Maternal depression in first 1000 days of life and early childhood caries prevalence at 48 months of age.

OBJECTIVES: The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000 days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort. MATERIALS AND METHODS: All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48 months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24 months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders. RESULTS: A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24 months increased the risk for ECC at 48 months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35). CONCLUSIONS: Children from mothers with high depression trajectory had higher risk of having dental caries at 48 months compared to children from mothers with low depression trajectory. CLINICAL RELEVANCE: Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.

Validity of partial protocols to evaluate the prevalence of developmental defects of enamel in permanent dentition: a birth cohort study in Southern Brazil.

OBJECTIVES: To evaluate the validity of partial protocols (PP) to assess the prevalence of developmental defects of enamel (DDE) in permanent teeth and identify the strength of the association between DDE and some risk factors, using PP compared to the full-mouth (FM) exam. MATERIALS AND METHODS: This study was conducted in a population-based birth cohort of children born in 2004 in Pelotas, Southern Brazil. Socioeconomic, demographic, pre-, per-, and post-birth variables were collected. A subsample of 994 children was clinically examined for DDE in 2017, using the modified DDE index, using the "full- mouth" (FM) protocol. After FM had been performed, a dataset was created. Two different partial protocols (PP) were simulated from FM data: "only buccal surfaces (BS)" and "incisive and molars only (IM)." Sensitivity, absolute and relative bias, and inflation factors were calculated. RESULTS: For any DDE, FM had prevalence of 40.8%. The prevalence of DDE was 38.8% and 36.0%, for BS and IM protocols, respectively. When tested for any DDE, PP "BS" and "IM" showed high sensitivity. The underestimation of the true prevalence did not exceed 6.9% for PP "BS" and 16.1% for PP "IM." All protocols showed similar magnitude of association with the selected risk factors. CONCLUSION: Both PP "BS" and "IM" can be used to estimate the prevalence of DDE in epidemiological studies. CLINICAL RELEVANCE: Oral health surveys now have the option of using PP to collect DDE prevalence and investigate their association with risk factors, being less time-consuming, expensive, and labor intensive.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study.

Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

Pre-, Peri-, and Postnatal Risk for the Development of Enamel Defects in Permanent Dentition: A Birth Cohort in Southern Brazil.

Purpose: The purpose of this study was to find potential risk factors associated with the occurrence of developmental defects of enamel (DDE) in permanent dentition of a birth cohort in Southern Brazil. Methods: This study is a 2004 birth cohort carried out in the city of Pelotas, Rio Grande do Sul, Brazil. A subsample of 996 children was clinically examined at 12 to 13 years of age. The pre- and perinatal variables used for this study were: twin pregnancy; type of delivery; prematurity; birth weight; Apgar score in the first and fifth minute; health problems at birth; and intensive care unit admission at birth. Gender and family income variables were also collected. Some postnatal variables were collected: "hospitalization in the first 24 months"; "breastfeeding"; "respiratory diseases in the first 48 months"; "urinary infection in the first 48 months"; and "ear pain in the first 48 months." To assess an association between the presence of DDE and various risk factors, unadjusted and adjusted Poisson regression with robust variance was performed with a respective prevalence ratio. Results: The prevalence of DDE was 40.8 percent. The variables investigated did not present a statistical association with DDE. Conclusion: No association of developmental defects of enamel in permanent dentition with any of the factors investigated in this study was found.

Wich factors influencing the number of teeth at 12 months of age: a birth cohort study.

This study aimed to verify, through a longitudinal follow-up, the pre-, peri- and postnatal factors associated with the eruption of deciduous teeth. The study was nested in a Birth Cohort Study conducted in Pelotas, a Southern Brazilian city. Mothers were followed prenatally and their children were followed-up perinatally, at 3 and 12 months of age. The outcome was the number of teeth at 12 months, and exploratory variables included maternal habits and characteristics, anthropometric measures of children and mothers, and socioeconomic and demographic information. Data were collected through interviews with the mother and children's clinical exam. Poisson regression models were used for the analysis. Participants included 4,014 children with a mean number of erupted teeth at 12 months of 5.50. After adjustments, a lower mean number of teeth was observed in children from non-white mothers, early preterm children, and shorter children at birth and at 12 months. A higher number of teeth was observed for mothers with excessive weight gain during pregnancy, mothers who smoked during pregnancy, weightier children at birth and at 12 months, and for children with larger heads at birth and at 12 months. Our findings suggest that maternal and children characteristics influenced primary tooth eruption.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study

Abstract Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

Ultra-processed food consumption by children from a Pelotas Birth Cohort / Consumo de alimentos ultraprocessados por crianças de uma Coorte de Nascimentos de Pelotas

ABSTRACT OBJECTIVE Assessing the regular consumption of ultra-processed foods by children at 24 months of age from the 2015 Pelotas Birth Cohort and the main demographic, socioeconomic, and behavioral factors related to the consumption of these products. METHODS Population-based cohort in the city of Pelotas, RS, where 4,275 children were assessed at birth and 95.4% of them were followed up until 24 months of age. Food consumption was assessed by a questionnaire on regular consumption of ultra-processed foods, which collected information regarding sex, household income, maternal skin color, schooling level, and age, the child attending day care and having siblings, breastfeeding status, and obesity. The outcome was the sum of ultra-processed foods regularly consumed by a child. A multivariate Poisson regression analysis was used to calculate the association between the regular consumption of ultra-processed foods and exposure variables. RESULTS The mean number of ultra-processed foods consumed was 4.8 (SD = 2.3). The regular consumption of ultra-processed foods was positively associated with black skin color and having siblings, and negatively associated with household income and maternal schooling level and age. CONCLUSION The mean regular consumption of ultra-processed foods by children from the 2015 Pelotas Birth Cohort is high, which can negatively affect the children's diet. The risk of consuming this kind of food was higher among children from families of lower socioeconomic status, whose mothers present lower education level, black skin color, and younger age.

RESUMO OBJETIVO Avaliar o consumo habitual de alimentos ultraprocessados aos 24 meses de idade por crianças pertencentes à Coorte de Nascimentos de Pelotas de 2015 e os principais fatores demográficos, socioeconômicos e comportamentais relacionados ao consumo desses produtos. MÉTODOS Coorte de base populacional na cidade de Pelotas-RS, onde foram avaliadas 4.275 crianças ao nascimento, das quais 95,4% foram acompanhadas até os 24 meses. O consumo alimentar foi avaliado por meio de um questionário de consumo habitual de alimentos ultraprocessados, coletando informações sobre sexo, renda familiar, cor da pele, escolaridade e idade da mãe, frequentar creche, ter irmãos, status de amamentação e obesidade. O desfecho foi a somatória de alimentos ultraprocessados consumidos habitualmente pela criança. Análise multivariada por regressão de Poisson foi utilizada para estimar a associação entre consumo habitual de alimentos ultraprocessados e as variáveis de exposição. RESULTADOS O número médio de alimentos ultraprocessados consumidos habitualmente foi de 4,8 (DP = 2,3). O consumo habitual de alimentos ultraprocessados foi associado positivamente à cor da pele preta e ter irmãos e negativamente associado com renda familiar, escolaridade e idade materna. CONCLUSÕES A média de consumo habitual de alimentos ultraprocessados por crianças pertencentes à Coorte de Nascimentos de 2015 da cidade de Pelotas é elevada, o que pode causar um efeito negativo na dieta das crianças. O risco de consumo desses alimentos foi maior entre crianças de famílias de menor posição socioeconômica, filhas de mães de baixa escolaridade, de cor da pele preta, mais jovens e de baixa renda.

Number of erupted teeth at the age of 12 and 24 months: a maternal report validation study

Aim: To verify the validity of maternal reports on the number of deciduous teeth erupted in their children. Methods: This cross-sectional study was performed with children enrolled in a Birth Cohort at the age of 12 months in the first stage and 24 months in the second stage. At both stages, children were clinically examined, and mothers reported the number of teeth of their children. Comparison between groups was performed using the Mann-Whitney non-paired Wilcoxon test. Level of agreement between two methods were estimated by the Observed Agreement, Weighted Kappa and Intraclass Correlation coefficients. Results: A total of 125 children were examined in the first stage, with mean number of reported teeth of 6.2. In the second stage, 149 children were examined, with mean number of reported teeth of 15.9. High level of agreement, kappa values and intraclass correlation coefficients were observed for both arches in both periods (p<0.001). Conclusions: Maternal report on the number of teeth erupted in children was reliable and valid. Thus, it seems to be a useful instrument for collecting data in population-based epidemiological studies targeting young children

Chronic non-communicable diseases and Covid-19: Epicovid-19 Brazil results / Doenças crônicas não transmissíveis e covid-19: resultados do estudo Epicovid-19 Brasil

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.

RESUMO OBJETIVO Descrever a prevalência de doenças crônicas e fatores socioeconômicos e demográficos associados, avaliar os padrões de distanciamento social e a prevalência de anticorpos contra SARS-CoV-2 e sintomas de covid-19 em portadores e não portadores de doenças crônicas. MÉTODOS Foram avaliados dados de 77.075 mil indivíduos de 20 a 59 anos de três etapas do inquérito sorológico de abrangência nacional Epicovid-19 Brasil, realizadas entre maio e junho de 2021. A presença de anticorpos contra SARS-CoV-2 foi avaliada por teste rápido. Foram investigadas as prevalências autorreferidas de hipertensão, diabetes, asma, câncer, doença renal crônica e doença cardíaca. A prevalência de uso de máscara, de adesão a medidas de isolamento e de anticorpos foi avaliada separadamente entre portadores e não portadores de doenças crônicas. A prevalência de sintomas foi avaliada entre doentes crônicos e não doentes portadores de anticorpos. RESULTADOS A prevalência do pelo menos uma doença crônica foi de 43%, maior na região Sudeste, entre indivíduos brancos e indígenas, mulheres, menos escolarizados e em menor posição socioeconômica. O uso de máscara ao sair do domicílio não diferiu entre doentes crônicos e não doentes (98%). A proporção de participantes que referiram adesão ao isolamento foi maior entre doentes crônicos (15,9%) que entre não doentes (24,9%). A prevalência de anticorpos contra SARS-CoV-2 foi semelhante entre doentes crônicos e não doentes (2,4% e 2,3%). A prevalência de tosse, dispneia, palpitações e mialgia foi significativamente maior entre doentes crônicos, mas a proporção de sintomáticos não diferiu entre os grupos. CONCLUSÃO A prevalência de doenças crônicas no país é alta e a pandemia de covid-19 atinge de forma semelhante doentes e não doentes. Doentes crônicos apresentam formas mais graves de covid-19 e maior prevalência de sintomas. A maior adesão às medidas de distanciamento social entre doentes crônicos não se reflete em menor incidência de covid-19 nesse grupo.

Social and biological early life influences on the prevalence of open bite in Brazilian 6-year-olds.

OBJECTIVE: Little is known about the effects of social and biological risk factors for open bite on the primary dentition. The aim of this study was to assess the early-life risk factors affecting anterior open bite. METHODS: A cross-sectional study using a birth cohort was carried out in Pelotas, Brazil. A sample of 400, 6-year-old children was employed. The Foster and Hamilton criteria were used to classify open bite. Data concerning social conditions, and perinatal and childhood health and behaviour were obtained from birth to 12 months of age and during the fifth year of the children's lives. Unconditional bivariate and multiple logistic regression analysis were performed. RESULTS: The prevalence of anterior open bite was 46.3%. Risk factors included: a maternal age of between 30 and 39 years, as compared with children whose mothers were younger; breast-feeding for < 9 months; dental caries experience; pacifier sucking between 12 months and 5 years, as compared to no sucking or a shorter duration of sucking; and the presence of finger-sucking at 6 years of age. CONCLUSION: Open bite in the primary dentition was associated with older mothers, early weaning, dental caries occurrence, long-term use of a pacifier and finger-sucking at 6 years of age. These findings support the common risk approach for intervention to prevent open bite in the primary dentition.

Methodological aspects of the 1993 Pelotas (Brazil) birth cohort study

Descrever aspectos metodológicos do estudo da coorte de crianças que podem ser relevantes para pesquisadores que estejam planejando investigações semelhantes. Em 1993, uma coorte de base populacional foi recrutada em Pelotas, RS. Os 5.249 recém-nascidos nos hospitais da cidade foram acompanhados com um, três e seis meses, e com um e quatro anos de idade. Subestudos estão sendo realizados sobre saúde bucal, desenvolvimento psicológico e saúde mental, composição corporal e aspectos etnográficos. Em 2004-5 foi possível entrevistar 87,5 por cento da coorte inicial, com a idade de 10-12 anos. Estudos de coortes de nascimentos são essenciais para investigar os determinantes precoces da morbidade e estado nutricional de adultos. No entanto, há poucos estudos com esta metodologia em países de renda média e baixa, e alguns dos determinantes da situação de saúde podem ser distintos daqueles observados em países ricos.

Determinantes sociais e biológicos da cárie dentária em crianças de 6 anos de idade: um estudo transversal aninhado numa coorte de nascidos vivos no Sul do Brasil / Effects of Social and biological factors on dental caries in 6-year-old children: a cross sectional study nested in a birth cohort in Southern Brazil

OBJETIVO: O objetivo deste estudo foi investigar os determinantes sociais e biológicos, medidos no período perinatal e na infância, sobre a ocorrência de cárie dentária em crianças de 6 anos de idade. MÉTODOS: Foi realizado um estudo transversal de cárie dentária em 1999, em uma subamostra de 400 crianças pertencentes a uma coorte de nascidos vivos iniciada em 1993, em Pelotas, RS. Os índices e critérios de diagnóstico adotados foram os preconizados pela Organização Mundial da Saúde (1997). Os resultados do estudo de cárie foram inseridos no banco de dados da coorte, que continha informações sobre as condições sociais e de saúde coletadas ao nascimento, no primeiro, terceiro, sexto e décimo segundo meses e no sexto ano de vida da criança. O índice de cárie (ceo-d = 0 ou > 1) foi a variável dependente. Foram realizadas análises univariada e de regressão logística múltipla não condicional, tendo como base um modelo teórico hierárquico de determinação. RESULTADOS: Escolaridade materna abaixo ou igual a 8 anos, renda familiar menor que 6 salários mínimos, não freqüentar pré-escola e consumo de doces pelo menos uma vez ao dia aos 6 anos de idade foram fatores de risco à cárie. CONCLUSÕES: Os fatores de risco sociais, como baixa escolaridade materna e baixa renda familiar, não freqüentar a pré-escola e dieta inadequada são comuns à cárie dentária e outras doenças e agravos infantis, sugerindo que medidas de intervenção dirigidas a estes fatores seriam mais adequadas à prevenção da cárie do que medidas específicas.