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Comprehensive health care for children in the Unified Health System of Botucatu, SP: growth of pre-school and school children born with low birth weight from 2004 to 2008

Grant number: 14/06553-4
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): August 01, 2014
Effective date (End): July 31, 2016
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Cátia Regina Branco da Fonseca
Grantee:Marília de Medeiros Couto
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The low birth weight newborn has been the objective of many studies due to its important participation in infant's mortality and morbidity, besides the risks to its growth and development. Nowadays, the premature and low birth weight newborn have more chance to survive. The attendance and the opportune intervention, functions of the different levels of health assistance in its integrality, seek to offer the newborn child the conditions to its global development, as adequate as it can be, therefore modifying its prognosis. For the group with less than 1500 grams of weight, the knowledge about a bigger probability of changes in its growth and development motivated the construction of specific protocols for their accompaniment and interventions. However, for the children between 1500 e 2500 grams of weight - a more heterogeneous group of causes and alterations - there's only little definition about evaluation instruments, as well as for accompaniment methods in health and in school.General purpose: To describe the frequency of growth alterations in pre-scholar and scholar children, low birth weight newborn between 2004 and 2008, in the city of Botucatu-SP. Specific purposes:*To describe the nutritional status of the selected children through anthropometric evaluation followed by calculation and ordination of BMI.*To describe the incidence of short stature, overweight and obesity in the population studied and analyze possible associations with gestational age and intra uterine growth restricted set.*To compare the results, concerning to growth and nutritional status, of the underweight born children, to a group of children born in the same period, though with appropriate weight. Method: A case-control study, approved in the Ethics Committee. After the consent in participating the Project, the first and second steps will take place simultaneously for the children in both groups (Case - low birth weight newborn, and Control - not low birth weight).In the first step, from the SINASC data - The Birth Certificate, the following information will be collected: maternal age at the time of the child's birth; maternal schooling (complete years of study); number of children in previous pregnancies, live born and stillborn; neighborhood or district of residence; gestation length (measured in weeks) grouped in pre-term pregnancy (shorter than 37 complete weeks), term pregnancy (between 37 and 41 complete weeks) and post-term pregnancy (longer than 42 complete weeks); type of pregnancy - single, twins, triplets; type of delivery - normal, cesarean, with forceps; number of prenatal queries; newborn gender; Apgar score in the fifth minute; birth weight; presence of congenital malformations and/or chromosomal abnormalities.In the second step, anthropometric and skin folds evaluation and blood pressure measurement will be made in a random sample of the underweight born children population and in the non-underweight as a control group (204 children per group). The present study intends to evaluate the growth conditions of this group of low birth weight newborn, in comparison to the control group, and to assist the municipal management of the Basic Attention in Pediatrics, in the Public Health System, in the definition of protocols and required procedures to improve the attendance of these children, specifically those between 1500 and 2500 grams of weight, in order to avoid deviations in their growth as well as to potentiate health actions for this population group. (AU)