1
|
Santos IS, Echevarria P, Tovo-Rodrigues L, Matijasevich A, Domingues MR, Hallal PC. Are nocturnal awakenings at age 1 predictive of sleep duration and efficiency at age 6: Results from two birth cohorts. Sleep Med X 2024; 7:100105. [PMID: 38312370 PMCID: PMC10837084 DOI: 10.1016/j.sleepx.2024.100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/06/2024] Open
Abstract
Objective To investigate the association of nighttime awakenings at 12 months with the duration and efficiency of nighttime sleep at 6 years of age. Methods Data from two population-based prospective studies (The Pelotas 2004 and The Pelotas 2015 Birth Cohorts) were used. Information on nighttime awakenings was provided by mothers during the 12-month follow-up interview. Infants who awakened >3 times after sleep onset at 12 months were considered frequent wakeners. Sleep duration and sleep efficiency were obtained by actigraphy at the 6-year follow-up. Children wore the device at the wrist of the non-dominant arm continuously for 3-7 days, including at least one weekend day. Unadjusted and adjusted beta coefficients were obtained by linear regression for each cohort separately. Results 2500 children from the 2004 and 2793 from the 2015 cohort had full information on nighttime awakenings at 12 months and actigraphy at 6 years and were analyzed. Prevalence of frequent wakeners was 6.3 % and 5.9 % in the 2004 and 2015 cohort, respectively. Mean bedtime and wake-up time at 6 years were, respectively, 23:23 and 08:41 h in the 2004 cohort, and 00:10 and 09:00 h int the 2015 cohort. Nighttime sleep lasted on average 7.54 and 7.24 h respectively in the 2004 and the 2015 cohort, and the sleep efficiency was 81.1 and 82.5 % respectively. In adjusted analyses, no associations were found between awakening at 12 months and sleep duration or sleep efficiency at 6 years of age. Conclusion In both cohorts sleep duration and efficiency were below the recommendation for school-age children (respectively 9-11 h and 85 %). There was no relationship between the number of nighttime awakenings at 12 months and sleep duration or efficiency at 6 years.
Collapse
Affiliation(s)
- Ina S. Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Priscila Echevarria
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | - Marlos R. Domingues
- Post-graduate Program in Physical Education, Federal University of Pelotas, Brazil
| | - Pedro C. Hallal
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| |
Collapse
|
2
|
Santos IS, Bierhals IO, Tovo-Rodrigues L, Barros AJ, Munhoz T, Carpena MX, Matijasevich A. Mental health from childhood to adolescence predicts excessive weight and body composition at 18 years. Nutrition 2024; 126:112527. [PMID: 39089133 DOI: 10.1016/j.nut.2024.112527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/21/2024] [Accepted: 06/30/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVE To investigate the association of mental health in childhood and adolescence with four outcomes at 18 years: ultra-processed food (UPF) consumption, body mass index (BMI), excessive weight (EW), and body composition, including fat mass (FM) and fat free mass (FFM) in kg, FM index (FMI) and FFM index (FFMI) in kg/m2. METHODS Cohort study in which The Development and Well-Being Assessment (DAWBA) (6 and 11 years) and the MINI International Neuropsychiatric Interview (MINI) (18 years) provided information on internalizing (INT), externalizing (EXT) and any mental disorder (ANY). The exposure was classified in: "never", "at 6 and/or 11 years", "at 18 years only" and "at 6, 11, and 18 years". Linear and logistic regression were run. All analyses were stratified by sex. RESULTS A total of 2722 participants were analyzed. At 18 years, female with EXT disorders at 6 and/or 11 years presented higher BMI (β: 1.70; 0.18-3.23), FM (β: 4.74; 1.42-8.06), and FMI (β: 1.53; 0.28-2.79) than those who never had. The odds of EW at 18 years was also higher in females with EXT disorders at 6 and/or 11 years (OR: 3.39; 1.56-7.36) and at the three time points (OR: 7.08; 1.69-29.59). Males with EXT disorders at 6 and/or 11 years presented higher FM (β: 4.45; 1.85-7.06) and FMI (β: 1.47; 0.63-2.31). CONCLUSIONS Among children and adolescents showing symptoms of EXT disorders, weight should be monitored carefully, thus ultimately contributing to reduce the burden of EW in adolescence.
Collapse
Affiliation(s)
- Iná S Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil
| | - Isabel O Bierhals
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil.
| | - Luciana Tovo-Rodrigues
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil
| | - Aluísio Jd Barros
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil
| | - Tiago Munhoz
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil; School of Psychology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil
| | - Marina Xavier Carpena
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil
| | - Alicia Matijasevich
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas. Rio Grande do Sul, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Xavier MO, Tovo-Rodrigues L, Santos IS, Murray J, Maruyama JM, Matijasevich A. Harsh parenting trajectories from childhood through adolescence and socioemotional competences at age 18: 2004 Pelotas Birth Cohort Study. J Affect Disord 2024; 366:434-444. [PMID: 39181164 DOI: 10.1016/j.jad.2024.08.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Limited research has explored the course of harsh parenting practices throughout childhood and adolescence and its impact on socioemotional competences from a longitudinal perspective. This study examined the association between harsh parenting trajectories and socioemotional competences at age 18. METHODS Data from the 2004 Pelotas (Brazil) Birth Cohort study, originally comprising 4231 live births, were used. Harsh parenting was measured using the parent-report version of the Parent-Child Conflict Tactics Scale at ages 6, 11, 15 and 17 years, and trajectories were identified using a group-based modelling approach. Socioemotional competences were emotion regulation, assessed by the Emotional Regulation Index for Children and Adolescents; self-esteem, measured by the self-report Rosenberg Self-esteem Scale; prosocial behaviour and peer relationship problems, both assessed by the Strengths and Difficulties Questionnaire. Multivariate linear and Poisson regression models were applied to examine the effects of harsh parenting trajectories on socioemotional competences, adjusting for confounding variables. RESULTS We identified three trajectories: a "low harsh parenting" trajectory (49.7 %), a "moderate harsh parenting" (44.7 %), and a "high harsh parenting" trajectory (5.6 %). Compared to those belonging to the low harsh parenting trajectory group, adolescents who experienced either a moderate or high harsh parenting trajectory exhibited lower scores in emotion regulation, self-esteem, and prosocial behaviour scales, along with higher scores of peer relationships problems. LIMITATIONS Data on harsh parenting at 15 and 17 years were available only for a sub-sample. CONCLUSIONS Our study extends the evidence of the adverse effects of persistent harsh parenting on socioemotional competences during adolescence.
Collapse
Affiliation(s)
- Mariana Otero Xavier
- Universidade de São Paulo, Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP - São Paulo, Brazil.
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil.
| | - Jessica Mayumi Maruyama
- Postgraduate Program on Human Developmental Sciences, Mackenzie Presbyterian University, São Paulo, Brazil.
| | - Alicia Matijasevich
- Universidade de São Paulo, Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP - São Paulo, Brazil.
| |
Collapse
|
4
|
Xavier MO, Maruyama JM, Santos IS, Tovo-Rodrigues L, Barros AJD, Matijasevich A. Changes of adolescent sleep patterns during the COVID-19 pandemic. Rev Saude Publica 2024; 58:24. [PMID: 38985055 PMCID: PMC11196094 DOI: 10.11606/s1518-8787.2024058005866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/07/2023] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic has raised numerous concerns regarding its effects on individuals' health and lifestyle. We aim to analyze potential changes in adolescent sleep patterns from before and during the pandemic and identify specific predictors of changes. METHODS A subgroup of adolescents from a population-based birth cohort from Pelotas, Brazil, was assessed pre-pandemic (T1, November-2019 to March-2020) and peri-pandemic (T2, August-2021 to December-2021) in in-person interviews (n = 1,949). Sleep parameters, including sleep duration and latency time on workdays and free days, as well as social jetlag (SJL), were assessed using the Munich ChronoType Questionnaire (MCTQ). Socio-demographic, pre-pandemic, and pandemic-related predictors were analyzed. Changes in sleep parameters from T1 to T2 were estimated by multivariate latent change score modeling. RESULTS The latent change factor shows a significant mean increase in workday sleep duration (M = 0.334, p < 0.001), workday sleep latency (M = 0.029, p = 0.002), and free day sleep latency (M = 0.021, p = 0.034), and a decreased in SJL (M = -0.758, p < 0.001) during the pandemic. Female adolescents presented higher increases in workday sleep duration. Adolescents who adopted a stricter social distancing level during the pandemic presented greater increases in workday sleep duration and smaller reductions in SJL. Self-evaluated insomnia during the pandemic predicted lower increases in workday and free day sleep duration and higher increases in workday and free day sleep latency. CONCLUSION The COVID-19 outbreak brought certain advantages regarding increased sleep duration and reduced SJL. However, the observed increase in sleep latency and the influence of self-reported insomnia could be related to psychological distress inherent to the pandemic.
Collapse
Affiliation(s)
- Mariana Otero Xavier
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
| | - Jessica Mayumi Maruyama
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
- Universidade Presbiteriana MackenziePrograma de Pós-Graduação em Ciências do Desenvolvimento HumanoSão PauloSPBrasil Universidade Presbiteriana Mackenzie. Programa de Pós-Graduação em Ciências do Desenvolvimento Humano. São Paulo, SP, Brasil
| | - Iná S. Santos
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Luciana Tovo-Rodrigues
- Universidade Presbiteriana MackenziePrograma de Pós-Graduação em Ciências do Desenvolvimento HumanoSão PauloSPBrasil Universidade Presbiteriana Mackenzie. Programa de Pós-Graduação em Ciências do Desenvolvimento Humano. São Paulo, SP, Brasil
| | - Aluísio J. D. Barros
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Alicia Matijasevich
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo,SP, Brasil
| |
Collapse
|
5
|
Samms-Vaughan M, Coore-Desai C, Reece JA, Pellington S, Dinnall-Johnson T. JA KIDS - Jamaica's second national birth cohort study: aims and methods. PSYCHOL HEALTH MED 2024; 29:1102-1114. [PMID: 38909287 DOI: 10.1080/13548506.2024.2348821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/04/2024] [Indexed: 06/24/2024]
Abstract
Birth cohort studies across the world have yielded information that has been used to inform policy and programme decisions that have improved the health and well-being of populations. A few such studies have been conducted in low- and middle-income countries due to funding, methodological and other challenges. This paper briefly reviews the methods of comprehensive birth cohort studies with extensive follow-up of participants through the life course conducted in low- and middle-income countries. It then reviews the first Jamaican birth cohort study of 1986 and discusses the methodological advances in implementing JA KIDS, the second Jamaican birth cohort study conducted in 2011. The aims and methods of JA KIDS are described in detail.
Collapse
Affiliation(s)
- Maureen Samms-Vaughan
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Charlene Coore-Desai
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Jody-Ann Reece
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Sydonnie Pellington
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Twana Dinnall-Johnson
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| |
Collapse
|
6
|
Tovo-Rodrigues L, Camerini L, Martins-Silva T, Carpena MX, Bonilla C, Oliveira IO, de Paula CS, Murray J, Barros AJD, Santos IS, Rohde LA, Hutz MH, Genro JP, Matijasevich A. Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study. Mol Psychiatry 2024:10.1038/s41380-024-02589-3. [PMID: 38744991 DOI: 10.1038/s41380-024-02589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (β = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (β = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(βASRS = 0.51; 95% CI: 0.26;0.77) and (βSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (β = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.
Collapse
Affiliation(s)
- Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
| | - Laísa Camerini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Isabel Oliveira Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Institute of Biology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Research and Innovation in Child Mental Health, Sao Paulo, Brazil
- Medical School Council, UniEduK, São Paulo, Brazil
| | - Mara Helena Hutz
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Pasqualini Genro
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Bioscience, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| |
Collapse
|
7
|
Sánchez-Luquez KY, Carpena MX, Karam SM, Martins-Silva T, Barros FC, de Oliveira IO, Santos IS, Barros AJD, Matijasevich A, Tovo-Rodrigues L. Evaluation of genomic factors and early childhood stimulation on intelligence in children from a Brazilian birth cohort: The primary role of independent factors. Prog Neuropsychopharmacol Biol Psychiatry 2024; 131:110932. [PMID: 38169242 DOI: 10.1016/j.pnpbp.2023.110932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Childhood cognitive abilities are a predictor of health outcomes and adult income potential. Identifying factors associated with childhood intelligence and their interactions is essential in behavioral research. We assessed the impact of genetic variants and early child stimulation (ECS) on child intelligence and examined their possible interaction as potential modifiers of IQ in a population-based longitudinal study. METHODS Participants of the 2004 Pelotas Birth Cohort study (N = 4231) underwent intelligent quotient (IQ) by WISC-III assessment at 6 years of age. At 24 and 48-months, mothers answered five ECS marker questions, whose sum was used to create a score. The polygenic score for intelligence (IQ-PGS) was constructed from the GWAS-weighted estimate of cognition. Association was assessed using multiple linear regression models adjusted for maternal, family, and child confounding variables. To explore the possible influence of skin color and ethnoracial classification, the regression models were stratified according to the skin color variable, as a sensitivity analysis. RESULTS In the adjusted analysis, IQ-PGS (β = 0.79, 95% confidence interval [95% CI] 0.26;1.31) as well as ECS (β = 2.34; 95% CI: 1.76;2.92) were associated with IQ in this sample. The association between IQ-PGS and IQ was significant only in the white Brazilian group in the sensitivity analysis. However, there was no interaction between IQ-PGS and ECS on IQ (p(IQ-PGS x ECS) = 0.46). CONCLUSIONS ECS did not modify the impact of genetic potential on intellectual development during childhood, suggesting that genetic factors and ECS exert independent effects on the IQ levels of children.
Collapse
Affiliation(s)
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
| | - Simone M Karam
- Department of Pediatrics, Medicine Faculty, Federal University of Rio Grande, Rio Grande, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
| | - Fernando C Barros
- Post Graduate Program in Health in the Vital Cycle, Catholic University of Pelotas, Pelotas, Brazil
| | - Isabel O de Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil.
| |
Collapse
|
8
|
Soares PSM, de Barros AJD, Dos Santos I, Matijasevich A, Wehrmeister FC, Menezes AMB, Gonçalves H, Hartwig FP. Maternal mental health and offspring's IQ: Evidence from two Brazilian birth cohorts. J Affect Disord 2024; 351:151-157. [PMID: 38246278 DOI: 10.1016/j.jad.2024.01.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024]
Abstract
Maternal mental health during different stages of life can have a significant impact on a child's cognitive development. This study aimed to investigate the association between maternal CMD at two distinct stages of the offspring's life (at 3 months and 11 years) and their IQ scores at 6 and 18 years across two birth cohorts. The study utilized data from two Brazilian birth cohorts: the 1993 cohort (full sample: N = 3719, subsample: N = 436), and the 2004 Pelotas Birth Cohort (N = 3440). IQ assessments were conducted at ages 18 and 6, employing the Wechsler Adult Intelligence Scale, third version (WAIS-III), and Wechsler Intelligence Scale for Children, third version (WISC-III), respectively. The presence of maternal CMD at 3 months and 11 years of age was evaluated using the Brazilian version of the Self-Reporting Questionnaire (SRQ-20). After adjustment, participants whose mothers experienced CMD at 3 months had average IQ scores 1.74 (95 % CI: -2.83 to -0.67) and 2.79 (95 % CI: -5.54 to -0.04) points lower at ages 6 (2004 cohort) and 18 (1993 cohort subsample), respectively. Furthermore, in the 1993 cohort (both full and subsample), maternal CMD at 11 years was associated with lower IQ scores at age 18. Understanding the mechanisms underlying this association, emphasized by these findings, is crucial for promoting children's cognitive development, educational achievement, and overall well-being.
Collapse
Affiliation(s)
- Pedro San Martin Soares
- Programa de pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.
| | | | - Iná Dos Santos
- Programa de pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Programa de pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Helen Gonçalves
- Programa de pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fernando Pires Hartwig
- Programa de pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| |
Collapse
|
9
|
Santos IS, Bierhals IO, Costa CS, Matijasevich A, Tovo-Rodrigues L. Variation in ultra-processed food consumption from 6 to 15 years, body weight and body composition at 15 years of age at The Pelotas 2004 Birth Cohort. Pediatr Obes 2024; 19:e13104. [PMID: 38296258 DOI: 10.1111/ijpo.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND The association of ultra-processed food (UPF) consumption with obesity and adipose tissue in children/adolescents remains poorly understood. OBJECTIVE To assess the association of UPF consumption with excessive weight (EW-defined as BMI-for-age ≥+1 z-score) and body composition at 15 years. METHODS In a birth cohort, daily UPF consumption was estimated by Food Frequency Questionnaires at 6 and 15 years. Those in the higher tercile of UPF consumption at both follow-ups were the 'always-high consumers'. Air-displacement plethysmography provided fat mass (FM-kg), fat-free mass (FFM-kg), %FM, %FFM, FM index (FMI-kg/m2 ) and FFM index (FFMI-kg/m2 ). Logistic regression and linear regression were used to estimate, respectively, odds ratios and beta coefficients. RESULTS Amongst 1584 participants, almost one in every seven were always-high consumers. In crude analyses, there was no association between variation in UPF consumption and EW, and body fat parameters were lower in the always-high consumer group than amongst the always-low consumers, in both sexes. With adjustment for confounders, the odds ratio for EW was higher in the always-high consumer than amongst the always-low consumer group, and the direction of the associations with FM parameters was reversed: males from the always-high consumer group presented almost twice as high FM (10.5 vs. 18.6 kg; p < 0.001) and twice as high FMI (3.4 vs. 6.3 kg/m2 ; p < 0.001) than the always-low consumer group, and females from the always-high consumer group presented on average 32% more FM and FMI than the always-low consumer group. CONCLUSIONS In crude and adjusted analyses there was a strong association between high UPF consumption from childhood to adolescence, EW and higher body fat parameters at 15 years, but its deleterious association with body adiposity was only uncovered after adjusting for confounders.
Collapse
Affiliation(s)
- Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Isabel O Bierhals
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Caroline S Costa
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | | |
Collapse
|
10
|
Tillmann TFF, de Camargo MBJ, Cascaes AM, Barros AJD, Santos IS, Corrêa MB, Matijasevich A, D'Ávila OP, Silva AER. Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort. Community Dent Oral Epidemiol 2024; 52:217-223. [PMID: 37861237 DOI: 10.1111/cdoe.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors. METHODS Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables 'previous history of dental pain', 'self-rated oral health', clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI). RESULTS At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14-1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15-1.39), the presence of dental caries (PR 1.27; 95% CI 1.20-1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05-1.25). CONCLUSIONS The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.
Collapse
Affiliation(s)
| | | | | | - Aluísio J D Barros
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Marcos Britto Corrêa
- Postgraduate Programme in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Otávio Pereira D'Ávila
- Postgraduate Programme in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | | |
Collapse
|
11
|
Maruyama JM, Tovo-Rodrigues L, Santos IS, Murray J, Matijasevich A. Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil. J Adolesc Health 2024; 74:729-738. [PMID: 38310505 DOI: 10.1016/j.jadohealth.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE There is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort. METHODS One thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models. RESULTS There was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic. DISCUSSION Family-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.
Collapse
Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
12
|
Martins-Silva T, Bauer A, Matijasevich A, Munhoz TN, Barros AJD, Santos IS, Tovo-Rodrigues L, Murray J. Early risk factors for conduct problem trajectories from childhood to adolescence: the 2004 Pelotas (BRAZIL) Birth Cohort. Eur Child Adolesc Psychiatry 2024; 33:881-895. [PMID: 37097345 PMCID: PMC10126565 DOI: 10.1007/s00787-023-02178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/23/2023] [Indexed: 04/26/2023]
Abstract
Conduct problems are associated with an increased risk of a wide range of physical, mental, and social problems. However, there is still uncertainty about how early risk factors differentiate different developmental patterns of conduct problems and whether findings replicate across diverse social contexts. We aimed to identify developmental trajectories of conduct problems, and test early risk factors, in the 2004 Pelotas Birth Cohort in Brazil. Conduct problems were measured at ages 4, 6, 11, and 15 years from caregiver reports on the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Conduct problem trajectories were estimated using group-based semi-parametric modeling (n = 3938). Multinomial logistic regression was used to examine associations between early risk factors and conduct problem trajectories. We identified four trajectories: three with elevated conduct problems, including early-onset persistent (n = 150; 3.8%), adolescence-onset (n = 286; 17.3%), and childhood-limited (n = 697; 17.7%), and one with low conduct problems (n = 2805; 71.2%). The three elevated conduct problem trajectories were associated with a wide range of sociodemographic risk factors, prenatal smoking, maternal mental health, harsh parenting, childhood trauma, and child neurodevelopmental risk factors. Early-onset persistent conduct problems were particularly associated with trauma, living without a father figure, and attention difficulties. The four trajectories of conduct problems from ages 4 to 15 years in this Brazilian cohort have similar longitudinal patterns to those identified in high-income countries. The results confirm previous longitudinal research and developmental taxonomic theories on the etiology of conduct problems in a Brazilian sample.
Collapse
Affiliation(s)
- Thais Martins-Silva
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Andreas Bauer
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Tiago N Munhoz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Luciana Tovo-Rodrigues
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| |
Collapse
|
13
|
Guttier MC, Halal CS, Matijasevich A, Del-Ponte B, Tovo-Rodrigues L, Barros F, Bassani DG, Santos IS. Trajectory of maternal depression and parasomnias. J Sleep Res 2024; 33:e13870. [PMID: 36940922 DOI: 10.1111/jsr.13870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/07/2023] [Accepted: 02/21/2023] [Indexed: 03/22/2023]
Abstract
Maternal depressive symptoms are associated with poorer sleep quality in their children. Although parasomnias can occur at any age, this group of sleep disorders is more common in children. The aim of this study was to assess whether maternal depression trajectories predict parasomnias at the age of 11 years. Data were from a Birth Cohort of 4231 individuals followed in the city of Pelotas, Brazil. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 12, 24, and 48 months, and 6 and 11 years postpartum. Maternal depression trajectories were calculated using a group-based modelling approach. Information on any parasomnias (confused arousals, sleepwalking, night terrors, and nightmares) was provided by the mother. Five trajectories of maternal depressive symptoms were identified: chronic-low (34.9%), chronic-moderate (41.4%), increasing (10.3%), decreasing (8.9%), and chronic-high (4.4%). The prevalence of any parasomnia at the age of 11 years was 16.8% (95% confidence interval [CI] 15.6%-18.1%). Confusional arousal was the most prevalent type of parasomnia (14.5%) and varied from 8.7% to 14.7%, 22.9%, 20.3%, and 27.5% among children of mothers at chronic-low, moderate-low, increasing, decreasing, and chronic-high trajectories, respectively (p < 0.001). Compared to children from mothers in the chronic-low trajectory, the adjusted prevalence ratio for any parasomnia was 1.58 (95% CI 1.29-1.94), 2.34 (95% CI 1.83-2.98), 2.15 (95% CI 1.65-2.81), and 3.07 (95% CI 2.31-4.07) among those from mothers in the moderate-low, increasing, decreasing, and chronic-high trajectory groups, respectively (p < 0.001). In conclusion, parasomnias were more prevalent among children of mothers with chronic symptoms of depression.
Collapse
Affiliation(s)
- Marília C Guttier
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Camila S Halal
- Hospital Criança Conceição, Grupo Hospitalar Conceição, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Bianca Del-Ponte
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Diego G Bassani
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
- Centre for Global Child Health, The Hospital for Sick Children & Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| |
Collapse
|
14
|
Tovo-Rodrigues L, Santos IS, Bierhals IO, Del-Ponte B, Murray J, Bielemann R, Munhoz TN, Crochemore-Silva I, de Oliveira IO, Barros FC, Barros AJD, Matijasevich A. Cohort Profile Update: 2004 Pelotas (Brazil) Birth Cohort Study follow-up during adolescent years. Int J Epidemiol 2024; 53:dyad156. [PMID: 37953504 PMCID: PMC10859134 DOI: 10.1093/ije/dyad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Bianca Del-Ponte
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Renata Bielemann
- Postgraduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- School of Psychology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Isabel O de Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernando C Barros
- Postgraduate Program in Health in the Life Cycle, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
15
|
Carpena MX, Barros AJ, Comelli EM, López-Domínguez L, Alves ED, Wendt A, Crochemore-Silva I, Bandsma RH, Santos IS, Matijasevich A, Borges MC, Tovo-Rodrigues L. Accelerometer-based sleep metrics and gut microbiota during adolescence: Association findings from a Brazilian population-based birth cohort. Sleep Med 2024; 114:203-209. [PMID: 38219656 DOI: 10.1016/j.sleep.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Sleep and gut microbiota are emerging putative risk factors for several physical, mental, and cognitive conditions. Sleep deprivation has been shown to be linked with unhealthy microbiome environments in animal studies. However, in humans, the results are mixed. Epidemiological studies evaluating the effect of accelerometer-based sleep measures on gut microbiome are scarce. This study aims to explore the relationship between sleep duration and efficiency with the gut microbiota in adolescence. METHODS A subsample of 352 participants from the 2004 Pelotas (Brazil) Birth Cohort Study with sleep and fecal microbiota data available were included in the study. Sleep duration and sleep efficiency were obtained from actigraphy information at 11 years old whereas microbiota information from fecal samples was collected at 12 years. The fecal microbiota was analyzed via Illumina MiSeq (16S rRNA V3-V4 region) and the UNOISE pipeline. Alpha was assessed in QIIME2. Association measures for sleep variables and microbial α-diversity, and bacterial relative abundance were assessed through generalized models (linear and logistic regression), adjusting for maternal and child variables confounders. RESULTS Adjusted models showed that sleep duration was positively associated with Simpson index of α-diversity (β = 0.003; CI95 %: 0.00004; 0.01). Both sleep duration (OR = 0.43; CI95 % 0.25; 0.74) and efficiency (OR = 0.55; CI95 % 0.38; 0.78) were associated with lower Bacteroidetes abundance. CONCLUSION Our results suggest that sleep duration and efficiency are linked to gut microbiota diversity and composition even with 1-2 years gap from exposure to outcome. The findings support the role of sleep in the gut-brain axis as well as provide insights on how to improve microbiota health.
Collapse
Affiliation(s)
| | - Aluisio Jd Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil.
| | - Elena M Comelli
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, ON, Canada; Joannah and Brian Lawson Centre for Child Nutrition, Faculty of Medicine, University of Toronto, ON, Canada.
| | - Lorena López-Domínguez
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, ON, Canada; Translational Medicine Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Etiene Dias Alves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil.
| | - Andrea Wendt
- Programa de Pós-Graduação Em Tecnologia Em Saúde, Pontifícia Universidade Católica Do Paraná, Curitiba, Brazil.
| | - Inacio Crochemore-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, RS, Brazil.
| | - Robert Hj Bandsma
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, ON, Canada; Translational Medicine Program, Hospital for Sick Children, Toronto, ON, Canada.
| | - Ina S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil.
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
| | - Maria Carolina Borges
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | | |
Collapse
|
16
|
de Andrade Leão OA, Bertoldi AD, Domingues MR, Murray J, Santos IS, Barros AJD, Matijasevich A, Mielke GI. Cross-sectional and prospective associations between screen time and childhood neurodevelopment in two Brazilian cohorts born 11 years apart. Child Care Health Dev 2024; 50:e13165. [PMID: 37609715 DOI: 10.1111/cch.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND The aim of this study was to investigate the associations between screen time from ages 2 to 4 years and child neurodevelopment at age 4. METHODS The participants were from the 2004 (N = 3787) and 2015 (N = 3604) Pelotas (Brazil) birth cohort studies. Childhood neurodevelopment was assessed at age 4 using the Battelle Development Inventory. The time children spent on screen devices was reported by their guardians at ages 2 and 4 years. Linear regression models were used to investigate the association of: (i) time spent on television at ages 2 and 4 years; (ii) time spent on other screens at age 4; and (iii) total screen time at age 4 (television + other screens) with childhood neurodevelopment at age 4. RESULTS Average daily screen time among children born in 2004 and those born in 2005 aged 4 years were 3.4 (SD: 2.4) and 4.4 h (SD: 2.9), respectively. Overall, few associations of very small magnitude between screen time and child neurodevelopment were observed. Television time at 2 years of age was statistically associated with lower neurodevelopment at 4 years of age in the 2015 cohort (β = -0.30, 95%CI = -0.55; -0.05). Conversely, television time (β = 0.17, 95%CI = 0.07, 0.26) and total screen time (β = 0.22, 95%CI = 0.13, 0.31) at age 4 were associated with higher neurodevelopment at age 4 in the 2004 cohort. CONCLUSIONS The findings of this study suggest that the amount of time spent on screen devices might not be associated with neurodevelopment of children under 5 years of age. The small magnitude and inconsistencies in the direction of associations did not find evidence to support the current guidelines for screen time at this age. Therefore, more studies, especially those with longitudinal data, are important to comprehend the true effect of screen time on neurodevelopment and other health outcomes.
Collapse
Affiliation(s)
| | | | | | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná Silva Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluisio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
17
|
Bierhals IO, de Oliveira GSP, Santos IS, Halal CS, Tovo-Rodrigues L, Matijasevich A, Barros FC. Relationship between sleep problems and headaches among adolescents: Pelotas 2004 Birth cohort. Sleep Med X 2023; 6:100079. [PMID: 37484546 PMCID: PMC10359655 DOI: 10.1016/j.sleepx.2023.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To investigate the cross-sectional association between sleep problems (the exposure) and headaches (the outcome) among 15-year-olds from the Pelotas 2004 Birth Cohort, a population-based study in the south of Brazil. Method The occurrence of headaches was obtained through the question: "Do you usually suffer headaches?" and the ICHD-3 criteria were used to classify as: tension-type headache, headache with characteristics of migraine with or without aura, or other. Regarding sleep, the weekly frequency in the last month of insomnia and bad dreams/nightmares, and self-reported sleep quality were investigated. Unadjusted and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression with robust variance. Results A total of 1916 adolescents were analyzed. The prevalence of headaches was 51.6% (69.0% in females and 34.8% in males): 31.8% (39.7% vs. 24.1%) reported tension-type headache; 14.7% (21.9% vs. 7.8%), headaches with characteristics of migraines without aura; 3.6%, headaches with characteristics of migraines with aura; and 1.5% (5.1% vs. 2.3%), other types. Adolescents with insomnia ≥3 times/week presented higher probability of headaches (PR = 1.54; 95%CI 1.23-1.93), compared with those with no problems falling asleep or maintaining sleep. Among those who classified their sleep as poor/very poor, the probability of headaches was 33% higher (PR = 1.33; 95%CI 1.13-1.57) than among those who classified their sleep as very good. Conclusions Headaches were highly prevalent among the adolescents and were related to sleep problems even after allowing for several confounders.
Collapse
Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Iná S. Santos
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Camila S. Halal
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital Nossa Senhora Conceição, Porto Alegre, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | - Fernando C. Barros
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduation in Health and Behavior Program, Catholic University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
18
|
Petracco AM, Mattiello R, Bortolotto CC, Ferreira RW, Matijasevich A, de Barros FCLF, Friedrich FO, Tovo‐Rodrigues L, de Barros AJD, Santos IS. Prevalence of and Factors Associated With High Blood Pressure at 15 Years of Age: A Birth Cohort Study. J Am Heart Assoc 2023; 12:e029627. [PMID: 38014655 PMCID: PMC10727349 DOI: 10.1161/jaha.123.029627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents. METHODS AND RESULTS The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years. CONCLUSIONS Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.
Collapse
Affiliation(s)
| | - Rita Mattiello
- Postgraduate Program in EpidemiologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | | | | | | | | | | | | | | | - Iná S. Santos
- Postgraduate Program in EpidemiologyUniversidade Federal de PelotasPelotasBrazil
| |
Collapse
|
19
|
Maruyama JM, Bauer A, Hammerton G, Halligan SL, Santos IS, Munhoz TN, Barros AJD, Barros FC, Fairchild G, Matijasevich A. Pathways from maternal depression to child resilience: Socioeconomic, family, and individual factors in the 2004 Pelotas (Brazil) birth cohort. JCPP ADVANCES 2023; 3:e12188. [PMID: 38054047 PMCID: PMC10694539 DOI: 10.1002/jcv2.12188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/16/2023] [Indexed: 12/07/2023] Open
Abstract
Background The negative impacts of maternal depression on child mental health outcomes are well-documented. However, some children show adaptive functioning following exposure to maternal depression, demonstrating resilience. In a large birth cohort from Brazil, a middle-income country, we examined direct and indirect pathways, considering socioeconomic, family, and individual factors, contributing to the development of resilience. Methods Using data from the 2004 Pelotas Birth Cohort (N = 4231), we restricted the sample to those exposed to maternal depression up to age 6 years (depression present at ≥2 out of 5 assessment waves; n = 1132; 50% boys). Resilience was defined as scoring below or equal to the mean of the unexposed group on all four problem subscales of the parent-report Strengths and Difficulties Questionnaire at age 11 years. We examined pathways from socioeconomic status (SES; measured at birth) to resilience via cognitive stimulation (CS) (at 24 and 48 months) and Intelligence quotient (IQ) (at 6 years), and from CS to resilience via IQ, using counterfactual mediation. Results A minority of children exposed to maternal depression showed resilience (12.4%). There was evidence of indirect pathways from SES to resilience via CS (odds ratio (OR) = 1.76, 95% confidence interval (CI) 1.02-3.38) and IQ (OR = 1.19, 95% CI 1.01-1.42), such that higher SES was associated with resilience via both higher levels of CS and higher IQ, which, in turn, were each positively associated with resilience. Furthermore, there was evidence of a direct (OR = 1.86, 95% CI 1.01-3.76) and total effect (OR = 1.94, 95% CI 1.05-3.89) of CS on resilience, even after controlling for SES. However, these effects varied depending on how persistent and severe depression was defined. Conclusions These findings suggest that CS in early childhood may represent a modifiable protective factor for children exposed to maternal depression and a promising intervention target to promote child resilience in the context of maternal depression exposure.
Collapse
Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
| | - Andreas Bauer
- Department of PsychologyUniversity of BathBathUK
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Gemma Hammerton
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUK
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Ina S. Santos
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Postgraduate Program in Paediatrics and Child HealthPontifical Catholic University of Rio Grande do SulPorto AlegreBrazil
| | - Tiago N. Munhoz
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Faculty of PsychologyFederal University of PelotasPelotasBrazil
| | | | - Fernando C. Barros
- Postgraduate Program in Health and BehaviourCatholic University of PelotasPelotasBrazil
| | | | - Alicia Matijasevich
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| |
Collapse
|
20
|
Echevarria P, Del-Ponte B, Tovo-Rodrigues L, Matijasevich A, Halal CS, Santos IS. Screen use and sleep duration and quality at 15 years old: Cohort study. Sleep Med X 2023; 5:100073. [PMID: 37305851 PMCID: PMC10251069 DOI: 10.1016/j.sleepx.2023.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Objective/background The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years. Methods With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions. Results 1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7-19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6-8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; -0.62;-0.16 and β = -0.54; -0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10-2.32). Conclusions The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.
Collapse
Affiliation(s)
- Priscila Echevarria
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Bianca Del-Ponte
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camila S. Halal
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iná S. Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
21
|
da Silva NRJ, de Camargo MBJ, Dos Vaz JS, Correa MB, Matijasevich A, da Silva Dos Santos I, Cascaes AM. Ultra-processed food consumption and dental caries in adolescents from the 2004 Pelotas Birth Cohort study. Community Dent Oral Epidemiol 2023; 51:1180-1186. [PMID: 37032457 DOI: 10.1111/cdoe.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/21/2023] [Accepted: 02/15/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE To investigate the relationship between ultra-processed food (UPF) consumption and dental caries in adolescents. METHODS Data from 996 adolescents aged 12-13 years who participated in an oral health sub-study of the 2004 Pelotas Birth Cohort in southern Brazil were analysed. The main exposure was daily UPF consumption at age 10-11 years, measured by a food frequency questionnaire containing 24 UPF items defined based on the NOVA system. UPF consumption was calculated in frequency, grams and calories, in general and for six types of food (biscuits, savoury snacks and sugar-sweetened cereals; ultra-processed meats and fats; sweets; fast food and instant noodles; soft drinks and artificially flavoured drinks; and sweetened milk and powdered chocolate). The outcome was dental caries, measured according to the decayed, missing and filled indexes (DMFS and dmfs) at age 12-13 years. Poisson regression models were used to analyse the association between UPF consumption and dental caries, adjusting for socioeconomic and demographic variables, dental visits and oral hygiene. RESULTS Overall, the daily UPF consumption in frequency, grams and calories was associated with caries. The findings were consistent for UPF consumption for all six food groups. The higher the UPF consumption, the higher the probability of having caries in adolescence. The associations between ultra-processed meats and fats, and fast food and instant noodles intake with dental caries alert to the cariogenic potential of such UPF foods. CONCLUSION Ultra-processed food consumption was associated with greater caries burdens in young adolescents. The findings reinforce the need for interventions and public policies to reduce UPF consumption in adolescence.
Collapse
Affiliation(s)
| | | | - Juliana Santos Dos Vaz
- Graduate Program in Nutrition and Foods, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Marcos Britto Correa
- Graduate Program in Dentistry, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Iná da Silva Dos Santos
- Graduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Andreia Morales Cascaes
- Department of Public Health, Graduate Program in Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
| |
Collapse
|
22
|
Rodrigues JDS, Matijasevich A, Tovo-Rodrigues L, Munhoz TN, Santos IS, Pastor-Valero M. Risk factors for executive function impairment in adolescence: an analysis of data from the 2004 Pelotas Birth Cohort study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:470-481. [PMID: 37995276 PMCID: PMC10897774 DOI: 10.47626/1516-4446-2023-3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/24/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To investigate risk factors associated with impaired attention-related executive functions (EFs) at age 11 and working memory at age 15. METHODS Data from participants of the population-based 2004 Pelotas Birth Cohort at ages 11 (n=3,582) and 15 (n=1,950) were analyzed. The study measured attentional control, cognitive flexibility, and selective attention using the Test of Everyday Attention for Children (TEA-Ch). Spatial working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Logistic regression was employed to explore the relationship between perinatal and childhood exposures and EF impairment. RESULTS Low maternal education had a significant negative impact on EFs. At age 11, it was associated with decreased attentional control (OR = 3.04; 95%CI 2.09-4.43), and at age 15, it was linked to impaired spatial working memory (OR = 2.21; 95%CI 1.58-3.09). Additional risk factors included low household income, black or brown maternal skin color, high parity, prematurity, low birth weight, and multiple siblings. Breastfeeding, regardless of duration, was found to be a protective factor against impaired cognitive flexibility (OR = 0.38; 95%CI 0.22-0.65). CONCLUSION This study underscores the lasting impact of perinatal exposures on EF development. Policies that mitigate the negative effects of risk factors and promote EF development, especially among vulnerable populations, are needed.
Collapse
Affiliation(s)
- Júlia de Souza Rodrigues
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Spain
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Tiago N Munhoz
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil. Faculdade de Psicologia, UFPel, Pelotas, RS, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Maria Pastor-Valero
- Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Spain. Centro de Investigación Biomédica en Red, Madrid, Spain
| |
Collapse
|
23
|
Maruyama JM, Valente JY, Tovo-Rodrigues L, Santos IS, Barros AJD, Munhoz TN, Barros FC, Murray J, Matijasevich A. Maternal depression trajectories in childhood, subsequent maltreatment, and adolescent emotion regulation and self-esteem: the 2004 Pelotas birth cohort. Eur Child Adolesc Psychiatry 2023; 32:1935-1945. [PMID: 35731302 PMCID: PMC9214189 DOI: 10.1007/s00787-022-02022-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents' self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent-Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents' emotion regulation are partly mediated by child maltreatment at age 11.
Collapse
Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil.
| | - Juliana Y Valente
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
24
|
Maruyama JM, Tovo-Rodrigues L, Santos IS, Murray J, Matijasevich A. Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:389-396. [PMID: 37400138 PMCID: PMC10894627 DOI: 10.47626/1516-4446-2023-3169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/25/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences. METHODS 1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents' socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses. RESULTS There were significant mean increases in adolescents' ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic. CONCLUSION Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.
Collapse
Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Iná S. Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
25
|
Massara P, Lopez-Dominguez L, Bourdon C, Bassani DG, Keown-Stoneman CDG, Birken CS, Maguire JL, Santos IS, Matijasevich A, Bandsma RHJ, Comelli EM. A novel systematic pipeline for increased predictability and explainability of growth patterns in children using trajectory features. Int J Med Inform 2023; 177:105143. [PMID: 37473656 DOI: 10.1016/j.ijmedinf.2023.105143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/28/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Longitudinal patterns of growth in early childhood are associated with health conditions throughout life. Knowledge of such patterns and the ability to predict them can lead to better prevention and improved health promotion in adulthood. However, growth analyses are characterized by significant variability, and pattern detection is affected by the method applied. Moreover, pattern labelling is typically performed based on ad hoc methods, such as visualizations or clinical experience. Here, we propose a novel pipeline using features extracted from growth trajectories using mathematical, statistical and machine-learning approaches to predict growth patterns and label them in a systematic and unequivocal manner. METHODS We extracted mathematical and clinical features from 9577 children growth trajectories embedded with machine-learning predictions of the growth patterns. We experimented with two sets of features (CAnonical Time-series Characteristics and trajectory features specific to growth), developmental periods and six machine-learning classifiers. Clinical experts provided labels for the detected patterns and decision rules were created to associate the features with the labelled patterns. The predictive capacity of the extracted features was validated on two heterogenous populations (The Applied Research Group for Kids and the 2004 Pelotas Birth Cohort, based in Canada and Brazil, respectively). RESULTS Features predictive ability measured by accuracy and F1 score was ≥ 80% and ≥ 0.76 respectively in both cohorts. A small number of features (n = 74) was sufficient to distinguish between growth patterns in both cohorts. Slope, intercept of the trajectory, age at peak value, start value and change of the growth measure were among the top identified features. CONCLUSION Growth features can be reliably used as predictors of growth patterns and provide an unbiased understanding of growth patterns. They can be used as tool to reduce the effort to repeat analysis and variability concerning anthropometric measures, time points and analytical methods, in the context of the same or similar populations.
Collapse
Affiliation(s)
- Paraskevi Massara
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto,Toronto, Canada.
| | - Lorena Lopez-Dominguez
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto,Toronto, Canada; Translational Medicine Program, Hospital for Sick Children, Toronto, Canada
| | - Celine Bourdon
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada
| | - Diego G Bassani
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Center for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Applied Health Research Center, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Catherine S Birken
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto,Toronto, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto,Toronto, Canada; Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Canada
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brasil
| | - Alicia Matijasevich
- Departmento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brasil
| | - Robert H J Bandsma
- Translational Medicine Program, Hospital for Sick Children, Toronto, Canada; Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada.
| | - Elena M Comelli
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto,Toronto, Canada; Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Toronto, Canada.
| |
Collapse
|
26
|
Berrutti B, Otero Xavier M, S. Santos I, Matijasevich A, Tovo-Rodrigues L. Sleep Duration in Adolescence and Its Prenatal, Perinatal, and Health Determinants in a Large Population-based Cohort Followed from Birth. Sleep Sci 2023; 16:148-158. [PMID: 37583372 PMCID: PMC10424492 DOI: 10.1055/s-0043-1770807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Objective To investigate sleep duration and its associated factors in adolescents aged 11 years from the 2004 Pelotas (Brazil) Birth Cohort Study. Methods Sleep duration was assessed using a self-report sleep habits. Independent variables included perinatal, sociodemographic, behavioral, and health characteristics. The associations were estimated using multiple linear regression. Results The mean sleep duration of 3,179 adolescents was 9.3 hour (SD =1.7 hour). Longer sleep duration was associated with lower socioeconomic status at birth (β: 0.37, 95% CI: 0.12; 0.61), lower mother's education level ( p < 0.001), and being female (β: 0.19, 95% CI: 0.06; 0.33). Shorter sleep duration was associated with cesarean section delivery (β: -0.16, 95% CI: -0.31; -0.02); having classes in the morning shift (β: -1.38, 95% CI: -1.51; -1.26), and lower terciles of physical activity ( p = 0.04). Conclusions The mean sleep duration observed in this study was consistent with the international recommendations for this age range. Adolescents from lower income families, who are more active, study in shifts other than morning, girls, and those born through vaginal delivery presented higher sleep duration than their counterparts.
Collapse
Affiliation(s)
- Barbara Berrutti
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Mariana Otero Xavier
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Iná S. Santos
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- School of Medicine, Graduate Program in Pediatrics and Child Health, Pontifical
Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul,
Brazil
| | - Alicia Matijasevich
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Department of Preventive Medicine, Faculty of Medicine FMUSP, Universidade de
São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Social Medicine Department, Postgraduate Program in Epidemiology, Federal
University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
27
|
Santos IS, Tovo-Rodrigues L, Maruyama JM, Barros AJD, Bierhals I, Del Ponte B, Matijasevich A. Impact of covid-19 pandemic over depressive symptoms among mothers from a population-based birth cohort in southern brazil. Arch Womens Ment Health 2023:10.1007/s00737-023-01331-2. [PMID: 37225910 DOI: 10.1007/s00737-023-01331-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/19/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE Our aim was to assess the impact of COVID-19 on depressive symptoms among mothers from a population-based birth cohort in Pelotas, Southern Brazil. METHODS A subgroup of mothers from the Pelotas 2004 Birth Cohort was assessed pre-pandemic (November,2019 to March,2020) and mid-pandemic (August-December,2021). In both follow-ups, depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Pre-pandemic (T1) and pandemic-related predictors (T2) were analyzed. Prevalence of depression (EPDS score ≥ 13) at T1 and T2 were compared with chi-square test. Changes in EPDS from T1 to T2 were estimated by multivariate latent change score modelling. RESULTS 1,550 women were assessed. Prevalence of depression increased 38.1% (from 18.9% at T1 to 26.1% at T2) (p < 0.001). At T1, higher schooling, higher family income and being employed or working were related to lower EPDS, whereas being beneficiary of a cash transfer program and a larger number of people living in the household predicted higher EPDS. The deterioration of ones' own perception of quality of overall health (β = 0.191; SE = 0.028; p < 0.001) and worst family financial situation due to the pandemic (β = 0.083; SE = 0.024; p = 0.001) predicted the increase in EPDS from T1 to T2. CONCLUSION Almost two years after the beginning of the pandemic, the prevalence of depressive symptoms among the women was higher than before the pandemic. The deterioration of ones' own perception of quality of overall health and worst family financial situation due to the pandemic are proxies for the effect of COVID-19 pandemic (the true exposure of interest) in the women mental health.
Collapse
Affiliation(s)
- Iná S Santos
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil.
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Jessica M Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Aluísio J D Barros
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Isabel Bierhals
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Bianca Del Ponte
- Programa de Pós-Graduação Em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160, 3º Piso, Pelotas, RS, CEP 96020-220, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
28
|
de Magalhães Bandeira C, Cascaes AM, Camargo MBJ, Santos IS, de Castilhos ED, Corrêa MB, Matijasevich A, Silva AER. Parental stress and dental caries experience in adolescents: analysis of data from a birth cohort study in Pelotas, Southern Brazil. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00797-z. [PMID: 37052793 DOI: 10.1007/s40368-023-00797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE Analyze the association between parental stress and dental caries experience in adolescents in southern Brazil using data from the Pelotas 2004 Birth Cohort. METHODS Interviews and oral health examinations for the determination of the main exposure and outcome of the study were performed in the homes of the adolescents. The outcome was dental caries experience in the permanent dentition analyzed using the Decayed, Missing and Filling Surfaces (DMFS) index. The main exposure was parental stress measured using the Parenting Stress Index-Short Form administered to the parents of the adolescents. Demographic/socioeconomic characteristics, oral health characteristics and oral health-related quality of life were considered potential confounding factors. Negative binomial regressions estimated mean ratios (MR) and 95% confidence intervals (CI). RESULTS Nine hundred ninety-six adolescents were evaluated at 12 and 13 years of age. The prevalence of dental caries experience in the adolescents was 36.9% (95% CI: 33.8-40.0) and 15.1% (95% CI: 12.8-17.3) of the parents had parental stress. After adjusting for confounding factors, parental stress was associated with a higher mean number of decayed, missing and filling surfaces in the adolescents (MR = 1.10; 95% CI: 1.01-1.26; p = 0.045). CONCLUSION Adolescents of parents with parental stress have more dental caries experience compared to those whose parents do not have parental stress.
Collapse
Affiliation(s)
- C de Magalhães Bandeira
- School of Dentistry, Universidade Federal de Pelotas, 457 Gonçalves Chaves Street, 5th Floor, Pelotas, RS, Brazil
| | - A M Cascaes
- Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - M B J Camargo
- School of Dentistry, Universidade Federal de Pelotas, 457 Gonçalves Chaves Street, 5th Floor, Pelotas, RS, Brazil
| | - I S Santos
- Epidemiology, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - E D de Castilhos
- School of Dentistry, Universidade Federal de Pelotas, 457 Gonçalves Chaves Street, 5th Floor, Pelotas, RS, Brazil
| | - M B Corrêa
- School of Dentistry, Universidade Federal de Pelotas, 457 Gonçalves Chaves Street, 5th Floor, Pelotas, RS, Brazil
| | - A Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, University de São Paulo, São Paulo, SP, Brazil
| | - A E R Silva
- School of Dentistry, Universidade Federal de Pelotas, 457 Gonçalves Chaves Street, 5th Floor, Pelotas, RS, Brazil.
| |
Collapse
|
29
|
Galvão da Silva M, Mattiello R, Del Ponte B, Matijasevich A, Silveira MF, Bertoldi AD, Domingues M, Barros F, Santos IS. Breastfeeding Duration and Exclusivity Among Early-Term and Full-Term Infants: A Cohort Study. Curr Dev Nutr 2023; 7:100050. [PMID: 37181939 PMCID: PMC10111589 DOI: 10.1016/j.cdnut.2023.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/27/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Background As compared to full-term infants (39-41 weeks of gestation), early-term infants (37-38 wk) are at increased risk of adverse outcomes, including shorter exclusive breastfeeding (EB) duration and continued breastfeeding. Objectives To compare early-term with full- and late-term infants regarding the prevalence of EB at 3 mo and any breastfeeding at 12 mo. Methods Data sets from two population-based birth cohorts conducted in the city of Pelotas, Brazil, were combined. Only term infants (37 0/7 through 41 6/7 weeks of gestation) were included in the analyses. Early-term infants (37 0/7 through 38 6/7 wk) were compared to the remaining term infants (39 0/7 through 41 6/7 wk). Information on breastfeeding was gathered through maternal interviews at the 3-mo and 12-mo follow-ups. The prevalence of EB at 3 mo and any breastfeeding at 12 mo with 95% CIs were calculated. Crude and adjusted prevalence ratios (PRs) were obtained through Poisson regression. Results A total of 6395 infants with information on gestational age and EB at 3 mo and 6401 infants with information on gestational age and any breastfeeding at 12 mo were analyzed. There was no difference between early-term infants and the remaining term infants regarding the prevalence of EB at 3 mo (29.2% and 27.9%, respectively) (P = 0.248). Prevalence of any breastfeeding at 12 mo was lower in early-term infants than among those born between 39 0/7 and 41 6/7 weeks of gestation (38.2% compared with 42.4%) (P = 0.001). In the adjusted analysis, the PR for any breastfeeding at 12 mo was 15% lower in the early-term group than in the remaining term infants (PR = 0.85; 95% CI: 0.76-0.95) (P = 0.004). Conclusions The prevalence of EB at 3 mo was similar among term infants. Nonetheless, in comparison with the remaining infants born at term, early-term infants were at increased risk of having been weaned before reaching 12 mo of age. Curr Dev Nutr 2023;xx:xx.
Collapse
Affiliation(s)
- Michele Galvão da Silva
- Postgraduate Program in Pediatrics and Child Health, Medical School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rita Mattiello
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Del Ponte
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Mariangela F. Silveira
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Andrea D. Bertoldi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Marlos Domingues
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
- Postgraduate Program in Health and Behaviour, Universidade Católica de Pelotas, Rio Grande do Sul, Brazil
| | - Ina S. Santos
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
30
|
López-Domínguez L, Bassani DG, Bourdon C, Massara P, Santos IS, Matijasevich A, Barros AJD, Comelli EM, Bandsma RHJ. A novel shape-based approach to identify gestational age-adjusted growth patterns from birth to 11 years of age. Sci Rep 2023; 13:1709. [PMID: 36720954 PMCID: PMC9889302 DOI: 10.1038/s41598-023-28485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
Child growth patterns assessment is critical to design public health interventions. However, current analytical approaches may overlook population heterogeneity. To overcome this limitation, we developed a growth trajectories clustering pipeline that incorporates a shape-respecting distance, baseline centering (i.e., birth-size normalized trajectories) and Gestational Age (GA)-correction to characterize shape-based child growth patterns. We used data from 3945 children (461 preterm) in the 2004 Pelotas Birth Cohort with at least 3 measurements between birth (included) and 11 years of age. Sex-adjusted weight-, length/height- and body mass index-for-age z-scores were derived at birth, 3 months, and at 1, 2, 4, 6 and 11 years of age (INTERGROWTH-21st and WHO growth standards). Growth trajectories clustering was conducted for each anthropometric index using k-means and a shape-respecting distance, accounting or not for birth size and/or GA-correction. We identified 3 trajectory patterns for each anthropometric index: increasing (High), stable (Middle) and decreasing (Low). Baseline centering resulted in pattern classification that considered early life growth traits. GA-correction increased the intercepts of preterm-born children trajectories, impacting their pattern classification. Incorporating shape-based clustering, baseline centering and GA-correction in growth patterns analysis improves the identification of subgroups meaningful for public health interventions.
Collapse
Affiliation(s)
- Lorena López-Domínguez
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada.,Translational Medicine Program, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Diego G Bassani
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Global Child Health, Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada.,Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Celine Bourdon
- Translational Medicine Program, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.,The Childhood Acute Illness & Nutrition Network, Nairobi, Kenya
| | - Paraskevi Massara
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada.,Translational Medicine Program, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.,Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Elena M Comelli
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada. .,Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Toronto, ON, Canada.
| | - Robert H J Bandsma
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada. .,Translational Medicine Program, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada. .,Centre for Global Child Health, Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada. .,Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.
| |
Collapse
|
31
|
Bortolotto CC, dos Santos IDS, Vaz JDS, Matijasevich A. Gestational age, intrauterine growth and body composition at 11 years of age. Rev Saude Publica 2023; 56:116. [PMID: 36629707 PMCID: PMC9749740 DOI: 10.11606/s1518-8787.2022056004022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022] Open
Abstract
OBJETIVE To assess the association of gestational age (GA) and intrauterine growth with body composition at 11 years of age. METHOD Analysis of data from the 2004 Pelotas birth cohort, whose outcomes were fat mass (FM, kg), fat mass index (FMI, kg/m2), fat-free mass (FFM, kg), fat-free mass index (FFMI, kg/m2) - measured by air displacement plethysmography - and body mass index for age (BMI/age, Z-score). The exposures of interest were the gestational index (GA) of infants born at less than 33 weeks, from 34 to 36 and from 37 to 41, and intrauterine growth categorized as small (SGA), adequate (AGA) and large (LGA) for gestational age. Analysis of variance was used to compare means and linear regression was used to assess the strength of association. The analyses were adjusted according to variables collected at birth, such as monthly family income, maternal characteristics - education, age, pre-gestational body mass index (BMI), weight gain during pregnancy, smoking during pregnancy, type of delivery, and parity - and adolescent characteristics - skin color and birth weight. For analysis, FM and FMI underwent logarithmic transformation due to data asymmetry. RESULTS A total of 3,401 adolescents were analyzed, including boys and girls born at less than 33 weeks, with lower FM and FFM means than those born at term. However, in the adjusted analyses, there was no association between GA and any of the outcomes in either sex. LGA boys had a 10.5% higher FMI (p = 0.026) and +0.3 BMI/age Z-score (p = 0.019) as compared to AGA boys, and LGA girls had +0.3 kg/m 2 of FFMI (p = 0.039) than AGA girls. CONCLUSION GA was not associated with body composition at 11 years of age. However, LGA boys had higher BMI and BMI/age Z-score, and LGA girls had higher FFMI than AGA girls.
Collapse
Affiliation(s)
- Caroline Cardozo Bortolotto
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaDepartamento de Medicina SocialPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Iná da Silva dos Santos
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaDepartamento de Medicina SocialPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Juliana dos Santos Vaz
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaDepartamento de Medicina SocialPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Departamento de Medicina Social. Pelotas, RS, Brasil
- Universidade Federal de PelotasFaculdade de NutriçãoDepartamento de NutriçãoPelotasRSBrasilUniversidade Federal de Pelotas. Faculdade de Nutrição. Departamento de Nutrição. Pelotas, RS, Brasil
| | - Alicia Matijasevich
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaDepartamento de Medicina SocialPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Departamento de Medicina Social. Pelotas, RS, Brasil
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaPelotasRSBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. Pelotas, RS, Brasil
| |
Collapse
|
32
|
Bierhals IO, Vaz JDS, Matijasevich A, Barros AJD, Tovo-Rodrigues L, Barros FC, Santos IS. Linear growth and relative weight gain in childhood and bone mass in adolescence: findings from the Pelotas (Brazil) 2004 birth cohort. Arch Osteoporos 2022; 18:5. [PMID: 36482131 DOI: 10.1007/s11657-022-01189-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
With the objective to investigate the relationship of weight and height growth with bone mass at 11 years, we found that boys who grew in weight and height, especially at 48 months, and girls, who grew in weight at 24 months and height at 11 years, gained more bone mass. PURPOSE To investigate independent relationships of linear growth and relative weight gain during defined periods of infancy, childhood, and early adolescence with areal bone mineral density (aBMD) of three sites at 11 years. METHODS Data on weight and length/height were obtained at birth, 3, 12, and 24 months, and the ages of 4, 6, and 11. The outcome was whole body, femoral neck, and lumbar spine aBMD (g/cm2) measured at 11 years using dual-energy X-ray absorptiometry. The effects of weight gain and linear growth were analyzed using conditional relative weight and conditional length/height. Associations between conditional growth and outcomes were analyzed using linear regression, adjusted for multiple confounders. RESULTS Individuals with data available for exposures and bone outcomes were 2875 and comprised the sample. For boys, the greatest magnitude of increase for whole body and height gain was at 48 months (β 0.014, 95% CI 0.010; 0.018). For girls, higher aBMD was observed for those with greater height gain at 11 years, representing for lumbar spine an increase of 0.056 g/cm2 (95% CI 0.050; 0.062). For body weight, among boys, the greatest magnitude in the whole body was also associated with weight gain at 48 months (β 0.014, 95% CI 0.010; 0.018). For girls, the highest coefficient was at 24 months, representing for lumbar spine an increase of 0.028 g/cm2, (95% CI 0.021; 0.035). CONCLUSION Positive associations were demonstrated between length/height and weight gain and aBMD in both sexes, with emphasis on girls' aBMD in response to the linear growth achieved mainly at 11 years.
Collapse
Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil.
| | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
- Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
- Faculdade de Medicina FMUSP, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
- Postgraduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3° Andar, Pelotas, RS, CEP 96020-220, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
33
|
Bauer A, Fairchild G, Hammerton G, Murray J, Santos IS, Tovo Rodrigues L, Munhoz TN, Barros AJD, Matijasevich A, Halligan SL. Associations between childhood trauma and childhood psychiatric disorders in Brazil: a population-based, prospective birth cohort study. Lancet Psychiatry 2022; 9:969-977. [PMID: 36328032 DOI: 10.1016/s2215-0366(22)00337-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood trauma is a proposed transdiagnostic risk factor for psychopathology, but epidemiological evidence from low-income and middle-income countries (LMICs) is scarce. We investigated associations between trauma and child psychiatric disorders in a birth cohort in Brazil. METHODS The 2004 Pelotas Birth Cohort is an ongoing, population-based, prospective birth cohort, including all hospital births occurring between Jan 1 and Dec 31, 2004, in the city of Pelotas, Brazil. When the children were aged 6 and 11 years, trained psychologists administered the Development and Well-Being Assessment clinical interview to caregivers to assess current child psychiatric disorders (anxiety disorders, mood disorders, ADHD and hyperactivity disorders, and conduct and oppositional disorders), and lifetime trauma exposure (ie, experiencing or witnessing life-threatening events) including interpersonal and non-interpersonal events. Analyses used multiple imputation and logistic regression models. OUTCOMES Of 4263 live births, 4231 children were included in the study sample, and 4229 (2195 [51·9%] boys and 2034 [48·1%] girls; 2581 [61·7%] with White mothers and 1600 [38·3%] with Black or mixed race mothers) were included in the imputed analyses. 1154 (34·3%) of 3367 children with complete data at age 11 years had been exposed to trauma by that age. After adjusting for confounders, at age 6 years, trauma was associated with increased odds of anxiety disorders (adjusted odds ratio 1·79 [95% CI 1·33-2·42]) and any psychiatric disorder (1·59 [1·22-2·06]), and at age 11 years, with any psychiatric disorder (1·45 [1·17-1·79]) and all four specific diagnostic classes of anxiety disorders (1·47 [1·04-2·09]), mood disorders (1·66 [1·08-2·55]), ADHD and hyperactivity disorders (1·47 [1·01-2·13]), and conduct and oppositional disorders (1·76 [1·19-2·61]). Interpersonal trauma and non-interpersonal trauma were each associated with increased odds of multiple psychiatric disorders, even when adjusting for their co-occurrence. INTERPRETATION A considerable mental health burden associated with childhood trauma is already evident by middle childhood in this sample from Brazil. Evidence-based efforts to reduce the incidence of childhood trauma in Brazil and address its consequences are urgently needed. FUNDING Children's Pastorate, WHO, National Support Program for Centres of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, São Paulo Research Foundation, University of Bath, Wellcome Trust. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
- Andreas Bauer
- Department of Psychology, University of Bath, Bath, UK; Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
| | | | - Gemma Hammerton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Joseph Murray
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Ina S Santos
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil
| | | | - Tiago N Munhoz
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
34
|
Martins‐Silva T, Bauer A, Matijasevich A, Santos I, Barros A, Ekelund U, Tovo‐Rodrigues L, Murray J. Educational performance and conduct problem trajectories from childhood to adolescence: Observational and genetic associations in a Brazilian birth cohort. JCPP ADVANCES 2022; 2:e12105. [PMID: 37431415 PMCID: PMC10242956 DOI: 10.1002/jcv2.12105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/24/2022] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Educational difficulties are an important potential influence on both the onset and course of children's conduct problems. This study evaluated the association between school failure and children's conduct problems in Brazil, a context with high rates of both conditions, using both observational and genetic approaches. METHODS Prospective, population-based, birth cohort study in Pelotas city, Brazil. Parents reported on conduct problems four times between ages 4-15 years, and group-based trajectory analysis was used to classify 3469 children into trajectories of childhood-limited, early-onset persistent, adolescence-onset, or low conduct problems. School failure was measured as having repeated a school grade up to age 11, and a polygenic risk score (PRS) predicting educational attainment was calculated. Multinomial adjusted regression models were used to estimate the association between school failure (observational measure and the PRS) and conduct problem trajectories. To consider possible variation in effects of school failure by social context, interactions were tested with family income and school environment (using both observational and PRS methods). RESULTS Children repeating a school grade had increased odds of being on to childhood-limited (OR: 1.57; 95% CI 1.21; 2.03), adolescence-onset (OR: 1.96; 95% CI 1.39; 2.75), or early-onset persistent trajectory (OR: 2.99; 95% CI 1.85; 4.83), compared to the low conduct problem trajectory. School failure also predicted increased risk for early-onset persistent problems versus the childhood-limited problems (OR: 1.91; 95% CI 1.17; 3.09). Using a genetic PRS approach, similar findings were observed. Associations varied according to the school environment: school failure had larger effects on children in better school environments. CONCLUSION School performance, whether measured in terms of repeating school grades or genetic susceptibility, was consistently associated with trajectories of child conduct problems into mid-adolescence. We also found a larger association for children in better school environments.
Collapse
Affiliation(s)
- Thais Martins‐Silva
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Andreas Bauer
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Alicia Matijasevich
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
| | - Iná Santos
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Postgraduate Program in Pediatrics and Child HealthSchool of MedicinePontifical Catholic University of Rio Grande do SulPorto AlegreBrazil
| | - Aluísio Barros
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- International Center for Equity in HealthFederal University of PelotasPelotasBrazil
| | - Ulf Ekelund
- Department of Sport MedicineNorwegian School of Sport SciencesOsloNorway
- Department of Chronic Diseases and AgeingNorwegian Institute of Public HealthOsloNorway
| | - Luciana Tovo‐Rodrigues
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| |
Collapse
|
35
|
Bozzini AB, Maruyama JM, Santos IS, Murray J, Tovo-Rodrigues L, Munhoz TN, Matijasevich A. Prevalence of adolescent's risk behaviors at age 11 and 15: data from the 2004 Pelotas birth cohort. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2022; 45:93-101. [PMID: 36318481 PMCID: PMC10154011 DOI: 10.47626/1516-4446-2022-2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/15/2022] [Indexed: 05/04/2023]
Abstract
PURPOSE The objective of this study was to investigate the prevalence of the following risk behaviors: cigarette, electronic cigarette, alcohol, substance and sexual experimentation and delinquent behavior at age 15, stratified by sex and socioeconomic position. We also investigated the prevalence of cigarette and alcohol experimentation at age 11 and the persistence and cumulative incidence of these behaviors between 11 to 15 age. METHODS Cohort study. We included 3,491 11-year-old and 1,949 15-year-old adolescents from the 2004 Pelotas Birth Cohort. All outcomes were identified via confidential questionnaires and were analyzed as binary variables. RESULTS At age 11, we found a male preponderance of cigarette experimentation. At age 15, alcohol experimentation, cigarette experimentation and substance experimentation had a female preponderance; and cigarette experimentation and sexual experimentation were more prevalent in individuals belonging to low socioeconomic position. We found high rates of cumulative incidence of 'alcohol experimentation' in male and in female adolescents; and high rates of persistence of alcohol experimentation both in male and female. CONCLUSIONS Further research should clarify causal paths of high prevalence of risk behaviors during adolescence and its increase in female adolescents.
Collapse
Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brasil
| | - Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brasil
| | - Iná S Santos
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | | | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. School of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina (FMUSP), Universidade de São Paulo, São Paulo, Brasil. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
36
|
Quinte GC, Munhoz TN, Matijasevich A, Santos IS. Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort. Sci Rep 2022; 12:14437. [PMID: 36002596 PMCID: PMC9402554 DOI: 10.1038/s41598-022-18032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Possible mechanisms by which maternal pre-pregnancy body mass index (BMI) programs offspring mental disorders in late childhood are not fully clarified. To assess the association between maternal BMI and mental health problems at 11 years old, we used data from the 2004 Pelotas birth cohort which comprised 4231 newborns. Maternal pre-pregnancy BMI was analyzed as underweight (< 18.5), normal (18.5-24.9), overweight (25.0-29.9), and obesity (≥ 30.0). Mental health problems were assessed at the child's age of 11 years by the Strengths and Difficulties Questionnaire, total difficulties score and subscale scores (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems), dichotomized into normal/borderline and abnormal category. The associations between maternal pre-pregnancy BMI and mental health problems in the whole sample and stratified by sex were estimated using crude and adjusted linear and logistic regression. Both linear and logistic regression showed that pre-pregnancy weight was associated with mental problems in early adolescents. Maternal pre-pregnancy obesity was associated with increased odds of total difficulty score among the whole sample. Boys whose mothers were pre-pregnancy overweight had higher odds of conduct problems (OR = 1.56; 95% CI: 1.13, 1.95), when compared to children of normal pre-pregnancy weight mothers, even after adjustments. Maternal pre-pregnancy obesity was associated with mental health problems in early adolescents; specifically, pre-pregnancy overweight increased the risk for conduct problems in 11 years old boys.
Collapse
Affiliation(s)
- Gabriela Callo Quinte
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro, Caixa Postal 464, Pelotas, RS, Cep: 96020-220, Brazil.
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro, Caixa Postal 464, Pelotas, RS, Cep: 96020-220, Brazil.,School of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ina S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Bairro Centro, Caixa Postal 464, Pelotas, RS, Cep: 96020-220, Brazil
| |
Collapse
|
37
|
Influence of maternal excess weight before pregnancy on breast-feeding and weaning: pooled analyses of four population-based cohorts born between 1982 and 2015. Br J Nutr 2022; 128:124-130. [PMID: 34378497 DOI: 10.1017/s0007114521003019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To investigate the associations of maternal excess weight before pregnancy with (1) weaning at 3 months of age, (2) duration of exclusive breast-feeding at 6 months of age, (3) duration of any breast-feeding at 12 months of age and (4) to compare the magnitude of these associations over four decades. Data were from participants in the Pelotas (Brazil) Birth Cohorts born in 1982 (n 5334), 1993 (n 1442), 2004 (n 4092) and 2015 (n 4102). Maternal pre-pregnancy weight was collected after the delivery and breast-feeding status was assessed when children were 3 and 12 months old. Only in the most recent cohort (2015), women with excess weight (BMI ≥ 25 kg/m2) before pregnancy had higher risk of discontinuing exclusive breast-feeding within the first 6 months postpartum than women with normal weight (hazard ratio = 1·22 (95 % CI 1·15, 1·30)). Duration of any type of breast-feeding until 12 months of age was not affected by pre-pregnancy weight. Excess weight before pregnancy is associated with exclusive breast-feeding only in the most recent birth cohort coinciding with increases in excess weight and breast-feeding over time.
Collapse
|
38
|
Carpena MX, Matijasevich A, Loret de Mola C, Santos IS, Munhoz TN, Tovo-Rodrigues L. The effects of persistent sleep disturbances during early childhood over adolescent ADHD, and the mediating effect of attention-related executive functions: Data from the 2004 Pelotas Birth Cohort. J Affect Disord 2022; 296:175-182. [PMID: 34607058 DOI: 10.1016/j.jad.2021.09.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/16/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Investigate effects of persistent sleep disturbances during early childhood over ADHD during the adolescence, and the potential attention-related executive functions mediating this effect. METHODS We used data from the 2004 Pelotas Birth Cohort. Children's Sleep disturbances were reported by their mothers at 12, 24, and 48 months of age, whereas the Test-of-Everyday-Attention-for-Children (TEA-Ch) and the Development and Well Being Assessment (DAWBA) were applied at 11 years of age to evaluate attention-related executive functions and ADHD, respectively. Persistent sleep problems were defined as reporting have two or more points of difficulty to sleep, nightmares, restless sleeps, and/or <10h/24h sleep duration. Logistic regression and mediation models were used, adjusting for maternal and child sociodemographic, behavior and health related variables. RESULTS The highest prevalence of adolescent ADHD (15.4%) was on the group who reported having nightmares at 2,4 and 6 years. In adjusted models, we observed an odd of ADHD in the adolescence 2.26 higher in those who reported persistent nightmares (CI95% 1.33, 4.01) compared to those reported transitory or no nightmares. Persistent difficulty to sleep (OR=1.74 CI95% 1.13, 2.66) and restless sleep (OR=1.80, CI95% 1.23, 2.64) during childhood also increased ADHD odds at 11 years. No indirect effect through attention related executive functions was found using mediating models. DISCUSSION Persistent early sleep disturbances may increase odds of ADHD among adolescents and could be consider as early marker of such disorder, specially nightmares problems. These effects were not mediated by attention-related executive functions. Nevertheless, we had 75% of cohort inception response.
Collapse
Affiliation(s)
- Marina Xavier Carpena
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Alicia Matijasevich
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Brasil
| | - Christian Loret de Mola
- Programa de Pós-Graduação em Saúde Pública, FURG, Rio Grande, RS, Brazil; Grupo de Pesquisa e Inovação em Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, RS, Brazil
| | - Ina S Santos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program Pediatrics Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tiago N Munhoz
- Faculty of Psychology, Federal University of Pelotas, Brazil
| | | |
Collapse
|
39
|
Harsh parenting and child conduct and emotional problems: parent- and child-effects in the 2004 Pelotas Birth Cohort. Eur Child Adolesc Psychiatry 2022; 31:1-11. [PMID: 33738622 PMCID: PMC9343272 DOI: 10.1007/s00787-021-01759-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/11/2021] [Indexed: 12/23/2022]
Abstract
In high-income countries, links between harsh and abusive parenting and child conduct and emotional problems are well-documented. However, less is known about these relationships in low- and middle-income countries, where harsh parenting may be more widely accepted and higher rates of conduct or emotional problems may exist which could influence the strength of these associations. We sought to investigate these relationships in a large population-based, prospective longitudinal study from Brazil, which also allowed us to test for sex differences. Using data from the 2004 Pelotas Birth Cohort Study (N = 4231) at ages 6 and 11 years, we applied cross-lagged path analysis to examine the relationships between harsh parenting (Conflict Tactics Scale Parent-Child version), and child conduct and emotional problems (Strengths and Difficulties Questionnaire). We found reciprocal relationships between harsh parenting and child conduct problems, with harsh parenting at age 6 predicting child conduct problems at age 11, and vice versa, even after adjusting for initial levels of conduct problems and harsh parenting, respectively. For child emotional problems, only unidirectional effects were found, with harsh parenting at age 6 predicting child emotional problems at age 11, after adjusting for initial levels of emotional problems, but not vice versa. No significant sex differences were observed in these relationships. These observations based on a middle-income country birth cohort highlight the potential universality of detrimental effects of harsh parenting on child conduct and emotional problems and affirm the importance of addressing parent- and child-effects in preventive and treatment interventions, especially those targeting conduct problems.
Collapse
|
40
|
Bridger Staatz C, Kelly Y, Lacey RE, Blodgett JM, George A, Arnot M, Walker E, Hardy R. Socioeconomic position and body composition in childhood in high- and middle-income countries: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2316-2334. [PMID: 34315999 PMCID: PMC8528703 DOI: 10.1038/s41366-021-00899-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The relation between socioeconomic position (SEP) and obesity measured by body mass index (BMI), a measure of weight for height, has been extensively reviewed in children, showing consistent associations between disadvantaged SEP and higher BMI in high-income countries (HICs) and lower BMI in middle-income countries (MICs). Fat mass (FM), a more accurate measure of adiposity, and fat-free mass (FFM) are not captured by BMI, but have been shown to track from childhood to adulthood, and be important for cardiovascular health and functional outcomes in later life. It is not clear whether body composition is associated with SEP. We systematically reviewed the association between SEP and body composition in childhood. METHODS A systematic review was carried out following PRISMA guidelines. The protocol was pre-registered with PROSPERO (CRD42019119937). Original studies in the English language, which examined the association between SEP and body composition in childhood, were included. An electronic search of three databases was conducted. Two independent reviewers carried out screening, data extraction and quality assessment. Due to heterogeneity in results, a narrative synthesis was conducted. Heterogeneity in findings according to SEP, sex, body composition measure and country income level was investigated. RESULTS 50 papers were included, the majority from HICs. No papers were from low-income countries. Disadvantage in childhood was associated with greater FM and lower FFM in HICs, but with lower FM and lower FFM in MICs. When measures of FFM indexed to height were used there was no evidence of associations with SEP. In HICs, more studies reported associations between disadvantaged SEP and higher FM among girls comparative to boys. CONCLUSIONS Inequalities in FM are evident in HICs and, in the opposite direction, in MICs and follow similar trends to inequalities for BMI. Inequalities in height are likely important in understanding inequalities in FFM.
Collapse
Affiliation(s)
- Charis Bridger Staatz
- Social Research Institute, Institute of Education, University College London, London, UK.
| | - Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca E Lacey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Anitha George
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Megan Arnot
- Department of Anthropology, University College London, London, UK
| | - Emma Walker
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca Hardy
- Social Research Institute, Institute of Education, University College London, London, UK
| |
Collapse
|
41
|
Booij L, Nicolosi M. Early childhood care, support and research: how early screening and longitudinal studies can help children thrive. J Pediatr (Rio J) 2021; 97:579-581. [PMID: 34019848 PMCID: PMC9432234 DOI: 10.1016/j.jped.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Linda Booij
- Concordia University, Department of Psychology, Montreal, Canada; Sainte-Justine University Hospital Research Center, Montreal, Canada.
| | - Melissa Nicolosi
- Concordia University, Department of Psychology, Montreal, Canada; Sainte-Justine University Hospital Research Center, Montreal, Canada
| |
Collapse
|
42
|
Giugliani ERJ, Gomes E, Santos IS, Matijasevich A, Camargo-Figuera FA, Barros AJD. All day-long pacifier use and intelligence quotient in childhood: A birth cohort study. Paediatr Perinat Epidemiol 2021; 35:511-518. [PMID: 33570810 DOI: 10.1111/ppe.12752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/23/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence. OBJECTIVES The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort. METHODS Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use. RESULTS IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively. CONCLUSIONS We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.
Collapse
Affiliation(s)
- Elsa R J Giugliani
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Erissandra Gomes
- Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Programa de Pós-Graduação em Pediatria e Saúde da Criança, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculdade de Medicina, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Fabio A Camargo-Figuera
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Escuela de Enfermería, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Aluísio J D Barros
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| |
Collapse
|
43
|
Costa FDS, Costa CDS, Chisini LA, Wendt A, Santos IDSD, Matijasevich A, Correa MB, Demarco FF. Socio-economic inequalities in dental pain in children: A birth cohort study. Community Dent Oral Epidemiol 2021; 50:360-366. [PMID: 34137065 DOI: 10.1111/cdoe.12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe socio-economic inequalities in dental pain and dental caries in 5 and 12-year-old children enrolled in a birth cohort. METHODS This prospective study was carried out with children enrolled in a birth cohort in Pelotas, Brazil. The main outcome was history of dental pain in the last six months, collected at 5 and 12 years of age. Dental caries was evaluated as a secondary outcome. Inequalities dimensions were investigated using maternal education and family income. The inequalities indicators used were the slope index of inequality (SII) and the concentration index (CIX). RESULTS Some 1,114 and 990 children were included in the analyses at the 5- and 12-year follow-ups, respectively. The prevalence of dental pain was 16.5% (95% CI 14.4-18.8) at 5 years and 31.6% (95% CI 28.7-34.6) at 12 years. Regarding SII, the difference in the prevalence of dental pain was 14 and 11 percentage points at 5 and 12 years, respectively, when comparing the less to the more maternal schooled strata. Relative inequalities (CIX) were found for dental pain only at age 12, considering family income (-5.8 CI95% -11.0; -0.6). Absolute socio-economic inequalities were also observed for dental caries in both ages. CONCLUSION Dental pain in the last six months and dental caries was unequally distributed. Economically disadvantaged groups had the highest prevalence of dental pain and dental caries in both dentitions. Actions to tackle socio-economic inequalities must be designed throughout life.
Collapse
Affiliation(s)
| | | | - Luiz Alexandre Chisini
- Center of Biological Sciences and Health, Taquari Valley University, Lajeado, RS, Brazil
| | - Andrea Wendt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná da Silva Dos Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Preventive Medicine, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Marcos Britto Correa
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Flávio Fernando Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
44
|
Mascarello KC, Matijasevich A, Barros AJDD, Barros FCLFD, Santos IDSD, Labrecque JA, Silveira MF. Analysis of early and late maternal complications associated with delivery using propensity score. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210027. [PMID: 34076146 DOI: 10.1590/1980-549720210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/11/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze early and late maternal complications associated with the mode of delivery in a birth cohort in Brazil, using the propensity score technique for analysis. METHODS This is a prospective cohort study, using data from the Pelotas Birth Cohort, RS, 2004. A total of 4,189 women were included and a descriptive analysis of the data and subsequent calculation of the propensity and pairing score of vaginal delivery women and cesarean delivery women with similar scores (1,366 pairs). We then assessed the difference in outcome risk between the groups. RESULTS Women in the cesarean group had 2.9 percentage points (pp) more risk of postpartum infection, 1.13 p.p. more risk of urinary infection, 1.10 p.p. more risk of anesthetic complications and 1.24 p.p. higher risk of headache compared to vaginal delivery, but less risk of anemia (-2.43 pp) and hemorrhoids (-1.24 p.p.). The use of propensity scores is extremely useful for reducing bias and increasing accuracy in observational studies when experimental studies cannot be performed. CONCLUSION Cesarean sections have been associated with a higher prevalence of postpartum and urinary tract infections, anesthetic complications and headache and lower prevalence of anemia and hemorrhoids, so they should be performed with clear indications and when their benefits outweigh potential risks.
Collapse
Affiliation(s)
| | - Alicia Matijasevich
- Epidemiological Research Center, Post-Graduation Program in Epidemiology, Universidade Federal de Pelotas - Pelotas (RS), Brazil.,Department of Preventive Medicine, School of Medicine, Universidade de São Paulo - São Paulo (SP), Brazil
| | | | | | - Iná da Silva Dos Santos
- Epidemiological Research Center, Post-Graduation Program in Epidemiology, Universidade Federal de Pelotas - Pelotas (RS), Brazil.,Post-Graduation Program in Pediatrics and Child Heallth, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | | | - Mariângela Freitas Silveira
- Epidemiological Research Center, Post-Graduation Program in Epidemiology, Universidade Federal de Pelotas - Pelotas (RS), Brazil
| |
Collapse
|
45
|
Carvalho CAD, Magalhães EIDS, Bettiol H, Barbieri MA, Cardoso VC, Matijasevich A, Menezes AMB, Horta BL, Wehrmeister FC, Gonçalves H, Santos IS, Lima NP, França AKTDC, Silva AAMD. Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís). CAD SAUDE PUBLICA 2021; 37:e00237020. [PMID: 34008736 DOI: 10.1590/0102-311x00237020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/04/2021] [Indexed: 11/21/2022] Open
Abstract
Our objective was to estimate the prevalence of excess weight and obesity, according to sex and income in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas, and São Luís). Participants in the Ribeirão Preto (1978/1979 and 1994), Pelotas (1982, 1993 and 2004) and São Luís (1997/1998) birth cohorts were included in different follow-ups from 7 years old onwards. Excess weight (overweight and obesity) were assessed by body mass index. The highest prevalences were observed in Ribeirão Preto (excess weight: 27.7% at 9-11 and 47.1% at 22-23 years; obesity: 8.6% at 9-11 and 19.8% at 22-23 years) while the smallest was in São Luís (excess weight: 5.4 to 7-9 and 17.2% at 18-19 years; obesity: 1.8% at 7-9 and 3.6% at 18-19 years). The younger the cohort, the greater the prevalence of excess weight and obesity when comparing similar age groups. Increases in obesity prevalence were greater than in excess weight prevalence. Women had lower excess weight prevalence in older cohorts and higher obesity prevalence in younger cohorts. Higher excess weight and obesity prevalence were observed in higher income children and adolescents, and in poorer adults. Differences in the prevalence of excess weight and obesity evidenced that individuals from younger cohorts are more exposed to this morbidity, as well as those who were born in the most developed city, low-income adults as well as children and adolescents belonging to families of the highest income tertile. Therefore, the results of this study indicate the need to prioritize actions aimed at younger individuals.
Collapse
Affiliation(s)
| | | | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | | | | | | | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Iná S Santos
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | | |
Collapse
|
46
|
Confortin SC, Ribeiro MRC, Barros AJD, Menezes AMB, Horta BL, Victora CG, Barros FC, Gonçalves H, Bettiol H, Santos ISD, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Silveira MFD, Domingues MR, Lima NP, Rocha PRH, Cavalli RC, Batista RFL, Cardoso VC, Simões VMF, Silva AAMD. RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. CAD SAUDE PUBLICA 2021; 37:e00093320. [PMID: 33950086 DOI: 10.1590/0102-311x00093320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/20/2020] [Indexed: 01/11/2023] Open
Abstract
This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.
Collapse
|
47
|
Costa CDS, Assunção MCF, Loret de Mola C, Cardoso JDS, Matijasevich A, Barros AJD, Santos IS. Role of ultra-processed food in fat mass index between 6 and 11 years of age: a cohort study. Int J Epidemiol 2021; 50:256-265. [PMID: 32888008 PMCID: PMC7938497 DOI: 10.1093/ije/dyaa141] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Ultra-processed food consumption and obesity have been highlighted as an important relationship to public health. We aimed to evaluate the association between ultra-processed food consumption and body fat from 6 to 11 years of age. METHODS We assessed the association between ultra-processed food consumption (from food frequency questionnaires) and body fat (measured by air displacement plethysmography) between 6 and 11 years of age among participants of the Pelotas-Brazil 2004 Birth Cohort. The NOVA classification was used to classify foods according to the processing degree. Body fat was evaluated relative to the height using fat mass index (FMI). Generalized estimating equations were used to answer the main research question and mediation analyses were run to assess the direct and indirect effect of ultra-processed food in body fat. RESULTS At fully adjusted analysis, an increase of 100 g in contribution from ultra-processed food to daily food intake at between 6 and 11 years of age was associated with a gain of 0.14 kg/m² in FMI in the same period; 58% of the total effect of ultra-processed food intake at 6 years (in grams) over the change in FMI from 6 to 11 years was mediated by its calorie content. CONCLUSIONS Ultra-processed food consumption was associated with an increase in body fat from childhood to early adolescence, and this association was not just due to the effect of ultra-processed food on calorie content.
Collapse
Affiliation(s)
- Caroline dos Santos Costa
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Christian Loret de Mola
- Post-Graduate Program in Public Health, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Juliane de Souza Cardoso
- Post-Graduate Program in Biochemistry and Bioprospecting, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
48
|
Bortolotto CC, Santos IS, Dos Santos Vaz J, Matijasevich A, Barros AJD, Barros FC, Santos LP, Munhoz TN. Prematurity and body composition at 6, 18, and 30 years of age: Pelotas (Brazil) 2004, 1993, and 1982 birth cohorts. BMC Public Health 2021; 21:321. [PMID: 33563247 PMCID: PMC7871570 DOI: 10.1186/s12889-021-10368-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background We aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies. Methods Gestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34–36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m2), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m2), body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI). Results A total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34–36 weeks) presented lower adjusted mean of FM (β = − 0.80 kg, − 1.45;-0.16, p = 0.046), %FM (β = − 2.39%, − 3.90;-0.88, p = 0.008), FMI (β = − 0.70 kg/m2, − 1.13;-0.27, p = 0.004) as well as lower FFM (β = − 0.4 kg, − 0.77; − 0.12, p = 0.010) and FFMI (β = − 0.3 kg/m2, − 0.46;-0.10, p < 0.001), and BMI Z-score (β = − 0.69,; − 0.99;-0.40, p < 0.001); but higher %FFM (β = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA. Conclusions Our results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10368-w.
Collapse
Affiliation(s)
- Caroline Cardozo Bortolotto
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.
| | - Iná S Santos
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Pontifical Catholic University of Rio Grande do Sul, Program of Pediatrics and Child Health, Porto Alegre, Brazil
| | - Juliana Dos Santos Vaz
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Federal University of Pelotas, Faculty of Nutrition, Pelotas, 96010610, Brazil
| | - Alicia Matijasevich
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Faculdade de Medicina FMUSP, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, 01246-903, Brazil
| | - Aluísio J D Barros
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Federal University of Pelotas, International Center for Equity in Health, Graduate Program in Epidemiology, Pelotas, 96020220, Brazil
| | - Fernando C Barros
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Catholic University of Pelotas, Medicine School, 96010-280, Pelotas, Brazil
| | - Leonardo Pozza Santos
- Federal University of Pampa (Unipampa), Nutrition College, Itaqui, 97650-000, Brazil
| | - Tiago Neuenfeld Munhoz
- Federal University of Pelotas (UFPel). Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160 - 3° Piso. Bairro Centro, Cep: 96020-220, Pelotas, RS, Caixa Postal 464, Brazil.,Federal University of Pelotas, Faculty of Psychology, Pelotas, 96030-001, Brazil
| |
Collapse
|
49
|
Laporte PP, Matijasevich A, Munhoz TN, Santos IS, Barros AJD, Pine DS, Rohde LA, Leibenluft E, Salum GA. Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. J Am Acad Child Adolesc Psychiatry 2021; 60:286-295. [PMID: 32004697 PMCID: PMC9073144 DOI: 10.1016/j.jaac.2019.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/18/2019] [Accepted: 01/22/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify the most appropriate threshold for disruptive mood dysregulation disorder (DMDD) diagnosis and the impact of potential changes in diagnostic rules on prevalence levels in the community. METHOD Trained psychologists evaluated 3,562 preadolescents/early adolescents from the 2004 Pelotas Birth Cohort with the Development and Well-Being Behavior Assessment (DAWBA). The clinical threshold was assessed in 3 stages: symptomatic, syndromic, and clinical operationalization. The symptomatic threshold identified the response category in each DAWBA item, which separates normative misbehavior from a clinical indicator. The syndromic threshold identified the number of irritable mood and outbursts needed to capture preadolescents/early adolescents with high symptom levels. Clinical operationalization compared the impact of AND/OR rules for combining irritable mood and outbursts on impairment and levels of psychopathology. RESULTS At the symptomatic threshold, most irritable mood items were normative in their lowest response categories and clinically significant in their highest response categories. For outbursts, some indicated a symptom even when present at only a mild level, while others did not indicate symptoms at any level. At the syndromic level, a combination of 2 out of 7 irritable mood and 3 out of 8 outburst indicators accurately captured a cluster of individuals with high level of symptoms. Analysis combining irritable mood and outbursts delineated nonoverlapping aspects of DMDD, providing support for the OR rule in clinical operationalization. The best DMDD criteria resulted in a prevalence of 3%. CONCLUSION Results provide information for initiatives aiming to provide data-driven and clinically oriented operationalized criteria for DMDD.
Collapse
Affiliation(s)
- Paola Paganella Laporte
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil.
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil; Faculty of Medicine FMUSP, University of São Paulo, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil; Faculty of Psychology, Federal University of Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Daniel Samuel Pine
- Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Luis Augusto Rohde
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil
| | - Ellen Leibenluft
- Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Giovanni Abrahão Salum
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil
| |
Collapse
|
50
|
Bozzini AB, Maruyama JM, Munhoz TN, Barros AJD, Barros FC, Santos IS, Matijasevich A. Trajectories of maternal depressive symptoms and offspring's risk behavior in early adolescence: data from the 2004 Pelotas birth cohort study. BMC Psychiatry 2021; 21:18. [PMID: 33413253 PMCID: PMC7792177 DOI: 10.1186/s12888-020-03026-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring's risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. METHODS We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: "low" "moderate low", "increasing", "decreasing", and "chronic high". The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome -yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring's risk behavior adjusting for potential confounding variable. RESULTS Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. CONCLUSION Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression.
Collapse
Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | - Jessica Mayumi Maruyama
- grid.11899.380000 0004 1937 0722Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Tiago N. Munhoz
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil ,grid.411221.50000 0001 2134 6519Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J. D. Barros
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C. Barros
- grid.411965.e0000 0001 2296 8774Post-graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- grid.412519.a0000 0001 2166 9094Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- grid.11899.380000 0004 1937 0722Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil ,grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|