ANA MARIA DE ULHOA ESCOBAR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
35 resultados
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Agora exibindo 1 - 10 de 35
- No Association between Low Birth Weight and Cardiovascular Risk Factors in Early Adulthood: Evidence from Sao Paulo, Brazil(2013) GOMES, Filumena Maria; SUBRAMANIAN, S. V.; ESCOBAR, Ana Maria de Ulhoa; VALENTE, Maria Helena; GRISI, Sandra Josefina Ferraz Ellero; BRENTANI, Alexandra; FINK, GuentherBackground: A growing literature suggests that low birth weight increases the risk of poor health outcomes in adulthood. We tested this hypothesis among young adults living in Sao Paulo State, Brazil. Methods and Findings: To identify the effects of low birth weight on young adulthood outcomes, a medical assessment of 297 individuals born between 1977 and 1989 was conducted at a primary care unit in Sao Paulo State, Brazil. We analyzed body mass index (BMI), waist-hip ratio, blood pressure, fasting glucose and total cholesterol levels using linear and logistic regressions. Low birth was negatively associated with BMI (beta = 22.0, 95% CI: 23.69, 20.27, p = 0.02), fasting glucose levels (beta = 21.9, 95% CI: 23.9, 20.07, p = 0.05), waist-hip ratio (beta = 20.03, 95% CI: 20.07, 20.01, p = 0.10), systolic blood pressure (beta = 23.32, 95% CI: 27.60, 0.96, p = 0.12), and total cholesterol levels (beta = 23.19, 95% CI: 216.43, 10.05, p = 0.636). Low birth weight was also associated with lower odds of young adults being overweight and obese, but neither association was statistically significant. Weight gain in the first 12 months of life was associated with higher adult BMI (beta = 0.79, 95% CI: 20.0455, 1.623, p = 0.064) and blood pressure (beta = 2.79, 95% CI: 0.22, 5.35, p = 0.034). No associations were found between low birth weight and early life (catch-up) growth. Conclusions: Low birth weight was not associated with poor health outcomes among young adults in Brazil. These results appear inconsistent with the original Barker hypothesis, but will need to be corroborated in larger samples with longer follow-ups to allow a more general evaluation of the validity of the hypothesis in low and middle income countries.
- Custos hospitalares da meningite causada por Streptococcus pneumoniae na cidade de São José dos Campos, São Paulo, Brasil(2012) LUCAREVSCHI, Bianca Rezende; ESCOBAR, Ana Maria de Ulhoa; GRISI, SandraKnowledge of hospital costs is highly important for public health decision-making. This study aimed to estimate direct hospital costs related to pneumococcal meningitis in children 13 years or younger in the city of Sao Jose dos Campos, Sao Paulo State, Brazil, from January 1999 to December 2008. Data were obtained from medical records. Hospital costs were calculated according to the mixed method for measurement of quantities of items with identified costs and value attribution to items consumed (micro-costing and gross-costing). All costs were calculated according to monetary values for November 2009 and in Brazilian currency (Real). Epi Info 3.5.1 was used for frequencies and means analysis. Forty-one cases were reported. Direct hospital costs varied from R$ 1,277.90 to R$ 19,887.56 (mean = R$ 5,666.43), or 10 to 20 times the mean cost of hospitalization for other diseases. Hospital staff labor was the highest cost, followed by medication, procedures, supplies, and lab tests.
bookPart Crescimento: influências fetais, a importância do catch-up do crescimento e a prevenção da obesidade(2013) GOMES, Filumena Maria da Silva; VALENTE, Maria Helena; ESCOBAR, Ana Maria de Ulhôa; BRENTANI, Alexandra; GRISI, Sandra Josefina Ferraz Ellero- Relation between Birth Weight, Growth, and Subclinical Atherosclerosis in Adulthood(2015) VALENTE, Maria Helena; GOMES, Filumena Maria da Silva; BENSENOR, Isabela Judith Martins; BRENTANI, Alexandra Valeria Maria; ESCOBAR, Ana Maria de Ulhoa; GRISI, Sandra J. F. E.Background and Objectives. Adverse conditions in the prenatal environment and in the first years of life are independently associated with increased risk for cardiovascular disease. This paper aims to study the relation between birthweight, growth in the first year of life, and subclinical atherosclerosis in adults. Methods. 88 adults aged between 20 and 31 were submitted to sociodemographic qualities, anthropometric data, blood pressure measurements, metabolic profile, and evaluation of subclinical atherosclerosis. Results. Birthweight <2,500 grams (g) was negatively correlated with (a) increased waist-to-hip ratio (WHR), according to regression coefficient (RC) equal to -0.323, 95% CI [-0.571, -0.075] P < 0.05; (b) diastolic blood pressure (RC = -4.744, 95% CI [-9.017, -0.470] P < 0.05); (c) low HDL-cholesterol (RC = -0.272, 95% CI [-0.516, -0.029] P < 0.05); (d) frequency of intima-media thickness (IMT) of left carotid >75th percentile (RC = -0.242, 95% CI [-0.476, -0.008] P < 0.05). Birthweight >3,500 g was associated with (a) BMI >25.0 kg/m(2), (RC = 0.317, 95% CI [0.782, 0.557] P < 0.05); (b) increased waist circumference (RC = 0.284, 95% CI [0.054, 0.513] P < 0.05); (c) elevated WHR (RC = 0.280, 95% CI [0.054, 0.505] P < 0.05); (d) minimum subcutaneous adipose tissue (SAT) (RC = 4.354, 95% CI [0.821, 7.888] P < 0.05); (e) maximum SAT (RC = 7.095, 95% CI [0.608, 13.583] P < 0.05); (f) right lobe of the liver side (RC = 6.896, 95% CI [1.946, 11.847] P < 0.001); (g) frequency's right lobe of the liver >75th percentile (RC = 0.361, 95% CI [0.169, 0.552] P < 0.001). Weight gain in the first year of life was inversely correlated with (a) mean IMT of left carotid (RC = -0.046, 95% CI [-0.086, -0.006] P < 0.05; (b) frequency IMT of left carotid > 75th percentile (RC = -0.253, 95% CI [-0.487, -0.018] P < 0.05); (c) mean IMT (RC = -0.038, 95% CI [0.073, -0.002] P < 0.05); (d) the frequency of the mean IMT > 75th percentile (RC = -0.241, 95% CI [-0.442, -0.041] P < 0.05). Conclusions. Adults birthweight <2,500 g and >3,500 g and with insufficient weight gain in the first year of life have showed different metabolic phenotypes, but all of them were related to subclinical atherosclerosis.
bookPart Triagem do comportamento seguro(2013) GOMES, Filumena Maria da Silva; ESCOBAR, Ana Maria de Ulhôa; WAKSMAN, Renata Dejtiar; BRENTANI, Alexandra; SILVA, Alexandre Funcia de Azeredo- The Intergenerational Effects on Birth Weight and Its Relations to Maternal Conditions, Sao Paulo, Brazil(2015) SILVA, Leide Irislayne Macena da Costa e; GOMES, Filumena Maria da Silva; VALENTE, Maria Helena; ESCOBAR, AnaMaria de Ulhoa; BRENTANI, Alexandra Valeria Maria; GRISI, Sandra J. F. E.Background and Objectives. Parents' birth weight acts as a predictor for the descendant birth weight, with the correlation more strongly transmitted through maternal line. The present research aims to study the correlation between the child's low or increased birth weight, the mother's birth weight, and maternal conditions. Methods. 773 mother-infant binomials were identified with information on both the baby's and the mother's birth weight recorded. Group studies were constituted, dividing the sample according to birth weight (<2,500 grams (g) and >= 3,500 grams (g)). The length at birth was also studied in children <= 47.5 cm (lower quartile). Chi(2) test or Fisher's exact test, Spearman's Rho, and odds ratio were performed in order to investigate the relation between the children's weight and length at birth and the mothers' and children's variables. Results. The girls were heavier at birth than their mothers, with an average increase at birth weight between the generations of 79 g. The child's birth weight <2,500 g did not show any correlation with maternal birth weight <2,500 g (Fisher 0.264; Spearman's Rho 0.048; OR 2.1 and OR lower 0.7) or with maternal stature below the lower quartile (<157 cm) (Chi(2) sig 0.323; with Spearman's Rho 0.036; OR 1.5 and OR lower 0.7). The child's low birth weight (<2,500 g) was lightly correlated with drug use by the mother during pregnancy (Fisher 0.083; Spearman's Rho 0.080; OR 4.9 and OR lower 1.0). The child's birth weight <2,500 g showed increased correlation with gestational age lower than 38 weeks and 3 days (Chi(2) sig 0.002; Spearman's Rho 0.113; OR 3.2 and OR lower 1.5). The child's weight at birth >= 3,500 g showed strong correlation with maternal weight at birth >= 3,500 g (Chi(2) sig 0; Spearman's Rho +0.142; OR 0.5 and OR upper 0.7). It was also revealed that the higher the maternal prepregnancy BMI, the stronger the correlation with child's birth weight >= 3,500 g ((maternal prepregnancy BMI > 25.0 with Chi(2) sig 0.013; Spearman's Rho 0.09; OR 1.54 and OR upper 2.17) and (maternal prepregnancy BMI > 30.0 with Chi(2) sig 0 Spearman's Rho 0.137; OR 2.58 and OR upper 4.26)). The child's length at birth in the lower quartile (<= 47.5 cm) showed strong correlation with drug use by the mother during pregnancy (Chi(2) sig 0.004; Spearman's Rho 0.105; OR 4.3 and OR lower 1.5). Conclusions. The mother's increased weight at birth and the prenatal overweight or obesity were correlated with increased weight and length at birth of the newborn, coupled with the tendency of increasing birth weight between generations of mothers and daughters. Also, descendants with smaller length at birth are the children of women with the lowest statures.
bookPart Prevenção da síndrome da morte súbita do lactente(2013) VALENTE, Maria Helena; OMORI, Luciana Harumi Miranda; ESCOBAR, Ana Maria de UlhôabookPart A neurociência e o desenvolvimento infantil com ênfase nos primeiros mil dias(2018) ESCOBAR, Ana Maria de Ulhôa; FERRER, Ana Paula Scoleze; GRISI, Sandra Josefina Ferraz Ellero- 21st century well-child care(2016) ESCOBAR, Ana Maria De Ulhoa; GRISI, Sandra Josefina Ferraz Ellero
- Celiac crisis with ataxia in a child(2011) OBA, Jane; ESCOBAR, Ana Maria; SCHVARTSMAN, Benita G. S.; GHERPELLI, Jose Luiz