140. Prevalence And Early Life Factors Associated With Risk Behaviors In Adolescence: A Population-Based Cohort Study

Abstract

Risk behaviors in adolescence affect the health status, well- being and the healthy development of individuals' personality. Understanding the early-life determinants of such risk behaviors is therefore extremely important for prevention. This study evaluates the extent to which maternal behavior during pregnancy, birth outcomes and perinatal health status affect risk behavior in adolescents at age 11. A population-based birth cohort (n=4231) in Pelotas, Brazil, was followed-up in several occasions from birth to 11 years. Prevalence of outcomes with their respective confident intervals were described. Logistic regression was used to study the associations between early variables and risk behavior in adolescents, adjusting for demographic factors. The prevalence of main variables related to aggressive behavior, physical inactivity, depressive behavior and substance and tobacco experimentation/use was: involvement in fights 14.0%, CI95%12.9-15.2; involvement in fights with the use of any kind of gun 7.8%, CI95%5.7-10.7; physical inactivity 87.4%, CI95%86.3-88.5; depressive episode 0.7%, CI95% 0.4-1.0; alcohol experimentation 8.0%, CI95%7.1-8.9; recent alcohol use 19.3%, CI95%14.9-24.4 and recent binge drinking episode 5.5% (among those who already had consumed alcohol), CI95% 3.3-8.9; tobacco experimentation 1.4%, CI95%1.0-1.8; and recent use of tobacco 24.4% (among those who already had consumed tobacco), CI95%13.7-39.6. Multiple risk behavior, which was considered as 2 or more risk behaviors, was found in 18.9%, CI95%17.6-20.2 of the sample. Maternal smoking during pregnancy, partner low support during pregnancy and adolescent's hospitalization during the first year of life were associated with involvement in fights at age 11 (OR 1.73, CI95%1.40-2.16; OR 1.44, CI95%1.12-1.85 and OR 1.33, CI95%1.04-1.70, respectively). Maternal smoking during pregnancy was associated with involvement in fights with gun (OR 2.66, CI95%1.31-5.39). Maternal depression during pregnancy and hospitalization in the first year of life were associated with adolescent's tobacco experimentation (OR 1.86, CI95% 1.03-3.35 and OR 2.74, CI95%1.52-4.94, respectively). Low birth weight was associated with adolescent's recent tobacco use (OR 16.23, CI95%2.01-131.10). Partner low support during pregnancy, breastfeeding duration and hospitalization in the first year of life were associated with depressive episode at age 11 (OR 2.39, CI95%1.00-5.70; OR 2.96, CI95%1.28-6.86 and OR 2.46, CI95%1.03-5.87, respectively). Maternal depression during pregnancy was associated with adolescent's physical inactivity (OR 1.35, CI95%1.04-1.75). Maternal smoking, depression, partner low support and adolescent's previous hospitalization were associated with multiple risk behavior at age 11 (OR 1.47, CI95%1.21-1.79; OR 1.23, CI95%1.01-1.50; OR 1.41, CI95%1.12-1.76 and OR 1.29 CI95%1.04-1.61, respectively). Other early factors such as maternal consumption of alcohol during pregnancy, difficulties in breastfeeding and colostrum intake were tested, however, they showed no significant associations with any risk behavior. All results were adjusted for maternal age, maternal schooling and adolescent's sex. Results demonstrated that maternal smoking and depression during pregnancy, partner low support during pregnancy and hospitalization in the first year of life, were the early determinants most associated with several risk behaviors. Thus, public policies should focus on reducing maternal smoking and depression, encouraging partner support and preventing causes of early life hospitalization. Differently from the existing literature, maternal alcohol consumption during pregnancy was not associated with risk behaviors in adolescence.