Corrigendum: Trends and Inequalities in Unplanned Pregnancy in Three Population-Based Birth Cohorts in Pelotas, Brazil.

[This corrects the article DOI: 10.1007/s00038-020-01505-0.].

Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil.

OBJECTIVES: To assess time trends in unplanned pregnancy, stratified by sociodemographic status, reproductive history, and inequalities in family income and women's skin color, in Pelotas, Brazil. METHODS: Data from mothers of participants of the 1993 (N = 5264), 2004 (N = 4243), and 2015 (N = 4268) Pelotas birth cohorts were analyzed. Unplanned pregnancy was investigated in the perinatal period, with tests to assess changes over time among different sociodemographic and reproductive history subgroups and inequalities as a function of family income and skin color. RESULTS: The prevalence of unplanned pregnancy was 62.7% (3299/ 5264), 65.9% (2794/ 4243), and 52.2% (2226/ 4268) in the 1993, 2004, and 2015 cohorts, respectively. Black or brown women and women of lower socioeconomic status had a higher prevalence of unplanned pregnancy in all cohorts. The overall rate of unplanned pregnancy decreased over time in most subgroups. Inequality as a function of family income and skin color increased during the time frame of assessment. CONCLUSIONS: The prevalence of unplanned pregnancies decreased in the period analyzed, but it is still unjustifiably high. Efforts aimed at reducing unplanned pregnancy are vital and will require special attention to the most vulnerable groups.

Maternal depression symptoms and use of child health-care services at The Pelotas 2004 Birth Cohort.

OBJECTIVE: To investigate the influence of maternal depression on child health-care services utilization. METHODOLOGY: Data from The Pelotas 2004 Birth Cohort collected at birth and at 12- and 24-month follow-ups were used. Four outcomes occurring in the second year of life were investigated: number of well-baby visits, number of medical appointments, number of visits to emergency rooms, and number of hospitalizations. The main exposure was maternal depression symptoms at 12-month post-partum as assessed by the Edinburgh Postpartum Depression Scale (EPDS). Adjusted prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by Poisson regression. RESULTS: The prevalence of mothers with depressive symptoms was 27.6% (95% CI: 26.2-29.0%). These mothers showed a 10% lower probability of taking their children to well-baby visits (0.90; 0.85-0.95; p = 0.001); 16% higher probability to seek medical consultations (1.16; 1.09-1.25, p = 0.001); and they sought emergency services for their children more often (1.30; 1.17-1.45, p < 0.001) as compared to mothers who did not present depressive symptoms. Although the PR for hospitalizations was 26% higher for children from mothers with depressive symptoms, the association did not achieve statistical significance (1.26; 0.98-1.63; p = 0.072). CONCLUSION: Children from mothers with depressive symptoms attend fewer number of preventive consultations. In contrast, they are taken to medical and emergency care more often, suggesting that these children are given healthcare when they are at more advanced stages of their illnesses.

Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years.

BACKGROUND: Intellectual disability (ID), characterized by impairments in intellectual function and adaptive behavior, affects 1-3% of the population. Many studies investigated its etiology, but few are cohort studies in middle-income countries. AIMS: To estimate prevalence, etiology, and factors related to ID among children prospectively followed since birth in a Southern Brazilian city (Pelotas). METHODS: In 2004, maternity hospitals were visited daily and births were identified. Live-born infants (n = 4,231) whose family lived in the urban area have been followed for several years. At the age of 2 and 4 years, performances in development and intelligence tests were evaluated using the Battelle Developmental Inventory and Wechsler Intelligence Scale, respectively. Children considered as having developmental delay were invited to attend a genetic evaluation. RESULTS: At 4 years of age, the prevalence of ID was 4.5%, and the etiology was classified into 5 groups: environmental (44.4%), genetic (20.5%), idiopathic (12.6%), neonatal sequelae (13.2%), other diseases (9.3%). Most children presented impairment in two or more areas of adaptive behavior. There was no difference in prenatal care attendance or maternal schooling among the groups. CONCLUSION: For about 40% of children, ID was attributed to nonbiological factors, suggesting that the rate may be reduced with appropriate interventions early in life.

Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature.

Age, obesity and family history of diabetes are well known risk factors for gestational diabetes mellitus. Others are more controversial. The objective of this review is to find evidence in the literature that justifies the inclusion of these other conditions among risk factors. The MEDLINE, Cochrane, LILACS and Pan American Health Organization databases were searched, covering articles dating from between 1992 and 2006. Keywords were used in combination (AND) with gestational diabetes mellitus separately and with each one of the risk factors studied. The methodological quality of the studies included was assessed, resulting in the selection of 41 papers. Most studies investigating maternal history of low birth weight, low stature, and low level of physical activity have found positive associations with gestational diabetes mellitus. Low socioeconomic levels, smoking during pregnancy, high parity, belonging to minority groups, and excessive weight gain during pregnancy presented conflicting results. Publication bias cannot be ruled out. Standardization of techniques, cutoff points for screening and diagnosis, as well as studies involving larger sample sizes would allow future meta-analyses.