Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 2006. / LICL has E-Thesis 0017 ; please contact computer services.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Neonatal mice have immature immune systems with defects in several components of inflammatory, innate, and specific immune responses and develop a preferential T helper type 2 (Th2) response following immunization with many vaccine antigens. Although maternal antibody is the major form of protection from disease in early life when the neonatal immune system is still immature, the presence of maternal antibody also interferes with active immunization, placing infants at risk for severe bacterial and viral infection. Recent studies have suggested that immunizing with DNA plasmids encoding the vaccine antigen of interest is highly efficacious in a variety of adult animal models. However, similar extensive studies have not been conducted in infants. In this dissertation, we examine both the quantitative and qualitative differences between neonatal and adult humoral and cell-mediated immune responses in the presence or absence of maternal antibody. First, we wished to determine if one-day-old neonatal mice immunized with plasmid DNA expressing influenza A/PR/8/34 hemagglutinin (HA) by either intramuscular (i.m.) or gene gun (g.g.) inoculation were capable of generating humoral responses comparable to those in mice immunized as adults. We found that newborn mice developed stable, long-lived, protective anti-HA-specific IgG responses similar in titer to those of adult DNA-immunized mice. However, unlike the adult i.m. and g.g. DNA immunizations, which develop polarized IgG2a and IgG1 responses, respectively, mice immunized as neonates developed a variety of IgG1-, IgG2a-, and mixed IgG1/IgG2a responses regardless of the inoculation method. Boosting increased, but did not change these antibody profiles. We also found that, in contrast to the DNA immunizations, inoculations of newborn mice with an A/PR/8/34 viral protein subunit preparation failed to elicit an antibody response. Further, temporal studies revealed that both responsiveness to protein vaccination and development of polarized patterns of T help following DNA immunization appeared by 2 weeks of age. To determine if the disparity of polarized IgG responses between neonatal and adult DNA vaccinated mice was due to deficiencies in Th1 promoting cytokines, we addressed the ability of DNA encoding Th1 cytokines to bias the isotype of antibody raised by neonatal DNA immunization. We found that neonatal mice coimmunized with HA and either IL-12 or IFNγ-expressing DNAs developed IgG2a-biased immune responses, regardless of inoculation method, whereas these DNAs had no effect on IgG subtype patterns in adult DNA immunized mice. Consistent with the Th1-promoting effects of these cytokines, we also observed that codelivery of IL-12 or IFNγ DNAs raised T helper responses toward Th1 in mice immunized both as neonates or adults. Thus, codelivery of cytokine DNAs may be effective at tailoring immune responses depending on the required correlates of protection for a given pathogen. Finally, we addressed the effect of maternal antibody on the elicitation of humoral and cell-mediated immune responses. We tested the ability of i.m. and g.g. immunization with DNA expressing influenza HA and/or nucleoprotein (NP) to raise protective humoral and cellular responses in the presence and absence of maternal antibody. We found that neonatal mice born to influenza-immune mothers raised full antibody responses to NP but failed to generate antibody responses to HA. In contrast, the presence of maternal antibody did not affect the generation of long-lived CD4+ and CD8+ T cell responses to both HA and NP. Thus, maternal antibody did not affect cell-mediated responses, but rather it limited humoral responses, with the ability to limit the antibody response correlating with whether the DNA-expressed immunogen was localized in the plasma membrane or within the cell. We further observed that protection from influenza virus challenge was dependent on the presence of anti-HA IgG and was independent of the presence T cell responses. Taken together with other published studies, the data presented in this dissertation help better characterize the responses elicited by DNA vaccines at birth. This dissertation presents several novel observations including the temporal development of polarized IgG subtype responses, the ability of codelivered Th1 cytokine DNA to affect both antibody and T cell responses in the neonate, and the ability to generate humoral responses to intracellular, but not plasma membrane proteins, in the presence of maternal antibody. Furthermore, the data provides rationale for further development of DNA vaccines in the neonate.

abstract: Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century. / Dissertation/Thesis / Masters Thesis Biology 2018

Orientador: Sílvia Cristina Mangini Bocchi / Resumo: A icterícia neonatal acomete de 60 a 80% dos neonatos, o tratamento empregado nestes casos é a fototerapia. Apesar de eficaz, leva as mães a vivenciar sobrecargas física e psicológica durante a hospitalização. Objetivos. Compreender a experiência de puérperas com seu RN em tratamento fototerápico e elaborar um modelo teórico representativo dessa experiência. Método. Pesquisa qualitativa conduzida em um Hospital Público do Estado de São Paulo, Brasil. As entrevistas foram conduzidas e audiogravadas em locais que assegurassem o anonimato e o sigilo das informações das atrizes. A saturação teórica se configurou mediante a análise da 15a entrevista, segundo os passos da Teoria Fundamentada nos Dados. Resultados. As categorias identificadas e as relações teóricas das ações e das interações que compõem a experiência da puérpera com o cuidado de RN em fototerapia desdobram-se em quatro subprocessos: decepcionando-se com a má notícia; sentindo-se responsabilizada, reclusa e com apoio insuficiente para o cuidado; resignando-se ao papel protetor de mãe de bebê em sofrimento e em risco; buscando estratégias para lidar com a situação. Mediante o realinhamento dos componentes que formaram esses subprocessos, pode-se descobrir uma categoria designada central que os abarcassem, constituindo então o processo da experiência (modelo teórico), denominado: do sofrimento à resignação para enfrentar a experiência do recém-nascido em fototerapia. À luz do Interacionismo Simbólico identificou-se o p... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Neonatal jaundice affects 60-80% of newborns; the treatment used in these cases is phototherapy. Although effective, it leads mothers to experience physical and psychological burdens during hospitalization. Objective. To understand the experience of mothers with their newborns in phototherapy and to develop a theoretical model representing this experience. Method. Qualitative research conducted in a public hospital of São Paulo, Brazil. Interviews were conducted and audio recorded in places that would ensure anonymity and confidentiality of information of the actresses. Theoretical saturation was configured through the analysis of the 15th interview, according of the Grounded Theory. Results. The identified categories and the theoretical relationships of actions and interactions that make up the experience of postpartum women with the care of newborns in phototherapy unfolds in four sub-processes: disappointed with the bad news; feeling responsible, reclusive and insufficient support for care; resigning himself to the role of mother baby saver in distress and at risk; seeking strategies to deal with the situation. Through the realignment of the components that formed these sub-processes, one can discover a designated core category that included then constituting the process of experience (theoretical model), called: the suffering resignation to face the experience of the newborn in phototherapy. In the light of Symbolic Interactionism identified the mother's protective role a... (Complete abstract click electronic access below) / Mestre

A violência por parceiro íntimo (VPI) é uma das formas mais frequentes de violência contra a mulher, e se constitui em um fenômeno complexo, que faz parte de uma construção histórica e possui íntima relação com as questões de gênero e suas relações de poder. Durante a gestação, a mulher utiliza com maior frequência os serviços de saúde, o que pode facilitar a construção de vínculo com a equipe de saúde e favorecer a identificação de casos de violência. Os objetivos deste estudo foram: identificar a prevalência de casos de VPI entre gestantes usuárias de um serviço público de saúde e classificar quanto ao tipo e frequência; identificar fatores sociais e demográficos das gestantes e seus parceiros que poderiam estar associados a episódios de violência; identificar os resultados obstétricos e neonatais e suas associações com a ocorrência da VPI na gestação atual. Trata-se de um estudo observacional, descritivo e analítico, desenvolvido no CRSM-MATER e no HCFMRP-USP, situados em Ribeirão Preto, SP. O projeto de pesquisa foi aprovado pelo CEP da EERP-USP, sob nº 1383/2011. Os dados foram coletados no período de maio a dezembro de 2012, por meio de entrevista estruturada por um questionário que contemplava as características sociodemográficas da mulher e de seu parceiro e características obstétricas, além das questões relacionadas à violência; também foram coletados dados dos prontuários das participantes com a utilização de um instrumento que contemplava as variáveis relacionadas aos resultados obstétricos e neonatais. Durante a coleta de dados, iniciada no ambulatório de pré-natal do CRSM-MATER, algumas participantes foram encaminhadas ao HC-FMRP e tiveram a coleta nos prontuários realizada nesta última instituição. Para análise dos dados, utilizou-se o programa estatístico SAS® 9.0. Esta análise foi fundamentada na estatística descritiva, além da utilização do Teste Exato de Fisher e Regressão Logística. Verificou-se que 15,5% das participantes sofreram algum tipo de VPI durante a gestação, sendo que 14,7% sofreram violência psicológica, 5,2%, violência física e 0,4% sofreu violência sexual. As mulheres que se autorreferiram como pretas ou pardas, que não moravam com o parceiro e que referiram consumir bebida alcoólica eventualmente, apresentaram maior chance de sofrer VPI na gestação. Além disso, as mulheres que não desejaram a gestação tinham 4,3 vezes a chance de sofrer VPI na gestação, quando comparadas com aquelas que desejaram a gestação (p<0,00; OR= 4,32 e IC 95% [1,77 - 10,54]). As participantes com parceiros na faixa etária de 15 a 18 anos apresentaram 5,5 vezes a chance de sofrer violência, quando comparadas com aquelas que tinham parceiros com 30 anos ou mais (OR= 5,5; IC 95% [1,02 - 30,2]). Com relação às repercussões obstétricas, não houve associação estatisticamente significativa entre as variáveis investigadas. Quanto às repercussões neonatais dos filhos das participantes, as análises também não apresentaram resultados estatisticamente significativos. Conclui-se que, para as participantes do estudo, não houve repercussões obstétricas e neonatais negativas relacionadas à VPI na gestação. No entanto, outras variáveis se mostraram associadas a este tipo de violência, o que indica, aos profissionais de saúde, a importância de se atentar a outras características das gestantes e de seus parceiros, favorecendo a identificação da violência e o oferecimento de suporte adequado a estas mulheres, quando necessário / The intimate partner violence (IPV) is one of the most frequent ways of violence against women, and it is constituted in a complex phenomenon, which is part of a historical construction and is intimately related to gender questions and its power relationships. During pregnancy, the woman attend health care more frequently, which can facilitate the bond building with the health staff and favours the identifications of violence cases. This study aims were: identify the prevalence of IPV cases between pregnant women who use public healthcare service and classify according to its type and frequency; identify the pregnant e their partners\' social and demographic factors which could be associated with violence episodes; identify the obstetric and neonatal results and their associations with the IPV occurrence in the current pregnancy. This is an observational, descriptive and analytic study, developed at CRSM-MATER and HCFMRP-USP, located in Ribeirão Preto, SP. The research project was approved by ethics committee from EERP-USP, under number 1383/2011. The data were collected between May and December 2012, via interview structured by a questionnaire which beheld the woman\'s and their partner\'s social- demographic characteristics and obstetric characteristics, beside the questions related to violence; there were also collected the participants\' records data using an instrument that contemplated the variables related to the obstetric and neonatal results. During the data collection, initiated at CRSM-MATER prenatal clinic, some participants were leaded to HC- FMRP and had the records collection done at this last institution. To analyze the data the statistic program SAS® 9.0 was used. This analysis was underlay on descriptive statistic, besides using the Fisher Exact Test and Logistic Regression. It was verified that 15,5% of the participants suffered some sort of IPV during pregnancy, knowing that 14,7% suffered psychological violence, 5,2% physical violence and 0,4% sexual violence. Women whom were considered themselves as black or brown-skinned, who haven\'t lived with their partners and who were referred as eventual liquor drinkers showed bigger chance of suffering IPV during pregnancy. Furthermore, women who didn\'t desire the pregnancy had 4,3 times chances of suffering IPV during pregnancy when compared to those ones who desired the pregnancy (p<0,00; OR= 4,32 e IC 95% [1,77 - 10,54]). The participants with partners between 15 and 18 years old showed 5,5 times chances of suffering violence when compared to those ones whose partners were 30 years old or older (OR= 5,5; IC 95% [1,02 - 30,2]). Relating to the obstetric repercussions, there was no association statistically meaningful between the variables investigated. As the participants\' children\'s neonatal repercussion, the analysis didn\'t present results statistically meaningful either. In conclusion, for the study participants, there were no negative obstetric and neonatal repercussions related to IPV in pregnancy. Nevertheless, other variables are shown associated to this type of violence, which indicates, to the health care professionals, the importance to be attentive to other pregnant women\'s and their partners\' characteristics, favoring the violence identification and offering appropriate support to these women, when necessary

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T13:47:09Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_MargareteReginattoGiacomini.pdf: 2673689 bytes, checksum: 26438120dfcc7521140bab509eb60121 (MD5) / Made available in DSpace on 2018-08-22T13:47:09Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_MargareteReginattoGiacomini.pdf: 2673689 bytes, checksum: 26438120dfcc7521140bab509eb60121 (MD5) Previous issue date: 2017-06-26 / The objective of the present study was to delineate the epidemiological profile of pregnant women diagnosed with HIV/aids, syphilis and hepatitis B and C, notified in 2015, in a tertiary care regional referral service. As specific objectives: to present the epidemiological profile of the pregnant women notified in 2015 to the group responsible for the Maternal and Child Care Line of the hospital where the research was carried out, and to prepare a newsletter aiming at helping the visibility of the data to list the priorities of the team's actions. This is a cross-sectional retrospective study performed at a reference hospital in the central region of Rio Grande do Sul. Data collection took place in November and December 2016 and January 2017, through consultation in the system and notification forms of the Nucleus of Hospital Epidemiological Surveillance. From the survey, 179 cases of STI were identified in pregnant women in the year 2015. The age of women ranged from 15 to 41 years. The provenance of the pregnant women showed that many are coming from small municipalities of the central region of Rio Grande do Sul, considering that this hospital is a reference for this region. The product resulting from this work consisted of two articles of a newsletter, widely distributed and disseminated in the service in which the research was developed. As benefits, after the collection and analysis of the data, the results obtained were presented to the service, which allowed the knowledge of the situational diagnosis that could guide the planning of surveillance actions, prevention and control of the vertical transmission of STIs in municipalities of the 4th CRS, since HUSM is a reference in the hospital service for the region. / O presente trabalho teve por objetivo geral delinear o perfil epidemiológico das gestantes com diagnóstico de HIV/aids, sífilis e hepatites B e C, notificadas no ano de 2015, em um serviço de referência regional de atenção terciária. Como objetivos específicos: apresentar o perfil epidemiológico das gestantes notificadas no ano de 2015 ao grupo condutor da Linha de Cuidado Materno Infantil do hospital onde desenvolveu-se a pesquisa, e elaborar boletim informativo visando auxiliar a visibilidade dos dados para elencar prioridades de ações da equipe. Trata-se de um estudo transversal retrospectivo realizado em hospital de referência da região central do Rio Grande do Sul. A coleta de dados ocorreu de novembro e dezembro de 2016 e janeiro de 2017, por meio de consulta no sistema e fichas de notificação do Núcleo de Vigilância Epidemiológica Hospitalar. Do levantamento realizado, foram identificados 179 casos de IST em gestantes no ano de 2015. A idade das mulheres variou de 15 a 41 anos. A procedência das gestantes evidenciou que muitas são advindas de municípios de pequeno porte da região central do Rio Grande do Sul, tendo em vista que este hospital é referência para esta região. O produto resultante deste trabalho constou de dois artigos e boletim informativo, amplamente distribuído e divulgado no serviço no qual desenvolveu-se a pesquisa. Como benefícios, após o término da coleta e análise dos dados, os resultados obtidos foram apresentados ao serviço, o que permitiu o conhecimento do diagnóstico situacional que poderá balizar o planejamento de ações de vigilância, prevenção e controle da transmissão vertical das ISTs, nos municípios da 4ª CRS, visto que o HUSM é referência no serviço hospitalar para a região.

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T17:13:06Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_MaiaraBerlt.pdf: 1654805 bytes, checksum: 9e0b914c4211a485ae20dd619239430e (MD5) / Made available in DSpace on 2018-08-22T17:13:06Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_MaiaraBerlt.pdf: 1654805 bytes, checksum: 9e0b914c4211a485ae20dd619239430e (MD5) Previous issue date: 2017-12-22 / take into account that the poor state of oral health of the mother can interfere in the health of the babies, already in the intrauterine condition. This can occur due to caries contamination and periodontal diseases during pregnancy. Nursing care is surrounded by beliefs, many of them advocating inappropriate behaviors for women, or stimulating their removal from dental offices and, therefore, from the examinations common to prenatal dentistry, which consists of caring for and educating pregnant women, so that she has her baby in general and oral health. This work consists of two articles and an end product, the first one entitled "Education and autonomy in self-promotion of oral health of pregnant women", and it is a review of non-systematic literature that evaluated the evidence of the importance of education and of autonomy in self-promotion of oral health of women, demonstrating that education should be used as a health strategy. The second article entitled "Oral care in gestation: perspectives of student mothers: preliminary note is a quantitative exploratory study and sought to investigate the level of information on oral health in gestation of mothers who study in a federal institution of high school, technical and superior in the interior of Rio Grande do Sul, concluding that a high percentage of women did not even hear about prenatal dentistry, even though they had already undergone maternity experience. Finally, we present a set of guidelines for an educational strategy aimed at developing the self-promotion capacity of oral health of pregnant women, which is the final product of this dissertation. The authors suggest that the practice of education in oral health results in the formation of critical awareness, and induces the materialization of actions and oral health care, by pregnant women. With the development of their autonomy mediated, they enjoy the freedom and the ability to choose care and seek care, a decision that influences their quality of life and the healthy development of their babies. / A saúde bucal é parte importante e indissociável da saúde geral, e é necessário levar em consideração que o mal estado de saúde bucal da mãe pode interferir no quadro de saúde dos bebês, já na condição intrautero. Isso pode ocorrer por conta da contaminação por cárie e doenças periodontais na gestação. Os cuidados com a gestante são cercados de crenças, muitas delas preconizando comportamentos inadequados para as mulheres, ou estimulando seu afastamento dos consultórios odontológicos e, por conseguinte, dos exames comuns ao pré-natal odontológico, que consiste em cuidar e educar a mulher gestante, para que esta tenha seu bebê em condições de saúde geral e bucal. Este trabalho é constituído por dois artigos e um produto final, sendo o primeiro deles intitulado e trata-se de uma revisão de literatura não sistemática que avaliou as evidências da importância da educação e da autonomia na autopromoção da saúde bucal de mulheres, demonstrando que a educação deve ser utilizada como estratégia de saúde. O segundo prévia trata-se de um estudo quantitativo exploratório e buscou investigar o nível de informação sobre saúde bucal na gestação, de mães que estudam em uma instituição federal de ensino médio, técnico e superior do interior do Rio Grande do Sul, concluindo que um elevado percentual de mulheres sequer ouviu falar em pré-natal odontológico, mesmo já tendo passado pela experiência da maternidade. E por fim, apresenta-se um conjunto de diretrizes de uma estratégia educacional visando o desenvolvimento da capacidade de autopromoção da saúde bucal de mulheres gestantes, sendo este o produto final desta dissertação. Os autores sugerem que a prática da educação em saúde bucal resulta na formação de consciência crítica, e induz à materialização de ações e de cuidados em saúde bucal, por parte das mulheres gestantes. Tendo o desenvolvimento de sua autonomia mediada, elas passam a desfrutar da liberdade e da capacidade de escolher cuidarem-se e buscar os cuidados, decisão que influencia sua qualidade de vida e o desenvolvimento saudável de seus bebês.

Introdução - O uso de bicos artificiais é um hábito cultural com alta prevalência em diversos países. Profissionais e mães acreditam que o uso desses utensílios seja inofensivo, ou mesmo necessário, para o desenvolvimento da criança, tendo atitude indiferente ou permissiva frente ao seu uso indiscriminado. Há mais de 30 anos, consenso científico internacional reconhece bicos artificiais e leites industriais como responsáveis por parte dos índices de morbimortalidade infantil e alterações na saúde da criança. Objetivo - Analisar a influência de fatores socioeconômicos, biológicos e da atuação dos serviços de saúde sobre o uso de bicos artificiais (chupetas e mamadeiras) entre crianças menores de um ano nas capitais brasileiras e Distrito Federal(DF). Métodos- Estudo com delineamento transversal realizado a partir do banco de dados da II Pesquisa de Prevalência de Aleitamento Materno nas Capitais e DF em 2008 na segunda fase da Campanha Nacional de Multivacinação. Foi utilizada amostra por conglomerados, com sorteio em dois estágios. O questionário era composto por questões fechadas incluindo perguntas sobre o uso de chupeta e mamadeira no dia anterior à pesquisa. Foram analisados os fatores associados ao uso de bicos artificiais considerando três desfechos: 1)Uso exclusivo da chupeta; 2)Uso exclusivo da mamadeira; e 3)Uso de bicos artificiais (chupeta e mamadeira). As razões de prevalência e os intervalos de confiança foram obtidos por meio da regressão de Poisson seguindo modelo hierárquico. Resultados Participaram 34.366 crianças menores de um ano. Identificou-se como fatores associados ao uso exclusivo de chupeta mãe trabalhar fora do lar (RP=1,18), primiparidade (RP=1,28), não ter mamado na 1ªhora (RP=1,15) e uso de chá no1ºdia em casa (RP=1,37). Para o uso exclusivo de mamadeira, identificou-se: mãe trabalhar fora do lar (RP=1,39), primiparidade (RP=1,28), baixo peso ao nascer (RP=1,21) não ter mamado na 1ªhora (RP=1,08), uso de leite artificial (RP=1,82) e do chá (RP=1,96) no 1ºdia em casa. O uso de bicos artificiais associou-se ao trabalho materno fora do lar (RP=1,43), primiparidade (RP=1,21), parto cesáreo (RP=1,06), bebês do sexo masculino (RP=1,07), baixo peso ao nascer (RP=1,11), ter nascido em hospital não credenciado como Amigo da Criança (RP=1,12), realizar acompanhamento de saúde na UBS/SUS (RP=0,91), ter ingerido leite artificial (RP=2,06), água (RP=1,18) e chá (RP=1,38) no 1ºdia em casa. Conclusão Caracterizaram-se diferentes perfis de usuários de bicos artificiais, chupetas e mamadeiras. Observaram-se semelhanças e diferenças para cada desfecho. As semelhanças indicam os fatores comuns aos quais profissionais da saúde devem estar atentos. Já as diferenças sugerem que a utilização de chupeta e/ou mamadeira envolve diversas dimensões da vida da mulher/criança/família, perpassando aspectos biopsicossociais e culturais. / Introduction - The use of artificial nipples is a cultural habit with a high prevalence in many different countries. Professionals and mothers believe that the use of those tools is harmless or even necessary for the child\'s development therefore they do not discriminate their use having a permissive approach towards them. For over 30 years, international scientific consensus recognizes artificial nipples and industrialized milk as responsible for part of the morbidity and mortality rates and changes in child\'s health. Objective - To analyze the influence of socioeconomic, biological factors and the health services on the use of pacifier and baby\'s bottle among children under one year old in Brazilian Capitals and Federal District (FD). Methods Cross-sectional study conducted from the database of the Second Research Prevalence of Breastfeeding in all the Brazilian Capitals and FD performed in 2008 in the second phase of the National Vaccination Campaign. Cluster sampling was used, with a draw in two-stages. The questionnaire consisted of closed questions including questions about the use of pacifier and baby\'s bottle on the day preceding the survey. We analyzed the factors associated with the use of artificial nipples considering three possible outcomes: 1)Exclusive use of a pacifier, 2)Exclusive use of the baby\'s bottle, and 3)Use of artificial nipples (pacifiers and baby\'s bottle). Prevalence ratios (PR) and confidence intervals were obtained using Poisson regression following a hierarchical model. Results Sample included 34 366 children under one year old. It was identified as factors associated with exclusive use of a pacifier mother working outside the home (PR = 1.18), primiparity (PR = 1.28), not having breastfed within first hour (PR = 1.15) and use of tea on first day at home (PR = 1.37). For the exclusive use of a bottle, were identified: mother working outside the home (PR = 1.39), primiparity (PR = 1.28), low birth weight (PR = 1.21) had not suckled within first hour (PR = 1.08), use of artificial milk (PR = 1.82) and tea (PR = 1.96) on first day at home. The use of artificial teats was associated with maternal employment outside the home (OR = 1.43), primiparity (PR = 1.21), Cesarean section (PR = 1.06), male infants (PR = 1, 07), low birth weight (PR = 1.11), was born in a hospital is not accredited as \"Baby Friendly\" (PR = 1.12), perform health monitoring in the UBS / SUS (PR = 0.91) , having drunk formula (PR = 2.06), water (PR = 1.18) and tea (PR = 1.38) on first day at home. Conclusion - It was found various user profiles of of pacifier and/or baby\'s bottle. It was observed similarities and differences for each outcome. The similarities indicate common factors to which health professionals should be aware. And the differences suggest that the use of artificial nipples, pacifier or baby\'s bottle involves several dimensions of women\'s lives, biopsychosocial and cultural aspects.