Prevalência de desnutrição em crianças moradoras de favelas e sua associação com o estado nutricional materno e os fatores sócioambientais – Maceió-2008

Abstract

The protein-energy malnutrition, according to Pan American Health, is the most lethal form of malnutrition in the world but despite its prevalence has declined in Brazil, mainly in the Northeast, it is observed that due to the social differences, such kind of offense continues to be a relevant public health problem, especially in some pockets of poverty located on the outskirts of large cities. In turn, the short stature resulting from chronic malnutrition occurred during intra - uterine phase and / or in early childhood is closely associated obesity in adulthood. Biological and socio-environmental conditions, commonly found in these inadequate low-income populations, seem to be determinant in the association between high prevalence of child malnutrition and maternal stature. Based on information obtained regarding to this association, this study evaluated the influence of maternal factors on nutritional status of children. This is a cross-sectional householdbased, in households in the 7th Administrative Region of Maceió, Alagoas. We evaluated 2075 mothers included those ones which would be in the range 18 to 45 years and children between 4 months and 6 years of age. The 7th region was chosen through a cluster analysis, which showed the lowest Human Development Index (HDI), later, the slums of the region were grouped according to the average per capita income of its inhabitants. The statistics analyzed the odds ratios (odds ratios) of a child to be undernourished by regression analysis testing which maternal variables would be more associated with this malnutrition. As a result, it was found that child malnutrition was associated with age, maternal education, flooring, water source, type of residence and the number of rooms, and low birth weight (<2500g) in children aged less than 24 months, the same way, the stature of the mother, when accompanied by malnutrition or overweight. It is observed that in the total number of children, 8.62% had moderate and severe malnutrition, while for the diagnosis of overweight and obesity was found in 11.31% of them. Concerning to the mothers, 38.9% were low, and 45.62% had greater weight. Analyzing the socio-economic conditions, it is observed that almost all variables were significantly associated (p<0.05) with malnutrition, especially "maternal education", which showed that mothers with equal or less than four years study had na approximately three times higher risk (2.6) having a malnourished child than illiterate mothers (≥ 4 years). Additionally, the variables "flooring", "water source" and "number of rooms per household" were instrumental in the diagnosis of malnutrition, with the highest significance "type of residence” (p = 0.01), in other words, a house made of wood, canvas, paper, among others. Regarding to the characteristics of the child, it was found that children under the age of 24 months and with low birth weight (<2,500 g) had a higher susceptibility to impairment of nutritional status. As for maternal anthropometric variables, they also found related to malnutrition (p<0.05). Maternal age was strongly correlated (p = 0.006) with it, followed by height, with no correlation with BMI. When analyzing the mothers shorter than 1.55 m, it was observed that short stature represented more than twice the risk for malnutrition of their children. In relation to height and BMI, it shows that the excess and/or low weight alone is not significantly associated with malnutrition of children. However, in the presence of short stature, this association was highly significant (P<0.01) with OR equal to 2.61 and 2.42respectively.