Grandmaternal stress during pregnancy and DNA methylation of the third generation: an epigenome-wide association study.

Stress during pregnancy may impact subsequent generations, which is demonstrated by an increased susceptibility to childhood and adulthood health problems in the children and grandchildren. Although the importance of the prenatal environment is well reported with regards to future physical and emotional outcomes, little is known about the molecular mechanisms that mediate the long-term consequences of early stress across generations. Recent studies have identified DNA methylation as a possible mediator of the impact of prenatal stress in the offspring. Whether psychosocial stress during pregnancy also affects DNA methylation of the grandchildren is still not known. In the present study we examined the multigenerational hypothesis, that is, grandmaternal exposure to psychosocial stress during pregnancy affecting DNA methylation of the grandchildren. We determined the genome-wide DNA methylation profile in 121 children (65 females and 56 males) and tested for associations with exposure to grandmaternal interpersonal violence during pregnancy. We observed methylation variations of five CpG sites significantly (FDR<0.05) associated with the grandmother's report of exposure to violence while pregnant with the mothers of the children. The results revealed differential methylation of genes previously shown to be involved in circulatory system processes (FDR<0.05). This study provides support for DNA methylation as a biological mechanism involved in the transmission of stress across generations and motivates further investigations to examine prenatal-dependent DNA methylation as a potential biomarker for health problems.

[Evaluation of orientation and serological support centers in the Brazilian Northeast]. / Avaliação dos Centros de Orientação e Apoio Sorológico/CTA/Coas da Região Nordeste do Brasil.

This article presents the results of an evaluation of Orientation and Serological Support Centers, or Anonymous HIV Testing Centers, in the Northeast of Brazil. Methodological triangulation was used to evaluate these health programs and services, including qualitative and quantitative methodology and pointing to the insufficiency of single-discipline reasoning to encompass phenomena in social organizations. The article also shows results from this triangulation experience, seeking to combine Social Sciences and Epidemiology. It describes the structure and dynamics of these services, analyzes the relationships, perceptions, and representations of the actors, presents a self-evaluation by the professionals, expounds on some quantitative results, and discusses some limits and problems, as well as proposals to overcome them.

[Violence in the city of Rio de Janeiro: areas of risk and mortality trends among adolescents 10-19 years of age]. / Violência no Município do Rio de Janeiro: áreas de risco e tendências da mortalidade entre adolescentes de 10 a 19 anos.

This study presents data on general mortality and mortality from external causes (traffic accidents and homicides) among adolescents 10 to 19 years of age in Rio de Janeiro Municipality, Brazil, from 1980 to 1994. The purpose of the study was to describe and put into context mortality from external causes and to identify areas of the Municipality where the risk of these occurrences is highest. The study also sought to identify trends and seasonal patterns of this mortality and to place violence within the ambit of public health through application of the epidemiologic surveillance approach. Information on mortality was extracted from death certificates provided by the State Health Secretariat of Rio de Janeiro. A total of 20,224 death certificates were studied. The populations used as the denominators for determining rates were estimated from the censuses of 1980 and 1991. For purposes of the analysis; the Municipality was divided into eight programmatic areas, each composed of diverse neighboring districts. A time series analysis was done for traffic accidents and homicides. The results showed that external causes were the leading causes of death in the 10-19 age group, and that during the study period deaths from these causes had increased, especially among males. The results also revealed that mortality was heterogeneously distributed in areas of the Municipality that differed socioeconomically. The study points to the need for better integration of the health sector with other sectors and institutions and for a restructuring of the health system with regard to epidemiologic surveillance of violence.