Background: Adolescent female depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood. However, the long-term effects of pre-pregnancy depressive symptoms on birth outcomes in adulthood have not been given adequate empirical assessments. Method: In this study, we assessed the relationship between the life time duration of depressive symptoms over a 14-year period and birth outcomes (LBW and PTB) among a sample of 6023 female respondents who took part in the National Longitudinal Study of Adolescent to Adult Health (Add Health). We used the generalized estimating equation (GEE) models to assess these relationships. Results: Exposure to elevated depressive symptoms in late adolescence, but not in adulthood, was associated with increased odds of LBW by more than 2-fold in early and young adulthoods (adjusted odds ratio [aOR] = 2.19; 95% confidence interval, CI: 1.56, 3.08). Depressive symptoms in early adulthood were independently associated with increased odds of PTB and were higher for black mothers. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and LBW or PTB in adulthood. Conclusion: This study provides compelling evidence that effects of elevated depressive symptomatology on LBW or PTB appear to be linked to a specific development period in adolescence. National policies to address social inequalities and stratification particularly in health at all stages of human development, will provide an important step in reducing depressive symptoms prior to early adulthood and in pregnancy and childbirth.

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Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-06-22T20:19:45Z No. of bitstreams: 1 RainaLima.pdf: 6488864 bytes, checksum: db557811216cf129eb2f4baa56f2046f (MD5) / Made available in DSpace on 2017-06-22T20:19:45Z (GMT). No. of bitstreams: 1 RainaLima.pdf: 6488864 bytes, checksum: db557811216cf129eb2f4baa56f2046f (MD5) Previous issue date: 2016-02-18 / Objective. This study aims to analyze the effects of prepregnancy nutritional status and gestational weight gain on birth weight. Methodology. Cross-sectional study involving 5,024 mothers and their newborns who participated in the study BRISA São Luís - MA. Data were collected in 2010 and were applied two questionnaires after delivery: one with maternal data and other newborn´s data. The main explanatory variables were prepregnancy BMI and gestational weight gain. Theoretical model was proposed to explain the total, direct and indirect effects, using structural equation modeling in the analysis, with adjustment for sociodemographic variables, life habits and maternal comorbidities, with the outcome birth weight. Results. The final model had good fit according to indicators RMSEA, CFI / TLI and WRMR. The prepregnancy BMI had total effect (Standardized Coefficient SC=0.126; p <0.001) and direct (SC=0.211; p <0.001) positive on the newborn's weight, plus negative indirect effect on the total gestational weight gain. Gestational weight gain in turn had the highest effect on birth weight (SC=0.280; p <0.001), including modifying the effect of other variables. Socioeconomic status, maternal age, more stable marital status and gestational diabetes had positive total effects, while high blood pressure and smoking during pregnancy had negative effects on birth weight. Alcohol use during pregnancy showed no total effect. Conclusion. Mothers with higher prepregnancy BMI can have children with higher weight, as well as those with high gestational weight gain. These associations highlight the need for greater attention to the health of women of reproductive age and maintaining proper weight gain during pregnancy, which could contribute to reducing risks of maternal complications and newborn. / Objetivo. O presente estudo teve por objetivo analisar os efeitos do estado nutricional pré-gestacional e ganho de peso gestacional no peso ao nascer. Metodologia. Estudo transversal que envolveu 5.024 mães e seus recém-nascidos que participaram do estudo BRISA de São Luís – MA. Os dados foram coletados no ano de 2010 e aplicaram-se dois questionários após o parto: um com dados da mãe e outro do recém-nascido. As variáveis explanatórias principais foram o IMC pré-gestacional e o ganho de peso gestacional. Modelo teórico foi proposto para explicar efeitos totais, diretos e indiretos, utilizando modelagem de equações estruturais na análise, com ajuste para variáveis sociodemográficas, hábitos de vida e comorbidades maternas, tendo como desfecho peso ao nascer. Resultados. O modelo final teve bom ajuste segundo os indicadores RMSEA, CFI/TLI e WRMR. O IMC pré-gestacional teve efeitos total (Coeficiente padronizado CP=0.126; p<0.001) e direto (CP=0.211; p<0.001) positivos no peso do recém-nascido, além de efeito indireto negativo via ganho de peso gestacional total. O ganho de peso gestacional por sua vez apresentou o maior efeito no peso de nascimento (CP=0.280; p<0.001), inclusive modificando o efeito de outras variáveis. Situação socioeconômica, idade materna, situação conjugal mais estável e diabetes gestacional tiveram efeitos totais positivos, enquanto que hipertensão arterial e tabagismo na gestação apresentaram efeitos negativos no peso ao nascer. Uso de álcool durante a gestação não apresentou efeito total. Conclusão. Mães com maior IMC pré-gestacional podem gerar filhos com mais alto peso, assim como aquelas com elevado ganho de peso total. Essas associações ressaltam a necessidade de maior atenção à saúde de mulheres em idade reprodutiva e manutenção do ganho de peso adequado durante a gestação, o que poderá contribuir para a diminuição de riscos de intercorrências maternas e do recém-nascido.

The study was done to assess the information and care the men and women have on PCC and develop strategies that could improve provision of PCC that could advance maternal and newborn outcome after pregnancy in Malawi. Most for the interventions to improve pregnancy outcome are done too late in Malawi but there is an opportunity during preconception period to plan to improve the health of the couple so that the goal of a healthy mother and baby is attained. The objectives were to: explore and describe the knowledge men and women of childbearing age have on HTSP and PCC, identify variables that influence men and women to acquire appropriate knowledge on PCC and finally to develop strategies that could assist provision of PCC in developing countries like Malawi. Adverse issues that affect the couples could be addressed promptly before the occurrence of pregnancy. A quantitative non-experimental descriptive-correlation design method was used to determine the knowledge men and women of childbearing have on HTSP and PCC. A structured questionnaire was used to collect data from 300 men and women of childbearing age. The target population for the study was prospective parents that are couples that have an intention to conceive, women of childbearing age that could be accessible at family planning, gyneacological and under-five clinics between the ages of 18-35 years. A questionnaire was adapted from a study conducted in Texas. SPSS version 20 was used to analyse the data by generating frequencies and chi- square. Kruskal Wallis test was used to determine relationship between variables and knowledge on preconception care. The constructs examined were psychological preparation, reproductive health care and the physical care that are provided to ensure a healthy pregnancy outcome. With a 100% response rate the findings indicated a gap of information and care on PCC.Services on PCC were not available in the clinics which indicated a great need to empower health care providers on PCC that could reduce maternal and neonatal mortality rate. The findings were used to develop relevant preconception strategies that would assist health providers to give PCC that would improve maternal and newborn outcomes in Malawi. / D. Litt. et Phil. (Health Studies)