PRE- AND PERINATAL FACTORS ASSOCIATED WITH WEIGHT GAIN AMONG PRESCHOOL CHILDREN ENROLLED AT DAY CARE CENTERS

Almeida, Nykholle Bezerra; Menezes, Rísia Cristina Egito de; Sobral, Kariny dos Santos; Gomes, Jaqueline Fernandes; Longo-Silva, Giovana; Silveira, Jonas Augusto Cardoso da

doi:10.1590/1984-0462/2020/38/2019060

Acessibilidade / Reportar erro

Brasil

Revista Paulista de Pediatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. paul. pediatr. 38 • 2020 • https://doi.org/10.1590/1984-0462/2020/38/2019060 copy

PRE- AND PERINATAL FACTORS ASSOCIATED WITH WEIGHT GAIN AMONG PRESCHOOL CHILDREN ENROLLED AT DAY CARE CENTERS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the factors associated with excessive weight gain in preschool children enrolled at daycare centers in a capital of the Northeast region of Brazil.

Methods:

It was a cross-sectional study conducted at the five daycare centers located in the city’s district of most socioeconomic vulnerability. The study included 326 preschool children (17 to 63 months old) from both genders. The dependent variable was the conditional weight gain (CWG), that represents how much a child, according to their gender, deviated from their peers in relation to the expected weight gain, given sample’s birthweight, gender, and age at the survey. Univariate tests (t-test and analysis of variance) were used to compare CWG means according to environmental and biological factors, considering the independent variables with p<0.20 as electable for the multiple linear regression model. In the final model, variables with p<0.05 or that contributed to the model adjustment were kept.

Results:

Children’s mean age was 45.4±9.9 months, and 53.4% of the sample consisted of boys. The prevalence of overweight was 7%. In the multivariable linear regression model, it was possible to identify that the following factors were associated with excessive weight gain among preschool children: less than six prenatal care visits (0.36 SD [95%CI 0.13–0.60]), not rooming-in in the postpartum period (0.30 SD [95%CI 0.03–0.58]), and never breastfed (0.44 SD [95%CI 0.06–0.81]).

Conclusions:

Inadequate prenatal (appointments) and perinatal care (mother-infant rooming-in and absence of breastfeeding) were associated with excessive weight gain among low-income preschool children.

Keywords:
Child, preschool; Weight gain; Obesity; Child day care centers; Prenatal care; Breast feeding

Characteristics	n	%	Mean CWG (SD)	p-value
Gender
Female	152	46.6	0.00 (1.0)	0.998
Male	174	53.4	0.00 (1.0)	0.998
Age
<36 months	55	16.9	0.00 (1.0)	0.949
≥36 months	271	83.1	0.00 (1.0)	0.949
Nutritional status
Normal weight	263	80.7	-0.32 (0.7)	<0.001*
Risk of overweight	40	12.3	0.99 (0.5)
Overweight	23	7.0	1.96 (0.6)
Birth weight
<2.5 kg	30	9.2	0.09 (0.9)	0.574
≥2.5 kg	296	90.8	0.00 (1.0)	0.574
Gestational age
<37 weeks	45	13.8	0.27 (1.1)	0.050
≥37 weeks	281	86.2	-0.04 (0.9)	0.050
Disease at birth
Yes	41	12.6	0.13 (0.9)	0.354
No	285	87.4	-0.01 (1.0)	0.354
Reasons for hospitalization
Never hospitalized	237	72.7	0.00 (0.9)	0.087*
Preventable diseases	66	20.2	-0.14 (1.0)
Non-preventable diseases	23	7.1	0.39 (1.1)
Anemia
Yes	144	44.3	0.03 (1.0)	0.552
No	188	55.7	0.03 (0.9)	0.552
Group
Maternal I	61	18.7	-0.03 (1.0)	0.953*
Maternal II	150	46.0	0.01 (1.0)
Jardim I	115	35.3	0.00 (0.9)
School shift
Morning	178	54.6	0.00 (0.9)	0.486*
Afternoon	86	26.4	0.09 (1.1)
Full time	62	19.0	-0.10 (1.0)

Characteristics	n	%	Mean CWG (SD)	p-value
Breastfed
Yes	301	92.3	-0.03 (0.9)	0.033
No	25	7.7	0.40 (0.9)	0.033
Exclusive breastfeeding
≤30 days	143	47.5	0.04 (1.0)	0.385*
>30 and ≤180 days	140	46.5	-0.11 (0.9)
>180 days	18	6.0	-0.09 (0.8)
Breastfeeding
≤30 days	34	12.5	0.13 (0.9)	0.387*
>30 and ≤120 days	56	20.5	0.08 (1.0)
>120 days and <180 days	41	15.0	0.11 (1.0)
>180 days	142	52.0	-0.09 (0.9)
Age of sugary drinks introduction
0-6 months	32	9.9	0.12 (1.0)	0.695*
7-12 months	140	43.2	-0.04 (0.9)
>12 months	152	46.9	0.01 (1.0)
Age of ultraprocessed foods introduction
0-6 months	251	77.2	-0.03 (0.9)	0.651*
7-12 months	65	20.0	0.09 (1.0)
>12 months	9	2.8	0.05 (1.0)

Characteristics	n	%	Mean CWG (SD)	p-value
Mother’s age
<21 years	38	11.7	-0.10 (0.8)	0.506
≥21 years	287	88.3	0.01 (1.0)	0.506
Mother’s educational level
<4 years	45	13.8	0.03 (1.1)	0.824
≥4 years	281	86.2	0.00 (1.0)	0.824
Monthly per capita income
≤70 BRL	27	8.4	-0.30 (0.9)	0.097
>70 BRL	296	91.6	0.03 (1.0)	0.097
Government Assistance
Yes	249	76.6	0.00 (1.0)	0.850
No	76	23.4	-0.01 (1.0)	0.850
Planned pregnancy
Yes	173	53.4	0.03 (1.0)	0.419
No	151	46.6	-0.05 (0.9)	0.419
Prenatal (Number of appointments)
<6 appointments	75	23.0	0.26 (1.0)	0.008
≥6 appointments	250	77.0	-0.08 (0.9)	0.008
Type of delivery
Normal	112	34.4	-0.07 (0.9)	0.348
C-section	214	65.6	0.04 (1.0)	0.348
Rooming-in Care
Yes	274	84.3	-0.05 (0.9)	0.024
No	51	15.7	0.28 (1.0)	0.024
First child
Yes	108	33.1	-0.02 (0.9)	0.717
No	218	66.9	0.01 (1.0)	0.717
Siblings aging <5 years
None	235	72.1	0.00 (1.0)	0.708*
1 sibling	81	24.8	0.00 (0.8)
≥2 siblings	10	3.1	0.25 (1.2)

Characteristics	Reference	β*	95%CI	p-value
Prenatal	<6 appointments	0.36	0.13–0.60	0.003
Rooming-in Care	No	0.30	0.03–0.58	0.032
Breastfed	Never	0.44	0.06–0.81	0.022

Sociedade de Pediatria de São Paulo R. Maria Figueiredo, 595 - 10o andar, 04002-003 São Paulo - SP - Brasil, Tel./Fax: (11 55) 3284-0308; 3289-9809; 3284-0051 - São Paulo - SP - Brazil
E-mail: rpp@spsp.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Corresponding author. E-mail: jonas.silveira@fanut.ufal.br (J.A.C. Silveira).