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Pregnancy is accompanied by hormonal fluctuation, including increased cortisol and oxytocin (OT). Although the implications of these hormones during pregnancy are extensively studied, their normative variability is not well established. Therefore, we evaluated how serum cortisol and OT levels behave throughout pregnancy. This longitudinal study is part of a population-based cohort of pregnant women living in a city in Southern Brazil. Pregnant women up to 24 gestational weeks were evaluated at the time of identification (1st wave, N=983) and 60 days after the initial interview (2nd wave, N=840). At both times, blood samples were collected for hormonal dosage. We investigated the trajectory of these hormones throughout pregnancy using growth curve modeling. The best-fitting model was the exponential growth model, in which the variance explains approximately 79.1 % of the outcome. Thus, the cortisol level was, on average, at 44.2 μg/dl (95 %CI: 29.2;59.1, p<0.001) in the first gestational week, with an increase of approximately 2.0 % (95 %CI: 1.01;1.02, p<0.001) each week. OT showed no significant changes. While cortisol appears to follow a trajectory of exponential increase, possibly in response to the demands of fetal development, the variation in OT levels throughout pregnancy still remains constant subject to further investigation., Competing Interests: Declaration of Competing Interest Conflict of interest On behalf of all authors, the corresponding author states that no conflicts of interest exist., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Approximately 6 to 13% of women suffer from antenatal depression (AD) around the world. AD can lead to several health problems for mother-baby. Vitamin D is a molecule that appears to have great preventive/therapeutic potential against neuropsychiatric disorders. The present study aimed to analyze the association between deficiency of vitamin D and AD in pregnant women in a city in the south of Brazil (Pelotas, RS). We hypothesize that pregnant women with a positive AD diagnosis have deficient levels of 25-hydroxyvitamin D (25(OH)D)., Methods: This cross-sectional study was conducted in a cohort study (CEP/UCPEL 47807915.4.0000.5339). From this cohort, 180 pregnant women at up to 24 weeks gestation were selected (130 non-depressed and 50 depressed), and the diagnosis of depression was made using the MINI-Plus. Blood was collected and stored for the later analysis of vitamin D (25(OH)D) by chemiluminescence method. The SPSS program was used for data analysis, and p<0.05 was considered statistically significant., Results: In our study, we showed a significant association between Major Depressive Episode current in the antenatal period and vitamin D deficiency (OR: 0.9; CI 95%: 0.9;1.0, p=0.003)., Conclusion: Our results demonstrate that vitamin D deficiency may be involved in major depressive disorder in the antenatal period, in this way it advised a follow-up of vitamin D levels in the pregnancy-puerperal cycle to minimize mental health problems in women and prevent developmental deficits in children., Competing Interests: No conflicts of interest declared concerning the publication of this article.

Genetic alterations related to oxytocin system seem to influence the neurobiology of attention-deficit hyperactivity disorder and anxiety problems leading to greater functional, social and emotional impairment. Here, we analyzed the association of OXTR rs2254298 and CD38 rs6449182 variants with attention/hyperactivity problems and anxiety problems in children. The study enrolled 292 children and adjusted regression model revealed OXTR rs2254298 AA genotype as a risk factor for attention deficit/hyperactivity problems (PR: 2.37; P adjFDR = 0.006), attention problems (PR: 2.71; P adjFDR = 0.003) and anxiety problems (PR: 1.92; P adjFDR = 0.018). CD38 rs6449182 G allele showed as a risk factor for attention deficit/hyperactivity problems (PR: 1.56; P adjFDR = 0.028). Moreover, in silico approach for regulatory roles found markers that influence chromatin accessibility and transcription capacity. Together, these data provide genetic information of oxytocin in developmental and behavioral disorders opening a range of opportunities for future studies that clarify their neurobiology in childhood., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: MicroRNAs (miRNAs) are small non-coding RNAs capable of regulating gene expression post-transcriptionally. MiRNAs are recognized as key regulators of diverse biological and developmental processes. During the pregnancy-puerperal cycle, numerous changes occur in the female body for the formation, growth, and development of the baby. After birth, there is a critical period in child development, as rapid gains in the physical, cognitive, and socio-emotional domains constitute the "building blocks" of children's later growth., Objective: The aim of this study was to investigate the association between maternal expression of hsa-miR-423-5p during the first and second trimesters of pregnancy and neurocognitive development at 90 days of life in infants. Methods: This is a longitudinal study included in a population-based cohort study, carried out in a city in southern Brazil. The Bayley III was used to assess the babies' cognitive development. Blood samples from mothers were obtained for RNA extraction from serum and analysis of miRNA expression by qRT-PCR., Results: In total, 87 dyads (mother-baby) were included. The average gestational age was 15.86 weeks (SD ± 5.55). An association of maternal miRNA with infant cognitive development was found; as maternal miR-423-5p increases, infants' cognitive development increases by 2.40 (95% CI 0.37; 4.43, p  = 0.021) points at 3 months of age., Conclusion: In this context, it is suggested to use this miRNA as a biomarker of child neurocognitive development detectable in the prenatal period, thus allowing the planning of early interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 do Amaral, Nedel, Ferrúa, Garcia, Corrêa, Giorgi, Longoni dos Santos, de Assis, de Avila Quevedo, Ghisleni, de Matos, Pinheiro, Trettim and Pinheiro.)

Background: Exposure and introduction to digital media, especially in children, are a current cause for concern. The negative links associated with early screen exposure are extensive., Aims: To evaluate the association between the time of exposure to a screen in children at 18 months of age and cognitive development in a population-based sample in Southern Brazil., Study Design: This was a cross-sectional study corresponding to the fourth wave of a population-based cohort study with pregnant women and later, their children living in the city of Pelotas, Southern Brazil., Subjects: The sample consisted of 470 children who completed the cognitive assessment., Outcome Measures: Cognitive development was assessed using the Bayley Scales of Infant Development - Third Edition (BSID-III). Exposure to screen time was assessed using a questionnaire completed by the primary caregiver., Results: Of the total, 58.8 % of the children had ≥1 h of screen time per day and the average on the cognitive scale of the entire sample was 96.1 (SD = 14.0). Cognitive development was lower in children whose mothers had lower levels of education (CI 95 % -4.9; -2.1), where boys (CI 95 % 3.2; 8.4) and in children exposed to 2 h or more of screen time/day (CI 95 % -3.6; -0.5)., Conclusions: Exposure to screens may have a significant negative association with children's cognitive development and, therefore, we seek to intervene and to give advice to parents and guardians about the true impact of digital media. Further studies are necessary to consolidate the findings and to disclose information on the topic., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier B.V.)

Background: Suicide risk is prominent among the problems affecting populations, mainly due to the broad family, psychosocial and economic impact. Most individuals at suicidal risk have some mental disorder. There is considerable evidence that psychiatric disorders are accompanied by the activation of neuro-immune and neuro-oxidative pathways. The aim of the study is to evaluate the serum levels of oxidative stress biomarkers in women at risk of suicide after 18 months of postpartum., Methods: This is a case-control study, nested within a cohort study. From this cohort, 45 women [15 without mood disorders and 30 with mood disorders (Major depression and Bipolar disorder)] were selected at 18 months postpartum, the depression and suicide risk were assessed using the Mini-International Neuropsychiatric Interview Plus (MINI-Plus) instrument, module A and C, respectively. Blood was collected and stored for later analysis of the reactive species (DCFH), superoxide dismutase (SOD), and glutathione reduced (GSH). For data analysis, the SPSS program was used. To compare the nominal covariates with the outcome GSH levels, the Student's t -test or analysis of variance (ANOVA) was used. Spearman's correlation was performed for analysis between the quantitative covariates and the outcome. To analyze the interaction between the factors, multiple linear regression was performed. Bonferroni analysis was used as an additional/secondary result to visualize differences in glutathione levels according to risk severity. After the adjusted analysis, p -values < 0.05 were considered statistically significant., Results: The percentage of suicide risk observed in our sample of women at 18 months postpartum was 24.4% ( n = 11). After adjusting for the independent variables, only the presence of suicide risk remained associated with the outcome (β = 0.173; p = 0.007), low levels of GSH at 18 months after postpartum. Likewise, we verified the difference in GSH levels according to the degree of suicide risk, observing a significant association between the differences in glutathione means in the group of women with moderate to high risk compared to the reference group (no suicide risk) ( p = 0.009)., Conclusion: Our findings suggest that GSH may be a potential biomarker or etiologic factor in women at moderate to high risk of suicide., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 da Silva Schmidt, Trettim, Longoni, Grings, de Matos, de Avila Quevedo, Ardais, Nedel, Ghisleni, Leipnitz, Pinheiro and de Assis.)

Introduction: Studies on maternal microRNA expression have emerged to better understand regulatory mechanisms during the gestational period, since microRNA expression has been associated with pregnancy disorders., Objectives: This study aims to investigate the association between the expression of the maternal microRNAs miR-let-7d-3p and miR-451a during the second gestational trimester and neuropsychomotor development at 90 days of life of infants., Methods: This is a case-control study nested within a cohort, with the groups being divided into dyads in which pregnant women presented Major Depressive Episode (MDE) (n = 64), these being the cases, and their respective controls (no MDE; n = 64). The Bayley Scale III was used to assess the outcome of child development, and MDE was assessed through the Mini International Neuropsychiatric Interview Plus. The analysis of miR-let-7d-3p and miR-451a was done via serum from the pregnant women, utilizing the qRT-PCR (n = 128)., Results: The results indicated a negative association between expression levels of miR-451a (β -3.3 CI95% -6.4;-0.3) and a positive associated of the miR-let-7d-3p with the cognitive development domain (β 1.7 CI95% 0.1; 3.0), and a positive association between expression of miR-let-7d-3p with motor development of the infants (β 1.6 CI95% 0.3; 2.9)., Conclusion: This is a pioneering study on the topic that indicates a biological interrelationship between the miRNAs miR-let-7d-3p and miR-451a evaluated during the pregnancy and the motor and cognitive domains of infant development at 90 days postpartum., Competing Interests: Declaration of competing interest The authors have declared no conflict of interest. Ricardo Tavares Pinheiro., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The literature reports that teenage pregnancy is considered a risk factor for anxiety disorders (ADs). However, research on this topic is limited. This study aimed to investigate if pregnant adolescents presented a greater likelihood of having ADs by comparing two samples of pregnant women in a southern city of Brazil. We also observed the prevalence rates of antenatal ADs among adolescents and adult women., Methods: In this cross-sectional study, we evaluated 1852 women from two different studies: 995 pregnant adolescents attending prenatal care in the public health system (convenience sample) and 857 pregnant women from a population-based study. We used the Mini International Neuropsychiatric Interview (MINI Plus) to assess antenatal ADs, using the Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) modules. The primary aim of this study was tested through multivariate analysis using Poisson regression., Results: The prevalence of ADs was 11.0 % among pregnant adolescents and 13.8 % among adult pregnant women. Both samples presented similar rates of ADs (p = 0.065). In the adjusted analysis, maternal age did not predict antenatal ADs (PR = 0.97; p = 0.853)., Limitations: Considering the particularities of each study where the samples came from, it was not possible to include other ADs such as panic disorder or phobias., Conclusions: Our findings suggest that pregnancy in adolescence does not increase the likelihood of antenatal ADs. However, we emphasize the importance of an adequate psychological screening and care in pregnancy in order to prevent possible psychiatric disorders., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Aims: To evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age., Methods: Pre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery., Results: Data were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7-6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05)., Conclusions: We found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The revised Helping Alliance Questionnaire (HAq-II) is among the most used instruments that measure therapeutic alliance. Despite its use in research, this instrument is not validated for the Brazilian population. The aim of this study was to explore the evidence of validity of the HAq-II based on the internal structure in a sample of Brazilian psychiatric patients. An ambulatory convenience sample of 204 patients with major depressive disorder (MDD) and 81 patients with obsessive-compulsive disorder (OCD) was randomized between two different types of treatment. The HAq-II was completed by patients (patient version) and by 33 therapists who performed the interventions (therapist version) between the second and third sessions. We used confirmatory factor analysis (CFA) to investigate two models: (1) a one-dimensional therapeutic alliance model and (2) a two-dimensional model considering the factors 'positive alliance' and 'negative alliance'. The internal consistency of the HAq-II was measured by Cronbach's alpha. To investigate discriminant validity, we used the t-test for independent samples, ANOVA and Pearson's correlation coefficient. The analysis showed that the best model of the instrument was one-dimensional. Cronbach's alpha for both versions displayed values above 0.89. The Brazilian version of the HAq-II presented properties similar to those found in the original version. However, studies related to the one-dimensional model with other samples are necessary., (© 2021 John Wiley & Sons, Ltd.)

Background: Family members tend to modify their routine by assisting or participating in the patient's rituals. These behaviors have been identified as family accommodation (FA)., Aims: The aim of this study was to describe the relationship between family accommodation of relatives of Obsessive-Compulsive Disorder (OCD) patients and their perceptions about the obsessions and compulsions of the patient., Method: This was a cross-sectional study with family members of Obsessive-Compulsive Disorder in a Southern Brazilian city. The family perception of the OCD symptoms and their accommodation were assessed through the Family Accommodation Scale for Obsessive-Compulsive Disorder - Interviewer-Rated (FAS-IR)., Results: The level of family accommodation was higher in those family members who lived with the patient when compared to those who did not live with them ( p  = .011). The obsessions associated with higher levels of family accommodation were: contamination ( p  < .001), hoarding/saving ( p  = .001), symmetry/exactness ( p  = .001), religious ( p  = .019), and diverse ( p  = .003). Regarding compulsions, the perception of all symptoms was associated with higher levels of family accommodation ( p  < .05)., Conclusion: The family accommodation is present in family members of Obsessive-Compulsive Disorder patients, regardless of the type of obsessive/compulsive symptom perceived.

Background: Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD., Methods: Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression., Results: The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy., Limitations: Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model., Conclusions: Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Suicide associated with severe psychiatric illnesses is considered the leading cause of maternal deaths. We aimed to assess the suicide risk in women who experienced depressive or mixed episodes of mood change during the postpartum period and to determine which disorder is more related to suicide risk in the same period. We conducted a longitudinal study with 706 women whose children were born from April 2007 to May 2008 in a southern city in Brazil, and received prenatal care by the Brazilian National System of Public Health. The first assessment occurred during the prenatal period and the second within 30 to 60 days postpartum. The incidence of suicide risk was 10.9%. The odds of postpartum suicide risk were 6.50 (95% CI: 2.73; 15.48) higher in mothers with postpartum depression and 41.50 (95% CI: 12.11; 142.16) higher in those with mixed episodes than those who did not suffer from any mood disorder. Women with chronic episodes (who had depressive or mixed episodes during pregnancy and postpartum) were at increased odds of 4.94 (95% CI: 1.46; 16.69) of a postpartum suicide risk. The postpartum seems to be a critical period in the women's mental health. The impact of mental disorders in this period, especially mixed episodes, can increase the odds of a suicide risk onset. A good psychiatric evaluation and support during the prenatal and postpartum care may prevent the subsequent risk of suicide.

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

Background: The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents., Aims: This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil)., Study Design: This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale., Results: The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA., Conclusion: This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: To verify the association between mood and anxiety disorders, and suicide risk during pregnancy and their relationship with premature birth in a population of pregnant adolescents attending prenatal care in the public health system of Pelotas, a southern city in Brazil., Methods: This was a cohort study with all pregnant adolescents attending antenatal public services in the urban area of Pelotas between October 2009 and May 2011. The first assessment occurred between the 20th and 22 nd week of pregnancy and the second occurred one month after delivery. We used the Mini International Neuropsychiatric Interview (MINI) to assess mood and anxiety disorders and suicide risk., Results: A total of 645 pregnant women aged between 12 and 19 years old were interviewed. An anxiety disorder was present in 9.1% of the pregnant adolescent, and 28.5% had a mood disorder. The prevalence of suicide risk was 12.6%, and 15.3% of the babies were born premature. A multivariate analysis adjusted for maternal education, number of previous pregnancies and previous preterm birth indicated that adolescents who had suicide risk during pregnancy were approximately twice as likely to give birth prematurely when compared to those who were not diagnosed with suicide risk (PR 1.79; CI 1.06-3.03)., Conclusion: Our findings suggest that pregnant adolescents who were at risk of suicide during pregnancy were more likely to have premature babies. It is important to pay attention to the mental health of this specific population to prevent obstetric complications and consequently improve the health of the children., (Copyright © 2020. Published by Elsevier Ltd.)

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

Objectives: This study aimed to investigate the association between child maltreatment and depressive symptomatology during gestation in adolescents., Methods: This was a cross-sectional study with pregnant adolescents aged 12 to 19 years. Data were collected with the Beck Depression Inventory, Childhood Trauma Questionnaire, and Mini International Neuropsychiatric Interview., Results: Compared to adolescents who did not experience each type of neglect or abuse, experiencing them was associated with a higher proportion of depressive symptoms: emotional neglect PR = 1.4 (95% CI 1.1; 1.8); physical neglect PR = 1.7 (95% CI 1.3; 1.7); emotional abuse PR = 1.8 (95% CI 1.4; 2.2); and physical abuse PR = 1.3 (95% CI 1.1; 1.7)., Conclusions: This study demonstrates the association between childhood experiences and mental health in adolescence, especially in vulnerable samples, such as pregnant adolescents. This finding reveals the importance of studying early trauma in life and enabling preventive help, especially in adolescents. High-quality evidence of perinatal mental health problems should be generated to make pregnancy safer for women in low- and middle-income countries.

Background: The discussion on the safety of thimerosal-containing vaccines (TCVs) and their impact on child development it́s very relevant., Methods: This is a cohort study with mother-child dyads who received prenatal care in the Unified Health System. The domains of motor, cognitive and language development were evaluated in children between 24 and 36 months of age. Data on vaccination were obtained through the child's immunization record. A linear regression analysis was carried out considering possible confounders., Results: In bivariate analyses, motor and language development were associated with TCVs (p < 0.05). However, in the multivariate analysis, this association was not maintained (p > 0.05). These results indicate that the use of TCVs is not associated with child development. The importance of this study is summarized in transmitting relevant information regarding public health, based on reliable data., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: The parental bonding is influenced by two dimensions: care and control or protection over the child of both parents. The lack of care during childhood may make the individual more susceptible to the onset of psychiatric disorders when adult. These psychiatric disorders when present during pregnancy may have a negative impact on the health of pregnant women and children. The aim of this study was to assess the association between generalized anxiety disorder (GAD) in pregnant adolescents and the perception of parental bonding., Methods: This is a cross-sectional study with 871 pregnant women under the age of 19, receiving prenatal care in 47 Basic Health Units in the one city, Brazil. The generalized anxiety disorder was measured using the Mini International Neuropsychiatric Interview (MINI) and the perception of parental bonding in childhood using the Parental Bonding Instrument (PBI)., Results: The prevalence of GAD was 8.5%. Among all the parental bonding dimensions, only a perceived lack of maternal care under 16 years was associated with GAD., Conclusions: The results showed that only the perception of maternal bonding was associated with later GAD. It suggests that an adequate maternal bond is an essential component of psychological health., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil., Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis., Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively., Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Objective:: To evaluate the association between perceived social support and anxiety disorders in pregnant adolescents., Methods:: We conducted a cross-sectional study with a sample of 871 pregnant women aged 10 to 19 years who received prenatal care in the national public health care system in the urban area of Pelotas, state of Rio Grande do Sul, southern Brazil. We assessed perceived social support and anxiety disorders using the Medical Outcomes Study Social Support Survey and the Mini International Neuropsychiatric Interview. A self-report questionnaire was used to obtain sociodemographic information., Results:: The prevalence of any anxiety disorder was 13.6%. Pregnant adolescents with an anxiety disorder reported less perceived social support in all domains (affectionate, emotional, tangible, informational, and positive social interaction). Older teenagers reported lower perceived support in the emotional, informational, and positive social interaction domains, whereas those with low socioeconomic status reported lower perceived social support in the material domain. Women who did not live with a partner had less perceived social support in the affectionate and positive social interaction domains., Conclusion:: Perceived social support seems to be a protective factor against anxiety disorders in pregnant adolescents, with a positive effect on mental health.

Background: It has been shown that maternal mental health is associated with poorer skills development in the offspring. However, the evidence evaluating the association between social anxiety disorder (SAD) and cognitive or language development, is scarce., Aim: To evaluate the association between maternal SAD and performance in cognitive and language tests in 30-month old children., Study Design: This was a cohort study involving young women evaluated since pregnancy., Subjects: We evaluated 520 mother-child dyads who received prenatal medical assistance through the National Public Health System in a southern Brazilian city, from October 2009 to March 2011., Outcome Measures: We used the Mini Neuropsychiatric Interview Plus (MINI Plus) to assess SAD among young mothers. Cognitive and language performance in their offspring was analyzed using the Bayley Scales of Infant and Toddler Development - 3rd Edition., Results: We found an association between maternal SAD and performance in cognitive and language tests. Children of mothers with SAD had in average 4.5 less points in the Bayley scale, when compared to those with mothers without SAD: in the cognitive (β=-4.53 [95% CI -7.8; -1.1] p=0.008) and language subscales (β=-4.54 [95% CI -9.0; -0.5] p=0.047)., Conclusions: Our findings suggest that children with mothers suffering from SAD have poorer cognitive abilities and language skills., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: To evaluate the association between social anxiety disorder (SAD) and perceived maternal bonding styles among young women during pregnancy and 30 months after childbirth., Methods: A cohort of young women from the city of Pelotas, Brazil was followed up from pregnancy to 30 months postpartum. The Mini Neuropsychiatric Interview Plus was used to assess SAD and the Parental Bonding Instrument was administered to measure maternal bonding styles. Poisson regression with robust variance was used for multivariable analysis., Results: After adjusting for potential confounding factors, SAD prevalence was 6.39 times higher among young women who perceived their mothers as neglectful (prevalence ratio [PR] 6.39; 95% confidence interval [95%CI] 1.2-32.0), and 5.57 times higher in women who perceived their mothers as affectionless controlling (PR = 5.57; 95%CI 1.5-19.7) when compared with those who received optimal care., Conclusion: Maternal bonding style may have an influence on the development of SAD. Therefore, support and early prevention strategies should be offered to the family.

The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Homogeneous poly(ε-caprolactone) (PCL) and poloxamines (PLXs) porous blends were prepared using a supercritical carbon dioxide-assisted foaming/mixing (SFM) approach aiming to obtain cytocompatible implantable materials presenting tunable morphologies, bioerosion rates, bioactive molecules release and osteogenic features. Pure PCL, pure PLXs (T908 and T1107 varieties) and three distinct PCL:PLX 75:25, 50:50, 25:75% w/w blends, with and without the osteogenic and angiogenic bioactive molecule simvastatin were processed at constant pressure of 20 MPa and temperature of 40 °C or 43 °C, for T1107 and T908, respectively. Obtained porous blends were characterized applying a wide range of techniques and in vitro methods. Calorimetric analysis showed that hydrophilic T908 and T1107 PLXs are miscible with PCL for all tested compositions. Prepared PCL:PLX porous blends rapidly lost mass when immersed into phosphate buffer pH 7.4 due to PLXs dissolution and then went through slow and almost constant erosion rates for the subsequent weeks due to PCL slow hydrolytic degradation, which explains the rapid initial release of simvastatin and its subsequent sustained release for longer periods of time. PCL and PCL:PLX 75:25% w/w porous blends, containing or not simvastatin, showed a high cytocompatibility with SAOS-2 cells. In addition, prepared biomaterials promoted mesenchymal stem cells proliferation and their differentiation into osteoblasts. Overall, obtained results showed novel possibilities of addressing local treatment of small bone defects/fractures using highly porous PCL:PLX homogeneous blends., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Purpose: To assess the associations of the perceived quality of parental bonding with suicidality in a sample of pregnant adolescents., Methods: A cross-sectional study with a sample size of 828 pregnant teenagers receiving prenatal medical assistance in the national public health system in the urban area of Pelotas, southern Brazil. Suicidality and psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview (MINI), and the Parental Bonding Instrument (PBI) was employed to measure the perceived quality of parental bonding. A self-report questionnaire was used to collect sociodemographic, obstetric and other psychosocial data., Results: Forty-three (4.94 %) teenagers from a consecutive sample of 871 refused to participate, resulting in 828 participants. Prevalence of suicidality was 13.3 %, lifetime suicide attempts were 7.4 % with 1.3 % reporting attempting suicide within the last month. Significant associations of suicidality with the 18-19-year-old subgroup, low education, prior abortion, physical abuse within the last 12 months were present, and most psychiatric disorders were associated with a higher suicidality prevalence. Additionally, after adjustment in the multivariate analysis, the style of parental bonding was independently associated with suicidality in the pregnant adolescent, with a PR of 2.53 (95 % CI 1.14-5.59) for the maternal 'affectionless control' and a PR of 2.91 (95 % CI 1.10-7.70) for the paternal 'neglectful parenting.', Conclusions: We found that maternal 'affectionless control' and paternal 'neglectful parenting' were independent predictors of suicidality in this sample of pregnant teenagers.

A supercritical carbon dioxide (scCO2)-assisted foaming/mixing method (SFM) was implemented for preparing dexamethasone (DXMT)-loaded poly(ε-caprolactone)/silica nanoparticles (PCL/SNPs) composite materials suitable for bone regeneration. The composites were prepared from PCL and mesoporous SNPs (MCM-41/SBA-15) by means of scCO2-assisted SFM at several operational pressures, processing times and depressurization conditions. DXMT was loaded into SNPs (applying a scCO2 solvent impregnation/deposition method - SSID) and into PCL/SNPs composites (using the SFM method). The effects of the employed operational and compositional variables on the physicochemical and morphological features as well as in the in vitro release profiles of DXMT were analyzed in detail. This work demonstrates that the above-referred scCO2-based methods can be very useful for the preparation of DXMT-loaded PCL/SNPs composites with tunable physicochemical, thermomechanical, morphological and drug release properties and suitable for hard-tissue regeneration applications., (Copyright © 2013 Elsevier B.V. All rights reserved.)