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Objective: To analyze the temporal evolution of anemia in children aged six to 59 months in Pernambuco, based on population surveys from 1997, 2006, and 2016 and the factors associated with the situation in 2016., Methods: The field studies took place in the participants' households, in the Recife Metropolitan Area, as well as in the urban and rural inland. The trend study of anemia in children used data from the State Health and Nutrition Survey (Pesquisa Estadual de Saúde e Nutrição - PESN) II (40.9%) and III (32.8%). Data from PESN IV were collected using questionnaires administered to families to verify socioeconomic and individual conditions, as well as anthropometric - weight and height - and biochemical - hemoglobin - records. We adopted the test for trend in proportion for the time trend study and Poisson regression for hypothesis tests for the associated factors. Statistically significance was set at a p-value<0.05., Results: In 2016, the prevalence of anemia was 24.2%, indicating a significant reduction in disease incidence. In children aged 6-23 months, this number decreased from PENS II and III to PENS IV - 63 and 55.6 to 37.7% (p<0.001), respectively. In 2016, the statistically significant variables for anemia in children were maternal hemoglobin, child's age, current or recent case of diarrhea, and weight-for-age index., Conclusion: Between 1997 and 2016, anemia rates decreased, showing an epidemiological trend that can contribute to continuously improve the health of children under five years of age in Pernambuco.

Background: Globally, childhood immunization saves the lives of 2-3 million children annually by protecting them against vaccine-preventable diseases. In 2017, 116.2 million children were vaccinated worldwide according to the World Health Organization. Nevertheless, figures suggest that 19.5 million children around the world fail to receive the benefits of complete immunization., Methods: This cross-sectional study analyzed vaccine uptake and the factors associated with incomplete vaccination schedule in children of up to 36 months of age assisted by the family health strategy in an irregular settlement located in a state capital city in northeastern Brazil. This study was nested within a larger study entitled "Health, nutrition and healthcare services in an urban slum population in Recife, Pernambuco", conducted in 2015. A census included 309 children, with vaccination data obtained, exclusively, from their vaccination cards records. An ad hoc database was constructed with variables of interest. Absolute and relative values were calculated for the socioeconomic, demographic, obstetric and biological data. To identify possible factors associated with incomplete vaccination schedule, crude and multivariable Poisson regression analyses were performed, and conducted in accordance with the forward selection method with robust variance and the adjusted prevalence ratio was calculated with the 95% CI. Variables with p-values < 0.20 in the unadjusted stage were included in the multivariable analysis. The statistical significance of each variable was evaluated using the Wald test, with p-values < 0.05., Results: Just half of the children (52,1%) was classified as complete vaccination schedule. In the final model, the factors associated with incomplete vaccination schedule were age 12-36 months and the mother who did not complete high school., Conclusion: The percentage of vaccine uptake found was far below the recommendation of the National Childhood Immunization Schedule and was associated with child's age and mother's education level. Based on these findings, the family healthcare teams may elaborate vaccination strategies aimed at reaching the coverage rates established by the national immunization program. Optimizing coverage will ultimately prevent the resurgence, at epidemic level, of infectious diseases that are already under control in this country.

Objective: To describe and analyze indicators of feeding practices related to breastfeeding and factors associated with exclusive breastfeeding (EBF) in a subnormal urban cluster (slums) in Pernambuco, Brazil., Methods: Four breastfeeding indicators were used to interview mothers of children under 3 years of age. An inventory of the families' socioeconomic and environmental factors, maternal obstetric history, and basic health care access was undertaken. The sample consisted of all 310 children under the age of 3 years from Coelhos, PE, Brazil. Spearman's correlation was carried out, as well as crude and adjusted prevalence ratios for a final statistical model that showed associated factors with the main outcome at a level of 0.05., Results: The prevalence of breastfeeding in the first hour of life, exclusive breastfeeding up to 6 months, continued breastfeeding at 1 year, and continued breastfeeding at 2 years were 60.2%, 32.9%, 45.9, and 35.9%, respectively. A correlation was observed between start of pacifier use and duration of either exclusive (r s =0.358 [p<0.001]) or non-exclusive breastfeeding (r s =0.248 [p=0.006]). Maternal age over 35 years (p<0.001), home visit in the first week after birth (p=0.003), having had a male baby (p=0.029), and not using a pacifier (p<0.001) remained protective factors in the final model., Conclusion: The prevalence rates of exclusive breastfeeding at 6 months were well above the results obtained by other Brazilian authors. Home visit and maternal age prevailed as protective factors, while pacifier use was shown to be a discouraging practice., (Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Introduction: Exclusive breastfeeding (BF), after the sixth month of life, as a single food source is not recommended. It is believed that it is not possible to supply the caloric needs of protein, iron and vitamin without adequate food supplementation., Objective: To comparethe nutritional statusof children withexclusive breastfeeding(BF)for more than 6monthsversuschildren with otherbreastfeeding practices., Method: Cross-sectionalexploratory studywith685children(39BF >6months and646with otherbreastfeeding practices).Situations ofanthropometricdeficit were considered by values< -2 in Z score, anemia evaluated by hemoglobin < 11 g/dL,and deficient/lowlevels ofvitamin A by serumretinol < 1.05 µmol/L., Results: There were nocases ofdeficitin the anthropometric ratios of weight/height, weight/age andbody mass index(BMI)among childrenBF > 6months,while the comparison group was approximately 0.5%. In theheight/ageratio,the deficitwasaround 2.6% in both groups.Inthe weight/height ratioand BMI,the resultsranged from28.7 to 31.9% foroverweight in group comparisson. TheaverageHb, serumretinol, weightand heightwere similarbetween thegroups., Discussion: The low prevalence (≤ 0.6%) of protein energy malnutrition in both groups represents a surprising finding, below the values found in reference to normal international reference, WHO standard., Conclusion: Children who maintained BF after six months exhibited equivalent nutritional status to those of children with other breastfeeding practices.

Objective: To verify the adequacy and factors associated with compliance with the immunization schedule (BCG, DTP-Hib, MMR, PCV-10) in children hospitalized with pneumonia at a pediatric referral hospital in Northeast Brazil., Methods: This is a cross-sectional, descriptive study with an analytical component, with a sample of 452 children hospitalized with pneumonia at the Instituto de Medicina Integral Prof. Fernando Figueira, between 2010 and 2013. The inclusion criterion was children aged from one month to less than five years of age with proof in the immunization record. The exclusion criterion was the presence of hospital-acquired pneumonia or concomitant disease. We have evaluated the adequacy of the immunization schedule for the BCG, tetravalent, MMR, and 10-valent pneumococcal conjugate (PCV-10) vaccines. We used the chi-square test and Fisher's exact test followed by multivariate Poisson regression, estimating the crude and adjusted prevalence ratios and respective 95% confidence intervals. The variables with p < 0.20 in the univariate analysis were included in the multivariate analysis., Results: There was good adequacy in the immunization schedule, except for PCV-10, which presented a percentage lower than 85%. We have observed an association between adequate compliance with the immunization schedule and education level of the mother (89.9% complete high school), sex of the child (87.2% female), age of the child (94.2% younger than six months), and breastfeeding (84.3% breastfed)., Conclusions: Given the high rate of education level of the mother and the high percentage of breastfeeding, we can understand that there is a better understanding of the health of the child by the mothers studied in this study, showing the effectiveness of public policies for infant feeding. However, children did not have good adequacy of the immunization schedule of PCV-10, one of the main vaccines against pneumonia, which can be one of the main factors in the causes of hospitalization, with no influence on the classification of the severity of the disease. In this way, we emphasize that the causes of pneumonia morbidity are not associated with a single factor.

Objective: To describe Brazil's historical background with regard to child development surveillance and perform a systematic review of studies published on surveillance records of child development within Child Health Handbooks., Data Sources: A literature review was conducted in April of 2016 in the following electronic databases: Latin American and Caribbean Literature in Health Sciences (LILACS), the Scientific Electronic Library Online (SciELO), and the Medical Literature Analysis and Retrieval System Online (Medline). The search did not have any language or publication period restrictions, and included the bibliographic references of the selected articles. The keywords "child development and child health records," and "child development and child health handbook" were applied. Articles were included that were original and that evaluated the use of child development surveillance tools in Brazil. Publications that were not original were excluded. The articles were selected first based on their title, then their abstracts, and finally a thorough reading., Data Synthesis: The recommendation to support child development surveillance has been occurring since 1984. In 1995, developmental milestones were included in the Child's Health Handbook, and in 2004 they became normative acts for surveillance, which should be carried out using this booklet. In the systematic review, six articles were selected in which the prevalence of child development surveillance recording ranged from 4.6 to 30.4%. This variation was due to different criteria and sample sizes as well as different methodologies employed to analyze the adequacy of filling out the handbook., Conclusions: Despite the fact that the Brazilian Ministry of Health formalized child development surveillance 32 years ago, the act of recording the surveillance in the Child Health Handbook is still deficient and irregular.

OBJECTIVE To verify the frequency and factors associated with complications during pregnancy and the association between complications with premature birth and type of delivery in pregnant women aged 35 years or older. METHODS This is a cross-sectional study based on the records of pregnant women admitted between January and July 2012, totalling 430 pregnant women. To identify possible factors associated with complications during pregnancy, data were subjected to univariate analysis using the Poisson regression model. The chi-squared test was used to study the association of complications with premature birth ad type of delivery. RESULTS Complications occurred in 77.7% of the cases. Complications in pregnancy as an explanatory variable for premature birth (p < 0.001) and C-section (p = 0.002) was statistically significant. CONCLUSION The factors younger age, the absence of prenatal care, and the non-occurrence of morbidity prior to gestation were associated with complications in pregnancy.