Charles University, Faculty of Pharmacy, Hradec Králové Department: Department of Pharmacognosy Head of thesis: doc. PharmDr. Lenka T mová, Csc. Student: Bc. Rut Łu ská Title of the thesis: Teratogenic drugs The aim of this diploma thesis is to give an overview of teratogenic drugs. The work approaches the problems of teratogenesis, factors affecting teratogenicity, distribution of teratogens, classification of medication in pregnancy and methods of teratogenicity study. An overview of teratogenic plants broken down by family with manifestation of teratogenicity and substances responsible for teratogenicity is given here. Most teratogenic plants were found in the Fabacae, Compositae and Lamiacae families. Alkaloids and terpenes are most often responsible for teratogenic effects. In addition, the work focuses on the negative effects of cannabis, tobacco smoking and caffeine on the course of pregnancy. Keywords: teratogen, medicinal plant, drug, pregnancy

Introduction: The most common symptom of ankyloglossia is breastfeeding problems. Lately, more attention has been given to problems beyond infancy, like with speech and mobility. There is limited research done in that area though, and there is no research made comparing indication groups with each other.Aim: To investigate if there is a difference in the self-experienced benefit of the tongue-tie release, in relation to the indication for cutting the tongue-tie.Methods: A retrospective survey of all patients who underwent a tongue-tie release in Örebro county under a period of two years. The patient, or their caregiver if the patient was under 18 years old, were contacted for a telephone survey. 73 patients completed the survey.Results: The results demonstrated no significant difference in self-experienced benefit between the indication-groups. 88% of all patients included in the study experienced benefit, 98% of these patients had a primary (n=57) or secondary (n=6) symptom that got better. The remaining 2% (n=1) experienced benefit despite any symptom relief because of the possible future benefit. The 12% that did not experience benefit did not experience any symptom relief from the surgery.Conclusions: The self-experienced benefit after the tongue-tie release was high in general, without differences between the indication-groups. It turned out to be important to ask for other symptoms than just the primary to see the whole picture. More research with a larger study population is encouraged.

SAMMANFATTNING Bakgrund: De flesta kvinnor ser amning som det naturligaste sättet att ge ett nyfött barn näringsrik föda. Kvinnor får information via mödravården och sjukvården att bröstmjölken innehåller den näring som ett nyfött barn behöver. Dessutom skyddar den mot några av de vanligaste barnsjukdomarna. Alla kvinnor i dagens samhälle kan inte amma. Vissa kan inte amma på grund av fysiska orsaker. Det finns också kvinnor som har genomgått bröstoperationer. I dag opererar allt fler kvinnor sina bröst av olika anledningar, exempelvis på grund av missnöje med utseendet eller ryggproblematik. Antalet operationer har ökat markant och majoriteten av kvinnorna som genomgår en bröstoperation är i reproduktiv ålder. En del kvinnor erhåller inte adekvat information angående komplikationer som kan bli bestående. Kvinnor överväger inte eventuella bieffekter som bröstkirurgi kan ha gällande deras framtida förmåga att amma. Det är viktigt för barnmorskan att så tidigt som möjligt främja amning. För att stödet från barnmorskan ska bli optimalt behövs god kunskap och en positiv attityd till amning. Syfte: Syftet med detta arbete var att beskriva vilka effekter bröstoperationer kan ha på amning och att belysa hur stöd och information kan påverka amningen efter bröstoperation. Metod: En litteraturöversikt utfördes där 23 vetenskapliga artiklar inkluderades. Artikelsökningen genomfördes i databaserna PubMed och CINAHL där artiklar publicerade mellan åren 2000 – 2014 söktes. Även manuella sökningar förekom. Artiklar både med kvalitativ och med kvantitativ ansats inkluderades i översikten. Författaren klassificerade och utförde kvalitetsbedömning på samtliga artiklar. Alla artiklar hade granskats av etisk kommitté. Resultat: Operationerna som genomförs idag med uppdaterad teknik ska inte påverka amningsförmågan om operationen utförs på rätt sätt. I studien framkom att kvinnor har olika erfarenheter av bröstoperationer. Vissa kvinnor kunde amma exklusivt, det vill säga gav sitt barn endast bröstmjölk, under en längre tid medan andra inte hade tillräckligt med mjölkmängd för att under en längre tid amma sitt barn. Det framkom också att vissa mammor inte lyckades komma igång med amningen och avstod därmed. Stödet som ges är betydande. Något som genomsyrar litteraturöversikten är den bristande informationen, det vill säga kvinnorna som opererar sig får inte adekvat information angående möjligheten att kunna amma eller eventuellt inte. Slutsats: Resultatet visade att bröstoperationer och den teknik som användes kan påverka hur vida kvinnan kan amma eller inte. Dock är inte operationen den enda avgörande faktorn för en lyckad amning. Studien som utfördes påvisade att stödet och uppmuntran som gavs till mamman hade en avgörande roll. Stödet och uppmuntran som mamman fick i samband med förlossningen och vid eventuella svårigheter var avgörande för hennes beslut om att amma eller inte.

Enligt World Health Organizations rekommendationer bör kvinnor uteslutande amma sina barn under de första sex levnadsmånaderna. Amning medför kortsiktiga och långsiktiga hälsofördelar för både mamman och barnet och innebär miljömässiga och ekonomiska vinster både på individ och samhällsnivå. Trots detta sjunker amningsfrekvensen och det är i skrivande stund bara en tredjedel av världens spädbarn som helammas upp till sex månaders ålder. I Sverige har andelen helammade barn minskat under de senaste 30 åren och frekvensen fortsätter att sjunka. Detta är ett stort folkhälsoproblem där barnmorskan har en central uppgift i sitt arbete att främja och stödja kvinnor till amning.  Syftet var att undersöka vilka faktorer som bidrar till att kvinnor helammar sitt barn. Vald metod var en integrativ litteraturöversikt med en flerstegsprocess framställd av Whittemore och Knafl. Sexton artiklar inkluderades i resultatet, varav åtta kvantitativa, sjukvalitativa och en av mixad metod. All data insamlades via databaserna PubMed och CINAHL under våren 2023. I resultatet sammanställs fem kategorier som svarar på syftet: aktivt stöd från barnmorskan genom hela vårdkedjan, stöd från partner och omgivning, bemötande och motivation, kunskap och evidensbaserad information samt skyddsfaktorer och riskfaktorer till helamning. Slutsatsen var att kvinnor helammar i större utsträckning när de haft ett aktivt stöd från barnmorskan genom hela vårdkedjan. Ett individanpassat stöd med respekt för kvinnans autonomi var viktigt. Motivationen att helamma ökade i de fall barnmorskan uppmuntrade och stärkte kvinnornas upplevelse av självförmåga samt visade tilltro till deras nya roll som ammande mödrar. Att ha en stödjande partner samt att kvinnorna fick adekvat och evidensbaserad information om amning var också avgörande. Inkonsekventa och motsägelsefulla amningsråd minskade förtroendet för vårdgivarna och påverkade amningen negativt. Gemensamma riktlinjer för amningsstöd bör utformas inom vårdverksamheten och varje barnmorska bör hålla sig uppdaterade kring evidensbaserad kunskap om amning. / World Health Organization recommend women to exclusively breastfeed their children until the age of six months. Breastfeeding contributes to short-term and long-term health benefits for both the mother and child and entails environmental and economic gains at an individual and societal level. Despite this, breastfeeding rates are decreasing and currently only one third of the children worldwide are exclusively breastfed up to the age of six months. In Sweden, exclusive breastfeeding has decreased over the last 30 years and continues to do so. This is a major public health problem where midwives play a central role in their work to promote and support women to breastfeed. The aim was to investigate which factors contribute to women exclusively breastfeeding their children. The chosen method was an integrative literature review based on Whittemore and Knafl´s multi-stepprocess. Sixteen articles were included in the results, eight quantitative, seven qualitative and one of mixed method. All data were collected via the databases PubMed and CINAHL in the spring of 2023. The results compiled five categories: active support from the midwife throughout the care-chain, supportive partner and friends, treatment and motivation, knowledge and evidence-based information as well as protective factors and risk factors for exclusive breastfeeding. Women exclusively breastfeed longer when they recieve active support from midwives throughout the entire care-chain. Individuaized care and respect for womens autonomy was important. The motivation to breastfeed increased when the midwife encouraged and strengthened the womans self-efficacy and showed trust in their new role as breastfeeding mothers. Having a supportive partner as well as receiving adequate and evidence-based information about breastfeeding from midwives were also important. Inconsistent breastfeeding advice from care givers negatively affected their motivation. It is important that midwives create common guidelines for support and remain updated on evidence-based breastfeeding knowledge.

Cultural practices influence infant feeding choices and have a significant impact on children’s physiological growth and cognitive development. This study examined cultural knowledge of infant feeding among woman in rural and urban Bangladesh. The findings of this research indicated that there was sufficient agreement among the respondents to constitute a single shared cultural model of infant feeding among participants in Bangladesh. Results also indicated intracultural variation within this model in terms of duration of exclusive breastfeeding, age at introduction of water, and weaning practices. Better understanding infant feeding can inform future programs aimed at improving early nutrition, growth, and development by providing information about actual practices and their cultural importance.

Objectives: To assess the use of the “Core Competencies for Public Health Professionals” standards in practice and academic work settings by public health nurses (PHNs), and to determine differences between practitioners and faculty. Design: Nonexperimental, descriptive study using a cross‐sectional survey. Sample: Three public health nursing (PHN) organizations sent invitations to all members. A total of 334 (18.7%) from an estimated 1,786 members completed the survey. Measurements: The investigators developed a 17‐item web‐based survey with open‐ and closed‐ended responses, using Rogers' diffusion of innovations as a theoretical framework. Results: Respondents are equally familiar with the competencies for public health professionals disseminated by the Council on Linkages and for PHNs by the Quad Council of Public Health Nursing Organizations (Quad Council). Two thirds of PHNs are aware of the competencies after only 2 years, primarily from professional PHN organizations. Faculty are adopting and using the competencies at a significantly faster rate than practitioners. Conclusions: Faculty and practitioners who use the competencies value them, and rarely discontinued their use after adoption. Efforts to promote diffusion among faculty and especially practitioners need to continue. Professional organizations can actively provide and share examples of useable formats and best practices associated with the competencies.

Objectives- The purpose of this study was to determine if differences in breast milk (BM) short chain fatty acid (SCFA) and microbiome profiles are correlated to maternal BMI. Our hypothesis is that BM SCFA are a reflection of colonic SCFA distribution and concentration and may reflect microbiome diversity in the maternal gut. Methods- Study design-This was a cohort study in which forty-six Caucasian participants were recruited from BABE Breastfeeding Coalition of Tri-Cities, divided into two groups, one group with normal pre-gravid BMI between 18.5 and 24.9 kg/m2 (n=23) and the other group with overweight or obese pre-gravid BMI greater than 25.0 kg/m2 (n=23). Each participant completed a demographic and health survey and provided 4 ounces of expressed BM. This study was approved by the ETSU IRB (0915.8s-ETSU). 16s rRNA Isolation & Quantification- Microbiome analysis was performed on thirty-four samples (n=13 for overweight/obese, and n=21 for normal weight). Qiagen QIAmp PowerFecal Pro DNA Kit was utilized for isolation of microbiome DNA; Amplicon sequencing of the 16S rRNA region was performed at the University of Tennessee Genomics Core Laboratory utilizing a modified Klindworth et al method. Microbiome Analysis- Operational Taxonomic Unit (OUT) clustering and taxonomic analysis were performed using CLC Genomics Workbench. Alpha diversity indexes were calculated using the Abundance Analysis tool, and the weighted Unifrac metric was used to calculate Beta diversity. Fatty Acid Profile- BM samples were subjected to SCFA extraction and analysis using a modified Schwiertz et al. method. The resulting SCFA profiles were then utilized to determine if there were any significant differences between groups. Results- No significance was observed in BM microbiome between the normal weight and overweight/obese groups for alpha or beta diversity. Significance was detected between the groups for valeric (p=0.02) and isocaproic acids (p=0.05) with the normal weight group higher than the overweight/obese group. No significance was observed for any of the other SCFAs. Conclusions- Although these results are not significant due to low sample size and lack of diversity, they potentially offer insights into the impact of maternal BMI on microbiome and SCFA profiles, which can have implications for infant health and development. Funding Sources- ETSU Small RDC Grant

The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)

Estudos atuais mencionam os efeitos benéficos proporcionados pelo aleitamento materno e contato pele-a-pele no alívio da dor aguda em RN. A maioria dos estudos que trazem a amamentação como medida de alívio da dor aguda durante a administração da vacina intramuscular são feitos com bebês com mais de dois meses de idade. O objetivo deste estudo foi avaliar o efeito da amamentação materna na resposta à dor e ao estresse do RN submetido à vacina intramuscular contra Hepatite B, em comparação ao contato pele-a-pele. Trata-se de um estudo analítico de caráter experimental, do tipo ensaio clínico randomizado, realizado no Centro de Referência da Saúde da Mulher de Ribeirão Preto - MATER, no período de janeiro de 2009 a maio de 2010. A amostra constituiu-se de 55 bebês a termo que foram divididos aleatoriamente em dois grupos: grupo A (contato pele-a-pele), composto por 28 RN, que foram mantidos por 5 minutos em berço comum (período basal), 15 minutos em contato pele-a-pele antes da administração da vacina, (período de tratamento), durante todo o período de antissepsia/ injeção, durante a compressão e até 5 minutos após o término do procedimento (período de recuperação); e grupo B (aleitamento materno), composto por 27 RN, que foram mantidos em berço comum por 5 minutos (período basal), 5 minutos em contato pele-a-pele iniciando no 5° minuto o aleitamento materno (10 minutos no período de tratamento) e sendo mantidos nesta condição durante a antissepsia/ injeção, o período de compressão, e a recuperação (5 minutos após o término da compressão). O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Instituição e pelo Comitê de Ética em Pesquisa da EERP - USP, e o Termo de Consentimento Livre e Esclarecido foi firmado com as mães dos RN antes da coleta dos dados. O procedimento de coleta constituiu-se da monitorização da frequência cardíaca e filmagem para posterior análise das manifestações comportamentais (mímica facial por meio da escala NFCS adaptada) e fisiológicas dos RN. Os resultados dos grupos A e B foram comparados em todos os períodos. A normalidade das distribuições das variáveis quantitativas foi testada por meio do teste de Kolmorogov-Smirnov. Se normalmente distribuídos, foi utilizada a ANOVA. O teste de Mann-Whitney foi utilizado quando a normalidade não foi satisfeita. Para variáveis categóricas utilizamos o teste Qui-quadrado ou teste exato de Fisher. O nível de significância utilizado foi de α ≥ 0,05. Para verificação de diferenças entre os escores de NFCS entre os grupos e períodos (intra grupos) foram utilizados o teste não paramétrico Mann-Whitney para duas amostras independentes e o teste não paramétrico Friedman para mais do que duas amostras dependentes, seguido de comparações múltiplas, respectivamente. Para o resultado do teste Mann Whitney e para as comparações múltiplas, o teste de Wilcoxon foi utilizado, considerando-se o ajuste do valor do nível de significância α= 0,05 pelo número de comparações. O teste Mann Whitney mostrou diferenças entre os grupos e o percentual de manifestações de mímica facial, ocorrendo em proporção significativamente maior no grupo A quando comparado ao grupo B, no período basal (p=0,003), de compressão (p=0) e recuperação (p=0), ou seja, os bebês do grupo B se recuperaram melhor e mais rápido quando comparados aos bebês do grupo A. Na análise intra grupos, o teste de Friedman com α = 0,005 ajustado, mostrou que para o grupo A houve diferença estatisticamente significativa em quase todos os períodos com exceção do período basal para o tratamento (p=0,010) e para o grupo B tivemos diferenças estatisticamente significativa para quase todos os períodos com exceção dos períodos basal para o tratamento (p=0,808), e da compressão para a recuperação (p=0,064). Para verificação de diferenças entre os escores de FC entre os grupos e intra grupos foi utilizada a Análise Variância com Medidas Repetidas. Como a interação foi significativa (p=0,05) testes de comparações múltiplas foram aplicados. Para comparações múltiplas entre grupos utilizou-se o teste t de "Student" para duas amostras independentes e intra grupos, o teste t de "Student" pareado para duas amostras dependentes. Em ambas as análises, o valor de α foi ajustado segundo o número de comparações realizadas. Considerando os valores médios da FC, tivemos diferença estatisticamente significativa entre os grupos A e B no período da antissepsia/ injeção (p=0,004), ou seja, os bebês do grupo A apresentaram valores maiores de FC quando comparados aos do grupo B, durante este período. Na análise intra grupos o teste t de "Student" pareado com α = 0,005 ajustado mostrou diferença estatísticamente significativa em quase todos os períodos com exceção do período basal para o período de tratamento, e para o grupo B estatísticamente significativa em quase todos os períodos com exceção do período basal para o tratamento (p=0,617) e da antissepsia/ injeção para a compressão (p=0,425) . Conclui-se que a amamentação materna foi eficaz na redução das respostas relacionadas à dor decorrente da administração intramuscular da vacina contra hepatite B, pois os resultados mostraram redução da mímica facial no grupo B nos períodos de compressão e recuperação e redução nos valores da FC durante a antissepsia/ injeção, mostrando que estes bebês recuperaram-se mais rápido quando comparados aos do grupo A. / Current studies address the benefits provided by breast feeding and skin to skin contact in the relief of acute pain in new born infants (NB). Most studies that approach breast feeding as a measure of pain relief during the administration of intramuscular vaccine are carried out with babies older than 2 months of age. This study aimed to evaluate the effect of breast feeding in response to pain and stress of NB undergoing intramuscular vaccine against Hepatitis B, compared to skin-to-skin contact. This analytical experimental study is a randomized clinical trial, carried out at the Reference Center for Women Health in Ribeirão Preto - MATER, from January 2009 to May 2010. The sample consisted of 55 term NB who were randomly divided into two groups: group A (skin-to-skin contact), composed of 28 NB, who were kept for 5 minutes in an ordinary crib (baseline period), 15 minutes in skin-to-skin contact prior to the administration of the vaccine (treatment period), during the entire period of antisepsis/injection, during the compression and up to 5 minutes after the end of the procedure (recovery period); and group B (breast feeding) composed of 27 NB who were kept in an ordinary crib for 5 minutes (baseline period), 5 minutes on skinto- skin contact beginning breast feeding at the 5th minute (10 minutes in the treatment period) and being kept in this condition during antisepsis/ injection, the compression period, and recovery (5 minutes after the end of compression). The project was approved by the Ethics Research Committee of the Institution and by the Ethics Research Committee of the EERP-USP, and the Free and Informed Consent Form was signed by the mothers of the infants prior to data collection. The collection procedure consisted of monitoring the heart rate (HR) and recording images for later analysis of behavioral manifestations (facial expressions through the adapted NFCS scale) and physiological parameters of the NB. Results of groups A and B were compared in all periods. The normal distribution of quantitative variables was tested by the Kolmorogov-Smirnov test. If normally distributed, ANOVA was used. The Mann-Whitney test was used when normality was not met. For categorical variables the Chi-square test or Fisher's exact test were used. The level of significance used was α ≥ 0.05. In order to check for differences between NFCS scores between groups and periods (intra groups) nonparametric Mann-Whitney test was used for two independent samples and the Friedman nonparametric test for more than two dependent samples, followed by multiple comparisons, respectively. For the result of the Mann-Whitney test and for multiple comparisons, the Wilcoxon test was used, considering the value adjustment of the level of significance α = 0.05 by the number of comparisons. Regarding checking the differences between the scores of HR between groups and intra groups, Variance Analysis with Repeated Measures was used. As the interaction was significant (p = 0.05), multiple comparison tests were applied. For multiple comparisons between groups, Student's t test was used for two independent samples and intra groups, and paired Student's t test for two dependent samples. In both analysis, the alpha value was adjusted according to the number of comparisons carried out. The significance level used was 0.05 (α = 0.05). Mann- Whitney test showed differences between groups and the percentage of facial expressions, with a significantly higher occurrence in group A compared to group B, at baseline period (p = 0.003), compression (p=0) and recovery (p=0), that is, infants in group B recovered better and faster when compared to babies in group A. In the intra groups, the Friedman test with adjusted α = 0.005 showed that for group A there was statistically significant difference for all periods except for baseline period for baseline treatment (p=0.010) and for group B there was statistically significant differences for all periods except baseline period for treatment (p=0.808), and compression for recovery (p=0.064). Considering the average values of HR, there was statistically significant difference between groups A and B during the antisepsis/ injection (p=0.004), that is, infants in group A had higher values of HR when compared to Group B during this period. In the intra group analysis, the paired Student's t test with adjusted α = 0.005 showed statistically significant difference in all periods except the baseline period for the treatment period, and group B showed statistically significant difference in all periods except for baseline period for treatment (p=0.617) and antisepsis/injection for the compression (p=0.425). It was concluded that breast feeding was effective in reducing responses related to pain caused by intramuscular administration of hepatitis B vaccine, since the results showed reduction of facial expressions, in group B during periods of compression and recovery, and reduction in the values of HR during antisepsis/injection, showing that these babies have recovered faster when compared to Group A.

Submitted by Natalie Mendes (nataliermendes@gmail.com) on 2015-07-22T01:07:26Z No. of bitstreams: 1 Dissertacao versao final PPGSC.pdf: 1143429 bytes, checksum: 4001d67efdeaf38f6d494a206cf29031 (MD5) / Made available in DSpace on 2015-07-22T01:07:26Z (GMT). No. of bitstreams: 1 Dissertacao versao final PPGSC.pdf: 1143429 bytes, checksum: 4001d67efdeaf38f6d494a206cf29031 (MD5) Previous issue date: 2013-04-24 / Cohort study follow 672 couple of mothers and children since birth to 72 months of life. The objectives was identify economic, genetic and environment risk factors that are associated with overweight and obesity children at six years old. The research included all the children that birth in each from 10 hospitals of the city at 2004 year. The maternal hospital was visited a long period of two consecutive months, accord draw. Stander Inquiries was done after signing an informed consent. The classification to nutrition child was determinate from z-score of BMI graphics, have defined overweight/obesity that BMI ? +1 z-score. Stratified hierarchical statistical analysis, qui-quadratic test, p value, was considered significant values equivalent or minor of 5% with confidence interval (CI) of 95%. Logistic multivariate regression followed hierarchical levels. Overweight and obesity prevalence was 15,6% and 12,9% respective. The regress logistic analyses evidenced factors associated with final predictor maternal obesity for breastfeeding group. Children not breastfeeding had predictors as maternal obesity, father obesity, mother instruction level and cesarean delivery at the end of analysis. This study confirms the interaction of several factors to overweight and obesity, with genetics and environments factors. Early factors in the life were strongly with obesity than the neonatal predictors. There is important in the prevention of the obesity, modifier risk factors like breastfeeding practice and natural delivery. More research needs to investigate the association between cesarean delivery and excess BMI. / Estudo de coorte de nascidos vivos o qual pesquisou 672 duplas de m?es e filhos do nascimento aos 72 meses de vida. O objetivo ? identificar fatores socioecon?micos, gen?ticos e ambientais que est?o associados ao excesso de peso em crian?as aos seis anos de idade. Trata-se de um estudo prospectivo onde foram inclu?dos na pesquisa todas as crian?as que nasceram em cada uma das 10 maternidades do munic?pio no ano de 2004. As unidades foram visitadas por per?odo de dois meses consecutivos, conforme sorteio. Foram aplicados question?rios padronizados ap?s assinatura de Termo de Consentimento Livre e Esclarecido. Avaliado o estado nutricional da crian?a conforme o escore-z das curvas de IMC para idade, sendo considerado como sobrepeso/obesidade o IMC igual ou superior ao desvio padr?o +1. Foi realizado an?lise hierarquizada estratificada, teste do qui-quadrado (x?) com c?lculo do p valor, sendo considerados como significantes valores iguais ou menores a 5% com Intervalo de Confian?a (IC) de 95%. A regress?o log?stica multivariada seguiu o modelo conceitual te?rico em n?veis hier?rquicos. As preval?ncias de sobrepeso e obesidade foram de 15,6% e 12,9%, respectivamente. A an?lise de regress?o log?stica evidenciou como fatores associados ao desfecho a obesidade materna como preditor de risco para as crian?as amamentadas. No estrato de crian?as n?o amamentadas permaneceram no modelo as vari?veis obesidade materna, obesidade paterna, escolaridade das m?e e a via de parto ces?reo. O estudo corrobora a multifatoriedade do excesso de peso corporal com a participa??o de fatores gen?ticos e ambientais. Os fatores relativos a fases precoces da vida estiveram mais fortemente associados com a obesidade do que os preditores p?s neonatais. ? preciso valorizar, na preven??o da obesidade, os fatores de risco modific?veis como a pr?tica do aleitamento materno e a via de parto vaginal. S?o necess?rios mais estudos para elucidar a associa??o entre o parto ces?reo e obesidade.