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Background: The negative impacts of maternal depression on child mental health outcomes are well‐documented. However, some children show adaptive functioning following exposure to maternal depression, demonstrating resilience. In a large birth cohort from Brazil, a middle‐income country, we examined direct and indirect pathways, considering socioeconomic, family, and individual factors, contributing to the development of resilience. Methods: Using data from the 2004 Pelotas Birth Cohort (N = 4231), we restricted the sample to those exposed to maternal depression up to age 6 years (depression present at ≥2 out of 5 assessment waves; n = 1132; 50% boys). Resilience was defined as scoring below or equal to the mean of the unexposed group on all four problem subscales of the parent‐report Strengths and Difficulties Questionnaire at age 11 years. We examined pathways from socioeconomic status (SES; measured at birth) to resilience via cognitive stimulation (CS) (at 24 and 48 months) and Intelligence quotient (IQ) (at 6 years), and from CS to resilience via IQ, using counterfactual mediation. Results: A minority of children exposed to maternal depression showed resilience (12.4%). There was evidence of indirect pathways from SES to resilience via CS (odds ratio (OR) = 1.76, 95% confidence interval (CI) 1.02–3.38) and IQ (OR = 1.19, 95% CI 1.01–1.42), such that higher SES was associated with resilience via both higher levels of CS and higher IQ, which, in turn, were each positively associated with resilience. Furthermore, there was evidence of a direct (OR = 1.86, 95% CI 1.01–3.76) and total effect (OR = 1.94, 95% CI 1.05–3.89) of CS on resilience, even after controlling for SES. However, these effects varied depending on how persistent and severe depression was defined. Conclusions: These findings suggest that CS in early childhood may represent a modifiable protective factor for children exposed to maternal depression and a promising intervention target to promote child resilience in the context of maternal depression exposure. [ABSTRACT FROM AUTHOR]

The given text provides a summary of the 2004 Pelotas Birth Cohort Study conducted in Pelotas, Brazil. The study followed 4,231 participants from birth to 17 years of age and collected data on various factors such as mental health, non-communicable diseases, clinical conditions, human capital, violence, and the impact of the COVID-19 pandemic. The study aimed to investigate the impact of early life exposures on health outcomes and social inequities. The text also provides information on the follow-up rates of the study at different time points, with factors such as maternal age, education, smoking, and family income influencing the rates. The study found stable mental health among adolescents, an increase in maternal depression, a decrease in obesity, and an increase in alcohol and cigarette experimentation. The COVID-19 impact study revealed challenges faced by adolescents during the pandemic. The study has strengths in its design and high follow-up rates but has limitations due to the pandemic. The data from the study are available upon request. [Extracted from the article]

Background: This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring's risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. Methods: We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: "low" "moderate low", "increasing", "decreasing", and "chronic high". The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome –yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring's risk behavior adjusting for potential confounding variable. Results: Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. Conclusion: Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression. [ABSTRACT FROM AUTHOR]

Objective: Shared genetic mechanisms have been hypothesized to explain the comorbidity between ADHD and asthma. To evaluate their genetic overlap, we relied on data from the 1982 Pelotas birth cohort to test the association between polygenic risk scores (PRSs) for ADHD (ADHD-PRSs) and asthma, and PRSs for asthma (asthma-PRSs) and ADHD. Method: We analyzed data collected at birth, 2, 22, and 30 years from 3,574 individuals. Results: Subjects with ADHD had increased risk of having asthma (OR 1.92, 95% CI 1.01–3.66). The association was stronger for females. Our results showed no evidence of association between ADHD-PRSs and asthma or asthma-PRSs and ADHD. However, an exploratory analysis suggested that adult ADHD might be genetically associated with asthma. Conclusion: Our results do not support a shared genetic background between both conditions. Findings should be viewed in light of important limitations, particularly the sample size and the self-reported asthma diagnosis. Studies in larger datasets are required to better explore the genetic overlap between adult ADHD and asthma. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study used data from 2,222 mothers and infants participating in a population‐based birth cohort to verify whether maternal depression in the perinatal period was associated with poor infant sleep. Mothers who scored ≥13 points on the Edinburgh Postnatal Depression Scale at 16–24 weeks of gestation and/or 3 months after delivery were considered perinatally depressed. The main outcome variable was poor infant sleep at 12 months of age, defined as >3 night wakings, nocturnal wakefulness >1 hr or total sleep duration <9 hr. Infant sleep data were obtained with the Brief Infant Sleep Questionnaire (BISQ) and 24‐hr actigraphy monitoring. Prevalence of perinatal depression in the sample was 22.3% (95% confidence interval [CI], 20.5–24.0). After Poisson regression, infants of depressed mothers showed an adjusted relative risk (RR) of 1.44 (95% CI, 1.00–2.08; p =.04) for >3 night wakings with questionnaire‐derived data. When actigraphy data were analysed, no association was found between perinatal depression and poor infant sleep (adjusted RR, 1.20; 95% CI, 0.82–1.74; p =.35). In conclusion, although mothers in the depressed group were more likely to report more night wakings, objective data from actigraphy did not replicate this finding. Dysfunctional cognition, maternal behavioural factors and sleep impairment associated with perinatal depression may affect the mother's impression of her infant's sleep. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the association between preterm birth and body composition at 6, 18, and 30 years of age using data from three population-based birth cohort studies.Methods: Gestational age (GA), defined by the date of the last menstrual period (categorized in ≤33, 34-36, and ≥ 37 weeks), was gathered in the first 24-h after delivery for all live births occurring in the city of Pelotas, Brazil, in 2004, 1993 and 1982. Body composition was assessed by air-displacement plethysmography. Outcomes included fat mass (FM, kg), percent FM (%FM), FM index (FMI, kg/m2), fat-free mass (FFM, kg); percent FFM (%FFM), FFM index (FFMI, kg/m2), body mass index (BMI, kg/m2 at 18 years in the 1993 cohort and 30 years in the 1982 cohort), and BMI Z-score (at 6 years in the 2004 cohort). We further explored the association of birth weight for GA with body composition indicators and BMI. Crude and adjusted linear regressions provided beta coefficients with 95% confidence intervals (95%CI).Results: A total of 3036, 3027, and 3369 participants, respectively, from the 2004, 1993, and 1982 cohorts were analyzed. At 6 years, preterm boys (born at 34-36 weeks) presented lower adjusted mean of FM (β = - 0.80 kg, - 1.45;-0.16, p = 0.046), %FM (β = - 2.39%, - 3.90;-0.88, p = 0.008), FMI (β = - 0.70 kg/m2, - 1.13;-0.27, p = 0.004) as well as lower FFM (β = - 0.4 kg, - 0.77; - 0.12, p = 0.010) and FFMI (β = - 0.3 kg/m2, - 0.46;-0.10, p < 0.001), and BMI Z-score (β = - 0.69,; - 0.99;-0.40, p < 0.001); but higher %FFM (β = 2.4%, 0.87;-3.90, p = 0.008), when compared to boys born at term (≥37). At 30 years, FM (15.7 kg, 0.25;31.1, p = 0.102) was higher among males born at ≤33 weeks. No association was observed for females from the three cohorts and for 18-year-old males. The association of birth weight for GA with body composition and BMI was not significant in any cohort. At 6 years, SGA boys had lower FFMI than boys AGA.Conclusions: Our results suggest that preterm birth is associated with decreased body fat and fat-free mass in childhood but higher fat mass in adulthood. Nevertheless, results were only significant for males. SGA boys also showed lower FFMI. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Few low-middle-income countries have data from comparable birth cohort studies spanning over time. We report on the methods used by the Pelotas cohorts (1982, 1993, 2004 and 2015) and describe time trends in sociodemographic characteristics of the participant families.Methods: During the four study years, all maternity hospitals in the city were visited daily, and all urban women giving birth were enrolled. Data on socioeconomic and demographic characteristics were collected using standardized questionnaires, including data on maternal and paternal skin colour, age and schooling, maternal marital status, family income and household characteristics. The analyses included comparisons of time trends and of socioeconomic and ethnic group inequalities.Results: Despite a near 50% increase in the city's population between 1982 and 2015, the total number of births declined from 6011 to 4387. The proportion of mothers aged ≥35 years increased from 9.9% to 14.8%, and average maternal schooling from 6.5 [standard deviation (SD) 4.2] to 10.1 (SD 4.0) years. Treated water was available in 95.3% of households in 1982 and 99.3% in 2015. Three-quarters of the families had a refrigerator in 1982, compared with 98.3% in 2015. Absolute income-related inequalities in maternal schooling, household crowding, household appliances and access to treated water were markedly reduced between 1982 and 2015. Maternal skin colour was associated with inequalities in age at childbearing and schooling, as well as with household characteristics.Conclusions: During the 33-year period, there were positive changes in social and environmental determinants of health, including income, education, fertility and characteristics of the home environment. Socioeconomic inequality was also reduced. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are the leading cause of death, worldwide. Obesity is one of the factors that is associated with the development of such diseases. The role of reproductive factors on women body composition has been evaluated, but the findings are controversial. This study was aimed at assessing the association of parity with body composition among women.Methods: In 1982, the maternity hospital of Pelotas, a southern Brazilian city, were visited daily and all deliveries were identified. Those livebirths whose family lived in the urban area of the city have been prospectively followed (n = 5914). In 2012-13, we tried to follow the whole cohort, the subjects were interviewed and examined. We evaluated the association of parity with the following body composition variables: body mass index, waist circumference and fat mass %. Estimates were adjusted for family income, skin color, maternal schooling, occupational status, alcohol, smoking, physical activity, and consumption of processed and ultraprocessed foods. All these analyses were replicated among the cohort men as a comparison. We also assessed whether duration of breastfeeding moderated the association.Results: In the 2012-13 visit, 3701 subjects were evaluated (mean age of 30.2 years). In the present analysis, we included 1620 women and 1653 men. 33% of women were nulliparous and 48% of men were without children. Even after controlling for confounding, parous women had a BMI 0.96 kg/m2 (95% CI: 0.30; 1.62) higher than nulliparous and for men the regression coefficient was 0.79 kg/m2 (95% CI: 0.29; 1.29). Waist circumference was also higher among parous women. Among men, the association was not linear and the regression coefficients were lower than that observed among women [3.41 cm (95% CI: -0.91; 7.73) among men and 4.83 cm (95% CI: 2.43; 7.24) among women with more than 3 children when compared with those without children], but this difference was not statistically significant (interaction p value = 0.58). Fat mass % was not associated with parity. Breastfeeding did not modify the association between parity and body composition.Conclusions: Parity was positively associated with body mass index and waist circumference among women. However, similar results among men suggest that there is no causal effect of parity. [ABSTRACT FROM AUTHOR]

Background: Maternal depression impacts on several detrimental outcomes during a child's life course, and could increase their risk of victimization. This longitudinal study examined the association between antenatal maternal depression, postnatal trajectories, and current maternal depression and offspring bullying victimization at 11 years.Methods: We included 3,441 11-year-old adolescents from the 2004 Pelotas Cohort Study. Antenatal maternal depression, postnatal trajectories, and current maternal depression data were assessed during the follow-up waves. Bullying victimization was self-reported by the adolescents. We used ordinal logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CIs), for the association between maternal depression and offspring bullying victimization.Results: The most prevalent type of bullying was verbal victimization (37.9%). We observed a positive association between antenatal maternal depression, postnatal trajectories, and current maternal depression and physical bullying victimization. Maternal mood symptoms during pregnancy were associated with physical (OR = 1.30, 95%CI = 1.11-1.53), verbal (OR = 1.29, 95%CI = 1.12-1.49), and any victimization (OR = 1.22, 95%CI = 1.05-1.41). Severe current maternal depression was associated with physical (OR = 1.34, 95%CI = 1.10-1.62), social manipulation (OR = 1.29, 95%CI = 1.08-1.53), attacks on property (OR = 1.30, 95%CI = 1.08-1.57) and any victimization (OR = 1.32, 95%CI = 1.12-1.56). Regarding maternal depression trajectories, the "chronic-high" group was associated with higher risk of social manipulation, attacks on property and any victimization, than the "low" group.Conclusions: Our results strengthen the evidence of association between maternal depression and offspring bullying victimization, and physical victimization appears to be the main component. Further studies are warranted to confirm our findings and to elucidate the theoretical pathways for this longitudinal association. [ABSTRACT FROM AUTHOR]

Background: Studies conducted mainly in high-income countries have shown that preterm births are associated with increased risk of behavioral problems and psychiatric disorders. The aim of this study was to assess the prevalence of behavioral problems from middle-childhood to early-adolescence according to gestational age at birth in a middle-income setting.Methods: A population-based birth cohort (n = 4231) in Pelotas, Brazil, was followed-up in several occasions from birth to 11 years. Estimated GA was based on last menstrual period or, when unknown or inconsistent, on the Dubowitz method. Behavioral problems were assessed at 4 (Child Behavior Checklist - CBCL), and at 6 and 11 years (Development and Well-Being Assessment - DAWBA) tool. Maternal socio-economic characteristics and depression at 2, 4 and 6 years post-partum, child perinatal characteristics and breastfeeding duration were used as confounders. Analyses were run by linear and logistic regression.Results: Three thousand two hundred four children had full information on gestational age, CBCL and DAWBA. At 4 years, mean total (42.9 ± 24.0) and mean externalizing (18.8 ± 9.1) CBCL scores were higher among preterm girls born at <34 weeks than among full term girls (33.2 ± 15.1 and 15.0 ± 6.6, respectively). After controlling for confounders the association was no longer significant. At the age of 6 years there was no association between gestational age and behavior, neither in crude nor in adjusted analyses. Odds ratio for any psychiatric disorders at 11 years was 60% (1.6; 1.1-2.1) higher among those born at 34-36 weeks than in full-term children, but the association disappeared in adjusted analyses.Conclusion: At this large cohort, behavioral problems from middle-childhood to early-adolescence are more related to family socio-economic characteristics and to other child perinatal conditions than to gestational age at birth. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity has been reported to worsen pulmonary function (PF). This study aimed to examine the association between PF and several body composition (BC) measures in two population-based cohorts. Methods: We performed a cross-sectional analysis of individuals aged 18 and 30 years from two Pelotas Birth Cohorts in southern Brazil. PF was assessed by spirometry. Body measures that were collected included body mass index, waist circumference, skinfold thickness, percentages of total and segmented (trunk, arms and legs) fat mass (FM) and total fat-free mass (FFM). FM and FFM were measured by air-displacement plethysmography (BODPOD) and by dual-energy x-ray absorptiometry (DXA). Associations were verified through linear regressions stratified by sex, and adjusted for weight, height, skin color, and socioeconomic, behavioral, and perinatal variables. Results: A total of 7347 individuals were included in the analyses (3438 and 3909 at 30 and 18 years, respectively). Most BC measures showed a significant positive association between PF and FFM, and a negative association with FM. For each additional percentage point of FM, measured by BOD POD, the forced vital capacity regression coefficient adjusted by height, weight and skin color, at 18 years, was −33 mL (95% CI −38, −29) and −26 mL (95% CI −30, −22), and −30 mL (95% CI −35, −25) and −19 mL (95% CI −23, −14) at 30 years, in men and women, respectively. All the BOD POD regression coefficients for FFM were the same as for the FM coefficients, but in a positive trend (p<0.001 for all associations). Conclusions: All measures that distinguish FM from FFM (skinfold thickness–FM estimation–BOD POD, total and segmental DXA measures–FM and FFM proportions) showed negative trends in the association of FM with PF for both ages and sexes. On the other hand, FFM showed a positive association with PF. [ABSTRACT FROM AUTHOR]

Background: Youth violence is a major global public health problem. Three UK and Swedish studies suggest that low resting heart rate predicts male youth violence, but this has not been tested in other social settings nor for females.Methods: A prospective, population-based birth cohort study was conducted in Pelotas, Brazil. Heart rate was measured using a wrist monitor at ages 11, 15 and 18 years. Violent crime and non-violent crime were measured at age 18 in self-reports and official records (N = 3618). Confounding variables were assessed in the perinatal period and at age 11, in interviews with mothers and children. Logistic regression was used to estimate associations between quartiles of heart rate at each age, and violent and non-violent crime at age 18, separately for males and females.Results: Lower resting heart rate was a robust correlate of violent and non-violent crime for males. Comparing males in the lowest and top quartiles of heart rate at age 15 years, adjusted odds ratios were 1.9 for violent crime [95% confidence interval (CI) 1.4-2.7] and 1.7 for non-violent crime (95% CI 1.1-2.6). For females, crime outcomes were associated only with low resting heart rate at age 18. Associations were generally linear across the four heart rate quartiles. There was no evidence that associations differed according to socioeconomic status at age 15.Conclusions: Low resting heart rate predicted violent and non-violent crime for males, and was cross-sectionally associated with crime for females. Biological factors may contribute to individual propensity to commit crime, even in a middle-income setting with high rates of violence. [ABSTRACT FROM AUTHOR]

Background: Poor nutrition and growth during fetal life and childhood might be associated with depression in adulthood; however, studies evaluating these associations present controversial results, especially when comparing studies using different proxies for fetal growth. We evaluated the association of fetal and childhood growth/nutrition with depression, in adulthood, using different approaches and measurement methods. Method: In 1982, hospital births (n = 5914) in Pelotas, southern Brazil, were examined and have been prospectively followed. At 30 years, the presence of major depression and depressive symptoms severity was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Beck Depression Inventory (BDI-II). The present study assessed their association with birth weight, premature birth, small for gestational age (SGA), stunting and conditional growth during childhood. Results: At 30 years, 3576 individuals were evaluated and 7.9% had major depression. Low birth weight (PR = 1.01 95%CI [0.64–1.60]), having been born SGA (PR = 0.87 95%CI [0.64–1.19]) and premature birth (PR = 1.22 95%CI [0.72–2.07]) were not associated with major depression in multivariable models. However, those born SGA who were also stunted in childhood had a higher prevalence of major depression (PR = 1.87 95%CI [1.06–3.29]) and greater odds of scoring a higher level of depression in the BDI-II (OR = 2.18 95%CI [1.34–3.53]). Conclusion: In this Brazilian cohort of young adults, those born SGA who were also stunted during childhood had a higher risk of depression in adulthood. Our results show that the effect of growth impairment on depression is cumulative. [ABSTRACT FROM AUTHOR]

In this manuscript, we update the profile of the 1982 Pelotas Birth Cohort Study.In 1982, 5914 live births whose families lived in the urban are of Pelotas were enrolled in the cohort. In 2012-13, we tried to locate the whole original cohort; 3701 participants were interviewed who, added to the 325 known deaths, represented a follow-up rate of 68.1%. In contrast to the previous home interviews, in this wave all participants were invited to visit the research clinic to be interviewed and examined. The visit was carried out at a mean age of 30.2 years and mainly focused on four categories of outcomes: (i) mental health; (ii) body composition; (iii) precursors of complex chronic diseases; and (iv) human capital. Requests for collaboration by outside researchers are welcome. [ABSTRACT FROM AUTHOR]

Background: Active commuting is a good opportunity to accumulate physical activity (PA) across the lifespan that potentially might influence central body fat. We aimed to examine the prospective associations of active commuting at 11, 15 and 18 years of age with central body fat at 18 years. Methods: Participants were part of a large birth cohort study in Pelotas, Brazil (n = 3,649 participants). Active commuting, leisure-time PA and income were self-reported at 11, 15 and 18 years. Waist circumference and trunk fat mass were collected at 18 years with the use of a 3-dimensional photonic scanner and dual-energy X-ray absorptiometry, respectively. Results: Active commuting at 11 years was not prospectively associated with central body fat. However, we found that active commuting at 15 and 18 years were prospectively and cross-sectionally associated with central body fat variables, respectively, in boys but not in girls. Also, boys in the highest tertile of accumulated active commuting (i.e., average of active commuting at 11, 13 and 18 years) were associated with −2.09 cm (95%CI: −3.24; −0.94) of waist circumference and −1.11 kg (95%CI: −1.74; −0.48) of trunk fat mass compared to boys in the lowest tertile. Analyses on changes in tertiles of active commuting from 11 and 15 years to 18 years with central body fat variables at 18 years showed that boys who remained consistently in the highest tertile or moved to a higher tertile had lower levels of central body fat compared to those consistently in the lowest tertile. Conclusions: Active commuting throughout adolescence in boys, especially during middle and late adolescence, is associated with lower levels in central fatness before adulthood. [ABSTRACT FROM AUTHOR]

Background Low- and middle-income countries continue to experience a large burden of stunting; 148 million children were estimated to be stunted, around 30–40% of all children in 2011. In many of these countries, foetal growth restriction (FGR) is common, as is subsequent growth faltering in the first 2 years. Although there is agreement that stunting involves both prenatal and postnatal growth failure, the extent to which FGR contributes to stunting and other indicators of nutritional status is uncertain.Methods Using extant longitudinal birth cohorts (n = 19) with data on birthweight, gestational age and child anthropometry (12–60 months), we estimated study-specific and pooled risk estimates of stunting, wasting and underweight by small-for-gestational age (SGA) and preterm birth.Results We grouped children according to four combinations of SGA and gestational age: adequate size-for-gestational age (AGA) and preterm; SGA and term; SGA and preterm; and AGA and term (the reference group). Relative to AGA and term, the OR (95% confidence interval) for stunting associated with AGA and preterm, SGA and term, and SGA and preterm was 1.93 (1.71, 2.18), 2.43 (2.22, 2.66) and 4.51 (3.42, 5.93), respectively. A similar magnitude of risk was also observed for wasting and underweight. Low birthweight was associated with 2.5–3.5-fold higher odds of wasting, stunting and underweight. The population attributable risk for overall SGA for outcomes of childhood stunting and wasting was 20% and 30%, respectively.Conclusions This analysis estimates that childhood undernutrition may have its origins in the foetal period, suggesting a need to intervene early, ideally during pregnancy, with interventions known to reduce FGR and preterm birth. [ABSTRACT FROM AUTHOR]

Background: The number of cesarean sections (CSs) is increasing in many countries, and there are concerns about their short- and long-term effects. A recent Brazilian study showed a 58% higher prevalence of obesity in young adults born by CS than in young adults born vaginally. Because CS-born individuals do not make contact at birth with maternal vaginal and intestinal bacteria, the authors proposed that this could lead to long-term changes in the gut microbiota that could contribute to obesity. Objective: We assessed whether CS births lead to increased obesity during childhood, adolescence, and early adulthood in 3 birth cohorts. Design: We analyzed data from 3 birth-cohort studies started in 1982, 1993, and 2004 in Southern Brazil. Subjects were assessed at different ages until 23 y of age. Poisson regression was used to estimate prevalence ratios with adjustment for =15 socioeconomic, demographic, maternal, anthropometric, and behavioral covariates. Results: In the crude analyses, subjects born by CS had ~50% higher prevalence of obesity at 4, 11, and 15 y of age but not at 23 y of age. After adjustment for covariates, prevalence ratios were markedly reduced and no longer significant for men or women. The only exception was an association for 4-y-old boys in the 1993 cohort, which was not observed in the other 2 cohorts or for girls. Conclusion: In these 3 birth cohorts, CSs do not seem to lead to an important increased risk of obesity during childhood, adolescence, or early adulthood. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship between breastfeeding duration and blood pressure in a large birth cohort of Brazilians followed from birth to adolescence. Methods: All 5914 hospital births occurring in Pelotas in 1982 (over 99% of all deliveries) were studied prospectively. Detailed information on feeding practices was prospectively collected during childhood. In 1997 and 2001 we attempted to trace a sample of the cohort, whereas in 2000 we identified the male subjects when presenting for the army recruitment exam. Blood pressure measurements were taken in 1997 for both sexes, males in 2000 and females in 2001. Results: Information on breastfeeding collected between 1983 and 1986 was available for 90.8% of the 5914 original cohort subjects. We managed to follow 1076, 2250 and 1031 subjects in 1997, 2000 and 2001, respectively. Total breastfeeding duration was not associated with systolic and diastolic blood pressure in adolescence. Diastolic blood pressure at the age of 15 y (1997) was higher among girls who had been predominantly breastfed for at least 4 mo. After controlling for confounding variables (family income, maternal education at birth and maternal BMI at birth, skin colour, birthweight, gestational age, maternal smoking during pregnancy, adolescent smoking and alcohol drinking), the strength of the association was reduced and the 95% confidence interval encompassed the other blood pressure estimates. Furthermore, such association was not replicated in the 2001 follow-up visit. Conclusion: Breastfeeding duration was not related to blood pressure in adolescence. [ABSTRACT FROM AUTHOR]

Aim: To assess the effect of breastfeeding duration on school achievement in a Brazilian cohort. Methods : In a population-based birth cohort, we analysed the highest grade achieved in school of over 2000 male 18-y-olds relative to breastfeeding information collected in early life. Analyses were adjusted for birthweight, family income, maternal and paternal schooling, household assets, number of siblings, social class, maternal smoking during pregnancy, and ethnicity. Results : After adjustment for confounding variables, there was a highly significant trend in school achievement with increasing breastfeeding duration. Those breastfed for 9 mo or more were ahead by 0.5–0.8 school grades, relative to those breastfed for less than 1 mo. Data from a cross-sectional survey in the same population suggest that such a difference corresponds to a 10–15% difference in adult income levels. The duration of exclusive or predominant breastfeeding was also positively associated with schooling. Conclusion: Unlike studies from developed countries, there was no clear association between breastfeeding duration and either the family's socio-economic level or parental schooling in our sample and therefore residual confounding is improbable. These results suggest that the impact of breastfeeding on intellectual development may lead to sizeable differences in adult education and wage-earning performance. [ABSTRACT FROM AUTHOR]

Background: Reference values for umbilical artery Doppler indices are used clinically to assess fetal well-being. However, many studies that have produced reference charts have important methodologic limitations, and these result in significant heterogeneity of reported reference ranges.Objectives: To produce international gestational age-specific centiles for umbilical artery Doppler indices based on longitudinal data and the same rigorous methodology used in the original Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project.Study Design: In Phase II of the INTERGROWTH-21st Project (the INTERBIO-21st Study), we prospectively continued enrolling pregnant women according to the same protocol from 3 of the original populations in Pelotas (Brazil), Nairobi (Kenya), and Oxford (United Kingdom) that had participated in the Fetal Growth Longitudinal Study. Women with a singleton pregnancy were recruited at <14 weeks' gestation, confirmed by ultrasound measurement of crown-rump length, and then underwent standardized ultrasound every 5±1 weeks until delivery. From 22 weeks of gestation umbilical artery indices (pulsatility index, resistance index, and systolic/diastolic ratio) were measured in a blinded fashion, using identical equipment and a rigorously standardized protocol. Newborn size at birth was assessed using the international INTERGROWTH-21st Standards, and infants had detailed assessment of growth, nutrition, morbidity, and motor development at 1 and 2 years of age. The appropriateness of pooling data from the 3 study sites was assessed using variance component analysis and standardized site differences. Umbilical artery indices were modeled as functions of the gestational age using an exponential, normal distribution with second-degree fractional polynomial smoothing; goodness of fit for the overall models was assessed.Results: Of the women enrolled at the 3 sites, 1629 were eligible for this study; 431 (27%) met the entry criteria for the construction of normative centiles, similar to the proportion seen in the original fetal growth longitudinal study. They contributed a total of 1243 Doppler measures to the analysis; 74% had 3 measures or more. The healthy low-risk status of the population was confirmed by the low rates of preterm birth (4.9%) and preeclampsia (0.7%). There were no neonatal deaths and satisfactory growth, health, and motor development of the infants at 1 and 2 years of age were documented. Only a very small proportion (2.8%-6.5%) of the variance of Doppler indices was due to between-site differences; in addition, standardized site difference estimates were marginally outside this threshold in only 1 of 27 comparisons, and this supported the decision to pool data from the 3 study sites. All 3 Doppler indices decreased with advancing gestational age. The 3rd, 5th 10th, 50th, 90th, 95th, and 97th centiles according to gestational age for each of the 3 indices are provided, as well as equations to allow calculation of any value as a centile and z scores. The mean pulsatility index according to gestational age = 1.02944 + 77.7456*(gestational age)-2 - 0.000004455*gestational age3.Conclusion: We present here international gestational age-specific normative centiles for umbilical artery Doppler indices produced by studying healthy, low-risk pregnant women living in environments with minimal constraints on fetal growth. The centiles complement the existing INTERGROWTH-21st Standards for assessment of fetal well-being. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background:Prenatal cigarette smoke exposure may have adverse psychological effects on offspring. The objective was to assess the association between parental smoking during pregnancy and offspring happiness at age 18, as well as depression. Methodology:Participants were part of a birth cohort study in Pelotas, Brazil (5,249 participants). Happiness was measured by the SubjectiveHappinessScale, a Likert-like scale with four questions generating a score from 1 to 7, with ≥ 6 indicating "happiness". Depression was measured using the Mini International Psychiatric Interview. ​Results:About one third of mothers reported having smoked during pregnancy and 4.6% reported smoking 20 or more cigarettes a day. The prevalence of happiness was 32.2% (95% CI 30.8; 33.7), depression 6.8% (95% CI 6.1; 7.6), and simultaneous happiness and depression less than 1%. The prevalence of offspring happiness decreased as smoking in pregnancy increased, even after control for confounding variables, showing an OR = 0.79 [95% CI 0.55; 1.13]. The opposite happened to depression; the prevalence of offspring depression increased as smoking in pregnancy increased (<20 cigarettes/day OR = 1.38 [95% CI 1.03; 1.84] and ≥20 cigarettes/day OR = 2.11[95% CI 1.31; 3.40]. Smoking by the partner was associated with decreased offspring happiness after adjustment for confounders, but did no show association with offspring depression. Conclusions:Offspring were less likely to be happy and more likely to be depressed if their mother smoked during pregnancy, and less likely to be happy if their father smoked during mother’s pregnancy. Although we can not affirm that this is a “causal pathway”, public policies to reduce smoking in pregnancy could improve the health of the offspring in the short and long term. [ABSTRACT FROM AUTHOR]

Background: Little is known about the effect of bed-sharing with the mother over the child mental health.Methods: Population-based birth cohort conducted in Pelotas, Brazil. Children were enrolled at birth (n=4231) and followed-up at 3 months and at 1, 2, 4, and 6 years of age. Bed-sharing was defined as "habitual sharing of the bed between the child and the mother, for sleeping, for part of the night or the whole night". Trajectories of bed sharing between 3 months and 6 years of age were calculated. Mental health was assessed at the age of 6 years using the Development and Well-Being Assessment instrument that generates psychiatric diagnosis according to ICD-10 and DSM-IV criteria. Odds ratios (OR) with 95% confidence intervals were obtained by multivariate logistic regression.Results: 3583 children were analyzed. Four trajectories were identified: non bed-sharers (44.4%), early-only (36.2%), late-onset (12.0%), and persistent bed-sharers (7.4%). In the adjusted analyses persistent bed-sharers were at increased odds of presenting any psychiatric disorder (OR=1.7; 1.2-2.5) and internalizing problems (OR=2.1; 1.4-3.1), as compared to non bed-sharers. Among the early-only bed-sharers OR for any psychiatric disorder was 1.4 (1.1-1.8) and for internalizing problems 1.6 (1.2-2.1).Limitations: Although the effect of bed-sharing was adjusted for several covariates including the family socio-economic status, maternal mental health and excessive crying, there was no information on maternal personal reasons for bed-sharing. Mothers that bed-share intentionally and those that bed-share in reaction to a child sleep problem may have a different interpretation of their children behavior that may bias the study results.Conclusion: Bed-sharing is a common practice in our setting and is associated with impaired child mental health at the age of six years. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has caused major stress for families and children, particularly in the context of prolonged school closures. Few longitudinal studies are available on young children's mental health, including data both before and during the pandemic. This study examined experiences that might increase risk for mental health problems among caregivers and young children during the COVID-19 pandemic and inequalities driven by pre-pandemic disadvantage. This prospective, population-based birth cohort study in Pelotas, Brazil, analyzed 2,083 children and caregivers with data from before the pandemic in 2019, when children were 4 years old, and again in 2020, when schools were closed for a long period during the pandemic. Child conduct problems, emotional problems, and hyperactivity-inattention problems were assessed using the Strengths and Difficulties Questionnaire. Family financial hardship, relationship difficulties, caregiver mental health, parenting practices, and child fears and isolation were considered as potential risk factors. Across the whole population, the only significant increase in mental health problems from before to during the pandemic was found for maternal depression. However, poorer families were at far greater risk of experiencing serious financial problems, food shortages, increased conflict in adult relationships, parenting problems, and child worries about food availability during the pandemic. In turn, these difficulties were associated with increases in multiple mental health problems for both caregivers and children. Increased child mental health problems were most strongly associated with concurrent maternal anxiety (β > 0.20, p <.001, for each of child conduct, emotional, and hyperactivity problems), maternal depression (β = 0.26, p <.001, for child emotional problems), partner criticism (β = 0.21, p <.001, for child conduct problems), and harsh parenting (β > 0.20, p <.001, for both child conduct and hyperactivity problems). Child worry about COVID-19 was associated with increased emotional problems (β = 0.14, p <.001), but children's isolation was not associated with their mental health. Overall, the impact of the COVID-19 pandemic on mental health is a mixed picture, but for families in poverty, marked material and interpersonal difficulties were associated with increases in mental health problems among children and caregivers. [Display omitted] [ABSTRACT FROM AUTHOR]

The co-occurrence of two or more diseases is called multimorbidity, and the occurrence of two or more risk factors is called simultaneity of risk factors. Multimorbidity and simultaneity of risk factors are not widely understood in adolescence and early adulthood. This paper aims to describe how multimorbidity and simultaneity of risk factors are distributed throughout adolescence and early adulthood, considering demographic and socioeconomic characteristics, among the 1993 Pelotas Birth Cohort members. This study was carried out using data from the 11, 15, 18, and 22y of the 1993 Pelotas Birth Cohort, Brazil (n = 5249). A self-reported questionnaire assessed allergies, asthma/bronchitis/wheezing, diabetes, vision problems, hypertension, common mental disorders, other mental disorders, physical inactivity, sedentary behaviour, insufficient sleep time, smoking, alcohol abuse behaviour, and illicit drugs. Glucose, cholesterol, blood pressure, weight, and height were objectively collected. The prevalence of multimorbidity was 26.3%, 31.3%, 37.9%, and 44.4% at 11, 15, 18, and 22y, respectively. Around 70% of all ages presented simultaneity of risk factors. Women presented a higher prevalence of simultaneity of risk factors, and the multimorbidity gradually increased from 11 to 22y. The presence of both multimorbidity and simultaneity of risk factors was 19.7% at 11 and 35.4% at 22y. Less than 2% have no morbidity and no risk factors at each age assessed. This study highlighted the early emergence and accelerated growth of diseases and risk factors in a young population, especially their co-occurrence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the relationship between sleep duration trajectories from adolescence to early adulthood and working memory, schooling and income at 22 years in the Pelotas 1993 Birth Cohort.Methods: Sleep duration was self-reported at ages 11, 18 and 22. Sleep trajectories were identified using finite mixture models. Schooling was recorded as the number of completed years of education. Working memory was evaluated using The Digit Span test and income was recorded for who reported have a job and received a payment for this in the previous month. All analyses were stratified by sex.Results: We used crude and adjusted (for demographic, health and behavior characteristics measured at perinatal and 11-years) linear or quantile regression analyses. A total of 2915 individuals were included. Three trajectories for males were used: "increase and maintenance" (3.4%), "fast reduction and maintenance" (45.0%) and "constant reduction" (51.6%). For females, we used the trajectories: "increase and decrease" (2.4%), "fast reduction and maintenance" (25.6%) and "constant reduction" (72.0%). Males from "increase and maintenance" and females from "increase and decrease" trajectories scored, on average, 1.6 and 1.8 points lower, respectively, in working memory test. They presented a median of 1.4 and 2.6 fewer schooling years, respectively, compared to individuals from the "fast reduction and maintenance" trajectory. Regarding income, no significant association was observed.Conclusion: Sleep duration during adolescence could affect cognitive and educational outcomes in early adulthood. Individuals who presented the expected sleep trajectory (decrease of sleep duration across adolescence) presented better outcomes. [ABSTRACT FROM AUTHOR]

Childhood cognitive abilities are a predictor of health outcomes and adult income potential. Identifying factors associated with childhood intelligence and their interactions is essential in behavioral research. We assessed the impact of genetic variants and early child stimulation (ECS) on child intelligence and examined their possible interaction as potential modifiers of IQ in a population-based longitudinal study. Participants of the 2004 Pelotas Birth Cohort study (N = 4231) underwent intelligent quotient (IQ) by WISC-III assessment at 6 years of age. At 24 and 48-months, mothers answered five ECS marker questions, whose sum was used to create a score. The polygenic score for intelligence (IQ-PGS) was constructed from the GWAS-weighted estimate of cognition. Association was assessed using multiple linear regression models adjusted for maternal, family, and child confounding variables. To explore the possible influence of skin color and ethnoracial classification, the regression models were stratified according to the skin color variable, as a sensitivity analysis. In the adjusted analysis, IQ-PGS (β = 0.79, 95% confidence interval [95% CI] 0.26;1.31) as well as ECS (β = 2.34; 95% CI: 1.76;2.92) were associated with IQ in this sample. The association between IQ-PGS and IQ was significant only in the white Brazilian group in the sensitivity analysis. However, there was no interaction between IQ-PGS and ECS on IQ (p (IQ-PGS x ECS) = 0.46). ECS did not modify the impact of genetic potential on intellectual development during childhood, suggesting that genetic factors and ECS exert independent effects on the IQ levels of children. • Do genetic intelligence factors respond differently to early environmental exposure? • Intelligence polygenic score was associated with IQ at 6 years in a Brazilian cohort. • Parental socio-cognitive stimulation at 2 and 4 years pivots children's IQ at 6 years. • Environmental stimulation did not modify intelligence polygenic score effect on IQ. [ABSTRACT FROM AUTHOR]

Background: Studies comparing the outcome of spontaneous versus assisted reproductive technologies (ART) pregnancies report heterogeneous results. Despite the success of ART to overcome infertility, concern is growing regarding both its safety and its effect on maternal and child health. The objective of this study was to compare maternal and child-health outcomes after ART relative to natural conception.Methods: A population-based birth cohort study was carried out among pregnant women expected to deliver in 2015 in Pelotas, southern Brazil. Maternal outcomes included pregnancy complications and gestational weight gain. Gestational age, weight, intrauterine growth restriction, length and head circumference, and 1-min and 5-min Apgar, as well as health problems at birth and breastfeeding were defined as offspring outcomes. Statistical analyses were performed using linear and logistic regression. G-formula was used to perform mediation analysis.Results: The study included 4252 babies born by spontaneously pregnancies and 23 babies born after ART. Adjusted analyses showed that children conceived from ART presented lower means of gestational age (p = 0.001), birth weight (p = 0.002), length (p < 0.001), and head circumference at birth (p = 0.02). However, more than 90% of the effect of ART over these outcomes was mediated by multiple pregnancy.Conclusion: Our findings suggest that the possible negative effect on the child-health outcomes is due mainly to the higher incidence of multiple pregnancies and not because of ART. The reasons for the increase in adverse pregnancy outcomes associated with ART singleton pregnancies are still uncertain and warrants further research. Further large-population studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is negatively associate with behavioral and internalization problems, psychological stress, and depressive/anxiety symptoms. However, studies evaluating specific mental health disorders are scarce. We aimed to assess the association between breastfeeding and mental health outcomes in young adults.Methods: In 1982, hospital deliveries in Pelotas (Southern Brazil) were identified; liveborns were examined and their mothers interviewed (n=5914). Information on breastfeeding was collected in early childhood. In 2012-13, at 30 years of age, we used the Mini International Neuropsychiatric Interview (MINI) for the diagnosis of major depression (MD), generalized anxiety disorder (GAD) and social anxiety disorder (SAD). In addition, we used the Beck Depression Inventory (BDI-II) and the Self-reported Questionnaire (SRQ-20), to evaluate depressive symptoms severity and common mental disorders (CMD), respectively. We used multivariable regression models to evaluate the association between breastfeeding and mental health outcomes.Results: We evaluated 3657 individuals. Prevalence of CMD, MD, GAD and SAD was 24.3%, 7.9%, 12.7% and 3.6%, respectively. In multivariable models the odds of having a more severe case of depression (BDI-II) was smaller among those breastfed for 6 or more months (OR=0.69 95%CI [0.53-0.89]). We observed a similar pattern for MD and CMD, however, confidence intervals included the reference.Limitations: We had no information on home environment characteristics during childhood. Lack of power and a small effect size could explain why we did not detect an association between breastfeeding and MD.Conclusion: Breastfeeding reduced the odds of having more severe depressive symptoms. [ABSTRACT FROM AUTHOR]

Abstract: Background: Maternal mood symptoms have been associated with psychiatric disorders in children. This study aimed to assess critical periods when maternal symptoms would be more deleterious. Methods: Cohort of 4231 births followed-up in the city of Pelotas, Brazil. Mood symptoms during pregnancy were self-reported by mothers at perinatal interview; and at 3-months postpartum, mothers answered the Self-Reporting Questionnaire. Psychiatric disorders in 6-year-old children were evaluated through the Development and Well-Being Assessment instrument. Odds ratios with 95% confidence intervals (95% CI) were calculated by logistic regression. Results: Prevalence of mood symptoms in pregnancy was 24.6% (23.2–26.0%) and at three months postpartum 22.5% (21.1–23.9%). Prevalence of mental disorders in children was 13.3% (12.2–14.4%). After adjustment for confounders children of mothers with mood symptoms during pregnancy were 82% more likely of presenting psychiatric disorders than children of mothers that did not (1.82; 1.48–2.25); and the chance of having mental disorders among children whose mothers had positive SRQ-20 at three months postpartum was 87% greater than the observed among children whose mothers had it negative (1.87; 1.50–2.33). Limitations: Because maternal anxiety/depression may interfere with interpretation of the child behavior, child׳s mental health being obtained by interviewing the mother is a limitation of this study. Lack of information on other risk factors may have lead to residual confounding on the effect of maternal mood symptoms at three months postpartum. Conclusions: Children of mothers presenting mood symptoms during pregnancy and in the first months postpartum are more likely to present psychiatric disorders at 6 years of age. [Copyright &y& Elsevier]

Objective. To explore the association between maternal low birth weight (LBW) and adverse perinatal outcomes and to discriminate between confounders and mediating factors of these associations in a population-based birth cohort of Southern Brazil. Methods. Data from 794 female members of the 1982 Pelotas Birth Cohort Study known to have delivered a live-born singleton offspring up to December 2004 were analyzed. Maternal birth weights were recorded in 1982. The associations between maternal and offspring characteristics were estimated by Poisson regression. Confounding was tested for socioeconomic, demographic, and psychosocial factors. Maternal anthropometric characteristics and hypertensive diseases during pregnancy were considered mediating factors. Results. An increase of 100 grams (g) in mothers' birth weight predicted a gain of 21 g in their infants' birth weight (95% confidence interval (CI) 13.0-29.0 g, P < 0.001). Maternal LBW was associated with offspring LBW (prevalence ratio (PR) 2.28 (95% CI 1.34-3.89), P = 0.002), preterm birth (PR 1.78 (95% CI 1.12-2.81), P = 0.01), and small for gestational age (SGA) (PR 1.93 (95% CI 1.14-3.26), P = 0.01). A causal chain linking maternal LBW and offspring SGA was mediated by maternal prepregnancy weight. Conclusion. Offspring of young women born with LBW are more likely to be LBW, preterm, and SGA. Public health strategies aimed at decreasing the frequency of LBW are necessary to reduce the perpetuation of adverse perinatal outcomes in later generations. The intermediate role of prepregnancy weight among LBW women opens a promising window to decreasing the prevalence of SGA in similar populations. [ABSTRACT FROM AUTHOR]