ALEXANDRA VALERIA MARIA BRENTANI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Kangaroo mother care for preterm infants and child development - evidence from Sao Paulo, Brazil(2022) ONYANGO, Silas; BRENTANI, Alexandra; FINK, GuntherGlobally, an estimated 15 million children are born prematurely each year, resulting in a high burden of under-five mortality and neurodevelopmental disability. Kangaroo Mother Care (KMC) is a key intervention to support the development of preterm infants. However, evidence on the impact of KMC in routine care settings remains limited. This paper examines the associations between maternal KMC efforts and child development among preterm infants using data from a prospective cohort study conducted in Sao Paulo, Brazil. Study outcomes were height-for-age z-scores (HAZ) and cognitive development at age 3 years. Practicing KMC was positively associated with HAZ (+0.91 SD, 95% CI [0.126, 1.695]), and cognition (+0.37 SD, [0.034, 0.806]) of preterm children. The results suggest that KMC can improve children's cognitive and physical development. New programmes to increase KMC uptake in the setting studied may be beneficial for both mothers and their preterm children.
- Association between community noise and children's cognitive and behavioral development: A prospective cohort study(2022) RAESS, Michelle; BRENTANI, Alexandra Valeria Maria; FLUCKIGER, Benjamin; CAMPOS, Bartolomeu Ledebur de Antas de; FINK, Gunther; ROOSLI, MartinBackground: Noise exposure has been associated with adverse cognitive and behavioral outcomes in children, but evidence on longitudinal associations between community noise and child development in low- and middle-income countries is rare. We investigated associations between community noise and behavioral and cognitive development in preschool children in Sao Paulo. Methods: We linked child development data from the Sao Paulo Western Region Birth Cohort with average (Lden) and night-time (Lnight) community noise exposure at children's home, estimated by means of a land use regression model using various predictors (roads, schools, greenness, residential and informal settlements). Outcomes were the Strengths and Difficulties Questionnaire (SDQ) and Regional Project on Child Development Indicators (PRIDI) at 3 years of age and the Child Behavior Checklist (CBCL) and International Development and Early Learning Assessment (IDELA) at 6 years of age. We investigated the relationship between noise exposure and development using cross-sectional and longitudinal regression models. Results: Data from 3385 children at 3 years of age and 1546 children at 6 years of age were analysed. Mean Lden and Lnight levels were 70.3 dB and 61.2 dB, respectively. In cross-sectional analyses a 10 dB increase of Lden above 70 dB was associated with a 32% increase in the odds of borderline or abnormal SDQ total difficulties score (OR = 1.32, 95% CI: 1.04; 1.68) and 0.72 standard deviation (SD) increase in the CBCL total problems zscore (95% CI: 0.55; 0.88). No cross-sectional association was found for cognitive development. In longitudinal analyses, each 10 dB increase was associated with a 0.52 SD increase in behavioral problems (95% CI: 0.28; 0.77) and a 0.27 SD decrease in cognition (95%-CI: 0.55; 0.00). Results for Lnight above 60 dB were similar. Discussion: Our findings suggest that community noise exposure above Lden of 70 dB and Lnight of 60 dB may impair behavioral and cognitive development of preschool children.
- IDENTIFICATION OF O-LINKED N-ACETYLGLUCOSAMINE TRANSFERASE (OGT) EXPRESSION IN HUMAN PLACENTAS AS A POTENTIAL BIOMARKER OF PRENATAL STRESS EXPOSURE(2022) CAMILO, Caroline; VIEIRA, Luana Martos; TORREZAN, Arleti Caramori; SOUSA, Antonia Beatriz; GOUVEIA, Gisele Rodrigues; EUCLYDES, Veronica Luiza Vale; SILVA, Aloisio Souza Felipe da; BRENTANI, Alexandra; BRENTANI, Helena
- Impact of COVID-19 on maternal health and child care behavior: Evidence from a quasi-experimental study of vulnerable communities in Boa Vista, Brazil(2022) LOSS, G.; FINK, G.; BESSA, L.; BRENTANI, A.Background: COVID-19 related distress has been shown to have negative associations with family well-being. Objectives: To determine the immediate impact of acute COVID-19 infection on maternal well-being and parenting practices among Brazilian families. Participants and setting: We studied 2′579 mothers (29′913 observations) of young children from vulnerable neighborhoods in Boa Vista, Brazil over 12 months. Methods: We monitored family health and caregiving behavior including the incidence of COVID-19 infections in the surveyed households through bi-weekly phone interviews over 50 weeks, from June 2020 to May 2021. Primary outcomes were home-based child stimulation, positive parenting behavior, and parenting stress. We used fixed effects panel regressions to estimate the impact of household COVID-19 infections on parenting outcomes. Results: Over the study period, 441 participants (17.1%; 831 (3.0%) observations) reported at least 1 positive COVID-19 infection in their household. Household COVID-19 infections significantly reduced home-based stimulation by 0.10 SDs (95%CI: −0.18, −0.01), positive parenting behaviors by 0.14 SDs (−0.21, −0.01), and increased parenting stress by 0.07 SDs (0.02, 0.12). The impact on home-based stimulation was most pronounced when the mother herself had a COVID-19 infection (−0.16; −0.29, −0.04). Parenting stress responded most strongly to mother or child COVID-19 infections. Effects were relatively short-lived, only children's infections' on parental stress was still detectable 2 weeks after initial infection. Conclusion: Our findings suggest that COVID-19 infections cause substantial disruptions in children's home environments - additional short-term support for families with acute infections could attenuate the negative impact on children's home environment during the pandemic. © 2022 The Authors
- Assessing the association between air pollution and child development in Sao Paulo, Brazil(2022) LUMINATI, Ornella; BRENTANI, Alexandra; FLUCKIGER, Benjamin; CAMPOS, Bartolomeu Ledebur de Antas de; RAESS, Michelle; ROOSLI, Martin; HOOGH, Kees de; FINK, GuentherBackgroundOutdoor air pollution is increasingly recognised as a key threat to population health globally, with particularly high risks for urban residents. In this study, we assessed the association between residential nitrogen dioxide (NO2) exposure and children's cognitive and behavioural development using data from Sao Paulo Brazil, one of the largest urban agglomerations in the world. MethodsWe used data from the Sao Paulo Western Region Birth Cohort, a longitudinal cohort study aiming to examine determinants as well as long-term implications of early childhood development. Cross-sectional data from the 72-month follow-up was analysed. Data on NO2 concentration in the study area was collected at 80 locations in 2019, and land use regression modelling was used to estimate annual NO2 concentration at children's homes. Associations between predicted NO2 exposure and children's cognitive development as well as children's behavioural problems were estimated using linear regression models adjusted for an extensive set of confounders. All results were expressed per 10 mu g/m(3) increase in NO2. Results1143 children were included in the analysis. We found no association between NO2 and children's cognitive development (beta -0.05, 95% CI [-0.20; 0.10]) or behavioural problems (beta 0.02, 95% CI [-0.80; 0.12]). ConclusionNo association between child cognition or child behaviour and NO2 was found in this cross-sectional analysis. Further research will be necessary to understand the extent to which these null results reflect a true absence of association or other statistical, biological or adaptive factors not addressed in this paper.
- Gestational age acceleration is associated with epigenetic biomarkers of prenatal physiologic stress exposure(2022) EUCLYDES, Veronica; GOMES, Catarina; GOUVEIA, Gisele; GASTALDI, Vinicius Daguano; FELTRIN, Arthur Sant'Anna; CAMILO, Caroline; VIEIRA, Rossana Pulcineli; FELIPE-SILVA, Aloisio; GRISI, Sandra; FINK, Gunther; BRENTANI, Alexandra; BRENTANI, HelenaBackground Physiological maternal stress response, such as imbalance in the glucocorticoid pathway and immune system seems to be mediated by DNA methylation (DNAm) and might translate intrauterine stress exposures into phenotypic changes in a sex-specific manner. DNAm in specific sites can also predict newborn gestational age and gestational age acceleration (GAA). GAA occurs when the predicted biological age is higher than the chronological age. In adults, poor health outcomes related to this deviance are well documented and raise questions for the interpretation and prediction in early stages of life. Boys seem to be more vulnerable to intrauterine stress exposure than girls; however, the mechanisms of adaptive sex-specific responses are still unclear. We hypothesize that intrauterine stress exposure is associated with GAA and could be different in boys and girls if inflammatory or glucocorticoid pathways exposure is considered. Results Using the Western Region Birth Cohort (ROC-Sao Paulo, Brazil) (n = 83), we calculated DNAm age and GAA from cord blood samples. Two epigenetic risk scores were calculated as an indirect proxy for low-grade inflammation (i-ePGS) and for glucocorticoid exposure (GES). Multivariate linear regression models were applied to investigate associations of GAA with prenatal exposures. The i-ePGS and GES were included in different models with the same co-variates considering sex interactions. The first multivariate model investigating inflammatory exposure (adj. R-2 = 0.31, p = < 0.001) showed that GAA was positively associated with i-ePGS (CI, 0.26-113.87, p = 0.049) and negative pregnancy-related feelings (CI, 0.04-0.48 p = 0.019). No sex interaction was observed. The second model investigating glucocorticoid exposure (adj. R-2 = 0.32, p = < 0.001) showed that the higher was the GAA was associated with a lower the lower was the GES in girls (CI, 0.04-2.55, p = 0.044). In both models, maternal self-reported mental disorder was negatively associated with GAA. Conclusion Prenatal epigenetic score of exposure to low-grade inflammatory was a predictor of GAA for both sexes. Glucocorticoid epigenetic score seems to be more important to GAA in girls. This study supports the evidence of sex-specificity in stress response, suggesting the glucocorticoid as a possible pathway adopted by girls to accelerate the maturation in an adverse condition.