Coleção de Artigos Acadêmicos
URI permanente para esta coleçãohttps://repositorio.insper.edu.br/handle/11224/3227
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Resultados da Pesquisa
Artigo Científico Wildfire-sourced fine particulate matter and preterm birth risks in Brazil: A nationwide population-based cohort study(2024) Zhang, Yiwen; Huang, Wenzhong; Xu, Rongbin; Ye, Tingting; Chen, Gongbo; Yue, Xu; Coêl , Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Song, Jiangning; Guo, Yuming; Li, ShanshanWildfire-specific particulate matter with diameters ≤ 2.5 µm (PM2.5) is the key component of wildfire smoke, with potentially higher toxicity than PM2.5 from other sources. In this nationwide population-based cohort study, we included 22,163,195 births from Brazil during 2010–2019. Daily wildfire-specific PM2.5 was estimated through the chemical transport model. Time-varying Cox proportional hazards models were used to characterize the exposure-time-response (E-T-R) relationship between weekly wildfire-specific PM2.5 exposure and preterm birth (PTB) risks, followed by subgroup analyses. A 10 µg/m3 increment in wildfire-specific PM2.5 was associated with a hazard ratio of 1.047 (95 % confidence interval [CI]: 1.032–1.063) for PTB. Stronger associations between wildfire-specific PM2.5 and PTB were observed during earlier pregnancy, among female infants, and pregnant women < 18 years old, in ethnic minorities, with a length of education ≥ 11 years, from low-income or high temperature municipalities, and residing in North/Northeast regions. An estimated 1.47 % (95 % CI: 1.01 %–1.94 %) of PTBs were attributable to wildfire-specific PM2.5 in Brazil, increasing from 2010 to 2019. The PTBs attributable to wildfire-specific PM2.5 surpassed those attributed to non-wildfire PM2.5 (0.31 %, 95% CI: 0.09 %–0.57 %). Wildfire emerged as a critical source contributing to the PM2.5-linked PTBs. Prioritized fire management and emission control strategies are warranted for PTB prevention.Artigo Científico The impact of gestational weight gain on fetal and neonatal outcomes: the Araraquara Cohort Study(2024) Victor, Audêncio; Teles, Laísla de França da Silva; Aires, Isabel Oliveira; Carvalho, Leticia Falcão de; Luzia, Liania A.; Victor, Audêncio; Teles, Laísla de França da Silva; Rinaldo Artes; RINALDO ARTES; Rondó, Patrícia H.Background: Gestational weight gain (GWG) is an important indicator for monitoring maternal and fetal health. Objective: To evaluate the effect of GWG outside the recommendations of the Institute of Medicine (IOM) on fetal and neonatal outcomes. Study design A prospective cohort study with 1642 pregnant women selected from 2017 to 2023, with gestational age≤18 weeks and followed until delivery in the city of Araraquara, Southeast Brazil. The relationship between IOM recommended GWG and fetal outcomes (abdominal subcutaneous tissue thickness, arm and thigh subcutaneous tissue area and intrauterine growth restriction) and neonatal outcomes (percentage of fat mass, fat-free mass, birth weight and length, ponderal index, weight adequateness for gestational age by the Intergrowth curve, prematurity, and Apgar score) were investigated. Generalized Estimating Equations were used. Results: GWG below the IOM recommendations was associated with increased risks of intrauterine growth restriction (IUGR) (aOR 1.61; 95% CI: 1.14–2.27), low birth weight (aOR 2.44; 95% CI: 1.85–3.21), and prematurity (aOR 2.35; 95% CI: 1.81–3.05), and lower chance of being Large for Gestational Age (LGA) (aOR 0.38; 95% CI: 0.28–0.54), with smaller arm subcutaneous tissue area (AST) (-7.99 g; 95% CI: -8.97 to -7.02), birth length (-0.76 cm; 95% CI: -1.03 to -0.49), and neonatal fat mass percentage (-0.85%; 95% CI: -1.12 to -0.58). Conversely, exceeding GWG guidelines increased the likelihood of LGA (aOR 1.53; 95% CI: 1.20–1.96), with lower 5th-minute Apgar score (aOR 0.42; 95% CI: 0.20–0.87), and increased birth weight (90.14 g; 95% CI: 53.30 to 126.99). Conclusion: Adherence to GWG recommendations is crucial, with deviations negatively impacting fetal health. Effective weight control strategies are imperative.