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[巴西儿童中与婴儿发育相关的因素:快乐儿童计划影响评估的基线]

[Factors associated infant development in Brazilian children: baseline of the impact assessment of the Happy Child Program].

作者信息

Munhoz Tiago N, Santos Iná S, Blumenberg Cauane, Barcelos Raquel Siqueira, Bortolotto Caroline C, Matijasevich Alicia, Santos Júnior Hernane G, Santos Letícia Marques Dos, Correa Luciano L, Souza Marta Rovery de, Lira Pedro I C, Altafim Elisa Rachel Pisani, Macana Esmeralda Correa, Victora Cesar G

机构信息

Curso de Psicologia, Universidade Federal de Pelotas, Pelotas, Brasil.

Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil.

出版信息

Cad Saude Publica. 2022 Feb 11;38(2):e00316920. doi: 10.1590/0102-311X00316920. eCollection 2022.

Abstract

The study aimed to assess socioeconomic, family, and individual factors associated with infant development (i.e., in the first year of life) among families with social vulnerability. This was a cross-sectional analysis of baseline data from a randomized trial. The study included 3,242 children < 12 months of age living in 30 municipalities from five regions of Brazil. The choice of states and municipalities was intentional, based on the implementation of the Brazilian Happy Child Program. The sample was selected among eligible children for the Brazilian Happy Child Program, and the objective was the promotion of infant development. The Ages and Stages Questionnaire (ASQ) was used to assess infant development. A three-level analytical model (state, municipality, and individuals), using the Wald test for heterogeneity and linear trend, estimated the mean ASQ-3 and 95% confidence interval (95%CI). The analyses were adjusted for potential confounders. Information was analyzed for 3,061 (94.4%) children with available data for ASQ-3. Infant development scores (total and in all the domains) were some 12% lower in preterm children and those with intrauterine growth restriction (small for gestational age). Lower scores were seen in children of mothers with low schooling, depressive symptoms, two or more children under seven years of age living in the household, and who did not report self-perceived support or help during the pregnancy. In conclusion, potentially modifiable characteristics (schooling, maternal depression, and prematurity/intrauterine growth restriction) showed greater impact on reducing the infant development score in all the target domains.

摘要

该研究旨在评估社会脆弱家庭中与婴儿发育(即生命的第一年)相关的社会经济、家庭和个体因素。这是一项对随机试验基线数据的横断面分析。该研究纳入了来自巴西五个地区30个市的3242名12个月以下的儿童。州和市的选择是有意为之,基于巴西“快乐儿童计划”的实施情况。样本是从符合巴西“快乐儿童计划”条件的儿童中选取的,目的是促进婴儿发育。使用年龄与发育进程问卷(ASQ)来评估婴儿发育情况。采用三级分析模型(州、市和个体),运用Wald检验评估异质性和线性趋势,估计ASQ-3的均值及95%置信区间(95%CI)。分析对潜在混杂因素进行了校正。对有ASQ-3可用数据的3061名(94.4%)儿童的信息进行了分析。早产儿童和宫内生长受限(小于胎龄)儿童的婴儿发育得分(总分及所有领域得分)约低12%。母亲受教育程度低、有抑郁症状、家中有两个或更多7岁以下儿童且在孕期未报告有自我感知的支持或帮助的儿童得分较低。总之,潜在可改变的特征(受教育程度、母亲抑郁以及早产/宫内生长受限)对降低所有目标领域的婴儿发育得分影响更大。

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