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| Author(s): |
Joilane Alves Pereira
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR) |
| Defense date: | 2007-10-09 |
| Examining board members: |
Patricia Helen de Carvalho Rondo;
Raul Dias dos Santos Filho;
Jose Maria Pacheco de Souza
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| Advisor: | Patricia Helen de Carvalho Rondo |
| Abstract | |
Introduction: Epidemiological studies suggest that intra-utero exposure to malnutrition, hyperglycemia or hypercortisolemia during critical periods of development leads tometabolic and endocrinological changes that will be expressed in adult life, a condition known as Fetal Programming". Objectives: To assess the relationship between birth weight (BW) and blood pressure, anthropometric and body composition measurements. Methods: This is a retrospective cohort study based on RONDO (2003) data, involving 472 children, aging 5 8 years, from Jundiai, Sao Paulo. Clinical evaluation included blood pressure (BP), weight (W), height (H) and body mass index (BMI) to age. Body composition: tricipital (TSF) and subscapular skinfold thickness (SSF), mid-upper arm circumference (MUAC), waist circumference (WC), fat mid-upper arm area (FMUAA) and muscle mid-upper arm area (MMUAA). The following elements were determined by biochemical analysis: total cholesterol (TC), LDL-cholesterol (LDLc), HDLcholesterol (HDLc) and triglycerides (TG). Household interview included data about socioeconomic and demographic conditions. In order to check the association among continuous variables, Pearson correlation test" was performed. Chi-square" and tstudent" tests were also performed for categorical variables in order to compare means. Linear regression models were applied to investigate the relationship among independent variables (BW and birth length BL) and dependent variables (W, S, BMI, WC, FMUAA, systolic blood pressure SBP and diastolic blood pressure DBP), controlling for confounders such as gender, age, BMI, total cholesterol, HLD-c, per capita income and escolarity. Results: Mean age was 78,9 + 7,9 months; 53,81% of the children were female. The prevalences of malnutrition, risk of overweight and overweight were 9.53%, 14,19% and 8.47%, respectively. The prevalence of children with a SBP ≥ the 95 centile was high (35.16%) and 5.09% of the children had a DBP ≥ the 95 centile. Eight one (17.16%) of the children had low HDL-c; from those, 22,83% were female. BW was positively correlated with FMUAA and BMI (p < 0.001). SBP and DBP were positive correlated with BMI and FMUAA (p < 0.001). In the final linear regression model, adjusted for BMI, it was noticed a significant inverse relationship between BW and SBP. There were no statistically significant associations between BW and DBP and between BL and systolic and diastolic pressures. Conclusions: The inverse relationship between BW with actual SBP, the straight relationship of BP with fat and muscle mass and BMI, and the high prevalence of the risk of overweight/overweight, justify the control of the nutritional status of children since the fetal period and the monitoring of BP measurements in the pediatric routine. (AU) | |