Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís – MA

Lima, Raina Jansen Cutrim Propp; Batista, Rosângela Fernandes Lucena; Ribeiro, Cecília Claudia Costa; Simões, Vanda Maria Ferreira; Lima Neto, Pedro Martins; Bettiol, Heloisa; Silva, Antônio Augusto Moura da

doi:10.11606/s1518-8787.2020054002229

Raina Jansen Cutrim Propp Lima Correspondence: Raina Jansen Cutrim Propp Lima Av. Projetada, s/n 65930-000 Açailândia, MA, Brasil. E-mail: raina.propp@ifma.edu.br

Instituto Federal de Educação. Ciência e Tecnologia do Maranhão. Departamento de Ensino. Açailândia, MA, Brasil

https://orcid.org/0000-0003-4925-5648

Rosângela Fernandes Lucena Batista

Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil

https://orcid.org/0000-0002-1529-0165

Cecília Claudia Costa Ribeiro

Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Odontologia II. São Luís, MA, Brasil

https://orcid.org/0000-0003-0041-7618

Vanda Maria Ferreira Simões

Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil

https://orcid.org/0000-0001-8351-1348

Pedro Martins Lima Neto

Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil

https://orcid.org/0000-0001-5711-6280

Heloisa Bettiol

Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Puericultura e Pediatria. Ribeirão Preto, SP, Brasil

https://orcid.org/0000-0001-8744-4373

Antônio Augusto Moura da Silva

Universidade Federal do Maranhão. Centro de Ciências Biológicas e da Saúde. Departamento de Saúde Pública. São Luís, MA, Brasil

https://orcid.org/0000-0003-4968-5138

Correspondence: Raina Jansen Cutrim Propp Lima Av. Projetada, s/n 65930-000 Açailândia, MA, Brasil. E-mail: raina.propp@ifma.edu.br

Authors' Contribution: Conception and planning of the work: RJCPL, RFLB. Analysis and interpretation of data: RJCPL, RFLB, CCRR, VMFS, PMLN, HB, AAMS. Writing and review of the work: RJCPL, RFLB, CCRR, VMFS, PMLN, HB, AAMS. Approval of the final version: RJCPL, RFLB, CCRR, VMFS, PMLN, HB, AAMS. Public responsibility for the work: RJCPL, RFLB, CCRR, VMFS, PMLN, HB, AAMS.

Conflict of Interest: The authors declare no conflict of interest.

Variables		n	%
Sex of the newborn
	Male	344	59.4
	Female	235	40.6
Head of family schooling at birth (years)
	Never studied	5	0.9
	1 to 4	61	10.5
	5 to 8	168	29.0
	9 to 11	253	43.7
	≥ 12	28	4.8
	Unknown	64	11.1
Family income at birth (minimum wages)
	≤1	77	13.3
	1.1 to 1,9	96	16.6
	2 to 2.9	95	16.4
	3 to 4,9	124	21.4
	5 to 9,9	97	16.8
	≥ 10	55	9.5
	Unknown	35	6.0
Smoking during pregnancy
	No	549	94.8
	Yes	30	5.2
Type of delivery
	Vaginal	355	61.3
	Cesarean	224	38.7
Head of family schooling at adolescence (years))
	Never studied	11	1.9
	1 to 4	139	24.0
	5 to 8	288	49.7
	9 to 11	19	3.3
	≥ 12	60	10.4
	Unknown	62	10.7
Family income at adolescence (minimum wages)
	≤ 1	114	19.7
	1.1 to 1.9	128	22.1
	2 to 2.9	118	20.4
	3 to 4.9	87	15.0
	5 to 9.9	52	9.0
	≥ 10	20	3.4
	Unknown	60	10.4
“Neither-nor generation”
	Studies or works	446	77.0
	Does not study or work	133	23.0
Level of physical activity of the adolescent
	Sedentary	215	37.1
	Low	81	14.0
	Moderate	136	23.5
	High	144	24.9
	Unknown	3	0.5
Alcohol consumption by the adolescent
	Low	471	81.4
	Risky	90	15.5
	Harmful	10	1.7
	Probable dependence	8	1.4
	Total	579	100.0
		Mean	Standard deviation
Maternal age (years)		23.4	5.3
Pregestational BMI (kg/m ²2. Kuh D, Ben-Shlomo Y, editors. A life course approach chronic disease epidemiology. 2. ed. New York: Oxford University Press; 2004. )		21.1	2.8
Gestational weight gain (kg)		9.7	5.0
Gestational age (weeks)		38.9	2.4
Birth weight (kg)		3.2	0.5
Birth length (cm)		48.9	2.4
Fat-free mass index of the adolescent (kg/m ²2. Kuh D, Ben-Shlomo Y, editors. A life course approach chronic disease epidemiology. 2. ed. New York: Oxford University Press; 2004. )		16.0	2.4

Indices		Model ^a a Initial and final model since there was no suggestion of plausible modification.
χ ²2. Kuh D, Ben-Shlomo Y, editors. A life course approach chronic disease epidemiology. 2. ed. New York: Oxford University Press; 2004. ^b b Chi-square test.
	Value	137.594
	Degrees of freedom	78
	p-value	< 0.001
RMSEA ^c c Root mean square error of approximation.
	Value	0.036
	90% confidence interval	0.026–0.046
	p-value	0.990
CFI ^d d Comparative Fit Index.		0.963
TLI ^e e Tucker Lewis Index.		0.936

Pathways and estimates			Standardized coefficient	Standard error	p-value
Latent variables
	SES at birth
		Head of family schooling at birth	0.713	0.040	< 0.001
		Family income at birth	0.682	0.038	< 0.001
	SES of the adolescent
		Head of family schooling during adolescence	0.649	0.050	< 0.001
		Family income during adolescence	0.526	0.046	< 0.001
Direct effects
	Fat-free mass of the adolescent
		SES at birth	0.194	0.060	0.578
		Maternal age	-0.130	0.040	0.001
		Pregestational BMI	0.146	0.036	< 0.001
		Smoking during pregnancy	0.048	0.058	0.403
		Gestational weight gain	0.041	0.042	0.338
		Type of delivery	0.081	0.056	0.151
		Gestational age	-0.025	0.036	0.478
		Sex of the newborn	-0.523	0.030	< 0.001
		Birth length	-0.043	0.051	0.399
		Birth weight	0.121	0.051	0.019
		SES of the adolescent	-0.282	0.350	0.421
		“Neither-nor” generation	-0.077	0.045	0.084
Level of physical activity of the adolescent			0.191	0.044	< 0.001
		Alcohol consumption by the adolescent	0.054	0.052	0.300
Maternal age
		SES at birth	0.278	0.044	< 0.001
Pregestational BMI
		SES at birth	-0.088	0.055	0.109
		Maternal age	0.299	0.043	< 0.001
Smoking during pregnancy
		SES at birth	-0.115	0.086	0.185
	Gestational weight gain
		SES at birth	0.227	0.060	< 0.001
		Maternal age	0.092	0.052	0.074
		Pregestational BMI	-0.083	0.051	0.104
		Smoking during pregnancy	0.067	0.124	0.591
	Type of delivery
		SES at birth	0.452	0.057	< 0.001
		Maternal age	0.175	0.049	< 0.001
		Gestational weight gain	0.106	0.059	0.071
	Gestational age
		Maternal age	-0.001	0.047	0.983
		Gestational weight gain	0.127	0.044	0.004
		Type of delivery	-0.091	0.059	0.123
	Birth length
		SES at birth	-0.039	0.064	0.544
Pregestational BMI			0.170	0.039	< 0.001
		Gestational weight gain	0.117	0.043	0.007
		Type of delivery	-0.098	0.068	0.146
		Gestational age	0.374	0.028	< 0.001
		Sex of the newborn	-0.037	0.043	0.386
Birth weight
		SES at birth	-0.030	0.047	0.521
		Maternal age	0.091	0.039	0.020
		Pregestational BMI	0.068	0.036	0.061
		Smoking during pregnancy	-0.069	0.070	0.331
		Gestational weight gain	0.090	0.034	0.008
		Type of delivery	0.126	0.047	0.007
		Gestational age	0.135	0.025	< 0.001
		Sex of the newborn	0.014	0.030	0.644
		Birth length	0.655	0.023	< 0.001
	SES of the adolescent
		SES at birth	0.917	0.060	< 0.001
	“Neither-nor” generation
		Sex of the newborn	0.158	0.055	0.004
		SES of the adolescent	-0.073	0.070	0.303
	Level of physical activity of the adolescent
		Sex of the newborn	-0.442	0.037	< 0.001
		Birth weight	-0.072	0.046	0.122
		SES of the adolescent	-0.057	0.053	0.283
		“Neither-nor” generation	-0.114	0.058	0.048
	Alcohol consumption by the adolescent
		Sex of the newborn	-0.038	0.067	0.570
		SES of the adolescent	-0.001	0.072	0.994
		“Neither-nor” generation	-0.103	0.082	0.207
		Level of physical activity of the adolescent	0.293	0.070	< 0.001

Pathways and estimates			Standardized coefficient	Standard error	p
Total, direct and indirect effects
	SES at birth
		Total	-0.050	0.045	0.266
	Maternal age
		Total	-0.053	0.036	0.139
	Pregestational BMI
		Total	0.152	0.035	< 0.001
		Direct	0.146	0.036	< 0.001
		Indirect	0.006	0.009	0.481
	Smoking during pregnancy
		Total	0.045	0.057	0.429
	Gestational weight gain
		Total	0.063	0.041	0.125
	Type of delivery
		Total	0.092	0.054	0.091
	Gestational age
		Total	-0.001	0.032	0.972
	Sex of the newborn
		Total	-0.633	0.024	< 0.001
		Direct	-0.523	0.030	< 0.001
		Indirect	-0.110	0.020	< 0.001
		Indirect specific
		Via level of physical activity of the adolescent	-0.085	0.021	< 0.001
	Birth length
		Total	0.026	0.038	0.495
	Birth weight
		Total	0.106	0.050	0.034
		Direct	0.121	0.051	0.019
		Indirect	-0.015	0.010	0.147
	SES of the adolescent
		Total	-0.286	0.350	0.413
	“Neither-nor” generation
		Total	-0.106	0.044	0.015
		Direct	-0.077	0.045	0.084
		Indirect	-0.029	0.015	0.050
		Indirect specific
		Via level of physical activity of the adolescent	-0.022	0.012	0.075
	Level of physical activity of the adolescent
		Total	0.207	0.040	< 0.001
		Direct	0.191	0.044	< 0.001
		Indirect	0.016	0.015	0.295
	Alcohol consumption by the adolescent
		Total	0.054	0.052	0.300

[1] Correspondence: Raina Jansen Cutrim Propp Lima Av. Projetada, s/n 65930-000 Açailândia, MA, Brasil. E-mail: raina.propp@ifma.edu.br

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Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís – MA

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS: