Early motor development: risk factors for delay in a population study in Southern Brazil.

OBJECTIVE: To assess risk factors associated with motor development delay at three months of age. METHODS: Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development. RESULTS: We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors. CONCLUSION: Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

Screen time: Implications for early childhood cognitive development.

BACKGROUND: Exposure and introduction to digital media, especially in children, are a current cause for concern. The negative links associated with early screen exposure are extensive. AIMS: To evaluate the association between the time of exposure to a screen in children at 18 months of age and cognitive development in a population-based sample in Southern Brazil. STUDY DESIGN: This was a cross-sectional study corresponding to the fourth wave of a population-based cohort study with pregnant women and later, their children living in the city of Pelotas, Southern Brazil. SUBJECTS: The sample consisted of 470 children who completed the cognitive assessment. OUTCOME MEASURES: Cognitive development was assessed using the Bayley Scales of Infant Development - Third Edition (BSID-III). Exposure to screen time was assessed using a questionnaire completed by the primary caregiver. RESULTS: Of the total, 58.8 % of the children had ≥1 h of screen time per day and the average on the cognitive scale of the entire sample was 96.1 (SD = 14.0). Cognitive development was lower in children whose mothers had lower levels of education (CI 95 % -4.9; -2.1), where boys (CI 95 % 3.2; 8.4) and in children exposed to 2 h or more of screen time/day (CI 95 % -3.6; -0.5). CONCLUSIONS: Exposure to screens may have a significant negative association with children's cognitive development and, therefore, we seek to intervene and to give advice to parents and guardians about the true impact of digital media. Further studies are necessary to consolidate the findings and to disclose information on the topic.

Early motor development: risk factors for delay in a population study in Southern Brazil

ABSTRACT OBJECTIVE To assess risk factors associated with motor development delay at three months of age. METHODS Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development. RESULTS We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors. CONCLUSION Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

The protective role of postpartum resilience on anxiety rates of Brazilian mothers during the COVID-19 pandemic / O papel protetor da resiliência pós-parto nas taxas de ansiedade de mães brasileiras durante a pandemia de COVID-19

ABSTRACT Objective: We evaluated the protective effect of postpartum resilience (measured before the pandemic onset) on the prevalence of moderate to severe anxiety symptoms during the coronavirus disease (COVID-19) pandemic. Methods: The sample included 589 mothers from a longitudinal study in southern Brazil. Three months after delivery we assessed maternal resilience through the Resilience Scale (RS). The Generalized Anxiety Disorders 7-item (GAD-7) was used to assess anxiety symptoms during the COVID-19 pandemic. Results: The prevalence of severe to moderate anxiety symptoms in this sample was 28.4% (95% CI: 25.0; 32.0). Resilience showed to be a protective factor against moderate to severe anxiety symptoms during the pandemic (OR: 0.98; p<0.001). Conclusions: The results showed that postpartum resilience is a factor associated with lower odds of a more intense manifestation of anxiety during pandemic periods. Thus, strengthening resilience by reinforcing appropriate coping strategies can prevent mental health problems.

RESUMO Objetivo: Avaliou-se o efeito protetor da resiliência pós-parto (medida antes do início da pandemia) sobre a prevalência de sintomas de ansiedade moderados a graves durante a pandemia da doença por coronavírus (COVID-19). Métodos: A amostra incluiu 589 mães de um estudo longitudinal do Sul do Brasil. Três meses após o parto, avaliou-se a resiliência materna por meio da Resilience Scale (RS). O Generalized Anxiety Disorders 7-item (GAD-7) foi usado para medir os sintomas de ansiedade durante a pandemia de COVID-19. Resultados: A prevalência de sintomas de ansiedade moderados a graves nessa amostra foi de 28,4% (IC 95%: 25,0-32,0). A resiliência mostrou-se um fator protetor para os sintomas de ansiedade moderados a graves durante a pandemia (RC: 0,98; p<0,001). Conclusões: Os resultados revelaram que a resiliência pós-parto é um fator associado a menor chance de uma manifestação mais intensa da ansiedade durante os períodos pandêmicos. Dessa forma, fortalecer a resiliência, reforçando estratégias de enfrentamento apropriadas, pode prevenir problemas de saúde mental.

Major depressive episode in mothers during the COVID-19 pandemic: a population-based study in the Southern Brazil.

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

Major depressive episode in mothers during the COVID-19 pandemic: a population-based study in the Southern Brazil / Episódio depressivo maior entre mães durante a pandemia da COVID-19: um estudo populacional no Sul do Brasil / Episodio depresivo mayor en madres durante la pandemia de COVID-19: un estudio de base poblacional en el sur de Brasil

The COVID-19 pandemic has changed individuals and families, causing adverse psychological effects, especially in young adults, women, and parents. This study aimed to verify the prevalence of current major depressive episode (CMDE) in mothers of preschoolers (up to five years old) and its associated stressors during the COVID-19 pandemic in a municipality in the Southern Brazil. This is a cross-sectional, population-based study with mothers. All mothers were interviewed by telephone call during the COVID-19 pandemic. We used the Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) to assess the presence of CMDE. Statistical analysis was conducted using the chi-square test and a multivariate logistic regression. We evaluated 666 mothers. The prevalence of CMDE was 12.3%. Mothers with financial losses had 2.1 (95%CI: 1.3-3.4) more odds of presenting CMDE than those financially stable. We observed that financial losses were determinant for the higher prevalence of depression in mothers.

A pandemia da COVID-19 tem levado a mudanças em indivíduos e famílias, com efeitos psicológicos adversos, principalmente em adultos jovens, mulheres e pais e mães. O estudo buscou averiguar a prevalência de episódio depressivo maior atual (EDMA) em mães de pré-escolares (até 5 anos de idade) e estressores associados durante a pandemia da COVID-19 em uma cidade no Sul do Brasil. Este é um estudo transversal aninhado em um estudo de base populacional com mães. Todas as mães foram entrevistadas através de contato telefônico durante a pandemia da COVID-19. Os autores usaram a Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para avaliar a presença de EDMA. A análise estatística foi realizada, calculando o qui-quadrado e a regressão logística multivariada. Foram avaliadas 666 mães. A prevalência de EDMA foi de 12,3%. Mães com perdas financeiras apresentaram probabilidade 2,1 vezes maior (IC95%: 1,3-3,4) de apresentar EDMA, comparadas com aquelas que mantiveram a situação financeira. Com base nos resultados, os autores observaram que perdas financeiras foram determinantes para a prevalência maior de depressão materna.

La pandemia de COVID-19 ha provocado cambios en los individuos y las familias, causando efectos psicológicos adversos, especialmente en los adultos jóvenes, las mujeres y los padres y madres. El objetivo de este estudio fue verificar la prevalencia del episodio depresivo mayor actual (EDMA) en madres de preescolares (hasta 5 años) y sus estresores asociados durante la pandemia de COVID-19 en una ciudad del sur de Brasil. Se trata de un estudio transversal anidado en un estudio poblacional con madres. Todas las madres fueron entrevistadas mediante contacto telefónico durante la pandemia de COVID-19. Se utilizó la Mini-International Neuropsychiatric Interview (M.I.N.I. Plus) para evaluar la presencia de EDMA. El análisis estadístico se realizó calculando la prueba de chi-cuadrado y una regresión logística multivariante. Se evaluaron 666 madres. La prevalencia de EDMA fue del 12,3%. Las madres con pérdidas económicas tenían un 2,1 (IC95%: 1,3-3,4) más probabilidades de presentar EDMA que las que mantuvieron su situación económica. Teniendo en cuenta los resultados, observamos que las pérdidas económicas fueron determinantes para la mayor prevalencia de depresión materna.

Associação entre vínculo parental e qualidade da vinculação amorosa em universitários no sul do Brasil / Association between parental bond and quality of love bonding in university students in southern Brazil / Asociación entre el vínculo parental y la calidad del vínculo amoroso en estudiantes universitarios del sur de Brasil

A partir das primeiras experiências de vinculação, serão internalizados modelos representacionais que servirão de protótipo para as relações amorosas no futuro. Este estudo investigou a associação entre a percepção de vínculo parental e a qualidade da vinculação amorosa em universitários no sul do Brasil. Trata-se de um estudo transversal, no qual foram utilizados o Questionário de Vinculação ao Pai e à Mãe e o Questionário de Vinculação Amorosa. A análise estatística foi baseada no modelo de Regressão Linear Múltipla. Foram avaliados 89 universitários. A cada aumento de um ponto no escore da inibição da exploração e da individualidade no vínculo materno, houve uma diminuição no escore da confiança e um aumento no escore da ambivalência no vínculo amoroso. Os resultados demonstram que dificuldades no estabelecimento de um vínculo precoce saudável podem ocasionar sentimento de insegurança, ambivalência e baixa confiança nos relacionamentos amorosos futuros.

From the first experiences of bonding, representational models will be internalized that will serve as a prototype for loving relationships in the future. This study investigated the association between the perception of parental bond and the quality of love bonding in university students in southern Brazil. This is a cross-sectional study, in which the Questionário de Vinculação ao Pai e à Mãe and the Questionário de Vinculação Amorosa were used. The statistical analysis was based on the Multiple Linear Regression model. We assessed 89 university students. For each increase of one point in the mean of inhibition of exploitation and individuality in the maternal bond, there was a decrease in the mean of confidence and an increase in the mean of ambivalence in the love bond. The results demonstrate that difficulties in establishing a healthy early bond can lead to feelings of insecurity, ambivalence and low confidence in future relationships.

A partir de las primeras experiencias de vinculación, se internalizarán modelos representativos que servirán como prototipo de relaciones amorosas en el futuro. Este Estudio investigó la asociación entre la percepción del vínculo parental y la calidad del vínculo amoroso entre los estudiantes universitarios del sur de Brasil. Este es un estudio transversal, en el que se utilizaron el Questionário de Vinculação ao Pai e à Mãe y e l Questionário de Vinculação Amorosa. El análisis estadístico se basó en el modelo de Regresión Lineal Múltiple. Se evaluaron 89 estudiantes universitarios. Por cada aumento de un punto en el promedio de inhibición de la exploración e individualidad en el vínculo materno, hubo una disminución en el promedio de confianza y un aumento en la promedio de ambivalencia en el vínculo amoroso. Los resultados demuestran que las dificultades para establecer un vínculo temprano saludable pueden generar sentimientos de inseguridad, ambivalencia y poca confianza en las relaciones futuras.

Brief cognitive behavioral therapy in pregnant women at risk of postpartum depression: Pre-post therapy study in a city in southern Brazil.

BACKGROUND: Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD. METHODS: Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression. RESULTS: The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy. LIMITATIONS: Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model. CONCLUSIONS: Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD.

Prevalence of mental health problems in preschoolers and the impact of maternal depression.

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

Childhood trauma and depressive symptoms in pregnant adolescents in Southern Brazil.

OBJECTIVES: This study aimed to investigate the association between child maltreatment and depressive symptomatology during gestation in adolescents. METHODS: This was a cross-sectional study with pregnant adolescents aged 12 to 19 years. Data were collected with the Beck Depression Inventory, Childhood Trauma Questionnaire, and Mini International Neuropsychiatric Interview. RESULTS: Compared to adolescents who did not experience each type of neglect or abuse, experiencing them was associated with a higher proportion of depressive symptoms: emotional neglect PR = 1.4 (95% CI 1.1; 1.8); physical neglect PR = 1.7 (95% CI 1.3; 1.7); emotional abuse PR = 1.8 (95% CI 1.4; 2.2); and physical abuse PR = 1.3 (95% CI 1.1; 1.7). CONCLUSIONS: This study demonstrates the association between childhood experiences and mental health in adolescence, especially in vulnerable samples, such as pregnant adolescents. This finding reveals the importance of studying early trauma in life and enabling preventive help, especially in adolescents. High-quality evidence of perinatal mental health problems should be generated to make pregnancy safer for women in low- and middle-income countries.

The perception of parental bonding in pregnant adolescents and its association with generalized anxiety disorder.

BACKGROUND: The parental bonding is influenced by two dimensions: care and control or protection over the child of both parents. The lack of care during childhood may make the individual more susceptible to the onset of psychiatric disorders when adult. These psychiatric disorders when present during pregnancy may have a negative impact on the health of pregnant women and children. The aim of this study was to assess the association between generalized anxiety disorder (GAD) in pregnant adolescents and the perception of parental bonding. METHODS: This is a cross-sectional study with 871 pregnant women under the age of 19, receiving prenatal care in 47 Basic Health Units in the one city, Brazil. The generalized anxiety disorder was measured using the Mini International Neuropsychiatric Interview (MINI) and the perception of parental bonding in childhood using the Parental Bonding Instrument (PBI). RESULTS: The prevalence of GAD was 8.5%. Among all the parental bonding dimensions, only a perceived lack of maternal care under 16 years was associated with GAD. CONCLUSIONS: The results showed that only the perception of maternal bonding was associated with later GAD. It suggests that an adequate maternal bond is an essential component of psychological health.