Abstract:
:This study proposed the application of structural equation modeling (SEM) to investigate variables associated with preterm birth based on a theoretical model analyzed previously by hierarchical logistic regression. The data came from a population-based case-control observational study of hospital births to mothers residing in Londrina, Paraná State, Brazil (June 2006 to March 2007). For the SEM, the study considered the association between socioeconomic characteristics and psychosocial aspects pertaining to reproductive history, work and physical activity, complications during the pregnancy, and fetal characteristics. It also considered the relationship between these associations and the outcome preterm birth mediated by adequacy of prenatal care. The weighted least square mean and variance adjusted estimator (WLSMV) was used for categorical data and robust maximum likelihood (MLR) for odds ratios. Three latent variables were created: socioeconomic vulnerability, family vulnerability, and unwanted pregnancy. The effect of socioeconomic and family vulnerability and unwanted pregnancy on prematurity occurred indirectly through inadequacy of prenatal care. The proposed methodology allowed using constructs, verifying the role of mediation by inadequacy of prenatal care, and identifying the variables' direct and indirect effects on the outcome preterm birth. :O estudo propôs a aplicação da modelagem com equações estruturais (MEE) para estudar variáveis associadas ao nascimento pré-termo com base em um modelo teórico analisado previamente pela regressão logística hierarquizada. Os dados foram provenientes da pesquisa observacional do tipo caso-controle populacional sobre nascidos vivos hospitalares de mães residentes em Londrina, Paraná, Brasil (junho de 2006 a março de 2007). Para a MEE foi considerada a associação de características socioeconômicas e aspectos psicossociais sobre história reprodutiva, trabalho e atividade física, intercorrências durante a gestação e características fetais. Considerou-se, ainda, a relação dessas associações sobre o desfecho nascimento pré-termo mediado pela adequação da assistência pré-natal. Foram utilizados estimadores de mínimos quadrados ajustados pela média e variância (WLSMV), para dados categóricos, e a máxima verossimilhança robusta (MLR), para obter razões de chances. Foram criadas três variáveis latentes: vulnerabilidade socioeconômica, vulnerabilidade familiar e não aceitação da gravidez. O efeito da vulnerabilidade socioeconômica, da família e da não aceitação da gravidez sobre a prematuridade ocorreu de modo indireto por meio da inadequação da assistência pré-natal. A metodologia proposta possibilitou utilizar construtos, verificar o papel de mediação da inadequação da assistência pré-natal e identificar efeitos diretos e indiretos das variáveis sobre o desfecho nascimento pré-termo. :Este estudio propuso la aplicación de modelos de ecuaciones estructurales (SEM) para investigar las variables asociadas con el parto prematuro basándose en un modelo teórico previamente analizado mediante regresión logística jerárquica. Los datos provienen de un estudio observacional de casos y controles de base poblacional de nacidos vivos en hospitales de madres que residen en Londrina, estado de Paraná, Brasil (junio de 2006 a marzo de 2007). Para el SEM, el estudio consideró la asociación entre las características socioeconómicas y los aspectos psicosociales relacionados con el historial reproductivo, el trabajo y la actividad física, las complicaciones durante el embarazo y las características fetales. También consideró la relación entre estas asociaciones y el parto prematuro mediado por la adecuación de la atención prenatal. Se utilizó el estimador de los mínimos cuadrados ponderados ajustados por la media y variancia (WLSMV) para datos categóricos y la probabilidad máxima robusta (MLR) para los odds ratios. Se crearon tres variables latentes: vulnerabilidad socioeconómica, vulnerabilidad familiar y embarazo no deseado. El efecto de la vulnerabilidad socioeconómica y familiar y el embarazo no deseado en la prematuridad ocurrió indirectamente por la insuficiencia de la atención prenatal. La metodología propuesta permitió usar constructos, verificar el papel de la mediación por la insuficiencia de la atención prenatal e identificar los efectos directos e indirectos de las variables sobre el resultado “parto prematuro”.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Oliveira AA,Almeida MF,Silva ZPD,Assunção PL,Silva AMR,Santos HGD,Alencar GPdoi
10.1590/0102-311X00211917subject
Has Abstractpub_date
2019-01-21 00:00:00pages
e00211917issue
1eissn
0102-311Xissn
1678-4464pii
S0102-311X2019000104001journal_volume
35pub_type
杂志文章abstract::The article addresses Brazil's historical development in the use of vital data, incorporating procedures for the evaluation of such data and research with active search of births and deaths, resulting in the proposal of methods for calculating birth and mortality indicators through the use of continuous records. In ad...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00206015
更新日期:2017-04-03 00:00:00
abstract::Dengue, a reemerging disease, is one of the most important viral diseases transmitted by mosquitoes. Climate is considered an important factor in the temporal and spatial distribution of vector-transmitted diseases. This study examined the effect of seasonal factors and the relationship between climatic variables and ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012001100018
更新日期:2012-11-01 00:00:00
abstract::This study aimed to evaluate key characteristics of structure in a sample of maternity hospitals in Brazil. Structure was evaluated according to Ministry of Health criteria and included: geographic location, obstetric volume, presence of ICU, teaching activities, staff qualifications, and availability of equipment and...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00176913
更新日期:2014-08-01 00:00:00
abstract::Different factors have been identified as influencing drug prescribers. Some studies emphasize the role played by sources of information available to physicians. Reports have been published on the influence of marketing strategies on these health professionals. Such strategies include advertisements in medical journal...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2000000200012
更新日期:2000-04-01 00:00:00
abstract::The objective of this study was to analyze aspects of the physician-patient and pharmacist-patient relationship, based on patients' opinions. It consists of community-based research performed in Fortaleza, Ceará State, Brazil, where 957 persons were interviewed; 904 answered questions about the last visit to the physi...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007000400020
更新日期:2007-04-01 00:00:00
abstract::Two districts in Recife (Santo Amaro and Campo Grande) and two districts in Olinda (Sapucaia and Salgadinho), were selected for a comparative study of bancroftian filariasis in Greater Recife. Selection parameters included similar socio-economic, demographic, and endemic levels of lymphatic filariasis. In the district...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::This study aimed to assess the program for use of the monoclonal antibody palivizumab in São Paulo State, Brazil. The evaluation adopted the frame of reference proposed by Donabedian, and the data were discussed on the basis of the guidelines from the Ruling on the use of palivizumab in the national network and in the...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00117816
更新日期:2018-07-23 00:00:00
abstract::This study evaluated influenza vaccine coverage among elderly individuals (≥ 60 years) living in the city of São Paulo, Brazil, in 2015, and analyzed associated factors. This was a cross-sectional population-based study of data from the SABE Study (Health, Well-Being, and Aging). The dependent variable was influenza v...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00237419
更新日期:2020-01-01 00:00:00
abstract::The aim of the present study was to describe vulnerability profiles and to verify their association with non-adherence to antiretroviral therapy (ART) among 295 HIV-patients receiving their first prescription in two public-referral centers in Minas Gerais States, Brazil. The cumulative incidence of non-adherence was 3...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,多中心研究
doi:10.1590/s0102-311x2008001100015
更新日期:2008-11-01 00:00:00
abstract::This study's objective was to evaluate quality of life in older adults living with HIV/AIDS and the associations with socio-demographic, economic, and clinical characteristics, using a cross-sectional design. Data were collected on demographics, disease history, and economic status according to the Brazilian Economic ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00095613
更新日期:2014-07-01 00:00:00
abstract::Knowledge on the incidence of childhood accidents according to the child's stage of development is important for designing preventive programs targeting each age bracket. The aim of this study was to describe the incidence of falls, cuts, and burns in children up to four years of age according to family economic statu...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00139115
更新日期:2017-03-09 00:00:00
abstract::The present study aimed to review the literature on the prevalence of metabolic syndrome and its components in adolescents (10-19 years old). The search was conducted in online databases (MEDLINE and SciELO), references from retrieved articles, and contacts with authors. Only original articles using either the criteri...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2009000600002
更新日期:2009-06-01 00:00:00
abstract::This study analyzed social representations of institutional eating and nutritional patterns among residents of long-term homes for the elderly, in order to identify conditioning factors for eating behavior that may interfere in their nutritional status. A qualitative exploratory study was performed in five homes for t...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007001200029
更新日期:2007-12-01 00:00:00
abstract::Rio Grande do Sul State has the highest suicide rates in Brazil. Previous studies have suggested a possible role of agricultural activities, especially tobacco farming, where pesticide use is intensive. An ecological study was designed to assess associations between age-adjusted suicide rates based on death certificat...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006001200011
更新日期:2006-12-01 00:00:00
abstract::This study describes the main social, economic, biological, and demographic characteristics of children and families who participate or have participated in the Children's Pastoral as compared to the overall urban population of Criciúma (Southern Brazil). A population-based cross-sectional study with a probabilistic s...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1999000300011
更新日期:1999-07-01 00:00:00
abstract::Prevalence of wheezing was studied in Guarani indigenous children hospitalized for acute lower respiratory tract infections in Southern and Southeastern Brazil, recruited by a surveillance routine established in villages from May 2007 to June 2008. Data were obtained from hospital records. Crude and adjusted prevalenc...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00155013
更新日期:2014-07-01 00:00:00
abstract::The present study aims to evaluate the current operation of Brazilian syringe exchange programs (SEP). After consulting national and regional networks of people working in projects/programs aiming to reduce drug-related harm, we identified 134 potential participant programs. Unfortunately, only 45 SEPs answered a surv...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006000400015
更新日期:2006-04-01 00:00:00
abstract::The aim of this study was to explore the distribution of reproductive outcomes following dengue virus infection during pregnancy (2001-2005). An ecological epidemiological study was conducted in all counties with more than 80,000 inhabitants in Southeast Brazil. The study explored the correlation between dengue incide...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012000600005
更新日期:2012-06-01 00:00:00
abstract::This article debates the principal guidelines and procedures that shape HIV/AIDS prevention in Portugal, focusing on risk reduction in the two major scenarios for spread of the epidemic: sexuality and injection drug use. The analysis views the risks of infection as expressions of practices that are densely interwoven ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00129715
更新日期:2016-06-20 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, and outpatient pulmonary rehabilitation (OPR) has shown positive results. The aim of this study was to investigate the effects of home or community-based pulmonary rehabilitation (HCPR) in individuals with COPD. This ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,meta分析,评审
doi:10.1590/0102-311X00085915
更新日期:2016-06-20 00:00:00
abstract::This article describes the clinical and socio-demographic characteristics of deaths from ill-defined causes in the State of Rio de Janeiro, Brazil, in 1998, and reclassifies the groups of probable causes based on data from death certificates in the Mortality Information System and the Hospital Information System of th...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006000600020
更新日期:2006-06-01 00:00:00
abstract::This paper analyzes factors affecting the risk of malaria among individuals working in wildcat gold mining camps (garimpos) in northern Mato Grosso State in the Brazilian Amazon. Historically, such mining camps have the locations with the highest malaria prevalence in the Brazilian Amazon. However, little attention ha...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007001200009
更新日期:2007-12-01 00:00:00
abstract::This article provides information on the spatial distribution of schistosomiasis, correlating snail foci with human cases using spatial analysis. The locations studied were Merepe III, Pantanal, Salinas, and Socó, comprising 70% of the populated area of Porto de Galinhas. Malacological and parasitological surveys by a...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007000200017
更新日期:2007-02-01 00:00:00
abstract::The objective of this study was to validate the Alcohol Use Disorders Identification Test (AUDIT) for a river population in the Brazilian Amazon. The original English version of AUDIT was translated into Portuguese, using the procedure recommended by the World Health Organization. The text was then back-translated and...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2011000300010
更新日期:2011-03-01 00:00:00
abstract::This study was conducted in a rural area endemic for schistosomiasis in Minas Gerais, Brazil. The objective was to determine the relationship between an environmental and health education program for schistosomiasis, implemented for teachers and students from the state secondary school in the village of Boa União, and...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2002000600017
更新日期:2002-11-01 00:00:00
abstract::The study's overall objective was to investigate the relationship between psychosocial stressors, sense of community, and subjective wellbeing in urban and rural schoolchildren in Northeast Brazil, focusing on differences according to territorial context. The sample consisted of 757 participants, 495 from urban school...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00126815
更新日期:2016-09-19 00:00:00
abstract::The objective of the present study was to investigate the significance of linear childhood growth retardation in relation to classroom performance. It began with a Height Census carried out in the 1989 school year, involving children attending the first grade of all public and private schools in Osasco (Greater S o Pa...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1995000200007
更新日期:1995-04-01 00:00:00
abstract::This study's objective was to assess the contribution of selected chronic diseases to the prevalence of disability in elderly Brazilians, based on data from the National Health Survey (PNS 2013). Disability was defined as some degree of difficulty in performing ten activities, considering three levels: (i) without dis...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00204016
更新日期:2018-02-05 00:00:00
abstract::Given the characteristics of the COVID-19 pandemic and the limited tools for orienting interventions in surveillance, control, and clinical care, the current article aims to identify areas with greater vulnerability to severe cases of the disease in Rio de Janeiro, Brazil, a city characterized by huge social and spati...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00075720
更新日期:2020-01-01 00:00:00
abstract::The primary health care model implemented by the Family Health Program in Brazil still lacks systematized, validated mechanisms for its monitoring and evaluation. Based on an actual experience, the current study sought to understand experiences and explore concepts held by staff and managers in the Ceará State Health ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008001200018
更新日期:2008-12-01 00:00:00