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.

Early Sugar Introduction Associated with Early Childhood Caries Occurrence.

Consensus has yet to be reached on the impact of early sugar introduction on early childhood dental caries (ECC). This study aimed to evaluate the association between the time of introduction of sugar in the infant's diet and ECC at 48 months, using data from the 2015 Pelotas Birth Cohort Study. This cohort comprises 4,275 children. At 48 months, 3,654 (91.1%) children had their oral health clinically evaluated by a team of 12 trained and calibrated dentists and their dental caries experience and cavitated lesions were assessed. The period of life in which sugar was first introduced into the child's diet was considered the primary exposure of the study, collected through questionnaires at 3, 12, 24, and 48 months of age. Analyses were conducted using Stata, version 15.0. Descriptive analyses were initially performed. Poisson regression with robust variance adjustment for the crude and adjusted analysis was used to estimate the effect of the sugar introduction on ECC. The highest prevalence of caries experience (43.3%) was in children in which sugar was introduced into the infant's diet before 12 months of age. A higher prevalence of caries experience was found for less educated (49.8%) and younger (51.7%) mothers, and in poorer families (48.3%). In the adjusted analysis, the experience of caries was 48% greater in the group with sugar introduction before 12 months of age, compared to those where sugar was introduced after 24 months of age In conclusion, our results support the adoption of preventive measures to delay the supply of sugar in early life in order to reduce the caries experience in children.

Genetic Variations in Elements of the Oxytocinergic Pathway are Associated with Attention/Hyperactivity Problems and Anxiety Problems in Childhood.

Genetic alterations related to oxytocin system seem to influence the neurobiology of attention-deficit hyperactivity disorder and anxiety problems leading to greater functional, social and emotional impairment. Here, we analyzed the association of OXTR rs2254298 and CD38 rs6449182 variants with attention/hyperactivity problems and anxiety problems in children. The study enrolled 292 children and adjusted regression model revealed OXTR rs2254298 AA genotype as a risk factor for attention deficit/hyperactivity problems (PR: 2.37; PadjFDR = 0.006), attention problems (PR: 2.71; PadjFDR = 0.003) and anxiety problems (PR: 1.92; PadjFDR = 0.018). CD38 rs6449182 G allele showed as a risk factor for attention deficit/hyperactivity problems (PR: 1.56; PadjFDR = 0.028). Moreover, in silico approach for regulatory roles found markers that influence chromatin accessibility and transcription capacity. Together, these data provide genetic information of oxytocin in developmental and behavioral disorders opening a range of opportunities for future studies that clarify their neurobiology in childhood.

Generalized Anxiety Disorder, Depressive Symptoms and the Occurrence of Stressors Events in a Probabilistic Sample of Pregnant Women.

The aim of the study is to verify the association between GAD, the severity of depressive symptoms and stressors in pregnant women between the first and second trimester. Cross-sectional study, part of a cohort that followed 980 women during the gestational period of a city in southern Brazil. We performed bivariate analysis using the t-test and chi-square. The variables that presented p ≤ 0.20 were taken for multivariate analysis, through logistic regression, in order to control possible confounding factors. The Mini International Neuropsychiatric Interview Plus was used to evaluate GAD, the severity of depressive symptoms was investigated through the Beck Inventory of Depression II, and stress events according to the Social Readjustment Assessment Scale of Holmes e Rahe. The sample consisted of 980 women. Women with mild depression symptoms had 9.8 (IC95% 4.6;21.0) times more GAD, those with moderate symptoms had 27.5 (IC95% 12.5;60.0) times more GAD, and those with severe symptoms had 52.9 (IC95% 19.1;146.5) times more GAD when compared to pregnant women with no symptoms or minimal symptoms. Regarding the stressful events, the pregnant women who presented GAD had an increase of 1.0 (IC95% 1.0;1.1) point in the mean of occurrence of stressor events when compared to those without GAD. These findings highlight the need for prevention strategies and interventions to promote maternal mental health, which benefit the development of infants in the long term.

Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort.

BACKGROUND: Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality. METHODS: In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview. RESULTS: Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality. LIMITATIONS: We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up. CONCLUSION: MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.

People living with HIV/AIDS: body image and its important associations with mental health and BMI.

Patients on antiretroviral therapy face new challenges, such as bodily changes. We conducted a cross-sectional study with people living with HIV/AIDS. We investigate the self-perception of body image and its associations. Most of the patients reported negative self-perception of body image (NSPBI), being mostly women, up to 40 years old and with changes in BMI. NSPBI was associated with depressive symptoms and punctual alterations in the redistribution of body fat: face, abdomen and legs, subjects still little elucidated. Assessing neglected aspects can improve the way these patients see themselves, and come to understand the disease as only a part of their lives.

Overweight trajectory and cardio metabolic risk factors in young adults.

BACKGROUND: Obesity is one of the conditions that increases the risk of cardiovascular disease. Studies about obesity trajectory and cardio metabolic outcomes at adulthood are still scarce. Therefore, we aimed to assess the association between patterns of overweight over the life-course and cardio metabolic risk factors in young adults. METHODS: In 1982, the maternity hospitals in Pelotas were visited daily and those newborns whose family lived in the urban area of the city were identified (n = 5914), and have prospectively followed for several occasions. Weight and height were measured at every visit. BMI-for-age z-score was calculated using the WHO Child Growth Standards. Overweight and obesity were defined as a BMI greater than or equal to 25 kg/m2 and 30 kg/m2 respectively. This was the definition adopted for evaluations overweight and obesity at 30 years. The participants were divided into eight groups according to the presence of overweight or obesity in childhood, adolescence and adulthood. Blood pressure, random blood glucose, HDL cholesterol, LDL cholesterol triglycerides and fat mass were measured. RESULTS: From 2219 participants with anthropometric data in childhood, adolescence and adulthood, 25% never had been overweight, whereas 11.6% were overweight in the three periods. Random blood glucose, SBP and DBP were higher among those subjects who were always overweight/ obese or only overweight/obese during adolescence and adulthood. The participants who were never overweight/obese or only in childhood or adolescence had a lower cardiovascular risk profile (higher HDL cholesterol, lower blood pressure, lower random glucose, lower LDL cholesterol) at 30 years. Fat mass captured from 25 to 100% of the association of overweight and obesity trajectory with cardiometabolic risk factors. CONCLUSIONS: The tracking of overweight/obesity is associated with an adverse cardio metabolic profile and this association is largely mediated by fat mass in adulthood.

Effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in hypertensive adults.

The aquatic exercise is an effective non-pharmacological therapy for prevention and control of hypertension. The objective of the present study was to investigate the effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in hypertensive adults. Methodologically 29 adults (mean age 53 ± 7.5 years) were included in the study, and were randomly grouped as hypertensive (n = 16) and non-hypertensive (n = 13). Both groups underwent low-intensity aquatic exercise program for 12 weeks. Outcomes were evaluated at week 0 and 12. The values for the following parameters decreased in the hypertensive group post training: anxiety (-6.2 ± 2 score; 60%), Timed Up and Go test (-7.4 ± 0.3 sec; 30%), protein carbonylation (-0.15 ± 0.03 nmol/mg protein; 50%), nitric oxide (12.4 ± 6 nmol/mg protein; 62%), interleukin-6 (-27.6 ± 5.7 pg/mg protein; 46%), and tissue necrosis factor-alpha (-52.4 ± 3.8 pg/mg protein; 40%); however, the values of the following parameters increased before training: Berg score (56 ± 2; 7.8%), flexibility (27 ± 1 cm; 71%); glutathione (3.1 ± 1.3 nmol/mg protein; 138%), and superoxide dismutase (1.6 ± 0.4 nmol/mg; 166%). In conclusion, we suggest that low-intensity aquatic exercise program improved anxiety, functional autonomy, and oxidative dysfunction in hypertensive adults.

Associations of Linear Growth and Relative Weight Gain in Early Life with Human Capital at 30 Years of Age.

OBJECTIVE: To assess the associations of birthweight, nutritional status and growth in childhood with IQ, years of schooling, and monthly income at 30 years of age. STUDY DESIGN: In 1982, the 5 maternity hospitals in Pelotas, Brazil, were visited daily and 5914 live births were identified. At 30 years of age, 3701 subjects were interviewed. IQ, years of schooling, and income were measured. RESULTS: On average, their IQ was 98 points, they had 11.4 years of schooling, and the mean income was 1593 reais. After controlling for several confounders, birthweight and attained weight and length/height for age at 2 and 4 years of age were associated positively with IQ, years of years of schooling, and income, except for the association between length at 2 years of age and income. Conditional growth analyses were used to disentangle linear growth from relative weight gain. Conditional length at 2 years of age ≥1 SD score above the expected value, compared with ≥1 SD below the expected, was associated with an increase in IQ (4.28 points; 95% CI, 2.66-5.90), years of schooling (1.58 years; 95% CI, 1.08-2.08), and monthly income (303 Brazilian reais; 95% CI, 44-563). Relative weight gain, above what would be expected from linear growth, was not associated with the outcomes. CONCLUSION: In a middle-income setting, promotion of linear growth in the first 1000 days of life is likely to increase adult IQ, years of schooling, and income. Weight gain in excess of what is expected from linear growth does not seem to improve human capital.

Caesarean section and adiposity at 6, 18 and 30 years of age: results from three Pelotas (Brazil) birth cohorts.

BACKGROUND: Association between caesarian section (C-section) and obesity is controversial and mostly based on body mass index (BMI), which has inherent limitations. Using direct estimates of body fat mass, we aimed to assess the association between C-section and adiposity using fat mass index and BMI z-score in three birth cohort studies from Pelotas, Brazil. METHODS: We measured weight, height and fat mass (using dual X-ray absorptiometry (DXA)) at ages 6, 18 and 30 years among participants in the 2004, 1993 and 1982 population-based Pelotas Birth Cohort Studies, respectively. We used multiple linear regression analysis to examine the crude and adjusted association between C-section and the body composition indicators. We also modelled height as an outcome to explore the presence of residual confounding. RESULTS: We observed that fat mass index and BMI z-score were strongly and positively associated with C-section in the crude analysis. However, when we adjusted for socioeconomic characteristics, maternal BMI, parity, age and smoking during pregnancy, effect estimates were attenuated towards the null, except for 30-year-old women. In those women from the 1982 cohort, C-section remained associated with fat mass index (ß = 0.82; CI95% 0.32;1.32) and BMI z-score (ß = 0.15; CI95% 0.03;0.28), even after adjusting for all potential confounders, suggesting an increase in fat mass index and BMI at 30 years among those born by C-section. CONCLUSION: We found no consistent association of C-section with fat mass index measured by DXA and BMI z-score in individuals aged 6, 18 and 30 years, except for women in the latter group, which might be explained by residual confounding. Confounding by socioeconomic and maternal characteristics accounted for all the other associations.

Association between obesity and suicide in woman, but not in man: a population-based study of young adults.

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk.

Genomic ancestry and the social pathways leading to major depression in adulthood: the mediating effect of socioeconomic position and discrimination.

BACKGROUND: Evidence suggests that there is an association between ethnicity/skin color and depression; however, many contextual and individual variables, like sense of discrimination and socioeconomic position (SEP), might influence the direction of this association. We assessed the association between African ancestry and major depression among young adults that have been followed-up since birth in a Southern Brazilian city, and the mediating effect of SEP and discrimination. METHODS: In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified; liveborns were examined and their mothers interviewed (n = 5914). In 2012-13, at 30 years of age, we used the Mini International Neuropsychiatric Interview (MINI) for major depression diagnosis. In addition, DNA samples were genotyped for approximately 2.5 million single nucleotide polymorphisms (SNPs) using Illumina (CA, USA) HumanOmni2.5-8v1 array. Genomic ancestry estimation was based on approximately 370 000 single nucleotide polymorphisms (SNPs) mutually available for the Pelotas cohort and selected samples (used as reference panels) of the HapMap and Human Genome Diversity (HGDP). We estimated prevalence ratios (PR) using Poisson regression models and evaluated the association between percentage of African ancestry and major depression. We used G-computation for mediation analysis. RESULTS: At 30 years, 3576 individuals were evaluated for major depression (prevalence = 7.9 %). Only individuals in the highest SEP, who had a percentage of African ancestry between >5-30 % and >30 % had a prevalence of major depression 2.16 (PR = 2.16 95 % CI [1.05-4.45]) and 2.74 (PR = 2.74 95 % CI [1.06-7.06]) times higher, than those with 5 % or less, respectively. Among these subjects, sense of discrimination by skin color, captured 84 % of the association between African ancestry and major depression. CONCLUSION: SEP is an important effect modifier of the positive association between African ancestry and major depression. In addition, this association is predominantly mediated by the sense of feeling discriminated by skin color.

[Social impact of literacy in the household: analysis of the association with smoking in illiterate co-residents in Brazil]. / Retorno social domiciliar da alfabetização: análise da associação com o tabagismo de analfabetos corresidentes no Brasil.

Objective To investigate the social impact of literacy on the smoking behavior of illiterate individuals who share the household with literate individuals. Method This cross-sectional study employed data from the 2008 Brazilian National Household Survey (Pesquisa Nacional por Amostra de Domicílios, PNAD). Smokers were defined as individuals reporting use of any tobacco product daily or less than daily. The literacy profiles of residents were identified. Poisson regressions adjusted for skin color, age, and maximum level of literacy in the household were performed. Four groups were analyzed: men living in rural areas, men living in urban areas, women living in rural areas, and women living in urban areas. Results For urban men, the presence of literate women only in the household was a protection factor against smoking (prevalence ratio, PR: 0.77; 95%CI: 0.71-0.82) vs. households in which all the males were illiterate. The same protective effect was found for rural men (PR: 0.79; 95%CI: 0.73-0.85). In turn, the presence of literate men only living in the same household with illiterate men did not provide protection against smoking in any case (PR: 0.93; 95%CI: 0.83-1.03 for the urban subsample; and PR: 0.99; 95%CI: 0.88-1.11 for the rural subsample). Illiterate women benefited from the presence of both literate men (PR: 0.77; 95%CI: 0.71-0.84 for the urban sample; and PR: 0.78; 95%CI: 0.69-0.89 for the rural subsample) and literate women (PR: 0.81; 95%CI: 0.72-0.92 for the urban subsample; and PR: 0.75; IC95%: 0.60-0.93 for the rural subsample). Conclusions Literate women seem to have positively affected illiterate co-residents of both sexes. This result is in agreement with reports showing broad advantages of female schooling.

Mediating effect of eating pattern on the relationship between television exposure and caries in children.

Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Children's eating behaviour traits and dental caries.

OBJECTIVES: This cross-sectional study aimed to assess eating behavior traits in children with or without dental caries. METHODS: A sample of 580 children aged 8 years enrolled in 20 public schools in the city of Pelotas, Brazil were included. Parents/caregivers provided sociodemographic information and answered the Children's Eating Behavior Questionnaire (CEBQ) to assess eating behavior traits. This instrument possesses the subscales: food responsiveness, enjoyment of food, satiety responsiveness, slowness in eating, food fussiness, emotional overeating, emotional undereating, and desire to drink. To assess the presence of decayed, missing or filled teeth (DMFT/dmft), the World Health Organization (WHO) criteria were adopted. WHO criteria were used to evaluate presence of overweight and obesity. Analysis of variance (ANOVA) was used to compare the mean score in each CEBQ subscale according to the different exposure variables. Linear regression was used to assess the association between dental caries and CEBQ subscales means. RESULTS: Approximately half of the children were male (51.03 percent) and 66.73 percent had low/middle socioeconomic status. The mean DMFT/dmft was 2.41, ranging from 0 to 13, and 63 percent of the children showed DMFT/dmft > 0. After adjustments for potential confounders, children with dental caries showed higher scores on the subscales desire to drink (P = 0.03), and satiety responsiveness (P = 0.04). CONCLUSION: The present study showed that some aspects of eating behaviors differ in children with or without caries. Such knowledge adds to the understanding of the multifactorial etiology of caries and may help in the development of nutritional interventions to promote healthy eating behaviors, with benefits for oral health.

Periodontitis Is Associated with Consumption of Processed and Ultra-Processed Foods: Findings from a Population-Based Study.

The association between periodontitis and lifestyle factors has been widely investigated. However, an association between periodontitis and dietary patterns has not been explored. Therefore, this study investigated the association between periodontitis and food consumption among a Southern Brazil population. Data from the 1982 Pelotas Birth Cohort were used (n = 537). The exposure, periodontitis, was clinically measured and classified using the AAP/CDC system, then two latent variables were defined: 'initial' and 'moderate/severe' periodontitis. The consumption of in natura, processed, and ultra-processed foods (NOVA classification) was the outcome and measured in calories using the food frequency questionnaire (FFQ). Confounders were sex, maternal education, smoking status, xerostomia, and halitosis. Data were analyzed by structural equation modeling. 'Initial' periodontitis was associated with a higher consumption of in natura food (standardized coefficient (SC) 0.102; p-value = 0.040), versus processed (SC 0.078; p-value = 0.129) and ultra-processed (SC 0.043; p-value = 0.400) foods. 'Moderate/severe' periodontitis was associated with higher consumption of ultra-processed foods (SC 0.108; p-value = 0.024), versus processed (SC 0.093; p-value = 0.053) and in natura (SC 0.014; p-value = 0.762) foods. 'Moderate/severe' periodontitis appears to be associated with the consumption of processed and ultra-processed foods.

Antenatal depression: Efficacy of a pre-post therapy study and repercussions in motor development of children during the first 18 months postpartum. Study: "Pregnancy care, healthy baby".

AIMS: To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age. METHODS: Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery. RESULTS: Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7-6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05). CONCLUSIONS: We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort.

This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Maternal-fetal attachment and perceived parental bonds of pregnant women.

BACKGROUND: The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents. AIMS: This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil). STUDY DESIGN: This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale. RESULTS: The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA. CONCLUSION: This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus.

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.