Childbearing in adolescence: intergenerational dejà-vu? Evidence from a Brazilian birth cohort.

BACKGROUND: Pregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life. METHODS: The study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model. RESULTS: The rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence - RR = 1.35 (95% CI 1.04-1.74). CONCLUSION: Adolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime.

Signs and symptoms of laryngopharyngeal reflux and its relation to complaints and vocal quality. / Sinais e sintomas de refluxo laringofaríngeo e sua relação com queixas e qualidade vocal.

PURPOSE: To verify the association between laryngopharyngeal reflux (LPR) with age, gender, vocal deviation and voice complaints. METHODS: The study included patients between 18 and 70 years old, referred to the Otorhinolaryngology service for complaints of voice or reflux, of both sexes. Endolaryngeal findings were classified using the Reflux Finding Score (RFS) scale. The presence or absence of vocal and reflux complaints was verified and correlated with the RFS classification. On the same date, they were submitted to sustained vowel voice recording and chained speech. The auditory-perceptual assessment was performed by a speech therapist, classifying the general degree of vocal deviation based on the GRBASI scale. RESULTS: Ninety-seven patients were evaluated, with a mean age of 42. 6 years, 62. 3% female, and mean RFS scores of 6. 26 points. Among the patients, 48 subjects had vocal complaints, 34 women with a mean age of 44. 9 years and an average RFS score of 6. 94 points. The other 49 individuals had no vocal complaints, and of these 27 were women, with a mean age of 41. 2 years and a mean RFS score of 5. 5 points. The variables "reflux complaint", "vocal complaint" and age were the ones that most correlated with the RFS scale scores. CONCLUSION: There is a relationship among reflux complaints, laryngeal findings and vocal complaint.

OBJETIVO: Verificar a associação entre Refluxo laringofaríngeo (RLF) com idade, sexo, desvio vocal e queixas de voz. MÉTODO: Participaram do estudo pacientes entre 18 e 70 anos, encaminhados ao serviço de otorrinolaringologia por queixas de voz ou refluxo, de ambos os sexos. Os achados endolaríngeos foram classificados utilizando a escala Reflux Finding Score (RFS). A presença ou não de queixas vocais e de refluxo foi verificada e correlacionada com a classificação RFS. Na mesma data, os pacientes foram submetidos à gravação de voz de vogal sustentada e fala encadeada. A avaliação perceptivo-auditiva foi realizada por uma fonoaudióloga, classificando o grau geral do desvio vocal com base na escala GRBASI. RESULTADOS: Foram avaliados 97 pacientes, com média de idade de 42,6 anos, sendo 62,3% do sexo feminino e média dos escores da escala RFS igual a 6,26 pontos. Do total de pacientes, 48 indivíduos apresentavam queixas vocais, sendo 34 mulheres com idade média de 44,9 anos e escore RFS médio de 6,94 pontos. Os outros 49 indivíduos não apresentavam queixas vocais, e desses 27 eram mulheres, com idade média de 41,2 anos e média de escore RFS igual a 5,5 pontos. As variáveis "queixa de refluxo", "queixa vocal" e idade foram as que mais se correlacionaram com os escores da escala RFS. CONCLUSÃO: Há relação entre queixas de refluxo, achados laríngeos e queixa vocal.

Sinais e sintomas de refluxo laringofaríngeo e sua relação com queixas e qualidade vocal / Signs and symptoms of laryngopharyngeal reflux and its relation to complaints and vocal quality

RESUMO Objetivo: Verificar a associação entre Refluxo laringofaríngeo (RLF) com idade, sexo, desvio vocal e queixas de voz. Método: Participaram do estudo pacientes entre 18 e 70 anos, encaminhados ao serviço de otorrinolaringologia por queixas de voz ou refluxo, de ambos os sexos. Os achados endolaríngeos foram classificados utilizando a escala Reflux Finding Score (RFS). A presença ou não de queixas vocais e de refluxo foi verificada e correlacionada com a classificação RFS. Na mesma data, os pacientes foram submetidos à gravação de voz de vogal sustentada e fala encadeada. A avaliação perceptivo-auditiva foi realizada por uma fonoaudióloga, classificando o grau geral do desvio vocal com base na escala GRBASI. Resultados: Foram avaliados 97 pacientes, com média de idade de 42,6 anos, sendo 62,3% do sexo feminino e média dos escores da escala RFS igual a 6,26 pontos. Do total de pacientes, 48 indivíduos apresentavam queixas vocais, sendo 34 mulheres com idade média de 44,9 anos e escore RFS médio de 6,94 pontos. Os outros 49 indivíduos não apresentavam queixas vocais, e desses 27 eram mulheres, com idade média de 41,2 anos e média de escore RFS igual a 5,5 pontos. As variáveis "queixa de refluxo", "queixa vocal" e idade foram as que mais se correlacionaram com os escores da escala RFS. Conclusão: Há relação entre queixas de refluxo, achados laríngeos e queixa vocal.

ABSTRACT Purpose: To verify the association between laryngopharyngeal reflux (LPR) with age, gender, vocal deviation and voice complaints. Methods: The study included patients between 18 and 70 years old, referred to the Otorhinolaryngology service for complaints of voice or reflux, of both sexes. Endolaryngeal findings were classified using the Reflux Finding Score (RFS) scale. The presence or absence of vocal and reflux complaints was verified and correlated with the RFS classification. On the same date, they were submitted to sustained vowel voice recording and chained speech. The auditory-perceptual assessment was performed by a speech therapist, classifying the general degree of vocal deviation based on the GRBASI scale. Results: Ninety-seven patients were evaluated, with a mean age of 42. 6 years, 62. 3% female, and mean RFS scores of 6. 26 points. Among the patients, 48 subjects had vocal complaints, 34 women with a mean age of 44. 9 years and an average RFS score of 6. 94 points. The other 49 individuals had no vocal complaints, and of these 27 were women, with a mean age of 41. 2 years and a mean RFS score of 5. 5 points. The variables "reflux complaint", "vocal complaint" and age were the ones that most correlated with the RFS scale scores. Conclusion: There is a relationship among reflux complaints, laryngeal findings and vocal complaint.