Who we are

Currently almost all countries in Europe and several countries worldwide (USA, Australia, Brasil South Africa and others) are designing cohort studies like Geração 21 to better understand how the population of the country grows and what influences healthy life outcomes. These studies demand a scientific structure with very complex research facilities, human resources with high training, an efficient administrative machinery and high financial support. In 2005, it was possible to meet the logistic conditions needed to start this work and thus it was born the Geração 21 project at the Departmento de Epidemiologia Clinica, Medicina preditiva e Saúde pública da Universidade do Porto.

This department had extensive experience having, at the time, already implemented studies to follow both an adult (EPIPorto) and an adolescent (EPITeen) cohort. And in 2005 embraced the challenge to evaluate and monitor the development of 8,647 newborns. This is a groundbreaking study, the first of its kind to be held in Portugal, aiming to identify pregnancy and childhood characteristics that relate to the development and health in later stages of life. We intend to follow the evolution of several health parameters (social, behavioral, organizational, biological) in order to explore new hypothesis, new problems, that may allow us to understand the influence of prenatal and early life years in the development and health during adolescence and adulthood.

Our goal is to continuously evaluate the growth and health of Portuguese children so that in the future we will be at the forefront of planning intervention strategies in public health.

Objectives

With Geração 21 we intend:

To estimate indicators of maternal and child health (for example, how many women smoke during pregnancy, how many women breastfeed their children and until what age, how many children are overweight, how many children have access to health care, among other indicators).

We will study the association between parental characteristics and perinatal development and anthropometric and biological parameters of children in their early years. These factors work as risk markers of cardiovascular disease, particularly evidenced by the study of obesity and factors related to child development.

All the Geração 21 evaluations, both past and future, must be seen as a tool to monitor the Portuguese children health-status and its determinants. Thus, we believe that this project will play an important role in the future planning of health intervention strategies, and may work as a Health Observatory, continuously monitoring the growth and health of the future Portuguese adults throughout their childhood and adolescent years.

Evaluations

Over time we will monitor the children that participate in the Geração 21 project. Starting from an initial evaluation at birth, we followed up groups of children at 6, 15 and 24 months. At 4 and 7 years old we tried to examine all participants. It is essential to collect information at key moments of the growth of children. Therefore in the early years of development, the evaluations have been more frequent.

To be able to maintain this monitoring and ensure the success of these steps, it is very important to have the parents/legal guardians’ updated contacts, so that we can always be in touch.

Thus, if you move house, telephone or e-mail address, please use the form that we provide or contact us.

13 years Birth 6 months 15 months 24 months 4-5 years 7 years 10 years

13 years

The 13-year evaluation took place between August 2018 and March 2020, at the Department of Clinical Epidemiology, Predictive Medicine and Public Health of the Faculty of Medicine of the University of Porto.

The evaluation was interrupted due to the pandemic caused by the SARS-COV-2 virus, but still, it was possible to re-evaluate approximately 4600 adolescents who are part of the cohort.

At this stage, we performed tests and collected information about teenagers and mothers.

Teens:

Anthropometry
Bio-impedance
Blood pressure
Pubertal development
Spirometry and oscillometry with bronchodilation test
Pressure algorithm
Pupillometry
Assessment of transdermal water loss
Blood collection
Cognitive assessment
Physical activity
Eating habits
Consumption of alcoholic beverages
Smoking habits
Musculoskeletal pain
Accidents
Bullying
Depression scale
Conflict Tactics Scale
Body image
Sociodemographic characterization
Pathologies and health care utilization
Allergies and respiratory symptoms

Mothers:

Anthropometry
Bio-impedance
Blood pressure
Blood collection
Clinical and obstetric history

Questionnaires applied:

Parents questionnaire

Teen questionnaire

Birth

The first evaluation, at birth, took place at the 5 public hospitals with maternity unit in the metropolitan area of Porto, namelly:
a) Hospital Geral de Santo António e Maternidade Júlio Dinis (atualmente Centro Hospitalar do Porto);
b) Hospital de São João (atualmente Centro Hospitalar de São João);
c) Centro Hospitalar de Vila Nova de Gaia (atualmente Centro Hospitalar de Vila Nova de Gaia / Espinho);
d) Unidade Local de Saúde de Matosinhos - Hospital Pedro Hispano.

Between April 2005 and August 2006, 8495 women admitted at one of the five hospitals that gave birth to a live-newborn were invited to participate in the Geração 21 project. In the end, and given that the twins are also part of the Geração 21, 8647 babies were included. Over 90% of the invited parents agreed to participate!
About 300 mothers were invited to participate even before the baby was born. This group included women who went to an appointment up to 13 weeks of pregnancy at the Maternidade Julio Dinis and Hospital São João, and were followed throughout pregnancy. Very important data was collected through questionnaires, physical examinations and blood collection.

Information collected:
Parents
- History and sociodemographic condition
- Clinical, gynecological and obstetrical history (mother)
- Pregnancy and prenatal care (mother)
- Consumption of tobacco, alcohol and other drugs
- Anthropometry
- Delivery
Newborn
- First days of life
- Anthropometry
- Head, abdominal, chest and arm circumferences

6 months

The 6-month evaluation took place in the primary health care centers (Centros de Saúde) where infants were enrolled. Later the evaluation was moved to the Departmento de Epidemiologia Clinica, Medicina preditiva e Saúde Publica da Faculdade de Medicina, Universidade do Porto.

In this evaluation data on children was collected through questionnaires and physical evaluation.

Information collected:
- House and child caregivers Eating habits
- Sleeping habits and crying pattern
- Health status
- Psycho-motor development
- Use of healthcare services
- Accidents
- Acidentes
- Anthropometry

15 months

In this evaluation, data on children was collected through questionnaires and physical evaluation.

Information collected:
- House and child caregivers
- Eating habits
- Sleeping Habits
- Psycho-motor development
- Health status
- Use of healthcare services
- Accidents
- Anthropometry

24 months

This evaluation was performed to a smaller number of participants and took place at the primary health care center Centro de Saúde de Carvalhosa, Porto, in collaboration with internal pediatric doctors. In 2008, a group of participants was evaluated in the Faculdade de Medicina Dentária (FMDUP) da Universidade do Porto.
In this evaluation data was collected on children through questionnaires and physical examination.

Information collected:
- House and child caregivers
- Eating habits
- Sleeping Habits
- Health status
- Use of healthcare
- Accidents
- Anthropometry
- Eyesight
- Oral health

4-5 years

Between April 2009 and August 2011, the cohort was totally evaluated in the Faculdade de Medicina Dentária, Universidade do Porto.

Nearly 7500 children and their mothers were evaluated.

Information collected:
Child
- House and child caregivers
- Eating habits
- Physical activity
- Sleeping habits and crying pattern
- Pathology and use of health care
- Accidents
- Physical condition
- Anthropometry
- Body composition
- Blood pressure
- Oral Health (evaluation performed by dentists)
- Biochemical parameters from blood samples
Mother
- Sociodemographic characterization
- Eating habits
- Sleeping Habits
- Physical activity
- Tobacco and alcohol consumption
- Body image
- Clinical history
- Physical condition- Anthropometry
- Blood pressure
- Oral Health (evaluation performed by dentists)
- Biochemical parameters from blood samples

7 years

The 7-year evaluation occurred between April 2012 and March 2014.
The evaluation took place at the Departmento de Epidemiologia Clinica, Medicina preditiva e Saúde Publica da Faculdade de Medicina, Universidade do Porto.

At this stage, similarly to what happened during the 4-5 years evaluation, we intended to re-evaluate all children who are part of the cohort. For this, a team of trained health professionals received the families who agreed to participate, on a daily-basis at the Departmento de Epidemiologia Clinica, Medicina preditiva e Saúde Publica da Faculdade de Medicina, Universidade do Porto.
Using several questionnaires and food diaries, we collected data on:

Child
- House and child caregivers
- Eating habits
- Physical activity
- Pathologies and use of health care
- Accidents
- Musculoskeletal pain
- Discipline
Parents
- Sociodemographic characterization
- Eating habits
- Tobacco and alcohol consumption
- Body image
- Clinical and obstetrical history (mother)

The physical examination of the child was quite detailed and included:
- Anthropometry
- Bio-impedance
- Blood pressure
- Electrocardiogram
- Spirometry
- Bone Densitometry
- Blood collection

Tooth Fairy

In the 7-year evaluation, we've stored one of each child's baby tooth.
We asked parents to bring in a child baby tooth (also called deciduous, temporary or milk tooth) at the time of the 7-year evaluation.
Our goal is similar to what already exists in other European countries with projects similar to ours, to create the first teeth Biobank in Portugal. The analysis of the primary dentition may be important to study environmental factors, to which the child was exposed in the womb of the mother and throughout childhood, and realize their influence on future health.

10 years

It’s been running since July 2015, at Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública da Faculdade de Medicina da Universidade do Porto, the 10 year’s follow-up.
The main goal is to re-evaluate all the children who are part of the cohort. For that purpose we have, once again, a team of trained health professionals in Departmento de Epidemiologia Clinica, Medicina preditiva e Saúde Publica da Faculdade de Medicina to receive the families who agreed to participate.

At this stage we are collecting data focusing specially on:
- Child caregivers
- Eating habits
- Physical activity
- Pathologies and use of health care
- Accidents
- Musculoskeletal pain
- Bullying

Children also do very detailed physical exams including:
- Weight and height measurements
- Bioimpedance
- Blood pressure
- Electrocardiogram
- Spirometry with bronchodilation test
- Bone Densitometry
- Blood collection
- Pubertal development