Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 278
Filtrar
1.
Public Health Nutr ; : 1-10, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32204744

RESUMO

OBJECTIVE: To describe the consumption of ultra-processed foods according to demographic and socioeconomic characteristics in three birth cohorts. DESIGN: Cross-sectional analysis. SETTING: Data from the 2004, 1993 and 1982 Pelotas Birth Cohorts were used at 11, 22 and 30 years, respectively, collected between 2012 and 2015. Outcome was the relative contribution of ultra-processed foods from the total daily energy intake. Maternal-independent variables were self-reported skin colour, schooling, age and family income (obtained in the perinatal study), and variables of the cohort member, sex, skin colour, schooling and current family income (the last two obtained at the 11-, 22- and 30-year follow-ups of the respective cohorts). We calculated crude and adjusted means of the outcome for the whole cohorts and according to the independent variables. PARTICIPANTS: 11-, 22- and 30-year-old individuals. RESULTS: Daily energetic contribution from ultra-processed foods was higher in the younger cohort (33·7, 29·8 and 25·1 % at 11, 22 and 30 years, respectively). Maternal schooling and family income at birth showed an inverse dose-response relationship at 11 and 22 years, but a positive dose-response at 30 years. Female sex, lower schooling and family income at 22 years and higher schooling at 30 years were associated to a higher contribution from ultra-processed foods in the daily energy intake. CONCLUSIONS: Information from food and nutrition policies needs a higher dissemination, mostly among women and population groups of lower income and schooling, including its promotion in media and health services, aiming for a decreased consumption of ultra-processed foods.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32196712

RESUMO

BACKGROUND: Several studies have reported that there is an association between developmental and emotional/behavioural problems in children exposed to acetaminophen during foetal development. However, few studies have focused on development and behavioural outcomes in early life. OBJECTIVES: To test the association between prenatal exposure to acetaminophen and low neurodevelopmental performance at 24 months and behavioural/emotional problems at 48 months of life. METHODS: We used data from the 2004 Pelotas Birth Cohort, a population-based longitudinal prospective study. Neurodevelopment was evaluated at 24 months using Battelle's Developmental Inventory (BDI) (n = 3737). We assessed global function as well as each domain (personal-social, adaptative, motor, cognitive, and communication). Behavioural/emotional problems were assessed at 48 months using the Child Behaviour Checklist (CBCL) (n = 3624). We used the CBCL total, externalising, and internalising symptomatology and individual subscales (withdrawn, somatic complaints, anxious/depressed, social problems, cognitive problems, attention problems, aggressive behaviour, and rule-breaking behaviour). Acetaminophen use during pregnancy was retrospectively assessed at the perinatal follow-up. Poisson regression and multiple linear regression analyses were used to test the association, adjusting for several family and maternal sociodemographic and health factors, medication use during pregnancy, and the sex of the child. RESULTS: Acetaminophen exposure during prenatal development was not associated with low neurodevelopmental performance at 24 months assessed using the BDI or to emotional and behavioural problems assessed at 48 months using the CBCL in the adjusted models. CONCLUSIONS: We cannot confirm the existence of an association between acetaminophen used during pregnancy and low neurodevelopmental performance at 24 months and emotional/behavioural problems at 48 months of life based on the present results.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32004697

RESUMO

OBJECTIVE: The aim of this study is to identify the most appropriate threshold for Disruptive Mood Dysregulation Disorder (DMDD) diagnosis and the impact of potential changes in diagnostic rules on prevalence levels in the community. METHOD: Trained psychologists evaluated 3,562 pre-adolescents/early adolescents from the 2004 Pelotas Birth Cohort with the Development and Well-Being Behavior Assessment (DAWBA). The clinical threshold was assessed in three stages: symptomatic, syndromic and clinical operationalization. The symptomatic threshold identified the response category in each DAWBA item which separates normative misbehavior from a clinical indicator. The syndromic threshold identified the number of irritable mood and outbursts needed to capture pre-adolescents/early adolescents with high symptom levels. Clinical operationalization compared the impact of AND/OR rules for combining irritable mood and outbursts on impairment and levels of psychopathology. RESULTS: At the symptomatic threshold, most irritable mood items were normative in their lowest response categories and clinically significant in their highest response categories. For outbursts some indicated a symptom even when present at only a mild level, while others did not indicate symptoms at any level. At the syndromic level, a combination of 2 out of 7 irritable mood and 3 out of 8 outburst indicators accurately captured a cluster of individuals with high level of symptoms. Analysis combining irritable mood and outbursts delineated non-overlapping aspects of DMDD, providing support for the OR rule in clinical operationalization. The best DMDD criteria resulted in a prevalence of 3%. CONCLUSION: Results provide information for initiatives aiming to provide data-driven and clinically oriented operationalized criteria for DMDD.

4.
BMJ Open ; 10(2): e034513, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-32071188

RESUMO

PURPOSE: Maternal and Child Health and Nutrition in Acre, Brazil (MINA-Brazil) is a longitudinal, prospective population-based birth cohort, set-up to understand the effects of early environmental exposures and maternal lifestyle choices on growth and development of the Amazonian children. PARTICIPANTS: Mother-baby pairs (n=1246) were enrolled at delivery from July 2015 to June 2016 in Cruzeiro do Sul, Acre, Brazil. Mothers of 43.7% of the cohort were recruited in the study during pregnancy from February 2015 to January 2016. Study visits took place during pregnancy, delivery, at 1 month, 6 months, 1 year and 2 years after delivery. In addition to clinical and epidemiological data, samples collected by the MINA-Brazil study include plasma, serum and extracted DNA from blood and faeces, which are stored in a biobank. FINDINGS TO DATE: Key baseline reports found a high prevalence of gestational night blindness (11.5%; 95% CI 9.97% to 13.25%) and maternal anaemia (39.4%; 95% CI 36.84% to 41.95%) at delivery. Antenatal malaria episodes (74.6% of Plasmodium vivax) were diagnosed in 8.0% of the women and were associated with an average reduction in birth weight z-scores of 0.35 (95% CI 0.14 to 0.57) and in birth length z-scores of 0.31 (95% CI 0.08 to 0.54), compared with malaria-free pregnancies. At 2-year follow-up, data collection strategies combined telephone calls, WhatsApp, social media community and home visits to minimise losses of follow-up (retention rate of 79.5%). FUTURE PLANS: A 5-year follow-up visit is planned in 2021 with similar interviews and biospecimens collection. The findings from this prospective cohort will provide novel insights into the roles of prenatal and postnatal factors in determining early childhood development in an Amazonian population.

5.
Paediatr Perinat Epidemiol ; 34(1): 60-69, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31960475

RESUMO

BACKGROUND: Optimal sleep is essential for child growth, development, and immune function. Few studies have evaluated factors associated with sleep duration in childhood from a longitudinal perspective. OBJECTIVES: This study aimed to identify trajectories of sleep duration in childhood and associated maternal and child characteristics. METHODS: Sleep duration was assessed by maternal report at 3, 12, 24, and 48 months among children from the Pelotas (Brazil) 2004 Birth Cohort. Independent variables included family income, maternal and child demographics, and clinical characteristics. Trajectory analysis was carried out using a semi-parametric, group-based modelling approach. Multinomial logistic regression provided odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between independent variables and sleep duration trajectory groups. RESULTS: A total of 3824 participants were included in the analyses. Three trajectories of sleep duration were identified: "short sleepers" (9.1%), "typical sleepers" (72.1%), and "initially longer sleepers" (18.8%). When compared to typical sleepers, children from less schooled mothers (OR 1.82, 95% CI 1.26, 2.62) and those whose mothers reported depressive symptoms during pregnancy (OR 1.31, 95% CI 1.02, 1.68) and consumed alcohol beverages at 3 months post-partum (OR 1.60, 95% CI 1.03, 2.50) were more likely to be short sleepers. Children who shared the bedroom with another child were about 40% (OR 1.41, 95% CI 1.07, 1.87) more likely to be short sleepers. None of the investigated maternal and child characteristics remained associated with the "initially longer sleeper" group. CONCLUSIONS: Among the identified trajectories, the group with short sleep duration trajectory deserves special attention given the importance of adequate sleep duration in the first years of life for the child's growth and development and the high concomitance of other risk factors, such as less schooled mothers, and mothers who reported depressive symptoms during pregnancy and consumed alcohol at 3 months post-partum.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31897581

RESUMO

PURPOSE: This study aimed to evaluate the association between mood symptoms during pregnancy and exclusive breastfeeding at 3 months, as well as the association between exclusive breastfeeding at 3 months and maternal depression at 12 months postpartum. METHODS: Data from the Pelotas 2004 Birth Cohort with 4231 live births were used. Maternal mood symptoms during pregnancy were assessed through the question "During pregnancy, did you have depression or nervous problems?" and depression symptomatology at 12 months postpartum was assessed with the Edinburg Postnatal Depression Scale (EPDS). Information on exclusive breastfeeding at 3 months was collected through a dietary recall questionnaire. Crude and adjusted relative risks (RR) with 95% confidence intervals (95% CI) were estimated by Poisson regression. RESULTS: Prevalence of mood symptoms during pregnancy was 25.1% (95% CI 23.8; 26.4%) and prevalence of EPDS ≥ 10 at 12 months after birth was 27.6% (95% CI 26.2; 29.0%). Prevalence of exclusive breastfeeding at 3 months was 26.5% (95% CI 25.2; 27.9%). In crude analyses, maternal mood symptoms during pregnancy were associated with non-exclusive breastfeeding at 3 months and non-exclusive breastfeeding at 3 months was associated with postpartum maternal depression at 12 months. In the adjusted analyses, both associations were lost after the inclusion of maternal education (RR 0.92; 95% CI 0.81-1.04 and RR 0.92; 95% CI 0.81-1.03, respectively). CONCLUSION: In our study, the crude association between mood symptoms in pregnancy, exclusive breastfeeding at 3 months, and postpartum depression was due more to the low maternal education than to a true relationship between them.

7.
J Atten Disord ; 24(4): 590-600, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31617436

RESUMO

Objective: We aimed to investigate the association between sleep in early life and ADHD in adolescence. As a secondary analysis, we tested whether the associations may be specific to ADHD. Method: Data from 3,467 participants of the 2004 Pelotas Birth Cohort were used. Information on their sleep duration and problems was collected at 12, 24, and 48 months of age. ADHD diagnosis and hyperactivity/inattention problems were assessed with the Development and Well-Being Assessment (DAWBA) and the Strengths and Difficulties Questionnaire (SDQ) among participants at 11 years of age. Results: Difficulty going to sleep at 24 months, nightmares at 24 months and at 48 months, and restless sleep at 48 months were consistently associated with ADHD as well as with other mental disorders. Conclusion: The results suggest that sleep disturbances may be more important ADHD predictors than sleep duration or sleep duration trajectories. However, it may also be considered early markers of other mental disorders.

8.
Pediatr Allergy Immunol ; 31(1): 27-37, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31541568

RESUMO

BACKGROUND: Diet has been of interest for asthma; however, it remains unknown whether the consumption of ultra-processed food (UPF) increases the risk of the disease. Our objective was to investigate whether UPF consumption during childhood was associated with wheeze, asthma, and severe asthma in adolescence. METHODS: We included 2190 11-year-old children from the 2004 Pelotas Birth Cohort Study, without asthma at the age of 6 years. Consumption of UPF was assessed by Food Frequency Questionnaires at 6- and 11-year follow-ups. Wheeze, asthma, and severe asthma data were assessed at 11-year follow-up. We classified foods according to the processing degree in ultra-processed food. We used logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CIs), for the association between UPF consumption and the asthma outcomes. RESULTS: Cumulative incidence of wheeze and asthma between 6 and 11 years was 12.7% and 23.2%, respectively. In prospective analyses, comparing children in the highest and the lowest quintile of UPF consumption at age 6, we found no association with wheeze (OR = 0.85; 95% CI = 0.54-1.34), asthma (OR = 0.84; 95% CI = 0.58-1.21), or severe asthma (OR = 1.12; 95% CI = 0.62-2.03) in early adolescence. In cross-sectional analyses, comparing adolescents in the highest and lowest quintile of UPF consumption at 11 years, we found no association with wheeze (OR = 1.12; 95% CI = 0.72-1.75), asthma (OR = 1.00; 95% CI = 0.7-1.44), or severe asthma (OR = 1.05; 95% CI = 0.59-1.86). CONCLUSION: Our study provided evidence that UPF consumption during childhood or adolescence is not associated with asthma or wheeze among adolescents.

9.
Vaccine ; 38(3): 482-488, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31718899

RESUMO

Vaccine hesitancy has been increasingly reported in Brazil. We describe secular trends and socioeconomic disparities from 1982 to 2015, using data from four population-based birth cohorts carried out in the city of Pelotas. Full immunization coverage (FIC) was defined as having received four basic vaccines (one dose of BCG and measles, and three doses of polio and DTP) scheduled for the first year of life. Information on income was collected through standardized questionnaires, and the slope index of inequality (SII) was calculated to express the difference in percent points between the rich and poor extremes of the income distribution. Full immunization coverage was 80.9% (95% CI 79.8%; 82.0%) in 1982, 97.2% (96.1%; 98.0%) in 1993, 87.8% (86.7%; 88.8%) in 2004 and 77.2% (75.8%; 78.4%) in 2015. In 1982 there was a strong social gradient with higher coverage among children from wealthy families (SII = 25.0, P < 0.001); by 2015, the pattern was inverted with higher coverage among poor children (SII = -6.0; P = 0.01). Vertical immunization programs in the 1980s and creation of the National Health Services in 1980 eliminated the social gradient that had been present up to the 1980s, to reach near universal coverage. The recent decline in coverage is likely associated with the growing complexity of the vaccination schedule and underfunding of the health sector. In addition, the faster decline observed among children from wealthy families is probably due to vaccine hesitancy.

11.
JAMA Netw Open ; 2(12): e1918062, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31860110

RESUMO

Importance: Poor sleep during early childhood is associated with adverse outcomes, including obesity, cognitive impairment, and mental and behavioral disorders. Objective: To assess the efficacy of an educational intervention in the promotion of nighttime sleep duration. Design, Setting, and Participants: This single-blind, intent-to-treat randomized clinical trial included participants in Pelotas, Brazil, aged 3 months who were followed up until age 24 months. Eligibility criteria included healthy infants aged approximately 3 months who slept less than 15 hours per 24 hours. Infants were randomized to the intervention group or control group. Interventions: Information on sleep characteristics, improvements in the environment, establishment of a nighttime sleep routine, and waiting before attending nocturnal awakenings was delivered to mothers in the intervention group by trained home-visitors at baseline. The intervention group received a telephone call on the first and second day after the intervention and a home visit on the third day after the intervention. The intervention's content was reinforced at health care visits for ages 6 months and 12 months. Mothers allocated to the control group were counseled on the benefits of breastfeeding for the mother's and child's health and given written material with content on breastfeeding. Main Outcomes and Measures: Nighttime sleep duration was measured by interview and actigraphy at baseline and ages 6, 12, and 24 months and diaries at baseline and age 6 months. At ages 3 and 6 months, nighttime sleep self-regulation was calculated by subtracting nighttime sleep duration recorded by actigraphy from nighttime sleep duration recorded in the diaries and at ages 12 and 24 months by subtracting nighttime sleep duration recorded by actigraphy from nighttime sleep duration obtained by interview. Results: Among 1812 mother-infant dyads invited to participate, 798 met the inclusion criteria and 586 agreed to participate. The intervention group included 298 infants (154 [52.9%] boys), and the control group included 288 infants (164 [58.2%] boys). At age 6 months, mean (SD) nighttime sleep duration recorded in diaries was 9.80 (1.85) hours in the intervention group and 9.49 (2.07) hours in the control group, a difference of 19 minutes longer for the intervention group. At age 12 months, mean (SD) nighttime sleep duration based on the Brief Infant Sleep Questionnaire was 8.43 (1.35) hours in the intervention group and 8.52 (1.35) hours in the control group, a difference of 5 minutes shorter for the intervention group. At age 24 months, compared with information from the interview, actigraphy records showed that children in the intervention group stayed awake at night without signalizing for a mean (SD) of 0.52 (2.52) hours, whereas children in the control group stayed awake at night without signalizing for a mean (SD) of 0.23 (2.43) hours. There were no statistically significant difference between groups in any of the sleep parameters investigated. Conclusions and Relevance: This randomized clinical trial found that the educational intervention did not achieve longer nighttime sleep duration among infants in the intervention group. Trial Registration: ClinicalTrials.gov identifier: NCT02788630.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31748986

RESUMO

The study aimed to explore associations between socioeconomic position (SEP) indicators, early child stimulation (ECS) and attention-related executive functions (EF) at age 11. Children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort (n = 4231, non-response rate at recruitment < 1%) and followed from birth to age 11. SEP variables were family income and maternal schooling. At the 24 and 48-month follow-ups, five markers of cognitive stimulation and social interaction were recorded and positive answers were summed to a score ranging from 0 to 5. At age 11, attentional-switching and control, and selective-attention were assessed using the adapted Test-of-Everyday-Attention-for-Children (TEA-Ch). We used multivariable logistic regression models and mediation analysis to investigate potential mediator role of ECS in the association between SEP and EF. 3106 children were included in the analyses. Less than 7% of the more stimulated individuals showed low performance in attention-related EFs at age 11 compared with almost 20% in the bottom groups of stimulation. Higher child stimulation scores were associated with fewer impairments in attentional-control (OR adj 0.84; CI 95% 0.72-0.98) and attentional-switching (OR adj 0.85; CI 95% 0.73-0.99). Mediation analysis suggested that for attentional-switching, ECS mediated almost 20% of the total protective effect of maternal schooling for impaired EF. Assuming causal relationships, if maximum stimulation was provided to all children, the advantageous effect of maternal schooling on EF would be reduced by 47%. ECS may represent a protective factor for cognitive impairments in childhood and can be easily implemented at relatively low cost.

13.
Breastfeed Med ; 14(10): 691-704, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31657632

RESUMO

Aim: To assess the current scientific evidence about the relationship between breastfeeding and the development of infant's socio-emotional competencies. Materials and Methods: A systematic review of literature was conducted through PubMed, LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), and PsycINFO of population-based cohorts. Records were screened, data extracted, and a quality assessment performed by two authors independently. Results: Thirteen studies were included in the review with six finding a statistically significant association between breastfeeding and the development of socio-emotional competencies such as problem solving, agreeableness, and optimism. In five studies, no statistically significant association was found, and in three, a negative association existed. Regarding quality assessment, four studies had a strong global rating, four had a moderate rating, and five had a weak global rating. Conclusion: Almost half (6/13) of the studies found a positive association between breastfeeding and the development of social-emotional competencies in infants; however, a great heterogeneity was present in the quality of the included studies. There is a need for further and higher quality research into this field of study.

14.
BMJ Open ; 9(10): e026449, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31585969

RESUMO

OBJECTIVE: To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs). DESIGN: Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. DATA SOURCES: We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. ANALYSES: Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses. RESULTS: We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs. CONCLUSIONS: Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

15.
BMC Public Health ; 19(1): 1260, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510953

RESUMO

BACKGROUND: We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. METHODS: All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. RESULTS: A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2-2.1%), 2.3% (1.8-2.9%) and 1.2% (0.9-1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13-7.58) and obesity at 11 years (2.44; 1.29-4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59-9.85) and gestational age < 34 weeks (4.08; 1.52-10.96). Repeated high SDBP was not associated with any of the characteristics investigated. CONCLUSION: Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.


Assuntos
Hipertensão/epidemiologia , Brasil/epidemiologia , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco
16.
Artigo em Inglês | MEDLINE | ID: mdl-31442562

RESUMO

OBJECTIVE: To investigate the effect of relatively younger age on Attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis. METHOD: Individuals included in this study were participants of three community-based cohorts in Brazil: the 1993 Pelotas Cohort (N=5,249), the 2004 Pelotas Cohort (N=4,231), and the Brazilian High-Risk Study for Psychiatric disorders (HRC study, N=2,511). We analyzed the effect of relatively younger age on ADHD symptoms and diagnosis. For the meta-analysis, we searched MEDLINE, PsycINFO, and Web of Science from inception through December 25th, 2018. We selected studies that reported measures of association between relative immaturity and an ADHD diagnosis. We followed the Meta-analysis of Observational Studies in Epidemiology guidelines. The protocol for meta-analysis is available on PROSPERO (CRD42018099966). RESULTS: In the meta-analysis, we identified 1,799 potentially eligible records, from which 25 studies including 8,076,570 individuals (164,049 ADHD cases) were analyzed with their effect estimates. The summarized relative risk of an ADHD diagnosis was 1.34 (95% Confidence Interval, 1.26 to 1.43, p <.001) for children born in the first four months of the school year (relatively younger). Heterogeneity was high (I2 = 96.7%). Relative younger age was associated with higher levels of ADHD symptoms in the 1993 Pelotas cohort (p=.003), in the 2004 Pelotas cohort (p=.046) and in the HRC study (p=.010). CONCLUSION: Children and adolescents who are relatively younger compared to their classmates have a higher risk of receiving an ADHD diagnosis. Clinicians should consider the developmental level of young children when evaluating ADHD symptoms.

17.
Genes (Basel) ; 10(8)2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434288

RESUMO

BACKGROUND: It has been suggested that microRNAs (miRNAs; short non-protein-coding RNA molecules that mediate post-transcriptional regulation), including mir-9 and mir-34 families, are important for brain development. Current data suggest that mir-9 and mir-34 may have shared effects across psychiatric disorders. This study aims to explore the role of genetic polymorphisms in the MIR9-2 (rs4916723) and MIR34B/C (rs4938723) genes on the susceptibility of psychiatric disorders in children from the 2004 Pelotas Birth Cohort. METHODS: Psychiatric disorders were assessed in 3585 individuals using Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), criteria through the application of standard semi-structured interviews (using the Development and Well-Being Assessment, DAWBA) at the six-years-of-age follow-up. The outcome was defined as the presence of any mental disorder. We also considered two broad groups of internalizing and externalizing disorders to further investigate the role of these variants in mental health. RESULTS: We observed an association between rs4916723 (MIR9-2) and the presence of any psychiatric disorder (odds ratios (OR) = 0.820; 95% CI = 0.7130-0.944; p = 0.006) and a suggestive effect on internalizing disorders (OR = 0.830; 95% CI = 0.698-0.987; p = 0.035). rs4938723 (MIR34B/C) was not associated with any evaluated outcome. CONCLUSION: The study suggests that MIR9-2 may have an important role on a broad susceptibility for psychiatric disorders and may be important mainly for internalization problems.


Assuntos
Transtornos Mentais/genética , MicroRNAs/genética , Polimorfismo de Nucleotídeo Único , Criança , Pré-Escolar , Feminino , Humanos , Masculino
18.
J Psychosom Obstet Gynaecol ; : 1-7, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438746

RESUMO

Background: We evaluated the association between mother-child bonding and maternal depression at 6-8 months after birth with bonding impairment at 12-15 months in a sample of mothers at high risk of postnatal depression. Methods: A prospective cohort study with 346 low-income postpartum women with antenatal depression. The Postpartum Bonding Questionnaire (PBQ) and the Patient Health Questionnaire-9 (PHQ-9) were used, at 6-8 and 12-15 months after delivery, to assess the mother-infant bonding and postnatal depression (PPD), respectively. Results: The percentage of the main outcome, bonding impairment (BI) at 12-15 months, was 9.9% (95% CI 6.6-13.7). Using logistic regression models, BI was associated with: having an occupation (OR = 2.82; 95% CI 1.00-7.94, p = .049), unplanned pregnancy (OR = 3.46; 95% CI 1.01-11.8, p = .047), and presence of BI at 6-8 months (OR= 13.0; 95% CI 3.76-45.4, p ≤ .001). Maternal depression was marginally associated with BI at 12-15 months. Conclusions: BI affects 1 in 10 mothers, and although BI and PPD are strongly associated at 6-8 and 12-15 months after delivery, BI at 6-8 months is the main predictor of later BI. Based on the study findings, PPD screening in combination with BI assessment is highly recommended during the first year of child's life.

19.
BMC Public Health ; 19(1): 1152, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438903

RESUMO

BACKGROUND: Depression is a common and recurrent condition among older adults and is associated with poor quality of life and increased health care utilization and costs. The purpose of this pilot study was to assess the feasibility of delivering a psychosocial intervention targeting depression, and to develop the procedures to conduct a cluster randomized controlled trial among older adults registered with primary care clinics in poor neighbourhoods of São Paulo, Brazil. METHODS: We conducted a pilot study of a two-arm cluster, non-randomized controlled trial. Two primary care clinics adhering to the Family Health Strategy were allocated to either the intervention or the control arm. In the control arm, patients received enhanced usual care consisting of staff training for improved recognition and management of depression. In the intervention arm, alongside the enhanced usual care, patients received a 17-week psychosocial intervention delivered by health workers assisted with an application installed in a tablet. RESULTS: We randomly selected 579 of 2020 older adults registered in the intervention clinic to participate in the study. Among these individuals, 353 were assessed for depression and 40 (11.0%) scored at least 10 on the PHQ-9 and were therefore invited to participate. The consent rate was 33/40 (82%) with a resulting yield of 33/579 (5.7%). In the control arm, we randomly selected 320 older adults among 1482 registered in the clinic, 223 were assessed for depression and 28 (12.6%) scored 10 or above on the PHQ-9. The consent rate was 25/28 (89%), with a resulting yield of 25/320 (7.8%). Of the 33 who consented in the intervention arm, 19 (59.4%) completed all sessions. The mean PHQ-9 at follow-up (approximately 30 weeks after inclusion) were 12.3 (SD = 3.7) and 3.8 (SD = 3.9) in the control and intervention arms, respectively. Follow-up rates were 92 and 94% in control and intervention arms, respectively. CONCLUSIONS: Identification and engagement of clinics, randomization, recruitment of individuals, measures, and baseline and follow-up assessments all proved to be feasible in primary care clinics in São Paulo, Brazil. Results support the development of a definitive cluster randomized controlled trial. TRIAL REGISTRATION: This study was retrospectively registered with Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-5nf6wd . Registered 06 August 2018.


Assuntos
Depressão/prevenção & controle , Áreas de Pobreza , Psicoterapia , Idoso , Brasil , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Atenção Primária à Saúde , Resultado do Tratamento
20.
J Dent ; 89: 103183, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31449840

RESUMO

OBJECTIVES: The aim of this study was to assess the prevalence of direct restorations in posterior teeth in children aged 12, from a birth cohort, and to test the association between the quality of the restorations and individual variables experienced in the life cycle. METHODS: All live-born children in Pelotas, in 2004, were prospectively investigated and a representative sample was assessed for oral conditions at ages 5 and 12. The outcome was the quality of the restoration (satisfactory/unsatisfactory). Independent variables included socioeconomic, behavioral and oral health characteristics at the individual level and the size of cavity and material at the tooth level. Associations were tested using multilevel logistic regression models. RESULTS: A total of 1,000 participants and 249 restorations in the permanent dentition were examined. Most of the restorations were composites (73.5%), while only 6.8% were amalgam. After adjusted analyses, children whose parents received information on how to prevent their child from developing caries before reaching 5 years of age had 91.0% less chance of having an unsatisfactory restoration compared to children whose parents never received information (OR = 0.09; 95% CI 0.01-0.59). Also, the chances of presenting unsatisfactory restorations were 5.3 higher in children at high-risk for untreated dental caries in the permanent dentition, in comparison with children at low risk (OR = 5.32; 95% CI 1.07-26.6). CONCLUSIONS: Low-risk for untreated dental caries and having received information on preventing dental caries, reduced the chance of presenting failed restorations, showing that factors related to individuals play an important role in the quality of restorations. CLINICAL SIGNIFICANCE: Our findings highlight the role that individual-related factors play in restoration longevity in children, reinforcing the need for a patient-centered approach in restorative dentistry.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA