Trajectory Patterns of Weight and Length in Children: From Birth Until 2-Years of Age.

OBJECTIVE: The aim was to identify trajectory patterns of weight and length in children from birth until two years of life and establish associations with maternal and child characteristics. METHODS: A mixed-cohort study was conducted in public health services in Colombo-PR, Brazil, between 2018 and 2022. Pregnancy information was gathered through anthropometric data collection and questionnaires. Birth data were extracted from birth record forms, while weight and length data in the first two years of life were obtained from physical and electronic health service records. Weight and length trajectory patterns were identified using a group-based trajectory model. The definition of the number of trajectory patterns to be selected considered the model fit to the type of variable, its practical utility, as well as the probabilities of group membership. RESULTS: Two trajectory patterns of weight and length were identified among the children. The majority exhibited a pattern of weight (67.8%, n = 382) and length (90.9%, n = 472) considered high and stable, with a tendency to decelerate from one and a half years of age. The probability of belonging to the lower weight gain group was associated with female sex (41.5%, p < 0.001), smoking during pregnancy (48.7%, p = 0.008), prematurity (65.0%, p = 0.001), cesarean delivery (36.4%, p = 0.009), small for gestational age (69.0%, p < 0.001), and twinning (69.2%, p = 0.002). Similarly, the probability of belonging to the lower length gain group was associated with female sex (11.7%, p < 0.001), smoking during pregnancy (20.6%, p = 0.003), cesarean delivery (10.1%, p = 0.048), born small for gestational age (46.4%, p < 0.001), and twinning (46.1%, p < 0.001). CONCLUSION: Conditions during pregnancy and childbirth can impact growth patterns in the first two years of life.

Trajectory of blood pressure levels and weight gain in pregnant women: A group-based approach.

BACKGROUND AND OBJECTIVES: Morbidities associated with increased blood pressure levels during pregnancy represent one of the main causes of maternal mortality. The objective was to identify patterns of systolic blood pressure (SPB) trajectory in pregnant women undergoing prenatal care at the Unified Health System, and associations with weight gain trajectory, demographic, obstetric, anthropometric data, and health related behaviors. METHODS AND RESULTS: Cohort study with pregnant women using the public health services in Brazil. Data were collected through questionnaires and medical records. Trajectory patterns of SBP and weight gain were identified by a group-based trajectory model. For trajectory analysis, 460 women had SBP information available, totaling 2839 measurements, with an average of 6.2 measurements during pregnancy. Three SBP trajectory patterns were identified and classified as "Group 1" (48.0%), with a mean of 103 mmHg (95% CI 102.5-103.7 mmHg), "Group 2" (42.7%) with a mean of 114 mmHg (95% CI 113.7-114.9 mmHg), and "Group 3" (9.1%) with the highest mean SBP value of 130 mmHg (95% CI 128.8-131.5 mmHg). It was observed that regardless of the weight gain trajectory group, women classified in the group with the highest SBP had the highest SBP levels. The probability of being classified in Group 3 was higher among women with higher education, who started pregnancy presenting obesity, and who were using antihypertensive drugs. CONCLUSION: The probability of belonging to groups with a greater trajectory of SBP during pregnancy was associated with obesity, education, and hypertension under treatment.

Trajectory Patterns of Gestational Weight Gain.

OBJECTIVE: To identify gestational weight gain trajectories and their association with demographic, obstetric, and anthropometric characteristics. METHOD: Information of 599 pregnant women undergoing prenatal care in public health units was collected through questionnaires and medical records, resulting in 4,272 measures of body weight. Group-based trajectory models were applied to identify patterns of gestational weight gain. RESULTS: The average gestational weight gain at 40 weeks was 14.1 kg (95%CI: 13.2, 15.0). Three different trajectory groups were identified: low (9.9%), intermediate (66.4%), and high (23.7%). Pregnant women who smoked and those classified above IOM's weight gain recommendations were more likely to be classified in the group with a high weight gain trajectory; while those with pre-pregnancy overweight or obesity, and with greater parity were more likely to be categorized in the low weight gain trajectory. After adjusting for other variables in the model, parity remained significantly associated with gestational weight gain (ß: 0.88; 95%CI: 0.27, 0.73). In the multilevel model, weight gain remained different among the categories of group-based trajectory, even after adjustment for other investigated variables for intermediate (ß: 2.94; 95%CI: 2.32, 3.58) and high (ß: 5.88; 95%CI: 5.09, 6.66) gestational weight gain trajectory groups. CONCLUSIONS: Behavioral, obstetric, and anthropometric characteristics determined the belonging to groups with a high or low trajectory of gestational weight gain. The findings contribute to a better understanding of patterns of gestational weight gain in middle-income women groups.

Socioeconomic, demographic, and obstetric inequalities in food insecurity in pregnant women / Desigualdades socioeconômicas, demográficas e obstétricas na insegurança alimentar em gestantes

Abstract Objectives: to estimate the prevalence of Food Insecurity (FI) in pregnant women and to identify its association with demographic, socioeconomic, obstetric, and anthropometric variables in female users of Family Health Units (FHUs) in the city of Colombo, state of Paraná, South Region of Brazil. Methods: a cross-sectional study of a representative sample of pregnant women from 17 FHUs in Colombo. We used the short version of the Brazilian Household Food Insecurity Measurement Scale (EBIA). In addition, we used Poisson Regression Models with robust, crude, and adjusted variance to investigate the association between FI and exposure variables. Results: 316 pregnant women participated in the study. The prevalence of FI was 45.1% (CI95% = 39.6-50.6). Adjusted analysis showed higher prevalence of FI in pregnant women with 30 years of age or older (PR = 1.66; IC95% = 1.02-2.69), with black skin or indigenous background (PR= 1.39; CI95%= 1.08-1.79), with 7 years of education or less (PR = 1.58; CI95% = 1.14-2.19), and with lower income (PR = 2.07; CI95% = 1.36-3.14). Conclusions: There was a high prevalence of FI among pregnant women, particularly among those of older age and with worse socioeconomic conditions, a group that should be considered a priority for actions aimed at promoting food security.

Resumo Objetivos: estimar a prevalência da insegurança alimentar (IA)em gestantes e identificar sua associação com variáveis demográficas, socioeconômicas, obstétricas e antropométricas em usuárias de Unidades de Saúde da Família (USFs) em Colombo, PR. Métodos: estudo transversal com amostra representativa de gestantes de 17 USFs do município. Utilizou-se a versão curta da Escala Brasileira de IA. Modelos de Regressão de Poisson com variância robusta, brutos e ajustados foram utilizados para investigar associação entre IA e variáveis de exposição. Resultados: participaram da pesquisa 316 gestantes. A prevalência de IA foi de 45,1% (IC95%= 39,6-50,6). Após análise ajustada, apresentaram maiores prevalências de IA as gestantes com 30 anos ou mais (RP= 1,66; IC95%= 1,02-2,69), de cor/raça negra e indígena (RP= 1,39; IC95%= 1,08-1,79), com até sete anos de estudo (RP= 1,58; IC95%= 1,14-2,19) e de menor renda (RP= 2,07; IC95%= 1,36-3,14). Conclusões: verificou-se elevada prevalência de IA entre as gestantes, especialmente entre aquelas com maior idade e piores condições socioeconômicas, grupo que deve ser considerado prioritário para ações que visem promover segurança alimentar.