Concordância Entre O Estado Nutricional Aferido E O Percebido Pelas Mães Em Crianças Pré-Escolares

Abstract

Objective: To verify the agreement between nutritional status perceived by mothers and that diagnosed in preschool children, by providing the differences according to children’s sex and age.Methods: Study with data from a cohort of 269 preschool children assisted in public daycare centers of Campina Grande, Paraíba (Northeast Brazil). Children’s information about their date of birth, sex and nutritional status (weight/stature Z scores) was collected. Furthermore, the mothers were asked about their perception of children’s weight. The diagnostic agreement between the measured nutritional status and that perceived by mothers was assessed through the weighted Kappa test, with a 5% significance level.Results: The percentage of disagreement between the measured nutritional status and that perceived by mothers was 32.7%, with Kappa of 0.122, which is considered insignificant. There was a remarkable overweight underestimation (69.6%). Agreement between maternal perception of overweight and the diagnosed nutritional status was higher for older children (36-59 months versus 24-35 months) and for girls.Conclusions: The study regarding maternal perception of preschool children’s nutritional status showed the difficulty that mothers face in recognizing the real nutritional status of their children, especially the underestimation of overweight. Maternal perception of overweight in children is misrepresented in boys and in younger children with more importance.

Percepção materna do estado nutricional do filho sob a óptica da análise dos resíduos ajustados

“…We found similarity with some studies for the Kappa result, which showed poor agreement for the general data 16,17,21 while others obtained agreement ranging from mild to moderate 14,25,27,28 . Regarding gender, the agreement obtained in our study was similar to a study carried out in daycare centers in a city in southern Brazil 29 , being higher for mothers of girls; greater agreement for these mothers was also found in a study conducted with preschooler s17 .…”

“…The correct classifications of nutritional status varied little from the data in the literature for the total number of cases, for overweight and obese children. Among the incorrect classifications of mothers, our study showed a lower prevalence of overestimation in relation to the studies consulted 13,14,[16][17][18][19][20][21][22][23][24][25][26][27] .…”

Maternal Underestimation of Child’s Weight at Pre-School Age and Weight Development between Age 5 and 12 Years: The ABCD-Study

“…Then, two multivariate models were built: the first adjusted for child sex and baseline SDS-BMI, to adjust for variation in SDS BMI within the spectrum of normal weight and overweight, respectively (Model 1), and the second adjusted further for maternal and paternal BMI, maternal age, ethnicity, and educational level (Model 2) to investigate the explanatory role of these characteristics on the association between maternal perception and child’s weight development. Growth differs between boys and girls [ 21 ] and some studies show sex differences to be in agreement between measured and perceived child’s weight by mothers [ 22 ]. Therefore, effect modification by child’s sex in the association between maternal child’s weight perception and weight development was tested by creating an interaction term between maternal child’s weight perception and child’s sex and adding it to the multivariable regression analysis (Model 2).…”

Agreement between the nutritional status of schoolchildren and the perception of their guardians

“…Other studies, although they did not use the same classification criteria [23,24], found similar results. This trend was reported by Batista & Rissin [25] who described an accelerated decline in malnutrition and increase in the prevalence of overweight and obesity in the Brazilian population, thus establishing the process of nutritional transition.…”