Evaluation of the Blood Level of Adiponectin in Pregnant Adolescents.

OBJECTIVE: To evaluate serum levels of adiponectin in pregnant adolescents between 30 and 36 weeks of gestation. METHOD: A prospective cross-sectional study enrolled 67 normal pregnant women between 30 and 36 weeks of gestation and eutrophic (body mass index [BMI]: 18.5-25 kg/m2), of which 36 were adolescents (< 20 years old) and 31 adults (≥ 20 years old). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay (ELISA). The t-student or Mann-Whitney tests were used for intergroup comparison. RESULTS: Pregnant adolescents showed significantly higher serum adiponectin concentrations compared with pregnant adults (p = 0.04). No differences were observed in adiponectin levels in younger pregnant adolescents (< 16 years old) compared with older pregnant adolescents (≥ 16 years old). Adiponectin values were divided into 3 subgroups: < 3,000 ng/mL, between 3,000 and 5,000 ng/mL, and > 5,000 ng/mL. Birthweight was significantly higher in women > 5,000 ng/mL when compared with < 3,000 ng/mL in the adolescent group. No association between pregestational adiponectin levels and BMI, gestational weight gain, and gestational age was observed; however, there was a positive relation with birthweight (p = 0.0239). CONCLUSION: Serum adiponectin values in pregnant adolescents between 30 and 36 weeks of gestation were higher compared with pregnant adults; however, no differences between younger and older pregnant adolescents were observed.

OBJETIVO: Avaliar os níveis séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação. MéTODOS: Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5­25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney. RESULTADOS: As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p = 0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em 3 grupos: < 3.000 ng/mL, entre 3.000 e 5.000 ng/mL e > 5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com > 5.000 ng/mL, quando comparadas as com < 3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p = 0,0239). CONCLUSãO: Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Evaluation of the Blood Level of Adiponectin in Pregnant Adolescents / Avaliação dos níveis séricos de adiponectina em gestantes adolescentes

Abstract Objective To evaluate serum levels of adiponectin in pregnant adolescents between 30 and 36 weeks of gestation. Method: A prospective cross-sectional study enrolled 67 normal pregnant women between 30 and 36 weeks of gestation and eutrophic (body mass index [BMI]: 18.5-25 kg/m2), of which 36 were adolescents (< 20 years old) and 31 adults (≥ 20 years old). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay (ELISA). The t-student or Mann-Whitney tests were used for intergroup comparison. Results Pregnant adolescents showed significantly higher serum adiponectin concentrations comparedwith pregnant adults (p=0.04). No differences were observed in adiponectin levels in younger pregnant adolescents (< 16 years old) compared with older pregnant adolescents (≥ 16 years old). Adiponectin values were divided into 3 subgroups:<3,000 ng/mL, between 3,000 and 5,000 ng/mL, and>5,000 ng/mL. Birthweight was significantly higher in women>5,000 ng/mL when compared with<3,000 ng/mL in the adolescent group. No association between pregestational adiponectin levels and BMI, gestational weight gain, and gestational age was observed; however, there was a positive relation with birthweight (p=0.0239). Conclusion Serum adiponectin values in pregnant adolescents between 30 and 36 weeks of gestation were higher compared with pregnant adults; however, no differences between younger and older pregnant adolescents were observed.

Resumo Objetivo Avaliar os níveis séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação. Métodos Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5-25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney. Resultados As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p=0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em3 grupos:<3.000 ng/mL, entre 3.000 e 5.000 ng/mL e>5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com>5.000 ng/mL, quando comparadas as com<3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p=0,0239). Conclusão Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Nutritional assessment of pregnant adolescents: comparison of two popular classification systems.

The objective of this study was to assess the degree of concordance between two popular classification systems [the Centers for Disease Control and Prevention (CDC)-2000 and the Institute of Medicine (IOM)-2009] used to categorise the nutritional status of pregnant adolescents. This cross-sectional study involved 327 pregnant adolescents (10-19 years) booking for antenatal care at a single public maternity in São Paulo, Brazil. Participants were classified into one of four categories, by both systems according to their pre-pregnancy body mass index and age. The CDC-2000 system classified significantly fewer pregnant adolescents as underweight (3.7% vs. 12.5%, P < 0.0001) and significantly more adolescents as normal-weight (86.8% vs. 75.6%, P = 0.0003) than the IOM-2009 system. The distribution of the adolescents in the two systems differed significantly. The global rate of discordance was 13.5%. The overall concordance between the two systems was marginally good (K = 0.63), being moderate for younger (<16 years) adolescents (K = 0.52). Approximately one in every seven pregnant adolescent would be classified in a non-corresponding category if the IOM-2009 classification was used instead of the CDC-2000 classification. The IOM-2009 nutritional classification, which does not take into account age and gender, tends to overestimate the proportion of underweight adolescents, especially in the younger-age group. The use of this classification system can lead to recommendations of higher gestational weight gain in a substantial proportion of pregnant adolescents, which could predispose to post-partum weight retention and future obesity.

Levantamento de problemas comportamentais/emocionais em um ambulatório para adolescentes / Survey of behavioral/emotional problems in an adolescent outpatient service / Estudio de problemas conductuales/emocionales en una clínica para adolescentes

Este estudo teve como objetivo identificar os principais problemas comportamentais e emocionais percebidos por adolescentes que frequentam um ambulatório de saúde. Participaram 320 adolescentes que não estavam em atendimento psicoterápico e que responderam, na sala de espera de um ambulatório, o Youth Self Report. O principal problema relatado foi Ansiedade/Depressão. Os meninos obtiveram escores mais altos em Problemas Sociais e mais baixos em Comportamento Delinquente; as meninas apresentaram-se com menos problemas no agrupamento Problemas Somáticos e com mais problemas em Ansiedade/Depressão. Quanto à faixa etária, observou-se que Problemas Sociais esteve associado ao início da adolescência. Quanto à incidência, menos de um quarto dos adolescentes apresentaram-se com problemas, sugerindo que a adolescência não é um período de turbulência. Observou-se que alguns adolescentes necessitam de uma avaliação mais detalhada, pois relataram comportamentos indicativos de transtornos mentais. Conclui-se a necessidade de profissionais de saúde mental integrarem a equipe de saúde que atende adolescentes.(AU)

This study's objective was to identify the main behavioral and emotional problems perceived by adolescents attending an outpatient service. A total of 320 adolescents were included in the study. The respondents were not undergoing psychotherapy and self-applied the Youth Self Report in the ambulatory's waiting room. The main problem reported was Anxious/Depressed. Male adolescents obtained higher scores for Social Problems and lower scores for Delinquent Behavior, while females obtained lower scores for Somatic Complaints and higher scores for the Anxious/Depressed scale. Social Problems were associated with the initial phase of adolescence. In terms of incidence, less than one quarter of the adolescents presented problems, suggesting that adolescence is not a period of turbulence. Some adolescents require a more detailed evaluation because they reported behaviors indicative of mental disorders. We conclude that there is a need for mental health workers to integrate the health staff providing care to adolescents.(AU)

El objetivo del estudio fue identificar los problemas comportamentales y emocionales notados en adolescentes que frecuentan una clínica de salud. Participaron 320 adolescentes, que no estaban en psicoterapia y que respondieron, en la sala de espera, de una clínica de salud, al Youth Self Report. El principal problema relatado fue Ansiedad/Depresión. Los niños obtuvieron calificaciones más altas en Problemas Sociales y más bajas en Comportamiento Delincuente; las niñas se presentaron con menos problemas en el grupo Problemas Somáticos y con más problemas en Ansiedad/Depresión. En lo referente al rango de edad, se observó que Problemas Sociales estuvieron asociados al inicio de la adolescencia. En lo referente a la incidencia, menos de un cuarto de los adolescentes se presentaron con problemas, sugiriendo que la adolescencia no es un periodo de turbulencia. Se observó que algunos adolescentes necesitan una evaluación más detallada, pues relataron comportamientos indicativos de trastornos mentales. Se concluye que existe la necesidad de que profesionales de salud mental integren el equipo de salud que atiende a adolescentes.(AU)

Levantamento de problemas comportamentais/emocionais em um ambulatório para adolescentes / Survey of behavioral/emotional problems in an adolescent outpatient service / Estudio de problemas conductuales/emocionales en una clínica para adolescentes

This study's objective was to identify the main behavioral and emotional problems perceived by adolescents attending an outpatient service. A total of 320 adolescents were included in the study. The respondents were not undergoing psychotherapy and self-applied the Youth Self Report in the ambulatory's waiting room. The main problem reported was Anxious/Depressed. Male adolescents obtained higher scores for Social Problems and lower scores for Delinquent Behavior, while females obtained lower scores for Somatic Complaints and higher scores for the Anxious/Depressed scale. Social Problems were associated with the initial phase of adolescence. In terms of incidence, less than one quarter of the adolescents presented problems, suggesting that adolescence is not a period of turbulence. Some adolescents require a more detailed evaluation because they reported behaviors indicative of mental disorders. We conclude that there is a need for mental health workers to integrate the health staff providing care to adolescents.

El objetivo del estudio fue identificar los problemas comportamentales y emocionales notados en adolescentes que frecuentan una clínica de salud. Participaron 320 adolescentes, que no estaban en psicoterapia y que respondieron, en la sala de espera, de una clínica de salud, al Youth Self Report. El principal problema relatado fue Ansiedad/Depresión. Los niños obtuvieron calificaciones más altas en Problemas Sociales y más bajas en Comportamiento Delincuente; las niñas se presentaron con menos problemas en el grupo Problemas Somáticos y con más problemas en Ansiedad/Depresión. En lo referente al rango de edad, se observó que Problemas Sociales estuvieron asociados al inicio de la adolescencia. En lo referente a la incidencia, menos de un cuarto de los adolescentes se presentaron con problemas, sugiriendo que la adolescencia no es un periodo de turbulencia. Se observó que algunos adolescentes necesitan una evaluación más detallada, pues relataron comportamientos indicativos de trastornos mentales. Se concluye que existe la necesidad de que profesionales de salud mental integren el equipo de salud que atiende a adolescentes.