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Level RA, Zhang Y, Tiemeier H, Estabrook R, Shaw DS, Leve LD, Wakschlag LS, Reiss D, Neiderhiser JM, Massey SH. Unique influences of pregnancy and anticipated parenting on cigarette smoking: results and implications of a within-person, between-pregnancy study. Arch Womens Ment Health 2024; 27:301-308. [PMID: 37994923 DOI: 10.1007/s00737-023-01396-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023]
Abstract
Not all pregnant individuals want to become parents and "parenting intention" can also vary within individuals during different pregnancies. Nevertheless, the potential impact of parenting intention on health-related behavior during pregnancy has been heavily underexplored. In this study, we employed a within-person between pregnancy design to estimate the effect of parenting-specific influences on smoking, separate from pregnancy-specific and individual-level influences. We quantified within-mother differences in smoking during pregnancies of infants they reared (n = 84) versus pregnancies of infants they placed for adoption at birth (n = 65) using multivariate mixed-effects Poisson regression models. Mean cigarettes/day declined as the pregnancy progressed regardless of whether infants were reared or placed. However, participants smoked fewer cigarettes/day during reared pregnancies. Relative to "adopted" pregnancies, smoking during "reared" pregnancies was lower by 24%, 41%, and 54% in first (95% CI 0.64-0.90; p = 0.001), second (95% CI 0.48-0.72; p < 0.001), and third trimesters (95% CI 0.36-0.59; p < 0.001), respectively, independent of between-pregnancy differences in maternal age, fetal sex, parity, and pregnancy complications. Female sex and nulliparity were protective. Parenting intention was associated with a protective effect on pregnancy smoking independent of pregnancy-specific influences and individual characteristics. Failure to consider the impact of parenting intention on health-related behavior during pregnancy could perpetuate an unrealistic expectation to "do what's best for the baby" and stigmatize women with unintended or unwanted pregnancies.
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Affiliation(s)
- Rachel A Level
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Yingzhe Zhang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, MA, USA
| | - Ryne Estabrook
- Department of Psychology, University of Illinois Chicago, Chicago, IL, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - David Reiss
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Suena H Massey
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Massey SH, Pool LR, Estabrook R, Level RA, Shisler S, Stacks AM, Neiderhiser JM, Espy KA, Wakschlag LS, Eiden RD, Allen NB. Within-person decline in pregnancy smoking is observable prior to pregnancy awareness: Evidence across two independent observational cohorts. Addict Biol 2022; 27:e13245. [PMID: 36301213 PMCID: PMC9939010 DOI: 10.1111/adb.13245] [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] [Received: 05/11/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 01/24/2023]
Abstract
Decreased consumption of nicotine and other drugs during pregnancy appears to be a cross-species phenomenon from which mechanism(s) capable of interrupting addictive processes could be elucidated. Whether pregnancy influences smoking behaviour independent of women's knowledge of the pregnancy, however, has not been considered. Using repeated measures analysis of variance (ANOVA), we estimated within-person change in mean cigarettes/day smoked across the estimated date of conception but prior to individually reported dates of pregnancy recognition using longitudinal smoking data from two independent observational cohorts, the Growing Up Healthy (GUH, n = 271) and Midwest Infant Development Studies (MIDS, n = 145). Participants smoked an average of half a pack/day in the month immediately before conception (M (SD) = 12(8.1) and 9.5(6.7) cigarettes/day in GUH and MIDS, respectively). We observed within-person declines in smoking after conception, both before (MGUH = -0.9; 95% CI -1.6, -0.2; p = 0.01; MMIDS = -1.1; 95% CI -1.9, -0.3; p = 0.01) and after (MGUH = -4.8; 95% CI -5.5, -4.1; p < 0.001; MMIDS = -3.3; 95% CI -4.4, -2.5; p < 0.001) women were aware of having conceived, even when women who had quit and women who were planning to conceive were excluded from analyses. Pregnancy may interrupt smoking-related processes via mechanisms not previously considered. Plausible candidates and directions for future research are discussed.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Deparment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsay R. Pool
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Deparment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ryne Estabrook
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Rachel A. Level
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Shannon Shisler
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Ann M. Stacks
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kimberly A. Espy
- Department of Neuroscience, Developmental and Regenerative Biology; Department of Psychiatry and Behavioral Science, Long School of Medicine, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lauren S. Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rina D. Eiden
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Norrina B. Allen
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Massey SH, Allen NB, Pool LR, Miller ES, Pouppirt NR, Barch DM, Luby J, Perlman SB, Rogers CE, Smyser CD, Wakschlag LS. Impact of prenatal exposure characterization on early risk detection: Methodologic insights for the HEALthy Brain and Child Development (HBCD) study. Neurotoxicol Teratol 2021; 88:107035. [PMID: 34606910 PMCID: PMC8578417 DOI: 10.1016/j.ntt.2021.107035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND A major challenge in prenatal drug exposure research concerns the balance of measurement quality with sample sizes necessary to address confounders. To inform the selection of optimal exposure measures for the HEALthy Brain and Child Development (HBCD) Study, we employed integrated analysis to determine how different methods used to characterize prenatal tobacco exposure influence the detection of exposure-related risk, as reflected in normal variations in birth weight. METHODS Participants were N = 2323 mother-infant dyads derived from 7 independent developmental cohorts harmonized on measures of exposure, outcome (birthweight), and covariates. We compared estimates of PTE-related effects on birthweight derived from linear regression models when PTE was categorized dichotomously based on any fetal exposure (30% exposed; 69% not exposed); versus categorically, based on common patterns of maternal smoking during pregnancy (never smoked 69%; quit smoking 16%; smoked intermittently 2%; smoked persistently 13%). We secondarily explored sex differences in PTE-birthweight associations across these categorization methods. RESULTS When PTE was categorized dichotomously, exposure was associated with a - 125-g difference in birthweight (95% C.I. -173.7 - -76.6, p < .0001). When PTE was characterized categorically based on maternal smoking patterns, however, exposure was associated with either no difference in birthweight if mothers quit smoking by the end of the first trimester (B = -30.6, 95% C.I. -88.7-27.4, p = .30); or a - 221.8 g difference in birthweight if mothers did not [95% C.I. (-161.7 to -282.0); p < .001]. Qualitative sex differences were also detected though PTE x sex interactions did not reach statistical significance. Maternal smoking cessation during pregnancy was associated with a 239.3 g increase in birthweight for male infants, and a 114.0 g increase in birthweight for females infants (p = .07). CONCLUSIONS Categorization of PTE based on patterns of maternal smoking rather than the presence or absence of exposure alone revealed striking nuances in estimates of exposure-related risk. The described method that captures both between-individual and within-individual variability in prenatal drug exposure is optimal and recommended for future developmental investigations such as the HBCD Study.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Avenue, Suite 2100, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA.
| | - Norrina B Allen
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lakeshore Drive, Suite 1400, Chicago, IL 60611, USA.
| | - Lindsay R Pool
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lakeshore Drive, Suite 1400, Chicago, IL 60611, USA.
| | - Emily S Miller
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 East Superior Street, Room 05-2175, Chicago, IL 60611, USA.
| | - Nicole R Pouppirt
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA; Department of Pediatrics, Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 45, Chicago, IL 60611, USA.
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University, Box 1125, One Brookings Drive, St. Louis, MO 63130, USA.
| | - Joan Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Box 8511, St. Louis, MO 63110, USA.
| | - Susan B Perlman
- Department of Child and Adolescent Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, St. Louis, MO 63110, United States of America.
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Box 8511, St. Louis, MO 63110, USA.
| | - Chris D Smyser
- Departments of Neurology, Pediatrics, and Radiology, Washington University School of Medicine in St. Louis, 4525 Scott Avenue, St. Louis, MO 63110, USA.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Avenue, Suite 2100, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19(th) floor, Chicago, IL 60611, USA.
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Jussila H, Pelto J, Korja R, Ekholm E, Pajulo M, Karlsson L, Karlsson H. The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study. BMC Pregnancy Childbirth 2020; 20:741. [PMID: 33256653 PMCID: PMC7708161 DOI: 10.1186/s12884-020-03393-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/04/2020] [Indexed: 11/20/2022] Open
Abstract
Background Smoking in pregnancy constitutes a preventable risk factor for fetal/child development and maternal-fetal attachment (MFA) seems to contain a momentum that can break the chain of adverse outcomes by promoting maternal prenatal health practices. This study aimed to explore the association of MFA with smoking at any time during pregnancy and smoking cessation in early pregnancy, and the modifying role of MFA on the expected effects of education and prenatal psychological distress (PPD) on prenatal smoking behavior. Methods The pregnant women (n = 3766) participated in the The FinnBrain Birth Cohort Study in Finland between December 2011 and April 2015. The binary outcomes, smoking at any time during pregnancy and smoking cessation in early pregnancy, were obtained from self-reports at gestational weeks (gwks) 14 and 34 and The Finnish Medical Birth Register. MFA was assessed with the Maternal-Fetal Attachment Scale (MFAS) at gwks 24 and 34. Logistic regression analyses were used to determine the association between MFA and maternal prenatal smoking behavior. Findings The prevalence of smoking was 16.5%, and 58.1% of the smokers quit smoking during pregnancy. The independent associations of total MFA scores with prenatal smoking behavior were not established (aOR = 1.00-1.02, multiplicity adjusted p > 0.05). A higher score in the altruistic subscale of MFA, Giving of self, associated with a higher probability of smoking cessation (24 gwks: aOR = 1.13, 95% CI [1.04, 1.24], p = 0.007, multiplicity adjusted p = 0.062; 34 gwks: aOR = 1.17, 95% CI [1.07, 1.29], p < 0.001, multiplicity adjusted p = 0.008). The modifying effect of MFA on the observed associations between PPD and smoking in pregnancy and between maternal education and smoking in pregnancy / smoking cessation in early pregnancy was not demonstrated. Conclusions The altruistic dimension of maternal-fetal attachment associates with an increased probability of smoking cessation during pregnancy and therefore strengthening altruistic maternal-fetal attachment may constitute a promising novel approach for interventions aiming at promoting smoking cessation during pregnancy.
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Affiliation(s)
- Heidi Jussila
- Doctoral Programme of Clinical Investigation, Department of Child Psychiatry, University of Turku, Turku, Finland. .,FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Psychology , University of Turku , Turku, Finland
| | - Eeva Ekholm
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Obstetrics and Gynecology , Turku University Hospital , Turku, Finland
| | - Marjukka Pajulo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Child Psychiatry , University of Turku , Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Centre for Population Health Research , University of Turku and Turku University Hospital , Turku, Finland.,Department of Child Psychiatry , Turku University Hospital and University of Turku , Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Psychiatry , Turku University Hospital and University of Turku , Turku, Finland
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Massey SH, Clark CAC, Sun MY, Burns JL, Mroczek DK, Espy KA, Wakschlag LS. Dimension- and context-specific expression of preschoolers' disruptive behaviors associated with prenatal tobacco exposure. Neurotoxicol Teratol 2020; 81:106915. [PMID: 32693011 PMCID: PMC7484981 DOI: 10.1016/j.ntt.2020.106915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Precise phenotypic characterization of prenatal tobacco exposure (PTE)-related disruptive behavior (DB) that integrates nuanced measures of both exposures and outcomes is optimal for elucidating underlying mechanisms. Using this approach, our goals were to identify dimensions of DB most sensitive to PTE prior to school entry and assess contextual variation in these dimensions. METHODS A community obstetric sample of N = 369 women (79.2% lifetime smokers; 70.2% pregnancy smokers) from two Midwestern cities were assessed for PTE using cotinine-calibrated interview-based reports at 16, 28, and 40 weeks of gestation. A subset of n = 244 who completed observational assessments with their 5-year-old children in a subsequent preschool follow-up study constitute the analytic sample. Using two developmentally-meaningful dimensions previously associated with emergent clinical risk for DB-irritability and noncompliance-we assessed children with 2 parent-report scales: the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) and the Early Childhood Inventory (ECI). We also assessed children by direct observation across 3 interactional contexts with the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). We used generalized linear models to examine between-child variability across behavioral dimensions, and mixed effects models to examine directly observed within-child variability by interactional context. RESULTS Increasing PTE predicted increasing impairment in preschoolers' modulation of negative affect (irritability), but not negative behavior (noncompliance) across reported (MAP-DB) and observed (DB-DOS) dimensional measures. Moreover, children's PTE-related irritability was more pronounced when observed with parents than with the examiner. The ECI did not detect PTE-related irritability nor noncompliance. CONCLUSIONS Nuanced, dimension- and context-specific characterization of PTE-related DB described can optimize early identification of at-risk children.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA.
| | - Caron A C Clark
- Department of Educational Psychology, University of Nebraska at Lincoln, 241 Teacher College Hall, Lincoln, NE 68508, USA
| | - Michael Y Sun
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - James L Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
| | - Kimberly A Espy
- Departments of Psychology and Biology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249-1644, USA; Department of Psychiatry & Behavioral Sciences, Long School of Medicine, University of Texas at San Antonio, 7703 Floyd Curl Drive, MC 7792 San Antonio, TX 78229, USA
| | - Lauren S Wakschlag
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair St, 19th Floor, Chicago, IL 60611, USA
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Aksu E, Albayrak Y, Beyazyüz E, Potas N, Durankuş F, Tenel B, Beyazyüz M. Distinct temperament and character traits in patients with hyperemesis gravidarum. Gynecol Endocrinol 2020; 36:525-529. [PMID: 31668106 DOI: 10.1080/09513590.2019.1683820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. In present study, we aimed to compare temperament and character traits between pregnant women with and without HG by Temperament and Character Inventory. 48 pregnant women with HG and 64 healthy pregnant women were included to study. The HG groups and control group were compared in terms of temperament and character traits and anxiety levels. The temperament scores of novelty seeking, harm avoidance and reward dependence were found to be similar between groups while the score of persistence was significantly lower in HG group compared with control group (p = .021). All character scores in HG group as cooperativeness, self-directedness, and self-transcendence were significantly lower compared with control groups (respectively; p = .002, p = .018 and p = .029). The scores of STAI-1 was higher in HG group compared with control group (p = .027) whereas the score of STAI-2 was found to be similar between groups. Present study is the first to demonstrate different temperament and character traits in patients with HG. We argue that our results support the psychiatric background of HG; however further studies are needed to confirm our results.
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Affiliation(s)
- Erson Aksu
- Department of Gynecology and Obstetrics, Vatan Hospital, İstanbul Rumeli University, İstanbul, Turkey
| | - Yakup Albayrak
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Elmas Beyazyüz
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Nihan Potas
- Faculty of Economics and Administrative Science, Department of Healthcare Managment, Ankara Hacıbayram Veli University, Ankara, Turkey
| | - Ferit Durankuş
- Department of Pediatrics, Göztepe Education and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey
| | - Burçak Tenel
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Murat Beyazyüz
- Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
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Leve LD, Neiderhiser JM, Ganiban JM, Natsuaki MN, Shaw DS, Reiss D. The Early Growth and Development Study: A Dual-Family Adoption Study from Birth Through Adolescence. Twin Res Hum Genet 2019; 22:716-727. [PMID: 31526412 PMCID: PMC7056588 DOI: 10.1017/thg.2019.66] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Early Growth and Development Study (EGDS) is a prospective adoption study of birth parents, adoptive parents and adopted children (n = 561 adoptees). The original sample has been expanded to include siblings of the EGDS adoptees who were reared by the birth mother and assessed beginning at age 7 years (n = 217 biological children), and additional siblings in both the birth and adoptive family homes, recruited when the adoptees were 8-15 years old (n = 823). The overall study aims are to examine how family, peer and contextual processes affect child and adolescent adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Adoptive and birth parents were originally recruited through adoption agencies located throughout the USA following the birth of a child. Assessments are ongoing and occurred in 9 month's intervals until the adoptees turned 3 years of age, and in 1 to 2 year intervals thereafter through age 15. Data collection includes the following primary constructs: child temperament, behavior problems, mental health, peer relations, executive functioning, school performance and health; birth and adoptive parent personality characteristics, mental health, health, context, substance use, parenting and marital relations; and the prenatal environment. Findings highlight the power of the adoption design to detect environmental influences on child development and provide evidence of complex interactions and correlations between genetic, prenatal environmental and postnatal environmental influences on a range of child outcomes. The study sample, procedures and an overview of findings are summarized and ongoing assessment activities are described.
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Affiliation(s)
- Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, 97403, USA
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, 16802, USA
| | - Jody M. Ganiban
- Center for Family Research, George Washington University, Washington DC, 20037, USA
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, California, 92521, USA
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, 15260, USA
| | - David Reiss
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, 06519, USA
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Lev-Ari L, Bachner-Melman R, Zohar AH, Ebstein R, Mankuta D. Weight gain, feeding and eating in the first year of life of babies of smoking and non-smoking mothers. Early Hum Dev 2019; 140:104889. [PMID: 31670174 DOI: 10.1016/j.earlhumdev.2019.104889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 01/02/2023]
Abstract
Babies of mothers who smoke during pregnancy tend to be born underweight but are at risk for pediatric obesity. Maternal feeding practices, maternal disordered eating, and child temperament were assessed as potential mediators of early weight gain in babies of smoking and non-smoking mothers. The BMIs of babies of 88 smoking and 107 non-smoking mothers were recorded at birth and reported one year later. Mothers self-reported on disordered eating and child feeding practices, and on their infants' temperament. Babies of smoking mothers had lower BMI at birth but not at age one. For babies of non-smoking but not for those of smoking mothers, BMI at birth predicted BMI at age one. Smoking mothers' disordered eating and pressure for children to eat predicted their babies' BMI at age one. In the non-smoking group only, there were significant correlations between babies' temperamental difficulties and babies' BMI at age one. In contrast to non-smoking mothers, smoking mothers tend to pressure their babies to eat, and not to feed them in response to their distress. This interim picture may provide insight into the transition of the children of smoking mothers from underweight newborns to children classified as overweight.
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Affiliation(s)
- Lilac Lev-Ari
- Clinical Psychology Program, School of Social and Community Sciences, Ruppin Academic Center, Emek Hefer, Israel.
| | - Rachel Bachner-Melman
- Clinical Psychology Program, School of Social and Community Sciences, Ruppin Academic Center, Emek Hefer, Israel; School of Social work, Hebrew University of Jerusalem, Mt Scopus, Jerusalem, Israel
| | - Ada H Zohar
- Clinical Psychology Program, School of Social and Community Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Richard Ebstein
- China Center for Behavior Economics & Finance & Southwestern University of Finance & Economics
| | - David Mankuta
- Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel
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Schuetze P, Zhao J, Eiden RD, Shisler S, Huestis MA. Prenatal exposure to tobacco and marijuana and child autonomic regulation and reactivity: An analysis of indirect pathways via maternal psychopathology and parenting. Dev Psychobiol 2019; 61:1022-1034. [PMID: 30868568 DOI: 10.1002/dev.21844] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 01/16/2019] [Accepted: 01/30/2019] [Indexed: 11/08/2022]
Abstract
We examined a conceptual model for the associations of prenatal exposure to tobacco (PTE) and marijuana with child reactivity/regulation at 16 months of age. We hypothesized that PTE would be associated with autonomic reactivity and regulation that these associations would be indirect via maternal anger/hostility, depression/stress, or harsh parenting assessed at 2 months and that these effects would be most pronounced among children exposed to both tobacco and marijuana (PTME). Participants were 247 dyads (81 PTE, 97 PTME, and 69 nonexposed) who were followed up at 2 (N = 247) and 16 months (N = 238) of child age. Results from model testing indicated an indirect association between PTME and autonomic functioning during the second year of life, which was mediated by harsh parenting during caregiver-infant interactions. This study fills an important gap in the literature on PTE, PTME, and autonomic regulation during the toddler years, highlighting the role of maternal parenting as important intervening variables.
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Affiliation(s)
- Pamela Schuetze
- Department of Psychology, State University of New York Buffalo State, Buffalo, New York.,Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York
| | - Junru Zhao
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York
| | - Rina D Eiden
- Department of Psychology, University at Buffalo, Buffalo, New York
| | - Shannon Shisler
- Department of Psychology, University at Buffalo, Buffalo, New York
| | - Marilyn A Huestis
- The Lambert Center for the Study of Medicinal Cannabis and Hemp, Thomas Jefferson, Philadelphia, PA
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10
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Godleski SA, Shisler S, Eiden RD, Huestis MA. Co-use of tobacco and marijuana during pregnancy: Pathways to externalizing behavior problems in early childhood. Neurotoxicol Teratol 2018; 69:39-48. [PMID: 30081085 PMCID: PMC6396313 DOI: 10.1016/j.ntt.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022]
Abstract
Use and co-use of tobacco and marijuana during pregnancy are associated with the development of social, cognitive, and behavioral problems for infants and children. However, less is known about the potential developmental impact of the use of tobacco and marijuana in tandem. The present study examined an etiological model for the development of externalizing behavior problems (EBP) in early childhood in a high risk sample (N = 247) of mother-infant dyads with prospective data from pregnancy to 36 months of child age. Co-use during pregnancy and continued maternal tobacco and marijuana use from infancy through early childhood were investigated. Although direct pathways from exposure during pregnancy to EBP were not significant, there was a significant indirect pathway from prenatal tobacco use to EBP via lower breastfeeding duration to lower maternal warmth/sensitivity to EBP, and a pathway from higher maternal affective dysregulation to higher EBP. These results highlight the importance of considering cascading effects of substance use during pregnancy on parental processes within the context of developmental risk and protection.
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Affiliation(s)
- Stephanie A Godleski
- College of Liberal Arts, Rochester Institute of Technology, 18 Lomb Memorial Drive, Rochester, NY 14623, USA.
| | - Shannon Shisler
- Research Institute on Addictions, University at Buffalo, The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Rina D Eiden
- Department of Psychology, University at Buffalo, The State University of New York, 204 Park Hall, Buffalo, NY 14260, USA
| | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA 19107, USA
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11
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Massey SH, Mroczek DK, Reiss D, Miller ES, Jakubowski JA, Graham EK, Shisler SM, McCallum M, Huestis MA, Ganiban JM, Shaw DS, Leve LD, Eiden RD, Stroud LR, Neiderhiser JM. Additive drug-specific and sex-specific risks associated with co-use of marijuana and tobacco during pregnancy: Evidence from 3 recent developmental cohorts (2003-2015). Neurotoxicol Teratol 2018; 68:97-106. [PMID: 29886244 PMCID: PMC6116514 DOI: 10.1016/j.ntt.2018.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Methodologic challenges related to the concomitant use (co-use) of substances and changes in policy and potency of marijuana contribute to ongoing uncertainty about risks to fetal neurodevelopment associated with prenatal marijuana use. In this study, we examined two biomarkers of fetal neurodevelopmental risk-birth weight and length of gestation-associated with prenatal marijuana use, independent of tobacco (TOB), alcohol (ALC), other drug use (OTH), and socioeconomic risk (SES), in a pooled sample (N = 1191) derived from 3 recent developmental cohorts (2003-2015) with state-of-the-art substance use measures. We examined differential associations by infant sex, and multiplicative effects associated with co-use of MJ and TOB. METHODS Participants were mother-infant dyads with complete data on all study variables derived from Growing Up Healthy (n = 251), Behavior and Mood in Babies and Mothers (Cohorts 1 and 2; n = 315), and the Early Growth and Development Study (N = 625). We estimated direct effects on birth weight and length of gestation associated with MJ, TOB, and co-use (MJ x TOB), using linear regression analysis in the full sample, and in male (n = 654) and female (n = 537) infants, separately. RESULTS Mean birth weight and length of gestation were 3277 g (SD = 543) and 37.8 weeks (SD = 2.0), respectively. Rates of prenatal use were as follows: any use, n = 748 (62.8%); MJ use, n = 273 (22.9%); TOB use, n = 608 (51.0%); co-use of MJ and TOB, n = 230 (19.3%); ALC use, n = 464 (39.0%); and OTH use n = 115 (9.7%.) For all infants, unique effects on birth weight were observed for any MJ use [B(SE) = -84.367(38.271), 95% C.I. -159.453 to -9.281, p = .028], any TOB use [B(SE) = -0.99.416(34.418), 95% C.I. -166.942 to -31.889, p = .004], and each cigarette/day in mean TOB use [B(SE) = -12.233(3.427), 95% C.I. -18.995 to -5.510, p < .001]. Additional effects of co-use on birth weight, beyond these drug-specific effects, were not supported. In analyses stratified by sex, while TOB use was associated with lower birth weight in both sexes, MJ use during pregnancy was associated with lower birth weight of male infants [B(SE) = -153.1 (54.20); 95% C.I. -259.5 to -46.7, p = .005], but not female infants [B(SE) = 8.3(53.1), 95% C.I. -96.024 to 112.551, p = .876]. TOB, MJ, and their co-use were not associated with length of gestation. CONCLUSIONS In this sample, intrauterine co-exposure to MJ and TOB was associated with an estimated 18% reduction in birth weight not attributable to earlier delivery, exposure to ALC or OTH drugs, nor to maternal SES. We found evidence for greater susceptibility of male fetuses to any prenatal MJ exposure. Examination of dose-dependence in relationships found in this study, using continuous measures of exposure, is an important next step. Finally, we underscore the need to consider (a) the potential moderating influence of fetal sex on exposure-related neurodevelopmental risks; and (b) the importance of quantifying expressions of risk through subtle alterations, rather than dichotomous outcomes.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - David Reiss
- Yale Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06519, USA.
| | - Emily S Miller
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, 05-2175, Chicago, IL 60611, USA.
| | - Jessica A Jakubowski
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA.
| | - Eileen K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Shannon M Shisler
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203-1016, USA.
| | - Meaghan McCallum
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Marilyn A Huestis
- Institute for Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Jody M Ganiban
- George Washington University Columbian College of Arts and Sciences, 2125 G Street, NW, Room 308, Washington, DC 20052, USA.
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, 4101 Sennott Square, 3rd Floor, Pittsburgh, PA 15260, USA.
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, College of Education 6217, University of Oregon, Eugene, OR 97403, USA.
| | - Rina D Eiden
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203-1016, USA.
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA; The Miriam Hospital Centers for Behavioral and Preventive Medicine, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, 411 Moore Building, University Park, PA 16801, USA.
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12
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Eiden RD, Schuetze P, Shisler S, Huestis MA. Prenatal exposure to tobacco and cannabis: Effects on autonomic and emotion regulation. Neurotoxicol Teratol 2018; 68:47-56. [PMID: 29727701 PMCID: PMC6161361 DOI: 10.1016/j.ntt.2018.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/28/2018] [Accepted: 04/30/2018] [Indexed: 01/14/2023]
Abstract
Tobacco and cannabis are often used together in pregnancy and both have effects on children's regulatory system. Yet, little is known about the impact of co-use on the development of emotion regulation at the developmentally salient age of 2 years. One pathway linking co-exposure to tobacco and cannabis to toddler regulation may be via poor autonomic regulation in infancy. In addition, substance using mothers may be more dysregulated themselves, which may have direct effects on toddler regulation, but may also affect parenting, particularly maternal sensitivity during mother-child interactions. Thus, a second pathway linking exposure to toddler regulation may be via maternal dysregulation and low maternal sensitivity. We examined a conceptual model linking prenatal exposure to toddler regulation via these two pathways in a prospective sample (N = 247) of mother-child dyads recruited in the first trimester of pregnancy. Results indicated significant effects of co-exposure on poor autonomic regulation in infancy, which in turn predicted poor toddler emotion regulation. Mothers who used both tobacco and cannabis displayed lower sensitivity during play interactions with their infants. Maternal sensitivity was modestly stable from infant to toddler period and was predictive of higher toddler emotion regulation. Continued postnatal exposure to tobacco was also a significant, unique predictor of lower toddler emotion regulation. Results highlight the importance of examining co-exposure effects and suggest that this common pattern of use may be associated with higher infant/toddler risks.
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Affiliation(s)
- Rina D Eiden
- University at Buffalo, State University of New York.
| | - Pamela Schuetze
- State University of New York at Buffalo State, United States
| | | | - Marilyn A Huestis
- Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA, United States
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13
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Massey SH, Mroczek DK, Burns JL, Clark CAC, Espy KA, Wakschlag LS. Positive parenting behaviors in women who spontaneously quit smoking during pregnancy: Clues to putative targets for preventive interventions. Neurotoxicol Teratol 2018; 67:18-24. [PMID: 29501649 PMCID: PMC5970967 DOI: 10.1016/j.ntt.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND While the majority of pregnant smokers do not respond to intervention, little is known about how a subset of pregnant smokers known as spontaneous quitters achieve sustained biologically-confirmed abstinence through delivery in the absence of intervention. We explore a developmental framework to address this question by viewing spontaneous quitting as an adaptive parenting behavior, facilitated by abilities necessary for sensitive parenting, or responsiveness. Utilizing existing data, we examined responsiveness from parenting assessments in women who exhibited a variety of smoking patterns during pregnancy, including spontaneous quitting. METHODS Participants were N = 305 pregnant women assessed for smoking prospectively and biochemically at 16 weeks, 28 weeks, delivery, and 4 weeks postpartum, then reassessed with their children 5 years later with directly-observed home- and lab-based measures of parenting. We used linear regression analysis to compare spontaneous quitters with women who exhibited other prenatal smoking patterns on parenting responsiveness, controlling for potential confounders. RESULTS In home-based observations, spontaneous quitters (n = 22) exhibited greater responsiveness with their children relative to intermittent pregnancy smokers [n = 70; β = 0.258, p = .022]; persistent pregnancy smokers [n = 66; β = 0.228, p = .040]; former smokers (quit before pregnancy) [n = 78; β = 266, p = .028]; and never smokers [n = 69; β = 0.312, p = .009]. Hypothesized differences were not observed in lab-based and self-report measures. CONCLUSIONS Putative protective characteristics in spontaneous quitters were captured in mother-child interactions at home, but not in lab-based and maternal report measures of responsiveness. Specification of these characteristics using prospective designs that oversample for spontaneous quitters is recommended to enable translation to preventive interventions.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - James L Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Caron A C Clark
- Department of Educational Psychology, University of Nebraska - Lincoln, 241 Teachers College Hall, Lincoln, NE 68588-0308, USA.
| | - Kimberly A Espy
- Department of Psychology, University of Arizona, 1503 E University Blvd., P.O. Box 210068, Tucson, AZ 85721, USA; Department of Psychiatry, University of Arizona, 1503 E University Blvd., P.O. Box 210068, Tucson, AZ 85721, USA.
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
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Massey SH, Decety J, Wisner KL, Wakschlag LS. Specification of Change Mechanisms in Pregnant Smokers for Malleable Target Identification: A Novel Approach to a Tenacious Public Health Problem. Front Public Health 2017; 5:239. [PMID: 28975128 PMCID: PMC5610685 DOI: 10.3389/fpubh.2017.00239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022] Open
Abstract
Maternal smoking during pregnancy (MSDP) continues to be a leading modifiable risk factor for perinatal complications and a range of neurodevelopmental and cardio-metabolic outcomes across the lifespan. Despite 40 years of intervention research less than one in five pregnant smokers who receive an intervention quit by delivery. Within this context, recognition of pregnancy is commonly associated with abrupt suspension or reduction of smoking in the absence of intervention, yet has not been investigated as a volitional target. The goal of this article is to provide the empirical foundation for a novel direction of research aimed at identifying malleable targets for intervention through the specification of behavior change mechanisms specific to pregnant women. To do so, we: (1) summarize progress on MSDP in the United States generated from conventional empirical approaches to health behavior change; (2) discuss the phenomenon of spontaneous change in the absence of intervention among pregnant smokers to illustrate the need for mechanistic specification of behavior change motivated by concern for fetal well-being; (3) summarize component processes in neurobiological models of parental and non-parental social behaviors as a conceptual framework for understanding change mechanisms during pregnancy; (4) discuss the evidence for the malleability of these processes to support their translational relevance for preventive interventions; and (5) propose a roadmap for validating the proposed change mechanism using an experimental medicine approach. A greater understanding of social and interpersonal processes that facilitate health behavior change among expectant mothers and how these processes differ interindividually could yield novel volitional targets for prenatal interventions. More broadly, explicating other-oriented mechanisms of behavior change during pregnancy could serve as a paradigm for understanding how social and interpersonal processes positively influence health behaviors across the lifespan.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
| | - Jean Decety
- Department of Psychology, University of Chicago, Chicago, IL, United States
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren S. Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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15
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Schuetze P, Eiden RD, Colder CR, Huestis MA, Leonard KE. Prenatal Risk and Infant Regulation: Indirect Pathways via Fetal Growth and Maternal Prenatal Stress and Anger. Child Dev 2017; 89:e123-e137. [PMID: 28383108 DOI: 10.1111/cdev.12801] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pathways from maternal tobacco, marijuana, stress, and anger in pregnancy to infant reactivity and regulation (RR) at 9 months of infant age were examined in a low-income, diverse sample beginning in the first trimester of pregnancy, with fetal growth and postnatal stress/anger as potential mediators, and infant sex as a moderator. Participants were 247 dyads (173 substance-exposed infants). There were no direct effects of prenatal risk on RR and no moderation by sex. However, there were significant indirect effects on RR via poor fetal growth and higher postnatal anger. The study adds to the sparse literature on joint effects of tobacco and marijuana, and highlights the role of fetal growth and maternal anger as important pathways from prenatal risk to infant RR.
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16
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Godleski SA, Eiden RD, Schuetze P, Colder CR, Huestis MA. Tobacco exposure and maternal psychopathology: Impact on toddler problem behavior. Neurotoxicol Teratol 2016; 57:87-94. [PMID: 27498223 PMCID: PMC6059373 DOI: 10.1016/j.ntt.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/03/2016] [Accepted: 07/29/2016] [Indexed: 02/07/2023]
Abstract
Prenatal exposure to tobacco has consistently predicted later problem behavior for children. However, little is known about developmental mechanisms underlying this association. We examined a conceptual model for the association between prenatal tobacco exposure and child problem behavior in toddlerhood via indirect paths through fetal growth, maternal depression, and maternal aggressive disposition in early infancy and via maternal warmth and sensitivity and infant negative affect in later infancy. The sample consisted of 258 mother-child dyads recruited during pregnancy and assessed periodically at 2, 9, and 16months of child age. Pathways via maternal depression and infant negative affect to toddler problem behavior were significant. Further, combined tobacco and marijuana exposure during pregnancy and reduced fetal growth also demonstrated important associations with infant negative affect and subsequent problem behavior. These results highlight the importance of considering the role of maternal negative affect and poor fetal growth as risk factors in the context of prenatal exposure.
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Affiliation(s)
| | - Rina D Eiden
- Research Institute of Addictions, University at Buffalo, State University of New York, United States
| | - Pamela Schuetze
- Psychology Department, Buffalo State College, State University of New York, United States
| | - Craig R Colder
- Psychology Department, University at Buffalo, State University of New York, United States
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