What defines 'low birth weight' in Pacific infants born in New Zealand?

AIM

To report the combined and ethnic specific proportions of preterm and low birth weight (LBW) births, and average birth weights, for New Zealand's four major Pacific ethnic groups (Samoan, Tongan, Cook Island Māori, Niuean).

METHODS

Data were gathered from the Pacific Island Families Study (PIFS). Mothers of a cohort of 1398 Pacific infants born in South Auckland New Zealand (NZ) during 2000 were interviewed when their infants were 6 weeks old. Birth outcome data were obtained from hospital records on receipt of full informed consent.

RESULTS

Of the Pacific ethnic groups preterm rates ranged from 5.3% to 8.3% (7.3% overall), LBW rates ranged from 3.4% to 5.7% (4.0% overall), and average birth weight of full-term deliveries ranged from 3467 gm to 3751 gm (3664 gm overall). Cook Island and Niuean infants were significantly lighter than Samoan infants. Infants of Pacific born mothers were significantly heavier than infants born to NZ born Pacific mothers. There were no differences observed between infants of 'ethnically homogenous' parents compared 'ethnically heterogeneous' parents. The 10th percentile for all Pacific ethnic groups ranged from 2894 to 3065 grams.

CONCLUSION

These data reaffirm that infants of various Pacific ethnic groups are larger than other New Zealand infants. Furthermore, analyses of the PIFS cohort suggest that a LBW threshold for NZ born Pacific infants of 3000 grams may be more appropriate.

Prevalence and concordance of smoking among mothers and fathers within the Pacific Islands Families Study

Cigarette smoking continues to contribute to the adverse mortality and morbidity rates for Pacific people in New Zealand. Using a large cohort study of Pacific families, this paper investigates the prevalence of smoking amongst Pacific mothers and fathers over three time-points, up to six years after the arrival of their child, to determine the concordance of both partners' reports of that smoking. Moreover, the patterns of smoking between partners were investigated over the three major Pacific ethnicities that reside in New Zealand (Samoan, Tongan and Cook Island Māori). Maternal self-report prevalence of smoking estimates ranged from 29.8% (1-year) to 33.6% (6-years). Paternal self-reported prevalence of smoking estimates were higher, and ranged from 37.9% (2-years) to 45.2% (6-years). The prevalence estimates for smoking in both mothers and fathers over all three measurement waves were higher than the 26.9% reported for Pacific people in the 2006/07 New Zealand Health Survey. No significant change in fathers' smoking prevalence over time was observed (p = 0.37); however a significant increase in mothers' smoking prevalence over time was noted (p = 0.002). Significantly, for about 25% of Pacific children both their parents were current smokers. Reducing infant exposure to tobacco smoke, by encouraging parents to quit smoking or banning smoking in the home and local environment (such as vehicles), is likely to bring about improved health outcomes for many Pacific children. Findings suggest that the interaction between parents should be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation.

The evolution of family complexity from the perspective of nonmarital children

We document the incidence and evolution of family complexity from the perspective of children. Following a cohort of firstborn children whose mothers were not married at the time of their birth, we consider family structure changes over the first 10 years of the child's life-considering both full and half-siblings who are coresidential or who live in another household. We rely on detailed longitudinal administrative data from Wisconsin that include information on the timing of subsequent births to the mother and father, and detailed information on earnings, child support, and welfare. We find that 60% of firstborn children of unmarried mothers have at least one half-sibling by age 10. Our results highlight the importance of having fertility information for both fathers and mothers: estimates of the proportion of children with half-siblings would be qualitatively lower if we had fertility information on only one parent. Complex family structures are more likely for children of parents who are younger or who have low earnings and for those in larger urban areas. Children who have half-siblings on their mother's side are also more likely to have half-siblings on their father's side, and vice versa, contributing to very complex family structures-and potential child support arrangements-for some children.

Effect of pregnancy planning and fertility treatment on cognitive outcomes in children at ages 3 and 5: longitudinal cohort study

OBJECTIVE

To investigate how pregnancy planning, time to conception, and infertility treatment influence cognitive development at ages 3 and 5.

DESIGN

Prospective population based cohort study.

SETTING

Millennium Cohort Study in the United Kingdom.

PARTICIPANTS

18,818 children recruited at 9 months and followed up at 3 and 5 years. 11,790 singletons with available data on pregnancy, cognitive outcomes, and confounders were included in analyses at age 3 and 12,136 at age 5. Exposure measures Mothers reported whether the pregnancy was planned, and their feelings when first pregnant; those in whom the pregnancy was planned provided time to conception, and details of any assisted reproductive technologies. The population was divided into "unplanned" (unplanned and unhappy), "mistimed" (unplanned but happy), "planned" (planned, time to conception <12 months), "subfertile" (planned, time to conception ≥ 12 months), "induced ovulation" (received clomiphene citrate), and "assisted reproduction" (in vitro fertilisation or intracytoplasmic sperm injection). The "planned" group was the comparison group in all analyses.

OUTCOME MEASURES

Three components of the British Ability Scales (BAS II). Naming vocabulary assessed verbal ability at age 3; this test was repeated at age 5 with the picture similarities and pattern construction subscales, which measure non-verbal and spatial abilities.

RESULTS

In unadjusted analyses, the scores on all scales in children from unplanned pregnancies were significantly lower than in those from planned pregnancies-for example, the difference in mean verbal ability score at age 3 was -4.8 (95% confidence interval -6.0 to -3.7; P<0.05), equivalent to an average delay of four months. After adjustment for sociodemographic factors these differences were attenuated: -0.3 (-1.3 to 0.7), equivalent to no delay. Children born after assisted reproduction performed consistently better in verbal ability tests (3.8 (-0.2 to 7.9) at age 3 and 3.5 (0.2 to 6.8) at age 5), which suggests that on average these children are three to four months ahead; this difference did not completely disappear with adjustment for confounders. Children born after infertility treatment had lower mean scores in non-verbal tests (-1.2 (-4.1 to 1.6) after assisted reproduction and -1.5 (-3.5 to 0.4) after induced ovulation) and in spatial ability tests (-2.7 (-6.9 to 1.6) after assisted reproduction), though the differences were not significant.

CONCLUSIONS

Pregnancy planning, subfertility, or assisted reproduction do not adversely affect children's cognitive development at age 3 or 5. The differences observed in the unadjusted analyses are almost entirely explained by marked inequalities in socioeconomic circumstances between the groups.

[Contributions to the implementation of screening tests for assessing the neuropsychic development in children]

Currently, in Romania the general practitioner does not use screening tests to detect the developmental problems in children. That might be the reason why many cases are diagnosed too late.

AIM

To evaluate the impact and the usefulness of a screening tool for neurodevelopmental disorders in primary care.

MATERIAL AND METHODS

This trans-sequential study was carried out a on a series of 324 children under the age of 5 in the interval January 2007-December 2010. The neurodevelopmental status of the children was assessed by two methods: routine clinical assessment, and ASQ screening tools.

RESULTS

Compared to routine assessment, by which 33 children (10,2%) with development delays have been detected, the use of parent-addressed questionnaires raised the detection percentage to 12% (6 more children). The use of parent-addressed questionnaires also improved the doctor-patient communication, increased the degree of parental involvement in their child's development stimulation, especially with regard to the malfunctions in verbal and cognitive behavior.

CONCLUSIONS

The use of validated screening tests is a goal for improving the primary care practice.

Maternal smoking during pregnancy and offspring growth in childhood: 1993 and 2004 Pelotas cohort studies

OBJECTIVE

To explore the effects of maternal smoking during pregnancy on offspring growth using three approaches: (1) multiple adjustments for socioeconomic and parental factors, (2) maternal-paternal comparisons as a test of putative intrauterine effects and (3) comparisons between two birth cohort studies.

METHODS

Population-based birth cohort studies were carried out in Pelotas, Brazil, in 1993 and 2004. Cohort members were followed up at 3, 12, 24 and 48 months. Multiple linear regression analysis was used to examine the relationships between maternal and paternal prenatal smoking and offspring anthropometric indices. In the 2004 cohort, the association of smoking with trunk length, leg length and leg-to-sitting-height ratio at 48 months was also explored.

RESULTS

Maternal smoking during pregnancy was associated with reduced z scores of length/height-for-age at each follow-up in both cohorts and reduced leg length at 48 months in the 2004 cohort. Children older than 3 months born to smoking women showed a higher body mass index-for-age z score than children of non-smoking women.

CONCLUSIONS

The results of this study strongly support the hypothesis that maternal smoking during pregnancy impairs linear growth and promotes overweight in childhood.

Paternal contribution to small for gestational age babies: a multicenter prospective study

Our aims were to investigate whether men who fathered small for gestational age (SGA) infants themselves had lower birthweight, were more likely to be obese, have central adiposity and elevated blood pressure in adult life compared with men who fathered non-SGA infants. A total of 2,002 couples participating in the Screening for Pregnancy Endpoints (SCOPE) study were enrolled in early pregnancy and pregnancy outcome data collected prospectively. SGA was defined as birthweight <10th customized centile, obesity as BMI ≥30 kg/m(2), central adiposity as waist circumference >102 cm. Logistic regression was used to compare rates of obesity, and central adiposity between men who fathered SGA infants compared with those with non-SGA infants and the final model was adjusted for maternal and paternal confounders. The men who fathered an SGA infant (209 (10.4%)) themselves had lower mean birthweight (3,291 (530) g vs. 3,472 (584) g, P < 0.0001), were more likely to be obese (50 (24.8%) vs. 321 (18.3%), adjusted odds ratio (OR) 1.50, 95% confidence interval 1.05-2.16, adjusted for maternal and paternal factors) and to have central adiposity (52 (25.1%) vs. 341 (19.2%), adjusted OR 1.53, 95% confidence interval 1.06-2.20) compared with men who fathered a non-SGA infant. Elevated paternal blood pressure was not associated with SGA. In conclusion, we report a novel relationship between paternal obesity/central adiposity and birth of an SGA infant, which appears to be independent of maternal factors associated with fetal growth restriction.

Gender differences in filicide offense characteristics--a comprehensive register-based study of child murder in two European countries

OBJECTIVE

This study searched for gender differences in filicidal offense characteristics and associated variables.

METHODS

In this bi-national register-based study all filicide perpetrators (75 mothers and 45 fathers) and their crimes in Austria and Finland 1995-2005 were examined for putative gender differences. The assessed variables were associated with the offense characteristics, the offenders' socioeconomic and criminal history, and related stressful events.

RESULTS

Mothers had previously committed violent offenses less often than fathers (5% vs. 28%, p<0.001) and they were less often employed (27% vs. 49%, p<0.05). Mothers' victims were on average younger than those of fathers; median ages of the victims were 3.4 and 6.1 years, respectively (p<0.001). Fathers were more often intoxicated during the offense (11% vs. 42%, p<0.001) and also used shooting as the method of operation more often than mothers (5% vs. 27%, p<0.001). Mothers used drowning, criminal negligence, and poisoning more often than fathers. Fathers' motives were more impulsive in nature (13% vs. 41%, p<0.001). After the killing, mothers tried to get rid of the body more often than fathers (25% vs. 7%, p<0.05).

CONCLUSIONS

Fathers who commit filicide may represent at least two subgroups, the one not unlike the common homicide offender; the other, the overloaded, working and suicidal father. Mothers may include several types of offenders, one of which is the neonaticide offender. More detailed descriptions and, therefore, more research are needed.

PRACTICE IMPLICATIONS

Distressed parents and families need support and health care personnel, social work and other officials need to be alert to notice fatigued parents' signs of despair, especially when several stressful experiences amass. Straightforward enquiry to the situation and even practical and psychological help may be needed for enhanced protection of children. The role of employers should also be discussed in relation to the welfare of working parents.

Drug abuse and intimate partner violence: a comparative study of opioid-dependent fathers

Because very little is known about the coparenting relationships of drug-abusing men, this comparative study was designed to examine the lifetime prevalence and recent frequency of intimate partner violence in the coparenting relationships of 106 fathers enrolled in methadone maintenance treatment. When compared with 118 community controls, the opioid-dependent fathers reported greater prevalence of physical, sexual, and psychological aggression directed at the mother of their youngest biological child over the course of the relationship. They also reported more frequent physical, sexual, and psychological aggression directed at the mother during the previous year. Similarly, the opioid-dependent fathers reported both greater prevalence of physical and sexual aggression directed at them by the mother of their youngest child over the course of the relationship and more frequent sexual aggression directed at them over the previous year. The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.

Association between paternal smoking and nutritional status of under-five children attending Diarrhoeal Hospital, Dhaka, Bangladesh

AIM

The study aimed at determining whether there is an association between paternal smoking and nutritional status of children aged 0-59 months. Furthermore, the study looked at the presence of any nutritional differentials within different socio-economic groups.

METHODS

Secondary analysis of data on children aged 0-59 months enrolled in the Hospital Surveillance System of International Centre for Diarrhoeal Disease Research, Dhaka Hospital, Bangladesh, during 1996-2006.

RESULTS

Among 13,555 under-five children, fathers of 49% were smokers. In multivariate logistic regression models adjusting for potential confounders, fathers' smoking was significantly associated with increased risk of moderate underweight (OR 1.16, 95% CI 1.08-1.25), severe underweight (OR 1.15, 95% CI 1.06-1.26), moderate stunting (OR 1.15, 95% CI 1.06-1.23) and severe stunting (OR 1.13, 95% CI 1.03-1.25). In middle and lower socio-economic strata, risk of moderate and severe child malnutrition was found to be significantly increased in the group where the father was a smoker.

CONCLUSION

Results indicate that there is an association between fathers' smoking and malnutrition of under-five children particularly in lower socio-economic group. A possible mechanism - if this association is causal - may be through a negative effect on family economy.

Paternal psychosocial characteristics and corporal punishment of their 3-year-old children

This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the past month, 23% reported using CP once or twice, and 16% reported using CP a few times in the past month or more. In multivariate models controlling for important sociodemographic factors as well as characteristics of the child, fathers' parenting stress, major depression, heavy alcohol use, and drug use were significantly associated with greater use of CP, whereas involvement with the child and generalized anxiety disorder were not. Girls were less likely to be the recipient of CP than were boys, and child externalizing behavior problems but not internalizing behavior problems were associated with more CP.

Adolescent fathers involved with child protection: social workers speak

This study examined adolescent paternity through structured interviews with their social workers. It adds to the literature by exploring if there were young men involved with the child protection services (CPS) system who are fathers, identifying their unique needs, and beginning discussions on working with these young men. CPS social workers from six area offices and one juvenile detention facility completed surveys for each father on their caseload. A 3.5% rate of adolescent paternity was observed across these offices. Information about the nature of the young men's involvement with CPS, their involvement with their children, and their unique needs as fathers are provided. This paper also identifies some practice and policy implications for adolescent fathers and CPS charged with their care.

A care coordination program for substance-exposed newborns

The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by perinatal substance use. Findings from VIP-RI's final four years show that by 12 months, 86% of substance-exposed newborns had identified permanent placements and 77% were placed with biological parents or relatives.

The presence of a stepfather and child physical abuse, as reported by a sample of Brazilian mothers in Rio de Janeiro

OBJECTIVE

Substitute fathers are often reported to commit child abuse at higher rates than birth (i.e., putative genetic) fathers. Due to the paucity of studies, especially in developing countries, and to some conflicting results from developed countries regarding the identity of perpetrators of less extreme forms of physical abuse of children in stepfamilies, the aim of this study was to assess whether the presence of a stepfather would constitute a risk factor for violence against Brazilian children, as reported by their mothers.

METHODS

Three hundred eighty five women with a current male partner and a child aged 1-12 years were interviewed. Child physical abuse was assessed using the Conflict Tactic Scales Parent Child. Data were analyzed through multiple logistic regressions.

RESULTS

Physical abuse (including severe physical abuse) was reported for 34.0% of the children with stepfathers (N=54) versus 17.6% of those living with putative genetic fathers (N=331). When adjusted for income, education, ages, whether the child was the first born, number of siblings, number of people in the household, how much time the man spent with the child, how many years he resided with the mother, and alcohol abuse and drug use by the mother and her partner, the adjusted odds ratio was 2.7 (95% CI: 1.2-5.9) for stepfather households over 2 genetic parent households. Surprisingly, the elevated risk to stepchildren was due to alleged abuse by the interviewee herself rather than her partner.

CONCLUSION

Brazilian mothers professed to abuse their own children at substantially higher rates when their male partners were stepfathers to the focal child as compared to genetic fathers.

Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring

BACKGROUND

The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates.

METHOD

We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents.

RESULTS

Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous.

CONCLUSIONS

Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence.

Prevalence of childhood physical abuse in a representative sample of college students in Samsun, Turkey

The main objective of this article is to obtain the prevalence of childhood physical abuse experiences in college students.This cross-sectional study was performed on a gender-stratified random sample of 988 participants studying at Ondokuz Mayis University, with self-reported anonymous questionnaires. It included questions on physical abuse in childhood, on whom and why the violence was inflicted, and on the reactions exhibited. Of the 988 participants, 527 (53.3%) had a history of childhood physical abuse (64.0% in men and 41.6% in women). The prevalence of being subject to physical violence was 1.5 times higher in men. Mothers more frequently inflicted violence on daughters and fathers on sons. According to participants, most frequent reasons for physical violence were "loss of perpetrator's self-control" and "establishment of discipline at home." The most frequent statement observed among the participants was humiliation after subjection to physical violence. It is concluded that the first (and the most) important preventive measure is to protect and strengthen the social, economic, and judicial status of the Turkish family. Second, it should by all means be prevented that violence remains legal in some social conditions like child abuse.

Like father, like son: the intergenerational cycle of adolescent fatherhood

OBJECTIVES

Strong evidence exists to support an intergenerational cycle of adolescent fatherhood, yet such a cycle has not been studied. We examined whether paternal adolescent fatherhood (i.e., father of study participant was age 19 years or younger when his first child was born) and other factors derived from the ecological systems theory predicted participant adolescent fatherhood.

METHODS

Data included 1496 young males who were interviewed annually from the National Longitudinal Survey of Youth 1997. Cox regression survival analysis was used to determine the effect of paternal adolescent fatherhood on participant adolescent fatherhood.

RESULTS

Sons of adolescent fathers were 1.8 times more likely to become adolescent fathers than were sons of older fathers, after other risk factors were accounted for. Additionally, factors from each ecological domain-individual (delinquency), family (maternal education), peer (early adolescent dating), and environment (race/ethnicity, physical risk environment)-were independent predictors of adolescent fatherhood.

CONCLUSIONS

These findings support the need for pregnancy prevention interventions specifically designed for young males who may be at high risk for continuing this cycle. Interventions that address multiple levels of risk will likely be most successful at reducing pregnancies among partners of young men.

Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome

BACKGROUND

The study examined the profile of stress in mothers and fathers of preschool children with autism, Down syndrome and typically developing children. A further aim was to assess the association between parenting stress and coping style.

METHODS

A total of 162 parents were examined using Holroyd's 66-item short form of Questionnaire of Resources and Stress for Families with Chronically Ill or Handicapped Members and the Coping Inventory for Stressful Situations by Endler and Parker.

RESULTS AND CONCLUSIONS

The results indicated a higher level of stress in parents of children with autism. Additionally, an interaction effect was revealed between child diagnostic group and parent's gender for two scales of parenting stress: dependency and management and limits of family opportunities. Mothers of children with autism scored higher than fathers in parental stress; no such differences were found in the group of parents of children with Down syndrome and typically developing children. It was also found that parents of children with autism differed from parents of typically developing children in social diversion coping. Emotion-oriented coping was the predictor for parental stress in the samples of parents of children with autism and Down syndrome, and task-oriented coping was the predictor of parental stress in the sample of parents of typically developing children. The results strongly supported earlier findings on parenting stress in parents of children with autism. They also shed interesting light on the relationship between coping styles and parental stress.

Psychiatric family history and schizophrenia risk in Denmark: which mental disorders are relevant?

BACKGROUND

A family history of schizophrenia is the strongest single indicator of individual schizophrenia risk. Bipolar affective disorder and schizo-affective disorders have been documented to occur more frequently in parents and siblings of schizophrenia patients, but the familial occurrence of the broader range of mental illnesses and their role as confounders have not been studied in large population-based samples.

METHOD

All people born in Denmark between 1955 and 1991 (1.74 million) were followed for the development of schizophrenia (9324 cases) during 28 million person-years at risk. Information of schizophrenia in cohort members and psychiatric history in parents and siblings was established through linkage with the Danish Psychiatric Central Register. Data were analysed using log-linear Poisson regression.

RESULTS

Schizophrenia was, as expected, strongly associated with schizophrenia and related disorders among first-degree relatives. However, almost any other psychiatric disorder among first-degree relatives increased the individual's risk of schizophrenia. The population attributable risk associated with psychiatric family history in general was 27.1% whereas family histories including schizophrenia only accounted for 6.0%. The general psychiatric family history was a confounder of the association between schizophrenia and urbanization of place of birth.

CONCLUSIONS

Clinically diagnosed schizophrenia is associated with a much broader range of mental disorders in first-degree relatives than previously reported. This may suggest risk haplotypes shared across many disorders and/or shared environmental factors clustering in families. Failure to take the broad range of psychiatric family history into account may bias results of all risk-factor studies of schizophrenia.

Predictors of coping in parents of children with an intellectual disability: comparison between Lebanese mothers and fathers

This cross-sectional study was designed to assess the predictors of coping behaviors of 147 Lebanese parents (101 mothers and 46 fathers) with a child with intellectual disability. It assessed the contribution of child's and parent's characteristics, informal social support, and stress on the coping behaviors of fathers and mothers. Multiple regression analysis confirmed that the father's education, informal social support, and stress were the best predictors of coping. The child's age, severity of illness, and parental health did not significantly contribute to predicting coping behaviors. Contrary to expectations in a Middle Eastern culture, both fathers and mothers reported similar levels of stress, perceived informal social support, and coping. Although informal social support cannot be forced on parents, health professionals can mobilize resources that are culturally sensitive, such as home visitation by nurses or support from other parents. This may especially be beneficial in developing countries with limited resources.

Parental socioeconomic status and unintentional injury deaths in early childhood: consideration of injury mechanisms, age at death, and gender

The aim of this study was to determine whether the socioeconomic status (SES) of parents influences early childhood unintentional injury deaths for different injury mechanisms and the gender and age at death of the child. Study design is a population-based retrospective study. Death certificate data from 1995 to 2004 were linked to birth certificate data from 1995 to 1996 for each child who died when aged < or = 8 years. Parental age, birth order, marital status, residence area, educational level, and occupation were used as indices for SES. Cox proportional-hazards analysis was employed. Our results indicate that nonmetropolitan residence, low parental education level, and a father working in a nonadministrative job or as a farmer were associated with a higher risk of death from injury for both boys and girls. A mother aged younger than 20 years and parents working in manual jobs were associated with a higher risk in boys only. The risks of some socioeconomic factors (low parental education and a father working in a manual job or as a farmer) were evident for children aged 1-4 years. The risks of rural residency tended to increase in older children, and the risk of injury from having a mother aged younger than 20 years increased for younger children. The risks of childhood injury deaths from traffic accidents, falls, and fire/burns were associated with the SES of the parents. Younger parents were associated with higher risks of injury deaths from traffic accidents (hazard ratio [HR]: father, 7.9; mother, 1.9) and falls (HR: father, 2.0; mother, 2.5). A father working as a farmer was associated with a higher risk of childhood injury death from fire/burns (HR = 4.0). In conclusion, the parental SES risk profiles of childhood injury deaths varied with the age and gender of the child, and with the injury mechanism. Therefore, reducing excess injury deaths during early childhood requires preventive efforts targeted at high-risk parents, and based on injury mechanism and on the gender and age of the child.

Maternal and paternal filicides: a retrospective review of filicides in Finland

The purpose of this retrospective study was to illustrate the differences in maternal and paternal filicides in Finland during a 25-year period. In the sample of 200 filicides [neonaticides (n = 56), filicide-suicides (n = 75), other filicides (n = 69)], the incidence was 5.09 deaths per 100,000 live births: 59 percent of filicides were committed by mothers, 39 percent by fathers, and 2 percent by stepfathers. The mean age of the maternal victims (1.6 y) was significantly lower than that of the paternal victims (5.6 y), but no correlation between the sex of the victim and the sex of the perpetrator was found, and the number of female and male victims was equal. The sample of other filicides (n = 65) was studied more closely by forensic psychiatric examination and review of collateral files. Filicidal mothers showed mental distress and often had psychosocial stressors of marital discord and lack of support. They often killed for altruistic reasons and in association with suicide. Maternal perpetrators also dominated in filicide cases in which death was caused by a single episode or recurrent episodes of battering. Psychosis and psychotic depression were diagnosed in 51 percent of the maternal perpetrators, and 76 percent of the mothers were deemed not responsible for their actions by reason of insanity. Paternal perpetrators, on the other hand, were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent toward their mates. In 18 percent of the cases, they were not held responsible for their actions by reason of insanity. During childhood, most of the perpetrators had endured emotional abuse from their parents or guardians, some of whom also engaged in alcohol abuse and domestic violence. The purpose of this study was to examine the differences between maternal and paternal filicides in a sample of 200 cases in Finland. This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a discussion of the influence of diagnoses on decisions regarding criminal responsibility.

The association between BMI and mortality using offspring BMI as an indicator of own BMI: large intergenerational mortality study

OBJECTIVES

To obtain valid estimates of the association between body mass index (BMI) and mortality by using offspring BMI as an instrumental variable for own BMI.

DESIGN

Cohort study based on record linkage, with 50 years of follow-up for mortality. Associations of offspring BMI with all cause and cause specific maternal and paternal mortality were estimated as hazard ratios per standard deviation of offspring BMI.

SETTING

A large intergenerational prospective population based database covering the general population of Sweden.

PARTICIPANTS

More than one million Swedish parent-son pairs.

RESULTS

The final dataset analysed contained information on 1 018 012 mother-son pairs (122 677 maternal deaths) and 1 004 617 father-son pairs (242 126 paternal deaths). For some causes of death, the patterns of associations between offspring BMI and mortality were similar to those seen for own BMI and mortality in previous studies. Parental mortality from diabetes, coronary heart disease, and kidney cancer had the strongest positive associations with offspring BMI (for example, hazard ratio (HR) for coronary heart disease per standard deviation increase in offspring BMI for mothers 1.15, 95% CI 1.14 to 1.17 and for fathers 1.10, 1.09 to 1.11). However, in contrast to the inverse association of own BMI with lung cancer and respiratory disease mortality seen in other studies, there was a positive association between offspring BMI and lung cancer mortality in mothers (1.12, 1.09 to 1.15) and fathers (1.03, 1.02 to 1.05) and between offspring BMI and respiratory mortality in mothers (1.05, 1.02 to 1.08) and fathers (1.02, 1.00 to 1.04). Associations of own BMI and offspring BMI with all cause, cardiovascular disease related, and non-cardiovascular disease related mortality were compared in a subset of father-son pairs (n=72 815). When offspring BMI was used as an instrumental variable for paternal BMI, the causal association between BMI and paternal cardiovascular disease mortality (HR per standard deviation of BMI 1.82, 95% CI 1.17 to 2.83) was stronger than that indicated by the directly observed association between own BMI and cardiovascular disease mortality (1.45, 1.31 to 1.61).

CONCLUSIONS

Use of offspring BMI as a predictor of own BMI, a technique that avoids problems of reverse causality, suggests that positive associations of BMI with all cause and cardiovascular mortality may be underestimated in conventional observational studies. Use of offspring BMI instead of own BMI in analyses of respiratory disease and lung cancer mortality, for which previous studies have reported consistent and strong inverse associations with own BMI, suggests that such studies have overstated the apparent adverse consequences of lower BMI with respect to these outcomes.

The association of early IQ and education with mortality: 65 year longitudinal study in Malmö, Sweden

OBJECTIVES

To establish whether differences in early IQ explain why people with longer education live longer, or whether differences in father's or own educational attainment explain why people with higher early IQ live longer.

DESIGN

Population based longitudinal study. Mortality risks were estimated with Cox proportional hazards regressions.

SETTING

Malmö, Sweden.

PARTICIPANTS

1530 children who took IQ tests at age 10 and were followed up until age 75.

RESULTS

Own educational attainment was negatively associated with all cause mortality in both sexes, even when early IQ and father's education were adjusted for (hazard ratio (HR) for each additional year in school 0.91 (95% CI 0.85 to 0.97) for men and HR 0.88 (95 % CI 0.78 to 0.98) for women). Higher early IQ was linked with a reduced mortality risk in men, even when own educational attainment and father's education were adjusted for (HR for one standard deviation increase in IQ 0.85 (95 % CI 0.75 to 0.96)). In contrast, there was no crude effect of early IQ for women, and women with above average IQ had an increased mortality risk when own educational attainment was adjusted for, but only after the age of 60 (HR 1.60 (95 % CI 1.06 to 2.42)). Adding measures of social career over and above educational attainment to the model (for example, occupational status at age 36 and number of children) only marginally affected the hazard ratio for women with above average IQ (<5%).

CONCLUSIONS

Mortality differences by own educational attainment were not explained by early IQ. Childhood IQ was independently linked, albeit differently, to male adult mortality and to female adult mortality even when father's education and own educational attainment was adjusted for, thus social background and own social career seem unlikely to be responsible for mortality differences by childhood IQ. The clear difference in the effect of IQ between men and women suggests that the link between IQ and mortality involves the social and physical environment rather than simply being a marker of a healthy body to begin with. Cognitive skills should, therefore, be addressed in our efforts to create childhood environments that promote health.

Childhood motor coordination and adult schizophrenia spectrum disorders

OBJECTIVE

The authors examined whether motor coordination difficulties assessed in childhood predict later adult schizophrenia spectrum outcomes.

METHOD

A standardized childhood neurological examination was administered to a sample of 265 Danish children in 1972, when participants were 10-13 years old. Adult diagnostic information was available for 244 members of the sample. Participants fell into three groups: children whose mothers or fathers had a psychiatric hospital diagnosis of schizophrenia (N=94); children who had at least one parent with a psychiatric record of hospitalization for a nonpsychotic disorder (N=84); and children with no parental records of psychiatric hospitalization (N=66). Psychiatric outcomes of the offspring were assessed through psychiatric interviews in 1992 when participants were 31-33 years of age, as well as through a scan of national psychiatric registers completed in May 2007.

RESULTS

Children who later developed a schizophrenia spectrum disorder (N=32) displayed significantly higher scores on a scale of coordination deficits compared with those who did not develop a mental illness in this category (N=133).

CONCLUSIONS

Results from this study provide further support for the neurodevelopmental hypothesis of schizophrenia and underscore the potential role of cerebellar and/or basal ganglia abnormalities in the etiology and pathophysiology of schizophrenia.

Focusing on young men: developing integrated services for young fathers

While some girls cope well as teenage mothers and often have a range of support services, young fathers do not often access services in their own right. This paper reviews literature about services for young men from the time they become sexually active. Through the use of a case study, it then asks questions about the type and nature of services required by young fathers. Health and social care practitioners may identify critical points in the life of a young father and offer appropriate services and 'joined-up' intervention, thereby facilitating long- and short-term involvement in the life of the child.

Fathers, physical child abuse, and neglect: advancing the knowledge base

Fathers are overrepresented as perpetrators of physical child maltreatment, particularly in its most severe forms. Despite this, the research literature continues to lack specificity regarding the role fathers play in risk for physical child abuse or neglect (PCAN). Furthermore, although fathers have received more attention with respect to child sexual abuse and its treatment, their influence has been largely disregarded in many intervention efforts to reduce PCAN. Inadequate attention to the role of fathers, both in research and practice, has numerous problematic implications for the prevention of child maltreatment. The goal of this special issue is to disseminate new research that examines fathers' roles by focusing on multiple fathering factors that may directly and indirectly shape both maternal and paternal risk of engaging in PCAN. In the introduction to the special issue, we highlight key questions in the research literature and present our perspective on how the articles included in this special issue address some of these gaps.

Mothers, men, and child protective services involvement

This study used data on 2,297 families from the Fragile Families and Child Wellbeing Study to examine whether Child Protective Services (CPS) involvement varies by maternal relationship status. Families were categorized according to whether the mother was living with a (male) partner or spouse, was involved in a dating relationship, or was not romantically involved. Families in which the mother was romantically involved were further delineated by whether her partner was the biological father of none, some, or all of the children in her household. Results indicated that families in which the mother was living with a man who was not the biological father of all children and those in which she was not romantically involved were significantly more likely to be contacted by CPS than those in which she was living with the biological father of all resident children. These findings withstood the inclusion of detailed controls for the mother's characteristics and behaviors and (in two-parent families) her partner's characteristics and behaviors, suggesting that they are not fully explained by observable social selection factors.

Fathers and maternal risk for physical child abuse

This study set out to examine father-related factors predicting maternal physical child abuse risk in a national birth cohort of 1,480 families. In-home and phone interviews were conducted with mothers when index children were 3 years old. Predictor variables included the mother-father relationship status; father demographic, economic, and psychosocial variables; and key background factors. Outcome variables included both observed and self-reported proxies of maternal physical child abuse risk. At the bivariate level, mothers married to fathers were at lower risk for most indicators of maternal physical child abuse. However, after accounting for specific fathering factors and controlling for background variables, multivariate analyses indicated that marriage washed out as a protective factor, and on two of three indicators was linked with greater maternal physical abuse risk. Regarding fathering factors linked with risk, fathers' higher educational attainment and their positive involvement with their children most discernibly predicted lower maternal physical child abuse risk. Fathers' economic factors played no observable role in mothers' risk for physical child maltreatment. Such multivariate findings suggest that marriage per se does not appear to be a protective factor for maternal physical child abuse and rather it may serve as a proxy for other father-related protective factors.

Family structure and fathers' well-being: trajectories of mental health and self-rated health

The association between marital status and health among men has been well documented, but few studies track health trajectories following family structure transitions among unmarried fathers. Using the Fragile Families and Child Wellbeing Study this article examines trajectories of paternal mental health and self-rated health, focusing on transitions into and out of residential relationships with the child's biological mother or a new partner during a five-year post-birth period (N = 4,331). Continuously married fathers report higher time-specific self-rated health and fewer mental health problems than continuously single fathers, controlling for underlying health trajectories. The disparity, however does not increase over time, providing little support for the marital resource model during these years. Static group differences suggest that resources fathers carry with them into unions may buffer them from the negative effects of union dissolution. The implications of these findings for cohabitation, as well as selection and causation arguments, are also discussed.

Do we see eye to eye? Chinese mothers' and fathers' parenting beliefs and values for toddlers in Canada and China

This study explores maternal and paternal parenting practices (authoritative or authoritarian) and parental values and goals for toddlers among Chinese mothers and fathers in Canada and China. The participants included 126 families of 1-year-old toddlers (67 Chinese Canadians and 59 mainland Chinese). The findings revealed that Chinese Canadian parents were more supportive of authoritative practices, and Chinese parents were more likely to support authoritarian practices. Between mothers and fathers, gender differences were found within countries. Interparental agreement for parenting beliefs varied by infant gender and country. For parental values, parents generally endorsed self-confidence as the most important trait for their toddlers. Endorsement of other traits (collectivistic and individualistic) varied in importance. Links among parenting beliefs and desired personality traits for their children were also explored.

Qualitative analysis of dermatoglyphics of the digito-palmar complex in children with severe recessive perceptively impaired hearing

The possible hereditary indicated differences in the ascending family tree was investigated in children with severe recessive perceptively impaired hearing, their parents, and healthy controls, using qualitative analysis of dermatoglyphics of the digito-palmar complex. The chi2 test was performed and biological distance was investigated by means according to Hiernaux Ag methods, and presented using Ward's method for the examined groups. The results show that the healthy control group differs from the groups of boys and girls with impaired hearing and also from their fathers mostly in palmar variables. The mothers were biologically more distant from the examined groups of patients, and more similar to the control group of randomly selected healthy female controls. The results indicate polygenic inheritance of sporadic sensoneurial hearing loss.

The role of mothers' and fathers' adrenocortical reactivity in spillover between interparental conflict and parenting practices

Guided by the affective spillover hypothesis, the present study examined the mediational role of parental adrenocortical reactivity to interparental conflict in explaining associations between interparental conflict and subsequent changes in mothers' and fathers' parenting practices over a 2-year period in a sample of 202 parents and their 6-year-old children. Results of autoregressive path models indicated that marital withdrawal was associated with increases in adrenocortical reactivity to conflict for mothers but not fathers. Furthermore, elevated adrenocortical reactivity in turn predicted greater psychologically controlling parenting practices and inconsistent discipline over time for mothers, but was not associated with changes in maternal warmth. Implications for clinicians and therapists working with maritally distressed parents and families are discussed.

Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders

Screening for postnatal mood disorders in English-speaking women often uses the validated cut-off score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) to detect probable major depression. Increasingly there is evidence that for many women, and men, anxiety disorders can occur postnatally in the absence of depression. This study therefore examined data on the three EPDS items frequently found to cluster together on an anxiety factor for women (items 3, 4, and 5: EPDS-3A), to determine the optimum cut-off score to screen for specified anxiety disorders. A sample of 238 women and 218 men were administered a diagnostic interview for anxiety and depressive disorders, and completed the EPDS, at 6 weeks postpartum. The receiver operating characteristics show that the optimum cut-off score on the EPDS-3A for women is 6 or more (possible range: 0-9), and for men it is 4 or more, though it appears that the factor structure for men is different than for women. The conclusion is that the EPDS can be used to screen for probable depression in women (using the validated total cut-off score of 13 or more) and also probable anxiety (using the EPDS-3A cut-off score of 6 or more). For men there is already a validated total cut-off score for both depression and anxiety (6 or more)--however, if services are not using this, they can use the EPDS-3A score of 4 or more to screen for probable anxiety disorders in fathers, though further work needs to be undertaken to clarify whether the anxiety factor structure for men is different to that found for women.

Mental health well-being amongst fathers within the Pacific Island Families Study

This article investigates the prevalence of potential psychological disorder amongst a cohort of primarily Pacific fathers in New Zealand over their child's first 6-years of life. The analysis is based on data collected at 12-months, 2-years and 6-years postpartum during the Pacific Islands Families Study, and uses the 12-item General Health Questionnaire (GHQ12) to assess the prevalence of psychological distress amongst participant fathers at each measurement wave. Various sociodemographic and potentially confounding variables were also investigated to determine their effect on the risk of developing potential mental health disorder. The majority of fathers within the study reported good overall health and well-being and their prevalence of 'symptomatic' disorder was initially low at 12-months (3.90%) but increased significantly at 2-years (6.6%) and at 6-years (9.80%) in crude and adjusted analyses (both P-values < 0.001). In the adjusted analysis, the odds of symptomatic cases at 2-years was 1.7 (95% confidence interval: 1.1, 2.8) times that observed at 12-months postpartum and at 6-years the odds was 3.2 (95% confidence interval: 1.9, 5.2) times that observed at 12-months. Moreover in the adjusted analysis, smoking status, marital status, employment status, and ethnicity, were all significantly associated with the risk of developing symptomatic mental health disorder

Hypermasculinity, intimate partner violence, sexual aggression, social support, and child maltreatment risk in urban, heterosexual fathers taking parenting classes

This study examines the relationships between hypermasculinity, sexual aggression, intimate partner violence, social support, and child maltreatment risk among heterosexual fathers completing parenting classes. Hypermasculinity scores were found to be significant predictors of study participants' reported verbal, physical, and sexual aggression toward their intimate partners. Only lack of social support, operationalized as the reported frequency of participants' conversations with friends, relatives, or neighbors about their problems, was found to be a significant predictor of child maltreatment risk. Alcohol frequency, education, and monthly income were not found to be unique, significant predictors of any dependent variables. Implications for clinical practice and research as well as limitations to the current study are discussed.

Association of criminal convictions between family members: effects of siblings, fathers and mothers

BACKGROUND

Crime runs in families. Previous research has shown the existence of intergenerational transmission of criminal behaviour.

AIM

The aim of the present study was to investigate the extent to which variation in criminal convictions may be explained by the criminality of siblings and by the intergenerational transmission of criminal behaviour.

METHOD

Data from the Dutch Criminal Career and Life-course Study (CCLS) were used to analyse cross-tabulations and to conduct multi-level logistic regression analyses.

RESULTS

The results indicate that criminal convictions of other family members are indeed correlated with individual conviction risk. The criminal history of siblings is most strongly correlated with the convictions of focal respondents. Results furthermore show that parental convictions only account modestly for the association of criminal convictions between siblings.

CONCLUSIONS

These findings indicate that a direct influence between siblings is plausible, providing support for learning or imitation theories.

Intergenerational continuity in convictions: a five-generation study

BACKGROUND

Intergenerational continuity in offending has been assessed in several studies. However, this has rarely been studied using more than two prospective generations. Also, within-gender and cross-gender effects have rarely been addressed. The evidence for mechanisms that may explain transmission is mixed.

METHOD

Using conviction data on five generations (n = 6322) that span the years 1882-2007, transmission from parent to child was studied, disaggregating for males and females. Parental conviction before the birth of the child was studied separately from parental conviction after the birth of the child. Transmission was studied using odds ratios.

RESULTS

Parental convictions increase the risk of offspring convictions, although the risk increase is, at around two on average, not extremely high. Delinquency by the mother was also associated with offspring criminality, although because of low prevalence the odds ratios were more variable. Parental delinquency before birth does not lead to increased risk. For serious delinquency, these findings were stronger.

CONCLUSIONS

The study suggests that nurture rather than hereditary or labelling mechanisms may play a role in intergenerational continuity.

Paternal race/ethnicity and birth outcomes

OBJECTIVES

I sought to identify whether there were associations between paternal race/ethnicity and birth outcomes among infants with parents of same- and mixed-races/ethnicities.

METHODS

Using the National Center for Health Statistics 2001 linked birth and infant death file, I compared birth outcomes of infants of White mothers and fathers of different races/ethnicities by matching and weighting racial/ethnic groups following a propensity scoring approach so other characteristics were distributed identically. I applied the same analysis to infants of Black parents and infants with a Black mother and White father.

RESULTS

Variation in risk factors and outcomes was found in infants of White mothers by paternal race/ethnicity. After propensity score weighting, the disparities in outcomes by paternal or parental race/ethnicity could be largely attributed to nonracial parental characteristics. Infants whose paternal race/ethnicity was unreported on their birth certificates had the worst outcomes.

CONCLUSIONS

The use of maternal race/ethnicity to refer to infant race/ethnicity in research is problematic. The effects of maternal race/ethnicity on birth outcomes are estimated to be much larger than that of paternal race/ethnicity after I controlled for all covariates. Not listing a father on the birth certificate had a strong association with outcomes, which might be a source of bias in existing data and a marker for identifying infants at risk.

Very high birth weight of offspring is associated with an increased risk of leukemia in their mothers: results of a population-based cohort study

Although the association between birth weight and childhood leukemia is well described, the relation between a child's birth weight and parental risk of leukemia is unknown. We linked data from the Jerusalem Perinatal Study to the Israel Cancer Registry to ascertain the incidence of leukemia in mothers and fathers in relation to their offspring's birth weight. Birth weight >or=4500 g in any of the offspring was associated with a >3-fold risk of leukemia in mothers, but not fathers. Potential mechanisms include shared exposures of high birth weight infants and their mothers, possibly to radiation or growth factors, or genetic pathways leading to both high birth weight and leukemia.

The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: a registry study of Swedish mothers and fathers

BACKGROUND

In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work.

METHODS

The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978-1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981-2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks.

RESULTS

The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time.

CONCLUSION

A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

Risk factors for paternal physical child abuse

OBJECTIVE

This study uses the developmental-ecological framework to examine a comprehensive set of paternal factors hypothesized to be linked to risk for paternal child abuse (PCA) among a diverse sample of fathers. Attention was given to fathers' marital status and their race/ethnicity (White, African American, and Hispanic).

METHODS

Interviews were conducted with 1257 married or cohabiting biological fathers who participated in the Fragile Families and Child Wellbeing Study. PCA was assessed when the index children were 3 years old. Analyses included a comprehensive set of self-reported paternal variables as well as controls for maternal variables linked to child maltreatment. PCA was measured using proxy variables: two questions assessing the frequency of spanking in the past month and Parent-Child Conflict Tactics Scales (CTS-PC) [Straus, M., Hamby, S., Finkelhor, D., Moore, D., & Runyan, D. (1998). Identification of child maltreatment with the parent-child conflict tactics scales: Development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22, 249-270] psychological and physical aggression subscales.

RESULTS

Bivariate results indicated that Hispanic fathers were the least likely to spank or engage in psychological or physical aggression. Multiple regression analyses indicated that paternal employment and earnings were not significantly associated with PCA. Compared to cohabiting African American fathers, married African American fathers were found to be at greater risk for some forms of PCA. This pattern was not found for White or Hispanic families.

CONCLUSIONS

In this diverse sample of involved, biological fathers, there appear to be multiple potential risk-heightening pathways that vary across race/ethnic groups. With the proper control variables, paternal employment and earnings may not be as directly linked to fathers' physical abuse risk as has been previously thought.

PRACTICE IMPLICATIONS

There is a need for interventions within the child welfare system that better promote family wellbeing by including fathers in services. Patterns linking paternal socio-demographic and psychosocial factors to psychological and physical child abuse varied as a function of paternal race/ethnicity, indicating that race/ethnic differences are among the important factors that intervention efforts should take into account.

Maternal type 1 diabetes reduces the risk of islet autoantibodies: relationships with birthweight and maternal HbA(1c)

AIMS/HYPOTHESIS

The risk of type 1 diabetes is reduced in the children of mothers with type 1 diabetes compared with children of fathers with type 1 diabetes. We asked whether children of mothers with type 1 diabetes also have a decreased risk of developing islet autoantibodies, and which factors associated with maternal diabetes contribute to a reduced islet autoantibody risk in offspring.

METHODS

Singleton offspring of a mother (n = 1,008) or father with type 1 diabetes (n = 578) from the BABYDIAB study were included. Children were followed from birth for the development of islet autoantibodies defined as two or more autoantibodies to insulin, glutamic acid decarboxylase or insulinoma antigen 2 in two or more blood samples.

RESULTS

Islet autoantibody risk was lower in children of mothers with type 1 diabetes (5 year risk, 3.2% vs 5.7% in children of fathers with type 1 diabetes; p = 0.04). Among factors that differed between pregnancies from mothers with and without type 1 diabetes, birthweight was associated with islet autoantibody risk. Risk was reduced in children with birthweights in the lower (adjusted HR 0.33; 95% CI 0.14-0.75; p = 0.009) and upper (HR 0.45; 95% CI 0.21-0.97; p = 0.04) tertiles compared with the middle tertile. A sub-analysis of maternal HbA(1c) suggested that moderately elevated third trimester maternal HbA(1c) was also associated with a reduced islet autoantibody risk in children of mothers with type 1 diabetes (5.7-7%; HR 0.38; 95% CI 0.15-0.96; p = 0.04 vs children of mothers with HbA(1c) < 5.7%).

CONCLUSIONS/INTERPRETATION

The risk of islet autoimmunity is modified by maternally influenced events such as birthweight.

Disaggregating the distal, proximal, and time-varying effects of parent alcoholism on children's internalizing symptoms

We tested whether children show greater internalizing symptoms when their parents are actively abusing alcohol. In an integrative data analysis, we combined observations over ages 2 through 17 from two longitudinal studies of children of alcoholic parents and matched controls recruited from the community. Using a mixed modeling approach, we tested whether children showed elevated mother- and child-reported internalizing symptoms (a) at the same time that parents showed alcohol-related consequences (time-varying effects), (b) if parents showed greater alcohol-related consequences during the study period (proximal effects), and (c) if parents had a lifetime diagnosis of alcoholism that predated the study period (distal effects). No support for time-varying effects was found; proximal effects of mothers' alcohol-related consequences on child-reported internalizing symptoms were found and distal effects of mother and father alcoholism predicted greater internalizing symptoms among children of alcoholic parents. Implications for the time-embedded relations between parent alcoholism and children's internalizing symptoms are discussed.

Depression and common mental disorders in lone parents: results of the 2000 National Psychiatric Morbidity Survey

BACKGROUND

Lone mothers experience higher rates of psychiatric morbidity, while rates in lone fathers have never been studied. We aimed to determine the relative contributions of financial strain and decreased social support to the excess of depression and common mental disorders (CMD) in lone parents.

METHOD

We investigated whether parent status (lone parent, partnered parent, others) was associated with psychiatric morbidity measured using the revised Clinical Interview Schedule, after controlling for self-reported financial strain (income and debt) and social support.

RESULTS

Lone mothers were twice as likely to have a CMD (OR 1.8, 95% CI 1.4-2.3) as other women. This was not significant after controlling for financial strain or social support. Lone fathers were nearly four times more likely to have a CMD than other men (OR 3.9, 95% CI 2.3-6.8), and this risk remained undiminished by controlling for age, income, debt and levels of social support.

CONCLUSION

Debt management would be a rational strategy to reduce psychiatric morbidity in lone mothers. More studies are needed to inform prevention strategies in lone fathers.

Familial patterns of preterm delivery: maternal and fetal contributions

Women who deliver preterm (<37 completed weeks' gestation) are at high risk for recurrence. This has prompted exploration of candidate genes (both maternal and fetal) associated with preterm delivery. Epidemiologists can use recurrence patterns of preterm delivery across generations to assess the relative contributions of maternal and fetal genes. The authors used data from the Medical Birth Registry of Norway (1967-2004) to identify 191,282 mothers and 127,830 fathers who subsequently had at least one singleton offspring. The authors stratified parents according to whether or not they had been born preterm and calculated the risk of preterm delivery among their firstborn. Mothers born preterm had a relative risk for preterm delivery of 1.54 (95% confidence interval (CI): 1.42, 1.67). This association was weaker for fathers born preterm (relative risk (RR) = 1.12, 95% CI: 1.01, 1.25). Among early preterm births (<35 weeks), the effect became stronger for mothers (RR = 1.85, 95% CI: 1.52, 2.27) and weaker for fathers (RR = 1.06, 95% CI: 0.77, 1.44). These data suggest that paternal genes have little, if any, effect on preterm delivery risk. This argues against major contributions of fetal genes inherited from either parent. The increased risk of preterm delivery among mothers born preterm is consistent with heritable maternal phenotypes that confer a propensity to deliver preterm.