title: Perinatal and early life factors associated with symptoms of depression in Brazilian children.
abstract: BACKGROUND
  Few studies have been conducted on the association between perinatal and early life factors with childhood depression and results are conflicting. Our aim was to estimate the prevalence and perinatal and early life factors associated with symptoms of depression in children aged 7 to 11 years from two Brazilian birth cohorts.
  
  
  METHODS
  The study was conducted on 1444 children whose data were collected at birth and at school age, in 1994 and 2004/2005 in Ribeirao Preto, where they were aged 10-11 years and in 1997/98 and 2005/06 in São Luís, where children were aged 7-9 years. Depressive symptoms were investigated with the Child Depression Inventory(CDI), categorized as yes (score ≥ 20) and no (score < 20). Adjusted and non-adjusted prevalence ratios (PR) were estimated by Poisson regression with robust estimation of the standard errors.
  
  
  RESULTS
  The prevalence of depressive symptoms was 3.9% (95%CI = 2.5-5.4) in Ribeirão Preto and 13.7% (95%CI = 11.0-16.4) in São Luís. In the adjusted analysis, in Ribeirão Preto, low birth weight (PR = 3.98; 95%CI = 1.72-9.23), skilled and semi-skilled manual occupation (PR = 5.30; 95%CI = 1.14-24.76) and unskilled manual occupation and unemployment (PR = 6.65; 95%CI = 1.16-38.03) of the household head were risk factors for depressive symptoms. In São Luís, maternal schooling of 0-4 years (PR = 2.39; 95%CI = 1.31-4.34) and of 5 to 8 years (PR = 1.80; 95%CI = 1.08-3.01), and paternal age <20 years (PR = 1.92; 95%CI = 1.02-3.61), were independent risk factors for depressive symptoms.
  
  
  CONCLUSIONS
  The prevalence of depressive symptoms was much higher in the less developed city, São Luís, than in the more developed city, Ribeirão Preto, and than those reported in several international studies. Low socioeconomic level was associated with depressive symptoms in both cohorts. Low paternal age was a risk factor for depressive symptoms in the less developed city, São Luís, whereas low birth weight was a risk factor for depressive symptoms in the more developed city, Ribeirão Preto.
authors.affiliation: Department of Public Health, Federal University of Maranhão, São Luís, MA, Brazil.
authors.forename: Thaís S
authors.initials: TS
authors.lastname: Pereira
authors.forename: Antônio A
authors.initials: AA
authors.lastname: Silva
authors.forename: Maria T
authors.initials: MT
authors.lastname: Alves
authors.forename: Vanda M
authors.initials: VM
authors.lastname: Simões
authors.forename: Rosângela F
authors.initials: RF
authors.lastname: Batista
authors.forename: Juliana D
authors.initials: JD
authors.lastname: Rodriguez
authors.forename: Felipe P
authors.initials: FP
authors.lastname: Figueiredo
authors.forename: Fernando
authors.initials: F
authors.lastname: Lamy-Filho
authors.forename: Marco A
authors.initials: MA
authors.lastname: Barbieri
authors.forename: Heloisa
authors.initials: H
authors.lastname: Bettiol
mesh_terms: D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004522:Educational Status; D004651:Employment / Q000523:psychology; D006801:Humans; D007230:Infant, Low Birth Weight / Q000523:psychology; D007231:Infant, Newborn; D015999:Multivariate Analysis; D010290:Parents; D016012:Poisson Distribution; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors