 descendentes. Resultados e Conclusões: O 68 por cento dos descendentes presentaram obesidade, 60 por cento com risco de doença cardiovascular, 42 por cento com resistência à insulina (RI) e 15 por cento intolerância à glucose; nenhum dos fatores de risco associaram-se com as etapas de mudança. O componente genético para RI foi mínimo (h² = 1.37 por cento). Uma maior proporcão dos menores de 40 anos (Xi² = 6.04, p = .020) e das mulheres (Xi² = 4.41, p=.040) contemplam diminuir o consumo de gorduras. Os resultados sugerem um maior peso dos fatores do meio ambiente sobre o estilo de vida nocivo dos participantes.

¿Cómo es la salud mental de los hijos de madres deprimidas consultantes a servicios de atención primaria? / Psychopathology and social functioning among offspring of depressed women

Background: Offspring of depressive parents have two times more risk of developing a depression, other psychiatric diseases or a poor social functioning. Aim: To assess psychopathology and social functioning among offspring of currently depressed mothers. Material and methods: We enrolled 290 depressed mother-child pairs in five primary-care clinics in Santiago. A two-stage screening process to identify female primary-care patients with current major depressive illness with children aged 6-16 years, was used. AH eligible and consenting patients were asked to complete the general health questionnaire (GHQ-12). Those scoring 5 or more were invited to participate in a baseline assessment. The final sample consisted of 290 mother-child pairs. Patients with a current DSM-IV diagnosis of major depression were eligible unless they had current psychotic symptoms, imminent suicide risk, history of mania, or current alcohol abuse. Child psychopathology was assessed with the Child Behavior Checklist (CBCL), a highly reliable and widely used parent-rated checklist to assess competencies and behavioural and emotional problems in children 4 to 18 years of age. Results: Fifty percent (95 percent confidence interval (CI): 43.9-55.7) of children had overall CBCL psychopathology scores in clinical range. Internalizing symptoms were more prevalent than externalizing symptoms (62.2 percent [9596CI: 56.3-67.8] and 35.7 percent [9596CI: 30.2-41.5]. Conclusions: A large proportion of children of depressed poor mothers attending primary care clinics in Chile, had psychopathological symptom scores in the clinical range, with a predominance of internalizing symptoms. These results are similar to those previously reported in the United States of America.

Iron status of babies born to iron-deficient anaemic mothers in an Iranian hospital

We investigated the relation between maternal anaemia and neonatal iron status in 97 mothers and their babies. Haemoglobin [Hb], serum iron, total iron binding capacity and serum ferritin were determined. Mothers were divided into 3 groups: iron-deficient anaemic [22.7%], non-anaemic iron-deficient [27.8%] and non-anaemic non-iron-deficient [49.5%]. There was no significant difference in the mean ages of the 3 groups but there were significant differences in relation to parity, Hb and serum ferritin levels. There was no significant difference in the mean value of serum iron or total iron binding capacity among the neonates of the 3 groups. Babies of iron-deficient anaemic mothers had significantly lower levels of serum ferritin [115.3 ng/mL] than nonanaemic, non-iron-deficient mothers [204.8 ng/mL] but not compared with the non-anaemic iron-deficient group. Maternal iron deficiency may affect iron status in their babies and predispose them to iron deficiency

Frecuencia de maltrato infamtil y sexual en escolares de Santiago de Chile: antecedentes familiares y consecuencias / Frequency of child maltreatment and sexual abuse in school children at Santiago, Chile: familiar antecedents and consequences

El objetivo de este estudio fue medir la prevalencia informada de maltrato en la niñez en escolares adolescentes de Santiago de Chile, así como explorar su asociación con 3 variables: ser hijos de padres separados, con tratamiento por alcoholismo o con psicopatología que motivó una hospitalización. En cuanto a las consecuencias, se exploró la relación con la frecuencia de consumo de sustancias químicas y la presencia de síntomas emocionales. La población objetivo fueron 365.425 escolares entre 10 y 19 años, pertenecientes a colegios municipalizados y particulares subvencionados. Se encuestaron 2.058 alumnos de 41 colegios. El instrumento utilizado fue la Escala de Conductas de Riesgo Adolescente (ECRA), adaptada del Minnesota Adolescent Health Survey (MAHS). La frecuencia global del antecedente de maltrato físico fue de 13.9 porciento y la de maltrato sexual de 9.3 porciento. No hubo diferencias significativas por nivel socioeconómico de la comuna. Las frecuencias fueron mayores entre hijos de padres tratados por alcoholismo, hospitalizados por un cuadro psiquiátrico o separados. Los nilos con antecedentes de maltrato físico presentan mayor frecuencia de síntomas psiquiátricos y de consultas a profesionales de la salud mental, así como de conductas de riesgo. Se revisan posibles explicaciones de estos hallazgos, así como sus implicancias preventivas