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Maxwell SL, Price JC, Perito ER, Rosenthal P, Wojcicki JM. Food insecurity is a risk factor for metabolic dysfunction-associated steatotic liver disease in Latinx children. Pediatr Obes 2024; 19:e13109. [PMID: 38453472 PMCID: PMC11146202 DOI: 10.1111/ijpo.13109] [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: 01/30/2023] [Revised: 11/29/2023] [Accepted: 01/24/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease among US children. Studies have associated food insecurity with MASLD in adults, but there are few studies of pediatric MASLD, particularly in high-risk populations. We assessed the impact of household food insecurity at 4 years of age on MASLD in Latinx children. METHODS Using a prospective cohort design, Latina mothers were recruited during pregnancy and followed with their children until early to mid-childhood. Our primary exposure was household food insecurity at 4 years of age measured using the validated US Household Food Security Food Module. Our primary outcome, MASLD, was defined as alanine transaminase (ALT) ≥95th% for age/gender plus body mass index (BMI) ≥85% at time of ALT measurement (assessed between ages 5-12). We used multivariable logistic regression models to test for independent associations between household food insecurity and pediatric MASLD. RESULTS Among 136 children, 28.7% reported household food insecurity at 4 years of age and 27.2% had MASLD in early to middle childhood. Approximately 49% of children with MASLD and 21% of children without MASLD were food insecure (p < 0.01). Exposure to household food insecurity at age 4 was independently associated with a 3.7-fold higher odds of MASLD later in childhood (95% CI: 1.5-9.0, p < 0.01). CONCLUSIONS Exposure to household food insecurity at 4 years of age was associated with increased risk for MASLD later in childhood. Further studies are needed to explore mechanism(s) and impact of reducing food insecurity on risk for MASLD.
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Affiliation(s)
- Sarah L. Maxwell
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer C. Price
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Emily R. Perito
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Philip Rosenthal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Janet M. Wojcicki
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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Hanson M, Hellem T, Alexander-Ruff J, Newcomer SR. Systematic Review of Barriers to and Facilitators of Screening for Postpartum Depression at Well-Child Visits in the United States. Nurs Womens Health 2024; 28:213-221. [PMID: 38518811 DOI: 10.1016/j.nwh.2023.11.009] [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: 09/05/2023] [Revised: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE To identify and evaluate barriers to and facilitators of screening for postpartum depression (PPD) during well-child visits in the United States. Additionally, to describe prior work on PPD screening tool evaluation and outcomes from PPD screenings conducted within the well-child setting. DATA SOURCES A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Five databases (Pub Med, PsycINFO, Web of Science, CINAHL, and Cochrane Library) were searched. STUDY SELECTION Randomized controlled trials, case studies, cross-sectional studies, case-control studies, cohort studies, qualitative studies, and quasi-experimental studies conducted in the United States were included. The Standard Quality Assessment Criteria Tool (QualSyst) was used to assess the methodologic quality of each included study. DATA EXTRACTION Sample, setting, methods, screening tools used, location of study setting, intervention, and salient findings were extracted and summarized for further analysis and synthesis. DATA SYNTHESIS Quantitative studies were rated on 14 aspects, and qualitative studies were rated on 10 aspects, per QualSyst. Studies received a score of 2, 1, 0, or not applicable based on scoring criteria, with higher scores indicating greater methodologic quality. CONCLUSION We found that barriers to PPD screening included concerns regarding time for screening, adequate training, and limited ability for referral. Facilitators of PPD screening included electronic prompts for providers, as well as tool availability and familiarity. Our results indicate that education and training about PPD screening in the pediatric setting are important next steps in addressing the rising concern of PPD in the United States.
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Platt IS, Pendl-Robinson EL, Dehus E, O'Neil SS, Vohra D, Kenny M, Pentenrieder L, Zivin K. Societal costs of untreated perinatal mood and anxiety disorders in Vermont. Arch Womens Ment Health 2024:10.1007/s00737-024-01429-1. [PMID: 38321244 DOI: 10.1007/s00737-024-01429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE To estimate the societal costs of untreated perinatal mood and anxiety disorders (PMADs) in Vermont for the 2018-2020 average annual birth cohort from conception through five years postpartum. METHODS We developed a cost analysis model to calculate the excess cases of outcomes attributed to PMADs in the state of Vermont. Then, we modeled the associated costs of each outcome incurred by birthing parents and their children, projected five years for birthing parents who do not achieve remission by the end of the first year postpartum. RESULTS We estimated that the total societal cost of untreated PMADs in Vermont could reach $48 million for an annual birth cohort from conception to five years postpartum, amounting to $35,910 in excess societal costs per birthing parent with an untreated PMAD and their child. CONCLUSION Our model provides evidence of the high costs of untreated PMADs for birthing parents and their children in Vermont. Our estimates for Vermont are slightly higher but comparable to national estimates, which are $35,500 per birthing parent-child pair, adjusted to 2021 US dollars. Investing in perinatal mental health prevention and treatment could improve health outcomes and reduce economic burden of PMADs on individuals, families, employers, and the state.
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Affiliation(s)
- Isabel S Platt
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002, USA.
| | | | - Eric Dehus
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002, USA
| | - Sasigant So O'Neil
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002, USA
| | - Divya Vohra
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002, USA
| | - Michael Kenny
- Vermont Department of Health, 108 Cherry Street, Burlington, VT, 05402, USA
| | - Laura Pentenrieder
- Vermont Department of Health, 108 Cherry Street, Burlington, VT, 05402, USA
| | - Kara Zivin
- Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002, USA
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4
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Costin MR, Taut D, Baban A, Ionescu T, Murray A, Lindsay C, Secara E, Abbasi F, Sarfo Acheampong I, Katus L, Luong Thanh Bao Y, Hernandez SCLS, Randeny S, Du Toit S, Valdebenito S, Eisner MP. The Role of Maternal Depression Symptoms and Maternal Attachment in Predicting Exclusive Breastfeeding: A Multisite Prospective Study. J Womens Health (Larchmt) 2024; 33:187-197. [PMID: 38011004 DOI: 10.1089/jwh.2023.0076] [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: 11/29/2023] Open
Abstract
Background: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. Materials and Methods: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. Conclusions: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context.
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Affiliation(s)
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Thea Ionescu
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Carene Lindsay
- Department of Basic Medical Sciences, Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Eugen Secara
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Fahad Abbasi
- Department of Jhpiego-Gender and Research, Fazaia Medical College, Islamabad, Pakistan
| | - Isaac Sarfo Acheampong
- Department of Medical Laboratory Science, Koforidua Technical University, Koforidua, Ghana
| | - Laura Katus
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London, United Kingdom
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Yen Luong Thanh Bao
- Department of Epidemiology-Biostatistics and Demography, Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | | | - Shobhavi Randeny
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Stefani Du Toit
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Manuel P Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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He Q, Cheng G, He S, Tian G, Xie X, Jiang N, Min X, Li C, Li R, Shi Y, Zhou T, Yan Y. Association between maternal postpartum depression and children's physical growth in early childhood: a birth cohort study. Front Pediatr 2023; 11:1135876. [PMID: 37565240 PMCID: PMC10410140 DOI: 10.3389/fped.2023.1135876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/12/2023] [Indexed: 08/12/2023] Open
Abstract
Background Untreated maternal postpartum depression (PPD) has consequences for children's physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort. Methods Between 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers' depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months. Results A total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (β = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (β = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children. Limitations The number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken. Conclusions After adjustments for confounders, no dynamic association was found between PPD and children's weight and height growth. EPDS scores, in contrast, did negatively affect children's weight and height growth at age 1-3 months, but this effect was not long-lasting.
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Affiliation(s)
- Qiong He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Medical Record Management and Statistical Information Center, Xiangya Hospital, Central South University, Changsha, China
| | - Gang Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Simin He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiaowei Xie
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ni Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xianying Min
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Chao Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Rui Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yan Shi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tong Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Zhou J, Zhang S, Teng Y, Lu J, Guo Y, Yan S, Tao F, Huang K. Maternal pregnancy-related anxiety and children's physical growth: the Ma'anshan birth cohort study. BMC Pregnancy Childbirth 2023; 23:384. [PMID: 37231487 DOI: 10.1186/s12884-023-05711-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Epidemiological studies have identified maternal antenatal anxiety and several adverse birth outcomes, but limited studies have focused on the relationship with the long-term physical growth of children. The study aimed to assess the influence of maternal pregnancy-related anxiety on physical growth in children at different exposure periods during pregnancy. METHODS 3,154 mother-child pairs were included based on the Ma'anshan birth cohort study. Maternal prenatal anxiety was obtained by administering a questionnaire using the pregnancy-related anxiety questionnaire (PRAQ) scale during the 1st, 2nd and 3rd trimesters of pregnancy. Body fat (BF) (48 to 72 months) and Body Mass Index (BMI) (birth to 72 months) were collected repeatedly for children. Group-based trajectory models were applied to fit the different trajectories of BMI and BF. RESULTS Maternal anxiety in the 2nd (OR = 0.81; 95% CI: 0.68 to 0.98; P < 0.025) and 3rd (OR = 0.80; 95% CI: 0.67 to 0.97; P = 0.020) trimesters was associated with a decreased risk of rapid weight gain (RWG) in the first year of life. Children aged 48 to 72 months of mothers with anxiety in the 3rd trimester had lower BMI (β = -0.161; 95% CI, -0.293 to -0.029; P = 0.017) and BF (β = -0.190; 95% CI, -0.334 to -0.046; P = 0.010), and these children were less likely to develop a very high BMI trajectory (OR = 0.54; 95% CI: 0.34 to 0.84; P = 0.006), and a high BF trajectory (OR = 0.72; 95% CI: 0.53 to 0.99; P = 0.043). Similar associations were found between maternal anxiety in both 2nd and 3rd trimesters and children's physical growth. CONCLUSIONS Offspring of mothers with prenatal anxiety in the 2nd and 3rd trimesters predicts poorer growth in infancy and preschool age. Early improvement and treatment of prenatal anxiety could benefit physical health and development in early childhood.
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Affiliation(s)
- Jixing Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Shanshan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Yuzhu Teng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Jingru Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Yufan Guo
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Shuangqin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan, 243011, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
- Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China.
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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Depression during pregnancy and gestational weight gain: A study of Brazilian pregnant women. Nutrition 2023; 106:111883. [PMID: 36435089 DOI: 10.1016/j.nut.2022.111883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The relationship between psychosocial factors/mental health/depressive symptoms and inadequate gestational weight (GW) change remains poorly understood. Thus, the aim of this study was to evaluate the association between depressive symptoms and inadequate GW change according to the criteria established by the Institute of Medicine in 2009. METHODS This cross-sectional study was part of a prospective cohort, and conducted in Botucatu, São Paulo, Brazil. Pregnant women who received prenatal care at basic health care units in the city participated in the study (n = 297). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms during pregnancy, and the cutoff point used for the positive screening of depressive symptoms was ≥13. The association between depressive symptoms and two outcomes (insufficient and excessive weight change during second and third trimesters) was investigated using logistic regression models with adjustment for potential confounders. Crude and adjusted effect measures (odds ratios) and their relevant 95% confidence intervals were estimated. RESULTS There was an association between a positive score for depression during pregnancy and insufficient GW gain. No association was observed between depressive symptoms and excessive GW gain. CONCLUSIONS The presence of depressive symptoms significantly increased the chance of insufficient GW change. This finding enhances the need for screening for depression in prenatal care.
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Li H, Ning W, Zhang N, Zhang J, He R, Mao Y, Zhu B. Association between maternal depression and neonatal outcomes: Evidence from a survey of nationally representative longitudinal studies. Front Public Health 2022; 10:893518. [PMID: 36159263 PMCID: PMC9500377 DOI: 10.3389/fpubh.2022.893518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/22/2022] [Indexed: 01/22/2023] Open
Abstract
Background and aims Maternal depression before and after delivery has dramatically increased in China. Therefore, this study aimed to examine the association between antepartum and postpartum depression and neonatal outcomes. Design A population-based retrospective cohort study. Setting China. Participants Data were obtained from China Family Panel Studies (CFPS). Different mother-child/infant samples were included in this study. Mother in CFPS2012 and CFPS2016 were linked with 1-2-year-old children in CFPS2014 and CFPS2018, respectively. Besides, and mothers in CFPS2012, CFPS2016, and CFPS2018 were linked with 0-1-year-old infants in CFPS2012, CFPS2016, and CFPS2018, respectively. Methods Maternal depression was measured using the Center for Epidemiologic Studies Depression Scale. The neonatal outcomes included duration of gestational days, preterm birth, birth weight, birth weight z-score, weight, weight z-score, illness in the past month, and hospitalization in the past year. Propensity score matching was used to balance maternal, family, and infant/child characteristics between the maternal depression and non-maternal depression groups. Results Multivariable regression analysis of matched samples estimated that antepartum depression was associated with a shorter duration of gestation by 3.99 days (95% confidence interval [CI] = -7.21, -0.78). The association between antepartum depression and preterm birth, birth weight and birth weight z-score were not statistically significant. Postpartum depression was associated with more episodes of illness in the last month by 0.23 times (95% CI = 0.11, 0.36) and a higher odd of hospitalization in the previous year (OR = 1.59, 95% CI = 1.15, 2.20). The association between postpartum depression and weight or the weight z-score was not significant. Conclusion Maternal depression appears to be associated with worse neonatal outcomes.
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Affiliation(s)
- Haoran Li
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Wei Ning
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jingya Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China,*Correspondence: Ying Mao
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China,Bin Zhu
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Wojcicki JM, Escobar M, Mendez AD, Martinez SM. Household and social characteristics associated with COVID-19 vaccine intent among Latino families in the San Francisco Bay Area. BMC Infect Dis 2022; 22:527. [PMID: 35672658 PMCID: PMC9171483 DOI: 10.1186/s12879-022-07467-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Latinos have had higher case counts, hospitalization rates and deaths during the COVID-19 pandemic nationally and in the state of California. Meanwhile, Latino vaccination rates remain lower than those of non-Hispanic Whites. COVID-19 vaccine nonintent, defined as intent to not vaccinate against COVID-19, among Latino individuals continues to be an issue in the state of California. Methods Families from three Latino longitudinal mother–child cohorts previously recruited in the San Francisco Bay Area were surveyed telephonically from February to June 2021 to assess attitudes towards vaccination against COVID-19 and prior vaccination, in general, for themselves and their children. Risk for vaccine nonintent was assessed using the Mann–Whitney rank sum non-parametric test for continuous predictors and chi-squared tests for categorical ones. Results Three hundred and nineteen families were surveyed from the Telomere at Birth (TAB), Hispanic Eating and Nutrition (HEN) and Latino Eating and Diabetes Cohort (LEAD). Approximately 36% from TAB and 28% from HEN/LEAD indicated COVID-19 vaccine nonintent for themselves and/or their children. Risk factors for vaccine nonintent included lower maternal age (p = 0.01), concern about vaccine side effects (p < 0.01) and prior history of a household members being infected with SARS-CoV-2 (p < 0.01) and indexes of household crowding including number of people sharing a bathroom (p = 0.048). Vaccine intent was also associated with receiving vaccine input from friends (p = 0.03), family (p < 0.01) and/or coworkers (p = 0.02) compared with those who were not planning on getting vaccinated against COVID-19. Conclusions Latino families living in crowded living situations who may not have received any COVID-19 advice from family, coworkers or friends are at particular risk for nonintent for vaccinatation against COVID-19. Community-based grassroots or promotor/a based interventions centered on trusted individuals with close community ties and counseling concerning vaccination against COVID-19 could help boost vaccination rates in this population group.
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07467-3.
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Affiliation(s)
- Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, UCSF, 550 16th Street, San Francisco, CA, 94134-0136, USA. .,Department of Epidemiology and Biostatistics, UCSF, San Francisco, USA.
| | - Milagro Escobar
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, UCSF, 550 16th Street, San Francisco, CA, 94134-0136, USA
| | - Andrea DeCastro Mendez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, UCSF, 550 16th Street, San Francisco, CA, 94134-0136, USA
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Mendez AD, Escobar M, Romero M, Wojcicki JM. Overcrowding and exposure to secondhand smoke increase risk for COVID-19 infection among Latinx families in the greater San Francisco Bay Area. Tob Induc Dis 2021; 19:79. [PMID: 34712109 PMCID: PMC8507798 DOI: 10.18332/tid/140827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/08/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Environmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19 in high risk, urban Latinx families. METHODS We evaluated risk factors for COVID-19 infection in three, preexisting, longitudinal, Latinx family cohorts in the San Francisco Bay Area from May through September 2020 (N=383 households, 1875 people). All households were previously recruited before the pandemic. For the COVID-19 sub-study, participants responded to a telephone interview where we assessed food consumption patterns, housing and employment status, and history of COVID-19 infection. Secondhand smoke exposure was based on previously collected selfreported data, and environmental pollution exposure was determined from census tract residence. Non-parametric tests and multiple logistic regression were used to assess independent predictors of COVID-19 infection. RESULTS Larger household size increased risk for infection (OR=1.58; 95% CI: 1.12–2.23, p<0.01) as did increasing number of children in household (OR=3.79; 95% CI: 1.51–9.56). Any exposure to secondhand smoke was also associated with increased risk for COVID infection (OR 4.69; 95% CI: 1.01–21.85) and having a greater number of family members eating at home was protective against infection (OR=0.10; 95% CI: 0.02–0.52, p<0.01). CONCLUSIONS Crowding, as indicated by larger household size, increases risk for COVID-19 infection in Latinx families, as does exposure to secondhand smoke. Public policy and health interventions need to ensure that multiunit residential complexes do not allow exposure to secondhand smoke between units, that individuals eat in the home environment, and that large households can safely separate individuals exposed to COVID-19.
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Affiliation(s)
- Andrea DeCastro Mendez
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
| | - Milagro Escobar
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
| | - Maria Romero
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
| | - Janet M Wojcicki
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
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11
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Maternal depressive symptoms and stress during pregnancy as predictors of gestational age at birth and standardized body mass index from birth up to 2 years of age. BMC Pregnancy Childbirth 2021; 21:635. [PMID: 34537004 PMCID: PMC8449913 DOI: 10.1186/s12884-021-04111-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 08/29/2021] [Indexed: 11/28/2022] Open
Abstract
Background While depressive symptoms and stress during pregnancy are known to affect gestational age and weight at birth, evidence on their impact on child anthropometric development in the long term remains limited, showing inconsistent effects. Importantly, previous research indicated a substantially stronger impact of categorically rather than dimensionally assessed mental health problems on birth outcomes and child development. Methods The Patient Health Questionnaire was used to assess depressive symptoms and stress during the 2nd trimester of pregnancy dimensionally and categorically, with scores ≥10 indicating clinical significance. Gestational age at birth and BMI-SDS from birth up to 2 years of age were examined as dependent variables. Structural equation modeling was used to examine the prediction of birth outcomes and child anthropometry by mental health problems while controlling for multiple maternal and child characteristics in 322 mother-child dyads. Results Dimensionally assessed mental health problems did not significantly predict birth outcomes. While categorical depressive symptoms significantly predicted a higher child BMI-SDS, categorical stress significantly predicted a lower gestational age at birth. Neither categorical nor dimensional mental health problems significantly predicted child BMI-SDS at 6, 12, and 24 months postpartum. Conclusions Depressive symptoms and stress during pregnancy seem to differentially affect birth outcomes, and only if clinically relevant. The results implicate the importance to timely treat pregnant women that are greatly affected by mental health problems to potentially reduce adverse birth outcomes.
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12
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Goldschmidt T, Petersen L, Booley S, Roman NV. Perspectives of nurturance within the parent-child relationship in resource-constrained families. Child Care Health Dev 2021; 47:494-500. [PMID: 33638196 DOI: 10.1111/cch.12861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 02/09/2021] [Accepted: 02/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nurturing parents raise children in an engaged, flexible, emotionally expressive and supportive manner, which is associated with positive outcomes for children. While parenting research within the South African context is increasing, there is a lack of focus on nurturance within the parent-child relationship. Thus, this study sought to explore how parents nurture their children in resource-constrained environments in South Africa. METHOD A qualitative approach with an exploratory research design was used. Participants were purposively recruited via non-governmental institutions and key informants in the communities. A sample of 77 semi-structured interviews was conducted with participants from two rural areas, Calvinia and Lamberts Bay, in South Africa. RESULTS A thematic analysis of the data revealed two themes. The first theme is nurturance approaches, which encapsulate how parents nurture their children physically and emotionally. The second theme focuses on factors contributing to nurturance within the parent-child relationship with regard to parenting practices and external factors. CONCLUSION Although parents are nurturing children physically and emotionally, parenting capacity needs to be improved in the South African context.
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Affiliation(s)
- Tessa Goldschmidt
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
| | - Lisa Petersen
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
| | - Shakierah Booley
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
| | - Nicolette V Roman
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
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13
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Escobar M, Mendez AD, Encinas MR, Villagomez S, Wojcicki JM. High food insecurity in Latinx families and associated COVID-19 infection in the Greater Bay Area, California. BMC Nutr 2021; 7:23. [PMID: 34112257 PMCID: PMC8192129 DOI: 10.1186/s40795-021-00419-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. METHODS We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. RESULTS We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5-14.3%); 7.2% (95%CI, 3.6-13.9%) and 3.5% (95%CI, 1.7-7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). CONCLUSIONS Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.
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Affiliation(s)
- Milagro Escobar
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Andrea DeCastro Mendez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Maria Romero Encinas
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Sofia Villagomez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA.
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14
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Ek A, Vásquez‐Barquero MY, Sandvik P, Eli K, Somaraki M, Nowicka P. The role of parental depression during early childhood obesity treatment-Secondary findings from a randomized controlled trial. Pediatr Obes 2021; 16:e12754. [PMID: 33291185 PMCID: PMC8243967 DOI: 10.1111/ijpo.12754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parental depression is a risk factor for childhood obesity. OBJECTIVES To examine the influence of parental depression on child weight status, eating behaviours, and parental feeding practices during childhood obesity treatment. METHODS Hundred and twenty eight children with obesity aged 4 to 6 years and their parents were randomized to a parent support program or to standard treatment. At baseline and after 12 months, children's heights and weights were measured. Parents reported levels of depression (Beck's Depression Inventory-II), feeding practices (Child Feeding Questionnaire), and children's eating behaviors (Child Eating Behavior Questionnaire). Independent and dependent paired sample t-tests and linear regressions were used to analyze data. RESULTS After obesity treatment, mothers reported lower levels of depression, whereas fathers did not. No associations were found between parental level of depression and child weight status, or between baseline level of parental depression and feeding practices. Associations were found between baseline parental depression and children's food responsiveness (β = .03; P = .01; 95% CI [0.01, 0.05]), emotional overeating (β = .02; P = .02; 95% CI [0.004, 0.04]), and desire to drink (β = .02; P = .03; 95% CI [0.002, 0.04]) (adjusted for background variables). CONCLUSIONS Parental depression did not influence child weight status or parental feeding practices but was associated with obesity-related child eating behaviors.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden
| | | | - Pernilla Sandvik
- Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
| | - Karin Eli
- Division of Health Sciences, Warwick Medical SchoolUniversity of WarwickCoventryUK,Unit for Biocultural Variation and Obesity, Institute of Social and Cultural AnthropologyUniversity of OxfordOxfordUK
| | - Maria Somaraki
- Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden,Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
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15
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Pierce M, Hope HF, Kolade A, Gellatly J, Osam CS, Perchard R, Kosidou K, Dalman C, Morgan V, Di Prinzio P, Abel KM. Effects of parental mental illness on children's physical health: systematic review and meta-analysis. Br J Psychiatry 2020; 217:354-363. [PMID: 31610824 DOI: 10.1192/bjp.2019.216] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Children of parents with mental disorder face multiple challenges. AIMS To summarise evidence about parental mental disorder and child physical health. METHOD We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620). RESULTS Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders. CONCLUSIONS Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations. DECLARATION OF INTEREST None.
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Affiliation(s)
- Matthias Pierce
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Holly F Hope
- Research Associate, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Adekeye Kolade
- Research Assistant, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Judith Gellatly
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Cemre Su Osam
- PhD Student, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Reena Perchard
- Clinical Research Fellow, Division of Developmental Biology & Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Kyriaki Kosidou
- Senior Consultant, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Christina Dalman
- Professor of Psychiatric Epidemiology and Research Group Leader, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Vera Morgan
- Winthrop Professor and Head, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Patricia Di Prinzio
- Research Fellow, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Kathryn M Abel
- Professor of Psychological Medicine and Director, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
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16
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Reid BM, Doom JR, Argote RB, Correa-Burrows P, Lozoff B, Blanco E, Gahagan S. Pathways to inflammation in adolescence through early adversity, childhood depressive symptoms, and body mass index: A prospective longitudinal study of Chilean infants. Brain Behav Immun 2020; 86:4-13. [PMID: 31185272 PMCID: PMC6899213 DOI: 10.1016/j.bbi.2019.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/08/2023] Open
Abstract
Early adversity, depression, and obesity are associated with increases in low-grade inflammation. However, there are few prospective and longitudinal studies to elucidate how these associations unfold in children. The present study used latent growth curve models to examine pathways between family adversity in infancy, depressive symptoms in childhood, body mass index (BMI) in childhood, and inflammation in adolescence (age = 16-18). The study is an adolescent follow-up of infants from working-class communities around Santiago, Chile, who participated in a preventive trial of iron supplementation at 6 months of age. Anthropometrics, stressful life events, maternal depression, socioeconomic status, and developmental assessments were measured at 12 months, 5 years, 10 years, and adolescence. In adolescence, participants provided blood samples for high-sensitivity C-reactive protein (hsCRP) assessment. Greater exposure to early adversity in the form of interpersonal conflict stress in infancy indirectly associated with increased hsCRP through its association to increased intercept and slope of childhood BMI. Depressive symptoms at any time were not directly or indirectly associated with increased hsCRP. These findings contribute to our understanding of how early family adversity and its associations with obesity and depressive symptoms across childhood are linked to low-grade, chronic inflammation in adolescence. The model identified as best capturing the data supported the pivotal role of childhood BMI in explaining how early-life adversity is associated with inflammation in adolescence.
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Affiliation(s)
- Brie M. Reid
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States,Corresponding author. (B.M. Reid)
| | - Jenalee R. Doom
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States,Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, United States
| | | | | | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States,Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Estela Blanco
- Division of Child Development and Community Health, University of California, San Diego, CA, United States
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California, San Diego, CA, United States
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17
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Luca DL, Margiotta C, Staatz C, Garlow E, Christensen A, Zivin K. Financial Toll of Untreated Perinatal Mood and Anxiety Disorders Among 2017 Births in the United States. Am J Public Health 2020; 110:888-896. [PMID: 32298167 DOI: 10.2105/ajph.2020.305619] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To estimate the economic burden of untreated perinatal mood and anxiety disorders (PMADs) among 2017 births in the United States.Methods. We developed a mathematical model based on a cost-of-illness approach to estimate the impacts of exposure to untreated PMADs on mothers and children. Our model estimated the costs incurred by mothers and their babies born in 2017, projected from conception through the first 5 years of the birth cohort's lives. We determined model inputs from secondary data sources and a literature review.Results. We estimated PMADs to cost $14 billion for the 2017 birth cohort from conception to 5 years postpartum. The average cost per affected mother-child dyad was about $31 800. Mothers incurred 65% of the costs; children incurred 35%. The largest costs were attributable to reduced economic productivity among affected mothers, more preterm births, and increases in other maternal health expenditures.Conclusions. The US economic burden of PMADs is high. Efforts to lower the prevalence of untreated PMADs could lead to substantial economic savings for employers, insurers, the government, and society.
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Affiliation(s)
- Dara Lee Luca
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
| | - Caroline Margiotta
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
| | - Colleen Staatz
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
| | - Eleanor Garlow
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
| | - Anna Christensen
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
| | - Kara Zivin
- Dara Lee Luca is with Mathematica and Harvard Kennedy School, Cambridge, MA. Caroline Margiotta and Colleen Staatz are with Mathematica, Cambridge. Eleanor Garlow is with Mathematica, Washington, DC, and Emory University, Atlanta, GA. Anna Christensen is with Mathematica, Washington, DC. Kara Zivin is with Mathematica, University of Michigan Medical School, and Department of Veterans Affairs, Ann Arbor
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18
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Rapid infant weight gain and prenatal maternal depression are associated with prehypertension/hypertension before age 9. J Hum Hypertens 2020; 34:795-801. [PMID: 32020050 DOI: 10.1038/s41371-020-0306-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/09/2022]
Abstract
Early life prevention of obesity and associated metabolic disease is necessary to address the current obesity epidemic. Latino children have a higher risk of obesity, and associated comorbidities such as hypertension than Caucasian children. This study focuses on perinatal childhood and maternal risk factors associated with prehypertension and hypertension prior to age 9 in an urban Latino cohort. A cohort of low income, US born Latino children (n = 131) in San Francisco was followed from birth. Annual assessments were conducted including child dietary intake, anthropometrics, and blood pressure measurements. Maternal body mass index and depressive symptoms were assessed concurrently. Leukocyte telomere length was assessed at age 4 and 5 in children. Rapid infant weight gain (odds ratio (OR) 7.25, 95% confidence interval (CI) 1.33-39.38) and prenatal maternal clinical depression (OR 6.70 95% CI 1.15-39.16) were associated with prehypertension/hypertension before age 9. Early life obesity and leukocyte telomere length were not associated with childhood hypertension. Rapid infant weight gain and exposure to prenatal maternal depression are predictive of childhood prehypertension/hypertension before age 9 in low income, US-born Latino children. The perinatal period is an important time point to target for prevention of childhood hypertension.
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19
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Pineros-Leano M. Association between Early Maternal Depression and Child Growth: A Group-Based Trajectory Modeling Analysis. Child Obes 2020; 16:26-33. [PMID: 31483170 DOI: 10.1089/chi.2019.0121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Childhood overweight and obesity have become a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States have increased dramatically from 6% to 35%. A potential risk factor of interest is maternal depression. To date, there are mixed findings available on the association between maternal depression and childhood obesity development, and there is a dearth of longitudinal research available. To address these gaps in the literature, this study investigated the association between maternal depression at age 1 and/or age 3 years and childhood obesity longitudinally. Methods: This study used data from the Fragile Families Child Wellbeing Study (FFCWS) to investigate the research questions. FFCWS is a national dataset that has information on 4898 women, and their children, from predominantly nonmarital, low-income minority groups in the United States. This study used information collected at the birth of the child (wave 1) through age 9 years (wave 5). The analytic sample consisted of 3500 mother-children dyads. Group-based trajectory modeling and multivariable logistic regression were used. Results: The results indicated that there was no association between maternal depression and childhood obesity development in this sample of low-income and mostly minority participants. Maternal prepregnancy BMI, number of biological children in the house, and Latino ethnicity were significant predictors of risky growth trajectories in the full sample. Suggestions for designing childhood obesity prevention interventions based on research are discussed.
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20
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Systematic Review of Expected Weight Changes After Birth for Full-Term, Breastfed Newborns. J Obstet Gynecol Neonatal Nurs 2019; 48:593-603. [DOI: 10.1016/j.jogn.2019.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2019] [Indexed: 11/20/2022] Open
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21
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Kjaer TW, Faurholt-Jepsen D, Medrano R, Elwan D, Mehta K, Christensen VB, Wojcicki JM. Higher Birthweight and Maternal Pre-pregnancy BMI Persist with Obesity Association at Age 9 in High Risk Latino Children. J Immigr Minor Health 2019; 21:89-97. [PMID: 29397484 DOI: 10.1007/s10903-018-0702-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.
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Affiliation(s)
- Thora Wesenberg Kjaer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.,School of Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Faurholt-Jepsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Rosalinda Medrano
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Deena Elwan
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Kala Mehta
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Vibeke Brix Christensen
- Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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Dib EP, Padovani FHP, Perosa GB. Mother-child interaction: implications of chronic maternal anxiety and depression. PSICOLOGIA-REFLEXAO E CRITICA 2019; 32:10. [PMID: 32026105 PMCID: PMC6967190 DOI: 10.1186/s41155-019-0123-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/21/2019] [Indexed: 12/19/2022] Open
Abstract
Background The literature has few studies on the quality of the mother-child interaction when mothers suffer from chronic anxiety and depression. This study aimed to compare characteristics of the interaction between 14-month-old children and their mothers who presented symptoms of chronic anxiety or depression with those of 14-month-old children and their mothers who did not present mental problems. Method The sample consisted of 40 mother-infant dyads selected from a prospective cohort study. They were assessed using the State-Trait Anxiety Inventory and the Beck Depression Inventory, at three time points: during pregnancy and at 6 months and 14 months of the infant’s life. Three groups were formed: 10 mothers with symptoms of chronic anxiety, 8 mothers with symptoms of chronic depression, and a control group of 22 mothers without mental health problems. The mothers responded to a socioeconomic questionnaire, and then a 7-min episode of the dyad interaction was recorded and assessed using categories indicated in a dyadic interaction assessment protocol. This consisted of six categories that evaluate the behavior of the caregiver and four categories that evaluate the child’s behavior. Results A significantly higher percentage of mothers with chronic depressive symptoms had not completed high school and did not live with a partner. When comparing the interaction behaviors of the three groups, mothers with symptoms of chronic depression were significantly less sensitive, were more disengaged, and showed less positive affect than those in the control group. They also engaged in significantly fewer stimulations and displayed more negative affect compared with both the control group and mothers with chronic anxiety symptoms. Anxious mothers presented greater intrusiveness compared with mothers in the control group. Regarding the children, those with mothers showing symptoms of chronic depression interacted significantly less than those with mothers showing symptoms of chronic anxiety and the control group. Conclusions The results indicate that mother-infant interaction is most severely compromised among mother-infant dyads comprised of mothers with chronic depressive symptoms, compared with dyads of mothers with chronic anxiety symptoms and dyads of control group mothers without mental health problems.
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Affiliation(s)
- Eloisa Pelizzon Dib
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), UNESP - Campus de Botucatu, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Bairro, Botucatu, SP, 18618-687, Brazil.
| | - Flávia Helena Pereira Padovani
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), UNESP - Campus de Botucatu, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Bairro, Botucatu, SP, 18618-687, Brazil
| | - Gimol Benzaquen Perosa
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), UNESP - Campus de Botucatu, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Bairro, Botucatu, SP, 18618-687, Brazil
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Cabeza de Baca T, Wojcicki JM, Epel ES, Adler NE. Lack of partner impacts newborn health through maternal depression: A pilot study of low-income immigrant Latina women. Midwifery 2018; 64:63-68. [PMID: 29990627 PMCID: PMC6084475 DOI: 10.1016/j.midw.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/23/2018] [Accepted: 05/30/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Latina women have a high burden of depression and other mental health issues, particularly in the perinatal period. Suboptimal maternal mental health can have adverse developmental and physiological impacts on child growth. The present study examines the impact of unplanned pregnancy and pregnancy relationship status on prenatal maternal depression in a sample of low-income Latina women. We hypothesized that the association between these prenatal stressors and newborn health would be mediated through prenatal depression. METHOD The present study included a sample 201 Latina mothers and their children recruited from prenatal clinics during their second or third trimesters. Depression symptomology, relationship status were collected prenatally. At birth, several indices of newborn health were examined, including head circumference percentile and birthweight. Finally, planned pregnancy status was retrospectively collected when the child was between 1 and 2 years old. RESULTS Structural equation modelling revealed that single women, compared to partnered women, had higher levels of depression. Higher levels of depression, in turn, predicted poorer newborn health. Unplanned pregnancy was not significantly associated with newborn health. DISCUSSION These results suggest that relationship status may be an important screening question for medical examiners to ask to pregnant Latina women during prenatal visits. These results are consistent with past research investigating the effects of maternal mental health on adverse birth outcomes that propose that stressful early environments shape developmental trajectories.
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Affiliation(s)
- Tomás Cabeza de Baca
- Division of Cardiology, Department of Medicine, University of California, San Francisco, 400 Parnassus Ave, Room AC-16, Box 0369, San Francisco, CA 94143, USA.
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158, USA.
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, USA
| | - Nancy E Adler
- Center for Health and Community, Department of Psychiatry, University of California, San Francisco, USA
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McCallister M, Medrano R, Wojcicki J. Early life obesity increases the risk for asthma in San Francisco born Latina girls. Allergy Asthma Proc 2018; 39:273-280. [PMID: 30095392 DOI: 10.2500/aap.2018.39.4125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous studies showed that youths who are obese are more likely to have asthma; however, some studies found important sex differences in the risk for asthma. METHODS We retrospectively assessed the asthma incidence in a Latino cohort of children recruited from birth and followed up until 9 years of age. We subsequently assessed risk factors for asthma and for an early asthma (defined as <4 years of age) diagnosis in relation to obesity. Asthma was assessed via maternal reports and medical records review of the children at 9 years of age. Each child's weight and height were collected annually. Independent and sex-specific risk factors for asthma diagnosis were assessed by using multivariable logistic regression models. RESULTS In our cohort, 24.6% (42/164) of the children were diagnosed with asthma by 9 years of age. The mean ± standard deviation age of asthma diagnosis was 29.5 ± 4.5 months; 79.5% had a diagnosis of asthma at <4 years of age. In girls, any breast-feeding at 6 months was associated with a reduced risk of asthma (odds ratio [OR] 0.21 [95% confidence interval {CI}, 0.05-0.86]) and obesity at 2 years of was associated with increased risk for asthma (OR 12.14 [95% CI 2.79-53.05]). Exposure to environmental toxins and consumption of sugar-sweetened beverages were associated with a risk for asthma diagnosis after 4 years of age. CONCLUSION In our high-risk Latino cohort, obesity was associated with asthma development in the girls. In addition, an asthma diagnosis after 4 years of age may be related to environmental toxin exposure and early consumption of sugar-sweetened beverages compared with an earlier diagnosis.
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Wojcicki JM, Elwan D, Lin J, Blackburn E, Epel E. Chronic Obesity and Incident Hypertension in Latina Women Are Associated with Accelerated Telomere Length Loss over a 1-Year Period. Metab Syndr Relat Disord 2018; 16:262-266. [PMID: 29750592 DOI: 10.1089/met.2017.0134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Shorter telomere length is associated with increased chronic disease risk in adulthood including diabetes mellitus and cardiovascular risk. Few studies have evaluated the relationship between telomere length change and incident disease risk in populations with a high percentage of overweight and obesity. RESULTS In an urban Latina population recruited in San Francisco (n = 82) with a high prevalence of overweight and obesity (78.4%), we assessed leukocyte telomere length and telomere length change over a 1-year period in relation to obesity, chronicity of obesity, and incident metabolic disease risk 5-6 years later. We also assessed the relationship between telomere length change over a 1-year period and weight loss. There were no significant associations between baseline telomere length and socio-demographics including age and ethnicity, or current weight status. Telomere length change, however, was associated with being obese at baseline and previous years of chronic obesity. A high percentage of women who were obese at baseline were also obese the year before (90%) and 2 years before (85%). Obesity at baseline was an independent predictor for increased telomere length attrition (β = -346.9, -568.4 to -125.4; P < 0.01). Similarly, chronic obesity was associated with increased risk for accelerated attrition (β = -280.6, -518.4 to -42.8; P < 0.01). INNOVATION We speculate that accelerated attrition may be a harbinger of metabolic disease. We also found that those who had or developed hypertension had accelerated attrition [-407.4 ± 464.0 vs. -168.1 ± 643.6 (P = 0.03)]. CONCLUSION In populations with chronic and long-standing obesity, telomere length attrition rate, rather than baseline telomere length may be a more sensitive indicator of health status including chronic disease development.
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Affiliation(s)
- Janet M Wojcicki
- 1 Department of Pediatrics, University of California , San Francisco, San Francisco, California
| | - Deena Elwan
- 1 Department of Pediatrics, University of California , San Francisco, San Francisco, California
| | - Jue Lin
- 2 Department of Biochemistry and Biophysics, University of California , San Francisco, San Francisco, California
| | - Elizabeth Blackburn
- 2 Department of Biochemistry and Biophysics, University of California , San Francisco, San Francisco, California
| | - Elissa Epel
- 3 Department of Psychiatry, University of California , San Francisco, San Francisco, California
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Marshall SA, Ip EH, Suerken CK, Arcury TA, Saldana S, Daniel SS, Quandt SA. Relationship between maternal depression symptoms and child weight outcomes in Latino farmworker families. MATERNAL AND CHILD NUTRITION 2018; 14:e12614. [PMID: 29740933 DOI: 10.1111/mcn.12614] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 03/06/2018] [Accepted: 03/15/2018] [Indexed: 12/14/2022]
Abstract
This study sought to characterize depressive symptoms among mothers in Latino farmworker families, determine if maternal depression increases children's risk of obesity, and ascertain whether relevant risk factors such as physical activity, diet, and feeding style mediate this relationship. Mothers from 248 families completed the 10-item Center for Epidemiologic Studies Depression Scale 9 times over a 2-year period. Four distinct patterns were used to describe mothers: few symptoms, moderate episodic symptoms, severe episodic symptoms, and chronic symptoms. Approximately two-thirds of women experienced moderate symptoms of depression at least once. Children of mothers fitting each pattern were compared. At the end of the study, children of mothers with severe episodic and chronic symptoms were significantly more likely to be overweight and obese than children of mothers with few symptoms (p < .05). After controlling for covariates, differences in weight status for children of mothers with severe episodic symptoms remained significant. Children of mothers with either moderate episodic or chronic symptoms were fed in a less responsive fashion (p < .05), and children of chronically symptomatic mothers had lower diet quality (p < .01). Although nonresponsive feeding has been linked to childhood obesity, in this analysis, feeding style did not mediate the relationship between maternal depression and diet quality. Elevated levels of depressive symptoms are common in this population, and those symptoms, especially when severe or chronic in nature, may increase children's risk of obesity. Additional research is needed to characterize the pathways through which maternal depression influences children's weight.
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Affiliation(s)
- Sarah A Marshall
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Edward H Ip
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Thomas A Arcury
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Santiago Saldana
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Sara A Quandt
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Netsi E, Pearson RM, Murray L, Cooper P, Craske MG, Stein A. Association of Persistent and Severe Postnatal Depression With Child Outcomes. JAMA Psychiatry 2018; 75:247-253. [PMID: 29387878 PMCID: PMC5885957 DOI: 10.1001/jamapsychiatry.2017.4363] [Citation(s) in RCA: 340] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/01/2017] [Indexed: 01/14/2023]
Abstract
Importance Maternal postnatal depression (PND) is common and associated with adverse child outcomes. These effects are not inevitable, and it is critical to identify those most at risk. Previous work suggests that the risks of adverse outcomes are increased when PND is severe and persistent, but this has not been systematically studied. Objective To examine the association between differing levels of persistence and severity of PND and long-term child outcomes. Design, Setting, and Participants The sample for this observational study comprised participants in the Avon Longitudinal Study of Parents and Children in the United Kingdom. Three thresholds of PND severity-moderate, marked, and severe-were defined using the self-rated Edinburgh Postnatal Depression Scale (EPDS). Depression was defined as persistent when the EPDS score was above the threshold level at both 2 and 8 months after childbirth. For each of these severity and persistence categories, the following were examined: (1) the trajectories of later EPDS scores (6 time points between 21 months and 11 years after childbirth) and (2) child outcomes-behavioral problems at 3.5 years of age, school-leaving mathematics grades at 16 years of age, and depression at 18 years of age. Data analysis was conducted from July 12, 2016, to February 8, 2017. Main Outcomes and Measures Child behavioral problems at 3.5 years of age using the Rutter total problems scale, school-leaving mathematics grades at 16 years of age extracted from records of external national public examinations, and offspring depression at 18 years of age using the Clinical Interview Schedule-Revised. Results For the 9848 mothers in the sample, the mean (SD) age at delivery was 28.5 (4.7) years. Of the 8287 children, 4227 (51%) were boys and 4060 (49%) were girls. Compared with women with PND that was not persistent and women who did not score above the EPDS threshold, for all 3 severity levels, women with persistent PND showed elevated depressive symptoms up to 11 years after childbirth. Whether persistent or not, PND doubled the risk of child behavior disturbance. The odds ratio (OR) for child behavioral disturbance for mothers with moderate PND was 2.22 (95% CI, 1.74-2.83), for mothers with marked PND was 1.91 (95% CI, 1.36-2.68), and for mothers with severe PND was 2.39 (95% CI, 1.78-3.22). Persistence of severe PND was particularly important to child development, substantially increasing the risk for behavioral problems at 3.5 years of age (OR, 4.84; 95% CI, 2.94-7.98), lower mathematics grades at 16 years of age (OR, 2.65; 95% CI, 1.26-5.57), and higher prevalence of depression at 18 years of age (OR, 7.44; 95% CI, 2.89-19.11). Conclusions and Relevance Persistent and severe PND substantially raises the risk for adverse outcome on all child measures. Meeting criteria for depression both early and late in the postnatal year, especially when the mood disturbance is severe, should alert health care professionals to a depression that is likely to be persistent and to be associated with an especially elevated risk of multiple adverse child outcomes. Treatment for this group should be prioritized.
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Affiliation(s)
- Elena Netsi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Rebecca M. Pearson
- School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, United Kingdom
| | - Lynne Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Stellenbosch University, Matieland, Stellenbosch, South Africa
- Department of Psychology, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Peter Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Stellenbosch University, Matieland, Stellenbosch, South Africa
- Department of Psychology, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Michelle G. Craske
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Farías-Antúnez S, Xavier MO, Santos IS. Effect of maternal postpartum depression on offspring's growth. J Affect Disord 2018; 228:143-152. [PMID: 29248820 DOI: 10.1016/j.jad.2017.12.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 11/16/2017] [Accepted: 12/06/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Previous studies have linked maternal depression to different child offspring's growth outcomes. However, its effect has not been well established. The aim of this review was to evaluate the available evidence on the effect of maternal postpartum depression on offspring weight and height growth outcomes. METHODS A systematic review of longitudinal studies that evaluated the effect of maternal depression on child's growth outcomes was conducted in PubMed, LILACs, Web of Science, Science Direct and PsyInfo databases, using maternal postpartum depression related keywords, according to each database searching tool. RESULTS A total of 9608 articles were screened and 20 met the final inclusion criteria. The child's first-year growth was the most affected by the exposure to maternal depression. Children of depressed mothers had a higher chance of being underweight and stunted in the first year of life. Maternal depression was also associated with child's linear growth impairment after the first year. LIMITATIONS As a literature review, a publication bias could not be ruled out. The diversity of the published data made it unfeasible for a pooled effect to be estimated. CONCLUSIONS Considering the results observed on child's first year of life growth, physicians should engage in assessing maternal depression, as it is a treatable and manageable disease, thus avoiding unnecessary harm on child's physical development.
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Affiliation(s)
| | | | - Iná Silva Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
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Beck AL, Heyman M, Chao C, Wojcicki J. Full fat milk consumption protects against severe childhood obesity in Latinos. Prev Med Rep 2017; 8:1-5. [PMID: 28856083 PMCID: PMC5552381 DOI: 10.1016/j.pmedr.2017.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/25/2017] [Accepted: 07/14/2017] [Indexed: 01/04/2023] Open
Abstract
Consumption of non- or low-fat dairy products is recommended as a strategy to lower the risk of childhood obesity. However, recent evidence suggests that consumption of whole fat dairy products may, in fact, be protective against obesity. Our objective was to determine the association between milk fat consumption and severe obesity among three-year-old Latino children, a population with a disproportionate burden of obesity and severe obesity. 24-hour-dietary recalls were conducted to determine child intake in San Francisco based cohort recruited in 2006–7. Mother-child dyads were weighed and measured. The 24-hour recall data was analyzed to determine participants' consumption of whole milk, 2% milk, and 1% milk. The milk consumption data was used to calculate grams of milk fat consumed. The cross-sectional association between milk fat intake and severe obesity (BMI ≥ 99th percentile) was determined using multivariable logistic regression. Data were available for 145 children, of whom 17% were severely obese. Severely obese children had a lower mean intake of milk fat (5.3 g vs. 8.9 g) and fewer drank any milk (79% versus 95% for not severely obese children (p < 0.01)). Among the potential confounders assessed, maternal BMI and maternal marital status were associated with severe obesity and were included in a multivariate model. In the multivariate model, higher milk fat consumption was associated with lower odds of severe obesity (OR 0.88 CI 0.80–0.97). Higher milk fat consumption is associated with lower odds of severe obesity among Latino preschoolers. These results call into question recommendations that promote consumption of lower fat milk. Current guidelines recommend that children consume low-fat milk. Prior literature suggests that full fat milk may protect against obesity. We evaluated how milk fat consumption relates to weight in Latino children. We found that milk fat consumption was protective against severe obesity.
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Affiliation(s)
- Amy L Beck
- University of California San Francisco, 3333 California St. Suite 245, Box 0503, San Francisco, CA, 94118, United States
| | - Melvin Heyman
- University of California San Francisco, 550 16th Street 5th Floor, Mail Stop 0136, San Francisco, CA, 94143, United States
| | - Cewin Chao
- University of California San Francisco, 505 Parnassus Ave., San Francisco, CA, 94143, United States
| | - Janet Wojcicki
- University of California San Francisco, 550 16th Street 5th Floor, Mail Stop 0136, San Francisco, CA, 94143, United States
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30
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Lima TFM, Maciel WM, Alencar MND, Cruz JADS, Carvalho CAD, Silva AAMD. Association between maternal depressive symptoms with child malnutrition or child excess weight. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2017. [DOI: 10.1590/1806-93042017000300010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to verify associations between maternal depressive symptoms with child malnutrition or child excess weight. Methods: prospective study with data from the BRISA prenatal cohort in São Luís, Brazil, obtained from the 22nd to the 25th week of gestation (in 2009 and 2010) and, later, when children were aged 12 to 32 months (in 2010 and 2012). Maternal depressive symptoms were identified using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Edinburgh Postnatal Depression Scale (EPDS). For the excess weight evaluation, BMI z-score for age > +2 was used. For measuring child malnutrition, height z-score for age < -2 was used. The confounding factors were identified using a directed acyclic graph in DAGitty software. Results: we did not find associations between maternal depressive symptoms with child malnutrition or child excess weight. The prevalence of maternal depressive symptoms was 27.6% during gestation and 19.8% in the second or third year of the child's life. The malnutrition rate was 6% and the excess weight rate was 10.9%. Conclusions: no associations between maternal depressive symptoms in prenatal or in the second or third year of the child's life and child malnutrition or excess weight were detected.
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Pineros-Leano M, Liechty JM, Piedra LM. Latino immigrants, depressive symptoms, and cognitive behavioral therapy: A systematic review. J Affect Disord 2017; 208:567-576. [PMID: 27810273 DOI: 10.1016/j.jad.2016.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/14/2016] [Accepted: 10/22/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND In order to address the needs of the growing Latino immigrant population, this study aimed to systematically review peer-reviewed articles of intervention studies that used cognitive behavioral therapy to treat depressive symptoms among Latino immigrants in the U.S. METHODS We searched PsycINFO, PubMed, and Medline databases from January 1995 through July 2016 as part of a registered review protocol (PROSPERO) following PRISMA guidelines. Inclusion criteria were intervention studies that used cognitive behavioral techniques to treat depressive symptoms among a predominantly U.S. Latino immigrant sample -- or subsample with disaggregated results, and the use of standardized measures of depression. We used the National Heart, Lung, and Blood Institute quality assessment tools for systematic reviews to assess risk of bias. RESULTS We identified 11 studies that met inclusion criteria. Nine of the included studies reported a reduction of depressive symptoms. Each study used a least one cultural adaptation to deliver the intervention. Using an existing content model, cultural adaptations were categorized as (a) cognitive-informational adaptations, (b) affective-motivational adaptations, and (c) environmental adaptations. LIMITATIONS Heterogeneity of articles in terms of sample size, cultural adaptations, methodological rigor, and setting limited comparability of effectiveness across studies. CONCLUSIONS Culturally adapted CBT to address depressive symptoms among Latino immigrants appears promising but further research is needed. The most commonly used cultural adaptations included language, inclusion of migration experience, and adjusting for literacy level. Study design elements and adaptations were often responsive to geographic characteristics and available resources.
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Affiliation(s)
| | - Janet M Liechty
- School of Social Work, University of Illinois at Urbana-Champaign, USA; College of Medicine, University of Illinois at Urbana-Champaign, USA
| | - Lissette M Piedra
- School of Social Work, University of Illinois at Urbana-Champaign, USA
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Wojcicki JM, Heyman MB, Elwan D, Lin J, Blackburn E, Epel E. Early exclusive breastfeeding is associated with longer telomeres in Latino preschool children. Am J Clin Nutr 2016; 104:397-405. [PMID: 27440083 PMCID: PMC4962153 DOI: 10.3945/ajcn.115.115428] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/09/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Telomere length (TL) is a marker of cellular aging, with the majority of lifetime attrition occurring during the first 4 y. Little is known about risk factors for telomere shortening in childhood. OBJECTIVE We evaluated the relation between early life feeding variables and preschool TL. DESIGN We assessed the relation between dietary, feeding, and weight-associated risk factors measured from birth and TL from blood samples taken at 4 y of age (n = 108) and 5 y of age (n = 92) in a cohort of urban, Latino children (n = 121 individual children). Feeding variables were evaluated in children with repeat measurements (n = 77). RESULTS Mean TL (in bp) was associated with exclusive breastfeeding at 4-6 wk of age (adjusted coefficient: 353.85; 95% CI: 72.81, 634.89; P = 0.01), maternal TL (adjusted coefficient: 0.32; 95% CI: 0.11, 0.54; P < 0.01), and older paternal age (adjusted coefficient: 33.27; 95% CI: 4.10, 62.44; P = 0.03). The introduction of other foods or drinks in addition to breast-milk or replacement-milk substitutes before 4-6 wk of age was associated with mean TL at 4 and 5 y of age (adjusted coefficient: -457.01; 95% CI: -720.50, -193.51; P < 0.01). Infant obesity at 6 mo of age and soda consumption at 4 y of age mediated the relation in part between exclusive breastfeeding at 4-6 wk of age and mean TL at 4 and 5 y of age. High soda consumption at 3 y of age was associated with an accelerated attrition from 4 to 5 y of age (adjusted coefficient: -515.14; 95% CI: -986.06, -41.22; P = 0.03). CONCLUSION Exclusive breastfeeding at 4-6 wk of age may have long-term effects on child health as evidenced by longer TL at 4 and 5 y of age.
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Affiliation(s)
| | | | | | - Jue Lin
- Biochemistry and Biophysics, and
| | | | - Elissa Epel
- Psychiatry, University of California, San Francisco, San Francisco, CA
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Robson JO, Verstraete SG, Shiboski S, Heyman MB, Wojcicki JM. A Risk Score for Childhood Obesity in an Urban Latino Cohort. J Pediatr 2016; 172:29-34.e1. [PMID: 26952117 PMCID: PMC4846503 DOI: 10.1016/j.jpeds.2016.01.055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/16/2015] [Accepted: 01/21/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess whether individual obesity risk factors, present during gestation, and the first 6 months of life, can be combined into a simple prognostic model that has the ability to accurately predict childhood obesity at age 5 years in a high-risk cohort. STUDY DESIGN A total of 201 Latina women were recruited during pregnancy, and their infants followed longitudinally. Ten risk factors for childhood obesity were included in an initial logistic model; a second reduced model was created via stepwise deletion (confirmed with nonparametric conditional random forest classifier), after which 5 risk factors remained. From each model, an obesity risk equation was derived, and an obesity risk score was generated for each patient. Derived algorithms were assessed using discrimination, calibration, and via predictive statistics. RESULTS Of the 166 children followed through age 5 years, 56 (32%) met criteria for childhood obesity. Discrimination accuracy for both derivation models was excellent, and after optimism-corrected bootstrapping, both models showed meaningful clinical performance. Both models were adequately calibrated, showed strong sensitivity and negative predictive value at conservatively set obesity risk thresholds, and displayed excellent specificity among those classified as highest risk. Birth weight z-score and change in weight-for-age z-score between birth and 6 months were the risk factors with the strongest contribution to the obesity risk score. CONCLUSIONS Obesity risk algorithms are reliable in their prediction of childhood obesity and have the potential to be integrated into the electronic medical record. These models could provide a filter for directing early prevention resources to children with high obesity risk but should be evaluated in a larger external dataset.
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Affiliation(s)
- Jacob O Robson
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, CA.
| | - Sofia G Verstraete
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Stephen Shiboski
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Melvin B Heyman
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, CA
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Wojcicki JM, Shiboski S, Heyman MB, Elwan D, Lin J, Blackburn E, Epel E. Telomere length change plateaus at 4 years of age in Latino children: associations with baseline length and maternal change. Mol Genet Genomics 2016; 291:1379-89. [PMID: 26965507 DOI: 10.1007/s00438-016-1191-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 02/24/2016] [Indexed: 01/30/2023]
Abstract
Telomeres are the protective complexes at the end of chromosomes, required for genomic stability. Little is known about predictors of attrition in young children or the relationship between parental and child patterns of telomere change. Telomere length was assessed twice over one year, at 4 and at 5 years of age, in Latino preschool children (n = 77) and their mothers (n = 70) in whole blood leukocytes. Maternal and child rates of attrition during the same time period were compared in 70 mother-child pairs. More children showed lengthened telomeres over one year compared to their mothers and very few children showed attrition (2.6 %). Approximately 31 % of children and 16 % of mothers displayed lengthening over one year while 66 % of children showed maintenance in contrast with 74 % of mothers. The strongest predictor for child telomere length change was child's baseline telomere length (r = -0.61, p < 0.01). Maternal rate of change was associated with child rate of change (r = 0.33, p < 0.01). After controlling for child baseline telomere length, the relationship between child and maternal rate of change trended towards significance (Coeff = 0.20, 95 % CI -0.03 to 0.43; p = 0.08). We found primarily maintenance and lengthening from 4 to 5 years of age in children, with minimal telomere attrition, indicating that most of the telomere loss happens in the first 4 years, plateauing by age 4. Lastly, we found close to 10 % of the variance in rate of change in children shared by mothers. While some of this shared variance is genetic, there are likely environmental factors that need to be further identified that impact rate of telomere length change.
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Affiliation(s)
- Janet M Wojcicki
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
| | - Stephen Shiboski
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Melvin B Heyman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Deena Elwan
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Jue Lin
- Department of Biophysics and Biochemistry, University of California, San Francisco, San Francisco, CA, USA
| | - Elizabeth Blackburn
- Department of Biophysics and Biochemistry, University of California, San Francisco, San Francisco, CA, USA
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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Maternal Depressive Symptoms and Attained Size Among Children in the First 2 Years of Life. Acad Pediatr 2016; 16:75-81. [PMID: 26498256 DOI: 10.1016/j.acap.2015.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 10/08/2015] [Accepted: 10/16/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the relation of maternal depressive symptoms with attained size and whether it is stronger for young children in low-income families. METHODS Secondary analysis was performed of longitudinal data from enrollment and parents surveys from the Healthy Steps for Young Children National Evaluation among 4745 children who made at least one visit to a Healthy Steps site. Length and weight data from medical records were converted to z scores and percentiles for length for age and weight for length at 6, 12, and 24 months using 2000 Centers for Disease Control and Prevention growth standards. Analyses evaluated the relation of maternal depressive symptoms at 2 to 4 months using a modified 14-item Center for Epidemiologic Depression Scale with attained size and child, maternal, and family characteristics. Regression models estimated the relation of symptoms with z scores and logistic regression the relation for short stature (below 10th percentile for length for age), adjusted for covariates. RESULTS Maternal depressive symptoms were associated with z scores for length for age at 6, 12, and 24 months and short stature at 6 and 24 months for children in low/middle-income families. The z scores at 24 months remained significantly lower for children in low/middle-income families whose mothers reported depressive symptoms, after adjustment for covariates. The odds of short stature were significantly increased at 6 months in the total sample and among low/middle-income families for children whose mothers reported symptoms. Other measures of attained size were not associated with depressive symptoms. CONCLUSIONS The link between maternal symptoms and young children's risk of short stature reinforces recommendations for increased screening for postpartum depressive symptoms and for clinicians to review growth charts with parents for impaired/unfavorable patterns.
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Wojcicki JM, Heyman MB, Elwan D, Shiboski S, Lin J, Blackburn E, Epel E. Telomere length is associated with oppositional defiant behavior and maternal clinical depression in Latino preschool children. Transl Psychiatry 2015; 5:e581. [PMID: 26080316 PMCID: PMC4490282 DOI: 10.1038/tp.2015.71] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/15/2015] [Accepted: 04/23/2015] [Indexed: 11/09/2022] Open
Abstract
Exposure to psychological stress and depression are associated with shorter white blood cell telomere length (TL) in adults, possibly via associated lifelong oxidative stressors. Exposure to maternal depression increases risk for future depression and behavior problems in children, and Latino youth are at high risk. Few studies have evaluated the role of exposure to maternal depression or child behavior in relation to TL in children. We assessed early-childhood exposures to maternal depression from birth to the age of 5 years and child behavior from ages 3-5 years in a cohort of Latino children in relation to child leukocyte TL at ages 4 and 5 years. Children who had oppositional defiant behavior at 3, 4 or 5 years had shorter TL than those without by ~450 base pairs (P < 0.01). In multivariate analyses, independent predictors for shorter TL at 4 and 5 years of age included oppositional defiant disorder at 3, 4 or 5 years (β = -359.25, 95% CI -633.84 to 84.66; P = 0.01), exposure to maternal clinical depression at 3 years of age (β = -363.99, 95% CI -651.24 to 764.74; P = 0.01), shorter maternal TL (β = 502.92, 95% CI 189.21-816.63) and younger paternal age at the child's birth (β = 24.63, 95% CI 1.14-48.12). Thus, exposure to maternal clinical depression (versus depressive symptoms) in early childhood was associated with deleterious consequences on child cellular health as indicated by shorter TL at 4 and 5 years of age. Similarly, children with oppositional defiant behavior also had shorter TL, possibly related to early exposures to maternal clinical depression. Our study is the first to link maternal clinical depression and oppositional defiant behavior with shorter TL in the preschool years in a relatively homogenous population of low-income Latino children.
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Affiliation(s)
- J M Wojcicki
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA,Department of Pediatrics, University of California, 550 16th Street, 5th Floor, Mail Stop 0136, San Francisco, CA 94143, USA. E-mail:
| | - M B Heyman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - D Elwan
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - S Shiboski
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - J Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - E Blackburn
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - E Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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Benton PM, Skouteris H, Hayden M. Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review. Appetite 2015; 87:259-82. [PMID: 25572134 DOI: 10.1016/j.appet.2014.12.227] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 11/14/2014] [Accepted: 12/24/2014] [Indexed: 11/29/2022]
Abstract
The preschool years may be a critical period for child obesity onset; however, literature examining obesity risk factors to date has largely focused on school-aged children. Several links have been made between maternal depression and childhood obesity risks; however, other types of maternal psychopathology have been widely neglected. The aim of the present review was to systematically identify articles that examined relationships between maternal psychopathology variables, including depressive and anxiety symptoms, self-esteem and body dissatisfaction, and risks for pre-schooler obesity, including weight outcomes, physical activity and sedentary behaviour levels, and nutrition/diet variables. Twenty articles meeting review criteria were identified. Results showed positive associations between maternal depressive symptoms and increased risks for pre-schooler obesity in the majority of studies. Results were inconsistent depending on the time at which depression was measured (i.e., antenatal, postnatal, in isolation or longitudinally). Anxiety and body dissatisfaction were only measured in single studies; however, both were linked to pre-schooler obesity risks; self-esteem was not measured by any studies. We concluded that maternal depressive symptoms are important to consider when assessing risks for obesity in preschool-aged children; however, more research is needed examining the impact of other facets of maternal psychopathology on obesity risk in pre-schoolers.
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Affiliation(s)
- Pree M Benton
- School of Psychology, Deakin University, Melbourne, Australia.
| | - Helen Skouteris
- School of Psychology, Deakin University, Melbourne, Australia
| | - Melissa Hayden
- School of Psychology, Deakin University, Melbourne, Australia
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Verstraete SG, Heyman MB, Wojcicki JM. Breastfeeding offers protection against obesity in children of recently immigrated Latina women. J Community Health 2014; 39:480-6. [PMID: 24249439 DOI: 10.1007/s10900-013-9781-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Breastfeeding has been found to have a protective effect on subsequent development of obesity in childhood, particularly in white, non-Hispanic populations. The protective effect of nursing for more than 12 months in children of Latina women is less clear, which may be due to differences in levels of acculturation in previously studied populations. We evaluated the association between breastfeeding for 12 months or more and risk for obesity in a cohort of children of recently immigrated relatively unacculturated Latina mothers. Maternal characteristics at birth, including length of stay in the United States, breastfeeding habits at 4-6 weeks of age, 6 months, and 1 year, and anthropometric measurements were obtained for a cohort of 196 children participating in a prospective study. At 1 year of age 39.0% of infants were being breastfed. Being breastfed at 1 year of age was associated with a decreased risk of obesity in both univariate (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.21-0.83) and multivariate models (OR 0.39, 95% CI 0.02-0.93) adjusting for maternal BMI, marital status, education level, country of origin, age, years of living in the United States, and child's birth weight at 3 years of age, regardless of mother's acculturation status using length of stay in the United States as a proxy for acculturation. The association with breastfeeding persisted at 4 years of age as a protective factor for obesity (OR 0.29, 95% CI 0.11-0.80). Breastfeeding for longer than 12 months provides a significant protective effect on the development of obesity in early childhood in a cohort of children of high-risk recently immigrated Latina women in San Francisco who were relatively unacculturated to the United States.
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Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384:1800-19. [PMID: 25455250 DOI: 10.1016/s0140-6736(14)61277-0] [Citation(s) in RCA: 1251] [Impact Index Per Article: 125.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Perinatal mental disorders are associated with increased risk of psychological and developmental disturbances in children. However, these disturbances are not inevitable. In this Series paper, we summarise evidence for associations between parental disorders and offspring outcomes from fetal development to adolescence in high-income, middle-income, and low-income countries. We assess evidence for mechanisms underlying transmission of disturbance, the role of mediating variables (underlying links between parent psychopathology and offspring outcomes) and possible moderators (which change the strength of any association), and focus on factors that are potentially modifiable, including parenting quality, social (including partner) and material support, and duration of the parental disorder. We review research of interventions, which are mostly about maternal depression, and emphasise the need to both treat the parent's disorder and help with associated caregiving difficulties. We conclude with policy implications and underline the need for early identification of those parents at high risk and for more early interventions and prevention research, especially in socioeconomically disadvantaged populations and low-income countries.
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Affiliation(s)
- Alan Stein
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - Rebecca M Pearson
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK; Elizabeth Blackwell Institute for Health Research, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Elizabeth Rapa
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Atif Rahman
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | | | - Louise M Howard
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
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Kaaya S, Garcia ME, Li N, Lienert J, Twayigize W, Spiegelman D, Smith Fawzi MC. Association of maternal depression and infant nutritional status among women living with HIV in Tanzania. MATERNAL AND CHILD NUTRITION 2014; 12:603-13. [PMID: 25382710 DOI: 10.1111/mcn.12154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Antenatal and post-natal depression has demonstrated a significant burden in sub-Saharan Africa, with rates ranging from 10% to 35%. However, perinatal women living with HIV in Tanzania have reported an even greater prevalence of depression (43-45%). The primary goal of this study was to examine the relationship between maternal depression and infant malnutrition among women living with HIV. The design was a retrospective cohort study within the context of a randomised controlled trial among women living with HIV and their infants. Within this trial, 699 mother-child pairs were analysed for the present study. Although antenatal depression was not associated with infant malnutrition and post-natal depression was negatively associated [relative risk (RR = 0.80, P = 0.04], cumulative depression demonstrated a positive association with infant wasting (RR = 1.08, P < 0.01) and underweight (RR = 1.03, P < 0.01) after controlling for confounding factors. Variation in the association between depression and infant nutritional status was observed for episodic vs. chronic depression. These findings suggest that providing evidence-based services for persistent depression among women living with HIV may have an effect on infant malnutrition. In addition, other positive outcomes may be related to infant cognitive development as well as HIV disease prognosis and survival among women.
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Affiliation(s)
- Sylvia Kaaya
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Maria E Garcia
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Nan Li
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Jeffrey Lienert
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - William Twayigize
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Alvarez-Segura M, Garcia-Esteve L, Torres A, Plaza A, Imaz ML, Hermida-Barros L, San L, Burtchen N. Are women with a history of abuse more vulnerable to perinatal depressive symptoms? A systematic review. Arch Womens Ment Health 2014; 17:343-57. [PMID: 25005865 DOI: 10.1007/s00737-014-0440-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 06/11/2014] [Indexed: 01/29/2023]
Abstract
The objective of this paper is to examine the association between maternal lifetime abuse and perinatal depressive symptoms. Papers included in this review were identified through electronic searches of the following databases: Pubmed Medline and Ovid, EMBASE, PsycINFO, and the Cochrane Library. Each database was searched from its start date through 1 September 2011. Keywords such as "postpartum," "perinatal," "prenatal," "depression," "violence," "child abuse," and "partner abuse" were included in the purview of MeSH terms. Studies that examined the association between maternal lifetime abuse and perinatal depression were included. A total of 545 studies were included in the initial screening. Forty-three articles met criteria for inclusion and were incorporated in this review. Quality of articles was evaluated with the Newcastle-Ottawa-Scale (NOS). This systematic review indicates a positive association between maternal lifetime abuse and depressive symptoms in the perinatal period.
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Affiliation(s)
- M Alvarez-Segura
- Department of Psychiatry and Psychology, CIBERSAM, Hospital Sant Joan de Déu, Barcelona, Spain,
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Surkan PJ, Ettinger AK, Hock RS, Ahmed S, Strobino DM, Minkovitz CS. Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort. BMC Pediatr 2014; 14:185. [PMID: 25047367 PMCID: PMC4114872 DOI: 10.1186/1471-2431-14-185] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 07/14/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child's life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. METHODS Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. RESULTS Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the child's first 6 years. CONCLUSIONS Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories.
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Affiliation(s)
- Pamela J Surkan
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E5523, Baltimore, MD 21205-2179, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna K Ettinger
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca S Hock
- Division of Global Psychiatry Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Saifuddin Ahmed
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Donna M Strobino
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cynthia S Minkovitz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Associations between family food behaviors, maternal depression, and child weight among low-income children. Appetite 2014; 79:97-105. [PMID: 24768937 DOI: 10.1016/j.appet.2014.04.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 04/03/2014] [Accepted: 04/14/2014] [Indexed: 11/23/2022]
Abstract
Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P < .05), maternal control of child's eating routines (P < .03), and food resource management skills (P < .01), and with higher scores on child control of snacking (P < .03) and negative mealtime practices (P < .05). Multiple regression results revealed that greater maternal presence whenever the child ate was significantly associated with lower child BMI z scores (β = .166, P < .05). Logistic regression analyses indicated that higher scores on food resource management skills reduced the odds of child overweight (odds ratios = .72-.95, P < .01). Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group.
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Broekman BFP, Chan YH, Chong YS, Kwek K, Cohen SS, Haley CL, Chen H, Chee C, Rifkin-Graboi A, Gluckman PD, Meaney MJ, Saw SM. The influence of anxiety and depressive symptoms during pregnancy on birth size. Paediatr Perinat Epidemiol 2014; 28:116-26. [PMID: 24266599 DOI: 10.1111/ppe.12096] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mental health problems during pregnancy can influence fetal growth. However, studies examining the influence of maternal mental health across the normal range of birth outcomes are uncommon. This study examined the associations between symptoms of maternal depression and anxiety during pregnancy on birth size among term Asian infants. METHODS One thousand forty-eight Asian pregnant women from a cohort Growing Up in Singapore Towards Healthy Outcomes were recruited between 2009 to 2010 at two Singaporean maternity hospitals. At 26 weeks gestation, depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory II (BDI-II), and anxiety was measured with the Spielberger State-Trait Anxiety Inventory (STAI). Health personnel recorded birthweight, birthlength, gestational age, and head circumference at birth. RESULTS Nine hundred forty-six women who delivered term infants had complete data. For this sample, the mean birthweight was 3146.6 g [standard deviation (SD) 399.0], the mean birthlength was 48.9 cm (SD 2.0). After controlling for several potential confounders, there was a significant negative association between STAI and birthlength [β = -0.248, confidence interval (CI) [-0.382, -0.115], P < 0.001] and a small negative association between EPDS and birthlength (β = -0.169, CI [-0.305, -0.033], P = 0.02). No associations were found between scores on the EPDS, BDI-II, and STAI with birthweight or head circumference. CONCLUSIONS Our preliminary data suggest that among term infants, anxiety and depressive symptoms are not associated with birthweight, while anxiety and depressive symptoms are associated with a shorter birthlength.
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Affiliation(s)
- Birit F P Broekman
- Department of Psychological Medicine, National University Hospital, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Singapore Institute for Clinical Sciences, Singapore
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Maternal depression and childhood obesity: a systematic review. Prev Med 2014; 59:60-7. [PMID: 24291685 PMCID: PMC4172574 DOI: 10.1016/j.ypmed.2013.11.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/18/2013] [Accepted: 11/19/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Maternal depression is prevalent and has been associated with parenting practices that influence child weight. In this systematic review we aimed to examine the prospective association between maternal depression and child overweight. METHODS We searched four databases (PsycINFO, PubMed, Embase, and Academic Search Premier) to identify studies for inclusion. We included studies with a prospective design with at least one year follow-up, measuring maternal depression at any stage after childbirth, and examining child overweight or obesity status, body mass index z-score or percentile, or adiposity. Two authors extracted data independently and findings were qualitatively synthesized. RESULTS We identified nine prospective studies for inclusion. Results were examined separately for episodic depression (depression at a single measurement occasion) and chronic depression (depression on multiple measurement occasions). Mixed results were observed for the relationship between episodic depression and indicators of child adiposity. Chronic depression, but not episodic depression, was associated with greater risk for child overweight. CONCLUSIONS While chronic depression may be associated with child overweight, further research is needed. Research is also needed to determine whether maternal depression influences child weight outcomes in adolescence and to investigate elements of the family ecology that may moderate the effect of maternal depression on child overweight.
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Abstract
One of the most important aspects of a well-child examination is an assessment of a child's growth. Children who are failing to grow are often labeled "failure to thrive." However, close examination of the pattern of growth on standardized growth charts often allows the caregiver to characterize the growth failure as failure to grow, failure to gain weight, or failure to grow and gain weight. Such refinement of the pattern of growth failure allows for a more specific differential diagnosis and helps to focus laboratory and radiographic evaluation.
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Affiliation(s)
- Alaa Al Nofal
- W. Frederick Schwenk, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
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47
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Holbrook KE, White MC, Heyman MB, Wojcicki JM. Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study. Int Breastfeed J 2013; 8:7. [PMID: 23835065 PMCID: PMC3711781 DOI: 10.1186/1746-4358-8-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 07/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization recommends exclusive breastfeeding until 6 months of age. Maternal attitudes toward infant feeding are correlated with chosen feeding method and breastfeeding duration. The Iowa Infant Feeding Attitude Scale (IIFAS) has been used to assess attitudes towards breastfeeding prenatally and is predictive of breastfeeding decisions in certain population groups. METHODS In a cohort of pregnant Latina women recruited from two hospitals in the San Francisco Bay Area (n=185), we administered the IIFAS prior to delivery. Information regarding feeding choice, maternal sociodemographic information, and anthropometrics were collected at 6 months and 1 year postpartum. Analysis of predictors for breastfeeding initiation, breastfeeding at 6 and 12 months and exclusive breastfeeding at 6 months were evaluated using multivariate logistic regression adjusting for potential confounders. RESULTS In our cohort of Latina mothers, breastfeeding a previous infant was associated with breastfeeding initiation (OR 8.29 [95% CI 1.00, 68.40] p = 0.05) and breastfeeding at 6 months (OR 18.34 [95% CI 2.01, 167.24] p = 0.01). College education was associated with increased exclusive breastfeeding at 6 months (OR 58.67 [95% CI 4.97, 692.08] p = 0.001) and having other children was associated with reduced breastfeeding at six months (OR 0.08 [95% CI 0.01, 0.70] p = 0.02). A higher IIFAS score was not associated with breastfeeding initiation, breastfeeding at 6 or 12 months or exclusive breastfeeding at 6 months of age. CONCLUSIONS Initial choices about breastfeeding will likely influence future breastfeeding decisions, so breastfeeding interventions should specifically target new mothers. Mothers with other children also need additional encouragement to maintain breastfeeding until 6 months of age. The IIFAS, while predictive of breastfeeding decisions in other population groups, was not associated with feeding decisions in our population of Latina mothers.
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Affiliation(s)
- Katherine E Holbrook
- Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 500 Parnassus Avenue, MU 4-East, San Francisco, CA, 94143-0136, USA.
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Kieffer EC, Caldwell CH, Welmerink DB, Welch KB, Sinco BR, Guzmán JR. Effect of the healthy MOMs lifestyle intervention on reducing depressive symptoms among pregnant Latinas. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 51:76-89. [PMID: 22638902 DOI: 10.1007/s10464-012-9523-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants ("intervention effect"). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.
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Affiliation(s)
- Edith C Kieffer
- School of Social Work, University of Michigan, 1080 S. University, Room 3770, Box 10, Ann Arbor, MI 48109-1106, USA.
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Pereira PK, Lima LA, Legay LF, de Cintra Santos JF, Lovisi GM. Maternal mental disorders in pregnancy and the puerperium and risks to infant health. World J Clin Pediatr 2012; 1:20-3. [PMID: 25254163 PMCID: PMC4145647 DOI: 10.5409/wjcp.v1.i4.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 09/06/2012] [Accepted: 09/13/2012] [Indexed: 02/06/2023] Open
Abstract
Prenatal and postnatal period presents the highest prevalence of mental disorders in women’s lives and depression is the most frequent one, affecting approximately one in every five mothers. The aggravating factor here is that during this period psychiatric symptoms affect not only women’s health and well-being but may also interfere in the infant’s intra and extra-uterine development. Although the causes of the relationship between maternal mental disorders and possible risks to a child’s health and development remain unknown, it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy, to substance abuse and the mother’s lifestyle. Moreover, after delivery, maternal mental disorders may also impair the ties of affection (bonding) with the newborn and the maternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition, impaired child growth that is expressed in low weight and height for age, and even behavioral problems and vulnerability to presenting mental disorders in adulthood. Generally speaking, research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight, whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality. Therefore, the success of infant growth care programs also depends on the mother’s mental well being. Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers. However, more research is necessary so as to confirm the association between all factors with greater scientific rigor.
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Affiliation(s)
- Priscila Krauss Pereira
- Priscila Krauss Pereira, Lúcia Abelha Lima, Letícia Fortes Legay, Jacqueline Fernandes de Cintra Santos, Giovanni Marcos Lovisi, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21944-970, RJ, Brazil
| | - Lúcia Abelha Lima
- Priscila Krauss Pereira, Lúcia Abelha Lima, Letícia Fortes Legay, Jacqueline Fernandes de Cintra Santos, Giovanni Marcos Lovisi, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21944-970, RJ, Brazil
| | - Letícia Fortes Legay
- Priscila Krauss Pereira, Lúcia Abelha Lima, Letícia Fortes Legay, Jacqueline Fernandes de Cintra Santos, Giovanni Marcos Lovisi, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21944-970, RJ, Brazil
| | - Jacqueline Fernandes de Cintra Santos
- Priscila Krauss Pereira, Lúcia Abelha Lima, Letícia Fortes Legay, Jacqueline Fernandes de Cintra Santos, Giovanni Marcos Lovisi, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21944-970, RJ, Brazil
| | - Giovanni Marcos Lovisi
- Priscila Krauss Pereira, Lúcia Abelha Lima, Letícia Fortes Legay, Jacqueline Fernandes de Cintra Santos, Giovanni Marcos Lovisi, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, CEP 21944-970, RJ, Brazil
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The Association Between Ante- and Postnatal Depressive Symptoms and Obesity in Both Mother and Child: A Systematic Review of the Literature. Womens Health Issues 2012; 22:e319-28. [DOI: 10.1016/j.whi.2011.12.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 12/06/2011] [Accepted: 12/12/2011] [Indexed: 01/07/2023]
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