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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Abreu de Carvalho C, Viola PCDAF, Magalhães EIDS, Machado SP, Matijasevich A, Menezes AMB, Tovo-Rodrigues L, Santos IS, Goncalves H, Wehrmeister FC, Horta BL, Moura da Silva AA. Association between breast feeding and food consumption according to the degree of processing in Brazil: a cohort study. BMJ Open 2024; 14:e083871. [PMID: 38569686 PMCID: PMC10989181 DOI: 10.1136/bmjopen-2024-083871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The benefits of breast feeding may be associated with better formation of eating habits beyond childhood. This study was designed to verify the association between breast feeding and food consumption according to the degree of processing in four Brazilian birth cohorts. METHODS The duration of exclusive, predominant and total breast feeding was evaluated. The analysis of the energy contribution of fresh or minimally processed foods (FMPF) and ultra-processed foods (UPF) in the diet was evaluated during childhood (13-36 months), adolescence (11-18 years) and adulthood (22, 23 and 30 years). RESULTS Those who were predominantly breastfed for less than 4 months had a higher UPF consumption (β 3.14, 95% CI 0.82 to 5.47) and a lower FMPF consumption (β -3.47, 95% CI -5.91 to -1.02) at age 22 years in the 1993 cohort. Exclusive breast feeding (EBF) for less than 6 months was associated with increased UPF consumption (β 1.75, 95% CI 0.25 to 3.24) and reduced FMPF consumption (β -1.49, 95% CI -2.93 to -0.04) at age 11 years in the 2004 cohort. In this same cohort, total breast feeding for less than 12 months was associated with increased UPF consumption (β 1.12, 95% CI 0.24 to 2.19) and decreased FMPF consumption (β -1.13, 95% CI -2 .07 to -0.19). Children who did not receive EBF for 6 months showed an increase in the energy contribution of UPF (β 2.36, 95% CI 0.53 to 4.18) and a decrease in FMPF (β -2.33, 95% CI -4 .19 to -0.48) in the diet at 13-36 months in the 2010 cohort. In this cohort, children who were breastfed for less than 12 months in total had higher UPF consumption (β 2.16, 95% CI 0.81 to 3.51) and lower FMPF consumption (β -1.79, 95% CI -3.09 to -0.48). CONCLUSION Exposure to breast feeding is associated with lower UPF consumption and higher FMPF consumption in childhood, adolescence and adulthood.
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Affiliation(s)
| | | | | | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | | | | | - Ina S Santos
- Universidade Federal de Pelotas, Pelotas, Brazil
| | - Helen Goncalves
- Social Medicine, Universidade Federal de Pelotas, Pelotas, Brazil
- Post-graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
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Jorge ACR, Montezano BB, de Aguiar KR, Noronha LT, Baldez DP, Watts D, Menezes AMB, Wehrmeister FC, Gonçalves H, Kunz M, Kapczinski F, Passos IC. Early exposure to cannabis and bipolar disorder incidence: Findings from a 22-year birth cohort study in Brazil. Acta Psychiatr Scand 2024; 149:340-349. [PMID: 38378931 DOI: 10.1111/acps.13670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND AND OBJECTIVES Bipolar disorder is a chronic condition affecting millions of people worldwide. Currently, there is some evidence to suggest that cannabis use during adolescence may be an environmental risk factor for its onset, however inconsistencies have been observed across the literature. Considering this, we aimed to assess whether early lifetime cannabis is associated with subsequent bipolar disorder in young adults between 18 and 22 years of age. METHODS Using data from the 1993 Pelotas (Brazil) birth cohort (n = 5249), cannabis exposure was examined at age 18 by self-report, and bipolar disorder diagnosis was measured at age 22 using the Mini International Neuropsychiatric Interview (MINI). In order to control the analysis, we considered socioeconomic status index, sex, skin color, physical abuse by parents and lifetime cocaine use. RESULTS A total of 3781 individuals were evaluated in 2015 aged 22 years, of whom 87 were diagnosed with the bipolar disorder onset after the age of 18. Lifetime cannabis use predicted bipolar disorder onset at 22 years old (OR 1.82, 95% CI [1.10, 2.93]), and the effect remained after adjusting for socioeconomic status, sex, skin color, and physical abuse by parents (OR 2.00, 95% CI [1.20, 3.25]). However, this association was attenuated to statistically non-significant after further adjustment for all available covariates, including lifetime cocaine use (OR 1.79, 95% CI [0.95, 3.19]). We also found similar results for early cocaine use, where the association with bipolar disorder onset did not maintain significance in the multivariate model (OR 1.35, 95% CI [0.62, 2.86]). Otherwise, when we considered cannabis or cocaine lifetime use as a unique feature, our findings showed that the adolescent exposure to cannabis or cocaine increased the odds by 1.95 times of developing bipolar disorder at 22 years age, even when controlling for all other study variables (OR 2.14, 95% CI [1.30, 3.47]). Finally, our models suggest that cocaine use may potentially exert a major influence on the effect of lifetime cannabis use on bipolar disorder onset, and that physical abuse by parents and sex may modify the effect of cannabis use for later bipolar disorder onset. CONCLUSION Based on our findings, early cannabis exposure predicted bipolar disorder onset in young adults, but this association was confounded by cocaine use. Contrary to schizophrenia, cannabis as a sole exposure was not associated with bipolar disorder onset after adjusting for control variables.
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Affiliation(s)
- Alan Cristian Rodrigues Jorge
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruno Braga Montezano
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kyara Rodrigues de Aguiar
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniel Prates Baldez
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Devon Watts
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Helen Gonçalves
- Post graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Maurício Kunz
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Psychiatry, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Silva LSD, Menezes AMB, Barros FC, Wehrmeister FC, Silva HDGD, Horta BL. [Association between birth conditions and bone mineral density in adults from the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil]. CAD SAUDE PUBLICA 2024; 40:e00085523. [PMID: 38477728 DOI: 10.1590/0102-311xpt085523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/19/2023] [Indexed: 03/14/2024] Open
Abstract
This study assessed the association of birth weight, gestational age, and intrauterine growth with bone mineral density (BMD) at 22 and 30 years of age in the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil. BMD was measured by dual-energy X-ray absorptiometry (DXA) and the association was assessed using analysis of variance. Multiple linear regression was used to control for confounding factors: sex; household income at birth; maternal smoking during pregnancy; maternal schooling; maternal ethnicity/skin color; and pre-pregnancy body mass index. The study tested whether body fat in adulthood was a mediator of the association analyzed, using the G-computation Formula. A total of 6,803 participants from the 1982 and 1993 cohorts were evaluated at 30 and 22 years of age, respectively. Birth weight was associated with BMD at all sites, with a greater difference at the femoral neck. Individuals born weighing less than 2,000g had on average -0.036g/cm2 (95%CI: -0.064; -0.008) of BMD in the femoral neck than individuals weighing more than 3,500g. Individuals with an intrauterine growth z-score at least 1.28 standard deviation below the mean had an average of -0.013g/cm2 (95%CI: -0.024; -0.002) of BMD in the lumbar spine compared with individuals with an above-average z-score. The mediation analysis showed that body fat in adulthood did not mediate the association. Birth conditions have been associated with BMD in adulthood and the identification of early factors related to bone loss is essential due to the demographic inversion that has been taking place in low- and middle-income countries.
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Bordignon E, Miranda VIA, de Mola Zanatti CL, Menezes AMB, da Silva HDG, Wehrmeister FC, Murray J. Child maltreatment associates with violent victimization in young adulthood: a Brazilian birth cohort study. BMC Public Health 2023; 23:2287. [PMID: 37985981 PMCID: PMC10658884 DOI: 10.1186/s12889-023-17245-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 11/16/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Maltreatment in childhood may leave people vulnerable to further experiences of violence and more severe effects of stress later in life. Longitudinal studies of risk for violent victimisation after maltreatment are lacking in low- and middle-income countries. The objective of this study was to quantify the risk for violent victimization in the family and community in young adulthood following experiences of childhood maltreatment (experiences of physical, emotional and sexual abuse and neglect) up to age 15 years in an urban Brazilian population. METHODS 3246 participants in a prospective, population-based birth cohort study in Pelotas, Rio Grande do Sul, Brazil, were assessed at birth, 15 and 22 years. Sociodemographic factors were reported by mothers at birth and adolescents at age 15 years. Maltreatment and violent victimisation were self-reported in confidential questionnaires at 15 and 22, respectively. Multinomial logistic regression analyses estimated the association between having experienced any maltreatment and later experiences of family and community violence in young adulthood (no adult violence, violence only in the family context, only in the community, or both violence in the family and community), adjusting for sociodemographic factors. RESULTS 39% of females and 27% of males reported any maltreatment up to age 15 years. At 22 years, rates of past year violence in the family or community were 17.6% for females and 20.2% for males. Maltreatment was strongly associated with community violence (Females: OR = 2.96, CI = 1.83-4.80; Males: OR = 2.01, 95%CI = 1.01-4.00) and its co-occurrence with family violence (Females: OR = 2.33, 95%CI = 1.34-4.04; Males: OR = 3.20, 95%CI = 1.82-5.65) in young adulthood, after adjustment for background sociodemographic factors. CONCLUSION Childhood maltreatment is an important risk factor for later violent victimisation in both the family and community context. The effects of repeated trauma through the life-course needs research and clinical attention.
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Affiliation(s)
- Eveline Bordignon
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Vanessa Iribarrem Avena Miranda
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Public Health, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | - Ana Maria Baptista Menezes
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil.
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Weber P, Menezes AMB, Gonçalves H, de Oliveira PD, Wendt A, Perez-Padilla R, Wehrmeister FC. Smoking exposure trajectories and pulmonary function in early adulthood in a Brazilian cohort. Pulmonology 2023:S2531-0437(23)00168-X. [PMID: 37903685 DOI: 10.1016/j.pulmoe.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVES To investigate smoking trajectories and their association with pulmonary function (PF) and respiratory symptoms at age 22. METHODS Data from a population-based cohort study of 3350 individuals and their spirometries were analysed. The outcomes were: forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), forced expiratory flow at the mid expiratory phase (FEF25-75 %), FEV1/FVC and FEF25-75/FVC ratio. Smoking data were collected at perinatal follow-up (gestational exposure) and 15, 18 and 22 years. Group-based trajectory model was applied. RESULTS Four groups were identified: no exposure (NE), gestational (GE), gestational and adulthood (GAE) and continuous (CE) exposure. Both CE and GAE trajectories were associated with lower values of FEV1/FVC (-1.77pp; p = 0.01 and -1.58 pp; p<0.001 respectively) and FEF25-75/FVC ratio (-7.27pp; p = 0.019 and -6.04pp; p<0.001 respectively) compared to the NE trajectory. Lower FEV1 and FEF25-75 % values were also related to the GAE trajectory (-68 ml; p = 0.03 and -253 ml/s;p<0.001 respectively). Compared to those who never smoked, individuals who smoked 10 or more cigarettes daily presented a reduction in the FEV1/FVC ratio by 1.37pp (p<0.001), FEF25-75 % by 126 ml (p = 0.012) and FEF25-75 %/FVC ratio by 3.62pp (p = 0.011). CE trajectory showed higher odds of wheezing (OR 4.14; p<0.001) and cough (OR 2.39; p = 0.002) compared to the non-exposed group. CONCLUSIONS The in-uterus exposure to maternal smoking reduces PF later in life. However, the perpetuation of smoking behaviour throughout adolescence and early adulthood is determinant for PF main reduction and the emergence of respiratory-related symptoms.
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Affiliation(s)
- P Weber
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Brazilian Company of Hospital Services (EBSERH), Brasilia, Brazil.
| | - A M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - H Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - P D de Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Brazilian Company of Hospital Services (EBSERH), Brasilia, Brazil
| | - A Wendt
- Graduate Program in Health Technology, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - R Perez-Padilla
- National Institute of Respiratory Diseases (INER), Mexico City, Mexico
| | - F C Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Farias CP, Soares PSM, Barros FC, Menezes AMB, Gonçalves H, Wehrmeister FC, Pinheiro RT, Quevedo LDA, Horta BL. [Birth conditions and attention deficit/hyperactivity disorders (ADHD) in adults in the Pelotas (Brazil) birth cohorts of 1982 and 1993]. CAD SAUDE PUBLICA 2023; 39:e00138122. [PMID: 37820233 PMCID: PMC10566560 DOI: 10.1590/0102-311xpt138122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 10/13/2023] Open
Abstract
This study evaluates the association of birth conditions with attention deficit/hyperactivity disorders (ADHD) in adults using data from two birth cohorts in the city of Pelotas Rio Grande do Sul State, Brazil. In 1982 and 1993 all births in the city were identified and have been prospectively monitored. In the follow-ups at 30 and 22 years of the 1982 (n = 3,574) and 1993 (n = 3,780) cohorts, respectively, participants were examined, and trained psychologists applied the Mini-International Neuropsychiatric Interview (M.I.N.I.). Those individuals who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria were defined as positive for ADHD. Poisson regression with robust variance adjustment was used to estimate the prevalence ratio (PR) adjusted for sex, maternal skin color, family income, maternal age, maternal schooling during pregnancy, maternal marital status, parity, and maternal smoking during pregnancy. The prevalence of adult ADHD was 4.4% and 4.5% in the 1982 and 1993 cohorts, respectively. The prevalence of ADHD was higher in those born with lower weight, but no linear trend was observed, and those born with weight between 3,000 and 3,499 grams (PR = 1.40; 95%CI: 1.05-1.86) had the highest risk. For gestational age, we observed an inversely proportional relationship for the presence of ADHD: preterm infants had a 33% higher risk (95%CI: 0.90-1.96) of being considered as having ADHD than those born at 39 or more weeks, but as the confidence interval included nullity, this association may have occurred at random. These results indicate that birth weight and gestational age may be associated with adult ADHD.
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da Silva BGC, Menezes AMB, Gonçalves H, Alves CPDL, Delpino FM, Martins RC, Wehrmeister FC. Physical Activity During Adolescence and Mental Health in Early Adulthood: Findings From the 1993 Pelotas Birth Cohort Study. J Phys Act Health 2023; 20:860-867. [PMID: 37558222 DOI: 10.1123/jpah.2022-0658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Low prevalence of physical activity (PA) and a high prevalence of mental health problems are common among youth. The aim of this study was to evaluate the association between PA during adolescence and depression and anxiety disorders in young adulthood. METHODS Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed. Leisure-time PA and total PA (leisure plus commuting) were evaluated at 11, 15, and 18 years using self-reported data. PA was evaluated at each age separately and during adolescence, considering the number of times participants reached PA recommendations. Depression and anxiety were assessed through Mini International Neuropsychiatric Interview at 22 years. Crude and adjusted association analyses were performed using Poisson regression with robust error variance, providing prevalence ratios and 95% confidence intervals. RESULTS Three thousand two hundred and forty-seven participants were included in the study. In the adjusted analyses, active participants in leisure-time PA (≥300 min/wk) and total PA at 11 years were less likely to be depressed at age 22 (prevalence ratios: 0.54; 95% confidence interval, 0.33-0.89; prevalence ratios: 0.63; 95% confidence interval, 0.41-0.97). For leisure-time PA, the more PA recommendations were met during adolescence, the lower the prevalence of depression. There was no association when PA variables were evaluated separately at 15 and 18 years and between PA and anxiety after controlling for potential confounders. CONCLUSIONS Early adolescence appears to be a sensitive period for PA benefits on depression in early adulthood. The more timepoints reaching PA recommendations during adolescence, the lower the risk of depression. On the other hand, PA during adolescence was not associated with anxiety in young adults.
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Affiliation(s)
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | | | | | - Rafaela Costa Martins
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
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Kramer Fiala Machado A, Wendt A, Menezes AMB, Gonçalves H, Wehrmeister FC. Sleep clusters and modifiable risk behaviors for noncommunicable diseases in young adults: Data from a birth cohort in Brazil. Sleep Health 2023; 9:346-353. [PMID: 36697320 DOI: 10.1016/j.sleh.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/17/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To determine sleep clusters among young adults and describe the prevalence of modifiable risk behaviors for noncommunicable diseases (NCDs) according to these clusters. METHODS A cross-sectional analysis was carried out with the 1993 Pelotas Birth Cohort participants at the 22-year follow-up. Sleep onset, sleep offset, total sleep time (TST), TST variability, and sleep efficiency were evaluated by a triaxial accelerometer. We asked participants to wear the devices for 7 days on a nondominant wrist. Excessive daytime sleepiness was assessed by the Epworth sleep scale and sleep quality by the Pittsburgh Sleep Quality Index. Sleep clusters of 2738 individuals were determined using k-means cluster analysis. Crude and adjusted prevalence of modifiable risk behaviors for NCDs (smoking, harmful alcohol intake, leisure physical inactivity, overweight, screen time, and ultra-processed food consumption) were presented according to the sleep clusters. Adjustments included wealth index, skin color, years of schooling, current occupation, shift work, and having children under 2 years. All analyses were stratified according to sex. RESULTS We identified 3 sleep clusters for men (Healthy sleepers, Late and variant sleepers, and Shorter and poorer sleepers) and 3 for women (Healthy sleepers, Late and poor-quality sleepers, and Shorter, variant, and inefficient sleepers). Both males and females classified as Healthy sleepers presented a lower prevalence of modifiable risk behaviors for NCDs compared to individuals from other sleep clusters. CONCLUSIONS Poor sleep health is associated with higher prevalence of modifiable risk behaviors for NCDs. Prevention strategies for NCDs should also focus on sleep health.
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Affiliation(s)
| | - Andrea Wendt
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
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Degli Esposti M, Matijasevich A, Collishaw S, Martins-Silva T, Santos IS, Baptista Menezes AM, Domingues MR, Wehrmeister FC, Barros F, Murray J. Secular trends and social inequalities in child behavioural problems across three Brazilian cohort studies (1993, 2004 and 2015). Epidemiol Psychiatr Sci 2023; 32:e23. [PMID: 37066785 PMCID: PMC10130841 DOI: 10.1017/s2045796023000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/31/2023] [Accepted: 03/24/2023] [Indexed: 04/18/2023] Open
Abstract
AIMS Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019. METHODS The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019. RESULTS Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = -2.75; 95% confidence interval [CI]: -3.56, -1.94; P < 0.001), aggression (mean change = -1.84; 95% CI: -2.51, -1.17; P < 0.001) and rule-breaking behaviour (mean change = -0.91; 95% CI: -1.13, -0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019. CONCLUSIONS Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.
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Affiliation(s)
- Michelle Degli Esposti
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Stephan Collishaw
- Wolfson Centre for Young People’s Mental Health and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales
| | - Thaís Martins-Silva
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - Fernando Barros
- Post Graduate Course in Health in the Life Cycle, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Poveda NE, Adair LS, Martorell R, Patel SA, Ramirez-Zea M, Bhargava SK, Bechayda SA, Carba DB, Kroker-Lobos MF, Horta BL, Lima NP, Mazariegos M, Menezes AMB, Norris SA, Nyati LH, Richter LM, Sachdev H, Wehrmeister FC, Stein AD. Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration). BMJ Open 2023; 13:e068427. [PMID: 36921951 PMCID: PMC10030655 DOI: 10.1136/bmjopen-2022-068427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE We examined associations among serial measures of linear growth and relative weight with adult body composition. DESIGN Secondary data analysis of prospective birth cohort studies. SETTINGS Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa. PARTICIPANTS 4173 individuals followed from birth to ages 22-46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life. EXPOSURES Birth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence. PRIMARY OUTCOME MEASURES Body mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood. RESULTS In pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women's adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude. CONCLUSIONS Prenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity.
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Affiliation(s)
- Natalia E Poveda
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Santosh K Bhargava
- Department of Pediatrics, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
| | - Sonny A Bechayda
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Delia B Carba
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Maria F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Bernardo Lessa Horta
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Natália Peixoto Lima
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Harshpal Sachdev
- Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Fernando C Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Soares PSM, Leão OADA, Dias MDS, Wehrmeister FC, Menezes AMB, Gonçalves H. Effect of Adolescent Body Mass Index Trajectories on Working Memory: A Prospective Birth Cohort in Brazil. J Atten Disord 2023; 27:521-529. [PMID: 36779539 DOI: 10.1177/10870547231153973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Most research on the association between high body mass index (BMI) and working memory (WM) has been cross-sectional in design, limiting conclusions about long-term effects of overweight and obesity on WM. The aim of this study was to examine the association of BMI trajectory from 11 to 22 years with WM at 22 years of age. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N = 3,010). Information on BMI was collected at ages 11, 15, 18, and 22 years. Group-based trajectory modeling was used separately for each sex to identify BMI trajectories. Working Memory performance (Digit Span backward score) was examined at age 22. Multiple linear regression was used to assess the association between BMI trajectory from 11 to 22 years and WM at age 22. In both sexes, the trajectory groups were: stable normal weight, stable overweight, and stable obesity. In the adjusted analyses, women in the stable-obesity group had lower WM at 22 years (β = -.49; 95% CI: -0.75, -0.23; p < .001) than those in the stable-normal weight group. No associations were found between BMI trajectories and WM in men. This study may contribute to future investigations of possible explanatory avenues for the association between high BMI and WM.
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Magalhães EIDS, Lima NP, Menezes AMB, Gonçalves H, Wehrmeister FC, Assunção MCF, Horta BL. Maternal smoking during pregnancy and birthweight on the third generation: results from two birth cohort studies. Eur J Pediatr 2023; 182:2095-2104. [PMID: 36813908 DOI: 10.1007/s00431-023-04888-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
UNLABELLED The purpose of this research is to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight and whether maternal smoking during pregnancy modified this association. We also evaluated the effect of duration and intensity of smoking. This study included data from three generations from two birth cohorts carried out in Pelotas, a southern Brazilian city: women enrolled in the perinatal study in the 1982 and 1993 cohorts (G1); daughters (G2) of those G1 mothers who were followed to adulthood; and first children (G3) born from G2 women. Information on maternal smoking during pregnancy was obtained from women (G1) shortly after delivery of the two cohorts and from G2 in the follow-up in adulthood of the 1993 cohort. Mothers (G2) reported G3 birthweight during the follow-up visit at adulthood. Multiple linear regression was used to obtain effect measures adjusted for confounders. The study included 1602 grandmothers (G1), mothers (G2), and grandchildren (G3). Prevalence of maternal (G1) smoking during pregnancy was 43% and mean G3 birthweight was 3118.9 g (SD: 608.8). Grandmother's smoking in the pregnancy was not associated with grandchild's birthweight. However, offspring of both G1 and G2 smokers had lower mean birthweight than those whose mother and grandmother did not smoke (adjusted β: - 223.05; 95% CI: - 415.16, - 32.76). CONCLUSION No significant association was observed between grandmother's smoking in the pregnancy and grandchild's birthweight. But it seems that grandmother's smoking in pregnancy has an effect on grandchild's birthweight when the mother also smoked in the pregnancy. . WHAT IS KNOWN • Most studies on the association of maternal tobacco smoking in pregnancy with offspring birthweight have been restricted to two generations, and an inverse association is well known. WHAT IS NEW • Besides to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight, we examined whether this association varied according to maternal smoking during pregnancy.
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Affiliation(s)
- Elma Izze da Silva Magalhães
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Ana Maria Baptista Menezes
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Fernando C Wehrmeister
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Maria Cecília Formoso Assunção
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
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Menezes AMB, Wehrmeister FC, Sardinha LMV, de Paula PDCB, Costa TDA, Crespo PA, Hallal PC. Use of electronic cigarettes and hookah in Brazil: a new and emerging landscape. The Covitel study, 2022. J Bras Pneumol 2023; 49:e20220290. [PMID: 36753212 PMCID: PMC9970375 DOI: 10.36416/1806-3756/e20220290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/05/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of current commercial cigarette smoking, as well as those of e-cigarette and hookah experimentation and current use among adults (≥ 18 years of age) in Brazil. METHODS This study was based on a countrywide cross-sectional telephone-based survey conducted in 2022. The sample was designed to be representative of the five macroregions in Brazil and included 1,800 individuals from each of the regions. Telephone numbers, using a random digit dialing procedure, were proportionally selected for each direct distance dialing code in each region and then electronically validated (i.e., 900 cell and 900 landline phone numbers per region). Information on current commercial cigarette smoking (regardless of frequency/amount), as well as lifetime history of or current e-cigarette and hookah use (regardless of amount), were collected. RESULTS The prevalence of lifetime history of e-cigarette and hookah use was identical (7.3%; 95% CI: 6.0-8.9), whereas the prevalence of current commercial cigarette smoking was 12.2% (95% CI: 10.4-14.1). Young adults (18-24 years) had the highest prevalence of e-cigarette experimentation (19.7%; 95% CI: 15.1-17.0) and hookah experimentation (17%; 95% CI: 12.2-23.2). E-cigarette and hookah use was more common in the Central-West region and among those with a high level of education, whereas current commercial cigarette smoking was more common among those with a lower level of education. Individuals who used the three forms of nicotine delivery corresponded to 1.5% of the sample (nearly 2 million individuals based on the estimated size of the Brazilian adult population). CONCLUSIONS Surveillance is essential for the monitoring and prevention of these new forms of nicotine consumption.
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Bragança MLBM, Bogea EG, de Almeida Fonseca Viola PC, dos Santos Vaz J, Confortin SC, Menezes AMB, Gonçalves H, Bettiol H, Barbieri MA, Cardoso VC, da Silva AAM. High Consumption of Sugar-Sweetened Beverages Is Associated with Low Bone Mineral Density in Young People: The Brazilian Birth Cohort Consortium. Nutrients 2023; 15:324. [PMID: 36678194 PMCID: PMC9867470 DOI: 10.3390/nu15020324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18-23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm2), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1-16.7 times/day) was associated with a lower lumbar spine BMD (β = -0.009; 95% CI: -0.017; -0.001; standardized β = -0.03). This association persisted after adjustment for confounders (β = -0.008; 95% CI: -0.016; -0.001; standardized β = -0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.
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Affiliation(s)
| | - Eduarda Gomes Bogea
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Maranhão, Brazil
| | | | - Juliana dos Santos Vaz
- Postgraduate Programme in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas 96010-610, Rio Grande do Sul, Brazil
| | - Susana Cararo Confortin
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, Maranhão, Brazil
| | - Ana Maria Baptista Menezes
- Postgraduate Programme in Epidemiology, Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas 96020-220, Rio Grande do Sul, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, Pelotas 96020-220, Rio Grande do Sul, Brazil
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
| | - Marco Antonio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, São Paulo, Brazil
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Marques GÁ, de Oliveira PD, Montzel M, Menezes AMB, Malta DC, Sardinha LMV, Wehrmeister FC. Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013. Rev Saude Publica 2023; 56:119. [PMID: 36629710 PMCID: PMC9749731 DOI: 10.11606/s1518-8787.2022056004090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% - Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7-61.4) used medication, 4.7% (95%CI: 2.6-8.3) underwent physical therapy, and 6.0% (95%CI: 3.6-9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8-51.7) underwent drug treatment, 8.8% (95%CI: 5.4-14.2) physical therapy, and 10.0% (95%CI: 6.3-15.6) oxygen therapy. CONCLUSION The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy.
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Affiliation(s)
- Gabriela Ávila Marques
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Paula Duarte de Oliveira
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marina Montzel
- Universidade Federal de PelotasFaculdade de MedicinaDepartamento de Medicina SocialPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | | | - Fernando César Wehrmeister
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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Confortin SC, Santos IDS, Batista RFL, Eckeli AL, Tovo-Rodrigues L, Del-Ponte B, Menezes AMB, Wehrmeister FC, Gonçalves H, Cardoso VC, Barbieri MA, Bettiol H, Silva AAMD. Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium. Rev Bras Epidemiol 2023; 26:e230027. [PMID: 37162069 PMCID: PMC10168628 DOI: 10.1590/1980-549720230027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 03/03/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics. METHODS Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex. RESULTS Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes. CONCLUSION Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Graduate Program in Collective Health - São Luís (MA), Brazil
| | - Iná da Silva Santos
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Luciana Tovo-Rodrigues
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Bianca Del-Ponte
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | | | | | - Helen Gonçalves
- Universidade Federal de Pelotas, Graduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Viviane Cunha Cardoso
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Marco Antonio Barbieri
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto - Ribeirão Preto (SP), Brazil
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Flores TR, Wehrmeister FC, Gonçalves H, Menezes AMB. Pre-pregnancy weight excess and body mass index: Analysis of three generations Brazilian birth cohort. Clin Obes 2022; 12:e12547. [PMID: 36054462 DOI: 10.1111/cob.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022]
Abstract
To evaluate the relationship between the grandmother's maternal pre-pregnancy body mass index (BMI) (first generation-G1), the BMI of the female members of the birth cohort of Pelotas/RS, Brazil, 1993 (second generation-G2) and the children of the cohort members (third generation-G3). a longitudinal study using data from the 1993 Pelotas/RS cohort. The maternal pre-pregnancy BMI of the mothers of the members (first generation-G1) was self-reported, and of the participants in the cohort (second generation-G2) was collected using weight and height in follow-ups prior to 22 years of age. Children from the third generation (G3) were included in this last follow-up (22 years) and anthropometric measurements were collected. The outcome was BMI-for-age z-score obtained using weight and height measures collected in every follow-up. Linear regression was performed with adjustment for possible confounding factors. The cohort's original sample consists of 5249 participants and 855 children (their first children). At 12 and 48 months, the average increase in BMI-for-age z-score of children of women with pre-pregnancy weight excess was 0.11 and 0.47 kg/m2 , respectively, increasing to around 0.60 kg/m2 in adolescence, reaching an average increase of 2.71 kg/m2 in BMI at 22 years of age. The G2 pre-pregnancy weight excess was also associated with G3 BMI-for-age z-score [β = 0.43 kg/m2 (95% CI 0.21; 0.65)]. Maternal pre-pregnancy weight excess was associated with the child's BMI-for-age z-score, in both G2 and G3, suggesting a proximal relationship, with no association between G1 and G3.
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Affiliation(s)
- Thaynã Ramos Flores
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Martins RC, Gonçalves H, Blumenberg C, Könsgen B, Houvèssou GM, Carone C, Gil JD, Lautenschläger P, Wehrmeister FC, Menezes AMB, Murray J. School Performance and Young Adult Crime in a Brazilian Birth Cohort. J Dev Life Course Criminol 2022; 8:647-668. [PMID: 36632057 PMCID: PMC9825356 DOI: 10.1007/s40865-022-00214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Poor school performance may increase the risk of crime and violence via effects on self-esteem, risky behaviours, peer networks, and perceived stakes in society. Despite very high rates of violence in Latin America, no longitudinal research has addressed this issue in the region. Two aspects of educational performance (grade repetition and school completion) were examined during adolescence in a population-based Brazilian birth cohort study (n = 3584). Violent and non-violent crime were measured at age 22 years in confidential self-reports; sociodemographic, family, and individual confounders were measured between birth and age 11 years, and potential mediators were measured at age 18 years. The prevalence of violent and non-violent crimes at 22 years was 8.2% and 3.3%, respectively, referring to acts in the previous twelve months. For youth repeating school grades three times or more, the odds of violent crime were 2.4 (95%CI: 1.6-3.6) times higher than for those who had not repeated any school grade. Youth completing school had a lower risk for both violent (OR = 0.5; 95%CI: 0.4-0.7) and non-violent crime (OR = 0.3; 95%CI: 0.2-0.5), compared to those who did not finish school by the expected age. The protective effect of completing school was independent of the number of grades previously repeated. In conclusion, repeating school grades was associated with increased risk for crime; however, successfully managing to complete school by the expected age was an important protective factor against crime, even after multiple grade repetitions. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40865-022-00214-x.
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Affiliation(s)
- Rafaela Costa Martins
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Marechal Deodoro, 1160 – 3 floor, Centro, Pelotas, RS 96020-220 Brazil
| | - Helen Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Cauane Blumenberg
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Bruno Könsgen
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Gbènankpon M. Houvèssou
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Caroline Carone
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Jesus David Gil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Priscila Lautenschläger
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Fernando C. Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Ana Maria Baptista Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
| | - Joseph Murray
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 – 3rd floor, Marechal Deodoro, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Marechal Deodoro, 1160 – 3 floor, Centro, Pelotas, RS 96020-220 Brazil
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Confortin SC, Rocha PRH, Silva BGCD, Menezes AMB, Horta BL, Gonçalves H, Bettiol H, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Batista RFL, Cardoso VC, Silva ICMD, Silva AAMD. Physical activity in birth cohorts of three Brazilian cities (Ribeirão Preto, Pelotas, and São Luís): A cross-sectional study. Rev Bras Epidemiol 2022; 25:e220024. [PMID: 36074452 DOI: 10.1590/1980-549720220024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/19/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the prevalence of physical activity among subjects from birth cohorts of three cities located in different regions of Brazil according to sociodemographic characteristics and sex, comparing the relationships within and between cohorts. METHODS Cross-sectional study involving 12,724 adolescents and young adults who participated in five birth cohorts: Ribeirão Preto [1978/79 (37/39 years old in 2016) and 1994 (22 years in 2016)]; Pelotas [1982 (30 years in 2012) and 1993 (22 years in 2015)], and São Luís [1997/98 (18/19 years in 2016)]. Leisure-time physical activity was evaluated with questionnaires (insufficiently active: <150 min/week and active: ≥150 min/week) and moderate and vigorous physical activity (MVPA) was objectively measured by accelerometry. Those, in each city, were evaluated accordingly to skin color, socioeconomic classification, and study/work activities. RESULTS The prevalence of leisure-time physical activity ranged from 29.2% at 30 years old in Pelotas to 54.6% among adolescents from São Luís. The prevalence of leisure-time physical activity was higher among younger people (54.6% in São Luís 1997), while the same was not observed for total physical activity. MVPA (3rd tercile) was higher in the cohorts from Pelotas and São Luís. The prevalence of leisure-time physical activity and MVPA was higher in men. The data showed that the variation in physical activity was associated with sex and sociodemographic conditions in all cohorts. CONCLUSION Sociodemographic characteristics should be considered when promoting leisure-time physical activity and actions aimed at young people, and adults who are more socioeconomically vulnerable should be encouraged.
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Affiliation(s)
- Susana Cararo Confortin
- Universidade Federal do Maranhão, Collective Health Postgraduate Program - São Luís (MA), Brazil
| | | | | | | | - Bernardo Lessa Horta
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Helen Gonçalves
- Universidade Federal de Pelotas, Postgraduate Program in Epidemiology - Pelotas (RS), Brazil
| | - Heloisa Bettiol
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
| | | | | | | | | | - Viviane Cunha Cardoso
- Universidade de São Paulo, Ribeirão Preto Medical School - Ribeirão Preto (SP), Brazil
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Valério ID, Soares ALG, Menezes AMB, Wehrmeister FC, Gonçalves H. Child maltreatment and substances use throughout adolescence and adulthood: Data from a Brazilian Birth Cohort. Child Abuse Negl 2022; 131:105766. [PMID: 35763956 DOI: 10.1016/j.chiabu.2022.105766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment has been associated with substance use later in life, but few studies have used repeated measures. OBJECTIVE To assess the association between child maltreatment and use of psychoactive substances from adolescence to early adulthood, and whether this differs by sex. PARTICIPANTS AND SETTING 3641 participants from the 1993 Pelotas Birth Cohort, Brazil. METHODS Child maltreatment (psychological, physical and sexual abuse, and physical neglect) was assessed up to age 15 and use of psychoactive substances (smoking, harmful use of alcohol and use of illicit drugs) was assessed at ages 15, 18, and 22 years. Associations between child maltreatment and use of substances at each time point were analyzed using logistic regression, adjusted for confounders. RESULTS Overall, child maltreatment was associated with substance use, and the strength of the associations decreased over time. E.g., the association between psychological abuse and harmful use of alcohol was OR 2.17 (95%CI 1.80, 2.62; p-value < 0.001) at 15 years, OR 1.61 (95%CI 1.31, 1.97; p-value < 0.001) at 18 years, and OR1.55 (95%CI 1.22, 1.96; p-value < 0.001) at 22 years. When sex differences were evident, stronger associations were observed among females. E.g., the association between physical abuse and smoking at 15 years was OR 3.49 (95%CI 2.17, 5.62) in females and OR 0.87 (95%CI 0.30, 2.52) in males (p-value for sex interaction = 0.041). CONCLUSIONS Child maltreatment was associated with psychoactive substance in adolescence and early adulthood. Strategies to prevent use of substances could benefit those who suffered maltreatment in childhood.
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Affiliation(s)
- Inaê Dutra Valério
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil.
| | - Ana Luiza G Soares
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Ana Maria Baptista Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
| | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
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Soares PSM, de Oliveira PD, Wehrmeister FC, Menezes AMB, Horta BL, Gonçalves H. The influence of low family income from birth to adolescence and adulthood on intelligence: Findings from two Brazilian birth cohorts. Cognitive Development 2022. [DOI: 10.1016/j.cogdev.2022.101228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE This study examined the association between WM and ADHD symptoms in young adults and whether IQ-score influenced this association. METHOD Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N = 2,845). Working memory and ADHD symptoms were collected at 22 years. IQ was examined at age 18. Poisson regression with robust variance was used to assess the associations between working memory and ADHD symptoms. We also evaluated whether IQ modified associations between working memory and ADHD symptoms. RESULTS Working memory was negatively associated with Inattention symptoms of ADHD. The association between working memory and hyperactivity-impulsivity symptoms of ADHD varied by IQ. CONCLUSIONS This study provides new insights to theories about the relationship between WM and ADHD symptoms as well as the development of interventions aimed at improving the performance of WM in ADHD.
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Affiliation(s)
| | | | | | | | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Freire MDBO, Da Silva BGC, Bertoldi AD, Fontanella AT, Mengue SS, Ramos LR, Tavares NUL, Pizzol TDSD, Arrais PSD, Farias MR, Luiza VL, Oliveira MA, Menezes AMB. Benzodiazepines utilization in Brazilian older adults: a population-based study. Rev Saude Publica 2022; 56:10. [PMID: 35319670 PMCID: PMC8926397 DOI: 10.11606/s1518-8787.2022056003740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/04/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate the utilization of benzodiazepines (BZD) in Brazilian older adults, based on the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey of Access, Use and Promotion of Rational Use of Medicines). METHODS The PNAUM is a cross-sectional study conducted between 2013 and 2014, representing the Brazilian urban population. In the present study, we included 60 years or older (n = 9,019) individuals. We calculated the prevalence of BZD utilization in the 15 days prior to survey data collection according to independent variables, using a hierarchical Poisson regression model. A semistructured interview performed empirical data collection (household interview). RESULTS The prevalence of BZD utilization in the older adults was 9.3% (95%CI: 8.3–10.4). After adjustments, BZD utilization was associated with female sex (PR = 1.88; 95%CI: 1.52–2.32), depression (PR = 5.31; 95%CI: 4.41–6, 38), multimorbidity (PR = 1.44; 95%CI: 1.20–1.73), emergency room visit or hospitalization in the last 12 months (PR = 1.42; 95%CI: 1.18–1.70 ), polypharmacy (PR = 1.26; 95%CI: 1.01–1.57) and poor or very poor self-rated health (PR = 4.16; 95%CI: 2.10–8.22). Utilization was lower in the North region (PR = 0.18; 95%CI: 0.13–0.27) and in individuals who reported abusive alcohol consumption in the last month (PR = 0.42; 95%CI: 0.19–0.94). CONCLUSION Despite contraindications, results showed a high prevalence of BZD utilization in older adults, particularly in those with depression, and wide regional and sex differences.
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Affiliation(s)
- Marina de Borba Oliveira Freire
- Universidade Federal de Pelotas . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Pelotas , RS , Brasil
| | | | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas . Faculdade de Medicina . Departamento de Medicina Social . Pelotas , RS , Brasil
| | - Andréia Turmina Fontanella
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegre , RS , Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul . Faculdade de Medicina . Programa de Pós-Graduação em Epidemiologia . Porto Alegre , RS , Brasil
| | - Luiz Roberto Ramos
- Universidade Federal de São Paulo . Escola Paulista de Medicina . Departamento de Medicina Preventiva . São Paulo , SP , Brasil
| | - Noemia Urruth Leão Tavares
- Universidade de Brasília . Faculdade de Ciências da Saúde . Departamento de Farmácia . Brasília , DF , Brasil
| | - Tatiane da Silva Dal Pizzol
- Universidade Federal do Rio Grande do Sul . Faculdade de Farmácia . Departamento de Produção e Controle de Medicamentos . Porto Alegre , RS , Brasil
| | - Paulo Sérgio Dourado Arrais
- Universidade Federal do Ceará . Faculdade de Farmácia, Odontologia e Enfermagem . Departamento de Farmácia . Fortaleza , CE , Brasil
| | - Mareni Rocha Farias
- Universidade Federal de Santa Catarina . Centro de Ciências da Saúde . Departamento de Ciências Farmacêuticas . Florianópolis , SC , Brasil
| | - Vera Lucia Luiza
- Fundação Oswaldo Cruz . Escola Nacional de Saúde Pública Sergio Arouca . Departamento de Política de Medicamentos e Assistência Farmacêutica . Rio de Janeiro , RJ , Brasil
| | - Maria Auxiliadora Oliveira
- Fundação Oswaldo Cruz . Escola Nacional de Saúde Pública Sergio Arouca . Departamento de Política de Medicamentos e Assistência Farmacêutica . Rio de Janeiro , RJ , Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de Pelotas . Faculdade de Medicina . Departamento de Medicina Social . Pelotas , RS , Brasil
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Martins-Silva T, Dos Santos Vaz J, Schäfer JL, Salum GA, Carpena MX, Vitola ES, Breda V, Grevet EH, de Mola CL, Barros F, Menezes AMB, Gonçalves H, Wehrmeister FC, Rohde LA, Tovo-Rodrigues L. ADHD in childhood predicts BMI and body composition measurements over time in a population-based birth cohort. Int J Obes (Lond) 2022; 46:1204-1211. [PMID: 35236922 DOI: 10.1038/s41366-022-01098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/31/2021] [Accepted: 02/09/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Obesity has been reported as an attention-deficit hyperactivity disorder (ADHD) comorbidity. So far, few studies have aimed to explore the potential causal relationship between ADHD and obesity, as well as used other measures of body composition like fat-free mass (FFM) and fat mass (FM) as measures of obesity. This study aimed to test the association between ADHD and body composition (body mass index [BMI] and others) and to evaluate the potential causal relationship with obesity. SUBJECTS/METHODS Data from the 1993 Pelotas (Brazil) birth cohort at age 11-, 15-, 18-, and 22-year follow-up was used. We performed a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI to explore the causal relationship between both traits. Finally, we tested whether ADHD, inattention, and hyperactivity symptom scales were associated with BMI, FM, and FFM at 22 years. RESULTS In the CLPM, higher ADHD scores at age 11 predicted higher BMI at age 15 (β = 0.055, 95% CI [0.037; 0.073]). ADHD symptoms at age 11 was also associated with a decrease in the FFM (β = -0.16, 95% CI [-0.28; -0.05]), and an increase in the BMI (β = 0.17, 95% CI [0.10; 0.23]) and FM (β = 0.17, 95% CI [0.06; 0.29]) at 22 years. At 22 years of age, ADHD was associated with FFM and FM. Moreover, an increase in BMI was observed with an increase in several symptoms of ADHD in general (β = 0.06, 95% CI [0.004; 0.12]), and hyperactivity symptoms (β = 0.15, 95% CI [0.05; 0.25]). CONCLUSION ADHD at 11 years predicted a higher BMI at 15 years, and body fat composition in adulthood, suggesting higher scores on ADHD symptoms in early life may be a critical point for body composition in early adulthood. The hyperactivity symptoms may play an important role in the BMI increase.
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Affiliation(s)
- Thais Martins-Silva
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.
| | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculty of Nutrition, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Julia Luiza Schäfer
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Eduardo Schneider Vitola
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vitor Breda
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eugênio Horacio Grevet
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christian Loret de Mola
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.,Postgraduate Program in Public Health, Universidade Federal de Rio Grande, Rio Grande, Brazil.,Universidad Cientifica del Sur, Lima, Peru.,Grupo de Pesquisa e Inovação em Saúde (GPIS), Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.,Post-graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Corrêa ML, da Silva BGC, Wehrmeister FC, Horta BL, Gonçalves H, Anselmi L, Barros F, Menezes AMB. Maternal smoking during pregnancy and intelligence quotient of offspring aged 18 and 30 years: Evidence from two birth cohorts in southern Brazil. Prev Med 2022; 156:106983. [PMID: 35150754 DOI: 10.1016/j.ypmed.2022.106983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 01/07/2022] [Accepted: 02/06/2022] [Indexed: 11/25/2022]
Abstract
Maternal smoking during pregnancy causes several harmful effects, including deficits in the intelligence quotient (IQ), a measure associated with academic achievements and higher socioeconomic position. We aimed to measure the association between maternal smoking during pregnancy and offspring's IQ in two birth cohorts from Pelotas, Brazil. Data from the 1982 and 1993 birth cohorts were analyzed. Smoking during pregnancy was ascertained at the perinatal follow-up, and IQ was measured at 30 years (1982) and 18 years (1993). Simple and multiple linear regressions were used for crude and adjusted analysis. Mediation analysis was performed using birth weight and breastfeeding as possible mediators. Data analysis was conducted in 2020. There were 3611 and 4050 participants from the 1982 and 1993 cohorts, respectively. After adjustment for potential confounders, the inverse association between smoking during pregnancy and children's IQ remained significant in both cohorts. Offspring of mothers who smoked during pregnancy had an average of 1.32 less IQ points (95%CI: -2.23, -0.242) in the 1982 cohort, and an average of 1.66 less IQ points (95%CI: -2.42, -0.90) in the 1993 cohort. Neither cohort showed association with paternal smoking (negative controls) after adjustment. Breastfeeding's mediated effects accounted for 26.2% and 23.9% of the association in the 1982 and 1993 cohorts, respectively, while birth weight's accounted for 6.8% and 30.1%, respectively; indirect effects were not significant. The inverse association between maternal smoking and IQ and the lack of association with paternal smoking reinforces our findings of a negative association between exposure and outcome.
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Affiliation(s)
- Mariana Lima Corrêa
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil; Centro de Epidemiologia Ufpel Dr. Amilcar Gigante, R. Mal. Deodoro, 1160 - Centro, Pelotas, Brazil.
| | | | | | - Bernardo L Horta
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil
| | - Luciana Anselmi
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil
| | - Fernando Barros
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil
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Soares PSM, de Oliveira PD, Wehrmeister FC, Menezes AMB, Gonçalves H. Is Screen Time Throughout Adolescence Related to ADHD? Findings from 1993 Pelotas (Brazil) Birth Cohort Study. J Atten Disord 2022; 26:331-339. [PMID: 33666095 DOI: 10.1177/1087054721997555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated the association between screen time in adolescence and Attention Deficit Disorder (ADHD) at 22 years old. METHOD A sample of 2333 participants aged 11 years old without ADHD from the 1993 Pelotas Birth Cohort Study (Brazil) was followed up until the age of 22. Screen time variables included time spent in television, video game and computer at 11, 15, and 18 years old. ADHD was assessed at 22 years. RESULTS ADHD symptoms at 22 years was positively associated with television time at 11 years, computer time at 18 years and total screen time at ages 11, 15, and 18 years. Television time at 11 years and total screen time at 18 years were associated with diagnosis of ADHD at 22 years of age. CONCLUSIONS Our findings may contribute to future investigations of possible explanatory avenues for these associations.
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Menezes AMB, Flores TR, Pereira AM, Berrutti B, Marques GÁ, Luquez KYS, Brum LW, Echeverry LFA, Freire MDBO, Weisshahn NK, Albuquerque PVCD, Borges RDC, Oliveira RR, Santos TM, Wehrmeister FC. Atraso na vacina tetravalente (DTP+Hib) em crianças de 12 a 23 meses de idade: Pesquisa Nacional de Saúde, 2013. CAD SAUDE PUBLICA 2022; 38:e00063821. [DOI: 10.1590/0102-311x00063821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo: O objetivo foi estimar a prevalência do atraso nas três doses da vacina tetravalente (DTP+Hib) em crianças de 12 a 23 meses de idade, no Brasil, por meio dos dados da Pesquisa Nacional de Saúde (PNS) de 2013 e descrever o atraso em cada uma das doses segundo variáveis sociodemográficas, utilização de serviços e intervenções públicas de saúde. Foram utilizados dados da PNS, estudo transversal realizado em 2013. O desfecho foi o atraso pelo menos em uma das três doses da vacina tetravalente. Considerou-se como atraso a dose recebida pelo menos 30 dias após a data preconizada, segundo informação da caderneta de vacinação. A prevalência do atraso foi descrita segundo variáveis sociodemográficas e utilização de serviços de saúde. Realizou-se análise descritiva obtendo-se frequências absolutas e relativas e seus respectivos intervalos de 95% de confiança. Das 2.016 crianças com informações coletadas, 1.843 foram analisadas. A prevalência de atraso de pelo menos uma dose da vacina foi de 44%. Observou-se atraso de 14,8% na primeira, 28,8% na segunda e 45,4% na terceira dose, sendo que 10% das crianças tiveram atraso nas três doses. Maiores prevalências de atraso foram encontradas em crianças do sexo masculino, de cor da pele parda, pertencentes ao quintil mais pobre de riqueza, moradores da zona rural e da Região Norte do Brasil. Evidenciou-se alta prevalência de atraso na vacina tetravalente (DTP+Hib) em crianças de 12 a 23 meses do Brasil, sendo maior na terceira dose.
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Cislaghi B, Weber AM, Shakya HB, Abdalla S, Bhatia A, Domingue BW, Mejía-Guevara I, Stark L, Seff I, Richter LM, Baptista Menezes AM, Victora CG, Darmstadt GL. Innovative methods to analyse the impact of gender norms on adolescent health using global health survey data. Soc Sci Med 2021; 293:114652. [PMID: 34915243 PMCID: PMC8819155 DOI: 10.1016/j.socscimed.2021.114652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 12/05/2022]
Abstract
Background Understanding how gender norms affect health is an important entry point into designing programs and policies to change norms and improve gender equality and health. However, it is rare for global health datasets to include questions on gender norms, especially questions that go beyond measuring gender-related attitudes, thus limiting gender analysis. Methods We developed five case studies using health survey data from six countries to demonstrate approaches to defining and operationalising proxy measures and analytic approaches to investigating how gender norms can affect health. Key findings, strengths and limitations of our norms proxies and methodological choices are summarised. Findings Case studies revealed links between gender norms and multiple adolescent health outcomes. Proxys for norms were derived from data on attitudes, beliefs, and behaviours, as well as differences between attitudes and behaviours. Data were cross-sectional, longitudinal, census- and social network-based. Analytic methods were diverse. We found that gender norms affect: 1) Intimate partner violence in Nigeria; 2) Unhealthy weight control behaviours in Brazil and South Africa; 3) HIV status in Zambia; 4) Health and social mobility in the US; and 5) Childbirth in Honduras. Interpretation Researchers can use existing global health survey data to examine pathways through which gender norms affect health by generating proxies for gender norms. While direct measures of gender norms can greatly improve the understanding of how gender affects health, proxy measures for norms can be designed for the specific health-related outcome and normative context, for instance by either aggregating behaviours or attitudes or quantifying the difference (dissonance) between them. These norm proxies enable evaluations of the influence of gender norms on health and insights into possible reference groups and sanctions for non-compliers, thus informing programmes and policies to shape norms and improve health. This article presents effective methods to study gender norms in existing global health survey data. We devised conceptual pathways linking gender norms to gender-based health disparities. We identified gender norms proxies and reference groups enforcing the norm. We tested hypotheses linking gender norms to health. These methods can aid policy and programme design to advance gender equality and health.
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Affiliation(s)
- Beniamino Cislaghi
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, London, UK
| | - Ann M Weber
- School of Public Health, University of Nevada, Reno, NV, USA
| | - Holly B Shakya
- Department of Medicine, Center on Gender Equity and Health, University of California, San Diego, La Jolla, CA, USA
| | - Safa Abdalla
- Global Center for Gender Equality, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Amiya Bhatia
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, London, UK
| | | | - Iván Mejía-Guevara
- Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA; Stanford Aging and Ethnogeriatrics (SAGE) Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Lindsay Stark
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Ilana Seff
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Linda M Richter
- Centre of Excellence in Human Development, University of Witwatersrand, Durban, South Africa
| | - Ana Maria Baptista Menezes
- International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande de Sul, Brazil
| | - Cesar G Victora
- International Center for Equity in Health, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande de Sul, Brazil
| | - Gary L Darmstadt
- Global Center for Gender Equality, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Mesenburg MA, Hallal PC, Menezes AMB, Barros AJD, Horta BL, Hartwig FP, Jacques N, Pellanda LC, Zelmanowicz ADM, Vergani DOP, Ries EF, Harter J, Martínez-Mesa J, Carneiro M, Estima SL, Heck TG, Silveira MFD. Prevalence of symptoms of COVID-19 in the state of Rio Grande do Sul: results of a population-based study with 18,000 participants. Rev Saude Publica 2021; 55:82. [PMID: 34816983 PMCID: PMC8601401 DOI: 10.11606/s1518-8787.2021055004030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2. METHODS The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated. RESULTS A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies. CONCLUSION The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests.
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Affiliation(s)
- Marilia Arndt Mesenburg
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.,Universidade Federal de Ciências da Saúde de Porto Alegre. Departamento de Saúde Coletiva. Porto Alegre, RS, Brasil
| | - Pedro Curi Hallal
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Aluísio J D Barros
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Fernando Pires Hartwig
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Nadege Jacques
- Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Lucia Campos Pellanda
- Universidade Federal de Ciências da Saúde de Porto Alegre. Departamento de Saúde Coletiva. Porto Alegre, RS, Brasil
| | | | | | - Edi Franciele Ries
- Universidade Federal de Santa Maria. Centro de Ciências da Saúde. Departamento de Saúde Coletiva. Santa Maria, RS, Brasil
| | - Jenifer Harter
- Universidade Federal do Pampa. Unidade Uruguaiana. Curso de Enfermagem. Uruguaiana, RS, Brasil
| | - Jeovany Martínez-Mesa
- Faculdade IMED Passo Fundo. Escola de Medicina. Programa de Pós-Graduação em Psicologia. Passo Fundo, RS, Brasil
| | - Marcelo Carneiro
- Universidade de Santa Cruz do Sul. Curso de Medicina. Programa de Pós-Graduação Promoção da Saúde. Santa Cruz, RS, Brasil
| | | | - Thiago Gomes Heck
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul. Programa de Pós-Graduação em Atenção Integral à Saúde. Ijuí, RS, Brasil.,Universidade Regional do Noroeste do Estado do Rio Grande do Sul. Programa de Pós-Graduação em Modelagem Matemática e Computacional. Ijuí, RS, Brasil
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Fernandes MP, Lima NP, Barros FC, Gonçalves H, Menezes AMB, Wehrmeister FC, Hartwig FP, Horta BL. Association between cesarean section and human capital in adulthood: 1982 and 1993 Pelotas birth cohorts, Rio Grande do Sul State, Brazil. CAD SAUDE PUBLICA 2021; 37:e00235520. [PMID: 34586169 DOI: 10.1590/0102-311x00235520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess the association between mode of delivery and human capital among young adults enrolled in the 1982 and 1993 Pelotas birth cohorts, Rio Grande do Sul State, Brasil. In 1982 and 1993, the maternity hospitals of the municipality were daily visited, the births identified, and those live births, whose family lived in the urban area of Pelotas, were examined and their mothers interviewed. Information on mode of delivery, vaginal or cesarean, was provided by the mother in the perinatal study. Performance in intelligence tests achieved schooling and income were evaluated in the 30 years visit at the 1982 cohort. At the 1993 cohort, schooling and income were assessed at the 22 years visit, whereas IQ was evaluated at 18 years. Tobacco smoking in adulthood and type of school was used as negative outcomes to strength causal inference. Initially, cesarean section was positively associated with human capital at adulthood, with the exception of income in the 1993 cohort. After controlling for confounders, the magnitude of the associations was strongly reduced, and the regression coefficients were close to the null value. The negative outcome analysis showed that, after controlling for confounding variables, the mode of delivery was not associated with tobacco smoking and type of school. Suggesting that the variables included in the regression model to control for confounding, provided an adequate adjustment and it is unlikely that the results are due to residual confounding by socioeconomic status. On the other hand, considering the short- and long-term risks and the epidemic of cesarean sections, measures should be implemented to reduce its prevalence.
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Kramer Fiala Machado A, Wendt A, Baptista Menezes AM, Barros FC, Gonçalves H, Wehrmeister FC. Associations between sleep duration trajectories from adolescence to early adulthood and working memory, schooling and income: a prospective birth cohort study from Brazil. Sleep Med 2021; 86:40-47. [PMID: 34461596 DOI: 10.1016/j.sleep.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/15/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the relationship between sleep duration trajectories from adolescence to early adulthood and working memory, schooling and income at 22 years in the Pelotas 1993 Birth Cohort. METHODS Sleep duration was self-reported at ages 11, 18 and 22. Sleep trajectories were identified using finite mixture models. Schooling was recorded as the number of completed years of education. Working memory was evaluated using The Digit Span test and income was recorded for who reported have a job and received a payment for this in the previous month. All analyses were stratified by sex. RESULTS We used crude and adjusted (for demographic, health and behavior characteristics measured at perinatal and 11-years) linear or quantile regression analyses. A total of 2915 individuals were included. Three trajectories for males were used: "increase and maintenance" (3.4%), "fast reduction and maintenance" (45.0%) and "constant reduction" (51.6%). For females, we used the trajectories: "increase and decrease" (2.4%), "fast reduction and maintenance" (25.6%) and "constant reduction" (72.0%). Males from "increase and maintenance" and females from "increase and decrease" trajectories scored, on average, 1.6 and 1.8 points lower, respectively, in working memory test. They presented a median of 1.4 and 2.6 fewer schooling years, respectively, compared to individuals from the "fast reduction and maintenance" trajectory. Regarding income, no significant association was observed. CONCLUSION Sleep duration during adolescence could affect cognitive and educational outcomes in early adulthood. Individuals who presented the expected sleep trajectory (decrease of sleep duration across adolescence) presented better outcomes.
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Affiliation(s)
| | - Andrea Wendt
- Post Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Fernando C Barros
- Post Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Post Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Menezes AMB, Hallal PC, Silveira MF, Wehrmeister FC, Horta BL, Barros AJDD, Hartwig FP, Oliveira PD, Vidaletti LP, Mesenburg MA, Jacques N, Barros FC, Victora CG. Influenza vaccination in older adults during the COVID-19 pandemic: a population-based study in 133 Brazilian cities. Cien Saude Colet 2021; 26:2937-2947. [PMID: 34378687 DOI: 10.1590/1413-81232021268.09382021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022] Open
Abstract
Routine immunization during pandemics can be harmed. This study estimated the influenza vaccination coverage in older adults during the COVID-19 through the EPICOVID-19, a population-based study conducted in 133 cities from the 26 Brazilian states and Federal District. We selected 25 census tracts per city, with probability proportional to the tract's size, ten households by census tract, and one random individual interviewed. A total of 8,265 older adults (≥60 years old) were interviewed and asked whether they had been vaccinated against flu in 2020. Vaccination coverage was 82.3% (95% CI: 80.1-84.2) with no difference by gender, age, and region; higher vaccination coverage was observed among the wealthiest (84.7% versus 80.1% in the poorest) and among the more educated (87.3% versus 83.2% less educated); lower coverage among indigenous (56.9% versus > 80% among other ethnic groups). A positive association was identified with the number of comorbidities among men but not among women. Most of the population was vaccinated (97.5%) in the public health system. The private network was chosen mainly in the South by the wealthiest and more educated. Vaccination coverage was seven percentage points lower than the government target (90%), and inequalities should be reversed in future campaigns.
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Affiliation(s)
- Ana Maria Baptista Menezes
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Pedro Curi Hallal
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Fernando César Wehrmeister
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Fernando Pires Hartwig
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Paula Duarte Oliveira
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Luís Paulo Vidaletti
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Nadege Jacques
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Cesar Gomes Victora
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
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Tissot JDCM, Silva BGCD, Menezes AMB. [Validation study on self-reported visual impairment among undergraduate students at the Federal University of Pelotas]. Cien Saude Colet 2021; 26:1977-1986. [PMID: 34076137 DOI: 10.1590/1413-81232021265.11352019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/26/2019] [Indexed: 11/22/2022] Open
Abstract
The objectives of the study were to assess the prevalence of self-reported visual impairment among undergraduate students between 18 and 39 years of age at the Federal University of Pelotas, and to validate a question about visual impairment in a subsample of the participants. A cross-sectional study was conducted by asking the question "Do you have any difficulty seeing up close and/or in the distance?" As the gold standard for the validation study, visual acuity (VA) was measured using the Snellen chart. Patients with VA less than 20/40 in either eye were considered to have reduced VA. The prevalence of self-reported visual impairment was 37.3% (95% CI: 35.1-39.6) and VA less than 20/40 in either eye was 6.9% (95% CI: 5.3-8.9). The question revealed sensitivity of 71.4% (95 CI: 57.8-82.7), specificity of 66.9% (95% CI: 63.4-70.2), positive predictive value of 13.8% (95% CI: 10.0-18.3), and negative predictive value of 96.9% (95% CI: 95,1-98.2). The results indicated a high prevalence of self-reported visual impairment among university students. The question showed reasonable sensitivity and specificity and high negative predictive value and may be used for screening for ophthalmological evaluation among young adult university students.
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Affiliation(s)
- Juliana das Chagas Meroni Tissot
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Prof. Dr. Araújo 538, Centro. 96020-360 Pelotas RS Brasil.
| | - Bruna Gonçalves Cordeiro da Silva
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Prof. Dr. Araújo 538, Centro. 96020-360 Pelotas RS Brasil.
| | - Ana Maria Baptista Menezes
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Prof. Dr. Araújo 538, Centro. 96020-360 Pelotas RS Brasil.
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Mesenburg MA, Hallal PC, Menezes AMB, Barros AJD, Horta BL, de Barros FC, Hartwig FP, Jacques N, da Silveira MF. Chronic non-communicable diseases and COVID-19: EPICOVID-19 Brazil results. Rev Saude Publica 2021; 55:38. [PMID: 34105606 PMCID: PMC8139841 DOI: 10.11606/s1518-8787.2021055003673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Describing the prevalence of chronic diseases and associated socioeconomic and demographic factors, evaluating the patterns of social distancing and the antibodies prevalence against SARS-CoV-2 and COVID-19 symptoms in carriers and non-carriers of chronic diseases. METHODS Data from 77,075 individuals aged 20 to 59 from three steps of the EPICOVID-19 Brazil (a nationwide serological survey conducted between May and June, 2021) were assessed. The presence of antibodies against SARS-CoV-2 was examined by rapid tests. Self-reported prevalence of hypertension, diabetes, asthma, cancer, chronic kidney disease and heart disease were investigated. The prevalence of mask use, adherence to isolation measures and antibodies were evaluated separately amid carriers and non-carriers of chronic diseases. The prevalence of symptoms was analyzed among carriers and non-carriers of chronic diseases with antibodies. RESULTS The prevalence of at least one chronic disease was 43%, higher in the Southeast region, among white and indigenous individuals, women, less schooled and in lower socioeconomic position. The use of masks when leaving home was similar among carriers and non-carriers of chronic diseases (98%). The proportion of participants who reported adherence to isolation measures was higher amid carriers (15.9%) than non-carriers (24.9%) of chronic diseases. The prevalence of antibodies to SARS-CoV-2 was similar amongst carriers and non-carriers (2.4% and 2.3%). The prevalence of cough, dyspnea, palpitations and myalgia was significantly higher among carriers, but the proportion of symptomatic patients was similar between groups. CONCLUSION The prevalence of chronic diseases in Brazil is high and the COVID-19 pandemic affects carriers and non-carriers of chronic diseases similarly. Carriers present more severe forms of COVID-19 and higher prevalence of symptoms. Greater adherence to social distancing measures among chronic patients is disassociated from a lower incidence of COVID-19 in this group.
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Affiliation(s)
- Marilia Arndt Mesenburg
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
- Universidade Federal de Ciências da Saúde de Porto AlegreDepartamento de Saúde ColetivaPorto AlegreRSBrasilUniversidade Federal de Ciências da Saúde de Porto Alegre. Departamento de Saúde Coletiva. Porto Alegre, RS, Brasil.
| | - Pedro Curi Hallal
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Ana Maria Baptista Menezes
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Aluísio J D Barros
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Bernardo Lessa Horta
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Fernando Celso de Barros
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Fernando Pires Hartwig
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Nadège Jacques
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
| | - Mariangela Freitas da Silveira
- Universidade Federal de PelotasPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniversidade Federal de Pelotas. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
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Blumenberg C, Wehrmeister FC, Barros FC, Flesch BD, Guimarães F, Valério I, Ferreira LZ, Echeverria M, Karam SA, Gonçalves H, Menezes AMB. Association of the length of time using computers and mobile devices with low back, neck and mid-back pains: findings from a birth cohort. Public Health 2021; 195:1-6. [PMID: 34022663 DOI: 10.1016/j.puhe.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/03/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Neck and low back pains are the leading causes of years lived with disability, and using computers or mobile devices in excess could be risk factors for back pain. Our aim was to evaluate the association of the length of time using computers and mobile devices with neck, mid-back and low back pains and the number of regions with pain. STUDY DESIGN Cross-sectional study nested in the 1993 Pelotas birth cohort with young adults aged 22 years. METHODS Outcomes analyzed were neck, mid-back and low back pains and the number of regions with pain. Exposures were the number of daily hours using computers and mobile devices. Crude and adjusted analyses were performed to estimate prevalence ratios using Poisson regression. RESULTS Almost half of the sample reported having back pain, the low back pain being the most prevalent. Compared with individuals using mobile devices for less than one hour, the prevalence of neck pain was 1.41 and 1.81 times higher among individuals using mobile devices from three to seven hours and for seven or more hours per day, respectively. Neck pain prevalence was 1.47 times higher among individuals using computers for more than two hours than among those not using computers. Using mobile devices for seven hours or more was associated to 1.19 times higher prevalence of low back pain. CONCLUSION Using mobile devices in excess was associated to neck and low back pains, while the use of computers in excess was associated only to neck pain. It is important that guidelines are developed to recommend the adequate length of time that computers and mobile devices should be used to prevent back pain.
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Affiliation(s)
- C Blumenberg
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil.
| | - F C Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - F C Barros
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil
| | - B D Flesch
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - F Guimarães
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - I Valério
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - L Z Ferreira
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - M Echeverria
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - S A Karam
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - H Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - A M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Brazil
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Corrêa ML, Soares PSM, da Silva BGC, Wehrmeister F, Horta BL, Menezes AMB. Maternal smoking during pregnancy and intelligence quotient in offspring: A systematic review and meta-analysis. Neurotoxicology 2021; 85:99-114. [PMID: 34004235 DOI: 10.1016/j.neuro.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Exposure to tobacco during pregnancy may disrupt fetal brain development and impact offspring cognitive development. AIMS To perform a systematic review and meta-analysis on maternal smoking during pregnancy and intelligence quotient (IQ) in childhood, adolescence, and adulthood. METHODS We searched PubMed, Lilacs, PsycINFO, and Web of Science. Original articles evaluating tobacco use/exposure during pregnancy and the offspring's IQ as the outcome. The review protocol is registered in PROSPERO (number CRD 42,019,116,257). For the meta-analysis, we included studies with information on the regression coefficient and its confidence interval (CI) or standard error. Random effects model was used for pooling the estimates. RESULTS 25 studies were included in the review, and of these 14 met the inclusion criteria for the meta-analysis. The overall pooled estimate showed that subjects who were exposed to maternal smoking during pregnancy presented lower IQ scores, compared to those not exposed to maternal smoking (β -1.30; 95 % CI -1.74, -0.86; I2 = 87.8 %); IQ scores were also lower in crude (β -5.46; 95 % CI -7.31, -3.60; I²: 79.0 %) and adjusted pooled estimates (β =-0.45; 95 % CI -0.76, -0.13; I2 = 80.4 %), for the group exposed to maternal smoking. In the stratified analysis, an inverse association was also observed in studies with large sample size (n≥1000 participants) (β=-0.49; 95 % CI -0.96, -0.02), among those performed with adolescents (β=-1.16; 95 % CI -2.18, -0.14), and among those adjusted for maternal education (β=-0.57; 95 % CI -1.05, -0.08). CONCLUSIONS Our findings suggest that exposure to tobacco during pregnancy may have negative effects on IQ. However, the findings of this meta-analysis should be interpreted with caution.
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Affiliation(s)
- Mariana Lima Corrêa
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Brazil; Centro de Epidemiologia Ufpel Dr. Amilcar Gigante, R. Mal. Deodoro, 1160, Centro, Pelotas, Brazil.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Oliveira RS, Schneider BC, Callo-Quinte G, Oliveira IO, Gonçalves H, Wehrmeister FC, Menezes AMB. Prevalence of ideal cardiovascular health in young adults: A birth cohort from southern Brazil. Am Heart J 2021; 235:65-73. [PMID: 33508220 DOI: 10.1016/j.ahj.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/21/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Ideal cardiovascular health (ICH) aims at primordial prevention of cardiovascular diseases in the population. However, there is a lack of research describing ICH in youth from middle-income countries. The aims of this study were to describe the prevalence of ICH at 18- and 22-year-old and to investigate the influence of socioeconomic status. METHODS The sample consisted of participants from the Pelotas 1993 birth-cohort followed-up at 18- (n = 4,106) and 22-year-old (n = 3,810). Ideal metrics were created for diet, smoking, body mass index, physical activity, blood pressure, total cholesterol, and blood glucose. The presence of 4 or more ideal metrics was defined as ICH. Socioeconomic status was obtained using wealth quintiles calculated with factor analysis based on analysis based on the ownership of household and education. The impact of socioeconomic status on ICH metrics was statistically measured using the slope index of inequality. RESULTS The prevalence of ICH was 84.5% (95% confidence interval [CI] = 82.7-86.2%) and 84.1% (82.3-85.8%) at 18-year-old and decreased to 61.1% (58.4-63.7%) and 68.7% (66.2-71.2%) at 22-years old, for male and female, respectively. Socioeconomic status influenced ICH and its components differently in males and females. Wealthiest females had ICH prevalence 19 percentage points (pp) (11-27 pp) higher compared to the poorest, whereas poorest males had ICH prevalence 12 pp (1-21 pp) higher compared to the wealthiest. Longitudinal decreases in ICH components were mostly present in the poorest females. CONCLUSIONS In middle-income countries, the prevalence of ICH is high at 18-year-old and decreases in a 4-year follow-up. Socioeconomic status influences differently individuals' ICH between sexes. Efforts are needed to maintain ICH in youth and different strategies may be required between the social status.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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Breda V, Rohde LA, Menezes AMB, Anselmi L, Caye A, Rovaris DL, Vitola ES, Bau CHD, Grevet EH. The neurodevelopmental nature of attention-deficit hyperactivity disorder in adults. Br J Psychiatry 2021; 218:43-50. [PMID: 33263274 DOI: 10.1192/bjp.2020.200] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Population studies have suggested that most adults with attention-deficit hyperactivity disorder (ADHD) did not have the disorder in childhood, challenging the neurodevelopmental conceptualisation of ADHD. Arbitrary definitions of age at onset and lack of defined trajectories were accounted for the findings. AIMS The objective of this study was to assess the proportion of individuals presenting with either a neurodevelopmental trajectory or late-onset disorder, and to assess risk factors associated with them. METHOD Data of 4676 individuals from the 1993 Pelotas birth cohort at 11, 15, 18 and 22 years of age were used. Polythetic and latent class mixed model analyses were performed to define ADHD trajectories from childhood to adulthood, and characterise the neurodevelopmental or late-onset courses. Regression models were applied to assess factors associated with different trajectories. RESULTS Classical polythetic analyses showed that 67% of those with ADHD at 22 years of age had a neurodevelopmental course of the disorder. Latent class mixed model analysis indicated that 78% of adults with ADHD had a trajectory of persistent symptoms, more common in males. The remaining adults with ADHD had an ascending symptom trajectory that occurred after puberty, with late-onset ADHD associated with female gender and higher IQ. CONCLUSIONS Both polythetic and latent trajectories analyses provided empirical evidence supporting that the large majority of adults with ADHD had a neurodevelopmental disorder.
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Affiliation(s)
- Vitor Breda
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre; and Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul; and National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
| | | | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil
| | - Arthur Caye
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil
| | - Diego Luiz Rovaris
- Department of Physiology and Biophysics, Instituto de Ciências Biomédicas, Universidade de São Paulo, Brazil
| | - Eduardo Schneider Vitola
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre; and Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil
| | - Claiton Henrique Dotto Bau
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre; and Department of Genetics, Universidade Federal do Rio Grande do Sul, Brazil
| | - Eugenio Horacio Grevet
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre; and Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil
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Menezes AMB, Schneider BC, Oliveira VP, Prieto FB, Silva DLR, Lerm BR, da Costa TB, Bouilly R, Wehrmeister FC, Gonçalves H, Assunção MCF. Longitudinal Association Between Diet Quality and Asthma Symptoms in Early Adult Life in a Brazilian Birth Cohort. J Asthma Allergy 2020; 13:493-503. [PMID: 33116657 PMCID: PMC7569030 DOI: 10.2147/jaa.s261441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
Background The role of diet in the etiology of asthma is still inconclusive. This paper evaluated the longitudinal association between diet quality and chest wheezing in young adults. Methods This is a longitudinal study with follow-up information from 18- and 22-year-olds (18y and 22y) of the 1993 Pelotas (Brazil) Birth Cohort. Chest wheezing occurrence and number of events in the last year were reported at 22y. Diet quality was measured with a revised version of the Healthy Eating Index (IQD-R) for the Brazilian population at 18y and 22y by food frequency questionnaire referring to the last 12 months. The diet quality continuity was classified as good (always 1st IQD-R tertile), intermediate (always 2nd tertile/change tertile) and poor (always 3rd tertile). Results A total of 2986 young individuals were evaluated; 51.4% were female. Prevalence of wheezing at 22y was 10.1% (95% CI: 9.1–11.2), and of these patients, 10% reported at least one event in the past year. Better IQD-R score, both at 18y and at 22y, the lower the odds of wheezing in the past year. Regarding the diet quality continuity from 18y to 22y, staying on a poor diet increased by more than three-fold the odds of chest wheezing (OR=3.28; 95% CI: 1.84–5.84) and of wheezing events (OR=3.32; 95% CI: 1.89–5.85) compared to staying on a good diet, after adjustment for confounding variables. Conclusion The overall quality of the diet seems to be more important than the individual components in the effect on asthma symptoms. Low-quality diet persistence increased the odds of chest wheezing and the number of events.
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Affiliation(s)
| | | | | | | | | | - Beatriz Raffi Lerm
- Epidemiology Postgraduate Program, Federal University of Pelotas, Pelotas, Brazil
| | | | - Roberta Bouilly
- Epidemiology Postgraduate Program, Federal University of Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Epidemiology Postgraduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cecília Formoso Assunção
- Epidemiology Postgraduate Program, Federal University of Pelotas, Pelotas, Brazil.,Public Health Postgraduate Program, Federal University of Rio Grande, Rio Grande, Brazil
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Hallal PC, Barros FC, Silveira MF, Barros AJDD, Dellagostin OA, Pellanda LC, Struchiner CJ, Burattini MN, Hartwig FP, Menezes AMB, Horta BL, Victora CG. EPICOVID19 protocol: repeated serological surveys on SARS-CoV-2 antibodies in Brazil. Cien Saude Colet 2020; 25:3573-3578. [PMID: 32876244 DOI: 10.1590/1413-81232020259.25532020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/19/2020] [Indexed: 11/21/2022] Open
Abstract
The first case of COVID-19 was reported in China in December 2019, and, as the virus has spread worldwide, the World Health Organization declared it a pandemic. Estimates on the number of COVID-19 cases do not reflect it real magnitude as testing is limited. Population based data on the proportion of the population with antibodies is relevant for planning public health policies. We aim to assess the prevalence of SARS-CoV-2 antibodies, presence of signs and symptoms of COVID-19, and adherence to isolation measures. A random sample comprising 133 sentinel cities from all states of the country will be selected. Three serological surveys, three weeks apart, will be conducted. The most populous municipality in each intermediate region of the country, defined by the Brazilian Institute of Geography and Statistics, was chosen as sentinel city. In each city, 25 census tracts will be selected, and 10 households will be systematically sampled in each tract, totaling 33,250 participants. In each household, one inhabitant will be randomly selected to be interviewed and tested for antibodies against SARS-CoV-2, using WONDFO SARS-CoV-2 Antibody Test. By evaluating a representative sample of Brazilian sentinel sites, this study will provide essential information for the design of health policies.
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Affiliation(s)
| | | | | | | | | | - Lúcia Campos Pellanda
- Fundação Universidade Federal de Ciências de Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Kramer Fiala Machado A, Wendt A, Baptista Menezes AM, Gonçalves H, Wehrmeister FC. Sleep duration trajectories from adolescence to emerging adulthood: Findings from a population-based birth cohort. J Sleep Res 2020; 30:e13155. [PMID: 32808393 DOI: 10.1111/jsr.13155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/29/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022]
Abstract
This study aimed to describe longitudinal trajectories of sleep duration, among adolescents and adults from the Pelotas (Brazil) 1993 Birth Cohort, as well as characterize different trajectories groups according to socioeconomic, demographic and behavior characteristics. Sleep duration, hours per day (from Monday to Friday), bedtime and wake-up time were self-reported by participants at ages 11, 18 and 22 years. Covariables included socioeconomic, demographic, health and behavior characteristics. Trajectory analysis was performed using a semi-parametric, group-based modelling approach. Prevalence and 95% confidence interval were obtained to describe covariables and sleep trajectory groups. Chi-square test was employed in statistical analysis and all analyses were stratified by sex. A total of 3.395 individuals were included in the analysis. In both sexes, bedtime became later across years, while wake-up time presented little variation. Differences according sex were more pronounced from 18 years onwards. Three trajectories of sleep duration from 11 to 22 years were identified for males: "increase and maintenance" (3.4%), "fast reduction and maintenance" (45.0%) and "constant reduction" (51.6%). While in females the trajectories identified were: "increase and decrease" (2.4%), "fast reduction and maintenance" (25.6%) and "constant reduction" (72.0%). Men and women who belong to trajectories with longer sleep durations were more likely to present higher percentages of some risk behaviors and poor socioeconomic condition. Our results have provided longitudinal information regarding sleep duration trajectories in a medium-sized city in Brazil, aiming at filling an existing gap in literature from low- and middle-income countries.
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Affiliation(s)
| | - Andrea Wendt
- Universidade Federal de Pelotas, Pelotas, Brazil
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Richter LM, Orkin FM, Adair LS, Kroker-Lobos MF, Mayol NL, Menezes AMB, Martorell R, Murray J, Stein AD, Victora C. Differential influences of early growth and social factors on young children's cognitive performance in four low-and-middle-income birth cohorts (Brazil, Guatemala, Philippines, and South Africa). SSM Popul Health 2020; 12:100648. [PMID: 32953965 PMCID: PMC7486449 DOI: 10.1016/j.ssmph.2020.100648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 11/28/2022] Open
Abstract
Background Studies relating childhood cognitive development to poor linear growth seldom take adequate account of social conditions related to both, leading to a focus on nutrition interventions. We aimed to assess the roles of both biological and social conditions in determining early childhood cognition, mediated by birthweight and early linear growth. Methods After exploratory structural equation modelling to identify determining factors, we tested direct and indirect paths to cognitive performance through birthweight and child height-for-age at 2 years, assessed between 4 and 8.5 years of age among 2448 children in four birth cohort studies in low-and-middle-income countries (Brazil, Guatemala, Philippines and South Africa). Determinants were compared across the cohorts. Findings Three factors yielded excellent fit, comprising birth endowment (primarily maternal age and birth order), household resources (crowding, dependency) and parental capacity (parental education). We estimated their strength together with maternal height in determining cognitive performance. Percentage shares of total effects of the four determinants show a marked transition from mainly biological determinants of birth weight (birth endowment 34%) and maternal height (30%) compared to household resources (25%) and parental capacity (11%), through largely economic determinants of height at 2 years (household resources (60%) to cognitive performance being predominantly determined by parental capacity (64%) followed by household resources (29%). The largely biological factor, birth endowment (maternal age and birth order) contributed only 7% to childhood cognitive performance and maternal height was insignificant. In summary, the combined share of social total effects (household resources and parental capacity) rises from 36∙2% on birth weight, to 78∙2% on height for age at 24 m, and 93∙4% on cognitive functioning. Interpretation Across four low- and middle-income contexts, cognition in childhood is influenced more by the parental capacity of families and their economic resources than by birth weight and early linear growth. Improving children's cognitive functioning requires multi-sectoral interventions to improve parental education and enhance their economic wellbeing, interventions that are known to improve also early childhood growth. We aimed to investigate separate and combined biological and social determination of young children’s cognitive performance. We used path analysis of longitudinal data from birth cohort studies in four differing low-and-middle countries. We distinguished biological and social factors, as well as household resources from parental capacity. Biological factors determine birthweight, 2-year height depends on social factors, and the latter drive child cognitive performance. No single domain intervention provides both necessary and sufficient support for young children’s unfolding development.
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Affiliation(s)
- L M Richter
- DSI-NRF Centre of Excellence in Human Development, School of Public Health, University of the Witwatersrand, York Road, 2193, Johannesburg, South Africa
| | - F M Orkin
- Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, York Road, 2193, Johannesburg, South Africa
| | - L S Adair
- Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA
| | - M F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - N Lee Mayol
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Talamban, Cebu City, Cebu, Philippines
| | - A M B Menezes
- Postgraduate Program in Epidemiology and Human Development, Federal University of Pelotas, Rua Mal. Deodoro, 1160, 3 Andar Zip Code: 96020-220, Pelotas, RS, Brazil
| | - R Martorell
- Rollins School of Public Health, Emory University, 1518 Clifton Rd NE #5001, Atlanta GA, 30322, USA
| | - J Murray
- Postgraduate Program in Epidemiology and Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Rua Mal. Deodoro, 1160, 3 Andar Zip Code: 96020-220, Pelotas, RS, Brazil
| | - A D Stein
- Hubert Department of Global Health, Emory University, 1518 Clifton Rd NE #5001, Atlanta, GA, 30322, USA
| | - C Victora
- Federal University of Pelotas, Rua Mal. Deodoro, 1160, 3 Andar Zip Code: 96020-220, Pelotas, RS, Brazil
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Caye A, Petresco S, de Barros AJD, Bressan RA, Gadelha A, Gonçalves H, Manfro AG, Matijasevich A, Menezes AMB, Miguel EC, Munhoz TN, Pan PM, Salum GA, Santos IS, Kieling C, Rohde LA. Relative Age and Attention-Deficit/Hyperactivity Disorder: Data From Three Epidemiological Cohorts and a Meta-analysis. J Am Acad Child Adolesc Psychiatry 2020; 59:990-997. [PMID: 31442562 DOI: 10.1016/j.jaac.2019.07.939] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/10/2019] [Accepted: 07/25/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the effect of relatively younger age on attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis. METHOD This study included participants of three community-based cohorts in Brazil: 1993 Pelotas Cohort (N = 5,249), 2004 Pelotas Cohort (N = 4,231), and Brazilian High-Risk Study for Psychiatric Disorders (HRC study) (N = 2,511). We analyzed the effect of relatively younger age on ADHD symptoms and diagnosis. For the meta-analysis, we searched MEDLINE, PsycINFO, and Web of Science from inception through December 25, 2018. We selected studies that reported measures of association between relative immaturity and an ADHD diagnosis. We followed the Meta-analysis Of Observational Studies in Epidemiology guidelines. The protocol for meta-analysis is available on PROSPERO (CRD42018099966). RESULTS In the meta-analysis, we identified 1,799 potentially eligible records, from which 25 studies including 8,076,570 subjects (164,049 ADHD cases) were analyzed with their effect estimates. The summarized relative risk of an ADHD diagnosis was 1.34 (95% CI, 1.26-1.43, p < .001) for children born in the first 4 months of the school year (relatively younger). Heterogeneity was high (I2 = 96.7%). Relative younger age was associated with higher levels of ADHD symptoms in the 1993 Pelotas Cohort (p = .003), 2004 Pelotas Cohort (p = .046), and HRC study (p = .010). CONCLUSION Children and adolescents who are relatively younger compared with their classmates have a higher risk of receiving an ADHD diagnosis. Clinicians should consider the developmental level of young children when evaluating ADHD symptoms.
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Affiliation(s)
- Arthur Caye
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Sandra Petresco
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rodrigo A Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Ary Gadelha
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Arthur Gus Manfro
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Alícia Matijasevich
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil; Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | | | - Euripides C Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | | | - Pedro M Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Giovanni A Salum
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Christian Kieling
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.
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Weber P, Menezes AMB, Gonçalves H, Perez-Padilla R, Jarvis D, de Oliveira PD, Wehrmeister FC. Characterisation of pulmonary function trajectories: results from a Brazilian cohort. ERJ Open Res 2020; 6:00065-2020. [PMID: 32864380 PMCID: PMC7445117 DOI: 10.1183/23120541.00065-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pulmonary function (PF) trajectories are determined by different exposures throughout the life course. The aim of this study was to investigate characteristics related to PF trajectories from 15 to 22 years in a Brazilian cohort. METHODS A birth cohort study (1993 Pelotas Birth Cohort) was conducted with spirometry at 15, 18 and 22 years. PF trajectories were built based on z-score of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and their ratio using a group-based trajectory model. Associations with exposures reported from perinatal to 22 years were described. RESULTS Three trajectories, low (LT), average (AT) and high (HT) were identified in 2917 individuals. Wealthiest individuals belonged to the HT of FEV1 (p=0.023). Lower maternal pregestational body mass index (BMI) (22.4±0.2; p<0.001 and 22.1±0.14; p<0.001) and lower birth weight (3164.8±25.4; p=0.029 and 3132.3±19.4; p=0.005) were related to the LT of FEV1 and FVC. Mother's smoking exposure during pregnancy (37.7%; p=0.002), active smoking at ages 18 and 22 years (20.1% and 25.8%; p<0.001) and family history of asthma (44.8%; p<0.001) were related to the LT of FEV1/FVC. Wheezing, asthma and hospitalisations due to respiratory diseases in childhood were related to the LT of both FEV1 and FEV1/FVC. Higher BMIs were related to the HT of FEV1 and FVC at all ages. CONCLUSIONS PF trajectories were mainly related to income, pregestational BMI, birth weight, hospitalisation due to respiratory diseases in childhood, participant's BMI, report of wheezing, medical diagnosis and family history of asthma, gestational exposure to tobacco and current smoking status in adolescence and young adult age.
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Affiliation(s)
- Priscila Weber
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
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Breda V, Rohde LA, Menezes AMB, Anselmi L, Caye A, Rovaris DL, Vitola ES, Bau CHD, Grevet EH. Revisiting ADHD age-of-onset in adults: to what extent should we rely on the recall of childhood symptoms? Psychol Med 2020; 50:857-866. [PMID: 30968792 DOI: 10.1017/s003329171900076x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND ADHD diagnosis requires the presence of symptoms before the age of twelve. In clinical assessment of adults, the most frequent strategy to check this criterion is investigating self-report recall of symptoms, despite little evidence on the validity of this approach. We aim to evaluate the recall accuracy and factors associated with its reliability in a large population-based sample of adults. METHODS Individuals from the 1993 Pelotas Birth Cohort were followed-up from childhood to adulthood. At the age of 22, 3810 individuals were assessed through structured interviews by trained psychologists regarding mental health outcomes, including ADHD diagnosis and ADHD symptoms in childhood. The retrospective recall was compared with available information on ADHD childhood symptoms at the age of eleven. We also assessed factors related to recall accuracy through multiple regression analyses. RESULTS Self-reported recall of childhood symptoms at 22 years of age had an accuracy of only 55.4%, with sensitivity of 32.8% and positive predictive value of 40.7%. Current inattention symptoms were associated with lower risk and social phobia with higher risk for false-positive endorsement, while higher levels of schooling correlated with lower risk and male gender with higher risk for false-negative endorsement. CONCLUSIONS Clinicians treating male patients with social phobia and ADHD symptoms should assess even more carefully retrospective recall of ADHD childhood symptoms. Moreover, characteristics associated with recall improvement do not impact accuracy robustly. In this context, the recall of childhood ADHD symptoms seems an unreliable method to characterize the neurodevelopmental trajectory in adults with currently-impairing ADHD symptomatology.
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Affiliation(s)
- V Breda
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - L A Rohde
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
| | - A M B Menezes
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - L Anselmi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - A Caye
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - D L Rovaris
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - E S Vitola
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C H D Bau
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - E H Grevet
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Orellana JDY, Ribeiro MRC, Barbieri MA, Saraiva MDC, Cardoso VC, Bettiol H, Silva AAMD, Barros FC, Gonçalves H, Wehrmeister FC, Menezes AMB, Del-Ben CM, Horta BL. Mental disorders in adolescents, youth, and adults in the RPS Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil. CAD SAUDE PUBLICA 2020; 36:e00154319. [PMID: 32022176 DOI: 10.1590/0102-311x00154319] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/21/2019] [Indexed: 01/14/2023] Open
Abstract
Although depression and anxiety are known to result in disabilities and workplace and health system losses, population-based studies on this problem are rare in Brazil. The current study assessed the prevalence of mental disorders in adolescents, youth, and adults and the relationship to sociodemographic characteristics in five birth cohorts (RPS) in Ribeirão Preto (São Paulo State), Pelotas (Rio Grande do Sul State), and São Luís (Maranhão State), Brazil. Major depressive episode, suicide risk, social phobia, and generalized anxiety disorder were assessed with the Mini International Neuropsychiatric Interview. Bootstrap confidence intervals were estimated and prevalence rates were stratified by sex and socioeconomic status in the R program. The study included 12,350 participants from the cohorts. Current major depressive episode was more prevalent in adolescents in São Luís (15.8%; 95%CI: 14.8-16.8) and adults in Ribeirão Preto (12.9%; 95%CI: 12.0-13.9). The highest prevalence rates for suicide risk were in adults in Ribeirão Preto (13.7%; 95%CI: 12.7-14.7), and the highest rates for social phobia and generalized anxiety were in youth in Pelotas, with 7% (95%CI: 6.3-7.7) and 16.5% (95%CI: 15.4-17.5), respectively. The lowest prevalence rates of suicide risk were in youth in Pelotas (8.8%; 95%CI: 8.0-9.6), social phobia in youth in Ribeirão Preto (1.8%; 95%CI: 1.5-2.2), and generalized anxiety in adolescents in São Luís (3.5%; 95%CI: 3.0-4.0). Mental disorders in general were more prevalent in women and in individuals with lower socioeconomic status, independently of the city and age, emphasizing the need for more investment in mental health in Brazil, including gender and socioeconomic determinants.
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Affiliation(s)
| | | | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Fernando C Barros
- Faculdade de Medicina, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | - Cristina Marta Del-Ben
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Bierhals IO, Assunção MCF, Vaz JDS, de Oliveira PD, Gonçalves H, Wehrmeister FC, Menezes AMB, de Mola CL, Costa C, Barros FC. Growth from birth to adolescence and bone mineral density in young adults: The 1993 Pelotas birth cohort. Bone 2020; 130:115088. [PMID: 31678487 DOI: 10.1016/j.bone.2019.115088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/03/2019] [Accepted: 10/01/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The study examined the association of body size (weight and length) at birth and gain in height and weight during childhood and adolescence with areal bone mineral density (aBMD) in adulthood for women and men. METHODS 756 members (335 men and 421 women) of the 1993 Pelotas (Brazil) Birth cohort were studied. Data on weight and length/height were obtained at birth and subsequent follow-ups at 1, 4, 11, 15, 18, and 22 years of age and specific z scores were calculated by sex. The outcome was whole body aBMD (g/cm²) measured at 22 years of age using dual-energy X-ray absorptiometry (DXA). The effects of exposures, weight and length/height gain, were analyzed using conditional relative weight (CWh) and conditional length/height (CH). Linear regression models were adjusted for multiple confounders, including mother's educational level, family income, maternal smoking during pregnancy, gestational age, breastfeeding and skin color. RESULTS In the adjusted models, among men greater height gain at 4, 11, and 18 years of age was associated with higher whole body aBMD, and the result with greatest magnitude was at 11 years of age (β 0.018 g/cm²; 95%CI 0.006; 0.030). Among women, aBMD was associated with height gain at all assessments from 1-15 years, with greatest effect size at 4 years of age (β 0.017 g/cm²; 95%CI 0.007; 0.027). Regarding to body weight, among men, greater weight at 4 and 15 years were associated with higher aBMD, with the highest coefficients for 15 years of age (β 0.015 g/cm²; 95%CI 0.003; 0.027); for women, except at birth, all weight gain variables were associated with aBMD and the highest coefficients were observed at 4 years (β 0.025 g/cm²; 95%CI 0.015; 0.035). CONCLUSIONS In this birth cohort, height and weight gain, especially from 4 to 15 years have important positive implications for aBMD to early adulthood.
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Affiliation(s)
| | | | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | | | | | | | - Caroline Costa
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Fernando Celso Barros
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
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