The effect of air pollutants on birth weight in medium-sized towns in the state of São Paulo<a class="elsevierStyleCrossRef" href="#fn1">*</a> | Revista Paulista de Pediatria (English Edition)

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"documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Paul Ped. 2014;32:313-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 184 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 113 "PDF" => 56 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Prevalence and clinical characteristics of wheezing in children in the first year of life, living in Cuiabá, Mato Grosso, Brazil<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "313" "paginaFinal" => "319" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Prevalência e características clínicas da sibilância em crianças no primeiro ano de vida, residentes na cidade de Cuiabá, Mato Grosso, Brasil" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lillian Sanchez Lacerda Moraes, Olga Akiko Takano, Javier Mallol, Dirceu Solé" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Lillian Sanchez Lacerda" "apellidos" => "Moraes" ] 1 => array:2 [ "nombre" => "Olga Akiko" "apellidos" => "Takano" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "Mallol" ] 3 => array:2 [ "nombre" => "Dirceu" "apellidos" => "Solé" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300658?idApp=UINPBA00004N" "url" => "/23593482/0000003200000004/v1_201507180038/S2359348215300658/v1_201507180038/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2359348215300634" "issn" => "23593482" "doi" => "10.1016/S2359-3482(15)30063-4" "estado" => "S300" "fechaPublicacion" => "2014-12-01" "aid" => "30063" "copyright" => "Sociedade de Pediatria de São Paulo. Published by Elsevier Editora Ltda. All rights reserved." "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Paul Ped. 2014;32:299-305" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 181 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 106 "PDF" => 69 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Epidemiological profile of exogenous poisoning in children and adolescents from a municipality in the state of Mato Grosso<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "299" "paginaFinal" => "305" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perfil epidemiológico das intoxicações exógenas em crianças e adolescentes em município do mato grosso" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Felipe Ferreira S. Oliveira, Eliane Aparecida Suchara" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Felipe Ferreira S." "apellidos" => "Oliveira" ] 1 => array:2 [ "nombre" => "Eliane Aparecida" "apellidos" => "Suchara" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2359348215300634?idApp=UINPBA00004N" "url" => "/23593482/0000003200000004/v1_201507180038/S2359348215300634/v1_201507180038/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "The effect of air pollutants on birth weight in medium-sized towns in the state of São Paulo<a class="elsevierStyleCrossRef" href="#fn1">*</a>" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "312" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Veridiana de Paula Santos, Andréa Paula Peneluppi de Medeiros, Thaiza Agostini Córdoba de Lima, Luiz Fernando Costa Nascimento" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Veridiana" "apellidos" => "de Paula Santos" ] 1 => array:4 [ "nombre" => "Andréa Paula Peneluppi" "apellidos" => "de Medeiros" "email" => array:1 [ 0 => "apeneluppi@uol.com.br" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 2 => array:2 [ "nombre" => "Thaiza Agostini Córdoba" "apellidos" => "de Lima" ] 3 => array:2 [ "nombre" => "Luiz Fernando Costa" "apellidos" => "Nascimento" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Universidade de Taubaté (UNITAU), Taubaté, SP, Brazil" "identificador" => "aff1" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Corresponding author" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O papel dos poluentes atmosféricos sobre o peso ao nascer EM cidade de médio porte Paulista" ] ] "textoCompleto" => "IntroductionAir pollution is currently one of the main public health problems, affecting the health of human beings, animals, and plants. The rapid technological advance of the modern world has resulted in an increase in the quantity and variety of pollutants eliminated in the atmosphere, affecting the quality of life on the planet.<a class="elsevierStyleCrossRef" href="#bib1">1</a> The main air pollutants in cities are particulate matter (PM10), ozone (O3), sulfur dioxide (SO2), carbon monoxide (CO), and nitrogen oxides (NO2).Exposure to air pollutants has shown to be associated with several deleterious effects to health, even at levels considered safe by environmental legislation.<a class="elsevierStyleCrossRefs" href="#bib1">1,2</a> When measuring the concentration of air pollutants in a given location, it can be identified that higher concentrations result in adverse health effects, such as an increase in the number of hospital admissions, increase in mortality, and decreased life expectancy.<a class="elsevierStyleCrossRef" href="#bib3">3</a> The effects of air pollution on outcomes related to pregnancy have also been considered in some studies.<a class="elsevierStyleCrossRefs" href="#bib4">4–6</a> Among these outcomes is low birth weight (LBW),<a class="elsevierStyleCrossRefs" href="#bib7">7,8</a> defined as a live birth weighing less than 2,500g.<a class="elsevierStyleCrossRef" href="#bib9">9</a> The biological mechanisms involved in fetal growth associated with environmental pollution seem related to placental changes, with anatomopathological and morphometric changes,<a class="elsevierStyleCrossRef" href="#bib10">10</a> placental infarction,<a class="elsevierStyleCrossRef" href="#bib11">11</a> and chronic villitis.<a class="elsevierStyleCrossRef" href="#bib12">12</a>A study conducted by Perera ET AL in Dominican and African-American pregnant women aged 18 to 35 years of age who had lived for at least one year in New York, who were nonsmokers without diabetes or hypertension and had negative serology for human immunodeficiency virus, indicated that in the population studied, the fetus and the newborn are more susceptible than adults to toxic environmental substances.<a class="elsevierStyleCrossRef" href="#bib13">13</a>Birth weight is an important determinant of neonatal morbimortality and post-neonatal mortality,<a class="elsevierStyleCrossRef" href="#bib14">14</a> and thus is of great importance in public health. Therefore, the World Health Organization (WHO) considers LBW as the single most important factor in child survival. Children with low birth weight are at significantly higher risk of mortality than children with birth weight ≥2,500 g.<a class="elsevierStyleCrossRef" href="#bib15">15</a> LBW is observed in 15.5% of all births worldwide.However, the problem does not occur uniformly among different locations, but rather is related to socioeconomic status. The highest percentage of children with LBW is concentrated in two regions of the world, Asia and Africa, with 27% and 22% of all live births showing low birth weight, respectively.<a class="elsevierStyleCrossRef" href="#bib16">16</a> In developed countries, in general the proportion of LBW is between 4% and 6%.<a class="elsevierStyleCrossRef" href="#bib17">17</a> In 2008, Brazil had a proportion of 8.3% and the city of São José dos Campos, 9.1%.<a class="elsevierStyleCrossRef" href="#bib18">18</a>LBW has been the subject of several epidemiological studies<a class="elsevierStyleCrossRefs" href="#bib4">4,7,8,15</a> aiming to identify its risk factors, in an attempt to develop interventions that can reduce these rates and prevent its occurrence. The importance of LBW for public health is determined not only by the subsequent risk of mortality and morbidity, but also by the frequency at which it occurs. In this context, the present study aimed to evaluate the effect of air pollution on birth weight of newborns of mothers living in São José dos Campos, state of São Paulo, Brazil, in the years 2005–2009.MethodsThis was a cross-sectional study of data on all births to mothers living in the city of São José dos Campos in the years 2005 to 2009, which had completed a live birth certificate.São José dos Campos is located 80 km from São Paulo, between the Serra do Mar and Mantiqueira mountain range, and has a population of approximately 700,000 inhabitants. Its altitude is 600m above sea level and it is located at latitude 23°11' south and longitude 45°53' west. It has approximately 1,100 industries, especially automotive, pharmaceutical, aerospace, and oil refining.Information on live births was obtained from the Live Birth Information System (SINASC) database through live birth certificates (LBCs), provided by the Department of Informatics of the Unified Health System (DATASUS), available at <a href="http://www.datasus.gov.br">http://www.datasus.gov.br</a>. It included infants born at term, weighing between 1,000g and 4,500g, the result of a single pregnancy, with maternal age between 20 and 34 years, after seven or more prenatal consultations and maternal level of schooling of eight or more complete years. These criteria were adopted to eliminate situations of greater vulnerability, such as preterm newborns and those weighing less than 1,000g, for which other risk factors might be more relevant than air pollution.The pollutants studied were PM10, SO2, and O3, which are quantified daily by Companhia de Tecnologia de Saneamento Ambiental (CETESB) of São José dos Campos. In Brazil, the air quality standards have been established by CONAMA Resolution No. 3/1990 (<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>);<a class="elsevierStyleCrossRef" href="#bib19">19</a> however, in the state of São Paulo, the State Decree No. 59113, published on 04/23/2013,<a class="elsevierStyleCrossRef" href="#bib20">20</a> established new standards for air quality (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>).<elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia>Daily measurements of pollutants are available at <a href="http://www.cetesb.sp.gov.br">www.cetesb.sp.gov.br</a> and, based on these values, the mean concentrations for the third trimester were calculated, for the last two months, and for the last month of pregnancy. Data analysis was primarily descriptive, and to assess the association between maternal exposure to air pollution and low birth weight, linear (univariate and multivariate) and logistic regression (univariate and multivariate) were used. In the linear regression, the variable outcome, birth weight in grams, was analyzed continuously, whereas in the logistic regression, birth weight was dichotomized (weight <2,500g and weight ≥2,500g).Regarding maternal exposure to pollutants, the linear regression considered the mean concentration, in the third trimester and monthly (each month of the third trimester) of each pollutant in the respective trimester of gestation, whereas in the logistic regression, these means were recoded into quartiles. The choice of the three month-period to estimate maternal exposure to air pollution was based on the fact that many studies<a class="elsevierStyleCrossRefs" href="#bib4">4,6–8,21</a> that assessed pregnancy outcomes used the trimester as a unit measurement, especially the third. From a physiological viewpoint, during pregnancy, the velocity of fetal weight gain has a maximum growth period between the 28th and 37th weeks of gestation.<a class="elsevierStyleCrossRef" href="#bib22">22</a>The linear and logistic univariate analyses first assessed the association of birth weight and low birth weight, respectively, with maternal exposure to several pollutants, aiming to estimate the gross effect, i.e., without adjustments, of this exposure on the child's weight. Furthermore, the univariate logistic model was used to investigate the association between outcome and each variable found in the live birth certificates (LBCs; variables: maternal marital status, type of delivery, and gender of the newborn), in order to identify possible confounding factors. In this case, the statistical analysis was based on the calculation of the OR to estimate the risk of newborns with low birth weight associated with each variable. All analyses included 95% confidence intervals and significance level was set at 5% (a=5%).Based on the results of the univariate logistic model, variables in the multivariate models were selected, in order to control for confounders. First, the multivariate model (linear and logistic) was considered without the pollutant, i.e., the exposure of interest. The independent variables were entered one by one in both the linear and logistic regression, using the smallest P-value as the input criteria, provided that this was less than 0.25. If the variables showed P<0.001, the variable entry criteria started from the highest value of the OR observed in the univariate logistic analysis.Furthermore, to verify the importance of each variable for the model and its permanence in it, the likelihood ratio was used, and only variables with P<0.05 remained in the final analysis. Only after obtaining the complete model were the pollutants included individually, and their association was tested with birth weight and low birth weight. Statistical analysis was performed using STATA v.7 (StataCorp LP – Texas, United States).The study project was approved by the Research Ethics Committee of Universidade de Taubate CEP/UNITAU No. 363/11.ResultsOf a total of 45,412 live births in the period of 2005 to 2009, 21,591 births were studied, considering the inclusion criteria described in the method section. Of the included newborns, it was observed that 13,149 (61.2%) were born to mothers who had partners, 14,575 (67.5%) were delivered by cesarean section, and 11,012 (51%) were males (<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>). The frequency of LBW in the total of live births between 1,000g and 4,500g was 647 (3.0%). As for the mean and the median birth weight, the values were 3,237g and 3,225g, respectively.<elsevierMultimedia ident="tbl3"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl4">Table 4</a> shows the prevalence and the chance of low birth weight (LBW) among live births in São José dos Campos-SP according to maternal marital status, type of delivery, and gender of the newborn. The chance of a child being born weighing <2,500g was higher for mothers without a partner (OR 1.26, 95% CI: 1.08–1.48) and for female newborns (OR 1.65, 95% CI: 1.41–1.94). As for cesarean delivery, no statistical significance was observed (P=0.979).<elsevierMultimedia ident="tbl4"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl5">Table 5</a> shows the descriptive analysis of the daily levels of air pollutants. The means of the pollutants are within acceptable air quality standards established in the CONAMA Resolution. However, PM10 and O3 had daily maximum values that were higher than the acceptable values, 171 and 209mg/m3, respectively, which fits the “inadequate” and “bad” air quality classifications, respectively. These results are of concern and deserve attention.<elsevierMultimedia ident="tbl5"></elsevierMultimedia>Maternal exposure to each pollutant was analyzed in quartiles and multiple logistic regression was performed using the last three months of pregnancy. In this analysis, adjustment was made for the variables maternal marital status and gender of the newborn. None of the pollutants showed statistically significant result, with the exception of SO2 in the last month, indicating that maternal exposure during this period is associated with a 1.25-fold greater chance of having a newborn with low birth weight (OR 1.25, 95% CI: 1.00 −1.56) for the second quartile of pollutant concentrations.<a class="elsevierStyleCrossRef" href="#tbl6">Table 6</a> shows the odds ratios and respective confidence intervals for the presence of low birth weight according to quartiles of concentration of air pollutants for the last trimester, last two months, and last month of pregnancy in the studied population. During the last month of pregnancy, exposure to the three air pollutants indicated greater frequency of low birth weight, but without statistical significance. With the increase in the concentration of pollutants, represented in quartiles, no increase in the chance of outcome occurrence was observed.<elsevierMultimedia ident="tbl6"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl7">Table 7</a> shows the coefficients of linear regression for birth weight according to the means of the last month, last two months, and last trimester of the corresponding concentration of air pollutants for the last trimester, last two months, and last month of pregnancy, adjusted for maternal marital status and gender of the newborn. It can be observed that in the last month, maternal exposure to PM10 and SO2 led to a decrease in mean birth weight: there was a decrease in weight of 3.8g and 38.6g for increases in mean maternal exposure of 10μg/m3 of PM10 and SO2, respectively.<elsevierMultimedia ident="tbl7"></elsevierMultimedia>Exposure to O3 also appears to indicate a decrease in mean birth weight in the last trimester of pregnancy and the last two months. However, no result showed statistical significance.DiscussionLow birth weight was associated with maternal marital status and gender of the newborn. Despite the predominance of male births, the prevalence of underweight was higher in female infants. Gouveia et al<a class="elsevierStyleCrossRef" href="#bib7">7</a> also identified an increased risk for birth weight <2,500g in female newborns (OR 1.22, 95% CI: 1.20–1.24). This tendency for birth weight distribution of males to higher values when compared to females was also observed in other studies, such as that by Areno<a class="elsevierStyleCrossRef" href="#bib23">23</a> and Tanaka.<a class="elsevierStyleCrossRef" href="#bib24">24</a>The study found a significant association between birth weight and maternal marital status, i.e., mothers living without a partner showed higher risk of having children with low birth weight. These results are consistent with those found by Miller et al,<a class="elsevierStyleCrossRef" href="#bib25">25</a> in the city of São Paulo, in which they estimated that the relative risk of LBW increased by 2.19-fold for mothers living without a partner in relation to mothers with a partner.Regarding the type of delivery, cesarean birth appears with a lower chance of insufficient weight; however, there was no statistically significant result in the present study. Antonio et al<a class="elsevierStyleCrossRef" href="#bib26">26</a> observed similar results in their study, and hypothesized that as lower weight gain may be associated with a lower socioeconomic level, women belonging to this socioeconomic stratum are commonly users of the Unified Health System (Sistema Único de Saúde – SUS) in Brazil, which imposes limitations on the performance of cesarean deliveries, justifying a lower chance of underweight (2,500g to 2,999g) in cesarean births. According to Carniel et al,<a class="elsevierStyleCrossRef" href="#bib27">27</a> there is a higher cesarean section rate in groups of low obstetric risk and women of higher socioeconomic status, suggesting that the criteria for the indication of this procedure are not purely technical.There was no statistical significance in the analyses conducted with atmospheric pollutants; however, the multiple logistic analysis showed that maternal exposure to SO2 in the last month of pregnancy poses an increased risk for low birth weight. The study by Reis<a class="elsevierStyleCrossRef" href="#bib28">28</a> showed a frequency of 9.1% for LBW, and risk of this outcome after exposure to SO2, PM10, and O3 in the second and third trimesters of pregnancy, even when the levels of pollutants found were below the standards established for air quality, i.e., a grade that represents good air quality (<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>). Romao et al<a class="elsevierStyleCrossRef" href="#bib29">29</a> also identified, in a population with 6% prevalence of low birth weight, an association between this outcome and maternal exposure to PM10 (fourth quartile) in the quartile trimester of pregnancy.It can be observed that SO2 and PM10 were not associated with birth weight, which may result from the low frequency of newborns with low birth weight (3%), adding to that the fact that the mean concentrations of pollutants did not reach very high values, although the maximum values were inadequate according to air quality standards.Regarding the study limitations, it is worth mentioning that, unlike the exposure data related to newborns, maternal factors, prenatal factors, and childbirth, which are obtained per individual, i.e., directly, the data regarding the exposure to air pollutants are obtained by indirect measurement by means of the concentration of air pollutants in the environment, which may hamper the consolidation of more consistent data. Another limitation refers to obtaining secondary data from DATASUL, an invaluable data source, but without the direct control of the researcher.Although the results were not statistically significant and despite the difficulty to isolate the effect of each pollutant due to the high correlation among them, it was observed that SO2 can lead to low birth weight in the last month of maternal exposure.FundingFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), process No. 2011/08741-4, for the scientific initiation scholarship.Conflicts of interestFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), process No. 2011/08741-4, for the scientific initiation scholarship." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres534296" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec554630" "titulo" => "KEYWORDS" ] 2 => array:3 [ "identificador" => "xres534297" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec554629" "titulo" => "PALAVRAS-CHAVE" ] 4 => array:2 [ "identificador" => "cesec10" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "cesec20" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "cesec30" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "cesec40" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "cesec50" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "cesec60" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-12-11" "fechaAceptado" => "2014-06-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec554630" "palabras" => array:4 [ 0 => "Low birthweight" 1 => "Air pollution" 2 => "Logistic regression" 3 => "Linear regression" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "PALAVRAS-CHAVE" "identificador" => "xpalclavsec554629" "palabras" => array:4 [ 0 => "Baixo peso ao nascer" 1 => "Poluição do ar" 2 => "Regressão logística" 3 => "Regressão linear" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo investigate the effect of air pollution on birth weight in a medium-sized town in the State of São Paulo, Southeast Brazil. MethodsCross-sectional study using data from live births of mothers residing in São José dos Campos from 2005 to 2009. Data was obtained from the Department of Information and Computing of the Brazilian Unified Health System. Air pollutant data (PM10, SO2, and O3) and daily averages of their concentrations were obtained from the Environmental Sanitation & Technology Company. Statistical analysis was performed by linear and logistic regressions using the Excel and STATA v.7 software programs. ResultsMaternal exposure to air pollutants was not associated with low birth weight, with the exception of exposure to SO2 within the last month of pregnancy (OR=1.25; 95% CI=1.00–1.56). Maternal exposure to PM10 and SO2 during the last month of pregnancy led to lower weight at birth (0.28g and 3.15g, respectively) for each 1mg/m3 increase in the concentration of these pollutants, but without statistical significance. ConclusionsThis study failed to identify a statistically significant association between the levels of air pollutants and birth weight, with the exception of exposure to SO2 within the last month of pregnancy." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "ObjetivoVerificar o efeito da poluição do ar sobre o peso ao nascer numa cidade de médio porte paulista. MétodosEstudo transversal, com dados relativos a todos os nascidos vivos de mães residentes no Município de São José dos Campos nos anos de 2005 a 2009. Foram obtidos dados do Departamento de Informações e Informática do Sistema Único de Saúde. Os dados dos poluentes do ar (PM10, SO2 e O3), as médias diárias de suas concentrações, foram fornecidos pela Companhia de Tecnologia de Saneamento Ambiental. Aplicou-se a regressão linear e a logística para a análise dos dados, realizadas nos programas Excel e STATA v.7. ResultadosA exposição materna aos poluentes do ar não se associou ao nascimento de crianças com baixo peso, com exceção do SO2, no último mês de gestação (OR=1,25; IC95% 1,00–1,56). Além disso, a exposição materna ao PM10 e SO2 no último mês levou à diminuição do peso ao nascer (0,28g e 3,15g, respectivamente) para cada 1mcg/m3 de aumento da concentração desses poluentes, porém sem significância estatística. ConclusõesEste estudo não permitiu identificar associação estatística entre os níveis de concentração dos poluentes atmosféricos e o peso ao nascer, com exceção da exposição SO2, no último mês de gestação." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusões" ] ] ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "*" "nota" => "Study conducted at the Department of Medicine of Universidade de Taubaté, Taubaté, SP, Brazil." "identificador" => "fn1" ] ] "multimedia" => array:7 [ 0 => array:8 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: CETESB. Companhia Ambiental do Estado de São Paulo.<a class="elsevierStyleCrossRef" href="#bib19">19</a>" "tabla" => array:2 [ "leyenda" => "An index is calculated for each measured pollutant. According to the obtained index, the air receives a qualification, i.e., a score, calculated as shown in the chart above.PM10, particulate matter" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Quality \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Index \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PM10 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">O3 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CO (ppm) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NO2 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SO2 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Good \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–4,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0–80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Regular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51–100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50–150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80–160 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4,5–9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100–320 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80–365 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Inadequate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">101–199 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">150–250 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">160–200 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9–15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">320–1,130 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">365–800 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BAD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">200–299 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">250–420 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">200–800 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15–30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,130–2,260 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">800–1,600 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Terrible \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>299 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>420 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>800 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>2,260 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>1,600 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858715.png" ] ] ] ] "descripcion" => array:1 [ "en" => "National standards for air quality (CONAMA Decree No. 03 of 06/28/90)." ] ] 1 => array:8 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: CETESB. Companhia Ambiental do Estado de São Paulo.<a class="elsevierStyleCrossRef" href="#bib20">20</a>" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Attention \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alert \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Emergency \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Fine inhalable particles (μg/m3) – 24h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">125 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">210 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">250 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Inhalable particles (μg/m3) – 24h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">250 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">420 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">500 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sulfur Dioxide (μg/m3) – 24h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">800 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,600 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2,100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Nitrogen Dioxide (μg/m3) – 1h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1,130 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2,260 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3,000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Carbon monoxide (ppm) – 8h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ozone (μg/m3) – 8h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">200 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">600 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858716.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Criteria for acute episodes of air pollution (State Decree No. 59113 of 04/23/2013)." ] ] 2 => array:7 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "No records: six cases for the variable “delivery” and one case for the variable “newborn gender.”" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n (total=21,591) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maternal marital status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> With partner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13,149 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> No partner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8,325 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Type of delivery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7,010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Caesarean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14,575 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Newborn gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11,012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10,578 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858718.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of live births to mothers residing in São José dos Campos-SP, from 2005 to 2009, according to maternal marital status, type of birth, and newborn gender." ] ] 3 => array:7 [ "identificador" => "tbl4" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence of LBW \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maternal marital status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> With partner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> No partner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.08–1.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Delivery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Vaginal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.979 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Caesarean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(0.84–1.18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Newborn gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">< 0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(1.41–1.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858713.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Prevalence and odds ratios (OR) with corresponding 95% confidence intervals (95% CI) for low birth weight (LBW) of live births in São José dos Campos-SP to mothers residing in the city between 2005 and 2009 according to maternal marital status, type of birth, and newborn gender." ] ] 4 => array:7 [ "identificador" => "tbl5" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">5% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">25% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">50% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">75% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">PM10 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.89 (15.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">171 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">SO2 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.28 (2.10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">O3 (μg/m3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80.35 (32.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">140 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">209 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858714.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Descriptive analysis of the daily levels of air pollution in São José dos Campos between 2005 and 2009." ] ] 5 => array:7 [ "identificador" => "tbl6" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Model adjusted for the variables “maternal marital status” and “newborn gender.”" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Quartile \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last trimester OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last two months OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last month OR (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="4" align="left" valign="top">PM10</td><td class="td" title="table-entry " align="left" valign="top">First \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Second \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.02 (0.82–1.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.98 (0.79–1.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.14 (0.92–1.42) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Third \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.02 (0.82–1.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.00 (0.81–1.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.15 (0.92–1.43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Fourth \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.86 (0.68–1.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.88 (0.70–1.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.98 (0.78–1.23) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="4" align="left" valign="top">SO2</td><td class="td" title="table-entry " align="left" valign="top">First \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Second \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.07 (0.86–1.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.89 (0.72–1.11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.25 (1.00–1.56) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Third \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.04 (0.83–1.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.96 (0.77–1.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.15 (0.92–1.44) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Fourth \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.91 (0.72–1.14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.92 (0.74–1.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.08 (0.86–1.35) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="4" align="left" valign="top">O3</td><td class="td" title="table-entry " align="left" valign="top">First \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Second \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.80 (0.64–1.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.03 (0.83–1.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.04 (0.84–1.30) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Third \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.86 (0.69–1.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.06 (0.85–1.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.02 (0.82–1.27) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Fourth \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.87 (0.70–1.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.96 (0.77–1.20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.03 (0.83–1.29) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858717.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Odds ratio (OR) and confidence intervals (95% CI) for low birth weight (LBW) according to quartiles of concentration of air pollutants for the last trimester, last two months, and last month of pregnancy, in São José dos Campos between 2005 and 2009 (logistic regression)." ] ] 6 => array:7 [ "identificador" => "tbl7" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Model adjusted for the variables “gender of newborn” and “maternal marital status”." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coefficients (DP) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IC 95% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">PM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.38 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.98–0.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last two months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.05 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.72–0.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last trimester \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.10 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.62–0.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">O3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.05 (0.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.37–0.47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last two months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.05 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.59–0.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last trimester \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−0.44 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−1.07–0.20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">SO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−3.86 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−8.92–1.20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last two months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.90 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−4.81–6.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"> Last trimester \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.34 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−2.88–9.56 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858712.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Regression coefficients with standard deviations (SD) and 95% confidence intervals (95% CI) according to the means of the last month, last two months, and last trimester of concentration of atmospheric pollutants corresponding to the last trimester, last two months, and last month of pregnancy, in São José dos Campos between 2005 and 2009 (multiple linear regression)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methodological issues of the research on the health effects of air pollution" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ HA Castro \n \t\t\t\t\t\t\t\t """ 1 => """ N Gouveia \n \t\t\t\t\t\t\t\t """ 2 => """ JA Escamilla-Cejudo \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Epidemiol" "fecha" => "2003" "volumen" => "6" "paginaInicial" => "135" "paginaFinal" => "149" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => 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The effect of air pollutants on birth weight in medium-sized towns in the state of São Paulo*

O papel dos poluentes atmosféricos sobre o peso ao nascer EM cidade de médio porte Paulista

Veridiana de Paula Santos, Andréa Paula Peneluppi de Medeiros

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apeneluppi@uol.com.br

Corresponding author

, Thaiza Agostini Córdoba de Lima, Luiz Fernando Costa Nascimento

Universidade de Taubaté (UNITAU), Taubaté, SP, Brazil

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">Introduction</span><p id="para10" class="elsevierStylePara elsevierViewall">Air pollution is currently one of the main public health problems&#44; affecting the health of human beings&#44; animals&#44; and plants&#46; The rapid technological advance of the modern world has resulted in an increase in the quantity and variety of pollutants eliminated in the atmosphere&#44; affecting the quality of life on the planet&#46;<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> The main air pollutants in cities are particulate matter &#40;PM<span class="elsevierStyleInf">10</span>&#41;&#44; ozone &#40;O<span class="elsevierStyleInf">3</span>&#41;&#44; sulfur dioxide &#40;SO<span class="elsevierStyleInf">2</span>&#41;&#44; carbon monoxide &#40;CO&#41;&#44; and nitrogen oxides &#40;NO<span class="elsevierStyleInf">2</span>&#41;&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">Exposure to air pollutants has shown to be associated with several deleterious effects to health&#44; even at levels considered safe by environmental legislation&#46;<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1&#44;2</span></a> When measuring the concentration of air pollutants in a given location&#44; it can be identified that higher concentrations result in adverse health effects&#44; such as an increase in the number of hospital admissions&#44; increase in mortality&#44; and decreased life expectancy&#46;<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a> The effects of air pollution on outcomes related to pregnancy have also been considered in some studies&#46;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#8211;6</span></a> Among these outcomes is low birth weight &#40;LBW&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib7"><span class="elsevierStyleSup">7&#44;8</span></a> defined as a live birth weighing less than 2&#44;500g&#46;<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a> The biological mechanisms involved in fetal growth associated with environmental pollution seem related to placental changes&#44; with anatomopathological and morphometric changes&#44;<a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a> placental infarction&#44;<a class="elsevierStyleCrossRef" href="#bib11"><span class="elsevierStyleSup">11</span></a> and chronic villitis&#46;<a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a></p><p id="para30" class="elsevierStylePara elsevierViewall">A study conducted by Perera <span class="elsevierStyleItalic">ET AL</span> in Dominican and African-American pregnant women aged 18 to 35 years of age who had lived for at least one year in New York&#44; who were nonsmokers without diabetes or hypertension and had negative serology for human immunodeficiency virus&#44; indicated that in the population studied&#44; the fetus and the newborn are more susceptible than adults to toxic environmental substances&#46;<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a></p><p id="para40" class="elsevierStylePara elsevierViewall">Birth weight is an important determinant of neonatal morbimortality and post-neonatal mortality&#44;<a class="elsevierStyleCrossRef" href="#bib14"><span class="elsevierStyleSup">14</span></a> and thus is of great importance in public health&#46; Therefore&#44; the World Health Organization &#40;WHO&#41; considers LBW as the single most important factor in child survival&#46; Children with low birth weight are at significantly higher risk of mortality than children with birth weight &#8805;2&#44;500 g&#46;<a class="elsevierStyleCrossRef" href="#bib15"><span class="elsevierStyleSup">15</span></a> LBW is observed in 15&#46;5&#37; of all births worldwide&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">However&#44; the problem does not occur uniformly among different locations&#44; but rather is related to socioeconomic status&#46; The highest percentage of children with LBW is concentrated in two regions of the world&#44; Asia and Africa&#44; with 27&#37; and 22&#37; of all live births showing low birth weight&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> In developed countries&#44; in general the proportion of LBW is between 4&#37; and 6&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> In 2008&#44; Brazil had a proportion of 8&#46;3&#37; and the city of S&#227;o Jos&#233; dos Campos&#44; 9&#46;1&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib18"><span class="elsevierStyleSup">18</span></a></p><p id="para60" class="elsevierStylePara elsevierViewall">LBW has been the subject of several epidemiological studies<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;7&#44;8&#44;15</span></a> aiming to identify its risk factors&#44; in an attempt to develop interventions that can reduce these rates and prevent its occurrence&#46; The importance of LBW for public health is determined not only by the subsequent risk of mortality and morbidity&#44; but also by the frequency at which it occurs&#46; In this context&#44; the present study aimed to evaluate the effect of air pollution on birth weight of newborns of mothers living in S&#227;o Jos&#233; dos Campos&#44; state of S&#227;o Paulo&#44; Brazil&#44; in the years 2005&#8211;2009&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Methods</span><p id="para70" class="elsevierStylePara elsevierViewall">This was a cross-sectional study of data on all births to mothers living in the city of S&#227;o Jos&#233; dos Campos in the years 2005 to 2009&#44; which had completed a live birth certificate&#46;</p><p id="para80" class="elsevierStylePara elsevierViewall">S&#227;o Jos&#233; dos Campos is located 80 km from S&#227;o Paulo&#44; between the Serra do Mar and Mantiqueira mountain range&#44; and has a population of approximately 700&#44;000 inhabitants&#46; Its altitude is 600m above sea level and it is located at latitude 23&#176;11&#39; south and longitude 45&#176;53&#39; west&#46; It has approximately 1&#44;100 industries&#44; especially automotive&#44; pharmaceutical&#44; aerospace&#44; and oil refining&#46;</p><p id="para90" class="elsevierStylePara elsevierViewall">Information on live births was obtained from the Live Birth Information System &#40;SINASC&#41; database through live birth certificates &#40;LBCs&#41;&#44; provided by the Department of Informatics of the Unified Health System &#40;DATASUS&#41;&#44; available at <a href="http://www.datasus.gov.br">http&#58;&#47;&#47;www&#46;datasus&#46;gov&#46;br</a>&#46; It included infants born at term&#44; weighing between 1&#44;000g and 4&#44;500g&#44; the result of a single pregnancy&#44; with maternal age between 20 and 34 years&#44; after seven or more prenatal consultations and maternal level of schooling of eight or more complete years&#46; These criteria were adopted to eliminate situations of greater vulnerability&#44; such as preterm newborns and those weighing less than 1&#44;000g&#44; for which other risk factors might be more relevant than air pollution&#46;</p><p id="para100" class="elsevierStylePara elsevierViewall">The pollutants studied were PM<span class="elsevierStyleInf">10</span>&#44; SO<span class="elsevierStyleInf">2</span>&#44; and O<span class="elsevierStyleInf">3</span>&#44; which are quantified daily by Companhia de Tecnologia de Saneamento Ambiental &#40;CETESB&#41; of S&#227;o Jos&#233; dos Campos&#46; In Brazil&#44; the air quality standards have been established by CONAMA Resolution No&#46; 3&#47;1990 &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#59;<a class="elsevierStyleCrossRef" href="#bib19"><span class="elsevierStyleSup">19</span></a> however&#44; in the state of S&#227;o Paulo&#44; the State Decree No&#46; 59113&#44; published on 04&#47;23&#47;2013&#44;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a> established new standards for air quality &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para110" class="elsevierStylePara elsevierViewall">Daily measurements of pollutants are available at <a href="http://www.cetesb.sp.gov.br">www&#46;cetesb&#46;sp&#46;gov&#46;br</a> and&#44; based on these values&#44; the mean concentrations for the third trimester were calculated&#44; for the last two months&#44; and for the last month of pregnancy&#46; Data analysis was primarily descriptive&#44; and to assess the association between maternal exposure to air pollution and low birth weight&#44; linear &#40;univariate and multivariate&#41; and logistic regression &#40;univariate and multivariate&#41; were used&#46; In the linear regression&#44; the variable outcome&#44; birth weight in grams&#44; was analyzed continuously&#44; whereas in the logistic regression&#44; birth weight was dichotomized &#40;weight &#60;2&#44;500g and weight &#8805;2&#44;500g&#41;&#46;</p><p id="para120" class="elsevierStylePara elsevierViewall">Regarding maternal exposure to pollutants&#44; the linear regression considered the mean concentration&#44; in the third trimester and monthly &#40;each month of the third trimester&#41; of each pollutant in the respective trimester of gestation&#44; whereas in the logistic regression&#44; these means were recoded into quartiles&#46; The choice of the three month-period to estimate maternal exposure to air pollution was based on the fact that many studies<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#44;6&#8211;8&#44;21</span></a> that assessed pregnancy outcomes used the trimester as a unit measurement&#44; especially the third&#46; From a physiological viewpoint&#44; during pregnancy&#44; the velocity of fetal weight gain has a maximum growth period between the 28<span class="elsevierStyleSup">th</span> and 37<span class="elsevierStyleSup">th</span> weeks of gestation&#46;<a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a></p><p id="para130" class="elsevierStylePara elsevierViewall">The linear and logistic univariate analyses first assessed the association of birth weight and low birth weight&#44; respectively&#44; with maternal exposure to several pollutants&#44; aiming to estimate the gross effect&#44; i&#46;e&#46;&#44; without adjustments&#44; of this exposure on the child&#39;s weight&#46; Furthermore&#44; the univariate logistic model was used to investigate the association between outcome and each variable found in the live birth certificates &#40;LBCs&#59; variables&#58; maternal marital status&#44; type of delivery&#44; and gender of the newborn&#41;&#44; in order to identify possible confounding factors&#46; In this case&#44; the statistical analysis was based on the calculation of the OR to estimate the risk of newborns with low birth weight associated with each variable&#46; All analyses included 95&#37; confidence intervals and significance level was set at 5&#37; &#40;a&#61;5&#37;&#41;&#46;</p><p id="para140" class="elsevierStylePara elsevierViewall">Based on the results of the univariate logistic model&#44; variables in the multivariate models were selected&#44; in order to control for confounders&#46; First&#44; the multivariate model &#40;linear and logistic&#41; was considered without the pollutant&#44; i&#46;e&#46;&#44; the exposure of interest&#46; The independent variables were entered one by one in both the linear and logistic regression&#44; using the smallest <span class="elsevierStyleItalic">P</span>-value as the input criteria&#44; provided that this was less than 0&#46;25&#46; If the variables showed <span class="elsevierStyleItalic">P</span>&#60;0&#46;001&#44; the variable entry criteria started from the highest value of the OR observed in the univariate logistic analysis&#46;</p><p id="para150" class="elsevierStylePara elsevierViewall">Furthermore&#44; to verify the importance of each variable for the model and its permanence in it&#44; the likelihood ratio was used&#44; and only variables with <span class="elsevierStyleItalic">P</span>&#60;0&#46;05 remained in the final analysis&#46; Only after obtaining the complete model were the pollutants included individually&#44; and their association was tested with birth weight and low birth weight&#46; Statistical analysis was performed using STATA v&#46;7 &#40;StataCorp LP &#8211; Texas&#44; United States&#41;&#46;</p><p id="para160" class="elsevierStylePara elsevierViewall">The study project was approved by the Research Ethics Committee of Universidade de Taubate CEP&#47;UNITAU No&#46; 363&#47;11&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Results</span><p id="para170" class="elsevierStylePara elsevierViewall">Of a total of 45&#44;412 live births in the period of 2005 to 2009&#44; 21&#44;591 births were studied&#44; considering the inclusion criteria described in the method section&#46; Of the included newborns&#44; it was observed that 13&#44;149 &#40;61&#46;2&#37;&#41; were born to mothers who had partners&#44; 14&#44;575 &#40;67&#46;5&#37;&#41; were delivered by cesarean section&#44; and 11&#44;012 &#40;51&#37;&#41; were males &#40;<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>&#41;&#46; The frequency of LBW in the total of live births between 1&#44;000g and 4&#44;500g was 647 &#40;3&#46;0&#37;&#41;&#46; As for the mean and the median birth weight&#44; the values were 3&#44;237g and 3&#44;225g&#44; respectively&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><p id="para180" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl4">Table 4</a> shows the prevalence and the chance of low birth weight &#40;LBW&#41; among live births in S&#227;o Jos&#233; dos Campos-SP according to maternal marital status&#44; type of delivery&#44; and gender of the newborn&#46; The chance of a child being born weighing &#60;2&#44;500g was higher for mothers without a partner &#40;OR 1&#46;26&#44; 95&#37; CI&#58; 1&#46;08&#8211;1&#46;48&#41; and for female newborns &#40;OR 1&#46;65&#44; 95&#37; CI&#58; 1&#46;41&#8211;1&#46;94&#41;&#46; As for cesarean delivery&#44; no statistical significance was observed &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;979&#41;&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia><p id="para190" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl5">Table 5</a> shows the descriptive analysis of the daily levels of air pollutants&#46; The means of the pollutants are within acceptable air quality standards established in the CONAMA Resolution&#46; However&#44; PM<span class="elsevierStyleInf">10</span> and O<span class="elsevierStyleInf">3</span> had daily maximum values that were higher than the acceptable values&#44; 171 and 209mg&#47;m<span class="elsevierStyleSup">3</span>&#44; respectively&#44; which fits the &#8220;inadequate&#8221; and &#8220;bad&#8221; air quality classifications&#44; respectively&#46; These results are of concern and deserve attention&#46;</p><elsevierMultimedia ident="tbl5"></elsevierMultimedia><p id="para200" class="elsevierStylePara elsevierViewall">Maternal exposure to each pollutant was analyzed in quartiles and multiple logistic regression was performed using the last three months of pregnancy&#46; In this analysis&#44; adjustment was made for the variables maternal marital status and gender of the newborn&#46; None of the pollutants showed statistically significant result&#44; with the exception of SO<span class="elsevierStyleInf">2</span> in the last month&#44; indicating that maternal exposure during this period is associated with a 1&#46;25-fold greater chance of having a newborn with low birth weight &#40;OR 1&#46;25&#44; 95&#37; CI&#58; 1&#46;00 &#8722;1&#46;56&#41; for the second quartile of pollutant concentrations&#46;</p><p id="para210" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl6">Table 6</a> shows the odds ratios and respective confidence intervals for the presence of low birth weight according to quartiles of concentration of air pollutants for the last trimester&#44; last two months&#44; and last month of pregnancy in the studied population&#46; During the last month of pregnancy&#44; exposure to the three air pollutants indicated greater frequency of low birth weight&#44; but without statistical significance&#46; With the increase in the concentration of pollutants&#44; represented in quartiles&#44; no increase in the chance of outcome occurrence was observed&#46;</p><elsevierMultimedia ident="tbl6"></elsevierMultimedia><p id="para220" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl7">Table 7</a> shows the coefficients of linear regression for birth weight according to the means of the last month&#44; last two months&#44; and last trimester of the corresponding concentration of air pollutants for the last trimester&#44; last two months&#44; and last month of pregnancy&#44; adjusted for maternal marital status and gender of the newborn&#46; It can be observed that in the last month&#44; maternal exposure to PM<span class="elsevierStyleInf">10</span> and SO<span class="elsevierStyleInf">2</span> led to a decrease in mean birth weight&#58; there was a decrease in weight of 3&#46;8g and 38&#46;6g for increases in mean maternal exposure of 10&#956;g&#47;m<span class="elsevierStyleSup">3</span> of PM<span class="elsevierStyleInf">10</span> and SO<span class="elsevierStyleInf">2</span>&#44; respectively&#46;</p><elsevierMultimedia ident="tbl7"></elsevierMultimedia><p id="para230" class="elsevierStylePara elsevierViewall">Exposure to O<span class="elsevierStyleInf">3</span> also appears to indicate a decrease in mean birth weight in the last trimester of pregnancy and the last two months&#46; However&#44; no result showed statistical significance&#46;</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Discussion</span><p id="para240" class="elsevierStylePara elsevierViewall">Low birth weight was associated with maternal marital status and gender of the newborn&#46; Despite the predominance of male births&#44; the prevalence of underweight was higher in female infants&#46; Gouveia <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a> also identified an increased risk for birth weight &#60;2&#44;500g in female newborns &#40;OR 1&#46;22&#44; 95&#37; CI&#58; 1&#46;20&#8211;1&#46;24&#41;&#46; This tendency for birth weight distribution of males to higher values when compared to females was also observed in other studies&#44; such as that by Areno<a class="elsevierStyleCrossRef" href="#bib23"><span class="elsevierStyleSup">23</span></a> and Tanaka&#46;<a class="elsevierStyleCrossRef" href="#bib24"><span class="elsevierStyleSup">24</span></a></p><p id="para250" class="elsevierStylePara elsevierViewall">The study found a significant association between birth weight and maternal marital status&#44; i&#46;e&#46;&#44; mothers living without a partner showed higher risk of having children with low birth weight&#46; These results are consistent with those found by Miller <span class="elsevierStyleItalic">et al</span>&#44;<a class="elsevierStyleCrossRef" href="#bib25"><span class="elsevierStyleSup">25</span></a> in the city of S&#227;o Paulo&#44; in which they estimated that the relative risk of LBW increased by 2&#46;19-fold for mothers living without a partner in relation to mothers with a partner&#46;</p><p id="para260" class="elsevierStylePara elsevierViewall">Regarding the type of delivery&#44; cesarean birth appears with a lower chance of insufficient weight&#59; however&#44; there was no statistically significant result in the present study&#46; Antonio <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib26"><span class="elsevierStyleSup">26</span></a> observed similar results in their study&#44; and hypothesized that as lower weight gain may be associated with a lower socioeconomic level&#44; women belonging to this socioeconomic stratum are commonly users of the Unified Health System &#40;Sistema &#218;nico de Sa&#250;de &#8211; SUS&#41; in Brazil&#44; which imposes limitations on the performance of cesarean deliveries&#44; justifying a lower chance of underweight &#40;2&#44;500g to 2&#44;999g&#41; in cesarean births&#46; According to Carniel <span class="elsevierStyleItalic">et al</span>&#44;<a class="elsevierStyleCrossRef" href="#bib27"><span class="elsevierStyleSup">27</span></a> there is a higher cesarean section rate in groups of low obstetric risk and women of higher socioeconomic status&#44; suggesting that the criteria for the indication of this procedure are not purely technical&#46;</p><p id="para270" class="elsevierStylePara elsevierViewall">There was no statistical significance in the analyses conducted with atmospheric pollutants&#59; however&#44; the multiple logistic analysis showed that maternal exposure to SO<span class="elsevierStyleInf">2</span> in the last month of pregnancy poses an increased risk for low birth weight&#46; The study by Reis<a class="elsevierStyleCrossRef" href="#bib28"><span class="elsevierStyleSup">28</span></a> showed a frequency of 9&#46;1&#37; for LBW&#44; and risk of this outcome after exposure to SO<span class="elsevierStyleInf">2</span>&#44; PM<span class="elsevierStyleInf">10</span>&#44; and O<span class="elsevierStyleInf">3</span> in the second and third trimesters of pregnancy&#44; even when the levels of pollutants found were below the standards established for air quality&#44; i&#46;e&#46;&#44; a grade that represents good air quality &#40;<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>&#41;&#46; Romao <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib29"><span class="elsevierStyleSup">29</span></a> also identified&#44; in a population with 6&#37; prevalence of low birth weight&#44; an association between this outcome and maternal exposure to PM<span class="elsevierStyleInf">10</span> &#40;fourth quartile&#41; in the quartile trimester of pregnancy&#46;</p><p id="para280" class="elsevierStylePara elsevierViewall">It can be observed that SO<span class="elsevierStyleInf">2</span> and PM<span class="elsevierStyleInf">10</span> were not associated with birth weight&#44; which may result from the low frequency of newborns with low birth weight &#40;3&#37;&#41;&#44; adding to that the fact that the mean concentrations of pollutants did not reach very high values&#44; although the maximum values were inadequate according to air quality standards&#46;</p><p id="para290" class="elsevierStylePara elsevierViewall">Regarding the study limitations&#44; it is worth mentioning that&#44; unlike the exposure data related to newborns&#44; maternal factors&#44; prenatal factors&#44; and childbirth&#44; which are obtained per individual&#44; i&#46;e&#46;&#44; directly&#44; the data regarding the exposure to air pollutants are obtained by indirect measurement by means of the concentration of air pollutants in the environment&#44; which may hamper the consolidation of more consistent data&#46; Another limitation refers to obtaining secondary data from DATASUL&#44; an invaluable data source&#44; but without the direct control of the researcher&#46;</p><p id="para300" class="elsevierStylePara elsevierViewall">Although the results were not statistically significant and despite the difficulty to isolate the effect of each pollutant due to the high correlation among them&#44; it was observed that SO<span class="elsevierStyleInf">2</span> can lead to low birth weight in the last month of maternal exposure&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">Funding</span><p id="para310" class="elsevierStylePara elsevierViewall">Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#41;&#44; process No&#46; 2011&#47;08741-4&#44; for the scientific initiation scholarship&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">Conflicts of interest</span><p id="para320" class="elsevierStylePara elsevierViewall">Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;FAPESP&#41;&#44; process No&#46; 2011&#47;08741-4&#44; for the scientific initiation scholarship&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xres534296"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "ceabs10"
              "titulo" => "Objective"
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          "identificador" => "xpalclavsec554630"
          "titulo" => "KEYWORDS"
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          "titulo" => "Resumo"
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              "titulo" => "Objetivo"
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              "titulo" => "M&#233;todos"
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            2 => array:2 [
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              "titulo" => "Resultados"
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            3 => array:2 [
              "identificador" => "ceabs80"
              "titulo" => "Conclus&#245;es"
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        3 => array:2 [
          "identificador" => "xpalclavsec554629"
          "titulo" => "PALAVRAS-CHAVE"
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        4 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "Introduction"
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        5 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "Methods"
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          "titulo" => "Funding"
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          "titulo" => "Conflicts of interest"
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        10 => array:1 [
          "titulo" => "References"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-12-11"
    "fechaAceptado" => "2014-06-25"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec554630"
          "palabras" => array:4 [
            0 => "Low birthweight"
            1 => "Air pollution"
            2 => "Logistic regression"
            3 => "Linear regression"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "PALAVRAS-CHAVE"
          "identificador" => "xpalclavsec554629"
          "palabras" => array:4 [
            0 => "Baixo peso ao nascer"
            1 => "Polui&#231;&#227;o do ar"
            2 => "Regress&#227;o log&#237;stica"
            3 => "Regress&#227;o linear"
          ]
        ]
      ]
    ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">Objective</span><p id="spara130" class="elsevierStyleSimplePara elsevierViewall">To investigate the effect of air pollution on birth weight in a medium-sized town in the State of S&#227;o Paulo&#44; Southeast Brazil&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">Methods</span><p id="spara140" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional study using data from live births of mothers residing in S&#227;o Jos&#233; dos Campos from 2005 to 2009&#46; Data was obtained from the Department of Information and Computing of the Brazilian Unified Health System&#46; Air pollutant data &#40;PM<span class="elsevierStyleInf">10</span>&#44; SO<span class="elsevierStyleInf">2</span>&#44; and O<span class="elsevierStyleInf">3</span>&#41; and daily averages of their concentrations were obtained from the Environmental Sanitation &#38; Technology Company&#46; Statistical analysis was performed by linear and logistic regressions using the Excel and STATA v&#46;7 software programs&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">Results</span><p id="spara150" class="elsevierStyleSimplePara elsevierViewall">Maternal exposure to air pollutants was not associated with low birth weight&#44; with the exception of exposure to SO<span class="elsevierStyleInf">2</span> within the last month of pregnancy &#40;OR&#61;1&#46;25&#59; 95&#37; CI&#61;1&#46;00&#8211;1&#46;56&#41;&#46; Maternal exposure to PM<span class="elsevierStyleInf">10</span> and SO<span class="elsevierStyleInf">2</span> during the last month of pregnancy led to lower weight at birth &#40;0&#46;28g and 3&#46;15g&#44; respectively&#41; for each 1mg&#47;m<span class="elsevierStyleSup">3</span> increase in the concentration of these pollutants&#44; but without statistical significance&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle50">Conclusions</span><p id="spara160" class="elsevierStyleSimplePara elsevierViewall">This study failed to identify a statistically significant association between the levels of air pollutants and birth weight&#44; with the exception of exposure to SO<span class="elsevierStyleInf">2</span> within the last month of pregnancy&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "Results"
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            "titulo" => "Conclusions"
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      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="ceabs50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">Objetivo</span><p id="spara170" class="elsevierStyleSimplePara elsevierViewall">Verificar o efeito da polui&#231;&#227;o do ar sobre o peso ao nascer numa cidade de m&#233;dio porte paulista&#46;</p></span> <span id="ceabs60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">M&#233;todos</span><p id="spara180" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal&#44; com dados relativos a todos os nascidos vivos de m&#227;es residentes no Munic&#237;pio de S&#227;o Jos&#233; dos Campos nos anos de 2005 a 2009&#46; Foram obtidos dados do Departamento de Informa&#231;&#245;es e Inform&#225;tica do Sistema &#218;nico de Sa&#250;de&#46; Os dados dos poluentes do ar &#40;PM<span class="elsevierStyleInf">10</span>&#44; SO<span class="elsevierStyleInf">2</span> e O<span class="elsevierStyleInf">3</span>&#41;&#44; as m&#233;dias di&#225;rias de suas concentra&#231;&#245;es&#44; foram fornecidos pela Companhia de Tecnologia de Saneamento Ambiental&#46; Aplicou-se a regress&#227;o linear e a log&#237;stica para a an&#225;lise dos dados&#44; realizadas nos programas Excel e STATA v&#46;7&#46;</p></span> <span id="ceabs70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Resultados</span><p id="spara190" class="elsevierStyleSimplePara elsevierViewall">A exposi&#231;&#227;o materna aos poluentes do ar n&#227;o se associou ao nascimento de crian&#231;as com baixo peso&#44; com exce&#231;&#227;o do SO<span class="elsevierStyleInf">2&#44;</span> no &#250;ltimo m&#234;s de gesta&#231;&#227;o &#40;OR&#61;1&#44;25&#59; IC95&#37; 1&#44;00&#8211;1&#44;56&#41;&#46; Al&#233;m disso&#44; a exposi&#231;&#227;o materna ao PM<span class="elsevierStyleInf">10</span> e SO<span class="elsevierStyleInf">2</span> no &#250;ltimo m&#234;s levou &#224; diminui&#231;&#227;o do peso ao nascer &#40;0&#44;28g e 3&#44;15g&#44; respectivamente&#41; para cada 1mcg&#47;m<span class="elsevierStyleSup">3</span> de aumento da concentra&#231;&#227;o desses poluentes&#44; por&#233;m sem signific&#226;ncia estat&#237;stica&#46;</p></span> <span id="ceabs80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Conclus&#245;es</span><p id="spara200" class="elsevierStyleSimplePara elsevierViewall">Este estudo n&#227;o permitiu identificar associa&#231;&#227;o estat&#237;stica entre os n&#237;veis de concentra&#231;&#227;o dos poluentes atmosf&#233;ricos e o peso ao nascer&#44; com exce&#231;&#227;o da exposi&#231;&#227;o SO<span class="elsevierStyleInf">2&#44;</span> no &#250;ltimo m&#234;s de gesta&#231;&#227;o&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">Study conducted at the Department of Medicine of Universidade de Taubat&#233;&#44; Taubat&#233;&#44; SP&#44; Brazil&#46;</p>"
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        "fuente" => "Source&#58; CETESB&#46; Companhia Ambiental do Estado de S&#227;o Paulo&#46;<a class="elsevierStyleCrossRef" href="#bib19"><span class="elsevierStyleSup">19</span></a>"
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          "leyenda" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">An index is calculated for each measured pollutant&#46; According to the obtained index&#44; the air receives a qualification&#44; i&#46;e&#46;&#44; a score&#44; calculated as shown in the chart above&#46;</p><p id="spara30" class="elsevierStyleSimplePara elsevierViewall">PM<span class="elsevierStyleInf">10</span>&#44; particulate matter</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Quality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Index&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PM10 &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">O<span class="elsevierStyleInf">3</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CO &#40;ppm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NO<span class="elsevierStyleInf">2</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SO<span class="elsevierStyleInf">2</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#8211;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Regular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#8211;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#8211;150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#8211;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;5&#8211;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#8211;320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#8211;365&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Inadequate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101&#8211;199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150&#8211;250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">160&#8211;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#8211;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320&#8211;1&#44;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">365&#8211;800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">BAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#8211;299&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&#8211;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&#8211;800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#8211;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;130&#8211;2&#44;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">800&#8211;1&#44;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Terrible&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;299&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;2&#44;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;1&#44;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab858715.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">National standards for air quality &#40;CONAMA Decree No&#46; 03 of 06&#47;28&#47;90&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl2"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Source&#58; CETESB&#46; Companhia Ambiental do Estado de S&#227;o Paulo&#46;<a class="elsevierStyleCrossRef" href="#bib20"><span class="elsevierStyleSup">20</span></a>"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Attention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alert&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Emergency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Fine inhalable particles &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; &#8211; 24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">210&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Inhalable particles &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; &#8211; 24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Sulfur Dioxide &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; &#8211; 24h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">800&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Nitrogen Dioxide &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; &#8211; 1h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Carbon monoxide &#40;ppm&#41; &#8211; 8h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Ozone &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41; &#8211; 8h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">400&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Criteria for acute episodes of air pollution &#40;State Decree No&#46; 59113 of 04&#47;23&#47;2013&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl3"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spara60" class="elsevierStyleSimplePara elsevierViewall">No records&#58; six cases for the variable &#8220;delivery&#8221; and one case for the variable &#8220;newborn gender&#46;&#8221;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n &#40;total&#61;21&#44;591&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maternal marital status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;With partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;149&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;No partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;325&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Type of delivery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Vaginal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;575&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Newborn gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;578&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Distribution of live births to mothers residing in S&#227;o Jos&#233; dos Campos-SP&#44; from 2005 to 2009&#44; according to maternal marital status&#44; type of birth&#44; and newborn gender&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl4"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prevalence of LBW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Maternal marital status</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;With partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;No partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;1&#46;08&#8211;1&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Delivery</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Vaginal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;979&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Caesarean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;0&#46;84&#8211;1&#46;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Newborn gender</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;1&#46;41&#8211;1&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab858713.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Prevalence and odds ratios &#40;OR&#41; with corresponding 95&#37; confidence intervals &#40;95&#37; CI&#41; for low birth weight &#40;LBW&#41; of live births in S&#227;o Jos&#233; dos Campos-SP to mothers residing in the city between 2005 and 2009 according to maternal marital status&#44; type of birth&#44; and newborn gender&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl5"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">25&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">75&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PM<span class="elsevierStyleInf">10</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;89 &#40;15&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">171&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">SO<span class="elsevierStyleInf">2</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;28 &#40;2&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">O<span class="elsevierStyleInf">3</span> &#40;&#956;g&#47;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&#46;35 &#40;32&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab858714.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara80" class="elsevierStyleSimplePara elsevierViewall">Descriptive analysis of the daily levels of air pollution in S&#227;o Jos&#233; dos Campos between 2005 and 2009&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl6"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spara100" class="elsevierStyleSimplePara elsevierViewall">Model adjusted for the variables &#8220;maternal marital status&#8221; and &#8220;newborn gender&#46;&#8221;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Quartile&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last trimester OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last two months OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Last month OR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">PM<span class="elsevierStyleInf">10</span></td><td class="td" title="table-entry  " align="left" valign="top">First&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Second&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;02 &#40;0&#46;82&#8211;1&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;98 &#40;0&#46;79&#8211;1&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;14 &#40;0&#46;92&#8211;1&#46;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Third&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;02 &#40;0&#46;82&#8211;1&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;00 &#40;0&#46;81&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;15 &#40;0&#46;92&#8211;1&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Fourth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;86 &#40;0&#46;68&#8211;1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;88 &#40;0&#46;70&#8211;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;98 &#40;0&#46;78&#8211;1&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">SO<span class="elsevierStyleInf">2</span></td><td class="td" title="table-entry  " align="left" valign="top">First&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Second&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;07 &#40;0&#46;86&#8211;1&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;89 &#40;0&#46;72&#8211;1&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;25 &#40;1&#46;00&#8211;1&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Third&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;04 &#40;0&#46;83&#8211;1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;96 &#40;0&#46;77&#8211;1&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;15 &#40;0&#46;92&#8211;1&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Fourth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;91 &#40;0&#46;72&#8211;1&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;92 &#40;0&#46;74&#8211;1&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;08 &#40;0&#46;86&#8211;1&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">O<span class="elsevierStyleInf">3</span></td><td class="td" title="table-entry  " align="left" valign="top">First&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Second&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;80 &#40;0&#46;64&#8211;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;03 &#40;0&#46;83&#8211;1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;04 &#40;0&#46;84&#8211;1&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Third&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;86 &#40;0&#46;69&#8211;1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;06 &#40;0&#46;85&#8211;1&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;02 &#40;0&#46;82&#8211;1&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Fourth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;87 &#40;0&#46;70&#8211;1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;96 &#40;0&#46;77&#8211;1&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;03 &#40;0&#46;83&#8211;1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab858717.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara90" class="elsevierStyleSimplePara elsevierViewall">Odds ratio &#40;OR&#41; and confidence intervals &#40;95&#37; CI&#41; for low birth weight &#40;LBW&#41; according to quartiles of concentration of air pollutants for the last trimester&#44; last two months&#44; and last month of pregnancy&#44; in S&#227;o Jos&#233; dos Campos between 2005 and 2009 &#40;logistic regression&#41;&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl7"
        "etiqueta" => "Table 7"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spara120" class="elsevierStyleSimplePara elsevierViewall">Model adjusted for the variables &#8220;gender of newborn&#8221; and &#8220;maternal marital status&#8221;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pollutants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coefficients &#40;DP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">IC 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Last month&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;38 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;98&#8211;0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">&#8195;Last two months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;0&#46;05 &#40;0&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spara110" class="elsevierStyleSimplePara elsevierViewall">Regression coefficients with standard deviations &#40;SD&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; according to the means of the last month&#44; last two months&#44; and last trimester of concentration of atmospheric pollutants corresponding to the last trimester&#44; last two months&#44; and last month of pregnancy&#44; in S&#227;o Jos&#233; dos Campos between 2005 and 2009 &#40;multiple linear regression&#41;&#46;</p>"
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                        "titulo" => "Pan American Health Organization&#59; Area of Sustainable Development and Environmental Health&#46; An assessment of health effects of ambient air pollution in Latin America and the Caribbean"
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Article information

ISSN: 23593482
Original language: English

DOI:10.1016/S2359-3482(15)30064-6

The statistics are updated each day

Year/Month	Html	Pdf	Total

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2024 August	10	1	11
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2020 February	4	2	6
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2019 December	6	7	13
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2018 September	1	0	1
2017 February	1	1	2
2017 January	17	7	24
2016 December	11	9	20
2016 November	4	3	7
2016 October	3	3	6
2016 September	4	2	6
2016 August	10	1	11
2016 July	6	0	6

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