Associações entre histórico do nascimento, histórico familiar e perfil cardiometabólico em escolares.

Abstract

Introduction: During the course of life, humans are exposed to a series of health risks. Cardiometabolic health is shaped by fetal life, family history, and lifestyle during childhood and adolescence. General objective: To identify whether perinatal history and/or family history are associated with the cardiometabolic profile in school-age children and adolescents. Manuscript I. Which are the ties that bind? Associations between birth, family history and future cardiometabolic risk in school-aged children and adolescents. Objective: To examine associations between birth-related variables and family history with future cardiometabolic profile in a structural equation model (SEM). Methods: Cross-sectional study developed from the research database of the “School Health – Phase IV” study. The sample was selected through conglomerates, respecting the population density of each region of the municipality of Santa Cruz do Sul - RS, in urban and rural areas. A structural equation model (SEM) was constructed in Jeffreys' Amazing Statistics Program (JASP – version 0.17.1.0; Netherlands), using the Robust Diagonally Weighted Least Squares estimation method. Results: The database consisted of 2,132 students and, for this study, a subsample of 505 students was used, 300 (59.4%) of whom were female and with a mean age of 11.62±2.72 years. The MEE demonstrated that parents' health history is significantly and directly associated with the cardiometabolic profile of students. Conclusions: There is a notable and direct correlation between the health history of parents and the cardiometabolic profile of students. The identification of cardiometabolic risk factors associated with birth and family history provides scientific support for the implementation of early interventions. Manuscript II. Perinatal variables and their associations with future cardiometabolic risk in school-aged children and adolescents. Objective: To verify the relationships between perinatal variables and the cardiometabolic profile in school-age children and adolescents. Methods: Retrospective study that used cross-sectional data from a project database called “School Health - Phase IV”. The study was carried out with a sample composed of children and adolescents of both sexes aged between 6 and 17 years. Participants were enrolled in public and private schools located in the municipality of Santa Cruz do Sul, Brazil. A self-administered questionnaire was used, anthropometric measurements of body mass index (BMI), waist circumference (WC) and percentage of body fat (BF%) were assessed, followed by anthropometric assessments and a cardiorespiratory fitness test (ACR). Results: 1.431 children and adolescents were evaluated, with a mean age of 11.48±2.75 years. Associations were found between perinatal factors and anthropometric measurements including birth weight with BMI (B:1.13; 95%CI:0.74;1.51); WC (B:2.20; 95%CI:1.37;3.04); and BF% (B: 1.84; 95%CI:0.83;2.84). Preterm birth was also associated with BMI (B:1.00; 95%CI:0.25;1.74); WC (B:1.88; 95%CI:0.25;3.50) and ACR (B:- 168.91; 95%CI:-299.53;-38.29). Pregnancy complications and BMI (B:0.48; 95%CI:0.02;0.93) and cesarean section and BMI (B:0.43; 95%CI:0.01;0.86). Conclusions: There are associations between perinatal factors and future cardiometabolic profile. It is imperative to establish efforts aimed at improving health literacy in both children and adolescents and pregnant women. Final considerations of the dissertation: There are associations between family and birth history and risk factors for cardiometabolic disease in school-age children and adolescents, where parental history for cardiometabolic diseases, birth weight and perinatal factors are related to the future cardiometabolic profile.