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To evaluate the relationship between maternal cognitive performance and language and cognitive development of children between 24 and 36 months old of mothers who became pregnant in adolescence, in the city of Pelotas, Southern Brazil. This is a cross-sectional study nested in a cohort study with adolescent mothers who received prenatal care in the city’s public health system. To assess maternal cognitive performance, the Montreal Cognitive Assessment (MoCA) was used and Bayley Scales of Infant Development III (BSID-III) are used to assess children's language and cognition development. Data were analyzed using SPSS (Version 22.0) software. Pearson correlation, t-test, ANOVA and linear regression were performed. We evaluated 496 mother-child dyads. In the adjusted analysis, we found that children's language remained associated with maternal cognitive performance (p = .027, CI [0.0, 0.6]) and child’s gender (p < .001, CI [−7.2, −2.4]). Besides that children cognitive development remained associated with maternal cognitive performance (p = .008, CI [0.1, 0.6]) and child’s gender (p = .030, CI [−4.5, −0.2]). Our results suggest that poor maternal cognitive performance is associated with lower levels of children's language and cognitive development. The results contributing to early identification and intervention in children of mothers with poor cognitive performance at higher risk of negative developmental outcomes.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2022-10-06T18:39:03Z No. of bitstreams: 1 Tese - Bárbara Borges Rubin.pdf: 4418313 bytes, checksum: 1226004354be334c1039766d387c509e (MD5) Made available in DSpace on 2022-10-06T18:39:03Z (GMT). No. of bitstreams: 1 Tese - Bárbara Borges Rubin.pdf: 4418313 bytes, checksum: 1226004354be334c1039766d387c509e (MD5) Previous issue date: 2022-06-29 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES Introduction: a core developmental task of pregnancy is for a mother to prepare herself psychologically for motherhood by gradually increasing her emotional engagement with the fetus. Maternal-Fetal Attachment (MFA) refers to the bond that the pregnant woman establishes with the baby during pregnancy and may be related to outcomes in the offspring. However, the factors associated with MFA are not well established in the literature. Few studies have population-based samples and validated instruments to explore these factors and fill gaps. Objective: to verify the factors associated to MFA, and the role of perceived maternal social support in a population-based sample of pregnant women in southern Brazil. Method: cross-sectional study corresponding to the second phase of a cohort study with pregnant women between the first and third trimester of pregnancy, living in the urban area of a municipality in southern Brazil, between 2016 and 2018. The Maternal-Fetal Attachment Scale (MFAS) was used to measure MFA. To identify factors associated with MFA, the Social Support Scale (MOS-SSS) was used to measure perceived maternal social support, the Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms, the Beck Anxiety Inventory (BAI), to assess anxiety symptoms, and the Alcohol, Tobacco, and Substance Involvement Screening Test (ASSIST), to explore alcohol and tobacco use/abuse. In addition, a questionnaire composed of sociodemographic and gestational variables was used. Data analyzes were performed using the Statistical Package for the Social Sciences 23.0 software, using the most appropriate statistical tests for each objective of the study. Results: the sample consisted of 840 pregnant women. The results of the first paper showed that pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [95%CI -6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [95%CI -5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [95%CI -4.6; -0.2]) and those with depressive symptoms (B=- 4.9 [95%CI -7.4; -2.5]). The results of the second paper showed that all dimensions of perceived social support remained associated with MFA after adjustment: material (tangible) support (B=0.13 [95%CI 0.08;0.18]); affectionate support (B=0.20 [95%CI 0.14;0.26]); emotional support (B=0.16 [95%CI 0.11;0.21]); informational support (B=0.14 [95%CI 0.09;0.19]); and positive social interaction (B=0.19 [95%CI 0.14;0.25]). Conclusion: the findings indicate evidence that a lower MFA may be related to lack of social support during pregnancy, maternal mental health problems, especially depression, and to a lower gestational trimester. An early evaluation of the MFA and effort to promote prenatal bonding, focusing on maternal psychological, emotional and social aspects are strongly suggested. Introdução: uma tarefa central do desenvolvimento da gravidez é a preparação psicológica da mulher para a maternidade, aumentando gradualmente o seu envolvimento emocional com o feto. O Apego Materno-Fetal (AMF) se refere ao vínculo que a gestante estabelece com o bebê durante a gravidez e pode estar relacionado a desfechos na prole. No entanto, os fatores associados ao AMF não estão bem estabelecidos na literatura. Poucos estudos utilizaram amostras representativas da população e instrumentos validados para explorar esses fatores e preencher lacunas. Objetivo: verificar os fatores associados ao AMF, bem como o papel do apoio social materno percebido em uma amostra de base populacional de gestantes no sul do Brasil. Método: ambos artigos são estudos transversais correspondentes à segunda fase de um estudo de coorte com gestantes entre o primeiro e o terceiro trimestre gestacional, residentes na zona urbana de um município no sul do Brasil, entre os anos de 2016 e 2018. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. Para identificar os fatores associados ao AMF, foram utilizadas a Escala de Apoio Social (MOS-SSS) para mensurar o apoio social materno percebido, a Escala de Depressão Pós-natal de Edimburgo (EPDS) para medir os sintomas depressivos, o Inventário de Ansiedade de Beck (BAI) para avaliar os sintomas ansiosos, e o Teste de Triagem de Envolvimento com Álcool, Tabagismo e Substâncias (ASSIST) para explorar o uso/abuso de álcool e tabaco. Além disso, foi utilizado um questionário composto por variáveis sociodemográficas e gestacionais. As análises dos dados foram realizadas no software Statistical Package for the Social Sciences 23.0, através de testes estatísticos adequados para cada objetivo do estudo. Resultados: a amostra foi composta por 840 gestantes. Os resultados do primeiro artigo mostraram que as gestantes que apresentaram menores médias de AMF foram aquelas que não viviam com um companheiro (B=-3,8 [IC 95% -6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC 95% -5,9; -2,6]), que não tiveram o apoio da mãe durante a gravidez (B-2,4 [IC 95% -4,6; -0,2]) e aquelas com sintomas depressivos (B=-4,9 [IC 95% -7,4 ; -2,5]). Os resultados do segundo artigo evidenciaram que todas as dimensões do apoio social materno percebido estiveram associadas ao AMF: apoio material (tangível) (B=0,13 [IC 95% 0,08; 0,18]); apoio afetivo (B=0,20 [IC 95% 0,14; 0,26]); apoio emocional (B=0,16 [IC95% 0,11; 0,21]); apoio informativo (B=0,14 [IC 95% 0,09; 0,19]); e interação social positiva (B=0,19 [IC 95% 0,14; 0,25]). Conclusão: os achados apontam para a evidência de que um menor AMF pode estar relacionado à falta de apoio social durante a gravidez, problemas de saúde mental materna, especialmente a depressão, e com o menor trimestre gestacional. Uma avaliação precoce do AMF e o trabalho de promoção do vínculo pré-natal, com foco nos aspectos psicológicos, emocionais e sociais maternos são fortemente sugeridos.