Segall-Corrêa Ana Maria, Gonçalves Neusa Nunes da Silva E, Chalita Liciana Vaz Arruda Silveira, Russo-Leite Gabriela Picarelli, Padovani Carlos Roberto, Gonçalves Aguinaldo
Universidade Estadual de Campinas (UNICAMP), Departamento de Medicina Preventiva e Social, Area de Epidemiologia, Brasil.
Rev Panam Salud Publica. 2002 Jul;12(1):19-25. doi: 10.1590/s1020-49892002000700004.
To assess factors determining growth in a group of children between 3 months and 6 years old enrolled in a public municipal (i.e., government-supported, not private) day-care center, in comparison to a group of children with similar characteristics but who were not enrolled in the center.
A quasi-experimental study was designed to observe 444 children aged 3 to 72 months from a low-income neighborhood in the city of Sorocaba, in the state of São Paulo, Brazil. Two groups were studied: 164 children enrolled in a local municipal day-care center (intervention group) and 280 not receiving care at the center (nonintervention, comparison group) but instead being cared for at home. Both groups were seen four times over a period of 16 months. At each observation session, the children's weight and height were measured. Information was also collected on the mother's sociodemographic characteristics and the illnesses she had suffered as well as the child's weight and other health characteristics at birth, the child's illnesses in the 15 days before each observation, and any hospitalizations.
The children in both groups were from low-income families, with 65% of the families having an average monthly income below US$ 100; 80% of the mothers had received 8 years of schooling or less. Multivariate linear regression analysis showed that at the first observation (just before enrollment in the day-care center), birth weight was the only factor that explained the nutritional differences between the two groups. Subsequent analyses showed that being in day care was the factor that best explained the differences between the groups, especially in terms of the adequacy of weight for age, after controlling for birthweight, sex, age at the beginning of the study, and illnesses in the 15 days before an observation session. The nutritional impact of the intervention was significant as early as 3 months after being enrolled in day care.
The nutritional benefits of the care provided at the center outweighed the negative effects sometimes seen in such centers, such as the greater morbidity that children in day-care centers often experience in comparison to children receiving care at home.
评估影响一组3个月至6岁儿童生长发育的因素，这些儿童就读于一家公立市立（即政府支持，非私立）日托中心，并与一组具有相似特征但未就读该中心的儿童进行比较。
设计了一项准实验研究，观察来自巴西圣保罗州索罗卡巴市一个低收入社区的444名3至72个月大的儿童。研究了两组儿童：164名就读于当地市立日托中心的儿童（干预组）和280名未在该中心接受照料（非干预、对照组）而是在家中接受照料的儿童。两组儿童在16个月的时间里接受了4次观察。在每次观察期间，测量儿童的体重和身高。还收集了母亲的社会人口学特征、她患过的疾病以及孩子出生时的体重和其他健康特征、每次观察前15天内孩子患的疾病以及任何住院情况的信息。
两组儿童均来自低收入家庭，65%的家庭月平均收入低于100美元；80%的母亲接受过8年或以下的学校教育。多变量线性回归分析表明，在第一次观察时（就在进入日托中心之前），出生体重是解释两组儿童营养差异的唯一因素。随后的分析表明，在控制了出生体重、性别、研究开始时的年龄以及观察前15天内的疾病情况后，进入日托中心是最能解释两组儿童差异的因素，尤其是在年龄别体重是否充足方面。干预的营养影响在进入日托中心3个月后就很明显。
该中心提供的照料对营养的益处超过了此类中心有时出现的负面影响，比如日托中心的儿童与在家中接受照料的儿童相比，发病率往往更高。
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