Relation between child maltreatment and human capital: results from a population-based birth cohort.

This study aimed to investigate the association between child maltreatment and human capital, measured by intelligence quotient (IQ) at age 18 years and schooling at age 22 years in 3,736 members from a population-based birth cohort in Southern Brazil. A multiple linear regression was used to assess the association between child maltreatment and human capital measurements. Physical and emotional abuse and physical neglect occurring up to 15 years of age were considered child maltreatment. Physical neglect was associated with lower IQ scores in women (ß = -4.40; 95%CI: -6.82; -1.99) and men (ß = -2.58; 95%CI: -5.17; -0.01) and lower schooling for all sexes: women (ß = -1.19; 95%CI: -1.64; -0.74) and men (ß = -0.82; 95%CI: -1.34; -0.30). Moreover, men who had experienced one type of child maltreatment and women who had experienced two or more types had lower years of schooling at 22 years (ß = -0.41; 95%CI: -0.73; -0.89 and ß = -0.57; 95%CI: -0.91; -0.22, respectively) than those who suffered no kind of maltreatment. Efforts to improve future educational and cognitive outcomes must include early prevention and intervention strategies for child maltreatment.

Investigating changes in IQ scores over a decade in Brazil: factors at play.

PURPOSE: This study aimed to determine whether the factors underlying potential differences between two birth cohorts, born in 1982 and 1993, influence the changes in IQ over time. METHODS: Data from two Brazilian birth cohorts were used (1993 and 1982 Pelotas Birth Cohorts). The IQ scores were assessed using the WAIS-III test. RESULTS: Results showed that women born in 1993 had a higher average IQ score than those born in 1982, but no difference was found among men. The increase in IQ scores was only limited to participants from families with an income ranging from 1.1 to 3 times the minimum wage at the time of birth. The mean IQ score of participants born to mothers below the age of 20 remained stable over time, but increase for participants whose mothers were 20 years of age or older at the time of birth. CONCLUSIONS: This study emphasizes the importance of considering socio-economic and demographic factors when examining differences in IQ scores over time. Further research is needed to understand the underlying mechanisms of these findings.

Maternal mental health and offspring's IQ: Evidence from two Brazilian birth cohorts.

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.

Relation between child maltreatment and human capital: results from a population-based birth cohort / Relação entre maus-tratos infantis e capital humano: resultados de uma coorte de nascimentos de base populacional / Relación entre maltrato infantil y capital humano: resultados de una cohorte de nacimientos de base poblacional

Abstract: This study aimed to investigate the association between child maltreatment and human capital, measured by intelligence quotient (IQ) at age 18 years and schooling at age 22 years in 3,736 members from a population-based birth cohort in Southern Brazil. A multiple linear regression was used to assess the association between child maltreatment and human capital measurements. Physical and emotional abuse and physical neglect occurring up to 15 years of age were considered child maltreatment. Physical neglect was associated with lower IQ scores in women (β = -4.40; 95%CI: -6.82; -1.99) and men (β = -2.58; 95%CI: -5.17; -0.01) and lower schooling for all sexes: women (β = -1.19; 95%CI: -1.64; -0.74) and men (β = -0.82; 95%CI: -1.34; -0.30). Moreover, men who had experienced one type of child maltreatment and women who had experienced two or more types had lower years of schooling at 22 years (β = -0.41; 95%CI: -0.73; -0.89 and β = -0.57; 95%CI: -0.91; -0.22, respectively) than those who suffered no kind of maltreatment. Efforts to improve future educational and cognitive outcomes must include early prevention and intervention strategies for child maltreatment.

Resumo: O objetivo deste estudo foi investigar a associação entre maus-tratos infantis e capital humano, medido por meio do quociente de inteligência (QI) aos 18 anos e escolaridade aos 22 anos, em 3.736 membros de uma coorte de nascimentos de base populacional no Sul do Brasil. A regressão linear múltipla foi utilizada para avaliar a associação entre maus-tratos infantis e medidas de capital humano. Foram considerados maus-tratos físicos, emocionais e a negligência física ocorrida até os 15 anos de idade. A negligência física associou-se a menores escores de QI entre mulheres (β = -4,40; IC95%: -6,82; -1,99) e homens (β = -2,58; IC95%: -5,17; -0,01), assim como menor escolaridade em mulheres (β = -1,19; IC95%: -1,64; -0,74 e homens (β = -0,82; IC95%: -1,34; -0,30). Além disso, homens que sofreram algum tipo de mau-trato na infância e mulheres que sofreram dois ou mais tipos apresentaram menor escolaridade aos 22 anos de idade (β = -0,41; IC95%: -0,73; -0,89 e β = -0,57; IC95%: -0,91; -0,22, respectivamente), em comparação com aqueles que não sofreram maus-tratos. Os esforços para aprimorar os futuros resultados educacionais e cognitivos devem incorporar estratégias de prevenção e intervenção precoce contra o mau-trato infantil.

Resumen: El objetivo de este estudio fue investigar la asociación entre el maltrato infantil y el capital humano, medido utilizando el cociente de inteligencia (CI) a los 18 años y escolaridad a los 22 años, en 3.736 miembros de una cohorte de nacimientos de base poblacional en el Sur de Brasil. Se utilizó una regresión lineal múltiple para evaluar la asociación entre el maltrato infantil y las medidas de capital humano. Se consideraron el maltrato físico y emocional y la negligencia física que ocurrieron hasta los 15 años de edad. La negligencia física se asoció con puntuaciones de CI más bajas entre mujeres (β = -4,40; IC95%: -6,82; -1,99) y hombres (β = -2,58; IC95%: -5,17; -0,01), así como con una menor escolaridad en las mujeres (β = -1,19; IC95%: -1,64; -0,74 y hombres (β = -0,82; IC95%: -1,34; -0,30). Además, los hombres que sufrieron algún tipo de maltrato en la infancia y las mujeres que sufrieron dos o más tipos de maltrato tenían menor escolaridad a los 22 años (β = -0,41; IC95%: -0,73; -0,89 y β = -0,57; IC95%: -0,91; -0,22, respectivamente), en comparación con aquellos que no sufrieron maltratos. Los esfuerzos para mejorar los resultados educativos y cognitivos futuros deben incorporar estrategias de prevención e intervención temprana contra el maltrato infantil.

Intimate partner violence against women during covid-19: A population-based study in Vitória, state of Espírito Santo, Brazil.

BACKGROUND: Violence against women has a negative impact on multiple dimensions of women's health. During the Covid-19 pandemic, intimate partner violence against women has continued, and in some contexts has intensified. The aim of this study was to identify the prevalence of intimate partner violence against women during covid-19 pandemic and its association with socioeconomic, behavioral, and life-experience factors. METHODS AND FINDINGS: Cross-sectional, population-based study conducted in the municipality of Vitória, state of Espírito Santo, from January to May 2022, where 1,086 women aged 18 years and over were interviewed. The World Health Organization (WHO) instrument on violence against women was used to screen outcomes. The prevalence of violence during the pandemic (psychological, physical, and sexual) and bivariate analysis with sociodemographic, behavioral, family, and life history characteristics of women were estimated. The multivariate analysis was carried out for each type of violence, the Poisson regression model was performed with an estimate of robust variance, inserting the variables of interest with (p<0.20). Those with p<0.05 remained in the adjusted model. RESULTS: The prevalence of violence psychological against women perpetrated by an intimate partner during the pandemic was the most frequent (20.2%), followed by physical (9.0%) and sexual violence (6.5%). Women with less schooling and who were single had a higher prevalence of physical and psychological violence, as did those with a history of sexual abuse in childhood and whose mothers had been beaten by their intimate partners. Sexual violence was more prevalent among non-white, with up to eight years of schooling, whose mothers had a history of intimate partner violence, and who consumed alcohol during four days or more (p<0.01). CONCLUSION: Psychological, physical, and sexual violence perpetrated by the intimate partner during the pandemic presented high magnitude among women living in Vitória. Sociodemographic, behavioral factors, and personal and maternal experiences of violence were associated with the phenomenon.

Child maltreatment associates with violent victimization in young adulthood: a Brazilian birth cohort study.

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.

[Birth conditions and attention deficit/hyperactivity disorders (ADHD) in adults in the Pelotas (Brazil) birth cohorts of 1982 and 1993]. / Condições de nascimento e transtorno do déficit de atenção com hiperatividade (TDAH) em adultos nas coortes de nascimento de Pelotas, Rio Grande do Sul, Brasil, de 1982 e 1993.

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.

Este artigo avaliou a associação das condições de nascimento com o transtorno do déficit de atenção com hiperatividade (TDAH) em adultos utilizando dados de duas coorte de nascimento da cidade de Pelotas, Rio Grande do Sul, Brasil. Em 1982 e 1993, todos os nascimentos ocorridos na cidade foram identificados e prospectivamente acompanhados. Nos acompanhamentos aos 30 e 22 anos das coortes 1982 (n = 3.574) e 1993 (n = 3.780), respectivamente, os participantes foram examinados e psicólogos treinados aplicaram a Mini-International Neuropsychiatric Interview (M.I.N.I.). Aqueles indivíduos que preencheram os critérios diagnósticos do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) foram definidos como positivos para TDAH. A regressão de Poisson com ajuste robusto da variância foi usada para estimar a razão de prevalência (RP) ajustadas para sexo, cor da pele materna, renda familiar, idade materna, escolaridade materna durante a gestação, estado civil materno, paridade e tabagismo materno durante a gestação. A prevalência do TDAH adulto foi de 4,4% e 4,5% nas coortes de 1982 e 1993, respectivamente. A prevalência de TDAH foi maior naqueles que nasceram com menor peso, mas não foi observada tendencia linear. Além disso, aqueles que nasceram com peso entre 3.000 e 3.499 gramas (g) (RP = 1,40, IC95%: 1,05-1,86) apresentaram maior risco para o transtorno. Para a idade gestacional, observamos uma relação inversamente proporcional acerca da presença de TDAH, os pré-termos apresentaram risco 33% maior (IC95%: 0,90-1,96) de ser considerado com TDAH do que os nascidos com 39 ou mais semanas, mas como o intervalo de confiança incluiu a nulidade, essa associação pode ter ocorrido ao acaso. Tais resultados indicam que o peso ao nascer e a idade gestacional podem estar associados ao TDAH adulto.

El presente estudio evaluó la asociación de las condiciones de nacimiento con el trastorno por déficit de atención con hiperactividad (TDAH) en adultos utilizando datos de dos cohortes de nacimiento de la ciudad de Pelotas. En 1982 y 1993 se identificaron todos los nacimientos de la ciudad y se les ha hecho un seguimiento prospectivo. En los seguimientos a los 30 y 22 años de las cohortes de 1982 (n = 3.574) y 1993 (n = 3.780), respectivamente, los participantes fueron examinados y psicólogos capacitados aplicaron la Mini-International Neuropsychiatric Interview (M.I.N.I.). Aquellas personas que cumplieron con los criterios de diagnóstico del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) se definieron como positivos para TDAH. Se utilizó la regresión de Poisson con ajuste robusto de la varianza para estimar la razón de prevalencia (RP) ajustada por sexo, color de piel materna, ingreso familiar, edad materna, educación materna en la gestación, estado civil materno, paridad y tabaquismo materno en la gestación. La prevalencia del TDAH en adultos fue de 4,4% y 4,5 %, en las cohortes de 1982 y 1993, respectivamente. La prevalencia de TDAH fue mayor en aquellos que nacieron con menor peso, pero no se observó una tendencia lineal, y aquellos que nacieron con peso entre 3.000 y 3.499 gramos (RP = 1,40; IC95%: 1,05-1,86) presentaron el mayor riesgo. Para la edad gestacional, se observó una relación inversamente proporcional para la presencia de TDAH, los niños prematuros presentaron un 33 % más de riesgo (IC95 %: 0,90-1,96), de ser considerado como teniendo TDAH que los nacidos con 39 o más semanas, pero como el intervalo de confianza incluyó la nulidad, esa asociación puede haber ocurrido al azar. Tales resultados indican que el peso al nacer y la edad gestacional pueden estar asociados con el TDAH en adultos.

Physical Activity During Adolescence and Mental Health in Early Adulthood: Findings From the 1993 Pelotas Birth Cohort Study.

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.

Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium.

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.

Effect of Adolescent Body Mass Index Trajectories on Working Memory: A Prospective Birth Cohort in Brazil.

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 (ß = -.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.

Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013.

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.

Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities — RPS Consortium / Características do sono e sonolência diurna excessiva em adolescentes e adultos: resultados das coortes de nascimento de três cidades brasileiras - Consórcio RPS

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.

RESUMO Objetivo: Descrever a prevalência de duração do sono, latência, insônia terminal, qualidade subjetiva do sono e sonolência diurna excessiva entre participantes de coortes de nascimentos realizadas em três cidades brasileiras, bem como avaliar as diferenças nas taxas de prevalência das coortes de acordo com características sociodemográficas. Métodos: Análises transversais envolvendo participantes de quatro coortes de nascimento realizadas em Ribeirão Preto (RP78 e RP94), Pelotas (PEL93) e São Luís (SL97). A duração, a latência, a insônia terminal e a qualidade subjetiva do sono foram obtidas por meio do Índice de Qualidade do Sono de Pittsburgh; e a sonolência diurna excessiva foi avaliada pela Escala de Sonolência de Epworth. As diferenças na prevalência dos desfechos foram analisadas em cada coorte segundo características sociodemográficas estratificadas por sexo. Resultados: A duração insuficiente do sono foi o desfecho mais comum nas quatro coortes, com maior frequência entre os homens. Latência longa foi mais frequentemente relatada por mulheres adultas jovens nas coortes RP94 e PEL93, e insônia por mulheres das quatro coortes, quando comparadas a homens da mesma idade. As mulheres geralmente sofriam mais com sonolência diurna excessiva e avaliavam a qualidade do sono de forma mais negativa do que os homens. Além do sexo, ser estudante e trabalhar estiveram associados ao maior número de desfechos em ambos os sexos. Conclusão: Os distúrbios do sono são mais prevalentes em mulheres, reforçando a necessidade de maior investimento na saúde do sono no Brasil, sem desconsiderar gênero e determinantes socioeconômicos.

Condições de nascimento e transtorno do déficit de atenção com hiperatividade (TDAH) em adultos nas coortes de nascimento de Pelotas, Rio Grande do Sul, Brasil, de 1982 e 1993 / Birth conditions and attention deficit/hyperactivity disorders (ADHD) in adults in the Pelotas (Brazil) birth cohorts of 1982 and 1993 / Condiciones de nacimiento y trastorno por déficit de atención con hiperactividad (TDAH) en adultos en las cohortes de nacimiento de Pelotas, Rio Grande do Sul, Brasil, de 1982 y 1993

Este artigo avaliou a associação das condições de nascimento com o transtorno do déficit de atenção com hiperatividade (TDAH) em adultos utilizando dados de duas coorte de nascimento da cidade de Pelotas, Rio Grande do Sul, Brasil. Em 1982 e 1993, todos os nascimentos ocorridos na cidade foram identificados e prospectivamente acompanhados. Nos acompanhamentos aos 30 e 22 anos das coortes 1982 (n = 3.574) e 1993 (n = 3.780), respectivamente, os participantes foram examinados e psicólogos treinados aplicaram a Mini-International Neuropsychiatric Interview (M.I.N.I.). Aqueles indivíduos que preencheram os critérios diagnósticos do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) foram definidos como positivos para TDAH. A regressão de Poisson com ajuste robusto da variância foi usada para estimar a razão de prevalência (RP) ajustadas para sexo, cor da pele materna, renda familiar, idade materna, escolaridade materna durante a gestação, estado civil materno, paridade e tabagismo materno durante a gestação. A prevalência do TDAH adulto foi de 4,4% e 4,5% nas coortes de 1982 e 1993, respectivamente. A prevalência de TDAH foi maior naqueles que nasceram com menor peso, mas não foi observada tendencia linear. Além disso, aqueles que nasceram com peso entre 3.000 e 3.499 gramas (g) (RP = 1,40, IC95%: 1,05-1,86) apresentaram maior risco para o transtorno. Para a idade gestacional, observamos uma relação inversamente proporcional acerca da presença de TDAH, os pré-termos apresentaram risco 33% maior (IC95%: 0,90-1,96) de ser considerado com TDAH do que os nascidos com 39 ou mais semanas, mas como o intervalo de confiança incluiu a nulidade, essa associação pode ter ocorrido ao acaso. Tais resultados indicam que o peso ao nascer e a idade gestacional podem estar associados ao TDAH adulto.

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.

El presente estudio evaluó la asociación de las condiciones de nacimiento con el trastorno por déficit de atención con hiperactividad (TDAH) en adultos utilizando datos de dos cohortes de nacimiento de la ciudad de Pelotas. En 1982 y 1993 se identificaron todos los nacimientos de la ciudad y se les ha hecho un seguimiento prospectivo. En los seguimientos a los 30 y 22 años de las cohortes de 1982 (n = 3.574) y 1993 (n = 3.780), respectivamente, los participantes fueron examinados y psicólogos capacitados aplicaron la Mini-International Neuropsychiatric Interview (M.I.N.I.). Aquellas personas que cumplieron con los criterios de diagnóstico del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) se definieron como positivos para TDAH. Se utilizó la regresión de Poisson con ajuste robusto de la varianza para estimar la razón de prevalencia (RP) ajustada por sexo, color de piel materna, ingreso familiar, edad materna, educación materna en la gestación, estado civil materno, paridad y tabaquismo materno en la gestación. La prevalencia del TDAH en adultos fue de 4,4% y 4,5 %, en las cohortes de 1982 y 1993, respectivamente. La prevalencia de TDAH fue mayor en aquellos que nacieron con menor peso, pero no se observó una tendencia lineal, y aquellos que nacieron con peso entre 3.000 y 3.499 gramos (RP = 1,40; IC95%: 1,05-1,86) presentaron el mayor riesgo. Para la edad gestacional, se observó una relación inversamente proporcional para la presencia de TDAH, los niños prematuros presentaron un 33 % más de riesgo (IC95 %: 0,90-1,96), de ser considerado como teniendo TDAH que los nacidos con 39 o más semanas, pero como el intervalo de confianza incluyó la nulidad, esa asociación puede haber ocurrido al azar. Tales resultados indican que el peso al nacer y la edad gestacional pueden estar asociados con el TDAH en adultos.

The bidirectional association between wheezing and obesity during adolescence and the beginning of adulthood in the 1993 birth cohort, Pelotas, Brazil.

OBJECTIVE: To analyze the bidirectional association between wheezing and obesity during adolescence and the beginning of adulthood in a cohort in southern Brazil. METHODS: This prospective longitudinal study used data from the 1993 birth cohort in Pelotas, Brazil. The following outcome variables were measured at 22 years of age: self-reported wheezing during the last 12 months and obesity (BMI ≥ 30 kg/m2). The following exposure variables were measured at ages 11, 15, and 18: self-reported wheezing (no wheezing or symptom presentation in 1, 2, or 3 follow-ups) and obesity (non-obese or obese in 1, 2, or 3 follow-ups). Crude and adjusted logistical regression stratified by sex were used in the analyses. The reference category was defined as participants who presented no wheezing or obesity. RESULTS: A total of 3,461 participants had data on wheezing and 3,383 on BMI. At 22 years of age, the prevalence of wheezing was 10.1% (95%CI: 9.1; 11.2), and obesity, 16.2% (95%CI: 15.0; 17.6). In females, the presence of wheezing in two follow-ups revealed a 2.22-fold (95%CI: 1.36; 3.61) greater chance of developing obesity at 22 years of age. Meanwhile, the presence of obesity in two follow-ups resulted in a 2.03-fold (95%IC: 1.05; 3.92) greater chance of wheezing at 22 years of age. No associations were found between wheezing and obesity in males. CONCLUSIONS: The obtained data suggest a possible positive bidirectional association between wheezing and obesity, with greater odds ratios in the wheezing to obesity direction in females and in the category of occurrence of exposure in two follow-ups.

Child maltreatment and substances use throughout adolescence and adulthood: Data from a Brazilian Birth Cohort.

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.

[Delay in quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age: Brazilian National Health Survey, 2013]. / Atraso na vacina tetravalente (DTP+Hib) em crianças de 12 a 23 meses de idade: Pesquisa Nacional de Saúde, 2013.

The study aimed to estimate the prevalence of delay in the three doses of quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age in Brazil, based on data from the Brazilian National Health Survey (PNS) of 2013 and to analyze the delay in each of the doses according to sociodemographic variables and use of health services and public health interventions. The data are from the PNS a cross-sectional study performed in 2013. The outcome was delay in at least one of the three doses of the quadrivalent vaccine. Delay was defined as a dose received at least 30 days after the recommended date according to information on the child's vaccination card. Prevalence of delay was analyzed according to sociodemographic variables and use of health services. A descriptive analysis was performed to obtain absolute and relative frequencies and their respective 95% confidence intervals. Of the 2,016 children with information collected, 1,843 were analyzed. The prevalence of delay in at least one dose of the vaccine was 44%. There was a delay of 14.8% in the first dose, 28.8% in the second, and 45.4% in the third, and 10% of the children had delays in all three doses. Higher prevalence of delay was associated with male gender, brown skin color, the poorest income quintile, and residence in rural areas and the North of Brazil. The study revealed high prevalence of delay with the quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age in Brazil, with the highest delay in the third dose.

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.

El objetivo fue estimar la prevalencia del atraso en las tres dosis de la vacuna tetravalente (DTP+Hib) en niños de 12 a 23 meses de edad, en Brasil, mediante los datos de la Encuesta Nacional de Salud (PNS) de 2013 y describir el retraso en cada una de las dosis, según variables sociodemográficas, utilización de servicios e intervenciones públicas de salud. Se trata de un estudio transversal, realizado en 2013, con datos de la PNS. El resultado fue el retraso por lo menos en una de las tres dosis de la vacuna tetravalente. Se consideró como un atraso la dosis recibida por lo menos 30 días tras la fecha prefijada, según la información de la cartilla de vacunación. La prevalencia del atraso fue descrita según variables sociodemográficas y utilización de servicios de salud. Se realizó un análisis descriptivo, obteniéndose frecuencias absolutas y relativas, así como sus respectivos intervalos de 95% de confianza. De los 2016 niños con información recogida, se analizaron 1843. La prevalencia de atraso de por lo menos una dosis de la vacuna fue de un 44%. Se observó un retraso de 14,8% en la primera, un 28,8% en la segunda y un 45,4% en la tercera dosis, siendo que un 10% de los niños sufrieron atraso en las tres dosis. Las mayores prevalencias de atraso se encontraron en niños de sexo masculino, mestizos, pertenecientes al quintil más pobre de riqueza, habitantes de la zona rural y de la Región Norte de Brasil. Se evidenció una alta prevalencia de atraso en la vacuna tetravalente (DTP+Hib) en niños de 12 a 23 meses de Brasil, siendo mayor en la tercera dosis.

Is Screen Time Throughout Adolescence Related to ADHD? Findings from 1993 Pelotas (Brazil) Birth Cohort Study.

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.

Does IQ Influence Association Between Working Memory and ADHD Symptoms in Young Adults?

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.

Effect Modification of Cardiorespiratory Fitness, Obesity, and Physical Activity in Adults.

We investigated if cardiorespiratory fitness modifies the association between obesity and the level of physical activity. In this cross-sectional study, we analyzed data from 746 adults, free of diagnosed cardiorespiratory or locomotor diseases. We analyzed sociodemographic and clinical information, cardiovascular risk factors, cardiorespiratory fitness, anthropometry, and level of physical activity (time spent in moderate-to-vigorous physical activity). Those that spent more time in moderate-to-vigorous physical activity were younger, male, with lower body mass index, without self-reported arterial blood hypertension, diabetes and dyslipidemia, non-smokers, and presented with better cardiorespiratory fitness. The linear regression coefficients showed that cardiorespiratory fitness changes according to the level of physical activity and body mass index (obesity in low cardiorespiratory fitness: ß 6.0, p=0.213, 95%CI-3.5 to 15.6; in intermediate cardiorespiratory fitness: ß 6.3, p=0.114, 95%CI-1.5 to 14.2; in high cardiorespiratory fitness: ß-6.3, p=0.304, 95%CI-18.4 to 5.8). This effect modification trend was present after adjusting the model by covariates. Cardiorespiratory fitness potentially modifies the association between body mass index and the level of physical activity. It should be routinely assessed to identify persons with overweight/ obesity with low/ intermediate cardiorespiratory fitness to prescribe individualized training.

Atraso na vacina tetravalente (DTP+Hib) em crianças de 12 a 23 meses de idade: Pesquisa Nacional de Saúde, 2013 / Delay in quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age: Brazilian National Health Survey, 2013 / Retraso en la vacuna tetravalente (DTP+Hib) en niños de 12 a 23 meses de edad: Encuesta Nacional de Salud, 2013

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.

Abstract: The study aimed to estimate the prevalence of delay in the three doses of quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age in Brazil, based on data from the Brazilian National Health Survey (PNS) of 2013 and to analyze the delay in each of the doses according to sociodemographic variables and use of health services and public health interventions. The data are from the PNS a cross-sectional study performed in 2013. The outcome was delay in at least one of the three doses of the quadrivalent vaccine. Delay was defined as a dose received at least 30 days after the recommended date according to information on the child's vaccination card. Prevalence of delay was analyzed according to sociodemographic variables and use of health services. A descriptive analysis was performed to obtain absolute and relative frequencies and their respective 95% confidence intervals. Of the 2,016 children with information collected, 1,843 were analyzed. The prevalence of delay in at least one dose of the vaccine was 44%. There was a delay of 14.8% in the first dose, 28.8% in the second, and 45.4% in the third, and 10% of the children had delays in all three doses. Higher prevalence of delay was associated with male gender, brown skin color, the poorest income quintile, and residence in rural areas and the North of Brazil. The study revealed high prevalence of delay with the quadrivalent vaccine (DTP+Hib) in children 12 to 23 months of age in Brazil, with the highest delay in the third dose.

Resumen: El objetivo fue estimar la prevalencia del atraso en las tres dosis de la vacuna tetravalente (DTP+Hib) en niños de 12 a 23 meses de edad, en Brasil, mediante los datos de la Encuesta Nacional de Salud (PNS) de 2013 y describir el retraso en cada una de las dosis, según variables sociodemográficas, utilización de servicios e intervenciones públicas de salud. Se trata de un estudio transversal, realizado en 2013, con datos de la PNS. El resultado fue el retraso por lo menos en una de las tres dosis de la vacuna tetravalente. Se consideró como un atraso la dosis recibida por lo menos 30 días tras la fecha prefijada, según la información de la cartilla de vacunación. La prevalencia del atraso fue descrita según variables sociodemográficas y utilización de servicios de salud. Se realizó un análisis descriptivo, obteniéndose frecuencias absolutas y relativas, así como sus respectivos intervalos de 95% de confianza. De los 2016 niños con información recogida, se analizaron 1843. La prevalencia de atraso de por lo menos una dosis de la vacuna fue de un 44%. Se observó un retraso de 14,8% en la primera, un 28,8% en la segunda y un 45,4% en la tercera dosis, siendo que un 10% de los niños sufrieron atraso en las tres dosis. Las mayores prevalencias de atraso se encontraron en niños de sexo masculino, mestizos, pertenecientes al quintil más pobre de riqueza, habitantes de la zona rural y de la Región Norte de Brasil. Se evidenció una alta prevalencia de atraso en la vacuna tetravalente (DTP+Hib) en niños de 12 a 23 meses de Brasil, siendo mayor en la tercera dosis.