Association between neonatal conditions and anthropometric indicators among children attending daycare centers in Southern Brazil

Lourenção, Luiz Felipe de Paiva; Borim, Lara Campos; Cassiano, Laura Thaciane Rodrigues; Sarni, Roseli Oselka Saccardo; Silva, Rosangela

doi:10.1590/1980-220X-REEUSP-2025-0598en

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Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 60 • 2026 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0598en linkcopy

Association between neonatal conditions and anthropometric indicators among children attending daycare centers in Southern Brazil

Associação entre condições neonatais e indicadores antropométricos em crianças que frequentam creches no Sul do Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To investigate the association between neonatal conditions and anthropometric indicators and to describe food insecurity among children attending daycare centers.

Methods: Cross-sectional study with 139 children enrolled in Early Childhood Education Centers in southern Minas Gerais, Brazil. Data on neonatal conditions, socioeconomic characteristics, food insecurity, and nutritional status were collected. Height-for-age (HAZ) and body mass index-for-age (BAZ) were classified according to the World Health Organization standards. Poisson regression with robust variance was used to estimate prevalence ratios (PR).

Results: The prevalence of overweight was 34.4%, and short stature was observed in 22.6% of children. Overweight prevalence was 34.4% and short stature 22.6%. BAZ was associated with birth weight (PR = 1.0016; 95%CI:1.0004–1.0028), food insecurity, socioeconomic status, and high-risk pregnancy. Higher food insecurity levels showed higher PRs for BAZ, while lower socioeconomic classes were inversely associated. No associations were observed for HAZ.

Conclusion: BAZ was associated with perinatal and socioeconomic factors, highlighting early-life determinants of excess weight and the influence of food insecurity, reinforcing the need for early interventions.

DESCRIPTORS
Child Nutrition; Growth and Development; Food Security; Anthropometry

Variable	N	(%)	95% CI
Sex	139
Male	79	56.83	48.17–65.20
Female	60	43.16	34.80–51.83
Age	139
Infants from 6 to 11 months	2	1.44	0.17–5.10
Infants from 12 to 23 months	47	33.81	26.01–42.32
Infants from 24 to 35 months	54	38.85	30.70–47.48
Children ≥ 36 months	36	25.90	18.84–34.01
Race/skin color	107
White	73	68.23	58.51–76.89
Brown (Mixed race)	24	22.43	14.92–31.51
Black	9	8.41	3.91–15.36
Asian	1	0.93	0.02–5.09
Socioeconomic Classification (ABEP)	137
Class A	1	0.73	0.01–3.99
Class B1	13	9.50	5.15–15.68
Class B2	47	34.31	26.41–42.89
Class C1	28	20.44	14.03–28.16
Class C2	33	24.08	17.19–32.13
Class D-E	15	10.94	6.25–17.41
Brazilian Food Insecurity Scale (EBIA)	137
Food Security	72	52.55	44.18–60.92
Mild Food Insecurity	49	35.77	27.76–44.40
Moderate Food Insecurity	12	8.76	4.60–14.80
Severe Food Insecurity	4	2.92	0.80–7.30
Mother’s schooling/Education	133
Unfinished elementary school (0 to 7 years)	12	9.02	4.74–15.23
Finished elementary school (8 to 10 years)	12	9.02	4.74–15.23
Finished high school (≥11 years)	64	48.13	39.37–56.95
Higher Education	45	33.83	25.86–42.54
Classification of Newborn according to Gestational Age	128
Preterm (≤ 37 weeks)	13	10.16	5.51–16.74
Full-term (37 to 41 weeks)	110	85.94	78.68–91.45
Postterm (> 42 weeks)	5	3.90	1.28–8.88
High-Risk Pregnancy	136
Yes	15	11.03	6.30–17.53
No	121	88.97	82.46–93.69
Gestational complications	134
Yes	33	24.63	17.59–32.81
No	101	75.37	67.18–82.40
Place of Delivery	138
Hospital	136	98.56	94.86–99.82
Home birth	1	0.72	0.01–3.97
Other	1	0.72	0.01–3.97
Type of Delivery	131
Vaginal	48	36.64	28.39–45.50
Cesarean section	82	62.60	53.71–70.89
Forceps delivery	1	0.76	0.02–4.17
Postpartum complications	132
Yes	13	9.85	5.34–16.25
No	119	90.15	83.74–94.65
Birth Weight	133
Low birth weight (1500–2499 g)	5	3.76	1.23–8.55
Insufficient birth weight (2500–2999 g)	26	19.55	13.18–27.31
Adequate weight (3000–3999 g)	95	71.43	62.95–78.92
Macrosomia (>4000 g)	7	5.26	2.14–10.54
Birth length	121
Low birth length	2	1.65	0.20–5.84
Adequate birth length	119	98.35	94.15–99.79
Head circumference at birth	101
Normal	92	91.09	83.75–95.84
Below normal range	9	8.91	4.15–16.24
Breastfeeding in the first hour of life	137
Yes	124	90.51	84.32–94.85
No	13	9.49	5.15–15.68
Exclusive breastfeeding on first day at home	134
Yes	117	87.31	80.47–92.43
No	17	12.69	7.57–19.53
Exclusive breastfeeding until 6 months of age	135
Yes	80	59.26	50.47–67.63
No	55	40.74	32.37–49.53

Explanatory variables	PR1	95% CI2	p-value3
Birth weight (continuous)	0.9996	0.9981–1.0012	0.636
Sex (male vs. female)	5.0438	0.8046–31.6151	0.084
Maternal education
├─ Finished elementary school	8.0312	0.2769–232.8990	0.225
├─ Finished high school	2.4249	0.0852–68.9697	0.604
└─ Higher education	0.7653	0.0619–9.4529	0.834
Race/skin color (Non-White vs. other)	2.2546	0.5298–9.5941	0.271
Food insecurity (ref.: Food	security)
├─ Mild	2.2708	0.8398–6.1401	0.106
├─ Moderate	2.2084	0.2901–16.8135	0.444
└─ Severe	0.0000	0.0000–—*	<0.001
Gestational age (continuous)	1.1782	0.9126–1.5212	0.208
Type of delivery (cesarean vs. vaginal)	0.4319	0.1176–1.5859	0.205
Maternal health condition (categorical)	2.9085	0.8258–10.2447	0.096
High-risk pregnancy (yes vs. no)	0.4461	0.0630–3.1614	0.419
Gestational complications (yes vs. no)	1.4307	0.2949–6.9415	0.656
Head circumference at birth (continuous)	1.0337	0.8672–1.2323	0.711

Explanatory variables	PR1	95% CI2	p-value3
Birth weight (continuous)	1.0016	1.0004–1.0028	0.008
Sex (male vs. female)	0.6629	0.2573–1.7078	0.394
Race/skin color (Non-White vs. other)	0.5846	0.230–1.4812	0.257
Food insecurity (ref.: Food security)
├─ Mild	4.1591	1.2746–13.5714	0.018
├─ Moderate	9.1878	1.3803–61.1547	0.021
└─ Severe	38.8732	4.6400–325.6740	<0.001
Socioeconomic Classification (ABEP) (ref.: Class A)
├─ Class B1	0.5335	0.1361–2.0912	0.367
├─ Class B2	0.4830	0.1652–1.4119	0.183
├─ Class C1	0.1416	0.0411–0.4873	0.001
├─ Class C2	0.0949	0.0156–0.5777	0.010
└─ Class D-E	0.0857	0.0120–0.6083	0.013
Gestational age (continuous)	0.8565	0.6745–1.0875	0.203
Type of delivery (cesarean vs. vaginal)	0.5773	0.2641–1.2618	0.168
High-risk pregnancy (yes vs. no)	3.0420	1.1698–7.9107	0.022
Head circumference at birth (continuous)	0.6829	0.4586–1.0169	0.060

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[1] Source: Study data. ABEP: Brazilian Association of Research Companies. Differences in total sample size (N) are due to missing data across variables.