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O’Neill S, Pehme PM, Kinsella-Kammerer B, Ginalis C, Wong WM, Blum M, Shereen AD, Nomura Y. Prenatal Superstorm Sandy stress and postnatal affectionless control as a conjoint risk for child psychopathology. JOURNAL OF CHILD AND FAMILY STUDIES 2025; 34:1005-1017. [PMID: 40308331 PMCID: PMC12043322 DOI: 10.1007/s10826-025-03046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2025] [Indexed: 05/02/2025]
Abstract
The current study investigates the conjoint effect of prenatal Superstorm Sandy stress (SS) and postnatal parenting, as measured by affectionless control (AC), in determining the risk of early childhood psychopathology. The study included 154 children (45.5% males) longitudinally tracked from ages 2-5 years. Maternal AC was assessed using the Parental Bonding Instrument. The prevalence of child diagnostic outcomes (DSM-IV anxiety disorders, phobias, and disruptive behavior disorders) was ascertained by trained clinical interviewers using maternal responses to the Preschool Age Psychiatric Assessment. Children were stratified into four groups by SS and AC status to identify synergistic effects on psychopathology exceeding the risks expected in an additive model. Children exposed to both SS and AC had over 5-fold increased risk of any anxiety disorder, a 12-fold increased risk for disruptive behavior disorders, and a nearly 5-fold increased risk of any disorder relative to the reference group of children with neither exposure. The risks of anxiety, disruptive behavior, and any disorders were synergistically greater than the sum of independent effects of the two stressors, as evident in the synergy index. Evaluation of synergistically increased risks for childhood disorders will help to identify high-risk children, which in turn could inform design of multi-level interventions to mitigate child psychopathology.
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Affiliation(s)
- Sarah O’Neill
- CUNY City College, Department of Psychology, 160 Convent Avenue, New York, NY 10031, USA
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA
| | - Patricia M. Pehme
- NYU Langone Child Study Center, 1 Park Avenue #7, New York, NY 10016, USA
| | | | - Christine Ginalis
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA
- CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA
| | - Wai M. Wong
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA
- CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA
| | - Melissa Blum
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, New York, NY 10029, USA
| | - Ahmed D. Shereen
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA
- CUNY Advanced Science Research Center at the Graduate Center, Neuroscience Initiative, 85 Saint Nicholas Terrace, New York, NY 10031, USA
| | - Yoko Nomura
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA
- CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl, New York, NY 10029, USA
- CUNY Advanced Science Research Center at the Graduate Center, Neuroscience Initiative, 85 Saint Nicholas Terrace, New York, NY 10031, USA
- CUNY Graduate School of Public Health & Public Policy, 55 W 125th St, New York, NY 10027, USA
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Levendosky AA, Grimm KJ, Lonstein JS, Bogat GA, Muzik M, Nuttall AK, Martinez-Torteya C. Pinpointing the timing of prenatal stress associated with infant biobehavioral reactivity. Psychoneuroendocrinology 2025; 173:107368. [PMID: 39874614 PMCID: PMC11888579 DOI: 10.1016/j.psyneuen.2025.107368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 01/15/2025] [Accepted: 01/19/2025] [Indexed: 01/30/2025]
Abstract
Prenatal stress has a well-established link to negative biobehavioral outcomes in young children, particularly for girls, but the specific timing during gestation of these associations remains unknown. In the current study, we examined differential effects of timing of prenatal stress on two infant biobehavioral outcomes [i.e., hypothalamic-pituitary-adrenal (HPA) axis reactivity and difficult temperament] that are early-life precursors to the development of psychopathology. We obtained the most granular assessment of prenatal stress to date involving weekly stress ratings from 396 pregnant women between 15 and 41 weeks gestation. At 6 months postpartum, infant salivary cortisol was collected (n = 173) before and after a stressful laboratory task and mothers reported on infant temperament (n = 244). Machine learning explored both between- and within-person regression effects of prenatal stress on the two infant biobehavioral outcomes. For HPA axis reactivity, we found a sensitive period during mid-gestation (weeks 20 and 29) for girls, but during late gestation (week 37) for boys. For difficult temperament, we found a between-persons effect of mean stress level as well as sensitive periods in mid (weeks 20, 21, 25) and late gestation (week 37) for girls, but across mid to late gestation (weeks 25, 27, 30, 34, 40) for boys. This study is the first to use a weekly assessment across gestation to demonstrate specific windows of sensitivity for infant biobehavioral precursors of child psychopathology. The findings highlight that biological sex critically influences specific timing of these prenatal stress associations with infant outcomes, thus informing our understanding of sex differences in early biobehavioral markers of psychopathology.
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Affiliation(s)
- Alytia A Levendosky
- Clinical Science Program, Department of Psychology, Michigan State University, USA.
| | - Kevin J Grimm
- Quantitative Methods, Department of Psychology, Arizona State University, USA
| | - Joseph S Lonstein
- Behavioral Neuroscience Program, Department of Psychology, Michigan State University, USA
| | - G Anne Bogat
- Clinical Science Program, Department of Psychology, Michigan State University, USA
| | - Maria Muzik
- Departments of Psychiatry, Obstetrics & Gynecology, University of Michigan - Michigan Medicine, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, USA
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Pham C, Mattera JA, Waters SF, Crespi EJ, Madigan JA, Lee S, Gartstein MA. Advancing the Study of Maternal Prenatal Stress Phenotypes and Infant Temperament Outcomes. Dev Psychobiol 2025; 67:e70035. [PMID: 40079473 PMCID: PMC11905339 DOI: 10.1002/dev.70035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 01/17/2025] [Accepted: 02/18/2025] [Indexed: 03/15/2025]
Abstract
Exposure to the in utero environment provides offspring risk or protection with respect to postpartum development and health across the lifespan. We used latent profile analysis (LPA), considering self-report and physiological indicators to assess the influence of maternal prenatal stress/distress on infant temperament. We predicted that participants who reported greater prenatal stress/distress would have infants with less optimal temperament characteristics (e.g., higher fearfulness, lower smiling/laughter). Women (N = 67) were recruited in the Southwest Washington and Eastern Washington/North Idaho areas. Participants responded to surveys during the third trimester and provided hair samples for cortisol analyses. Postpartum mothers reported on infant temperament. LPA resolved two statistically supported profiles, reflecting lower and higher maternal stress/distress during pregnancy, which we compared with respect to infant temperament (e.g., fearfulness, smiling/laughter). The greater stress/distress exposure group demonstrated higher cortisol concentrations, depression, general anxiety, and perceived stress. Mothers with greater prenatal stress/distress profiles reported their children exhibiting more challenging temperaments (e.g., higher negative emotionality). This pattern of results suggests that groups discernable in terms of prenatal stress/distress exposure also differ with respect to infant reactivity and regulation.
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Affiliation(s)
- Christie Pham
- Department of PsychologyWashington State UniversityPullmanWashingtonUSA
| | | | - Sara F. Waters
- Human Development DepartmentWashington State UniversityPullmanWashingtonUSA
| | - Erica J. Crespi
- School of Biological Sciences and Center for Reproductive BiologyWashington State UniversityPullmanWashingtonUSA
| | - J. A. Madigan
- School of Biological Sciences and Center for Reproductive BiologyWashington State UniversityPullmanWashingtonUSA
| | - SuYeon Lee
- Human Development DepartmentWashington State UniversityPullmanWashingtonUSA
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Lund IO, Hannigan LJ, Ask H, Askelund AD, Hegemann L, Corfield EC, Wootton RE, Ahmadzadeh YI, Davey Smith G, McAdams TA, Ystrom E, Havdahl A. Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches. BMC Med 2025; 23:18. [PMID: 39838367 PMCID: PMC11753172 DOI: 10.1186/s12916-024-03834-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 12/18/2024] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Maternal stress during pregnancy may impact offspring development via changes in the intrauterine environment. However, genetic and environmental factors shared between mothers and children might skew our understanding of this pathway. This study assesses whether prenatal maternal stress has causal links to offspring outcomes: birthweight, gestational age, or emotional and behavioral difficulties, triangulating across methods that account for various measured and unmeasured confounders. METHODS We used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), including maternal reports on prenatal stress at work, at home, and via stressful life events as exposures. Outcomes were children's birthweight and gestational age, from the Medical Birth Registry of Norway, and maternal reports on early offspring emotional and behavioral difficulties. We assessed associations using four approaches: sibling control analyses, gene-environment interaction analyses, intergenerational Mendelian randomization (MR), and negative control (i.e., postnatal stress) analyses. RESULTS Maternal prenatal stress was observationally associated with offspring lower birthweight (e.g., βwork = - 0.01 [95%CI: - 0.02, - 0.01]), earlier birth (e.g., βwork = - 0.04 [95%CI: - 0.04, - 0.03])), and more emotional (e.g., βevents = 0.08 [95%CI: 0.07, 0.09]) and behavioral difficulties (e.g., βrelationship = 0.08 [95%CI: 0.07, 0.09]) in the full sample (N = 112,784). However, sibling control analyses (N = 36,511) revealed substantial attenuation of all associations after accounting for familial factors. Gene-environment interaction models (N = 76,288) showed no clear evidence of moderation of associations by mothers' polygenic scores for traits linked to stress sensitivity. Intergenerational MR analyses (N = 29,288) showed no clear evidence of causal effects of maternal plasma cortisol on any offspring outcomes. Negative control exposure analyses revealed similar effect sizes whether exposures were measured prenatally or postnatally. CONCLUSIONS Our results indicate that links between prenatal maternal stress and variation in early offspring outcomes are more likely to be confounded than causal. While no observational study can rule out causality, the consistency of our findings across different approaches is striking. Other sources of prenatal stress or more extreme levels may represent intrauterine causal risk factors for offspring development. Nonetheless, our research contributes to identifying boundary conditions of the fetal programming and developmental origins of health and disease hypotheses, which may not be as universal as sometimes assumed.
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Affiliation(s)
- Ingunn Olea Lund
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Laurie J Hannigan
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Helga Ask
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Adrian D Askelund
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Laura Hegemann
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Elizabeth C Corfield
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Robyn E Wootton
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Yasmin I Ahmadzadeh
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - George Davey Smith
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom A McAdams
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eivind Ystrom
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
| | - Alexandra Havdahl
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PROMENTA, Department of Psychology, University of Oslo, Oslo, Norway
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Willford JA, Kaufman JM. Through a teratological lens: A narrative review of exposure to stress and drugs of abuse during pregnancy on neurodevelopment. Neurotoxicol Teratol 2024; 105:107384. [PMID: 39187031 DOI: 10.1016/j.ntt.2024.107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
Teratological research shows that both prenatal stress and prenatal substance exposure have a significant impact on neurodevelopmental outcomes in children. Using human research, the purpose of this narrative review is to explore the degree to which these exposures may represent complex prenatal and postnatal risks for the development of cognition and behavior in children. An understanding of the HPA axis and its function during pregnancy as well as the types and operationalization of prenatal stress provide a context for understanding the direct and indirect mechanisms by which prenatal stress affects brain and behavior development. In turn, prenatal substance exposure studies are evaluated for their importance in understanding variables that indicate a potential interaction with prenatal stress including reactivity to novelty, arousal, and stress reactivity during early childhood. The similarities and differences between prenatal stress exposure and prenatal substance exposure on neurodevelopmental outcomes including arousal and emotion regulation, cognition, behavior, stress reactivity, and risk for psychopathology are summarized. Further considerations for teratological studies of prenatal stress and/or substance exposure include identifying and addressing methodological challenges, embracing the complexity of pre-and postnatal environments in the research, and the importance of incorporating parenting and resilience into future studies.
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Affiliation(s)
- Jennifer A Willford
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Jesse M Kaufman
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America
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6
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Papadiochou A, Diamanti A, Metallinou D, Georgakopoulou VE, Taskou C, Kagkouras I, Sarantaki A. Impact of Climate Change on Reproductive Health and Pregnancy Outcomes: A Systematic Review. Cureus 2024; 16:e68221. [PMID: 39347228 PMCID: PMC11439441 DOI: 10.7759/cureus.68221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2024] [Indexed: 10/01/2024] Open
Abstract
Climate change has emerged as a significant global health challenge, with growing evidence linking environmental factors to adverse reproductive health outcomes. The primary objective of this review is to assess the effects of climate change-driven environmental factors, such as air pollution and temperature extremes, on reproductive health outcomes, including fertility rates, miscarriage, preterm birth, and congenital anomalies. A comprehensive search of PubMed, Google Scholar, and Web of Science was conducted until July 2024. Studies included in the review were observational, experimental, and randomized controlled trials that reported quantitative data on reproductive outcomes in relation to climate-related environmental exposures. A total of 49 studies were selected for qualitative synthesis. The review found that increased exposure to particulate matter (PM2.5), extreme temperatures, and proximity to traffic were consistently associated with reduced fertility, increased risks of miscarriage, preterm birth, and low birth weight. Adverse effects were particularly pronounced among vulnerable populations, such as pregnant women of lower socioeconomic status and those living in disaster-prone areas. The studies also highlighted potential transgenerational effects, with prenatal exposure to environmental stressors influencing the long-term health of offspring. The findings underscore the urgent need for public health interventions and policies to mitigate environmental exposures that negatively impact reproductive health. Future research should focus on longitudinal and interventional studies to establish causal relationships and inform effective public health strategies.
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Affiliation(s)
| | - Athina Diamanti
- Department of Midwifery, University of West Attica, Athens, GRC
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7
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Lipschutz R, Kulesz PA, Elgbeili G, Biekman B, Laplante DP, Olson DM, King S, Bick J. Maternal mental health mediates the effect of prenatal stress on infant temperament: The Harvey Mom Study. Dev Psychopathol 2024; 36:893-907. [PMID: 37078447 DOI: 10.1017/s0954579423000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Prenatal maternal stress and mental health problems are known to increase risk for developmental psychopathology in offspring, yet pathways leading to risk or resiliency are poorly understood. In a quasi-experimental design, we prospectively examined associations between disaster-related prenatal stress, maternal mental health symptoms, and infant temperament outcomes. Mothers who were pregnant during Hurricane Harvey (N = 527) reported on objective hardships (e.g., loss of belongings or income, evacuation, home flooding) related to the storm and subsequent mental health symptoms (anxiety/depression, posttraumatic stress) across time. At a postpartum assessment, mothers reported on their infant's temperament (negative affect, positive affect, orienting/regulatory capacity). Greater objective hardship indirectly predicted higher levels of infant orienting/regulatory capacity through its association with increased maternal posttraumatic stress symptoms. Greater objective hardship also indirectly predicted higher levels of infant negative affect through its association with increased maternal anxiety/depression symptoms across time. Our findings suggest a psychological mechanism linking prenatal stress with specific temperamental characteristics via maternal mental health symptoms. Findings point to the importance of high-quality assessment and mental health services for vulnerable women and young children.
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Affiliation(s)
| | - Paulina A Kulesz
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Brian Biekman
- Department of Psychology, University of Houston, Houston, TX, USA
| | - David P Laplante
- Lady Davis Institute - Jewish General Hospital, Montreal, Canada
| | | | - Suzanne King
- Psychosocial Research Unit, Douglas Research Centre, Verdun, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Johanna Bick
- Department of Psychology, University of Houston, Houston, TX, USA
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8
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065505. [PMID: 38374808 DOI: 10.1542/peds.2023-065505] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Buthmann JL, Miller JG, Gotlib IH. Maternal-prenatal stress and depression predict infant temperament during the COVID-19 pandemic. Dev Psychopathol 2024; 36:161-169. [PMID: 36345652 PMCID: PMC10164837 DOI: 10.1017/s0954579422001055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Researchers have begun to examine the psychological toll of the ongoing global COVID-19 pandemic. Data are now emerging indicating that there may be long-term adverse effects of the pandemic on new mothers and on children born during this period. In a longitudinal study of maternal mental health and child emotional development during the pandemic, we conducted online assessments of a cohort of women at two time points: when they were pregnant at the beginning of the surge of the pandemic in the United States (baseline, N = 725), and approximately 1 year postpartum (follow-up, N = 296), examining prenatal and postnatal maternal mental health, prenatal pandemic-related stress, and infant temperament. Pandemic-related stress at baseline was associated with concurrent depressive symptoms and infant negative affect at follow-up. Baseline maternal depressive symptoms were associated with follow-up depressive symptoms, which in turn were also associated with infant negative affect. Pandemic-related stress during pregnancy may have enduring effects on infant temperament. These findings have important implications for our understanding of the emotional development of children who were in utero during the COVID-19 pandemic.
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Affiliation(s)
| | - Jonas G Miller
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
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10
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White BP, Breakey S, Brown MJ, Smith JR, Tarbet A, Nicholas PK, Ros AMV. Mental Health Impacts of Climate Change Among Vulnerable Populations Globally: An Integrative Review. Ann Glob Health 2023; 89:66. [PMID: 37810609 PMCID: PMC10558031 DOI: 10.5334/aogh.4105] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/25/2023] [Indexed: 10/10/2023] Open
Abstract
Background Climate change has been shown to be directly linked to multiple physiological sequelae and to impact health consequences. However, the impact of climate change on mental health globally, particularly among vulnerable populations, is less well understood. Objective To explore the mental health impacts of climate change in vulnerable populations globally. Methods We performed an integrative literature review to identify published articles that addressed the research question: What are the mental health impacts of climate change among vulnerable populations globally? The Vulnerable Populations Conceptual Model served as a theoretical model during the review process and data synthesis. Findings/Results One hundred and four articles were selected for inclusion in this review after a comprehensive review of 1828 manuscripts. Articles were diverse in scope and populations addressed. Land-vulnerable persons (either due to occupation or geographic location), Indigenous persons, children, older adults, and climate migrants were among the vulnerable populations whose mental health was most impacted by climate change. The most prevalent mental health responses to climate change included solastalgia, suicidality, depression, anxiety/eco-anxiety, PTSD, substance use, insomnia, and behavioral disturbance. Conclusions Mental health professionals including physicians, nurses, physician assistants and other healthcare providers have the opportunity to mitigate the mental health impacts of climate change among vulnerable populations through assessment, preventative education and care. An inclusive and trauma-informed response to climate-related disasters, use of validated measures of mental health, and a long-term therapeutic relationship that extends beyond the immediate consequences of climate change-related events are approaches to successful mental health care in a climate-changing world.
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Affiliation(s)
- Bradley Patrick White
- MGH Institute of Health Professions School of Nursing, 36 1st Avenue, Boston, MA 02129, US
| | - Suellen Breakey
- MGH Institute of Health Professions School of Nursing, 36 1st Avenue, Boston, MA 02129, US
| | - Margaret J. Brown
- MGH Institute of Health Professions School of Nursing, 36 1st Avenue, Boston, MA 02129, US
| | - Jenny Rand Smith
- MGH Institute of Health Professions School of Nursing, 36 1st Avenue, Boston, MA 02129, US
| | - Amanda Tarbet
- SFPE Foundation, 9711 Washingtonian Blvd, Gaithersburg, MD 20878, US
| | - Patrice K. Nicholas
- Center for Climate Change, Climate Justice, and Health, MGH Institute of Health Professions School of Nursing, 36 1@st Avenue, Boston, MA 02129, US
| | - Ana M. Viamonte Ros
- Florida International University, Herbert Wertheim School of Medicine, Miami, Florida, US
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11
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O'Neill S, Nomura Y. Prenatal Stress Exposure Amplifies Effect of Maternal Suicidal Ideation on Early Childhood Behavioral Trajectories. Res Child Adolesc Psychopathol 2023; 51:1257-1271. [PMID: 37067623 PMCID: PMC11891748 DOI: 10.1007/s10802-023-01062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 04/18/2023]
Abstract
The in utero environment influences fetal development and may predispose to disease later in life. This study examines whether maternal suicidal ideation during pregnancy is associated with children's behavioral trajectories across early childhood, and whether prenatal maternal traumatic stress accelerates the trajectories. The study included mother-child dyads (N = 331, 51.1% boys) from the longitudinal Stress In Pregnancy study; 31.1% (n = 103) mothers were Exposed to Superstorm Sandy. During their second trimester, 12.4% (n = 41) women reported suicidal ideation during pregnancy. Mothers completed the Behavior Assessment Scale for Children-2 annually from ages 2- to 6-years-old to assess multiple behavioral domains. Hierarchical linear modeling estimated within-person longitudinal trajectories of clinical behaviors, and between-person effects of maternal suicidal ideation and disaster-related stress in utero on changes in child behavior. For children exposed to both risks, Atypical behaviors (i.e., unusual behaviors, social disconnection) increased linearly across early childhood. Exposure to Superstorm Sandy and maternal suicidal ideation were independently associated with non-linear increases in Anxiety severity and maternal suicidal ideation during pregnancy was associated with a linear increase in Attention problems across early childhood. Maternal suicidal ideation during pregnancy is associated with increased risk for a range of behavioral and emotional difficulties in early childhood and the trajectory of atypical behaviors was amplified by disaster-related traumatic stress. Findings highlight the need for health professionals to screen for suicidal ideation among their pregnant patients. Pregnant women who experience severe stress may require additional monitoring and support to reduce risk for poorer early childhood outcomes.
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Affiliation(s)
- Sarah O'Neill
- Psychology Department, The City College of New York, City University of New York, New York, NY, USA.
- Psychology Department, The Graduate Center, City University of New York, New York, NY, USA.
| | - Yoko Nomura
- Psychology Department, The Graduate Center, City University of New York, New York, NY, USA
- Psychology Department, Queens College, City University of New York, Flushing, NY, USA
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12
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Lobel M, Preis H, Mahaffey B, Schaal NK, Yirmiya K, Atzil S, Reuveni I, Balestrieri M, Penengo C, Colli C, Garzitto M, Driul L, Ilska M, Brandt-Salmeri A, Kołodziej-Zaleska A, Caparros-Gonzalez RA, Castro RA, La Marca-Ghaemmaghami P, Meyerhoff H. Common model of stress, anxiety, and depressive symptoms in pregnant women from seven high-income Western countries at the COVID-19 pandemic onset. Soc Sci Med 2022; 315:115499. [PMID: 36399984 PMCID: PMC9622432 DOI: 10.1016/j.socscimed.2022.115499] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/14/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Increases in stress, anxiety, and depression among women pregnant during the COVID-19 pandemic have been reported internationally. Yet rigorous comparison of the prevalence of maternal mental health problems across countries is lacking. Moreover, whether stress is a common predictor of maternal mental health during the pandemic across countries is unknown. METHODS 8148 pregnant women from Germany, Israel, Italy, Poland, Spain, Switzerland, and the United States were enrolled in the International COVID-19 Pregnancy Experiences (I-COPE) Study between April 17 and May 31, 2020. Sociodemographic characteristics, pandemic-related stress, pregnancy-specific stress, anxiety, and depression were assessed with well-validated instruments. The magnitude of stress and mood disturbances was compared across countries. A path model predicting clinically significant levels of anxiety and depression from maternal characteristics and stress was tested for all study participants and then examined separately in each country with >200 participants. RESULTS Countries differed significantly in magnitude of pandemic-related pregnancy stress and pandemic-unrelated pregnancy-specific stress, and in prevalence of clinically significant anxiety and depression levels. A well-fitting common path model for the entire sample indicated that mood and anxiety disturbances were strongly predicted by pandemic-related and pregnancy-specific stress after accounting for maternal characteristics. The model was replicated in individual countries. CONCLUSIONS Although pregnant women in high-income Western countries experienced different levels of stress resulting from the COVID-19 pandemic, stress is a strong, common predictor of anxiety and depressive symptoms in these individuals. The common model can be used to inform research and clinical interventions to protect against adverse consequences of prenatal maternal stress, anxiety, and depression for mothers and infants.
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Affiliation(s)
- Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States.
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Nora K Schaal
- Institute of Experimental Psychology, Heinrich-Heine-University, Duesseldorf, Germany
| | - Karen Yirmiya
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzlia, Israel
| | - Shir Atzil
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Affiliated with the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Chiara Penengo
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Chiara Colli
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Marco Garzitto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Lorenza Driul
- Obstetric-Gynecologic Clinic, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Michalina Ilska
- Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Anna Brandt-Salmeri
- Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | | | - Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain; Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Rita Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Pearl La Marca-Ghaemmaghami
- Psychology Research and Counselling Institute for Sexuality, Marriage, and Family, International Academy for Human Sciences and Culture, Walenstadt, Switzerland
| | - Hannah Meyerhoff
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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13
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Segal TR, Giudice LC. Systematic review of climate change effects on reproductive health. Fertil Steril 2022; 118:215-223. [PMID: 35878942 DOI: 10.1016/j.fertnstert.2022.06.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/07/2022] [Indexed: 12/26/2022]
Abstract
Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse gases trapping excess heat in the atmosphere, result in erratic weather patterns, wildfires, displacement of large communities, and stagnant water resulting in vector-borne diseases that, together, have set the stage for new and devastating health threats across the globe. These conditions disproportionately affect disadvantaged and vulnerable populations, including women, pregnant persons, young children, the elderly, and the disabled. This review reports on the evidence for the adverse impacts of air pollution, wildfires, heat stress, floods, toxic chemicals, and vector-borne diseases on male and female fertility, the developing fetus, and obstetric outcomes. Reproductive health care providers are uniquely positioned and have an unprecedented opportunity to educate patients and policy makers about mitigating the impact of climate change to assure reproductive health in this and future generations.
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Affiliation(s)
- Thalia R Segal
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Linda C Giudice
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California.
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14
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Fiske A, Scerif G, Holmboe K. Maternal depressive symptoms and early childhood temperament before and during the COVID-19 pandemic in the United Kingdom. INFANT AND CHILD DEVELOPMENT 2022; 31:e2354. [PMID: 35942046 PMCID: PMC9349650 DOI: 10.1002/icd.2354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 03/07/2022] [Accepted: 05/19/2022] [Indexed: 11/09/2022]
Abstract
The COVID-19 pandemic is an unexpected and major global event, with the potential to have many and varied impacts on child development. However, the implications of the pandemic for maternal depressive symptoms, early childhood temperament dimensions, and their associations, remain largely unknown. To investigate this, questionnaires were completed by mothers (N = 175) before and during the pandemic when their child was 10- and 16-months old (Study 1), and by an extended group of mothers with young children (6-48 months; 66 additional mothers) during the first and second national lockdowns in the United Kingdom in 2020 (Study 2). Results indicated that while maternal pandemic-related stress decreased over the first 6 months of the pandemic, there was an increase in mothers who reported feeling some level of pandemic-specific depression. Despite this, we did not observe an increase in the severity of global maternal depressive symptoms, or any negative impact of the pandemic on the development of temperament in infancy and early childhood.
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Affiliation(s)
- Abigail Fiske
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Gaia Scerif
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | - Karla Holmboe
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
- School of Psychological ScienceUniversity of BristolBristolUK
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15
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Buthmann J, Huang D, Casaccia P, O’Neill S, Nomura Y, Liu J. Prenatal Exposure to a Climate-Related Disaster Results in Changes of the Placental Transcriptome and Infant Temperament. Front Genet 2022; 13:887619. [PMID: 35571026 PMCID: PMC9099074 DOI: 10.3389/fgene.2022.887619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/14/2022] [Indexed: 11/25/2022] Open
Abstract
Maternal stress during pregnancy exerts long-term effects on the mental well-being of the offspring. However, the long-term effect of prenatal exposure on the offspring's mental status is only partially understood. The placenta plays a vital role in connecting the maternal side to the fetus, thereby serving as an important interface between maternal exposure and fetal development. Here, we profiled the placental transcriptome of women who were pregnant during a hurricane (Superstorm Sandy), which struck New York City in 2012. The offspring were followed longitudinally and their temperament was assessed during the first 6-12 months of age. The data identified a significant correlation between a Superstorm Sandy stress factor score and infant temperament. Further, analysis of the placental transcriptomes identified an enrichment of functional pathways related to inflammation, extracellular matrix integrity and sensory perception in the specimen from those infants with "Slow-to-Warm-up" temperament during the first year of life. Together, these findings provide initial evidence that maternal exposure to climate-related disasters results in altered placental transcriptome, which may be related to long-term emotional and behavioral consequences in children.
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Affiliation(s)
- Jessica Buthmann
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Dennis Huang
- The Graduate Center at the City University of New York, New York, NY, United States
| | - Patrizia Casaccia
- Advanced Science Research Center at the Graduate Center, Neuroscience Initiative, City University of New York, New York, NY, United States
| | - Sarah O’Neill
- The Graduate Center at the City University of New York, New York, NY, United States,The City College of New York at the City University of New York, New York, NY, United States
| | - Yoko Nomura
- Advanced Science Research Center at the Graduate Center, Neuroscience Initiative, City University of New York, New York, NY, United States,Department of Psychology, Queens College, City University of New York, New York, NY, United States,*Correspondence: Jia Liu, ; Yoko Nomura,
| | - Jia Liu
- Advanced Science Research Center at the Graduate Center, Neuroscience Initiative, City University of New York, New York, NY, United States,*Correspondence: Jia Liu, ; Yoko Nomura,
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16
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Brown MJ, White BP, Nicholas PK. Mental Health Impacts of Climate Change: Considerations for Nurse Practitioners. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Cuany D, Andetsion F, Fontannaz X, Bénet T, Spichtig V, Austin S. Determination of β-Galactooligosaccharides (GOS) in Infant Formula and Adult Nutritionals: Single-Laboratory Validation, First Action 2021.01. J AOAC Int 2022; 105:142-158. [PMID: 34293126 PMCID: PMC8824811 DOI: 10.1093/jaoacint/qsab095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND β-Galactooligosaccharides (GOS) are typically used in infant formula and adult nutritionals as a source of nondigestible oligosaccharides, which may bring beneficial effects through modulation of the gut microbiota. However, suitable methods for the determination of GOS in products with a high background of lactose do not exist. OBJECTIVE The aim of this work was to develop a method suitable for the determination of GOS in infant formula and adult nutritionals and demonstrate suitability through single laboratory validation. METHODS Reducing oligosaccharides are labeled with 2-aminobenzamide (2AB), separated by hydrophilic interaction LC, and determined assuming that all oligosaccharides give an equimolar response in the detector. The same sample is analyzed a second time after treatment with β-galactosidase to remove GOS. The difference in the determined oligosaccharides between the two measurements will be the GOS content of the sample. The method was validated in a single laboratory on infant formula and adult nutritionals. RESULTS Recoveries were in the range 91.5-102%, relative standards of deviation (RSDr) were in the range 0.7-5.99%, and one sample had an RSDr of 8.30%. Except for the one sample with an RSDr of 8.30%, the performance is within the requirements outlined in the Standard Method Performance Requirements, which specifies recoveries in the range 90-110% and RSDr of below 6%. CONCLUSIONS The method is suitable for the determination of GOS in infant formula and adult nutritionals. HIGHLIGHTS A method has been developed which is suitable for the determination of GOS in products with a high background concentration of lactose (infant fromula and adult nutritionals). The method does not require access to the GOS ingredient used for the production of the finished product. It is also possible to separately quantify the amount of GOS containing three or more monomeric units in order to support dietary fibre analysis.
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Affiliation(s)
- Denis Cuany
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Fikrey Andetsion
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Xavier Fontannaz
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Thierry Bénet
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Véronique Spichtig
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Sean Austin
- Société des Produits Nestlé S.A., Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
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18
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Rodríguez-Soto NC, Buxó CJ, Morou-Bermudez E, Pérez-Edgar K, Ocasio-Quiñones IT, Surillo-González MB, Martinez KG. The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review. Dev Psychobiol 2021; 63:e22195. [PMID: 34674245 PMCID: PMC8549868 DOI: 10.1002/dev.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022]
Abstract
The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.
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Affiliation(s)
- Nayra C. Rodríguez-Soto
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
- Carlos Albizu University, San Juan, PR
| | - Carmen J. Buxó
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
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19
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Preis H, Mahaffey B, Pati S, Heiselman C, Lobel M. Adverse Perinatal Outcomes Predicted by Prenatal Maternal Stress Among U.S. Women at the COVID-19 Pandemic Onset. Ann Behav Med 2021; 55:179-191. [PMID: 33724334 PMCID: PMC7980766 DOI: 10.1093/abm/kaab005] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND High stress prenatally contributes to poor maternal and infant well-being. The coronavirus disease 2019 (COVID-19) pandemic has created substantial stress for pregnant women. PURPOSE To understand whether stress experienced by women pregnant at the beginning of the pandemic was associated with a greater prevalence of adverse perinatal outcomes. METHODS Pregnant women across the USA aged ≥18 years old enrolled in a prospective cohort study during the pandemic onset (T1) in April-May 2020. This report focuses on the 1,367 participants who gave birth prior to July-August 2020 (T2). Hierarchical logistic regression models predicted preterm birth, small for gestational age infants, and unplanned operative delivery from T1 stress, sociodemographic, and medical factors. RESULTS After controlling for sociodemographic and medical factors, preterm birth was predicted by high prenatal maternal stress, delivering an infant small for gestational age was predicted by interpersonal violence and by stress related to being unprepared for birth due to the pandemic, and unplanned cesarean or operative vaginal delivery was predicted by prenatal appointment alterations, experiencing a major stressful life event, and by stress related to being unprepared for birth due to the pandemic. Independent of these associations, African American women were more likely than other groups to deliver preterm. CONCLUSION Pregnant women who are experiencing high stress during the COVID-19 pandemic are at risk of poorer perinatal outcomes. A longitudinal investigation is critical to determine whether prenatal maternal stress and resulting outcomes have longer-term consequences for the health and well-being of children born in the midst of the current pandemic.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Susmita Pati
- Department of Pediatrics, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Cassandra Heiselman
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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20
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Lipner E, Murphy SK, Ellman LM. Prenatal Maternal Stress and the Cascade of Risk to Schizophrenia Spectrum Disorders in Offspring. Curr Psychiatry Rep 2019; 21:99. [PMID: 31522269 PMCID: PMC7043262 DOI: 10.1007/s11920-019-1085-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Disruptions in fetal development (via genetic and environmental pathways) have been consistently associated with risk for schizophrenia in a variety of studies. Although multiple obstetric complications (OCs) have been linked to schizophrenia, this review will discuss emerging evidence supporting the role of prenatal maternal stress (PNMS) in the etiology of schizophrenia spectrum disorders (SSD). In addition, findings linking PNMS to intermediate phenotypes of the disorder, such as OCs and premorbid cognitive, behavioral, and motor deficits, will be reviewed. Maternal immune and endocrine dysregulation will also be explored as potential mechanisms by which PNMS confers risk for SSD. RECENT FINDINGS PNMS has been linked to offspring SSD; however, findings are mixed due to inconsistent and retrospective assessments of PNMS and lack of specificity about SSD outcomes. PNMS is also associated with various intermediate phenotypes of SSD (e.g., prenatal infection/inflammation, decreased fetal growth, hypoxia-related OCs). Recent studies continue to elucidate the impact of PNMS while considering the moderating roles of fetal sex and stress timing, but it is still unclear which aspects of PNMS (e.g., type, timing) confer risk for SSD specifically. PNMS increases risk for SSD, but only in a small portion of fetuses exposed to PNMS. Fetal sex, genetics, and other environmental factors, as well as additional pre- and postnatal insults, likely contribute to the PNMS-SSD association. Longitudinal birth cohort studies are needed to prospectively illuminate the mechanisms that account for the variability in outcomes following PNMS.
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Affiliation(s)
- Emily Lipner
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA
| | - Shannon K Murphy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA.
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21
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Buthmann J, Finik J, Ventura G, Zhang W, Shereen AD, Nomura Y. The children of Superstorm Sandy: Maternal prenatal depression blunts offspring electrodermal activity. Biol Psychol 2019; 146:107716. [PMID: 31176750 DOI: 10.1016/j.biopsycho.2019.107716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
We set out to examine the relations between prenatal exposure to the natural disaster Superstorm Sandy, maternal depression, and offspring electrodermal activity (EDA). EDA was measured via skin conductance response (SCR) magnitude in 198 children (M = 42.54 months, SD = 12.76) during a startle paradigm. In keeping with prior research, we expected prenatal depression to be associated with hyporeactive EDA and prenatal stress to be associated with hyperreactive EDA. SCR magnitude was lower in children prenatally exposed to depression alone, when compared to Superstorm Sandy, and controls. SCR magnitude of children prenatally exposed to both maternal depression and the storm was lower than that of all other groups. Our results emphasize the influence of maternal prenatal mental health, support targeted risk assessment for children who experienced an adverse prenatal environment, and highlight the need for a deeper understanding of the interactions between maternal mood and stress on the developing child.
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Affiliation(s)
- J Buthmann
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA; CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA.
| | - J Finik
- CUNY Graduate School of Public Health and Health Policy, Department of Epidemiology and Biostatistics, 55 W 125th St., New York, NY 10027, USA
| | - G Ventura
- CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA
| | - W Zhang
- CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA; New Jersey City University, Department of Psychology, 2039 John Fitzgerald Kennedy Blvd, Jersey City, NJ 07305, USA
| | - A D Shereen
- CUNY Advanced Science Research Center, Graduate Center, 85 St Nicholas Terrace, New York, NY 10031, USA; University of California, Department of Neurology, 680 California Ave, Irvine, CA 92697, USA
| | - Y Nomura
- CUNY Graduate Center, Department of Psychology, 365 5th Avenue, New York, NY 10016, USA; CUNY Queens College, Department of Psychology, 65-30 Kissena Blvd, Flushing, NY 11367, USA; CUNY Graduate School of Public Health and Health Policy, Department of Epidemiology and Biostatistics, 55 W 125th St., New York, NY 10027, USA; CUNY Advanced Science Research Center, Graduate Center, 85 St Nicholas Terrace, New York, NY 10031, USA; Mount Sinai School of Medicine, Department of Psychiatry, 1 Gustave Levy Pl, New York, NY 10029, USA
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