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Wendt A, Machado AKF, da Silva BGC, Costa CS, Ricardo LIC, da Silva SG. Inequalities in Leisure-Time Physical Activity and Television Viewing According to Age Among a Brazilian Adult Population. J Phys Act Health 2024; 21:146-154. [PMID: 37939706 DOI: 10.1123/jpah.2022-0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 05/02/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND The present study aims to estimate leisure-time physical activity and television (TV) viewing curves according to age stratified by sex, area of residence, and socioeconomic position. METHODS Using data from the Brazilian National Health Survey, we estimated the prevalence of leisure-time physical activity and TV viewing according to continuous age. The estimates were calculated using fractional polynomials and stratified by sex, wealth, skin color, and area of residence. RESULTS The sample included 87,376 adults (aged 18 y or over). In general, leisure-time physical activity decreased according to age while TV viewing increased. Regarding behavior of curves according to stratifiers, for leisure-time physical activity the disadvantaged groups maintained a pattern of low physical activity across all age groups or presented the decrease earlier when compared to groups in social advantage. On the other hand, for TV viewing, women presented an increase in prevalence before men, and individuals living in the urban area and the wealthiest group were those with a higher increase according to age. CONCLUSIONS Our findings may help researchers and policymakers further explore inequalities in physical activity across life in different settings, as well as develop sensitive cultural actions to support more vulnerable people to adopt public health recommendations.
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Affiliation(s)
- Andrea Wendt
- Graduate Program in Health Technology, Polytechnic School, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Adriana K F Machado
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Bruna G C da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline S Costa
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Luiza I C Ricardo
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Shana Ginar da Silva
- Postgraduate Program in Biomedical Science, School of Medicine, Federal University of Fronteira Sul, Passo Fundo, SC, Brazil
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Novaes TER, Lara DM, da Silva SG. Severe Acute Respiratory Syndrome (SARS) in the Context of the COVID-19 Pandemic Among Indigenous Peoples of Brazil: Epidemiology and Risk Factors Associated with Death. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01660-z. [PMID: 37314690 DOI: 10.1007/s40615-023-01660-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Severe Acute Respiratory Syndrome (SARS) represents a serious public health problem for the indigenous peoples of Brazil, since acute respiratory infections are the main causes of morbidity and mortality in this population. OBJECTIVE To assess cases of SARS in Brazilian indigenous peoples in the context of the COVID-19 pandemic, as well as sociodemographic and health factors associated with deaths from SARS in this population. METHODS Ecological study carried out based on secondary data from the Brazilian Database for Epidemiological Surveillance of Influenza referring to the Brazilian indigenous population with SARS in 2020. The variables included sociodemographic factors and health conditions. Statistical analyses were carried out considering absolute (n) and relative (%) frequencies and logistic regression with odds ratios (OR), with death as the outcome of interest. RESULTS A total of 3062 cases were reported in the analyzed period. Of these, there was a predominance of men (54.6%), adults (41.4%), with comorbidities (52.3%), with low levels of schooling (67.4%) and residents of rural areas (55.8%). Cases and deaths were concentrated in the states of Amazonas and Mato Grosso do Sul, states in the North and Midwest of Brazil. A greater chance of death was observed in elderly indigenous people (OR = 6.29; 95%CI 4.71-8.39), with low levels of schooling (OR = 1.72; 95%CI 1.22-2.28), residents of rural areas (OR = 1.35; 95%CI 1.12-1.62), and with comorbidities (OR = 1.87; 95%CI 1.42-2.46), especially obesity (OR = 2.56; 95%CI 1.07-6.11). CONCLUSION The study was able to trace the clinical-epidemiological profile, as well as identify the groups of indigenous people most vulnerable to SARS as a result of COVID-19 and evolution to death in Brazil. The findings show the high impact on the morbidity and mortality of the Brazilian indigenous population exposed to SARS and are relevant for epidemiological health surveillance, since they can guide preventive public policy actions and quality of life measures for this ethnic group in Brazil.
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Affiliation(s)
| | - Darlan Martins Lara
- Medical School of the Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil
| | - Shana Ginar da Silva
- Post-Graduate Program in Biomedical Sciences, School of Medicine, Federal University of Fronteira Sul, Campus Passo Fundo, Passo Fundo, Brazil
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Marcolin P, Mazzola Poli de Figueiredo S, Walmir de Araújo S, Mota Constante M, Moura Fé de Melo V, Ginar da Silva S, Mao RMD, DeJesus J, Lu R. Preoperative Optimization Before Ventral Hernia Repair: A Systematic Review and Meta-analysis. Surg Laparosc Endosc Percutan Tech 2023; 33:211-218. [PMID: 36971526 DOI: 10.1097/sle.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/07/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Obesity is associated with an increased risk of ventral hernia development and recurrence rates after ventral hernia repair (VHR). The metabolic derangements caused by obesity can also lead to many postoperative complications. Therefore, it is a common practice to attempt weight loss before VHR. However, there is still no consensus on optimal preoperative management for obese patients with a ventral hernia. This study aims to perform a meta-analysis to evaluate the effect of preoperative weight optimization on VHR outcomes. METHODS We performed a literature search of PubMed, Scopus, and Cochrane Library databases to identify studies comparing obese patients who underwent surgical or non-surgical weight loss interventions before undergoing hernia repair surgery to obese patients who underwent hernia repair surgery without prehabilitation. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I 2 statistics. RESULTS One thousand six hundred nine studies were screened and 13 were thoroughly reviewed. Five studies comprising 465 patients undergoing hernia repair surgery were included. No differences in hernia recurrence [odds ratio (OR) 0.66; 95% CI 0.23-1.89; P =0.44; I 2 =20%], seroma (OR 0.70; 95% CI 0.25-1.95; P =0.50; I 2 =5%), hematoma (OR 2.00; 95% CI 0.5-7.94; P =0.45; I 2 =0%), surgical site infection (OR 1.96; 95% CI 0.52-7.40; P =0.32; I 2 =0%), and overall complication (OR 0.80; 95% CI 0.37-1.74; P =0.58; I 2 =40%) rates were noted when comparing patients who underwent a preoperative weight loss intervention (prehabilitation or bariatric surgery) versus those who did not. In the subgroup analysis of patients who underwent bariatric surgery, we found no difference in hernia recurrence (OR 0.64; 95% CI 0.12-3.33; P = 0.59; I 2 =41%) or overall complications (OR 1.14; 95% CI 0.36-3.64; P =0.82; I 2 =64%). In the subgroup analysis of patients who lost weight versus patients who did not, there was no significant difference in overall complication rates (OR 0.86; 95% CI 0.34-2.21; P =0.76; I 2 =55%). CONCLUSIONS We found similar hernia recurrence, seroma, hematoma, and surgical site infection rates in patients who underwent preoperative optimization. These findings underline the need for prospective studies to define the optimal role of preoperative optimization and weight loss in obese patients undergoing ventral hernia repair.
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Affiliation(s)
| | | | | | | | | | - Shana Ginar da Silva
- Department of Epidemiology, Universidade Federal da Fronteira Sul, Passo Fundo, RS
| | - Rui-Min Diana Mao
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX
| | - Jana DeJesus
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX
| | - Richard Lu
- Department of Surgery, The University of Texas Medical Branch, Galveston, TX
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Pecinato V, Jacobo A, da Silva SG. Mortality trends of breast and cervical cancer in Passo Fundo, Rio Grande do Sul: an analysis by age and schooling, 1999-2019. Epidemiol Serv Saude 2023; 31:e2022440. [PMID: 36629594 PMCID: PMC9887960 DOI: 10.1590/s2237-96222022000300021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/19/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE to analyze the temporal trend of mortality due to malignant neoplasms of the breast and cervix from 1999 to 2019 in Passo Fundo, Rio Grande do Sul, Brazil. METHODS this was a time-series study based on data from the Mortality Information System; standardized rates were calculated according to age and schooling, and the temporal trend was assessed using Prais-Winsten regression. RESULTS the overall mortality coefficients for cervical cancer (β = -0.03; 95%CI -0.08;0.02) and for breast cancer (β = -0.006; 95%CI -0.02;0.01) were stable over the time series; in both types of neoplasms, a rising trend was identified in women with up to 7 years of schooling; on the other hand, a stationary trend was found in the majority of the age strata analyzed. CONCLUSION older women and those with low levels of schooling had the worst prognosis.
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Affiliation(s)
- Vanessa Pecinato
- Universidade Federal da Fronteira Sul, Curso de Medicina, Passo
Fundo, RS, Brazil
| | - Andréia Jacobo
- Universidade Federal da Fronteira Sul, Curso de Medicina, Passo
Fundo, RS, Brazil
| | - Shana Ginar da Silva
- Universidade Federal da Fronteira Sul, Programa de Pós-Graduação em
Ciências Biomédicas, Passo Fundo, RS, Brazil
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Sandri P, Rosa LA, Almeida ESD, Silva SGD. Cardiovascular Diseases Mortality Rates in Nine Cities of Rio Grande do Sul from 2009 to 2019: Temporal Trends and Demographic Differences. International Journal of Cardiovascular Sciences 2022. [DOI: 10.36660/ijcs.20220062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Rutzen AT, Annes RD, da Silva SG. Clinical and functional outcomes in patients submitted to early versus late surgery for lumbar disc herniation: A systematic review. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2022.101550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Blumenberg C, Martins RC, da Silva SG, da Silva BGC, Wehrmeister FC, Gonçalves H, Hallal PC, Crochemore-Silva I, Menezes AMB. Influence of parental physical activity on offspring's nutritional status: an intergenerational study in the 1993 Pelotas birth cohort. Public Health Nutr 2021; 25:1-8. [PMID: 34569464 PMCID: PMC9991797 DOI: 10.1017/s1368980021004079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the influence of parental physical activity on offspring's nutritional status in the 1993 Pelotas (Brazil) birth cohort. DESIGN Birth cohort study. SETTING The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring's nutritional status. All analyses were stratified according to the sex of the parent. PARTICIPANTS A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed. RESULTS Children were, on average, 3·1 years old. Crude analyses showed that the mother's cumulative physical activity measure had an indirect association with the prevalence of children's obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders. CONCLUSIONS The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring's nutritional status.
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Affiliation(s)
- Cauane Blumenberg
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Rafaela Costa Martins
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Shana Ginar da Silva
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Medical School, Federal University of Fronteira Sul (UFFS), Passo Fundo, Brazil
| | - Bruna Gonçalves Cordeiro da Silva
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Fernando C Wehrmeister
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
| | - Helen Gonçalves
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
| | - Pedro C Hallal
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Post-graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Inácio Crochemore-Silva
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Post-graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Ana MB Menezes
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
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Varela AR, Cruz GIN, Hallal P, Blumenberg C, da Silva SG, Salvo D, Martins R, da Silva BGC, Resendiz E, Del Portillo MC, Monteiro LZ, Khoo S, Chong KH, da Silva MC, Mannocci A, Ding D, Pratt M. Correction to: Global, regional, and national trends and patterns in physical activity research since 1950: a systematic review. Int J Behav Nutr Phys Act 2021; 18:35. [PMID: 33685444 PMCID: PMC7941990 DOI: 10.1186/s12966-021-01100-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Andrea Ramírez Varela
- School of Medicine, Universidad de los Andes, Cra 7 #116-05, 11001000, Bogotá, Colombia.
| | | | - Pedro Hallal
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Cauane Blumenberg
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Shana Ginar da Silva
- Post-Graduate in Biomedical Science, School of Medicine, Federal University of Fronteira Sul, Chapecó, Brazil
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA
| | - Rafaela Martins
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Eugen Resendiz
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA
| | | | | | - Selina Khoo
- University of Malaya, Kuala Lumpur, Malaysia
| | - Kar Hau Chong
- Early Start, University of Wollongong, Wollongong, Australia
| | | | | | - Ding Ding
- University of Sydney, Sydney, Australia
| | - Michael Pratt
- University of California San Diego Herbert Wertheim School of Public Health and Longevity Science, San Diego, USA
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Ramírez Varela A, Cruz GIN, Hallal P, Blumenberg C, da Silva SG, Salvo D, Martins R, da Silva BGC, Resendiz E, Del Portillo MC, Monteiro LZ, Khoo S, Chong KH, Cozzensa da Silva M, Mannocci A, Ding D, Pratt M. Global, regional, and national trends and patterns in physical activity research since 1950: a systematic review. Int J Behav Nutr Phys Act 2021; 18:5. [PMID: 33413479 PMCID: PMC7792158 DOI: 10.1186/s12966-020-01071-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/07/2020] [Indexed: 01/08/2023] Open
Abstract
Background National, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019. Methods A systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0. Results The search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest. Conclusion This study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-020-01071-x.
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Affiliation(s)
- Andrea Ramírez Varela
- School of Medicine, Universidad de los Andes, Cra 7 #116-05, 11001000, Bogotá, Colombia.
| | | | - Pedro Hallal
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Cauane Blumenberg
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Shana Ginar da Silva
- Post-Graduate in Biomedical Science, School of Medicine, Federal University of Fronteira Sul, Chapecó, Brazil
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA
| | - Rafaela Martins
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Eugen Resendiz
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA
| | | | | | - Selina Khoo
- University of Malaya, Kuala Lumpur, Malaysia
| | - Kar Hau Chong
- Early Start, University of Wollongong, Wollongong, Australia
| | | | | | - Ding Ding
- University of Sydney, Sydney, Australia
| | - Michael Pratt
- University of California San Diego Herbert Wertheim School of Public Health and Longevity Science, San Diego, USA
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da Silva SG, da Silveira MF, Bertoldi AD, Domingues MR, Dos Santos IDS. Maternal and child-health outcomes in pregnancies following Assisted Reproductive Technology (ART): a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:106. [PMID: 32079534 PMCID: PMC7033923 DOI: 10.1186/s12884-020-2755-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies comparing the outcome of spontaneous versus assisted reproductive technologies (ART) pregnancies report heterogeneous results. Despite the success of ART to overcome infertility, concern is growing regarding both its safety and its effect on maternal and child health. The objective of this study was to compare maternal and child-health outcomes after ART relative to natural conception. METHODS A population-based birth cohort study was carried out among pregnant women expected to deliver in 2015 in Pelotas, southern Brazil. Maternal outcomes included pregnancy complications and gestational weight gain. Gestational age, weight, intrauterine growth restriction, length and head circumference, and 1-min and 5-min Apgar, as well as health problems at birth and breastfeeding were defined as offspring outcomes. Statistical analyses were performed using linear and logistic regression. G-formula was used to perform mediation analysis. RESULTS The study included 4252 babies born by spontaneously pregnancies and 23 babies born after ART. Adjusted analyses showed that children conceived from ART presented lower means of gestational age (p = 0.001), birth weight (p = 0.002), length (p < 0.001), and head circumference at birth (p = 0.02). However, more than 90% of the effect of ART over these outcomes was mediated by multiple pregnancy. CONCLUSION Our findings suggest that the possible negative effect on the child-health outcomes is due mainly to the higher incidence of multiple pregnancies and not because of ART. The reasons for the increase in adverse pregnancy outcomes associated with ART singleton pregnancies are still uncertain and warrants further research. Further large-population studies are needed to confirm these results.
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Affiliation(s)
- Shana Ginar da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil. .,Medical school, Federal University of Fronteira Sul - Campus Passo Fundo, RS. Rua Cap. Araújo, 20 - Passo Fundo, Pelotas, Rio Grande do Sul, 99010-121, Brazil.
| | - Mariângela Freitas da Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil
| | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil
| | - Marlos Rodrigues Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, R. Luís de Camões, 625 - Três Vendas, Pelotas, RS, 96055-630, Brazil
| | - Iná da Silva Dos Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil
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da Silva SG, Evenson KR, Ekelund U, da Silva ICM, Domingues MR, da Silva BGC, Mendes MDA, Cruz GIN, Hallal PC. How many days are needed to estimate wrist-worn accelerometry-assessed physical activity during the second trimester in pregnancy? PLoS One 2019; 14:e0211442. [PMID: 31246953 PMCID: PMC6597041 DOI: 10.1371/journal.pone.0211442] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/15/2019] [Indexed: 11/28/2022] Open
Abstract
Background Objective methods to measure physical activity (PA) can lead to better cross-cultural comparisons, monitoring temporal PA trends, and measuring the effect of interventions. However, when applying this technology in field-work, the accelerometer data processing is prone to methodological issues. One of the most challenging issues relates to standardizing total wear time to provide reliable data across participants. It is generally accepted that at least 4 complete days of accelerometer wear represent a week for adults. It is not known if this same assumption holds true for pregnant women. Aim We assessed the optimal number of days needed to obtain reliable estimates of overall PA and moderate-to-vigorous physical activity (MVPA) during the 2nd trimester in pregnancy using a raw triaxial wrist-worn accelerometer. Methods Cross-sectional analyses were carried out in the antenatal wave of the 2015 Pelotas (Brazil) Birth Cohort Study. Participants wore the wrist ActiGraph wGT3X-BT accelerometer for seven consecutive days. The daily average acceleration, which indicated overall PA, was measured as milli-g (mg), and time spent in MVPA (minutes/day) was analyzed in 5-minute bouts. ANOVA and Kruskal-Wallis tests were used to compare variability across days of the week. Bland-Altman plots and the Spearman-Brown Prophecy Formula were applied to determine the reliability coefficient associated with one to seven days of measurement. Results Among 2,082 pregnant women who wore the accelerometer for seven complete days, overall and MVPA were lower on Sundays compared to other days of the week. Reliability of > = 0.80 to evaluate overall PA was reached with at least three monitoring days, whereas seven days were needed to estimate reliable measures of MVPA. Conclusions Our findings indicate that obtaining one week of accelerometry in adults is appropriate for pregnant women, particularly to obtain differences on weekend days and reliably estimate overall PA and MVPA.
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Affiliation(s)
- Shana Ginar da Silva
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Medical School, Federal University of Fronteira Sul–Passo Fundo, Passo Fundo, RS, Brazil
- * E-mail:
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Inácio Crochemore Mohsam da Silva
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- PostGraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | | | | | - Pedro Curi Hallal
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
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Silva SGD, Bertoldi AD, Silveira MFD, Domingues MR, Evenson KR, Santos ISD. Assisted reproductive technology: prevalence and associated factors in Southern Brazil. Rev Saude Publica 2019; 53:13. [PMID: 30726494 PMCID: PMC6390642 DOI: 10.11606/s1518-8787.2019053000737] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 04/06/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE: To assess the prevalence of successful assisted reproductive technology and to identify the associated factors. METHODS: This population-based birth cohort study was carried out with 4,333 pregnant women expected to deliver in 2015 in the urban area of Pelotas, Southern Brazil. Use of an assisted reproductive technology procedure, type of assisted reproductive technology [in vitro fertilization or intracytoplasmic sperm injection or artificial insemination], number of embryos transferred, success of embryo transfer, number of attempts, and reported reasons for seeking assisted reproductive technology were the main outcomes measured. Use of an assisted reproductive technology procedure was analyzed according to sociodemographic, nutritional, reproductive history, and behavioral characteristics. Unadjusted and adjusted analyses were performed by logistic regression. RESULTS: Among the 4,275 newborns enrolled in the Pelotas 2015 Birth Cohort Study, 18 births (0.4%) were conceived by assisted reproductive technology. Most cases of assisted reproductive technology were by in vitro fertilization (70.6%). All cycles were performed in private clinics under direct out-of-pocket payment. Even after controlling for confounders, maternal age > 35 years, nulliparity and high family monthly income were strongly associated with assisted reproductive technology. CONCLUSIONS: The use of assisted reproductive technology services was reported by only a few women in the Pelotas 2015 Birth Cohort Study. Our study highlights sociodemographic factors associated to assisted reproductive technology procedures. To better understand the patterns and barriers in overall use of assisted reproductive technology services over time, national-level trend studies in assisted reproductive technology treatments and outcomes, as well as studies exploring the characteristics of women who have sought this kind of treatment are needed in low-middle income countries.
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Affiliation(s)
- Shana Ginar da Silva
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Mariângela Freitas da Silveira
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marlos Rodrigues Domingues
- Universidade Federal de Pelotas. Escola Superior de Educação Física. Departamento de Desportos. Programa de Pós-Graduação em Educação Física. Pelotas, RS, Brasil
| | - Kelly R Evenson
- University of North Carolina at Chapel Hill. Gillings School of Global Public Health. Department of Epidemiology. NC, United States
| | - Iná Silva Dos Santos
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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Coll CDVN, Domingues MR, Stein A, da Silva BGC, Bassani DG, Hartwig FP, da Silva ICM, da Silveira MF, da Silva SG, Bertoldi AD. Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial. JAMA Netw Open 2019; 2:e186861. [PMID: 30646198 PMCID: PMC6324311 DOI: 10.1001/jamanetworkopen.2018.6861] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Interventions to reduce postpartum depression have mainly focused on enhancing screening to increase treatment rates among women. Preventive approaches are timely from a population health perspective, particularly in low- and middle-income countries where access to mental health services is limited. OBJECTIVE To assess the efficacy of regular exercise during pregnancy on the prevention of postpartum depression. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial examines a prespecified secondary outcome of the Physical Activity for Mothers Enrolled in Longitudinal Analysis (PAMELA) Study, a parallel-group, randomized clinical trial. This trial was nested in the 2015 Pelotas (Brazil) Birth Cohort Study. Between August 27, 2014, and March 14, 2016, pregnant women between 16 and 20 weeks of gestation with no contraindications to exercise were randomized 1:2 to the intervention group or control group via computer-generated randomization using a block size of 9. Data were analyzed from March 7 to May 2, 2018. INTERVENTIONS Participants assigned to the intervention were engaged in a 16-week supervised exercise program including aerobic and resistance training delivered in 60-minute sessions 3 times per week. MAIN OUTCOMES AND MEASURES Postpartum depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale 3 months after birth. A score of 12 or greater was defined as screening positive for postpartum depression. Primary analysis was performed on a complete case basis (90% of participants who had the primary end point ascertained). RESULTS A total of 639 participants (mean [SD] age, 27.1 [5.1] years; mean gestational age, 16.5 [1.5] weeks) were randomly assigned to the intervention group (n = 213) or control group (n = 426). Compliance with the protocol, defined as having engaged in at least 70% of exercise sessions, was low (40.4%). There was no significant difference in mean (SD) scores for postpartum depression between the intervention group (4.8 [3.7]) and the control group (5.4 [4.1]) (mean difference, -0.6; 95% CI, -1.3 to 0.1). There was also no significant difference in rates of postpartum depression between the intervention group (12 of 192 [6.3%]) and the control group (36 of 387 [9.3%]) (odds ratio, 0.65; 95% CI, 0.33-1.28). Instrumental variable analysis indicated that noncompliance may have attenuated the effect estimates obtained in the primary analysis. CONCLUSIONS AND RELEVANCE Moderate-intensity exercise during pregnancy did not lead to significant reductions in postpartum depression. However, noncompliance to the intervention protocol was substantial and may have led to underestimations of the possible benefits of exercise. The point estimates for this study are in the same direction as the previous randomized clinical trial on this topic. Future studies on how to promote regular exercise during pregnancy to improve compliance, particularly targeting young and less educated women, are warranted before further trials are undertaken. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02148965.
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Affiliation(s)
| | - Marlos Rodrigues Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | | | | | - Shana Ginar da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Borges MC, Santos LP, Zago AM, da Silva BGC, da Silva SG, de Mola CL. Socioeconomic development of cities and risk factors for non-communicable diseases: a comparative study across Brazilian state capitals. J Public Health (Oxf) 2018; 38:653-359. [PMID: 28158659 DOI: 10.1093/pubmed/fdv202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maria Carolina Borges
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul 96020-220, Brazil
| | - Leonardo Pozza Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul 96020-220, Brazil
| | - Adriana Marchon Zago
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul 96020-220, Brazil
| | | | - Shana Ginar da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul 96020-220, Brazil
| | - Christian Loret de Mola
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul 96020-220, Brazil
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da Silva SG, Hallal PC, Domingues MR, Bertoldi AD, Silveira MFD, Bassani D, da Silva ICM, da Silva BGC, Coll CDVN, Evenson K. A randomized controlled trial of exercise during pregnancy on maternal and neonatal outcomes: results from the PAMELA study. Int J Behav Nutr Phys Act 2017; 14:175. [PMID: 29273044 PMCID: PMC5741924 DOI: 10.1186/s12966-017-0632-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/07/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Women are encouraged to be physically active during pregnancy. Despite available evidence supporting antenatal physical activity to bring health benefits for both the mother and child, the most effective way to prevent some maternal and fetal outcomes is still unclear. The purpose of this study was to evaluate the efficacy of an exercise intervention to prevent negative maternal and newborn health outcomes. METHODS A randomized controlled trial (RCT) nested into the 2015 Pelotas (Brazil) Birth Cohort Study was carried-out with 639 healthy pregnant women, 213 in the intervention group (IG) and 426 in the control (CG) group. An exercise-based intervention was conducted three times/week for 16 weeks from 16-20 to 32-36 weeks' gestation. The main outcomes were preterm birth and pre-eclampsia. Gestational age was calculated based on several parameters, including routine ultrassounds and/or last menstrual period and categorized as < 37 weeks and ≥ 37 weeks for evaluation of preterm birth. Pre-eclampsia was self-reported. Secondary outcomes were gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. Analyses were performed by intention-to-treat (ITT) and per protocol (70% of the 48 planned exercise sessions). Odds ratio were derived using unconditional logistic regression. RESULTS The IG and CG did not differ at baseline regarding their mean age (27.2 years ± 5.3 vs. 27.1 years ± 5.7) and mean pre-pregnancy body mass index (25.1 ± 3.9 vs. 25.2 ± 4.1 kg/m2). The mean adherence to the exercise intervention was 27 ± 17.2 sessions (out of a potential 48) with 40.4% attending > = 70% of the recommended exercise sessions. A total of 594 participants (IG:198; CG: 396) were included in the ITT and 479 (IG: 83; CG: 396) were included in the per protocol analyses. There were no significant differences in the incidence of preterm birth and pre-eclampsia between groups in the ITT and per protocol analysis. There were also no differences between the two groups in mean gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. CONCLUSIONS While the RCT did not support the benefits of exercise performed during pregnancy on preeclampsia and preterm birth, the exercise program also did not present adverse impacts on newborn health. Our findings may contribute to promote intervention strategies that motivate health providers to encourage pregnant women to be more physically active. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02148965 , registered on 22 May 2014.
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Affiliation(s)
- Shana Ginar da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
| | - Pedro Curi Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | | | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Mariângela Freitas da Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Diego Bassani
- Department of Paediatrics, Faculty of Medicine, Centre for Global Child Health, University of Toronto; King’s College Circle, The Hospital for Sick Children, Toronto, Canada
| | - Inácio Crochemore Mohnsam da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Bruna Gonçalves Cordeiro da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Carolina de Vargas Nunes Coll
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Kelly Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
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Silva SGD, Duca GFD, Nahas MV. Self-reported well-being and associated factors among industrial workers in Brazil: findings from a national survey. CAD SAUDE PUBLICA 2017; 33:e00191215. [DOI: 10.1590/0102-311x00191215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract: The purpose of this study was to estimate self-perception of well-being and associated factors among industrial workers in Brazil. A cross-sectional survey was carried out with a representative sample from 23 Brazilian states and the Federal District. Self-reported of well-being was investigated by questionnaire. Multinomial logistic regression was used in unadjusted and adjusted analyses. For 93% of the 47,477 industrial workers, the perception of well-being was positive. Those who had the highest chances of being in the category of best perception of well-being were: male workers (OR = 1.35; 95%CI: 1.28; 1.43); those aged under thirty years old (OR = 1.24; 95%CI: 1.12; 1.39); those from Southern Brazil (OR = 1.99; 95%CI: 1.83; 2.16); and people with a high income. The prevalence of positive well-being was high. Sociodemographic, behavioral and social support characteristics, as well as the characteristics related to self-report on health were associated with well-being.
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Silva BGCD, Lima NP, Silva SGD, Antúnez SF, Seerig LM, Restrepo-Méndez MC, Wehrmeister FC. Mortalidade materna no Brasil no período de 2001 a 2012: tendência temporal e diferenças regionais. Rev bras epidemiol 2016; 19:484-493. [DOI: 10.1590/1980-5497201600030002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 03/24/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Avaliar a tendência de mortalidade materna no Brasil e nas cinco regiões brasileiras, de 2001 a 2012, e descrever suas principais causas. Métodos: Trata-se de uma série temporal, a partir de dados obtidos no Sistema de Informação sobre Mortalidade e no Sistema de Informação sobre Nascidos Vivos. A razão de mortalidade materna e as causas de morte materna foram descritas conforme as categorias da 10ª revisão da Classificação Internacional de Doenças, nos anos de 2001, 2006 e 2011. Para estimar a tendência temporal foi utilizada a regressão linear. Resultados: A razão de mortalidade materna mais elevada no Brasil foi no ano de 2009 (77,31 por 100 mil nascidos vivos). Foi observada tendência significativa de diminuição da razão de mortalidade materna para as regiões Nordeste e Sul e de aumento na região Centro-Oeste. Houve incremento nas mortes por outras afecções obstétricas e uma queda nas mortes por edema, proteinúria e transtornos hipertensivos. Conclusão: Embora tenham sido observadas tendências de diminuição da razão de mortalidade materna para o Nordeste e o Sul, as elevadas taxas observadas para o Brasil evidenciam a necessidade de melhoria à assistência pré-natal, ao parto e ao puerpério.
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Bielemann RM, Silva BGCD, Coll CDVN, Xavier MO, Silva SGD. Burden of physical inactivity and hospitalization costs due to chronic diseases. Rev Saude Publica 2015; 49:S0034-89102015000100307. [PMID: 26487291 PMCID: PMC4603264 DOI: 10.1590/s0034-8910.2015049005650] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 12/05/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio (Brazil’s National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.
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Domingues MR, Bassani DG, da Silva SG, Coll CDVN, da Silva BGC, Hallal PC. Physical activity during pregnancy and maternal-child health (PAMELA): study protocol for a randomized controlled trial. Trials 2015; 16:227. [PMID: 26003406 PMCID: PMC4446829 DOI: 10.1186/s13063-015-0749-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/07/2015] [Indexed: 12/16/2022] Open
Abstract
Background Preterm birth is associated with most cases of neonatal deaths and negative health outcomes, and hypertensive disorders. Hypertension is influenced by maternal behavior, such as physical activity. Physical activity is associated with better outcomes for mother and fetus, besides healthier weight gains during pregnancy. Few women are physically active during pregnancy and few clinical trials have been carried out with pregnant women. The aim of this paper is to describe the protocol of a controlled trial evaluating whether regular exercise during pregnancy may result in improved maternal-child health and neonatal outcomes. Methods/Design The PAMELA (Physical Activity for Mothers Enrolled in Longitudinal Analysis) trial is a randomized controlled trial nested in a birth cohort study. Eligible women belonging to the birth cohort will be invited (between the 16th and 20th week of gestation) to enroll in the trial. Baseline data (blood and urine samples, anthropometry and pulmonary function) will be collected at enrollment. The same assessments will be repeated eight and 16 weeks after baseline. After randomization, women will be allocated into either one of these groups: control, 426 women who will be advised to keep their usual daily activities; and intervention, 213 women who will engage in an exercise program, three sessions a week. At least 70 % attendance over 16 weeks will be required to be considered compliant to the intervention. Exercise protocol will include aerobics, strength and flexibility training. Maternal and child outcomes will be measured at the 36th week of gestation, at birth and at three, 12, 24 and 48 months postpartum. An intention-to-treat analysis will be performed. Discussion Few women are active during pregnancy and a vast majority decrease their activities or even quit exercising. We present a population-based regular exercise intervention focused on the prevention of hypertension, pre-eclampsia and preterm birth. Data on the underlying cohort will allow future analysis using different outcomes with low probability of recall bias or misclassification of exposure status. Results will potentially influence prenatal care counseling in regards to physical activity. Trial registration Clinicaltrials.gov identifier: NCT02148965, registered on 22 May 2014.
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Affiliation(s)
- Marlos Rodrigues Domingues
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil.
| | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Paediatrics, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Shana Ginar da Silva
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
| | - Carolina de Vargas Nunes Coll
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
| | | | - Pedro Curi Hallal
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
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Hoefelmann LP, Lopes ADS, Silva KSD, Silva SGD, Cabral LGA, Nahas MV. Lifestyle, self-reported morbidities, and poor sleep quality among Brazilian workers. Sleep Med 2012; 13:1198-201. [PMID: 22939837 DOI: 10.1016/j.sleep.2012.05.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 03/17/2012] [Accepted: 05/07/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine perceived poor sleep quality and its association with unhealthy lifestyle and self-reported morbidities among Brazilian workers. METHODS This study was part of a national survey involving 47,477 workers who received a questionnaire about lifestyle. Chi-square tests and logistic regression (OR=Odds Ratio) were conducted. RESULTS Poor sleep quality was reported by 21% of workers and was more prevalent among women (p<0.01). After being adjusted for socio-demographic indicators, negative perception of health, well-being, stress, self-reported morbidities, physical inactivity during leisure-time (OR: 1.18) in both genders, and inadequate fruit and vegetable intake (OR(men): 1.15; OR(women): 1.17), as well as excessive alcohol consumption (OR: 1.15) in men remained associated with poor sleep quality. With respect to morbidities, only diabetes in women (OR: 1.46) and hypertension in men (OR: 1.18) were associated with poor sleep quality. CONCLUSIONS Our findings indicate that certain unhealthy behaviors and self-reported morbidities were associated with poor sleep quality. Efficient initiatives should be implemented to promote a healthier lifestyle among workers, which could reduce or control glucose levels and blood pressure in addition to improving perceived sleep quality.
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Affiliation(s)
- Luana P Hoefelmann
- Federal University of Santa Catarina, Brazil; Physical Activity and Health research group, Trindade, Brazil.
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Silva SGD, Del Duca GF, Silva KSD, Oliveira ESAD, Nahas MV. Deslocamento para o trabalho e fatores associados em industriários do sul do Brasil. Rev Saude Publica 2012; 46:180-4. [DOI: 10.1590/s0034-89102011005000084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 09/15/2011] [Indexed: 11/21/2022] Open
Abstract
Estudo transversal visando estimar a prevalência das formas de deslocamento para o trabalho e identificar fatores associados em trabalhadores do Estado do Rio Grande do Sul. Um total de 2.265 trabalhadores responderam questionário sobre a forma de deslocamento utilizado para ir ao trabalho: caminhada/bicicleta, ônibus ou de carro/moto. Para estimar a associação entre o desfecho e variáveis sociodemográficas, ocupacionais e comportamental foi utilizada a regressão logística multinomial. O principal meio de deslocamento para o trabalho foi o ônibus (45,7%). Trabalhadores com maior condição socioeconômica tiveram maior probabilidade de deslocamento passivo.
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Del Duca GF, Silva SGD, Thumé E, Santos IS, Hallal PC. Indicadores da institucionalização de idosos: estudo de casos e controles. Rev Saude Publica 2012; 46:147-53. [DOI: 10.1590/s0034-89102012000100018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 08/23/2011] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Identificar indicadores da institucionalização de idosos. MÉTODOS: Estudo de casos e controles com 991 idosos em Pelotas, RS, de 2007 a 2008. Os casos (idosos institucionalizados; n = 393) foram detectados por meio de um censo em todas as instituições de longa permanência para idosos da cidade. Os controles populacionais (n = 598) foram selecionados de forma aleatória, por meio de um amplo inquérito de saúde. Na comparação dos grupos, foram empregados os testes qui-quadrado de Pearson e tendência linear na análise bruta e o modelo de regressão logística binária na análise ajustada, com medidas de efeito expressas em odds ratio. RESULTADOS: A institucionalização foi mais freqüente no sexo feminino (OR = 1,96; IC95% 1,31;2,95). Idosos com idade avançada (OR = 3,23 e OR = 9,56 para faixas etárias de 70-79 e > 80 anos, respectivamente), que viviam sem companheiro (solteiros, separados e viúvos), não possuíam escolaridade formal e apresentavam incapacidade funcional para atividades básicas da vida diária apresentaram maior probabilidade de institucionalização. Observou-se tendência inversa entre a ocorrência de institucionalização do idoso e o nível de atividade física, em que sujeitos pouco ativos e inativos apresentaram maiores probabilidades de institucionalização (OR = 1,71 e OR = 4,73, respectivamente). CONCLUSÕES: Dentre todas as características investigadas nos idosos, idade > 80 anos, viver sem companheiro e ser fisicamente inativo foram os indicadores mais fortemente associados à ocorrência de institucionalização. O incentivo ao cuidado informal, a partir de ações educativas e culturais focadas no papel da família para o idoso, pode impedir a institucionalização desses indivíduos.
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Silva SGD, Silva MCD, Nahas MV, Viana SL. Fatores associados à inatividade física no lazer e principais barreiras na percepção de trabalhadores da indústria do Sul do Brasil. CAD SAUDE PUBLICA 2011. [DOI: 10.1590/s0102-311x2011000200006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Identificar as principais barreiras percebidas e verificar os fatores associados à inatividade física no lazer em trabalhadores industriários do Estado do Rio Grande do Sul, Brasil. Estudo transversal com análise secundária de dados, incluindo 2.265 trabalhadores. Treze barreiras foram investigadas: cansaço, clima, excesso de trabalho, falta de vontade, obrigações de estudo, obrigações familiares, distância até o local da prática, falta de habilidade motora, falta de condições físicas, falta de instalações, falta de dinheiro e condições de segurança, além da opção outra. A prevalência de inatividade física no lazer entre os trabalhadores foi 45,4%, e as barreiras mais prevalentes foram cansaço (15,1%), excesso de trabalho (12,7%) e obrigações familiares (9,2%). Cansaço, excesso de trabalho, obrigações familiares, falta de vontade, falta de dinheiro, obrigações de estudo e clima estiveram associados à inatividade física no lazer. Políticas públicas focadas em macroestratégias de intervenção podem ajudar esses trabalhadores a superar tais barreiras e incorporarem um estilo de vida ativo.
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Silva SGD, Silva MCD, Nahas MV, Viana SL. [Variables associated with leisure-time physical inactivity and main barriers to exercise among industrial workers in Southern Brazil]. CAD SAUDE PUBLICA 2011; 27:249-259. [PMID: 21359461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 11/24/2010] [Indexed: 05/30/2023] Open
Abstract
The aim of this study was to identify the main perceived barriers to leisure-time physical activity and factors associated with physical inactivity among industrial workers in the State of Rio Grande do Sul, Brazil. A cross-sectional study with analysis of secondary data included 2,265 workers. Thirteen barriers were investigated: fatigue, weather, overwork, lack of will, study obligations, family obligations, distance to the facility/setting, affordability, lack of motor skills, poor physical conditioning, lack of facilities, lack of money, security, and others. Prevalence of physical inactivity among workers was 45.4%, and the most common barriers were fatigue (15.1%), overwork (12.7%), and family obligations (9.2%). Fatigue, overwork, family obligations, lack of will, affordability, study obligations, and weather were associated with leisure-time physical inactivity. Government policies focused on overarching interventions could help these workers overcome such barriers and adopt an active lifestyle.
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Affiliation(s)
- Shana Ginar da Silva
- Programa de Pós-graduação em Educação Física, Universidade Federal de Pelotas, Rua Luis de Camões 625, Pelotas, RS, Brazil
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