Influência do ambiente familiar na desnutrição infantil: um estudo caso controle

Abstract

Stunting is still a major public health problems in Brazilian children The stunting is still a problem in the Brazilian population at risk, currently being attributed to several factors among which are the psychosocial, family environment. Thus, this thesis proposes to address this issue through a review of the literature and presentation of an original article, in order to investigate the association between child malnutrition (stunting) and family environment. It is a case control study including 95 mother-child couples, 47 cases (malnourished children) of the Center for Nutritional Recovery and Education - CREN - Maceió and 48 controls (eutrophic children) living in the same neighborhood and under the same economic conditions. To evaluate the family environment it was used the Home Observation for Measurement of the Environment (HOME), in the Infant Toddler version (IT-HOME - 0-3 years) and Early Childhood version (EC-HOME - 3 to 6 years). The maternal mental health was evaluated through the Self Report Questionnaire (SRQ-20) and the degree of associated disability by the Sheehan Disability Scale (SDS) and sociodemographic and psychosocial variables using a specific questionnaire. In the bivariate analysis only version IT-HOME was significantly associated with malnutrition (OR 6,6; 95%CI 1,4 - 31.0). In the logistic regression of the total sample maternal and paternal education (OR 3,07; 95%CI 1,14 – 8,24) and (OR 3,45; 95%CI 1,30 – 9,18 ) were respectivelly significant. In the EC-HOME subscale 'stimulation of academic behavior "and paternal education were statistically significant (OR 4,94, 95%CI 1,11 - 21,9 and OR 5,85; 95%CI 1,29 – 26,5) respectively. We also found association between malnutrition and subscale "maternal involvement with the child" of the IT-HOME (OR 35,4; 95%CI 1,22 – 1029,5). These results suggest the importance of the family environment in child stunting and suggest the need of prospective studies for a deeper understanding of their role. It also indicates the importance of paternal education.