Size at birth and blood pressure in young adults: findings from a Brazilian birth cohort study

Brazilian cohorts with potential for life-course studies: a scoping review

OBJECTIVE To identify the Brazilian cohorts that started either in the prenatal period or at birth, to describe their characteristics and the explored variables, and to map the cohorts with potential for studies on early determinants on health and the risk of falling ill on later stages of the life cycle. METHODS A scoping review was carried out. The articles were searched in the electronic databases PubMed and Virtual Health Library (VHL). The descriptors used were [((("Child" OR "Child, Preschool" OR "Infant" OR "Infant, Newborn") AND (Cohort Studies" OR "Longitudinal Studies")) AND "Brazil")]. The inclusion criteria were Brazilian cohorts that started the baseline in the prenatal period or at birth and with at least two follow-ups with the participants. In order to meet the concept of LCE, we excluded those cohorts whose follow-ups were restricted to the first year of life, as well as those that did not address biological, behavioral and psychosocial aspects, and cohorts with data collection of a single stage of the life cycle. RESULTS The search step identified 5,010 articles. Eighteen cohorts were selected for descriptive synthesis. The median number of baseline participants was 2,000 individuals and the median age at the last follow-up was 9 years. Sample loss at the last follow-up ranged from 9.2 to 87.5%. Most cohorts monitored two phases of the life cycle (the perinatal period and childhood). The Southern region had the highest number of cohorts. The main variables collected were sociodemographic and environmental aspects of the family, morbidity aspects, nutritional practices and lifestyle. CONCLUSIONS We recommend the continuity of these cohorts, the approach to different social contexts and the performance of follow-ups with participants in different phases of the life cycle for the strengthening and expansion of life course epidemiology analyses in Brazil.

Conflicting Effects of Fetal Growth Restriction on Blood Pressure Between Human and Rat Offspring: A Meta-Analysis

Low birth weight is associated with hypertension. Low birth weight can result from fetal growth restriction (FGR) or prematurity. FGR is postulated to impact blood pressure (BP) by developmental programming. This systematic review and meta-analysis studies BP in human and animal offspring following FGR. Pubmed and Web of Science were searched for studies reporting on BP after placental insufficiency induced FGR compared with normal growth controls. Primary outcome was mean absolute BP difference (ΔBP mm Hg [95% CI]). Meta-analysis was performed using random-effects models. Subgroup analyses were executed on species, sex, age, pregnancy duration, and stress during BP readings. Due to large interspecies heterogeneity, analyses were performed separately for human (n=41) and animal (n=31) studies, the latter restricted to rats (n=27). Human studies showed a ΔBP between FGR and controls of -0.6 mm Hg ([95% CI, -1.7 to 0.6]; I²=91%). Mean ΔBP was -2.6 mm Hg (95% CI, -5.7 to 0.4) in women versus -0.5 mm Hg (95% CI, -3.7 to 2.7) in men. Subgroup analyses did not indicate age, gestational age, and stress during measurements as sources of heterogeneity. In rats, mean BP was 12.0 mm Hg ([95% CI, 8.8-15.2]; I²=81%) higher in FGR offspring. This difference was more pronounced in FGR males (13.6 mm Hg [95% CI, 10.3-17.0] versus 9.1 mm Hg [95% CI, 5.3-12.8]). Subgroup analyses on age showed no statistical interaction. BP readings under restrained conditions resulted in larger BP differences between FGR and control rats (15.3 mm Hg [95% CI, 11.6-18.9] versus 5.7 mm Hg [95% CI, 1.1-10.3]). Rat studies confirm the relation between FGR and offspring BP, while observational studies in humans do not show such differences. This may be due to the observational nature of human studies, methodological limitations, or an absence of this phenomenon in humans. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: CRD42018091819.

Revista de Saúde Pública: 50 years disseminating the knowledge in nutrition

This work describes and comments on articles in the area of Public Health Nutrition published in Revista de Saúde Pública (RSP – Public Health Journal) from 1967 to 2016. We searched in the PubMed database restricted to the periodical “Revista de Saúde Pública” and using terms related to key topics in the area of Public Health Nutrition. We retrieved 742 articles and, after exclusion of duplicates and articles unrelated to the subject, we analyzed 441 articles, grouped according to subject: dental caries, anemia, hypovitaminosis A, macro/micronutrients, malnutrition, nutritional assessment, overweight/obesity, food consumption, low birthweight, and breastfeeding. We observed significant increase in the number of articles published and diversification of subjects addressed over the 50 years, representing the consistent development of the scientific field of Nutrition in Brazil. Since its inception, RSP has played an important role in the dissemination of knowledge about the main nutritional issues in Brazil.