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OBJECTIVE:To analyze the risk factors associated with neonatal deaths among children with low birth weight. METHODS:A cohort study was carried out on live births weighing between 500 g and 2,499 g from single pregnancies without anencephaly in Recife RESULTS:After adjusting the variables through multivariate logistic regression, the factors from the distal level that remained signifi cantly associated with neonatal death were: cohabitation by the parents, number of live births and type of maternity hospital. At the intermediate level, the factors were: number of prenatal consultations, complexity of the maternity hospital and type of delivery. At the proximal level, the factors were: sex, gestational age, birth weight, Apgar score and presence of congenital malformation. CONCLUSIONS:The main factors associated with neonatal mortality among low weight live births are related to prenatal and postnatal care. Such factors are reducible through health sector actions.

OBJECTIVE:The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women.METHODS:This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ≥4 mm and an attachment loss ≥3 mm at the same site in four or more teeth. A logistic regression analysis was also performed.RESULTS:The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque.CONCLUSION:The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.

The aim of this prospective study was to investigate the association between breast feeding and mental and motor development at age 12 months, controlling for comprehensive measures of the child's socio-economic, maternal and environmental background, and nutritional status. A cohort of 205 infants born during May-August 2001 in a poor area in the interior of the State of Pernambuco was enrolled, of whom 191 were tested at age 12 months with the Bayley Scales of Infant Development II, and in whom breast-feeding status was measured at days 1, 10, 30, 60, 90, 120, 150, 180, 270 and 360. After adjusting for potential confounders, full breast feeding (i.e. exclusive or predominant) at 1 month was associated with a small but significant benefit in mental development (+3.0 points, P = 0.02) compared with partial or no breast feeding. No additional advantage in mental development was found with longer durations of full breast feeding. Full breast feeding at 1 month was associated with improved behaviour for two of 10 ratings tested: initiative with tasks (P = 0.003) and attention (P = 0.02). No association between breast feeding and motor development was found.

Several factors that were associated with neonatal mortality in this study may be due to inadequate care during the prenatal period and childbirth, and inadequate newborn care, all of which can be modified.

Objectives

Objective: Breast-feeding counselling has been identified as the intervention with the greatest potential for reducing child deaths, but there is little experience in delivering breast-feeding counselling at scale within routine health systems. The study aim was to compare rates of exclusive breast-feeding associated with a breast-feeding counselling intervention in which community health agents (CHA) received 20 h of training directed at counselling and practical skills with rates pre-intervention when CHA received 4 h of didactic teaching. Design: Cross-sectional surveys of breast-feeding practices were conducted pre-and post-intervention in random samples of 1266 and 1245 infants aged 0-5?9 months, respectively. Setting: Recife, Brazil, with a population of 2 million. Subjects: CHA (n 1449) of Brazil's Family Health Programme were trained to provide breast-feeding counselling at home visits. Results: Rates of exclusive breast-feeding improved when CHA were trained to provide breast-feeding counselling and were significantly higher by 10-13 percentage points at age 3-5?9 months when compared with pre-intervention rates (P , 0?05). Post-intervention point prevalence of exclusive breast-feeding for infants aged ,4 months was 63 % and for those aged ,6 months was 50 %. Conclusions: Multifunctional CHA were able to deliver breast-feeding counselling at scale within a routine health service and this was associated with a significant increase in rates of exclusive breast-feeding. The study reinforces the need to focus training on counselling and practical skills; a key component was an interactive style that utilized the knowledge and experience of CHA. The findings are relevant to the call by international organizations to scale up breast-feeding counselling.

The results suggest that within the population studied, periodontitis was a risk factor for preeclampsia.