Pelotas Birth Cohort Research Articles

Accelerometer-Derived Sleep Metrics in Adolescents Reveal Shared Genetic Influences with Obesity and Stress in a Brazilian Birth Cohort Study.

We aimed to test the association between sleep-related polygenic scores (PGSs) and accelerometer-based sleep metrics among Brazilian adolescents, and to evaluate potential mechanisms underlying the association through the enrichment of obesity, and cortisol pathway-specific polygenic scores (PRSet). Utilizing data from The 2004 Pelotas (Brazil) Birth Cohort, sleep time window and sleep efficiency were measured at the 11-year-old follow-up using ActiGraph accelerometers. Three sleep-PGSs were developed based on the most recent genome-wide association study (GWAS) of accelerometer-based sleep measures. PRSet, calculated using variants linked to body mass index (BMI) and plasmatic cortisol concentration, aimed to assess pleiotropic effects. Linear regression models, adjusted for sex and the first 10 principal components of ancestry, were employed to explore the impact of sleep-PGS and specific-PRSet on sleep phenotypes. The number of nocturnal sleep episodes-PGS was positively associated with sleep time window (β =2.306, SE: 0.92, p=0.011). Nocturnal sleep episodes were also associated with sleep time window when restricted to BMI-PRSet (β=2.682, SE: 0.912, competitive-p=0.003). Both number of sleep episodes and sleep time window cortisol-PRSets were associated (β=0.002, SE: 0.001, p=0.013; β=0.003, SE: 0.001, p=0.003, respectively) and exhibited enrichment in molecular pathways (competitive-p=0.011; competitive-p=0.003, respectively) with sleep efficiency. Sleep polygenetic components observed in European adults may partially explain accelerometer-based sleep time window in Brazilian adolescents. Specific BMI molecular pathway strengthened the association between sleep-PGS and sleep time window, while cortisol concentration pathway had a significant impact on the genetic liability for sleep efficiency. Our results suggest genetic overlap as a potential etiological pathway for sleep-related comorbidities, emphasizing common genetic mechanisms.

Perinatal Factors and Their Association with Early-Adulthood Suicidal Behavior in a Brazilian Birth Cohort

Background The objectives of this study were to investigate the relationship between perinatal risk factors and suicidal ideation and attempts in young adults in Pelotas, Brazil. Methods The data were collected from the 1993 Pelotas Birth Cohort study. Every pregnant woman who gave birth in one of the hospitals in Pelotas Brazil in 1993 was invited to participate in the study. The current study uses perinatal data collected in 1993, and follow-ups at ages 18 and 22. The primary outcome was lifetime suicide attempts with past month suicide ideation a secondary outcome. The association between perinatal predictors and suicidal ideation or lifetime suicide attempts was investigated using hierarchical logistic regression. Findings There was an analytic sample size of 3493. The perinatal factors association with lifetime suicide attempts were sex (OR = 2.25 CI: 1.76–2.89), paternal education at birth (OR = 0.60, 95%CI: 0.36–0.99), maternal education (9–11 years OR = 2.81, 95%CI: 1.41–5.59, & 0–8 years OR = 2.21, 95%CI: 1.07–4.58), support from friends or neighbors at birth (OR = 0.36 95%CI: 0.17–0.77), and maternal smoking during pregnancy (OR = 1.41, 95%CI: 1.10–1.79). Patterns of associations were broadly similar with suicidal ideation. Interactions between sex and the perinatal factors paternal education, maternal education, smoking and support from friends were assessed and found to be not significant. Conclusion Several factors during the perinatal period are associated with risk of lifetime suicide attempts and ideation in young adults in Brazil. Early-life factors associated with suicide-related concerns in early adulthood were similar to those observed in studies from high-income settings.

The Parenting and Family Adjustment Scales (PAFAS) questionnaire: psychometric qualities of the parenting scale in two large Brazilian birth cohorts.

Analyse the psychometric properties of the Portuguese version of the PAFAS (Parenting and Family Adjustment Scales) parenting scale, using data from two large Brazilian birth cohorts. The original PAFAS parenting scale, which consists of 18 items (parental inconsistency 5 items, coercive parenting 5 items, positive encouragement 3 items, and parent-child relationship 5 items) was applied in two Brazilian birth cohorts in Pelotas (ages 4 [n = 4010] and 6-7 [n = 3867]) and Rio Grande (age 3 [n = 992]). Confirmatory factor analysis was conducted, and internal consistency assessed, as well as construct validity in relation to maternal depression measured on the Edinburgh Postnatal Depression Scale. The model with a structure of 4 subscales showed that the global scale of parenting on the PAFAS had a good fit, but certain items did not fit well on sub-scales and were removed (2 items from parental inconsistency, 1 from coercive parenting, and 1 from positive encouragement). The original form of the parent-child relationship sub-scale was maintained. Considering the total PAFAS parenting score, we found that mothers with maternal depression had a higher likelihood of more problematic parental practices than mothers without depression. A revised 14-item PAFAS parenting scale has good psychometric properties and we encourage its use in Brazilian populations.

Harsh parenting trajectories from childhood through adolescence and socioemotional competences at age 18: 2004 Pelotas Birth Cohort Study

BackgroundLimited research has explored the course of harsh parenting practices throughout childhood and adolescence and its impact on socioemotional competences from a longitudinal perspective. This study examined the association between harsh parenting trajectories and socioemotional competences at age 18. MethodsData from the 2004 Pelotas (Brazil) Birth Cohort study, originally comprising 4231 live births, were used. Harsh parenting was measured using the parent-report version of the Parent–Child Conflict Tactics Scale at ages 6, 11, 15 and 17 years, and trajectories were identified using a group-based modelling approach. Socioemotional competences were emotion regulation, assessed by the Emotional Regulation Index for Children and Adolescents; self-esteem, measured by the self-report Rosenberg Self-esteem Scale; prosocial behaviour and peer relationship problems, both assessed by the Strengths and Difficulties Questionnaire. Multivariate linear and Poisson regression models were applied to examine the effects of harsh parenting trajectories on socioemotional competences, adjusting for confounding variables. ResultsWe identified three trajectories: a “low harsh parenting” trajectory (49.7 %), a “moderate harsh parenting” (44.7 %), and a “high harsh parenting” trajectory (5.6 %). Compared to those belonging to the low harsh parenting trajectory group, adolescents who experienced either a moderate or high harsh parenting trajectory exhibited lower scores in emotion regulation, self-esteem, and prosocial behaviour scales, along with higher scores of peer relationships problems. LimitationsData on harsh parenting at 15 and 17 years were available only for a sub-sample. ConclusionsOur study extends the evidence of the adverse effects of persistent harsh parenting on socioemotional competences during adolescence.

Child COVID-19 vaccine uptake among participants of the 2015 Pelotas (Brazil) Birth Cohort Study

ObjectiveTo analyze COVID-19 vaccine uptake in children and to investigate factors associated with two outcomes variables: (a) not even beginning; (b) not completing the COVID-19 vaccine series. MethodsWe used data of children aged 6–7 years from the 2015 Pelotas c Birth Cohort Study. COVID-19 vaccination status was collected from immunization cards and National Immunization Program Information System. Adjusted analyses were performed using a hierarchical model to identify factors associated with the two study outcomes. ResultsAmong 3867 children, 20.7 % (95 % CI, 19.5 %–22.0 %) did not even begin the 2-dose primary COVID-19 vaccine series, and 28.2 % (95 % CI, 26.6 %–29.8 %) did not complete the series with the second dose. Children not even beginning the COVID-19 vaccine series were more likely to have a White mother, not to have obesity, to have a history of COVID-19 infection, to have received non-recommended drugs for COVID-19, to be afraid of needles, and to have an incomplete diphtheria-tetanus-pertussis (DTP) and poliovirus immunization schedule. Not completing the 2-dose series was associated with lower maternal age and education, mother’s self-identification as White or Brown, lower household income, lack of access to health services, not having completed the DTP and poliovirus immunization schedule and living with a person with a history of infection with COVID-19. ConclusionThe results highlight a vaccine-hesitant parents’ group who chose not beginning the COVID-19 vaccine series of their children and, another group of parents who failure to complete the child’s series due to difficulty accessing health services.

Differential effect of social mobility on tooth loss by race in adulthood: 1982 Pelotas Birth Cohort Study.

To examine the association between social mobility and tooth loss in adults from the 1982 Pelotas Birth Cohort Study and whether race modifies this association. The Oral Health Study used data from 541 individuals who were followed up to 31 years of age. Social mobility, composed of the participants' socioeconomic position (SEP) at birth and at age 30, was categorized as never poor, upwardly mobile, downwardly mobile and always poor. The outcome was the prevalence of at least one tooth lost due to dental caries when the participants were examined at 31 years of age. The effect modifier was race (Black/Brown versus white people). Log-binomial regression models were used to estimate crude and sex-adjusted prevalence ratios (PR) and to determine whether the association varied with race. Statistical interactions were tested using an additive scale. The prevalence of any tooth loss was 50.8% (n = 274). In social mobility groups, the prevalence of at least one tooth lost in the never-poor group was about 31% points higher for Black/Brown (68.2%) than for white people (37.4%). Antagonistic findings were found for the interaction between race and social mobility (Sinergy Index = 0.48; 95% CI 0.24, 0.99; and relative excess of risk due to the interaction = -1.38; 95% CI -2.34, -0.42), suggesting that the observed joint effect of race and social mobility on tooth loss was lower than the expected sum of these factors. The estimates for Black/Brown people were smaller for those who were always poor during their lives, relative to their white counterparts. The findings suggest a higher prevalence of at least one tooth lost among people in the downward mobile SEP group and Black/Brown people. Greater racial inequity was found among Black/Brown people who had never experienced episodes of poverty, with Black/Brown people having a greater prevalence of at least one tooth lost than their white counterparts.

Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study.

Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (β = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (β = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(βASRS = 0.51; 95% CI: 0.26;0.77) and (βSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (β = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.

How much or how often? Examining the screening properties of the DSM cross-cutting symptom measure in a youth population-based sample.

The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders in a population-based sample and the impact of adverbial framings (intensity and frequency) on its performance are unknown. The study was based on cross-sectional data from the 1993 Pelotas birth cohort in Brazil. Participants with completed DSM-XC and structured diagnostic interviews (n = 3578, aged 22, 53.6% females) were included. Sensitivity, specificity, positive (LR+), and negative (LR-) likelihood ratios for each of the 13 DSM-XC domains were estimated for detecting five internalizing disorders (bipolar, generalized anxiety, major depressive, post-traumatic stress, and social anxiety disorders) and three externalizing disorders (antisocial personality, attention-deficit/hyperactivity, and alcohol use disorders). Sensitivities and specificities >0.75, LR+ > 2 and LR- < 0.5 were considered meaningful. Values were calculated for the DSM-XC's original scoring and for adverbial framings. Several DSM-XC domains demonstrated meaningful screening properties. The anxiety domain exhibited acceptable sensitivity and LR- values for all internalizing disorders. The suicidal ideation, psychosis, memory, repetitive thoughts and behaviors, and dissociation domains displayed acceptable specificity for all disorders. Domains also yielded small but meaningful LR+ values for internalizing disorders. However, LR+ and LR- values were not generally meaningful for externalizing disorders. Frequency-framed questions improved screening properties. The DSM-XC domains showed transdiagnostic screening properties, providing small but meaningful changes in the likelihood of internalizing disorders in the community, which can be improved by asking frequency of symptoms compared to intensity. The DSM-XC is currently lacking meaningful domains for externalizing disorders.

Cohort Profile Update: 2015 Pelotas (Brazil) Birth Cohort Study－follow-ups from 2 to 6-7 years, with COVID-19 impact assessment.

Cohort Profile Update: 2015 Pelotas (Brazil) Birth Cohort Study－follow-ups from 2 to 6-7 years, with COVID-19 impact assessment.

Contraindicated use of modern contraceptives among mothers from a Pelotas Birth Cohort.

To describe the prevalence of contraindicated use of combined hormonal contraceptives, progesterone-only contraceptives, and intrauterine devices in mothers participating in the 2015 Pelotas Birth Cohort according to the WHO medical eligibility criteria. The biological mothers of children belonging to the 2015 Pelotas birth cohort who attended the 48-month follow-up were studied. The 48-month follow-up data were collected from January 1, 2019, to December 31, 2019. Contraindicated use of modern contraceptives was considered to occur when these women presented at least one of the contraindications for the use of modern contraceptives and were using these methods. The prevalence of contraindicated use was calculated according to each independent variable and their respective 95% confidence intervals (95%CI). The analyzed sample consisted of 3,053 women who used any modern contraceptive method. The prevalence of contraindicated use of modern contraceptives totaled 25.9% (95%CI: 24.4-27.5). Combined hormonal contraceptives showed the highest prevalence of contraindicated use (52.1%; 95%CI: 49.3-54.8). The prevalence of contraindicated use of modern contraceptives methods was greater in women with family income between one and three minimum wages, a 25-30 kg/m2 body mass index, indication by a gynecologist for the used method, and purchasing the contraceptive method at a pharmacy. The higher the women's education, the lower the prevalence of inappropriate use of modern contraceptives. In total, one in four women used modern contraceptives despite showing at least one contraindication. Policies regarding women's reproductive health should be strengthened.

Early exposure to cannabis and bipolar disorder incidence: Findings from a 22-year birth cohort study in Brazil.

Bipolar disorder is a chronic condition affecting millions of people worldwide. Currently, there is some evidence to suggest that cannabis use during adolescence may be an environmental risk factor for its onset, however inconsistencies have been observed across the literature. Considering this, we aimed to assess whether early lifetime cannabis is associated with subsequent bipolar disorder in young adults between 18 and 22 years of age. Using data from the 1993 Pelotas (Brazil) birth cohort (n = 5249), cannabis exposure was examined at age 18 by self-report, and bipolar disorder diagnosis was measured at age 22 using the Mini International Neuropsychiatric Interview (MINI). In order to control the analysis, we considered socioeconomic status index, sex, skin color, physical abuse by parents and lifetime cocaine use. A total of 3781 individuals were evaluated in 2015 aged 22 years, of whom 87 were diagnosed with the bipolar disorder onset after the age of 18. Lifetime cannabis use predicted bipolar disorder onset at 22 years old (OR 1.82, 95% CI [1.10, 2.93]), and the effect remained after adjusting for socioeconomic status, sex, skin color, and physical abuse by parents (OR 2.00, 95% CI [1.20, 3.25]). However, this association was attenuated to statistically non-significant after further adjustment for all available covariates, including lifetime cocaine use (OR 1.79, 95% CI [0.95, 3.19]). We also found similar results for early cocaine use, where the association with bipolar disorder onset did not maintain significance in the multivariate model (OR 1.35, 95% CI [0.62, 2.86]). Otherwise, when we considered cannabis or cocaine lifetime use as a unique feature, our findings showed that the adolescent exposure to cannabis or cocaine increased the odds by 1.95 times of developing bipolar disorder at 22 years age, even when controlling for all other study variables (OR 2.14, 95% CI [1.30, 3.47]). Finally, our models suggest that cocaine use may potentially exert a major influence on the effect of lifetime cannabis use on bipolar disorder onset, and that physical abuse by parents and sex may modify the effect of cannabis use for later bipolar disorder onset. Based on our findings, early cannabis exposure predicted bipolar disorder onset in young adults, but this association was confounded by cocaine use. Contrary to schizophrenia, cannabis as a sole exposure was not associated with bipolar disorder onset after adjusting for control variables.

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

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. 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 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. 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.

Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil

PurposeThere is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort. MethodsOne thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models. ResultsThere was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic. DiscussionFamily-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.

Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil

BackgroundThe scale-up of parenting programmes to support early childhood development (ECD) is poorly understood. Little is known about how and when early interventions are most effective. Sustainability of ECD programming...

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.

Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil

Introduction: There is an inconclusive causal association between asthma symptoms and dental caries in the primary dentition. This study aimed to investigate, using SEM (structural equation modeling), a possible causal relation between asthma and dental caries in the primary dentition. Methods: Using data from the 2004 Pelotas Birth Cohort Study, a sub-sample of 1,303 individuals was selected. Dental caries was clinically evaluated at 5 years old based on decayed, missing, and filled tooth (dmft) index criteria. Asthma-related symptoms (wheezing and shortness of breath) at 1- and 4-year-olds composed a latent variable and were the main exposures to caries occurrence. SEM was used to identify possible direct, indirect, and mediated effects of asthma in primary dentition dental caries. Results: The general prevalence of caries at age 5 was 1.95 (SD: 3.56). When comparing the dmft values for children with asthma symptoms and those without, they presented similar values in both periods where asthma symptoms were evaluated (1- and 4-year-old). SEM analysis showed that asthma was neither directly nor indirectly related to dental caries. Conclusion: Asthma, using a latent variable constructed based on asthma symptoms, showed no causal effect on dental caries occurrence in the primary dentition.

Accelerometer-based sleep metrics and gut microbiota during adolescence: Association findings from a Brazilian population-based birth cohort

BackgroundSleep and gut microbiota are emerging putative risk factors for several physical, mental, and cognitive conditions. Sleep deprivation has been shown to be linked with unhealthy microbiome environments in animal studies. However, in humans, the results are mixed. Epidemiological studies evaluating the effect of accelerometer-based sleep measures on gut microbiome are scarce. This study aims to explore the relationship between sleep duration and efficiency with the gut microbiota in adolescence. MethodsA subsample of 352 participants from the 2004 Pelotas (Brazil) Birth Cohort Study with sleep and fecal microbiota data available were included in the study. Sleep duration and sleep efficiency were obtained from actigraphy information at 11 years old whereas microbiota information from fecal samples was collected at 12 years. The fecal microbiota was analyzed via Illumina MiSeq (16S rRNA V3–V4 region) and the UNOISE pipeline. Alpha was assessed in QIIME2. Association measures for sleep variables and microbial α-diversity, and bacterial relative abundance were assessed through generalized models (linear and logistic regression), adjusting for maternal and child variables confounders. ResultsAdjusted models showed that sleep duration was positively associated with Simpson index of α-diversity (β = 0.003; CI95 %: 0.00004; 0.01). Both sleep duration (OR = 0.43; CI95 % 0.25; 0.74) and efficiency (OR = 0.55; CI95 % 0.38; 0.78) were associated with lower Bacteroidetes abundance. ConclusionOur results suggest that sleep duration and efficiency are linked to gut microbiota diversity and composition even with 1–2 years gap from exposure to outcome. The findings support the role of sleep in the gut-brain axis as well as provide insights on how to improve microbiota health.

Association between birth conditions and bone mineral density in adults from the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil

This study assessed the association of birth weight, gestational age, and intrauterine growth with bone mineral density (BMD) at 22 and 30 years of age in the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil. BMD was measured by dual-energy X-ray absorptiometry (DXA) and the association was assessed using analysis of variance. Multiple linear regression was used to control for confounding factors: sex; household income at birth; maternal smoking during pregnancy; maternal schooling; maternal ethnicity/skin color; and pre-pregnancy body mass index. The study tested whether body fat in adulthood was a mediator of the association analyzed, using the G-computation Formula. A total of 6,803 participants from the 1982 and 1993 cohorts were evaluated at 30 and 22 years of age, respectively. Birth weight was associated with BMD at all sites, with a greater difference at the femoral neck. Individuals born weighing less than 2,000g had on average -0.036g/cm2 (95%CI: -0.064; -0.008) of BMD in the femoral neck than individuals weighing more than 3,500g. Individuals with an intrauterine growth z-score at least 1.28 standard deviation below the mean had an average of -0.013g/cm2 (95%CI: -0.024; -0.002) of BMD in the lumbar spine compared with individuals with an above-average z-score. The mediation analysis showed that body fat in adulthood did not mediate the association. Birth conditions have been associated with BMD in adulthood and the identification of early factors related to bone loss is essential due to the demographic inversion that has been taking place in low- and middle-income countries.

Socioeconomic inequalities in health problems in the first two years of life: Pelotas (Brazil) birth cohort, 2015.

Brazil is characterized by an unfinished agenda of health inequalities, which impact health problems in the childhood. This study aimed to evaluate the socioeconomic inequalities of health problems in the early childhood. This is a prospective study, using data from the birth cohort carried out in the city of Pelotas (Rio Grande do Sul State, Brazil) in 2015. The outcomes were health problems presented at 12 and 24 months: cough, breathing difficulty, diarrhea, ear pain, pneumonia, urinary infection, hospitalization, and other health problems. Socioeconomic inequalities were measured applying the slope index of inequality (SII) and the concentration index (CIX), with wealth index and maternal schooling being the socioeconomic variables. The inequalities in the number of health problems were evaluated by Poisson regression. The perinatal sample comprised 4,275 children. At 12 months approximately 74% of the children presented 1 or more health problems, while at 24 months, approximately 44% presented 2 or more health problems. For all period, the mean number of health problems was 2.9 (standard deviation = 2.0). Higher frequencies were observed for children belonging to the poorest income quintile and with lower maternal education, except for 1 or more health problems at 24 months. The greatest absolute and relative inequality was observed for 2 or more health problems at 12 months (SII: -0.23, 95%CI: -0.29; -0.18 and CIX: -0.19, 95%CI: -0.25; -0.14). There is an opposite dose-response relation for the risk of accumulation of health problems according to maternal schooling (1.07, 95%CI: 1.04; 1.09) and wealth categories (1.03, 95%CI: 1.01; 1.04), in the full adjusted models. The study confirms inequalities due to health problems in Brazilian children, especially in the first year of life.

Socioeconomic status in life course is associated with dental appearance dissatisfaction.

The present study aimed to investigate the prevalence of dissatisfaction with dental appearance among 24-year-old Brazilian adults and the associated factors in life course. A subsample (n = 720) of the 1982 Pelotas Birth Cohort in southern Brazil was investigated at the ages of 15 and 24 years using clinical (caries and periodontal) examinations and interviews. The outcome was dissatisfaction with dental appearance at the age of 24 years. Covariate variables included socioeconomic factors, oral health, and dissatisfaction with general appearance collected during different periods of life. Poisson regression models with robust variance were applied. The prevalence of dissatisfaction with dental appearance was 43.5% (95%CI: 39.8-47.1). Individuals with downward income mobility (PR = 1.22, 95%CI: 1.07-1.79) and those always poor (PR = 1.21, 95%CI: 1.00-1.57) presented a higher prevalence of dissatisfaction with their dental appearance even after oral health variables and dissatisfaction with general appearance were controlled for. Moderate/severe malocclusion at 15 years (PR = 1.34, 95%CI: 1.13-1.59), highest experience of untreated dental caries at 24 years (PR = 1.82, 95%CI: 1.46-2.27), and dental pain experience at 24 years (PR = 1.29, 95%CI: 1.22-1.75) were associated with the outcome. Also, the prevalence of dissatisfaction with dental appearance was 20% higher (PR = 1.20, 95%CI: 1.01-1.43) among those dissatisfied with their general appearance. Our findings demonstrated a high prevalence of dissatisfaction with dental appearance among young adults. Lifetime economic disadvantage and dental problems (malocclusion at 15 years, untreated dental caries at 24 years, and dental pain at 24 years) were associated with dissatisfaction with dental appearance among young adults.