Background We aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies. Methods Gestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34–36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m2), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m2), body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI). Results A total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34–36 weeks) presented lower adjusted mean of FM (β = − 0.80 kg, − 1.45;-0.16, p = 0.046), %FM (β = − 2.39%, − 3.90;-0.88, p = 0.008), FMI (β = − 0.70 kg/m2, − 1.13;-0.27, p = 0.004) as well as lower FFM (β = − 0.4 kg, − 0.77; − 0.12, p = 0.010) and FFMI (β = − 0.3 kg/m2, − 0.46;-0.10, p < 0.001), and BMI Z-score (β = − 0.69,; − 0.99;-0.40, p < 0.001); but higher %FFM (β = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA. Conclusions Our results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI.
OBJECTIVE To analyze the quality of life and its determinants in a population living in a rural area.METHODS This is a population-based, cross-sectional study with individuals aged 18 years or over from the rural area of Pelotas, State of Rio Grande do Sul, Brazil. We evaluated quality of life using the WHOQOL-BREF, which has four domains (physical, psychological, social relations, and environment) and two questions: overall quality of life and satisfaction with health. We considered as independent variables the demographic, socioeconomic, and health variables. We evaluated the associations using linear regression in the four domains and ordinal logistic regression in the two general questions on quality of life and satisfaction with health.RESULTS The sample consisted of 1,479 individuals. The prevalence of the perception of overall very poor quality of life and dissatisfaction with health were 22.5% and 26.3%, respectively. Individuals who were older (p < 0.001), non-white (p = 0.004), with lower education level (p < 0.001), poorer (p = 0.001), and who had always lived in the rural area (p = 0.049) were less likely to have a better perception of overall quality of life. As for satisfaction with health, women (p = 0.001), older individuals (p = 0.001), those unemployed (p = 0.023), and those with diseases were less likely to report higher satisfaction with health. For the four domains evaluated, the results were consistent with those observed for the general questions.CONCLUSIONS The most relevant aspects that negatively defined the quality of life of the population were being a woman, older, non-white, having a low income, having a lower education level, having always lived in the rural area, being unemployed, and having a disease. Given that they are significant factors as determinants of health, these results suggest that quality of life is an issue that should be placed among health needs, especially regarding the most vulnerable groups in rural areas.
RESUMO: Objetivos: Descrever a ocorrência simultânea de fatores de risco para doenças crônicas não transmissíveis e os fatores associados à simultaneidade dessas prevalências em adultos residentes na zona rural de um município no sul do Brasil. Métodos: Trata-se de estudo transversal com 1.445 adultos da zona rural de Pelotas, RS. Foram considerados quatro fatores de risco: tabagismo, consumo de álcool, inatividade física e consumo inadequado de legumes/verduras. Para verificar a ocorrência simultânea, utilizou-se análise de clusters. A associação foi avaliada por regressão ordinal, obtendo-se estimativas em razões de odds. Resultados: Dos quatro fatores de risco avaliados, três foram mais prevalentes entre os homens, sendo apenas inatividade física maior entre as mulheres. Na análise de clusters, consumo de álcool + tabagismo + consumo inadequado de vegetais foi a única combinação que apresentou prevalência observada significativamente maior que a esperada (O/E = 2,67; IC95% 1,30; 5,48), sendo superior a encontrada em outro estudo no sul do país, dado que pode ser justificado pois tal estudo incluiu o consumo de frutas além de ter avaliado população urbana, enquanto para este estudo avaliou-se apenas a população rural. Após ajuste, os homens, indivíduos solteiros, de cor da pele preta, parda ou outra, com baixa escolaridade, pior condição socioeconômica, pior percepção de saúde e que não desenvolviam atividades rurais apresentaram maior odds ratio de acúmulo de fatores de risco. Conclusão: Os achados evidenciam a importância do desenvolvimento de ações prioritárias em relação à saúde da população rural com atenção específica aos subgrupos de maior risco identificados.
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