Background: Differences in health and living conditions between urban and rural settings can be seen as an important example of gaps between population groups. Birth weight and child growth are important predictors for the future health of a person and at aggregate level, for the public health of a population.The general aim of this thesis is to describe and discuss birth weight, physical growth and breastfeeding of children, as well as associated factors, from birth to 24 months of age in urban and rural areas of Vietnam, thus contributing to the evidence base for health strategy and policy. Methods: Two Health and Demographic Surveillance Sites in Hanoi were used; urban Dodalab and FilaBavi in the rural part. To study rural birth weight 1999 to 2010 information was obtained for 10,114 newborn in FilaBavi. To study urban rural growth disparities 2008-2010, 1,466 children were followed for two years after birth with measurements of weight and length. A study of breastfeeding included 2,572 mothers followed for one year after delivery. Background information about households and mothers was taken from routine surveys in the two sites. Results: The mean birth weight in FilaBavi remained stable at about 3,100 grams, over the 12 years studied despite rapid economic and technological development. At the individual level we found birth weight to be associated with household economy and the education of mothers. In the urban rural comparison, the mean birth weight for urban boys and girls were 3,298 and 3,203 g as compared with 3,105 and 3,057 g for the rural infants. Children in the urban area grew faster than those in the rural area. There were markedly higher frequencies of stunting in the rural area compared with the urban. The initiation of breastfeeding during the first hour of life was more frequent in the urban area. Exclusive breastfeeding during the first three months of age was more commonly reported in the rural than in the urban area. Both birth weight and child growth were statistically significantly and positively associated with economic conditions and mother’s education. Conclusion: The results of the studies presented in this thesis show that there are large and important differences in child birth weight, child growth and infant breastfeeding between urban and rural areas. There are also major differences between the areas with respect to education and economic resources. All predictors of child birth weight and growth discussed are directly or indirectly associated with the social and economic conditions. Globalization and urbanization means obvious risks for increasing gaps between as well as within the rural and urban areas. Large discrepancies in a society will lead to serious public health problems in all segments of the population, not only the underprivileged.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1995.

Orientador: Ricardo Cordeiro / Resumo: As condições de vida das gestantes são muito importantes para a saúde de sua criança. Sabendo que muitos fatores podem interferir nessas condições e consequentemente no crescimento e desenvolvimento de seus filhos, foi proposto este trabalho, com o objetivo de caracterizar algumas variáveis biológicas, sociais, assistenciais e ocupacionais de gestantes e sua associação com o peso e crescimento de crianças nos primeiros meses de vida. Para tanto, em 1997 foram feitas 219 entrevistas domiciliares com puérperas que realizaram o pré-natal em 10 unidades básicas de saúde e em um consultório particular do município de Botucatu-SP, e foram avaliadas suas crianças entre 0 e 10 meses de vida. Os objetivos foram atingidos, calculando-se os valores médios das variáveis analisadas, sendo utilizada a técnica de análise de variância para verificar a existência de associação entre a ocupação do chefe da família das gestantes e o crescimento de seus filhos nos primeiros meses de vida. Observou-se que das mulheres entrevistadas, 62,5% (I.C. 56,1% - 68,9%) eram adolescentes e jovens, 82,2% (77,1% - 87,2%) iniciaram o pré-natal no primeiro trimestre de gestação e o número de consultas variou entre 7 e 15, sendo que 42,9% (36,3% - 49,4%) realizaram entre 7 e 9 consultas. No terceiro mês de vida das crianças somente 22,3% (16,7% - 27,7%) estavam sendo amamentadas com leite materno exclusivo. Quanto ao trabalho, 49,8% (43,1% - 56,3) das mulheres trabalharam durante a gestação e dessas, somente 41,8% (32,6% - 51,0%) tiveram o direito à licença gestante. A ocupação da maioria das gestantes foi na área de serviços, com 86,3%... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: An expecting mother's living conditions are extremely important for her child's health. Being aware that many factors interfere in these conditions and consequently in a child's growth and development, we have prepared this paper with the scope of characterizing some biogical, social, aiding, and occupational variables of expecting mothers and their correlation with a child's weight and development over its first months of existence. For that purpose 219 domestic interviews were conducted in 1997 with pregnant women who had undergone prenatal care in 10 basic heath units and in one private doctor's office in Botucatu, SP. Their babies were examined in the age span from 0 to 10 months old. Our objects were reached by calculating the mean results of the variables analyzed. Variance analysis technique was utilized to check the existence of interrelation between a child's father's occupation and his child's growth in its first months of life. The following results were obtained: 62.5% (I.C. 56.1% - 68.9%) were made up of adolescents and young people. 82.2% (77.1% - 87.2%) began their prenatal care in the first quarter of gestation and the number of doctor's appointments varied between 7 and 15; in this group 42.9% (36.3% - 49.4%) had between 7 and 9 appointments. Only 22.3% (16.7% - 27.7%) of three-month old children were solely breastfed. Regarding work, 49.8% (43.1% - 56.3%) of women worked during pregnancy and only 41,8% out of the latter figures (32.6% - 51.0%) were entitled to maternity leave. Most expecting mothers (86.3% e.g. 79.9% - 92.7%) worked in the service industry. It came to our attention by the time of the interview that few women returned to work after delivering... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2014-06-11T19:29:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2001Bitstream added on 2014-06-13T19:38:49Z : No. of bitstreams: 1 bassetto_hp_me_botfm.pdf: 398986 bytes, checksum: c132afdfc3e61e79557bacbfc9de4bfe (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / As condições de vida das gestantes são muito importantes para a saúde de sua criança. Sabendo que muitos fatores podem interferir nessas condições e consequentemente no crescimento e desenvolvimento de seus filhos, foi proposto este trabalho, com o objetivo de caracterizar algumas variáveis biológicas, sociais, assistenciais e ocupacionais de gestantes e sua associação com o peso e crescimento de crianças nos primeiros meses de vida. Para tanto, em 1997 foram feitas 219 entrevistas domiciliares com puérperas que realizaram o pré-natal em 10 unidades básicas de saúde e em um consultório particular do município de Botucatu-SP, e foram avaliadas suas crianças entre 0 e 10 meses de vida. Os objetivos foram atingidos, calculando-se os valores médios das variáveis analisadas, sendo utilizada a técnica de análise de variância para verificar a existência de associação entre a ocupação do chefe da família das gestantes e o crescimento de seus filhos nos primeiros meses de vida. Observou-se que das mulheres entrevistadas, 62,5% (I.C. 56,1% - 68,9%) eram adolescentes e jovens, 82,2% (77,1% - 87,2%) iniciaram o pré-natal no primeiro trimestre de gestação e o número de consultas variou entre 7 e 15, sendo que 42,9% (36,3% - 49,4%) realizaram entre 7 e 9 consultas. No terceiro mês de vida das crianças somente 22,3% (16,7% - 27,7%) estavam sendo amamentadas com leite materno exclusivo. Quanto ao trabalho, 49,8% (43,1% - 56,3) das mulheres trabalharam durante a gestação e dessas, somente 41,8% (32,6% - 51,0%) tiveram o direito à licença gestante. A ocupação da maioria das gestantes foi na área de serviços, com 86,3%... / An expecting mother´s living conditions are extremely important for her child´s health. Being aware that many factors interfere in these conditions and consequently in a child´s growth and development, we have prepared this paper with the scope of characterizing some biogical, social, aiding, and occupational variables of expecting mothers and their correlation with a child´s weight and development over its first months of existence. For that purpose 219 domestic interviews were conducted in 1997 with pregnant women who had undergone prenatal care in 10 basic heath units and in one private doctor´s office in Botucatu, SP. Their babies were examined in the age span from 0 to 10 months old. Our objects were reached by calculating the mean results of the variables analyzed. Variance analysis technique was utilized to check the existence of interrelation between a child´s father´s occupation and his child´s growth in its first months of life. The following results were obtained: 62.5% (I.C. 56.1% - 68.9%) were made up of adolescents and young people. 82.2% (77.1% - 87.2%) began their prenatal care in the first quarter of gestation and the number of doctor´s appointments varied between 7 and 15; in this group 42.9% (36.3% - 49.4%) had between 7 and 9 appointments. Only 22.3% (16.7% - 27.7%) of three-month old children were solely breastfed. Regarding work, 49.8% (43.1% - 56.3%) of women worked during pregnancy and only 41,8% out of the latter figures (32.6% - 51.0%) were entitled to maternity leave. Most expecting mothers (86.3% e.g. 79.9% - 92.7%) worked in the service industry. It came to our attention by the time of the interview that few women returned to work after delivering... (Complete abstract click electronic access below)

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Master of Science / Department of Human Nutrition / Brian Lindshield / Fortified blended foods (FBF) are used for the prevention and treatment of moderate acute malnutrition (MAM) in nutritionally vulnerable individuals, particularly children. A recent review of current FBF recommended the addition of animal source food (ASF), in the form of whey protein concentrate (WPC), to FBF, especially corn soy blend. The justifications for this recommendation include the potential of ASF to increase length, weight, muscle mass accretion, and recovery from wasting, as well as improve the product protein quality and provide essential growth factors. Evidence was collected from the following four different types of studies: 1) epidemiological, 2) ASF versus no intervention or a low-calorie control, 3) ASF versus an isocaloric non-ASF, and 4) ASF versus an isocaloric, isonitrogenous non-ASF. Epidemiological studies consistently associated improved growth outcomes with ASF consumption; however, little evidence from isocaloric and isocaloric, isonitrogenous interventions was found to support the inclusion of meat or milk in FBF. Evidence suggests that whey may benefit muscle mass accretion, but not linear growth. Overall, there is little evidence to support the costly addition of WPC to FBFs. Further randomized isocaloric, isonitrogenous ASF interventions with nutritionally vulnerable children are needed.

Introdução O estudo dos efeitos da amamentação sobre o crescimento ou na proteção contra a obesidade na infância ainda comporta muitos resultados controversos ou inconclusivos. No Brasil existem poucos dados e análises sobre este assunto. Objetivo - Analisar a influência do aleitamento materno sobre o estado nutricional de crianças menores de 3 anos do Município de São Paulo. Métodos Foi utilizada a subamostra longitudinal com760 crianças de 0 a 36 meses do estudo de base domiciliar Saúde das Crianças de São Paulo II (1995-1997). As variáveis utilizadas como desfecho foram os índices antropométricos altura-para-idade (ZAI), IMC-para-idade (ZBI), e dobra cutânea triciptal-para-idade (ZDI), expressos em desvios-padrão (escores Z) da curva de referência apresentada pela Organização Mundial da Saúde em 2006. A associação entre o aleitamento materno predominante (AMP) e os desfechos antropométricos foi ajustada por: renda familiar per capita, escolaridade da mãe, peso ao nascer, ordem de nascimento da criança, idade da mãe, status do trabalho da mãe. Os efeitos fixos e aleatórios dos determinantes do crescimento infantil, nas 3 visitas realizadas, foram estimados utilizando-se a análise de painel. Resultados A duração do AMP mostrou-se negativamente associada a todos os índices antropométricos. O efeito médio mensal do AMP sobre os índices antropométricos foi de -0,068 Z no ZAI, de -0,044 Z no ZBI e de -0,065 Z no ZDI (p<0,05 em todos os casos). As médias dos índices nutricionais apresentaram efeito dose-resposta decrescente conforme o aumento na duração do AMP. O efeito do AMP sobre a situação nutricional infantil foi modificado pelo controle da sua interação com a escolaridade materna: filhos de mulheres com 8 ou mais anos de estudo apresentaram altura 0,075 Z acima da altura dos filhos de mães com até 3 anos de estudo (p<0,05); no caso do IMC a interação não foi estatisticamente significante. Conclusão O aleitamento materno mostrou-se negativamente associado aos índices nutricionais infantis, com efeito protetor contra o aumento médio do IMC e da gordura corporal em menores de 3 anos do município de São Paulo. / Introduction The study of the effects of breastfeeding over growth or in protection against infant obesity still have many controversy or inconclusive results. In Brazil there are feel data and analysis about this subject. Objective To analyze the breastfeeding influence on nutritional status of children under 3 years old of São Paulo City. Methods The longitudinal sub-sample with 760 children aged less than 36 months of a population-based study called The Health of São Paulo Children II was used. The outcome variables were the anthropometric indexes height-for-age index (ZAI), BMI-for-age index (ZBI) and triceps-skinfold-thickness-for-age index (ZDI), expressed in standard deviations (Z scores) of the World Health Organization reference standard (2006). The association between predominant breastfeeding (PBF) and the nutritional indexes was adjusted for: family income, years of maternal education, birth weight, birth order, maternal age and maternal work status. The fixed and random effects of the determinants of child growth, in 3 home visits, were estimated using panel analysis. Results The duration of PBF was negatively associated with all the anthropometric indexes. The mean effect of PBF on the indexes was of -0,068 Z on ZAI, -0,044 Z on ZBI and -0,065 Z on ZDI (p<0,05, all cases). The means of each index had decreasing dose-response effects according to the raise of the PBF duration. The PBF effect over children nutritional status was modified by controlling its interaction with maternal education: children of women with 8 or more years of study had mean height 0,075 Z higher than children of women with 3 or less years of study (p<0,05); for BMI, this interaction was not statistically significant. Conclusion Predominant breastfeeding was negatively associated to the children nutritional indexes, with a protection effect against high mean of BMI and body fat in children aged less then 3 years old in São Paulo City.

Early life factors play important roles in disease susceptibility in later life. However, the relationship between dietary factors in early life on childhood growth, especially linear growth, remains unclear. This research aimed to improve our understanding of the associations between dietary factors in early life (i.e., infant feeding practices and age of introduction of solid foods) and childhood growth, especially using ulnar length as a surrogate measure of length/height, in a cross-sectional study of 1634 mother-child dyads across eight study centers in the National Children's Study Formative Research in Anthropometry in the United States from 2011-2012 (Chapter 1). Chapter 2 described the data acquisition and preprocessing procedures used in this research and provide practical guidelines of data quality control. In Chapter 3, predictive models for exclusive breastfeeding (XBR) initiation and duration was developed. Discriminant analysis revealed maternal sociodemographic factors had greater discriminating abilities to predict XBR initiation and XBR for 6 months, compared to child birth characteristics and maternal perinatal factors. Chapter 4 demonstrated that ulnar length can serve as an accurate and reliable surrogate measure of recumbent length in healthy infants/children aged 0-1.9 years and of height in healthy children aged 2-5.9 years, respectively. Bland-Altman plots and mixed-effects linear regression analyses showed that the three simple and portable tools (i.e., caliper, ruler, and grid) used to measure ulnar length could be used interchangeably in terms of prediction accuracy. Chapter 5 focused on assessing the interplay among gestational weight gain (GWG), birthweight, infant feeding practices, and childhood anthropometrics. Longer duration of breastfeeding reduced the positive associations of GWG and birthweight with weight-for-age z-scores, weight-for-height/length z-scores, and body mass index-for age z-scores in non-Hispanic Whites. These findings underscore the importance of promoting breastfeeding among women with excessive GWG to mitigate childhood obesity. Longer breastfeeding and a later age at introduction of solid foods had positive effects on ulnar length, a linear growth parameter of upper extremity, in Hispanics. Future prospective research aiming to investigate the underlying mechanisms that drive ethnic variation in these associations between early life dietary factors and childhood growth is warranted (Chapter 6). / text

Philosophiae Doctor - PhD (School of Public Health) / Poor water, sanitation and hygiene (WASH) services and practices in communities are known to be responsible for most of the infections occurring among infants and young children in developing countries. A combined effect of disease, poor diet, care practices and other factors among infants/children are known to lead to undernutrition reported in most developing countries. Apart from the reduced growth and productivity potential that malnutrition exhibits on the affected population, it is also an underlying cause to 50% of child mortality in poor communities. In light of this, the primary objective of the study was to evaluate the effect of poor WASH practices on growth and infectious disease incidence in infants and young children aged 6-23 months in the rural district of Monze in Zambia.