Infant nutrition and growth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

Gonçalves, Helen; Barros, Fernando C.; Buffarini, Romina; Horta, Bernardo Lessa; Menezes, Ana Maria Baptista; Barros, Aluísio J D; Domingues, Marlos Rodrigues; Victora, Cesar G; Matijasevich, Alícia; Bertoldi, Andréa Dâmaso; Bassani, Diego G.; Wehrmeister, Fernando C.; Santos, Iná S.; Murray, Joseph A.; Tovo‐Rodrigues, Luciana; Assunção, Maria Cecília Formoso; Silveira, Mariângela F.; Hallal, Pedro Rodrigues Curi

doi:10.1093/ije/dyy233

Cited by 37 publications

(36 citation statements)

References 33 publications

(69 reference statements)

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“…After adjustment for wealth and residence, two countries -Colombia and Ecuadorshowed a lower prevalence of stunting in afrodescendants than in the reference children, and no country showed higher prevalence among the latter. The published literature on this comparison is scarce; we were able to find a study from Colombia reporting that adult afrodescendants were taller than individuals classified as indigenous or "others" [55], and a birth cohort from Southern Brazil where oneyear old children born to white and black mothers had similar prevalence of stunting [56].…”

Section: Discussionmentioning

confidence: 95%

Ethnic inequalities in child stunting and feeding practices: results from surveys in thirteen countries from Latin America

Gatica-Domínguez

Mesenburg

Barros

et al. 2020

Int J Equity Health

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Background: Although the prevalence of child stunting is falling in Latin America, socioeconomic inequalities persist. However, there is limited evidence on ethnic disparities. We aimed to describe ethnic inequalities of stunting and feeding practices in thirteen Latin American countries using recent nationally representative surveys. Methods: We analyzed national surveys carried out since 2006. Based on self-reported ethnicity, skin color or language, children were classified into three categories: indigenous/ afrodescendant/reference group (European or mixed ancestry). Stunting was defined as height (length)-for-age < − 2 standard deviations relative to WHO standards. Family wealth was assessed through household asset indices. We compared mean length/height-for-age and prevalence of stunting among the three ethnic groups. Results: Thirteen surveys had information on indigenous and seven on afrodescendants. In all countries, the average length/height-for-age was significantly lower for indigenous, and in eleven countries there were significant differences in the prevalence of stunting: the pooled crude stunting prevalence ratio between indigenous and the reference group was 1.97 (95% CI 1.89; 2.05); after adjustment for wealth and place of residence, prevalence remained higher among indigenous (PR = 1.34, 95% CI 1.28; 1.39) in eight countries. Indigenous aged 6-23 months were more likely to be breastfed, but with poor complementary feeding, particularly in terms of dietary diversity. Afrodescendants showed few differences in height, and in two countries tended to be taller compared to the reference group. Conclusions: In all Latin American countries studied, indigenous tended to be shorter and afrodescendants presented few differences with relation to the reference group. In order to reach the SDG's challenge of leaving no one behind, indigenous need to be prioritized.

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Section: Discussionmentioning

confidence: 95%

Ethnic inequalities in child stunting and feeding practices: results from surveys in thirteen countries from Latin America

Gatica-Domínguez

Mesenburg

Barros

et al. 2020

Int J Equity Health

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“…The improvements in maternal height which we documented in our cohorts have also been observed for height of young children; Gonçalves et al . reported a marked decrease in the prevalence of stunting at 12 months of age, 25 as well as reductions in socioeconomic inequalities. In Brazil, the prevalence of stunting in childhood decreased from 37.1% in 1974–75 to 7.1% in 2006–7 33 .…”

Section: Discussionmentioning

confidence: 99%

Maternal anthropometry: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

Horta

Barros

Lima

et al. 2019

International Journal of Epidemiology

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Background Pre-pregnancy nutritional status and weight gain during pregnancy have short- and long-term consequences for the health of women and children. This study was aimed at evaluating maternal height,- and overweight or obesity at the beginning of the pregnancy and gestational weight gain, according to socioeconomic status and maternal skin colour of mothers in Pelotas, a southern Brazilian city, in 1982, 1993, 2004 and 2015. Methods In 1982, 1993, 2004 and 2015, the maternity hospitals in Pelotas were visited daily, all deliveries were identified and mothers who lived in the urban area of the city were interviewed. Maternal weight at the beginning of the pregnancy was self-reported by the mother or obtained from the antenatal card. Maternal height was collected from the maternity records or measured by the research team. Overweight or obesity was defined by a body mass index ≥25 kg/m2. Gestational weight gain was evaluated according to the Institute of Medicine guidelines. Results In the four cohorts, we evaluated 19 931 women. From 1982 to 2015, the prevalence of overweight or obesity at the beginning of the pregnancy increased from 22.1% to 47.0% and height increased by an average of 5.2 cm, whereas gestational weight gain did not change. Socioeconomic status was positively associated with maternal height, and the difference between the poorest and the wealthiest decreased. Overweight or obesity was lower among those mothers in the extreme categories of family income. Conclusions Over the 33-year span, mothers were taller at the beginning of the pregnancy, but the prevalence of overweight or obesity more than doubled.

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“…From 1982 to 2015, standards of housing, sanitation and water supply improved markedly, as well as levels of parental education and family income 10 . Although low birthweight remained stable, 15 undernutrition in infancy was markedly reduced 18 . Parental smoking was also reduced 19 .…”

Section: Discussionmentioning

confidence: 99%

Hospital admissions in the first year of life: inequalities over three decades in a southern Brazilian city

Wehrmeister

Victora

Horta

et al. 2019

International Journal of Epidemiology

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Background Hospital admissions in infancy are declining in several countries. We describe admissions to neonatal intensive care units (NICU) and other hospitalizations over a 33-year period in the Brazilian city of Pelotas. Methods We analysed data from four population-based birth cohorts launched in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. NICU and other hospital admissions during infancy were reported by the mothers in the perinatal interview and at the 12-month visit, respectively. We describe these outcomes by sex of the child, family income and maternal skin colour. Results In 1982, NICUs did not exist in the city; admissions into NICUs increased from 2.7% of all newborns in 1993 to 6.7% in 2015, and admission rates were similar in all income groups. Hospitalizations during the first year of life fell by 29%, from 23.7% in 1982 to 16.8% in 2015, and diarrhoea admissions fell by 95.2%. Pneumonia admissions fell by 46.3% from 1993 to 2015 (no data available for 1982). Admissions due to perinatal causes increased during the period. In the poorest income quintile, total admissions fell by 33% (from 35.7% to 23.9%), but in the richest quintile these remained stable at around 10%, leading to a reduction in inequalities. Over the whole period, children born to women with black or brown skin were 30% more likely to be admitted than those of white-skinned mothers. Conclusions Whereas NICU admissions increased, total admissions in the first year of life declined by nearly one-third. Socioeconomic disparities were reduced, but important gaps remain.

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Infant nutrition and growth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

Cited by 37 publications

References 33 publications

Ethnic inequalities in child stunting and feeding practices: results from surveys in thirteen countries from Latin America

Ethnic inequalities in child stunting and feeding practices: results from surveys in thirteen countries from Latin America

Maternal anthropometry: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

Hospital admissions in the first year of life: inequalities over three decades in a southern Brazilian city

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