Parenting practices have been identified as a key determinant of children’s developmental outcomes. The aim of this study was to evaluate the association of parenting practices with child development in a cross-sectional population-based study in a low-income state in northeastern Brazil. The study included data on 3566 caregiver–child pairs, and the children were aged 0–66 months. Positive parenting behaviors (PPBs) were conceptualized in areas of interactive play, social development, and speech and language interactions. Child development was evaluated using the Brazilian Ages and Stages Questionnaire. Linear regression analysis was used to assess the relationships. We found that a greater number of PPBs was associated with better child development domain scores. Among infants < 1 year, each additional PPB was associated with a 0.32 standardized mean difference (SMD) greater communication (95% CI: 0.24–0.41) and 0.38 SMD greater problem-solving scores (95% CI: 0.24–0.52). Among children aged 4–6 years old, each additional PPB was associated with improved communication (SMD: 0.22; 95% CI: 0.13–0.32), problem solving (SMD: 0.21; 95% CI: 0.10–0.32) and personal–social domain scores (SMD: 0.26; 95% CI: 0.17–0.36). Our findings indicate that PPB were robustly associated with better outcomes across developmental domains among Brazilian children. Programs and interventions that support PPB can contribute to improvements in development outcomes.

Background: Intimate partner violence (IPV) is a pervasive public health issue that affects millions of women worldwide. Women living below the poverty line experience higher rates of violence and fewer resources to escape or cope with the abuse, and the COVID-19 pandemic has significantly impacted women’s economic well-being worldwide. We conducted a cross-sectional study in Ceará, Brazil, on women in families with children living below the poverty line at the peak of the second wave of COVID to assess the prevalence of IPV and its association with common mental disorders(CMD). Methods: The study population comprised families with children up to six years of age who participated in the cash transfer program “Mais Infância”. The families selected to participate in this program must meet a poverty criterion: families must live in rural areas, in addition to a monthly per capita income of less than US$16.50 per month. We applied specific instruments to evaluate IPV and CMD. To access IPV, we used the Partner Violence Screen (PVS). The Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. To verify the association between IPV and the other evaluated factors with CMD, simple and hierarchical multiple logistic models were used. Results: Of the 479 participant women, 22% were positively screened for IPV (95% CI 18.2–26.2). After multivariate adjustment, the chances of CMD are 2.32 higher in women exposed to IPV than in those not exposed to IPV ((95%CI 1.30–4.13), p value = 0.004). CMD was also associated with job loss during the COVID-19 pandemic (ORa 2.13 (95% CI 1.09–4.35), p-value 0.029). In addition to these, separate or single marital status, as well as non-presence of the father at home and food insecurity were associated with CMD. Conclusion: We conclude that the prevalence of intimate partner violence in families with children up to six years of age living below the poverty line in Ceará is high and is associated with greater chances of common mental disorders in mothers. Also, job loss and reduced access to food caused by the Covid 19 pandemic exacerbated both phenomena, constituting a double burden generator factor on mothers.

To explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0–66 months of age residing in Ceará, Brazil. The authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazil (PESMIC). Children's development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework. A total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26–7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR 2,08 (1,38–3,12)) was also associated. The authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.

Maternal educational attainment has been identified as relevant to several child health and development outcomes. This study aimed to evaluate the association of sociodemographic and maternal education factors with child development in families living below the poverty line. A cross-sectional study was conducted through telephone contact from May to July 2021 in Ceará, a state in Northeastern Brazil. The study population comprised families with children up to six years of age participating in the cash transfer program “Mais infância”. The families selected to participate in this program must have a monthly per capita income of less than US$16.50. The Ages and Stages Questionnaire version 3 was applied to assess the children’s development status. The mothers reported maternal educational attainment as the highest grade and or degree obtained. The final weighted and adjusted model showed that maternal schooling was associated with the risk of delay in all domains except for the fine motor domain. The risk of delay in at least one domain was 2.5-fold higher in mothers with a lower level of schooling (95% CI: 1.6–3.9). The findings of this study suggest that mothers with higher educational attainment have children with better child development outcomes.

Childhood obesity is now an epidemic in many countries worldwide and is known to be a multifactorial condition. We aimed to examine the relationship of environmental, socioeconomic, and nutritional factors with childhood overweight and obesity. We conducted a population-based cross-sectional study of children from 2 to 6 years of age in Ceará, Brazil. Children’s nutritional status was assessed by body mass index (BMI) Z scores categorized as overweight and obesity. Ordinal logistic regression models were used to assess the relationship between the factors with overweight and obesity. A total of 2059 children participated, of which 50.4% were male. The mean age was 46 ± 17 months, with a prevalence of overweight and obesity of 12.0% (95% CI 10.7–13.6) and 8.0% (6.7–9.5), respectively. In multivariate analysis, the probability of childhood obesity increased as family income increased (adjusted hazard ratio (aHR) 0.6 (95% CI 0.37–0.95), p-value = 0.03). Moreover, families with fewer children had more than 30% fewer overweight children (aHR 0.68; 95% CI 0.48–0.96). Environmental, socioeconomic, and child nutritional factors were associated with overweight and obesity. The results provided could be used to design integrated interventions spanning from conception, or earlier, through the first years of life and may improve child nutritional outcomes.

Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0–2, 3–5, and 6–9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7–90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures.