1
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Brennan PA, Nozadi SS, McGrath M, Churchill ML, Dunlop AL, Elliott AJ, MacKenzie D, Margolis AE, Ghassabian A, McEvoy CT, Fry RC, Bekelman TA, Ganiban JM, Williams L, Wilson CL, Lewis J. COVID-19 Stress and Child Behavior: Examining Discrimination and Social Support in Racially Diverse ECHO Cohorts. J Am Acad Child Adolesc Psychiatry 2024; 63:528-538. [PMID: 37544643 PMCID: PMC10838355 DOI: 10.1016/j.jaac.2023.07.996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To examine the additive or moderating influences of caregiver COVID-19-related stress, social support, and discrimination on children's behavior problems across racially diverse populations. METHOD In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N = 1,999 caregiver/child pairs), we operationalized caregiver COVID-19-related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n = 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). RESULTS Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19-related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19-related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination. CONCLUSION Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes.
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Affiliation(s)
| | | | - Monica McGrath
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Marie L Churchill
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Amy J Elliott
- Avera Research Institute and the University of South Dakota, Sioux Falls, South Dakota
| | | | - Amy E Margolis
- Columbia University and the New York State Psychiatric Institute, New York
| | | | | | - Rebecca C Fry
- University of North Carolina, Chapel Hill, North Carolina
| | - Traci A Bekelman
- University of Colorado Denver - Anschutz Medical Campus, Denver, Colorado
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2
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Zheng S, Mansolf M, McGrath M, Churchill ML, Bekelman TA, Brennan PA, Margolis AE, Nozadi SS, Bastain TM, Elliott AJ, LeWinn KZ, Hofheimer JA, Leve LD, Rennie B, Zimmerman E, Marable CA, McEvoy CT, Liu C, Sullivan A, Woodruff TJ, Ghosh S, Leventhal B, Ferrara A, Lewis J, Bishop S. Measurement bias in caregiver-report of early childhood behavior problems across demographic factors in an ECHO-wide diverse sample. JCPP Adv 2024; 4:e12198. [PMID: 38486952 PMCID: PMC10933609 DOI: 10.1002/jcv2.12198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 08/11/2023] [Indexed: 03/17/2024] Open
Abstract
Background Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown. Methods Item-level data of CBCL/1.5-5 from a large sample of young children (N = 9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses. Results Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status. Conclusions The CBCL/1.5-5, a caregiver-report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.
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Affiliation(s)
- Shuting Zheng
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Maxwell Mansolf
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Monica McGrath
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Marie L. Churchill
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Traci A. Bekelman
- Department of EpidemiologyColorado School of Public HealthAuroraCOUSA
| | | | - Amy E. Margolis
- Department of PsychiatryColumbia University Irving Medical CenterNew York State Psychiatric InstituteNew YorkNYUSA
| | - Sara S. Nozadi
- Community Environmental HealthCollege of PharmacyHealth Sciences CenterUniversity of New MexicoAlbuquerqueNMUSA
| | - Theresa M. Bastain
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Julie A. Hofheimer
- Department of PediatricsDivision of Neonatal‐Perinatal MedicineNorth Carolina at Chapel HillChapel HillNCUSA
| | - Leslie D. Leve
- Prevention Science InstituteUniversity of OregonEugeneORUSA
| | - Brandon Rennie
- Health Sciences CenterDepartment of PediatricsCenter for Development and DisabilityUniversity of New MexicoNavajo Birth Cohort StudyAlbuquerqueNMUSA
| | - Emily Zimmerman
- Communication Sciences & DisordersNortheastern UniversityBostonMAUSA
| | - Carmen A. Marable
- School of MedicineUniversity of North Carolina at Chapel HillNeuroscience CurriculumChapel HillNCUSA
| | - Cindy T. McEvoy
- Department of PediatricsPape Pediatric Research InstituteOregon Health & Science UniversityPortlandORUSA
| | - Chang Liu
- Department of PsychologyWashington State UniversityPullmanWAUSA
| | - Alexis Sullivan
- Center for Health and CommunityUniversity of CaliforniaSan FranciscoCAUSA
| | - Tracey J. Woodruff
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCAUSA
| | - Samiran Ghosh
- Department of Biostatistics and Data Science & Coordinating Center for Clinical Trials (CCCT)University of Texas School of Public HealthHoustonTXUSA
| | - Bennett Leventhal
- University of ChicagoNavajo Birth Cohort StudyUniversity of New MexicoAlbuquerqueNMUSA
| | - Assiamira Ferrara
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCAUSA
| | - Johnnye Lewis
- Navajo Birth Cohort StudyCommunity Environmental Health ProgramCollege of PharmacyUniversity of New MexicoAlbuquerqueNMUSA
| | - Somer Bishop
- Department of Psychiatry and Behavioral SciencesWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCAUSA
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3
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Morales S, Bowers ME, Shuffrey L, Ziegler K, Troller-Renfree S, Hernandez A, Leach SC, McGrath M, Ola C, Leve LD, Nozadi SS, Swingler MM, Lai JS, Schweitzer JB, Fifer W, Camargo CA, Khurana Hershey GK, Shapiro ALB, Keating DP, Hartert TV, Deoni S, Ferrara A, Elliott AJ. Maternal education prospectively predicts child neurocognitive function: An environmental influences on child health outcomes study. Dev Psychol 2024:2024-56629-001. [PMID: 38407105 DOI: 10.1037/dev0001642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
A large body of research has established a relation between maternal education and children's neurocognitive functions, such as executive function and language. However, most studies have focused on early childhood and relatively few studies have examined associations with changes in maternal education over time. Consequently, it remains unclear if early maternal education is longitudinally related to neurocognitive functions in children, adolescents, and young adults. In addition, the associations between changes in maternal education across development and more broadly defined neurocognitive outcomes remain relatively untested. The current study leveraged a large multicohort sample to examine the longitudinal relations between perinatal maternal education and changes in maternal education during development with children's, adolescents', and young adults' neurocognitive functions (N = 2,688; Mage = 10.32 years; SDage = 4.26; range = 3-20 years). Moreover, we examined the differential effects of perinatal maternal education and changes in maternal education across development on executive function and language performance. Perinatal maternal education was positively associated with children's later overall neurocognitive function. This longitudinal relation was stronger for language than executive function. In addition, increases in maternal education were related to improved language performance but were not associated with executive functioning performance. Our findings support perinatal maternal education as an important predictor of neurocognitive outcomes later in development. Moreover, our results suggest that examining how maternal education changes across development can provide important insights that can help inform policies and interventions designed to foster neurocognitive development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Maureen E Bowers
- Department of Human Development and Quantitative Methodology, University of Maryland
| | | | | | | | | | | | | | - Cindy Ola
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Research Institute, University of Washington
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, University of Oregon
| | | | - Margaret M Swingler
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis
| | | | | | | | - Allison L B Shapiro
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus
| | | | - Tina V Hartert
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine
| | - Sean Deoni
- Department of Pediatrics, Brown University
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4
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Rennie BJ, Bishop SL, Leventhal BL, Zheng S, Geib E, Kim YS, Burnette C, Salzman E, Nozadi SS, Kim H, Ence W, Park M, Ghods S, Welch M, MacKenzie D, Lewis JL. Neurodevelopmental profiles of 4-year-olds in the Navajo Birth Cohort Study. JAACAP Open 2023; 1:184-195. [PMID: 38239266 PMCID: PMC10795771 DOI: 10.1016/j.jaacop.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Objective Native American children disproportionally face many risk factors for poor developmental outcomes; these factors include poverty, environmental toxicant exposure, and limited medical, and intervention services. To understand these risks, comprehensive documentation of developmental and behavioral phenotypes are needed. In the current descriptive study, we assessed the neurodevelopment of young Diné (Navajo) children using standardized assessment instruments in combination with expert clinician judgment. Methods As part of an ongoing, population-based, prospective birth cohort study, we conducted comprehensive neurodevelopmental assessments of 138, 3-5-year-old, Diné children residing on or near the Navajo Nation. We report results from standardized parent reports, psychiatric examinations, and direct assessments of children's language, cognitive, adaptive, and social-emotional development, as well as best estimate clinical diagnoses. Results Forty-nine percent of our sample met DSM-5 criteria for a neurodevelopmental disorder (NDD) diagnosis. Language and speech sound disorders were most common, although autism spectrum disorder (ASD) was also elevated compared to the general population. Though language performance was depressed amongst all groups of children with, and without, NDDs, those meeting criteria for certain NDDs performed significantly lower on all language measures, when compared to those without. Social-emotional, behavioral, and nonverbal cognitive ability were in the average range overall. Conclusions Diné children in our study were found to have a high percentage of clinically significant developmental delays. Overall, children presented with a pervasive pattern of depressed language performance across measures, irrespective of diagnosis (or no diagnosis), while other domains of functioning were similar to normative samples. Findings support the need to identify appropriate intervention and educational efforts for affected youth, while also exploring the causes of the specific developmental delays. However, longitudinal studies are necessary to establish best practices for identifying delays and delineating resilience factors to optimize development of Diné children.
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Affiliation(s)
| | - Somer L Bishop
- University of California San Francisco Weill Institute for Neurosciences
| | - Bennett L Leventhal
- Community Environmental Health Program, Health Sciences Center, College of Pharmacy, University of New Mexico
- The University of Chicago
| | - Shuting Zheng
- University of California San Francisco Weill Institute for Neurosciences
| | - Ellen Geib
- Nationwide Children's Hospital, Child Development Center
| | - Young Shin Kim
- University of California San Francisco Weill Institute for Neurosciences
| | | | - Emma Salzman
- University of California San Francisco Weill Institute for Neurosciences
| | - Sara S Nozadi
- Community Environmental Health Program, Health Sciences Center, College of Pharmacy, University of New Mexico
| | - Hosanna Kim
- University of California San Francisco Weill Institute for Neurosciences
- University of California Davis Health
| | - Whitney Ence
- University of California San Francisco Weill Institute for Neurosciences
| | - Mina Park
- University of California San Francisco Weill Institute for Neurosciences
| | - Sheila Ghods
- University of California San Francisco Weill Institute for Neurosciences
| | - Maria Welch
- Community Environmental Health Program, Health Sciences Center, College of Pharmacy, University of New Mexico
| | - Debra MacKenzie
- Community Environmental Health Program, Health Sciences Center, College of Pharmacy, University of New Mexico
| | - Johnnye L Lewis
- Community Environmental Health Program, Health Sciences Center, College of Pharmacy, University of New Mexico
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5
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Lewis JV, Knapp EA, Bakre S, Dickerson AS, Bastain TM, Bendixsen C, Bennett DH, Camargo CA, Cassidy-Bushrow AE, Colicino E, D'Sa V, Dabelea D, Deoni S, Dunlop AL, Elliott AJ, Farzan SF, Ferrara A, Fry RC, Hartert T, Howe CG, Kahn LG, Karagas MR, Ma TF, Koinis-Mitchell D, MacKenzie D, Maldonado LE, Merced-Nieves FM, Neiderhiser JM, Nigra AE, Niu Z, Nozadi SS, Rivera-Núñez Z, O'Connor TG, Osmundson S, Padula AM, Peterson AK, Sherris AR, Starling A, Straughen JK, Wright RJ, Zhao Q, Kress AM. Associations between area-level arsenic exposure and adverse birth outcomes: An Echo-wide cohort analysis. Environ Res 2023; 236:116772. [PMID: 37517496 PMCID: PMC10592196 DOI: 10.1016/j.envres.2023.116772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/20/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Drinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood. OBJECTIVES This study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). METHODS Data for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes. RESULTS Compared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA. CONCLUSIONS Our study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.
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Affiliation(s)
- Jonathan V Lewis
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shivani Bakre
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viren D'Sa
- Department of Pediatrics, Rhode Island Hospital, Providence, RI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA; Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Tina Hartert
- Departments of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caitlin G Howe
- Dartmouth College Geisel School of Medicine, Hanover, NH, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Teng-Fei Ma
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | | | - Debra MacKenzie
- Community Environmental Health Program, University of New Mexico College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Sarah Osmundson
- Department of OB/GYN, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy M Padula
- Department of Gynecology, Obstetrics and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Alicia K Peterson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Anne Starling
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA
| | - Amii M Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Keenan K, Hipwell AE, Stepp SD, Dunlop AL, Brennan PA, Farzan SF, Fichorova R, Hirko K, Nozadi SS. Is BMI a Useful Indicator of Prenatal Health Among Black American Women? J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01820-1. [PMID: 37801278 PMCID: PMC11013734 DOI: 10.1007/s40615-023-01820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE BMI is commonly used to measure risk to prenatal health but may not be sensitive to adiposity-associated health problems for Black women. The aim of the present study was to test associations between indices of prenatal health and BMI in Black women. METHODS Data were from 652 women enrolled in two studies. Height and weight were used to calculate BMI. Depression and perceived stress were measured via maternal report, systemic inflammation via C-reactive protein (CRP), and nutrition by the ratio of omega-3 docosahexaenoic acid to omega-6 arachidonic acid fatty acids. RESULTS Neither perceived stress, depression, nor fatty acids were associated with prenatal BMI. CRP levels were positively associated with BMI (beta = 6.56, t = 13.30, p < .001). The prevalence of high-risk levels of CRP (> 3 mg/L) was below 10% for all weight classes except for BMI ≥ 40. CONCLUSIONS Results suggest that BMI may not be a sensitive index of adiposity related risk to prenatal health for Black women.
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Affiliation(s)
- Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Raina Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kelly Hirko
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
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7
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Avalos LA, Chandran A, Churchill ML, Gao X, Ames JL, Nozadi SS, Roubinov D, Brennan PA, Bush NR, Camargo CA, Carroll KN, Cioffi CC, Ferrara A, Goldson B, Hedderson MM, Hipwell AE, Kerver JM, O’Connor TG, Porucznik CA, Shuffrey LC, Talavera-Barber MM, Wright RJ, Zhu Y, Croen LA. Prenatal depression and risk of child autism-related traits among participants in the Environmental influences on Child Health Outcomes program. Autism Res 2023; 16:1825-1835. [PMID: 37526980 PMCID: PMC10857745 DOI: 10.1002/aur.2988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/30/2023] [Indexed: 08/03/2023]
Abstract
This study evaluated the association between prenatal depression and offspring autism-related traits. The sample comprised 33 prenatal/pediatric cohorts participating in the Environmental influences on Child Health Outcomes program who contributed information on prenatal depression and autism-related traits. Autism-related traits were assessed continuously and at the diagnostic cut-off using the Social Responsiveness Scale for children up to 12 years of age. Main analyses included 3994 parent-child pairs with prenatal depression diagnoses data; secondary analyses included 1730 parent-child pairs with depression severity data. After confounder adjustment, we observed an increase in autism-related traits among children of individuals with prenatal depression compared to those without (adjusted β = 1.31 95% CI: 0.65, 1.98). Analyses stratified by child sex documented a similar significant association among boys (aβ = 1.34 95%CI: 0.36, 2.32) and girls (aβ = 1.26 95% CI: 0.37, 2.15). Prenatal depression was also associated with increased odds of moderate to severe autism-related traits (adjusted odds ratio: 1.64, 95%CI: 1.09, 2.46), the screening threshold considered high risk of autism spectrum disorder (ASD) diagnosis. Findings highlight the importance of prenatal depression screening and preventive interventions for children of pregnant individuals with depression to support healthy development. Future research is needed to clarify whether these findings reflect overlap in genetic risk for depression and ASD-related traits or another mechanism.
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Affiliation(s)
- Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland CA
| | | | | | | | - Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland CA
| | - Sara S. Nozadi
- Department of Pharmaceutical Sciences, Health Sciences Center, University of New Mexico
| | - Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | | | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- Department of Pediatrics, University of California, San Francisco
| | | | - Kecia N. Carroll
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland CA
| | - Brandon Goldson
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Jean M. Kerver
- Departments of Epidemiology & Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, University of Rochester
| | | | - Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Maria M. Talavera-Barber
- Avera McKennan Hospital and University Health Center, Avera Research Institute, Sioux Falls, SD, USA
| | - Rosalind J. Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland CA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland CA
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Melough MM, Li M, Hamra G, Palmore M, Sauder KA, Dunlop AL, LeWinn KZ, Zhao Q, Kelly RS, Switkowski KM, Hipwell AE, Korrick SA, Collett BR, MacKenzie D, Nozadi SS, Kerver JM, Schmidt RJ, McGrath M, Sathyanarayana S. Greater Gestational Vitamin D Status is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program. J Nutr 2023; 153:1502-1511. [PMID: 37147034 PMCID: PMC10367223 DOI: 10.1016/j.tjnut.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is common in pregnancy. Vitamin D plays an important role in the developing brain, and deficiency may impair childhood behavioral development. OBJECTIVES This study examined the relationship between gestational 25(OH)D concentrations and childhood behavior in the Environmental influences on Child Health Outcomes (ECHO) Program. METHODS Mother-child dyads from ECHO cohorts with data available on prenatal (first trimester through delivery) or cord blood 25(OH)D and childhood behavioral outcomes were included. Behavior was assessed using the Strengths and Difficulties Questionnaire or the Child Behavior Checklist, and data were harmonized using a crosswalk conversion. Linear mixed-effects models examined associations of 25(OH)D with total, internalizing, and externalizing problem scores while adjusting for important confounders, including age, sex, and socioeconomic and lifestyle factors. The effect modification by maternal race was also assessed. RESULTS Early (1.5-5 y) and middle childhood (6-13 y) outcomes were examined in 1688 and 1480 dyads, respectively. Approximately 45% were vitamin D deficient [25(OH)D < 20 ng/mL], with Black women overrepresented in this group. In fully adjusted models, 25(OH)D concentrations in prenatal or cord blood were negatively associated with externalizing behavior T-scores in middle childhood [-0.73 (95% CI: -1.36, -0.10) per 10 ng/mL increase in gestational 25(OH)D]. We found no evidence of effect modification by race. In a sensitivity analysis restricted to those with 25(OH)D assessed in prenatal maternal samples, 25(OH)D was negatively associated with externalizing and total behavioral problems in early childhood. CONCLUSIONS This study confirmed a high prevalence of vitamin D deficiency in pregnancy, particularly among Black women, and revealed evidence of an association between lower gestational 25(OH)D and childhood behavioral problems. Associations were more apparent in analyses restricted to prenatal rather than cord blood samples. Interventions to correct vitamin D deficiency during pregnancy should be explored as a strategy to improve childhood behavioral outcomes.
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Affiliation(s)
- Melissa M Melough
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States.
| | - Mingyi Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ghassan Hamra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Meredith Palmore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Rachel S Kelly
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Susan A Korrick
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent R Collett
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sara S Nozadi
- Health Sciences Center, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California at Davis, Davis, CA, United States
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
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9
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Lindly OJ, Henderson DE, Vining CB, Running Bear CL, Nozadi SS, Bia S. "Know Your Children, Who They Are, Their Weakness, and Their Strongest Point": A Qualitative Study on Diné Parent Experiences Accessing Autism Services for Their Children. Int J Environ Res Public Health 2023; 20:5523. [PMID: 37107805 PMCID: PMC10138717 DOI: 10.3390/ijerph20085523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 01/05/2023] [Accepted: 03/13/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Marked inequities in access to autism services and related health outcomes persist for U.S. children, undermining broader initiatives to advance the population's health. At the intersection of culture, poverty, and ruralness little remains known about autism in many Indigenous communities. This qualitative study on the lived experiences of Navajo (Diné) parents raising a child with autism sought to identify factors affecting access to services. METHODS A Diné researcher conducted in-depth interviews with 15 Diné parents of children with autism living in or around the Navajo Nation. A directed content analysis approach was used to identify themes, subthemes, and connections between themes. RESULTS Twelve overarching themes emerged on Diné parents' experiences accessing autism diagnostic and treatment services, as well as ways access to autism services can be improved. The following themes were related to diagnosis: the diagnostic process was often emotionally fraught; long wait times of up to years for diagnostic services were commonplace; limited clinician training and cultural humility impeded access to diagnostic services; and adequate health insurance, Indian Health Service referrals, care coordination, financial aid for travel, and efficient evaluation facilitated diagnosis. Themes on treatment access were as follows: parent perceptions of the extent to which an autism service helped their child affected access; social support helped parents to access treatment; obtaining referrals and care coordination influenced treatment access; treatment costs affected access; and service availability and geographic proximity impacted treatment access. Themes on ways to improve access to autism services were as follows: greater autism awareness is needed; autism-focused support groups may be helpful; and increased availability and quality of autism services across and around the Navajo Nation is paramount. CONCLUSIONS Diné parents' access to autism services was dynamically affected by sociocultural factors that must be addressed in future health equity-oriented initiatives.
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Affiliation(s)
- Olivia J. Lindly
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Davis E. Henderson
- Department of Communication Sciences and Disorders, Northern Arizona University, Flagstaff, AZ 86011, USA
| | | | - Candi L. Running Bear
- Department of Educational Specialties, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Sara S. Nozadi
- Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, USA
| | - Shannon Bia
- National University, San Diego, CA 92123, USA
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10
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Brennan PA, Dunlop AL, Croen LA, Avalos LA, Salisbury AL, Hipwell AE, Nozadi SS, Sathyanarayana S, Crum RM, Musci R, Li M, Li X, Mansolf M, O'Connor TG, Elliott AJ, Ghildayal N, Lin PID, Sprowles JLN, Stanford JB, Bendixsen C, Ozonoff S, Lester BM, Shuster CL, Huddleston KC, Posner J, Paneth N. Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study. Res Child Adolesc Psychopathol 2023; 51:513-527. [PMID: 36417100 PMCID: PMC10150657 DOI: 10.1007/s10802-022-01000-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
Prenatal antidepressant exposure has been associated with increased risk for neurodevelopmental disorders in childhood, including autism spectrum disorder (ASD). The current study utilized multi-cohort data from the Environmental influences on Child Health Outcomes (ECHO) program (N = 3129) to test for this association, and determine whether the association remained after adjusting for maternal prenatal depression and other potential confounders. Antidepressants and a subset of selective serotonin reuptake inhibitors (SSRIs) were examined in relation to binary (e.g., diagnostic) and continuous measures of ASD and ASD related traits (e.g., social difficulties, behavior problems) in children 1.5 to 12 years of age. Child sex was tested as an effect modifier. While prenatal antidepressant exposure was associated with ASD related traits in univariate analyses, these associations were statistically non-significant in models that adjusted for prenatal maternal depression and other maternal and child characteristics. Sex assigned at birth was not an effect modifier for the prenatal antidepressant and child ASD relationship. Overall, we found no association between prenatal antidepressant exposures and ASD diagnoses or traits. Discontinuation of antidepressants in pregnancy does not appear to be warranted on the basis of increased risk for offspring ASD.
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Affiliation(s)
- Patricia A Brennan
- Psychology Department, Emory University, 36 Eagle Row, 30322, Atlanta, GA, USA.
| | - Anne L Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lyndsay A Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Amy L Salisbury
- Virginia Commonwealth University School of Nursing, Richmond, VA, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sara S Nozadi
- Health Sciences Center University of New Mexico, Albuquerque, NM, USA
| | - Sheela Sathyanarayana
- Seattle Children's Research Institute, Seattle, WA, USA
- University of Washington, Seattle, WA, USA
| | - Rosa M Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rashelle Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mingyi Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maxwell Mansolf
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Amy J Elliott
- Avera Research Institute, Dept of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
| | - Nidhi Ghildayal
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Pi-I D Lin
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Jenna L N Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana- Champaign, ICF, Urbana, Durham, IL, NC, USA
| | - Joseph B Stanford
- Department of Family and Preventive Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA
| | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis, Davis, CA, USA
| | - Barry M Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI, USA
| | - Coral L Shuster
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI, USA
| | - Kathi C Huddleston
- College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Jonathan Posner
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Nigel Paneth
- Michigan State University, East Lansing, MI, USA
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11
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Hipwell AE, Tung I, Sherlock P, Tang X, McKee K, McGrath M, Alshawabkeh A, Bastain T, Breton CV, Cowell W, Dabelea D, Duarte CS, Dunlop AL, Ferrera A, Herbstman JB, Hockett CW, Karagas MR, Keenan K, Krafty RT, Monk C, Nozadi SS, O'Connor TG, Oken E, Osmundson SS, Schantz S, Wright R, Comstock SS. Impact of sedentary behavior and emotional support on prenatal psychological distress and birth outcomes during the COVID-19 pandemic. Psychol Med 2023; 53:1-14. [PMID: 36883203 PMCID: PMC10485176 DOI: 10.1017/s0033291723000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/06/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
Abstract. BACKGROUND Studies have reported mixed findings regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women and birth outcomes. This study used a quasi-experimental design to account for potential confounding by sociodemographic characteristics. METHODS Data were drawn from 16 prenatal cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) program. Women exposed to the pandemic (delivered between 12 March 2020 and 30 May 2021) (n = 501) were propensity-score matched on maternal age, race and ethnicity, and child assigned sex at birth with 501 women who delivered before 11 March 2020. Participants reported on perceived stress, depressive symptoms, sedentary behavior, and emotional support during pregnancy. Infant gestational age (GA) at birth and birthweight were gathered from medical record abstraction or maternal report. RESULTS After adjusting for propensity matching and covariates (maternal education, public assistance, employment status, prepregnancy body mass index), results showed a small effect of pandemic exposure on shorter GA at birth, but no effect on birthweight adjusted for GA. Women who were pregnant during the pandemic reported higher levels of prenatal stress and depressive symptoms, but neither mediated the association between pandemic exposure and GA. Sedentary behavior and emotional support were each associated with prenatal stress and depressive symptoms in opposite directions, but no moderation effects were revealed. CONCLUSIONS There was no strong evidence for an association between pandemic exposure and adverse birth outcomes. Furthermore, results highlight the importance of reducing maternal sedentary behavior and encouraging emotional support for optimizing maternal health regardless of pandemic conditions.
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Affiliation(s)
- Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Tung
- Department of Psychology, California State University Dominguez Hills, Carson, CA, USA
| | - Phillip Sherlock
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Xiaodan Tang
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Kim McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Tracy Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Whitney Cowell
- Department of Pediatrics, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Anne L. Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Assiamira Ferrera
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Christine W. Hockett
- Department of Pediatrics, Avera Research Institute, South Dakota School of Medicine, Vermillion, SD, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth, Lebanon, NH, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Catherine Monk
- Departments of Obstetrics & Gynecology, and Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, USA
| | - Sara S. Nozadi
- Community Environmental Health Program, Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
| | - Thomas G. O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sarah S. Osmundson
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, Urbana, IL, USA
| | | | - Sarah S. Comstock
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI, USA
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12
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Nozadi SS, Li X, Kong X, Rennie B, Kanda D, MacKenzie D, Luo L, Posner J, Blackwell CK, Croen LA, Ferrara A, O’Connor TG, Zimmerman E, Ghassabian A, Leve LD, Elliott AJ, Schmidt RJ, Sprowles JLN, Lewis JL. Effects of COVID-19 Financial and Social Hardships on Infants' and Toddlers' Development in the ECHO Program. Int J Environ Res Public Health 2023; 20:1013. [PMID: 36673770 PMCID: PMC9858743 DOI: 10.3390/ijerph20021013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The financial hardships and social isolation experienced during the COVID-19 pandemic have been found to adversely affect children's developmental outcomes. While many studies thus far have focused on school-aged children and the pandemic-related impacts on their academic skills and behavior problems, relatively less is known about pandemic hardships and associations with children's development during their early years. Using a racially and economically diverse sample, we examined whether hardships experienced during the pandemic were associated with children's development with a particular focus on communication and socioemotional development. METHODS Participants from eight cohorts of the Environmental influences on Child Health Outcomes program provided data on pandemic-related financial and social hardships as well as child developmental outcomes. Financial hardship was defined as at least one parent experiencing job loss or change, and social hardship was defined as families' quarantining from household members or extended family and friends. The development of children under 4 was assessed longitudinally, before and during the pandemic (N = 684), using the Ages and Stages Questionnaire (ASQ). The Generalized Estimating Equations, which accounted for within-child correlation, were used for analysis. RESULTS Families from minority backgrounds and low socioeconomic status disproportionately experienced pandemic-related hardships. Male children had higher odds of experiencing negative changes in communication and personal social skills from pre- to during-pandemic visits (ORs ranged between 2.24 and 3.03 in analysis with binary ASQ outcomes and ranged from -0.34-0.36 in analyses with ASQ z-scores, ps = 0.000). Pandemic-related hardships in the social and financial areas did not explain within-individual changes in children's developmental outcomes. CONCLUSION Negative developmental changes from pre- to during-pandemic were found in boys, yet we did not find any associations between increased experience of pandemic-related hardships and children's development. E how pandemic hardships affect development using a larger sample size and with longer follow-up is warranted.
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Affiliation(s)
- Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Ximin Li
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Xiangrong Kong
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD 21087, USA
| | - Brandon Rennie
- Department of Pediatrics, Center for Development and Disability, University of New Mexico Health Sciences Center, Albuquerque, NM 87107, USA
| | - Deborah Kanda
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87106, USA
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Li Luo
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87106, USA
| | - Jonathan Posner
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Duke University, Durham, NC 27705, USA
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Thomas G. O’Connor
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Emily Zimmerman
- Department of Communication Sciences and Disorder, Northeastern University, Boston, MA 02115, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Leslie D. Leve
- Department of Counseling Psychology, College of Education, University of Oregon, Eugene, OR 97403, USA
| | - Amy J. Elliott
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA
- Avera Research Institute, Sioux Falls, SD 57108, USA
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA 95616, USA
| | - Jenna L. N. Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- International Classification of Functioning, Disability, and Health, Durham, NC 27713, USA
| | - Johnnye L. Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
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13
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Zimmerman E, Gachigi KK, Rodgers RF, Watkins DJ, Woodbury M, Cordero JF, Alshawabkeh A, Meeker JD, Huerta-Montañez G, Pabon ZR, Hines M, Velez-Vega CM, Camargo CA, Zhu Y, Nozadi SS, Comstock SS, Hockett C, Tarwater PM. Association between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in the Environmental Influences on Child Health Outcome (ECHO) Program. Nutrients 2022; 14:4922. [PMID: 36432608 PMCID: PMC9695213 DOI: 10.3390/nu14224922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/02/2022] [Accepted: 11/06/2022] [Indexed: 11/22/2022] Open
Abstract
This study examined the relationship between maternal food source and preparation during pregnancy and the duration of breastfeeding among 751 mother-child dyads in the United States. The data collected from the Environmental influences on Child Health Outcomes (ECHO) Program included twelve cohorts of mothers (age ≥ 18) who delivered infant(s). Three categories of maternal food source and preparation including, High, Moderate, or Low Food Source Quality were derived from the mother report. The mean duration of breastfeeding differed strongly across the three categories. The High Food Source Quality group breastfed an average of 41 weeks, while shorter durations were observed for the Moderate (26 weeks) and Low (16 weeks) Food Source Quality groups. Cox proportional hazards models were used to estimate the relative hazard of time to breastfeeding cessation for each participant characteristic. The full model adjusted for clustering/cohort effect for all participant characteristics, while the final model adjusted for the subset of characteristics identified from variable reduction modeling. The hazard of breastfeeding cessation for those in the High Food Source Quality group was 24% less than the Moderate group (RH = 0.76; 95% CI, 0.63-0.92). Pregnant women in the High Food Source Quality group breastfed longer than the Moderate and Low groups. We encourage more detailed studies in the future to examine this relationship longitudinally.
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Grants
- UG3 OD035509 NIH HHS
- UG3 OD035517 NIH HHS
- UH3 OD023282 NIH HHS
- U2COD023375, U24OD023382, U24OD023319, UH3OD023251, UH3OD023313, UH3OD023328 , UH3OD023289, UH3OD023285, UH3OD023271, UH3OD023253, UH3OD023279, UH3OD023332, UH3OD023305, and UH3OD023286, UH3OD023282, UH3OD023244, UH3OD023275, UH3OD023268, UH3OD023272, U NIH HHS
- UG3 OD023282 NIH HHS
- P30 ES017885 NIEHS NIH HHS
- UH3OD023337, UH3OD023271 NIH HHS
- UH3 OD023251 NIH HHS
- UH3 OD023279 NIH HHS
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - Kennedy K. Gachigi
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34090 Montpellier, France
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Megan Woodbury
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA 02115, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Gredia Huerta-Montañez
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Zaira Rosario Pabon
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Morgan Hines
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - Carmen M. Velez-Vega
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
- Department of Social Sciences, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Sara S. Nozadi
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - Christine Hockett
- Avera Research Institute, Sioux Falls, SD 57108, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105, USA
| | - Patrick M. Tarwater
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX 77843, USA
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Geiger SD, Chandran A, Churchill M, Mansolf M, Zhang C, Musaad S, Blackwell CK, Eick SM, Goin D, Korrick S, Alshawabkeh A, Brennan PA, Cordero JF, Dunlop AL, Elliott AJ, Ferrara A, LeBourgeois M, LeWinn K, Lucchini M, Lugo-Candelas C, Nozadi SS, Pini N, Zhu Y, Zimmerman E, Schantz SL. Relationship between maternal stress during pregnancy and child sleep outcomes. Ann Epidemiol 2022. [DOI: 10.1016/j.annepidem.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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15
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Nozadi SS, Aguiar A, Du R, Enright EA, Schantz SL, Miller C, Rennie B, Quetawki M, MacKenzie D, Lewis JL. Cross-cultural applicability of eye-tracking in assessing attention to emotional faces in preschool-aged children. Emotion 2022:2023-01498-001. [PMID: 36107657 PMCID: PMC10014488 DOI: 10.1037/emo0001124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Humans show an attention bias toward emotional versus neutral information, which is considered an adaptive pattern of information processing. Deviations from this pattern have been observed in children with socially withdrawn behaviors, with most research being conducted in controlled settings among children from urban areas. The goal of the current study was to examine the cross-cultural applicability of two eye-tracking-based measures in assessing attention biases and their relations to children's symptoms of socially withdrawn behaviors in two independent and diverse samples of preschool children. The cross-cultural comparison was conducted between the Navajo Birth Cohort study (NBCS), an indigenous cohort with relatively low socioeconomic status (SES), and the Illinois Kids Development study (IKIDS), a primarily Non-Hispanic White and high SES cohort. Children in both cohorts completed eye-tracking tasks with pictures of emotional faces, and mothers reported on children's symptoms of socially withdrawn behaviors. Results showed that general patterns of attention biases were mostly the same across samples, reflecting heightened attention toward emotional versus neutral faces. The differences across two samples mostly involved the magnitude of attention biases. NBCS children were slower to disengage from happy faces when these emotional faces were paired with neutral faces. Additionally, socially withdrawn children in the NBCS sample showed a pattern of attentional avoidance for emotional faces. The comparability of overall patterns of attention biases provides initial support for the cross-cultural applicability of the eye-tracking measures and demonstrates the robustness of these methods across clinical and community settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Andrea Aguiar
- Beckman Institute for Advanced Science and Technology
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16
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Howe CG, Nozadi SS, Garcia E, O'Connor TG, Starling AP, Farzan SF, Jackson BP, Madan JC, Alshawabkeh AN, Cordero JF, Bastain TM, Meeker JD, Breton CV, Karagas MR. Prenatal metal(loid) mixtures and birth weight for gestational age: A pooled analysis of three cohorts participating in the ECHO program. Environ Int 2022; 161:107102. [PMID: 35081493 PMCID: PMC8891091 DOI: 10.1016/j.envint.2022.107102] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND A growing number of studies have identified both toxic and essential metals which influence fetal growth. However, most studies have conducted single-cohort analyses, which are often limited by narrow exposure ranges, and evaluated metals individually. The objective of the current study was to conduct an environmental mixture analysis of metal impacts on fetal growth, pooling data from three geographically and demographically diverse cohorts in the United States participating in the Environmental Influences on Child Health Outcomes program. METHODS The pooled sample (N = 1,002) included participants from the MADRES, NHBCS, and PROTECT cohorts. Associations between seven metals (antimony, cadmium, cobalt, mercury, molybdenum, nickel, tin) measured in maternal urine samples collected during pregnancy (median: 16.0 weeks gestation) and birth weight for gestational age z-scores (BW for GA) were investigated using Bayesian Kernel Machine Regression (BKMR). Models were also stratified by cohort and infant sex to investigate possible heterogeneity. Chromium and uranium concentrations fell below the limits of detection for most participants and were evaluated separately as binary variables using pooled linear regression models. RESULTS In the pooled BKMR analysis, antimony, mercury, and tin were inversely and linearly associated with BW for GA, while a positive linear association was identified for nickel. The inverse association between antimony and BW for GA was observed in both males and females and for all three cohorts but was strongest for MADRES, a predominantly low-income Hispanic cohort in Los Angeles. A reverse j-shaped association was identified between cobalt and BW for GA, which was driven by female infants. Pooled associations were null for cadmium, chromium, molybdenum, and uranium, and BKMR did not identify potential interactions between metal pairs. CONCLUSIONS Findings suggest that antimony, an understudied metalloid, may adversely impact fetal growth. Cohort- and/or sex-dependent associations were identified for many of the metals, which merit additional investigation.
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Affiliation(s)
- Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood, Ave, Rochester, NY 14642, USA
| | - Anne P Starling
- Department of Epidemiology, University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg, Campus Box 7435, Chapel Hill, NC 27599, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, 39 College St, Hanover, NH 03755, USA
| | - Juliette C Madan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA; Departments of Pediatrics and Psychiatry, Children's Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Akram N Alshawabkeh
- Department of Engineering, Northeastern University, 360 Huntington Ave, Boston, MA 02115, USA
| | - José F Cordero
- Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, 101 Buck Rd, Athens, GA 30602, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N Soto St, Los Angeles, CA 90032, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03766, USA
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17
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Nozadi SS, Li L, Luo L, MacKenzie D, Erdei E, Du R, Roman CW, Hoover J, O’Donald E, Burnette C, Lewis J. Prenatal Metal Exposures and Infants' Developmental Outcomes in a Navajo Population. Int J Environ Res Public Health 2021; 19:425. [PMID: 35010683 PMCID: PMC8744969 DOI: 10.3390/ijerph19010425] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/19/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022]
Abstract
Early-life exposure to environmental toxicants can have detrimental effects on children's neurodevelopment. In the current study, we employed a causal modeling framework to examine the direct effect of specific maternal prenatal exposures on infants' neurodevelopment in the context of co-occurring metals. Maternal metal exposure and select micronutrients' concentrations were assessed using samples collected at the time of delivery from mothers living across Navajo Nation with community exposure to metal mixtures originating from abandoned uranium mines. Infants' development across five domains was measured at ages 10 to 13 months using the Ages and Stages Questionnaire Inventory (ASQ:I), an early developmental screener. After adjusting for effects of other confounding metals and demographic variables, prenatal exposure to lead, arsenic, antimony, barium, copper, and molybdenum predicted deficits in at least one of the ASQ:I domain scores. Strontium, tungsten, and thallium were positively associated with several aspects of infants' development. Mothers with lower socioeconomic status (SES) had higher lead, cesium, and thallium exposures compared to mothers from high SES backgrounds. These mothers also had infants with lower scores across various developmental domains. The current study has many strengths including its focus on neurodevelopmental outcomes during infancy, an understudied developmental period, and the use of a novel analytical method to control for the effects of co-occurring metals while examining the effect of each metal on neurodevelopmental outcomes. Yet, future examination of how the effects of prenatal exposure on neurodevelopmental outcomes unfold over time while considering all potential interactions among metals and micronutrients is warranted.
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Affiliation(s)
- Sara S. Nozadi
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
| | - Li Li
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Li Luo
- Department of Internal Medicine, UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Debra MacKenzie
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
| | - Esther Erdei
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
| | - Ruofei Du
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Carolyn W. Roman
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
| | - Joseph Hoover
- Social Science and Cultural Studies, Montana State University Billing, Billings, MT 59101, USA;
| | - Elena O’Donald
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
| | - Courtney Burnette
- Munroe-Meyer Institute, University of Nebraska Medical Services, Omaha, NE 68106, USA;
| | - Johnnye Lewis
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA; (D.M.); (E.E.); (C.W.R.); (E.O.); (J.L.)
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18
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Schantz SL, Eskenazi B, Buckley JP, Braun JM, Sprowles JN, Bennett DH, Cordero J, Frazier JA, Lewis J, Hertz-Picciotto I, Lyall K, Nozadi SS, Sagiv S, Stroustrup A, Volk HE, Watkins DJ. A framework for assessing the impact of chemical exposures on neurodevelopment in ECHO: Opportunities and challenges. Environ Res 2020; 188:109709. [PMID: 32526495 PMCID: PMC7483364 DOI: 10.1016/j.envres.2020.109709] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/22/2020] [Accepted: 05/19/2020] [Indexed: 05/30/2023]
Abstract
The Environmental influences on Child Health Outcomes (ECHO) Program is a research initiative funded by the National Institutes of Health that capitalizes on existing cohort studies to investigate the impact of early life environmental factors on child health and development from infancy through adolescence. In the initial stage of the program, extant data from 70 existing cohort studies are being uploaded to a database that will be publicly available to researchers. This new database will represent an unprecedented opportunity for researchers to combine data across existing cohorts to address associations between prenatal chemical exposures and child neurodevelopment. Data elements collected by ECHO cohorts were determined via a series of surveys administered by the ECHO Data Analysis Center. The most common chemical classes quantified in multiple cohorts include organophosphate pesticides, polychlorinated biphenyls, polybrominated diphenyl ethers, environmental phenols (including bisphenol A), phthalates, and metals. For each of these chemicals, at least four ECHO cohorts also collected behavioral data during infancy/early childhood using the Child Behavior Checklist. For these chemicals and this neurodevelopmental assessment (as an example), existing data from multiple ECHO cohorts could be pooled to address research questions requiring larger sample sizes than previously available. In addition to summarizing the data that will be available, the article also describes some of the challenges inherent in combining existing data across cohorts, as well as the gaps that could be filled by the additional data collection in the ECHO Program going forward.
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Affiliation(s)
- Susan L Schantz
- Department of Comparative Biosciences, College of Veterinary Medicine, and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA.
| | - Jenna N Sprowles
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, CA, USA.
| | - Jose Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
| | - Jean A Frazier
- Eunice Kennedy Shriver Center, Division of Child and Adolescent Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Johnnye Lewis
- Community Environmental Health Program and Center for Native Environmental Health Equity Research, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
| | | | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Sara S Nozadi
- Community Environmental Health Program and Center for Native Environmental Health Equity Research, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
| | - Sharon Sagiv
- Center for Environmental Research and Children's Health, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
| | - AnneMarie Stroustrup
- Division of Newborn Medicine, Department of Pediatrics, Department of Environmental Medicine and Public Health, and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Heather E Volk
- Departments of Mental Health and Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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19
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Bush NR, Wakschlag LS, LeWinn KZ, Hertz-Picciotto I, Nozadi SS, Pieper S, Lewis J, Biezonski D, Blair C, Deardorff J, Neiderhiser JM, Leve LD, Elliott AJ, Duarte CS, Lugo-Candelas C, O’Shea TM, Avalos LA, Page GP, Posner J. Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward. Front Psychiatry 2020; 11:547. [PMID: 32636769 PMCID: PMC7318113 DOI: 10.3389/fpsyt.2020.00547] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program. We discuss the role that ECHO will play in advancing our understanding of the impact of the family environment on children's risk for psychiatric outcomes. Lastly, we conclude with important unanswered questions and controversies in this area of research, highlighting how ECHO will contribute to resolving these gaps in our understanding, clarifying relationships between the family environment and children's mental health.
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Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Il, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sarah Pieper
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Dominik Biezonski
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Julianna Deardorff
- Community Health Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, PA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Amy J. Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Claudia Lugo-Candelas
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Grier P. Page
- Department of Biostatistics and Epidemiology, RTI, Atlanta, GA, United States
| | - Jonathan Posner
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
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20
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Nozadi SS, Henderson HA, Degnan KA, Fox NA. Longitudinal patterns of anger reactivity and risk-taking: The role of peer-context. Soc Dev 2020; 29:600-614. [PMID: 34262242 PMCID: PMC8276680 DOI: 10.1111/sode.12412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 09/09/2019] [Indexed: 11/28/2022]
Abstract
The current study examined the interplay between children's dispositional anger and susceptibility to peers' influence in increasing children's risk-taking behaviors. Participants in the current study were children from a larger study of temperament and social-emotional development who were followed across 9, 24, 36, 48, and 60 months. Dispositional anger was measured using mothers' reports across 9 and 48 months. At 60 months, children played a risk-taking computer game in presence of an unfamiliar peer who watched the child play. The child's risk-taking was assessed during the game as the unfamiliar peers' reactions were coded based on comments that were peer directed, reflective of praising the target child's performance, or object directed, indicative of excitement toward the game. A latent profile analysis revealed three longitudinal anger profiles across infancy to early childhood: high stable, average stable, and low stable anger. Results suggested that as peers' object-directed comments predicted risk-taking independent of children's anger, the association between peer-directed comments and risk-taking was dependent on children's dispositional anger. Specifically, when peers praised the target child's performance, children in the high stable anger profile showed increased risk-taking propensity. Findings are discussed based on the importance of considering both temperamental characteristics and aspects of the peer context in relation to children's risk-taking.
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Affiliation(s)
- Sara S. Nozadi
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | | | - Kathryn A. Degnan
- Department of Psychology, Catholic University of America, Washington, District of Columbia, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
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21
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Nozadi SS, Li L, Clifford J, Du R, Murphy K, Chen L, Seanez P, Burnette C, MacKenzie D, Lewis JL. Use of Ages and Stages Questionnaires™ (ASQ) in a Navajo population: Comparison with the U.S. normative dataset. Child Care Health Dev 2019; 45:709-718. [PMID: 31276599 PMCID: PMC6894904 DOI: 10.1111/cch.12704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/25/2019] [Accepted: 06/30/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Ages and Stages Questionnaires-Third Edition (ASQ-3) is a parent-completed screening to identify young children at-risk for developmental delays in the United States and internationally. Federal programs operating on Navajo Nation use the ASQ-3 to determine the need for early intervention services, even though the ASQ-3 national sample used to establish cutoff scores for referral included only 1% Native American children. OBJECTIVES The current study aimed to compare the ASQ-3 results from a sample of Navajo infants to those from a representative national U.S. sample and to examine the specificity and sensitivity of the ASQ-3 in Navajo population. METHODS The sample included 530 Navajo infants (47.3% males) aged between 1 and 13 months who lived in remote and rural areas across the Navajo Nation. Children's development was assessed during home visits at 2-, 6-, 9-, and 12-month assessment windows. RESULTS Results showed that after 6 months, Navajo children had lower mean scores and higher percentages of children at-risk for developmental delays than those from the national sample. The sensitivities and specificities, estimated using a Bayesian diagnostic approach under both conservative and nonconservative prior range choices, suggested a comparable validity performance to that from other ASQ-3 studies. DISCUSSION The results of this study along with our ongoing comprehensive assessments at 4 years of age inform current programs working with Navajo children to improve early identification of developmental delays.
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Affiliation(s)
- Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | - Li Li
- Department of Math and Statistics, University of New Mexico, Albuquerque New Mexico
| | - Jantina Clifford
- Early Intervention Program, University of Oregon, Eugene, Oregon
| | - Ruofei Du
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Kimberly Murphy
- Early Intervention Program, University of Oregon, Eugene, Oregon
| | - Lu Chen
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Navajo Birth Cohort Study Team
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | | | - Courtney Burnette
- Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
| | - Johnnye L. Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico
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22
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Abstract
The current study examined whether an important temperamental characteristic, effortful control (EC), moderates the associations between dispositional anger and sadness, attention biases, and social functioning in a group of preschool-aged children (N = 77). Preschoolers' attentional biases toward angry and sad facial expressions were assessed using eye-tracking, and we obtained teachers' reports of children's temperament and social functioning. Associations of dispositional anger and sadness with time looking at relevant negative emotional stimuli were moderated by children's EC, but relations between time looking at emotional faces and indicators of social functioning, for the most part, were direct and not moderated by EC. In particular, time looking at angry faces (and low EC) predicted high levels of aggressive behaviors, whereas longer time looking at sad faces (and high EC) predicted higher social competence. Finally, latency to detect angry faces predicted aggressive behavior under conditions of average and low levels of EC. Findings are discussed in terms of the importance of differentiating between components of attention biases toward distinct negative emotions, and implications for attention training. (PsycINFO Database Record
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Affiliation(s)
| | | | - Scott P. Johnson
- Department of Psychology, University of California, Los Angeles, Los Angeles
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23
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Nozadi SS, White LK, Degnan KA, Fox NA. Longitudinal Relations between Behavioral Inhibition and Social Information Processing: Moderating Role of Maternal Supportive Reactions to Children's Emotions. Soc Dev 2018; 27:571-585. [PMID: 30147251 DOI: 10.1111/sode.12286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Utilizing multiple measures of interpretive biases, the current study examined the roles of toddlers' behavioral inhibition (BI) and maternal supportive reactions to children's negative emotions in relation to children's interpretive biases across middle to late childhood. Toddlers' BI was measured during several laboratory tasks (n = 248) at 2 and 3 years of age. Mothers reported on their reactions to children's negative emotional expressions when children were 7 years old (n = 203), and children's interpretations of social cues were assessed at 7 and 10 years of age (ns = 179 and 161, respectively). Toddlers with high levels of BI expressed less positivity towards social engagement with unfamiliar peers during discussion of ambiguous social situations. Further, children with high BI were less likely to attribute the cause of negative social situations to external factors, particularly when mothers were less accepting of children's negative emotional displays. Findings are discussed in terms of cognition related to the interpretation of ambiguous and threat-related social situations among temperamentally at-risk children.
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Abstract
The mediating and moderating roles of self-regulation in the associations of dispositional anger and fear to later conduct and anxiety symptoms were tested. Mothers and teachers rated children's anger and fear at 54 months (N = 191), and mothers reported on children's symptoms of anxiety and conduct disorders at 72 and 84 months (Ns = 169 and 144). Children's self-regulatory ability was assessed using the Tower of Hanoi task at 72 months. Children's self-regulation mediated the association between early dispositional fear and 84-month mother-reported anxiety disorder symptoms above and beyond the effects of earlier generalized anxiety symptoms. Children's anger directly predicted relatively high mother-reported conduct and anxiety disorder symptoms. Findings are discussed in terms of the importance of considering self-regulation as potential mechanism relating early childhood dispositional reactivity to later psychopathology symptoms.
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Affiliation(s)
- Sara S. Nozadi
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University
| | - Tracy L. Spinrad
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University
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Nozadi SS, Spinrad TL, Eisenberg N, Bolnick R, Eggum-Wilkens ND, Smith CL, Gaertner B, Kupfer A, Sallquist J. Prediction of toddlers' expressive language from maternal sensitivity and toddlers' anger expressions: a developmental perspective. Infant Behav Dev 2013; 36:650-61. [PMID: 23911594 DOI: 10.1016/j.infbeh.2013.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/08/2013] [Accepted: 06/07/2013] [Indexed: 11/16/2022]
Abstract
Despite evidence for the importance of individual differences in expressive language during toddlerhood in predicting later literacy skills, few researchers have examined individual and contextual factors related to language abilities across the toddler years. Furthermore, a gap remains in the literature about the extent to which the relations of negative emotions and parenting to language skills may differ for girls and boys. The purpose of this longitudinal study was to investigate the associations among maternal sensitivity, children's observed anger reactivity, and expressive language when children were 18 (T1; n = 247) and 30 (T2; n = 216) months. At each age, mothers reported on their toddlers' expressive language, and mothers' sensitive parenting behavior was observed during an unstructured free-play task. Toddlers' anger expressions were observed during an emotion-eliciting task. Using path modeling, results showed few relations at T1. At T2, maternal sensitivity was negatively related to anger, and in turn, anger was associated with lower language skills. However, moderation analyses showed that these findings were significant for boys but not for girls. In addition, T1 maternal sensitivity and anger positively predicted expressive language longitudinally for both sexes. Findings suggest that the relations between maternal sensitivity, anger reactivity and expressive language may vary depending on the child's developmental stage and sex.
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Affiliation(s)
- Sara S Nozadi
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, United States
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