Trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period

Silva Júnior, André Eduardo da; Macena, Mateus de Lima; Vasconcelos, Laís Gomes Lessa; Almeida, Nykholle Bezerra; Praxedes, Dafiny Rodrigues Silva; Pureza, Isabele Rejane de Oliveira Maranhão; Bueno, Nassib Bezerra; Clemente, Ana Paula Grotti

doi:10.1590/1413-81232021267.08172021

André Eduardo da Silva Júnior

Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu s/n, Vila Clementino. 04023-062 São Paulo SP Brasil. andreeduardojr@hotmail.com

https://orcid.org/0000-0002-1501-171X

Mateus de Lima Macena

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0002-7168-9605

Laís Gomes Lessa Vasconcelos

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0002-9445-1966

Nykholle Bezerra Almeida

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0002-8536-3972

Dafiny Rodrigues Silva Praxedes

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0002-5345-3869

Isabele Rejane de Oliveira Maranhão Pureza

Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu s/n, Vila Clementino. 04023-062 São Paulo SP Brasil. andreeduardojr@hotmail.com

https://orcid.org/0000-0002-0652-429X

Nassib Bezerra Bueno

Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu s/n, Vila Clementino. 04023-062 São Paulo SP Brasil. andreeduardojr@hotmail.com

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0002-3286-0297

Ana Paula Grotti Clemente

Faculdade de Nutrição, Universidade Federal de Alagoas. Maceió AL Brasil.

https://orcid.org/0000-0003-2315-5980

Collaborations

AE Silva Júnior participated in the design of the study, construction of the database, analysis and interpretation of data, writing of the paper, and critical review of the content. ML Macena participated in the construction of the database, analysis and interpretation of data, writing of the paper, and critical review of the content. LGL Vasconcelos, NB Almeida, DRS Praxedes, IROM Pureza, NB Bueno and APG Clemente participated in the writing of the paper and critical review of the content. All authors read and approved the final version of the content.

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Location		Underweight (%)			Normal weight (%)			Overweight (%)			Obesity (%)
Location		2008	2018	Relative variation^a	2008	2018	Relative variation^a	2008	2018	Relative variation^a	2008	2018	Relative variation^a
North
	Acre	36.4	28.7	-21.2	51.1	48.9	-4.3	11.4	17.1	50.0	1.1	5.3	381.8
	Amapá	31.0	34.7	11.9	48.3	43.4	-10.1	17.2	16.8	-2.3	3.5	5.2	48.6
	Amazonas	36.4	34.3	-5.8	49.3	46.8	-5.1	10.8	14.8	37.0	3.5	4.1	17.1
	Pará	40.0	34.6	-13.5	48.1	47.1	-2.1	9.6	14.1	46.9	2.4	4.2	75.0
	Rondônia	45.1	39.7	-12.0	43.7	39.1	-10.5	8.5	15.9	87.1	2.8	5.3	89.3
	Roraima	33.3	27.5	-17.4	58.3	51.8	-11.1	4.2	15.9	278.6	4.2	4.7	11.9
	Tocantins	42.2	35.9	-14.9	46.4	42.9	-7.5	8.4	15.8	88.1	3.0	5.4	80.0
Northeast
	Alagoas	38.0	35.1	-7.6	47.5	42.7	-10.1	10.6	15.4	45.3	4.0	6.8	70.0
	Bahia	42.6	37.3	-12.4	45.2	42.7	-5.5	10.2	14.3	40.2	2.0	5.8	190.0
	Ceará	40.6	32.3	-20.4	45.3	42.6	-6.0	11.8	18.1	53.4	2.3	7.0	204.3
	Maranhão	40.4	37.4	-7.4	50.6	44.4	-12.3	8.0	14.2	77.5	1.0	4.0	300.0
	Paraíba	34.2	32.1	-6.1	48.6	44.0	-9.5	14.4	16.9	17.4	2.9	7.0	141.4
	Pernambuco	36.5	33.3	-8.8	48.1	44.5	-7.5	13.0	15.8	21.5	2.5	6.5	160.0
	Piauí	41.5	36.9	-11.1	45.0	42.5	-5.6	11.9	15.1	26.9	1.6	5.6	250.0
	Rio Grande do Norte	35.6	30.2	-15.2	46.7	42.5	-9.0	13.8	19.3	39.9	4.0	8.1	102.5
	Sergipe	50.4	36.7	-27.2	37.6	41.3	9.8	8.6	15.1	75.6	3.4	6.9	102.9
Midwest
	Distrito Federal	43.9	37.6	-14.4	46.3	39.7	-14.3	9.8	14.7	50.0	0.0	7.9	-
	Goiás	38.4	33.2	-13.5	40.6	43.1	6.2	17.8	16.7	-6.2	3.3	7.1	115.2
	Mato Grosso	36.0	35.0	-2.8	46.7	40.8	-12.6	14.2	16.4	15.5	3.1	7.8	151.6
	Mato Grosso do Sul	37.3	30.3	-18.8	46.3	45.2	-2.4	14.9	15.7	5.4	1.5	8.7	480.0
Southeast
	Espírito Santo	37.4	32.3	-13.6	43.3	42.0	-3.0	15.6	17.7	13.5	3.8	8.1	113.2
	Minas Gerais	39.1	33.3	-14.8	45.9	43.0	-6.3	11.8	16.4	39.0	3.3	7.3	121.2
	Rio de Janeiro	38.1	32.8	-13.9	48.1	40.2	-16.4	11.4	18.2	59.0	2.4	8.8	266.7
	São Paulo	33.3	29.0	-12.9	46.2	42.6	-7.8	14.2	18.7	31.7	6.3	9.8	55.6
South
	Paraná	32.4	27.2	-16.0	50.3	44.7	-11.1	13.2	19.2	45.5	4.1	9.0	119.5
	Rio Grande do Sul	28.6	23.1	-19.2	47.8	44.6	-6.7	17.5	20.3	16.0	6.1	12.1	98.4
	Santa Catarina	29.6	21.7	-26.7	51.6	49.4	-4.3	13.6	19.1	40.4	5.2	9.8	88.5
Brazil		37.8	33.1	-12.4	46.9	43.7	-6.8	12.1	16.4	35.5	3.3	6.8	106.1

Location	2008			2018
	Pregnant women identified	Pregnant women with nutritional data		Pregnant women identified		Pregnant women with nutritional data
	n	n	%	n	n	%
North	9,946	6,648	66.8	66,916	60,057	89.8
Northeast	42,006	24,488	58.3	225,289	194,129	86.2
Midwest	4,455	2,396	53.8	24,424	20,457	83.8
Southeast	25,945	12,164	46.9	130,758	116,678	89.2
South	10,572	5,584	52.8	36,795	31,246	84.9
Brazil	92,924	51,280	55.2	484,182	422,567	87.3

Location	2008	2009	2010	2011	2012	2013	2014	2015	2016	2017	2018	Annual variation % [95%CI]	p^a	Trend
Location	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	% [95%CI]	Annual variation % [95%CI]	p^a	Trend
Underweight
North	39.3 [37.0; 41.6]	39.2 [37.2; 41.3]	42.3 [40.6; 44.1]	38.4 [36.9; 39.9]	37.4 [36.1; 38.8]	39.5 [38.3; 40.7]	39.3 [38.2; 40.4]	37.7 [36.7; 38.7]	36.3 [35.6; 37.0]	35.1 [34.3; 35.8]	34.2 [33.4; 34.9]	-1.4 [-2.3; -0.6]	< 0.01	Declining
Northeast	40.1 [38.7; 41.4]	39.2	39.4 [38.4; 40.5]	37.0 [36.1; 37.8]	37.5 [36.8; 38.2]	38.5 [37.9; 39.2]	38.3 [37.7; 38.9]	38.1 [37.5; 38.7]	36.0 [35.6; 36.4]	36.2 [35.7; 36.6]	34.9 [34.5; 35.4]	-1.2 [-1.9; -0.6]	< 0.01	Declining
Midwest	37.8 [34.1; 41.4]	42.3	37.8 [35.1; 40.4]	36.8 [34.4; 39.2]	34.6 [32.4; 36.7]	34.8 [33.0; 36.6]	34.0 [34.2; 37.8]	35.3 [33.6; 37.1]	32.7 [31.6; 33.9]	34.7 [33.4; 35.9]	33.3 [32.0; 34.6]	-1.4 [-1.9; -0.9]	< 0.01	Declining
Southeast	36.6 [34.9; 38.4]	38.4	34.2 [32.8; 35.5]	34.1 [32.9; 35.3]	34.6 [33.5; 35.6]	33.1 [32.3;33.9]	33.3 [32.5; 34.0]	32.6 [31.9; 33.3]	33.2 [32.7; 33.8]	32.9 [32.3; 33.5]	31.5 [30.9; 32.2]	-1.3 [-1.8; -0.8]	< 0.01	Declining
South	30.3 [27.9; 32.6]	37.4	27.6 [25.9; 29.3]	28.5 [26.9; 30.1]	29.1 [27.7; 30.5]	27.1 [25.9; 28.3]	28.4 [27.2; 29.6]	28.2 [26.9; 29.4]	26.4 [25.6; 27.3]	26.4 [25.5; 27.4]	24.9 [23.9; 25.8]	-1.5 [-2.1; -0.9]	< 0.01	Declining
Brazil	37.8 [36.9; 38.6]	39.5	37.0 [36.3; 37.6]	35.6 [35.0; 36.1]	35.7 [35.2; 36.2]	35.6 [35.2; 36.1]	35.9 [35.5; 36.3]	35.5 [35.1; 35.9]	34.2 [33.9; 34.5]	34.3 [34.0; 34.6]	33.1 [32.8; 33.4]	-1.2 [-1.6; -0.8]	< 0.01	Declining
Overweight
North	9.8 [8.4; 11.1]	10.2 [8.9; 11.4]	9.5 [8.5; 10.6]	11.7 [10.7; 12.7]	12.4 [11.5; 13.4]	11.1 [10.4; 11.9]	12.0 [11.2; 12.7]	12.8 [12.1; 13.5]	13.6 [13.1; 14.1]	13.6 [13.1; 14.1]	14.8 [14.3; 15.4]	4.1 [3.1; 5.2]	< 0.01	Increasing
Northeast	11.1 [10.2; 11.9]	11.2 [10.5; 11.9]	11.8 [11.1; 12.5]	13.6 [13.0; 14.2]	13.4 [12.9; 14.0]	13.1 [12.6; 13.6]	13.6 [13.1; 14.0]	14.1 [13.7; 14.5]	14.4 [14.1; 14.7]	15.0 [14.7; 15.4]	15.8 [15.4; 16.1]	3.4 [2.4; 4.4]	< 0.01	Increasing
Midwest	15.6 [12.8; 18.4]	12.8 [10.8; 14.9]	14.9 [13.0; 16.8]	14.3 [12.5; 16.0]	14.8 [13.2; 16.4]	17.0 [15.6; 18.4]	15.1 [13.8; 16.5]	14.9 [13.6; 16.2]	15.6 [14.8; 16.5]	15.2 [14.3; 16.2]	16.3 [15.3; 17.3]	1.1 [0.1; 2.2]	0.03	Increasing
Southeast	13.0 [11.7; 14.2]	13.9 [12.8; 14.9]	14.1 [13.1; 15.0]	15.1 [14.2; 16.0]	15.7 [14.9; 16.5]	15.9 [15.3; 16.5]	16.3 [15.7; 16.8]	16.6 [16.1; 17.2]	16.4 [15.9; 16.8]	16.6 [16.1; 17.0]	17.7 [17.1; 18.2]	2.9 [1.9; 3.8]	< 0.01	Increasing
South	15.2 [13.3; 17.0]	15.3 [13.9; 16.7]	16.7 [15.3; 18.1]	18.2 [16.9; 19.6]	18.0 [16.9; 19.2]	17.8 [16.7; 18.8]	18.4 [17.4; 19.5]	18.8 [17.7; 19.8]	18.2 [17.5; 19.0]	18.6 [17.7; 19.4]	19.6 [18.7; 20.5]	2.4 [1.1; 3.6]	< 0.01	Increasing
Brazil	12.1 [11.5; 12.7]	12.4 [11.9; 12.9]	12.8 [12.4; 13.3]	14.2 [13.8; 14.6]	14.4 [14.0; 14.8]	14.4 [14.1; 14.7]	14.7 [14.4; 15.0]	15.1 [14.8; 15.4]	15.3 [15.0; 15.5]	15.5 [15.2; 15.7]	16.4 [16.1; 16.6]	2.9 [2.0; 3.7]	< 0.01	Increasing
Obesity
North	2.7 [1.9; 3.4]	2.4 [1.8; 3.1]	2.2 [1.6; 2.7]	2.7 [2.2; 3.2]	2.9 [2.4; 3.3]	3.1 [2.7; 3.5]	3.1 [2.7; 3.5]	3.8 [3.4; 4.2]	3.8 [3.5; 4.1]	3.8 [3.5; 4.1]	4.4 [4.1; 4.8]	6.4 [4.4; 8.4]	< 0.01	Increasing
Northeast	2.3 [1.9; 2.7]	2.6 [2.3; 3.0]	3.0 [2.6; 3.3]	3.6 [3.3; 4.0]	4.0 [3.7; 4.3]	4.3 [4.0; 4.5]	4.7 [4.4; 4.9]	4.8 [4.5; 5.1]	5.3 [5.1; 5.5]	5.5 [5.3; 5.7]	6.2 [5.9; 6.4]	10.1 [7.8; 12.5]	< 0.01	Increasing
Midwest	2.6 [1.4; 3.9]	3.9 [2.7; 5.1]	3.9 [2.8; 4.9]	5.0 [3.9; 6.1]	5.6 [4.6; 6.6]	6.4 [5.5; 7.3]	6.9 [5.9; 7.8]	6.9 [5.9; 7.8]	6.5 [5.9; 7.0]	6.6 [5.9; 7.2]	7.7 [7.0; 8.5]	10.2 [5.3; 15.3]	< 0.01	Increasing
Southeast	4.4 [3.7; 5.2]	4.4 [3.8; 4.9]	5.1 [4.4; 5.7]	5.8 [5.2; 6.3]	5.8 [5.3; 6.4]	6.5 [6.1; 6.9]	7.0 [6.6; 7.4]	7.8 [7.4; 8.2]	7.3 [7.0; 7.6]	7.6 [7.2; 7.9]	8.5 [8.2; 8.9]	6.9 [5.7; 8.5]	< 0.01	Increasing
South	5.2 [4.0; 6.3]	6.3 [5.4; 7.2]	5.7 [4.8; 6.6]	6.9 [6.0; 7.7]	7.2 [6.4; 8.0]	8.2 [7.4; 8.9]	8.6 [7.8; 9.3]	9.0 [8.2; 9.8]	8.4 [7.9; 8.9]	8.9 [8.3; 9.5]	10.2 [9.5; 10.9]	6.2 [4.6; 7.8]	< 0.01	Increasing
Brazil	3.3 [2.9; 3.6]	3.7 [3.4; 3.9]	3.7 [3.5; 4.0]	4.4 [4.2; 4.7]	4.7 [4.5; 4.9]	5.3 [5.1; 5.5]	5.6 [5.4; 5.8]	6.0 [5.8; 6.1]	6.0 [5.8; 6.1]	6.0 [5.9; 6.2]	6.8 [6.6; 7.0]	7.5 [5.7; 9.3]	< 0.01	Increasing

[1] Collaborations

AE Silva Júnior participated in the design of the study, construction of the database, analysis and interpretation of data, writing of the paper, and critical review of the content. ML Macena participated in the construction of the database, analysis and interpretation of data, writing of the paper, and critical review of the content. LGL Vasconcelos, NB Almeida, DRS Praxedes, IROM Pureza, NB Bueno and APG Clemente participated in the writing of the paper and critical review of the content. All authors read and approved the final version of the content.

Brasil

Brasil

Trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period

Abstract