Estimating the Roles of Genetic Risk, Perinatal Risk, and Marital Hostility on Early Childhood Adjustment: Medical Records and Self-Reports

COVID-19 and the adequacy of antenatal care among Indigenous women: A retrospective crossover analysis

BACKGROUND

Often marginalized and disadvantaged by systems of oppression, Indigenous populations commonly face significant barriers to accessing adequate antenatal care (ANC). The COVID-19 pandemic had an unprecedented impact on healthcare systems worldwide, including on the provision of antenatal care; this was especially so for Indigenous communities in many regions. As such, our study aimed to estimate the association between the COVID-19 pandemic and adequate ANC received by Indigenous women in Chiapas, Mexico.

METHODS

We conducted a retrospective crossover analysis with data collected between June and December 2021 from Indigenous women who attended at least one ANC appointment at one of two health centers in San Cristóbal de las Casas, Chiapas. We used a multinomial logistic regression model considering the time frame (before and during the pandemic) as the primary independent variable. Adequate antenatal care comprised four dimensions: attendance by qualified personnel, timely first visit, sufficient frequency of visits, and adequacy of the content provided during the visits.

RESULTS

During the COVID-19 pandemic, there was a significant drop in ANC adequacy, with 12.7% (95% CI: 8.3, 18.9) of Indigenous women receiving ANC, compared with the pre-pandemic rate of 52.5% (95% CI: 44.7, 60.3), among the 158 participants. The pandemic resulted in a reduction of 75.8% in the adequacy of ANC. Considering the four dimensions of adequacy, we found that having only one dimension was associated with a relative risk ratio (RRR) of 12.45 (95% CI: 6.40, 24.23), while having two or three dimensions was associated with a RRR of 5.23 (95% CI: 2.83, 9.65) when using adequate ANC as the category of reference.

CONCLUSIONS

According to our results, Indigenous women's ANC adequacy was negatively affected by the COVID-19 pandemic. In light of these findings, we emphasize the importance of developing healthcare systems that are prepared to adapt consultation schemes by implementing virtual visits and incorporating community health workers.

Interactions Between Genetic, Prenatal Substance Use, Puberty, and Parenting are Less Important for Understanding Adolescents' Internalizing, Externalizing, and Substance Use than Developmental Cascades in Multifactorial Models

This study tested interactions among puberty-related genetic risk, prenatal substance use, harsh discipline, and pubertal timing for the severity and directionality (i.e., differentiation) of externalizing and internalizing problems and adolescent substance use. This is a companion paper to Marceau et al. (2021) which examined the same influences in developmental cascade models. Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (n = 4504 White boys, n = 4287 White girls assessed from the prenatal period through 18.5 years). We hypothesized generally that later predictors would strengthen the influence of puberty-related genetic risk, prenatal substance use exposure, and pubertal risk on psychopathology and substance use (two-way interactions), and that later predictors would strengthen the interactions of earlier influences on psychopathology and substance use (three-way interactions). Interactions were sparse. Although all fourteen interactions showed that later influences can exacerbate or trigger the effects of earlier ones, they often were not in the expected direction. The most robust moderator was parental discipline, and differing and synergistic effects of biological and socially-relevant aspects of puberty were found. In all, the influences examined here operate more robustly in developmental cascades than in interaction with each other for the development of psychopathology and transitions to substance use.

Examination of promotive and protective effects on early adolescent prosocial behavior through a bioecological lens

Introduction

Prosocial behavior during childhood has been associated with numerous positive developmental and behavioral outcomes in adolescence and adulthood. Prosocial behavior, which includes cooperation and helping others, develops within a bioecological context. Considering it through such a lens enhances the understanding of the roles of different bioecological factors in its development.

Methods

Using data from a longitudinal study of adopted children and children reared with their biological parents, this paper examined if positive aspects of a child's bioecological system at age 7 predict prosocial behavior in early adolescence (age 11), and whether these bioecological factors could offset risk due to biological family psychopathology and/or maternal prenatal substance use. The analyses incorporated variables from different levels of Bronfenbrenner's bioecological model (the individual, microsystem, exosystem, and macrosystem) and examined the promotive, and potentially protective, effect of each contextual factor, while also considering their interplay with biological family psychopathology and prenatal substance use.

Results

Results from linear regression models indicated that the microsystem variable of parental warmth at age 7 had a promotive effect on age 11 prosocial behavior. Further, in addition to its main effect, parental warmth was protective against maternal substance use during pregnancy when children were raised with their biological parent (s). Household type (biological family) and biological family internalizing psychopathology were the only other significant predictors in the model, with each associated with lower prosocial behavior at age 11.

Discussion

Study results extend prior work on the benefits of parental warmth on child outcomes by employing a strength-based, bioecological approach to the development of prosocial behavior during early adolescence and examining "for whom" the effects of parental warmth are most protective.

Assessment of Psychosocial and Neonatal Risk Factors for Trajectories of Behavioral Dysregulation Among Young Children From 18 to 72 Months of Age

Importance

Emotional and behavioral dysregulation during early childhood are associated with severe psychiatric, behavioral, and cognitive disorders through adulthood. Identifying the earliest antecedents of persisting emotional and behavioral dysregulation can inform risk detection practices and targeted interventions to promote adaptive developmental trajectories among at-risk children.

Objective

To characterize children's emotional and behavioral regulation trajectories and examine risk factors associated with persisting dysregulation across early childhood.

Design, Setting, and Participants

This cohort study examined data from 20 United States cohorts participating in Environmental influences on Child Health Outcomes, which included 3934 mother-child pairs (singleton births) from 1990 to 2019. Statistical analysis was performed from January to August 2022.

Exposures

Standardized self-reports and medical data ascertained maternal, child, and environmental characteristics, including prenatal substance exposures, preterm birth, and multiple psychosocial adversities.

Main Outcomes and Measures

Child Behavior Checklist caregiver reports at 18 to 72 months of age, with Dysregulation Profile (CBCL-DP = sum of anxiety/depression, attention, and aggression).

Results

The sample included 3934 mother-child pairs studied at 18 to 72 months. Among the mothers, 718 (18.7%) were Hispanic, 275 (7.2%) were non-Hispanic Asian, 1220 (31.8%) were non-Hispanic Black, 1412 (36.9%) were non-Hispanic White; 3501 (89.7%) were at least 21 years of age at delivery. Among the children, 2093 (53.2%) were male, 1178 of 2143 with Psychosocial Adversity Index [PAI] data (55.0%) experienced multiple psychosocial adversities, 1148 (29.2%) were exposed prenatally to at least 1 psychoactive substance, and 3066 (80.2%) were term-born (≥37 weeks' gestation). Growth mixture modeling characterized a 3-class CBCL-DP trajectory model: high and increasing (2.3% [n = 89]), borderline and stable (12.3% [n = 479]), and low and decreasing (85.6% [n = 3366]). Children in high and borderline dysregulation trajectories had more prevalent maternal psychological challenges (29.4%-50.0%). Multinomial logistic regression analyses indicated that children born preterm were more likely to be in the high dysregulation trajectory (adjusted odds ratio [aOR], 2.76; 95% CI, 2.08-3.65; P < .001) or borderline dysregulation trajectory (aOR, 1.36; 95% CI, 1.06-1.76; P = .02) vs low dysregulation trajectory. High vs low dysregulation trajectories were less prevalent for girls compared with boys (aOR, 0.60; 95% CI, 0.36-1.01; P = .05) and children with lower PAI (aOR, 1.94; 95% CI, 1.51-2.49; P < .001). Combined increases in PAI and prenatal substance exposures were associated with increased odds of high vs borderline dysregulation (aOR, 1.28; 95% CI, 1.08-1.53; P = .006) and decreased odds of low vs high dysregulation (aOR, 0.77; 95% CI, 0.64-0.92; P = .005).

Conclusions and Relevance

In this cohort study of behavioral dysregulation trajectories, associations were found with early risk factors. These findings may inform screening and diagnostic practices for addressing observed precursors of persisting dysregulation as they emerge among at-risk children.

Reliability of prospective and retrospective maternal reports of prenatal experiences

BACKGROUND

Extant perinatal research utilizes retrospective reports on the prenatal environment, but there are limited data on the validity of retrospective data compared with prospective data. The current study examined the reliability of birth mothers' memory of prenatal stress and distress and perinatal risks at 6-months postpartum with maternal reports gathered across each trimester of pregnancy and explored whether recall varied with maternal socioeconomic status.

METHODS

Surveys were collected from 34 pregnant women (M age = 29.14, SD = 5.06 years, 83% non-Hispanic White) on stress, distress, and pregnancy complications at 12(T1), 26(T2), and 38(T3) weeks of pregnancy, and at 6-month post-partum asking the same questions but specifically about the pregnancy. Cohen's kappa and Pearson's correlations were used to investigate maternal recall at post-partum with prospective reports at T1, T2, T3 and an average score of T1, T2, and T3. Correlations were also examined separately for those with high and relatively lower socioeconomic status.

RESULTS

Birth mothers' recall was generally reliable. Retrospective reports were most strongly related to prospective reports in T1 for perceived stress, T1 and T3 for anxiety symptoms and exposure to toxins, but T3 for depressive symptoms. Recall of pregnancy complications best reflected the average score across trimesters (rather than specific trimesters). Women with higher socioeconomic status better recalled prenatal (di)stress, but women with relatively lower socioeconomic status better recalled exposure to toxins.

CONCLUSION

This study provides support for utilizing retrospective reports of maternal prenatal experiences at 6-months post-partum, with implications for interpretation of specific recalled phenotypes.

Family interactions in toddlerhood influence social competence in preschool age: Accounting for genetic and prenatal influences

Identification of early promotive and risk factors for social competence is important for fostering children's successful social development; particularly given social competence is essential for children's later academic and psychological well-being. While research suggests that the early parent-child relationship, genetics, and prenatal influences are associated with social competence, there is less research considering how these factors may operate together to shape children's social competence in early childhood. Using a genetically informed sample from the Early Growth and Development Study (N = 561), we examined multiple levels of influence (i.e., genetic, prenatal, parenting, and child characteristics) on children's social competence at 4.5 years old. Results from structural equation models showed adoptive mother overreactivity at 18 months was positively associated with child dysregulation at 27 months, which, in turn, was associated with lower levels of social competence at 4.5 years. Also, child reactivity at 18 months was independently associated with higher levels of adoptive mother overreactivity at 27 months, which, in turn, was associated with lower levels of social competence at 4.5 years. Finally, we found an evocative effect on adoptive fathers' overreactivity at 18 months such that prenatal birth mother distress was negatively associated with adoptive fathers' overreactivity at 18 months. Overall, this study found evidence for genetic influences, and bidirectional associations between parent and child in toddlerhood that are related to lower levels of social competence when children were 4.5 years old. We also found that the prenatal environment was associated with parenting, but not with child behavior directly. This study's ability to simultaneously examine multiple domains of influence helps provide a more comprehensive picture of important mechanisms and developmental periods for children's early social competence.

Prenatal programming of developmental trajectories for obesity risk and early pubertal timing

The thrifty phenotype and fetal overnutrition hypotheses are two developmental hypotheses that originated from the developmental origins of health and disease (DOHaD) perspective. The DOHaD posits that exposures experienced prenatally and early in life may influence health outcomes through altering form and function of internal organs related to metabolic processes. Obesity risk and early pubertal timing might be influenced by similar mechanisms. The thrifty phenotype hypothesis is primarily characterized by experiencing a deprivation of nutrients during gestation paired with an energy rich postnatal environment. The fetal overnutrition hypothesis says that obesity experienced prenatally will be associated with increased lifetime risk of obesity in the offspring. Both hypotheses were tested by examining developmental pathways from genetic and prenatal risk through early growth trajectories (birth to 7 years) to pubertal timing at age 11 years. Participants included 361 children adopted at birth (57% male; 57% non-Hispanic White, 11% Black, 9% Hispanic; adoptive family income Mdn = $70,000-$100,000, birth family income Mdn = < $15,000). Associations between boys' childhood body mass index (BMI) and pubertal timing were confounded by genetics, prenatal risk, and early growth. The thrifty phenotype hypothesis was partially supported for boys' childhood BMI (at ages 4 to 7 years). Both hypotheses were partially supported for girls' childhood BMI but not pubertal timing. A novel Gene × Prenatal Risk interaction showed that genetic risk predicted girls' childhood BMI most strongly at adequate compared with at excessive levels of gestational weight gain. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining Research Domain Criteria (RDoC) constructs for anger expression and regulation in toddlers

The present study is focused on anger expression and regulation within the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) construct of Frustrative Nonreward. Although previous studies have examined associations between child anger regulation and expression, these studies do not directly address the dynamic processes involved in Frustrative Nonreward using microlongitudinal methods. The current study used data from 561 adopted children, their adoptive parents, and birth parents and aimed to address gaps in the literature by examining: (a) temporal associations between anger expression during a frustrating situation, and behaviors thought to regulate emotions (e.g., attempt-to-escape, support-seeking, distraction, and focus-on-restraint) on a microlongitudinal scale during an arm restraint task assessed at 27 months; (b) birth parent externalizing problems and overreactive parenting by adoptive parents as predictors of child anger expression and moderators of the moment-to-moment associations estimated in Step 1; and (c) longitudinal associations (linear vs. quadratic) between anger expressions and externalizing behaviors at 4.5 years. Findings indicated that children's attempt-to-escape and support-seeking predicted an increase in anger expression in the following 3-s interval, whereas distraction and focus-on-restraint were not associated with changes in anger expression. Furthermore, we found that birth parents' externalizing problems were significantly associated with child anger expression, suggesting heritable influences. Anger expression showed a U-shaped longitudinal association with paternal report of externalizing behaviors at 4.5 years. Taken together, the findings emphasize the significance of integrating microlongitudinal analysis approaches into the RDoC framework, helping to advance our understanding of dynamic processes underlying reactions to Frustrative Nonreward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Generalist genes and specialist environments for adolescent internalizing and externalizing problems: A test of severity and directionality

The generalist genes specialist environment model, when applied to developmental psychopathology, predicts that genetic influences should explain variance that is shared across internalizing and externalizing problems, whereas environmental influences should explain variance that distinguishes the two overarching problem types. The present study is a direct test of this hypothesis, leveraging a sample of 708 twins and siblings (aged 10-18 years, 93% White) from the United States. Measures of severity of symptoms, regardless of type, and of directionality of symptoms - whether the adolescent tended to exhibit more externalizing or internalizing problems - were subjected to genetic (A), shared environmental (C), and nonshared environmental (E) (ACE) variance decompositions. As expected, severity of problems was under substantial genetic influence, but there were also significant shared and nonshared environmental influences. Contrary to the generalist genes specialist environment model, directionality of problem type was also under considerable genetic influence, with modest nonshared environmental influence. Findings corroborate existing evidence from other designs highlighting the role of familial influences (including generalist genes) in comorbidity of adolescent internalizing and externalizing problems, but suggest that the specialist environments hypothesis may not be the key factor in distinguishing problem type.

Prenatal origins of suicide mortality: A prospective cohort study in the United States

Most suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9-17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26-3.93), White race (HR = 2.14, CI = 1.63-2.83), low parental education (HR = 2.23, CI = 1.38-3.62), manual parental occupation (HR = 1.38, CI = 1.05-1.82), being a younger sibling (HR = 1.52, CI = 1.10-2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08-5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99-1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.

Early Parenting Stress Links Obstetric Complications and Child Psychopathology in Middle Childhood in an At-Risk Sample

OBJECTIVE

Obstetric complications (OCs) are adverse events during pregnancy, birth, or immediately after birth. Evidence on cumulative OC and longitudinal associations with child psychopathology is sparse. Prospective studies testing mediating pathways such as parenting stress are needed. This study aimed to investigate the impact of OC on child psychopathology in middle childhood and to highlight whether and which type of parenting stress specifically mediates this association.

METHODS

We investigated n = 54 mother-child dyads from 5 months to 8 years of age. Child psychopathology at 8 years and parenting stress at 12 months were assessed using the Child Behavior Checklist (CBCL) and the Parenting Stress Index. OCs were evaluated by the Steinhausen Questionnaire and through access to official pregnancy records at the 5-month visit. Half of the mothers had experienced early-life maltreatment (ELM), assessed with the Childhood Trauma Questionnaire.

RESULTS

There was a significant indirect effect of maternal parenting stress at 12 months mediating the association between OC and child psychopathology at 8 years (β = 0.26; p < 0.01; 95% [0.35-1.83]). A significant proportion of 35% of CBCL-variance was explained. The significant effect remained even when maternal ELM and maternal psychological distress were controlled for. On the subscale level, only the "Difficult Child" subscale was a significant mediator.

CONCLUSION

Our findings suggest that parenting stress should be targeted to prevent adverse effects of OC on child psychopathology. More research focusing on families subjected to OC is needed to highlight how maternal parenting stress and child regulatory functioning interact to affect child development longitudinally.

Interactions between Genetic, Prenatal, Cortisol, and Parenting Influences on Adolescent Substance Use and Frequency: A TRAILS Study

INTRODUCTION

Dynamic relations between genetic, hormone, and pre- and postnatal environments are theorized as critically important for adolescent substance use but are rarely tested in multifactorial models. This study assessed the impact of interactions of genetic risk and cortisol reactivity with prenatal and parenting influences on both any and frequency of adolescent substance use.

METHODS

Data are from the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective longitudinal, multi-rater study of 2,230 Dutch adolescents. Genetic risk was assessed via 3 substance-specific polygenic scores. Mothers retrospectively reported prenatal risk when adolescents were 11 years old. Adolescents rated their parents' warmth and hostility at age 11. Salivary cortisol reactivity was measured in response to a social stress task at age 16. Adolescents' self-reported cigarette, alcohol, and cannabis use frequency at age 16.

RESULTS

A multivariate hurdle regression model showed that polygenic risk for smoking, alcohol, and cannabis predicted any use of each substance, respectively, but predicted more frequent use only for smoking. Blunted cortisol reactivity predicted any use and more frequent use for all 3 outcomes. There were 2 interactions: blunted cortisol reactivity exacerbated the association of polygenic risk with any smoking and the association of prenatal risk with any alcohol use.

CONCLUSION

Polygenic risk seems of importance for early use but less so for frequency of use, whereas blunted cortisol reactivity was correlated with both. Blunted cortisol reactivity may also catalyze early risks for substance use, though to a limited degree. Gene-environment interactions play no role in the context of this multifactorial model.

Developmental Cascades from Polygenic and Prenatal Substance Use to Adolescent Substance Use: Leveraging Severity and Directionality of Externalizing and Internalizing Problems to Understand Pubertal and Harsh Discipline-Related Risk

The current study leveraged the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (n = 4504 White boys, n = 4287 White girls assessed from the prenatal period through 18.5 years of age) to test a developmental cascade from genetic and prenatal substance use through pubertal timing and parenting to the severity of (regardless of type) and directionality (i.e., differentiation) of externalizing and internalizing problems to adolescent substance use. Limited associations of early pubertal timing with substance use outcomes were only observable via symptom directionality, differently for girls and boys. For boys, more severe exposure to prenatal substance use influenced adolescent substance use progression via differentiation towards relatively more pure externalizing problems, but in girls the associations were largely direct. Severity and especially directionality (i.e., differentiation towards relatively more pure externalizing problems) were key intermediaries in developmental cascades from parental harsh discipline with substance use progressions for girls and boys.

Exploring Links Between Prenatal Adversity and Adolescent Psychiatric Risk in a Canadian Population-Based Sample

OBJECTIVE

Adverse prenatal and postnatal exposures may have long-lasting effects on health and development. However, it remains unclear whether being exposed to a greater number of prenatal adversities affects mental health risk. The current study examined whether exposure to maternal health problems prenatally is associated with an increasing risk of psychiatric morbidity in adolescents.

METHODS

Using data from the 2014 Ontario Child Health Study (OCHS), we examined associations between a count of 7 prenatal risk factors (maternal hypertension, diabetes mellitus, bleeding during pregnancy, influenza, urinary tract infection, thyroid disease, and depression/anxiety) and adolescent psychiatric morbidity. Adolescents (N = 2219) aged 12 to 17 years were assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents.

RESULTS

Exposure to each additional prenatal adversity was correlated with increased odds of attention-deficit/hyperactivity disorder (odds ratio [OR] = 1.29, 95% confidence interval [CI] = 1.03-1.60), generalized anxiety disorder (OR = 1.27, 95% CI = 1.05-1.55), and social anxiety disorder (OR = 1.35, 95% CI = 1.01-1.80) after adjustment for confounding variables.

CONCLUSION

Exposure to prenatal adversity in the form of maternal health problems was correlated with an increased risk of attention deficit hyperactivity disorder and anxiety disorders in adolescence. Future studies should further investigate the effects of antenatal environmental exposures on these associations to determine the potential value of close monitoring of those exposed to prenatal risks.

Psychopathology Symptoms are Associated with Prenatal Health Practices in Pregnant Women with Heavy Smoking Levels

PURPOSE

Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy.

METHODS

Birth mothers from an adoption study (N = 912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum.

RESULTS

One-quarter of participants (N = 222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β =  - .14, p = .03) and depressive symptoms (β =  - .17, p = .03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β = .12, p = .01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers. CONCLUSIONS FOR PRACTICE: Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.

Maternal Consistency in Recalling Prenatal Experiences at 6 Months and 8 Years Postnatal

OBJECTIVE

Mothers are known to be reliable reporters of smoking during pregnancy, type of delivery, and birth weight when compared with medical records. Few studies have considered whether the timing of retrospective collection affects the mother's retrospective self-report. We examined the consistency of maternal retrospective recall of prenatal experiences, behaviors, and basic birth outcomes between 6 months and 8 years postpartum.

METHOD

We examined 117 mothers (62% White, 44% living in a committed relationship, median high school education) from the Early Growth and Development Study (EGDS). EGDS is a longitudinal adoption study that includes birth mothers of children born between 2003 and 2009 who were involved in a domestic adoption. Using the modified life history calendar and a pregnancy screener, mothers reported on their prenatal health behaviors, prenatal substance use, and labor and delivery at 6 months and 8 years postpartum. Cohen κ was calculated to examine consistency, and χ tests were used to test differences by parity and maternal education.

RESULTS

Mothers' recall was very good for recall of the type of delivery and good for smoking during pregnancy, medicine used for labor induction, and specific medical problems (i.e., pre-eclampsia, sexually transmitted infections, and kidney infections). Recall consistency was poor for illicit drug use, specific prenatal tests performed (i.e., amniocentesis and emergency room visits), and using drugs other than an epidural during delivery.

CONCLUSION

This study provides support for using retrospective collection of maternal self-report on some prenatal experiences up to 8 years postpartum and offers a potential way to more accurately collect self-reported prenatal experiences.

Hair cortisol moderates the association between obstetric complications and child wellbeing

Obstetric complications (OC) may have implications for later health outcomes. However, there is a lack of research examining the association between OC and behavior problems or quality of life (HRQoL). We aimed to close this gap and further investigate functioning of the hypothalamus-pituitary-adrenal (HPA)-axis as a potential physiological vulnerability moderating the association between OC and behavior problems and HRQoL. We investigated 232 mothers and their five to 12-year-old children. Presence of OC during the pre-, peri-, and postnatal phases was determined by interviewing mothers. Children's behavior problems (CBCL, TRF) and HRQoL (Kidscreen rated by mothers and children) were assessed. Children gave 3 cm strands of hair for analysis of hair cortisol (HC). Structural equation modeling analyses with a latent variable of child outcome ("distress"), OC as predictor and HC as a potential moderator were conducted. OC significantly predicted distress (β = .33, p < .01). The model showed a good fit to the data: χ2(14)=15.66, p < .33, CFI=.99, TLI=.99, RMSEA=.02, 90 %CI [.00, .06], SRMR=.04. In addition, HC moderated the association between OC and distress (β=-.32, p < .01). The moderation model also showed a good fit: χ2(14) =7.13, p = .93, CFI=1.00, TLI=1.06, RMSEA=.00, 90 %CI [.00, .02], SRMR=.03. Results indicated that the association between OC and distress was significant only when children had low HC-levels. This was also the case for both externalizing and internalizing behavior problems. Our results underline the notion of OC as a risk factor for child behavior problems and wellbeing and point to an important role of the children's physiological set-up such as HPA-functioning.

The Effect of Smoking during Pregnancy on Severity and Directionality of Externalizing and Internalizing Symptoms: A Genetically Informed Approach

The objective was to examine the association between maternal smoking during pregnancy (SDP) and (I) severity and (II) directionality of externalizing and internalizing symptoms in a sample of sibling pairs while rigorously controlling for familial confounds. The Missouri Mothers and Their Children Study is a family study (N = 173 families) with sibling pairs (aged 7 to 16 years) who are discordant for exposure to SDP. This sibling comparison study is designed to disentangle the effects of SDP from familial confounds. An SDP severity score was created for each child using a combination of SDP indicators (timing, duration, and amount). Principal component analysis of externalizing and internalizing behavior, assessed with the Child Behavior Checklist and Teacher Report Form, was used to create symptom severity and directionality scores. The variance in severity and directionality scores was primarily a function of differences between siblings (71% and 85%, respectively) rather than differences across families (29% and 15%, respectively). The severity score that combines externalizing and internalizing symptom severity was not associated with SDP. However, a significant within-family effect of SDP on symptom directionality (b = 0.07, p = 0.04) was observed in the sibling comparison model. The positive directionality score indicates that SDP is associated with differentiation of symptoms towards externalizing rather than internalizing symptoms after controlling for familial confounds with a sibling comparison model. This supports a potentially causal relationship between SDP and externalizing behavior.

Child Effects on Parental Negativity: The Role of Heritable and Prenatal Factors

This study examined two possible mechanisms, evocative gene-environment correlation and prenatal factors, in accounting for child effects on parental negativity. Participants included 561 children adopted at birth, and their adoptive parents and birth parents within a prospective longitudinal adoption study. Findings indicated child effects on parental negativity, such that toddlers' negative reactivity at 18 months was positively associated with adoptive parents' over-reactive and hostile parenting at 27 months. Furthermore, we found that child effects on parental negativity were partially due to heritable (e.g., birth mother [BM] internalizing problems and substance use) and prenatal factors (e.g., BM illicit drug use during pregnancy) that influence children's negative reactivity at 18 months. This study provides critical evidence for "child on parent" effects.

Using an adoption design to test genetically based differences in risk for child behavior problems in response to home environmental influences

Differential susceptibility theory (DST) posits that individuals differ in their developmental plasticity: some children are highly responsive to both environmental adversity and support, while others are less affected. According to this theory, "plasticity" genes that confer risk for psychopathology in adverse environments may promote superior functioning in supportive environments. We tested DST using a broad measure of child genetic liability (based on birth parent psychopathology), adoptive home environmental variables (e.g., marital warmth, parenting stress, and internalizing symptoms), and measures of child externalizing problems (n = 337) and social competence (n = 330) in 54-month-old adopted children from the Early Growth and Development Study. This adoption design is useful for examining DST because children are placed at birth or shortly thereafter with nongenetically related adoptive parents, naturally disentangling heritable and postnatal environmental effects. We conducted a series of multivariable regression analyses that included Gene × Environment interaction terms and found little evidence of DST; rather, interactions varied depending on the environmental factor of interest, in both significance and shape. Our mixed findings suggest further investigation of DST is warranted before tailoring screening and intervention recommendations to children based on their genetic liability or "sensitivity."

The Intergenerational Transmission of Early Educational Advantages: New Results Based on an Adoption Design

Sociological research has traditionally emphasized the importance of post-birth factors (i.e., social, economic, and cultural capital) in the intergenerational transmission of educational advantages, to the neglect of potentially consequential pre-birth endowments (e.g., heritable traits) that are passed from parent to child. In this study, we leverage an experiment of nurture-children who were adopted at birth into nonrelative families-in an effort to simultaneously model the effects associated with both pathways. To do so, we fit a series of simple linear regression models that relate the academic achievement of adopted children to the educational attainments of their adoptive and biological parents, using U.S. data from a recent nationwide sample of birth and adoptive families (the Early Growth and Development Study). Because our dataset includes both "genetic" and "environmental" relatives, but not "genetic-and-environmental" relatives, the separate contributions of each pathway can be identified, as well as possible interactions between the two. Our results show that children's early achievements are influenced not only by the attainments of their adoptive parents, but also the attainments of their birth parents-suggesting the presence of environmental and genetically mediated effects. Supplementary analyses provide little evidence of effect moderation, using both distal and proximate measures of the childhood environment to model gene-by-environment interactions. These findings are robust to a variety of parameterizations, withstand a series of auxiliary checks, and remain intact even after controlling for intrauterine exposures and other measurable variables that could compromise our design. The implications of our results for theory and research in the stratification literature, and for those interested in educational mobility, are discussed.

Perinatal complications are associated with social anxiety: Indirect effects through temperament

The current investigation examines the relation between perinatal complications and social anxiety incorporating the potential indirect effect of child temperament. Participants were 149 children 9 to 12 years of age (M_age=9.97, SD_age=1.00) screened for behavioral inhibition (BI) and assessed for social anxiety symptoms using parent- and child-report. Participating families also reported on the presence of perinatal complications. Results indicated that children who experienced perinatal complications were higher in BI and social anxiety, compared to children who did not experience complications. Furthermore, there was an indirect effect between perinatal complications and social anxiety via BI. These findings provide further support for the established relation between perinatal complications and anxiety and demonstrate, for the first time, that this relation may be mediated by temperament, setting the stage for longitudinal analyses.

The Early Growth and Development Study: A Dual-Family Adoption Study from Birth Through Adolescence

The Early Growth and Development Study (EGDS) is a prospective adoption study of birth parents, adoptive parents and adopted children (n = 561 adoptees). The original sample has been expanded to include siblings of the EGDS adoptees who were reared by the birth mother and assessed beginning at age 7 years (n = 217 biological children), and additional siblings in both the birth and adoptive family homes, recruited when the adoptees were 8-15 years old (n = 823). The overall study aims are to examine how family, peer and contextual processes affect child and adolescent adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Adoptive and birth parents were originally recruited through adoption agencies located throughout the USA following the birth of a child. Assessments are ongoing and occurred in 9 month's intervals until the adoptees turned 3 years of age, and in 1 to 2 year intervals thereafter through age 15. Data collection includes the following primary constructs: child temperament, behavior problems, mental health, peer relations, executive functioning, school performance and health; birth and adoptive parent personality characteristics, mental health, health, context, substance use, parenting and marital relations; and the prenatal environment. Findings highlight the power of the adoption design to detect environmental influences on child development and provide evidence of complex interactions and correlations between genetic, prenatal environmental and postnatal environmental influences on a range of child outcomes. The study sample, procedures and an overview of findings are summarized and ongoing assessment activities are described.

Parenting and prenatal risk as moderators of genetic influences on conduct problems during middle childhood

This study examines interactions of heritable influences, prenatal substance use, and postnatal parental warmth and hostility on the development of conduct problems in middle childhood for boys and girls. Participants are 561 linked families, collected in 2 cohorts, including birth parents, adoptive parents, and adopted children. Heritable influences on internalizing and externalizing (including substance use) problems were derived from birth mothers' and fathers' symptoms, diagnoses, and age of onset from diagnostic interviews, and the proportion of first-degree relatives with the same type of problems. Smoking during pregnancy (SDP) and alcohol use during pregnancy were assessed retrospectively from birth mothers at 5 months postpartum. Earlier externalizing problems and parental warmth and hostility and were assessed at 1 assessment prior to the outcome (Cohort II: 4.5 years; Cohort I: 7 years). Conduct problems were symptoms from a diagnostic interview assessed at age 6 (Cohort II) or 8 (Cohort I). Findings from regression analyses suggest that (a) SDP plays an important role for the development of conduct problems, (b) some relatively well-accepted effects (e.g., parental hostility) were less important when simultaneously considering multiple factors influencing the development of conduct problems, and (c) main effects of genetic risk and SDP, and interactions among genetic risk and postnatal warmth, SDP and postnatal warmth, and genetic risk, SDP, and postnatal hostility for conduct problems were important for boys' but not girls' conduct problems. Replication is needed, but the current results provide preliminary but empirically grounded hypotheses for future research testing complex developmental models of conduct problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Importance of the Prenatal Environment in Behavioral Genetics: Introduction to Special Issue

We introduce and discuss a special issue on prenatal factors in genetics research, that includes 14 papers ranging from studies on chorionicity, smoking during pregnancy, and more general prenatal risks to papers about theory, methods and measurement. There are two review papers, one focused on chorioncity and the second on pre- and perinatal ischemia-hypoxia, that help to frame the state of research in these areas with a focus on the relevance across multiple fields of study. Taken together, these papers clearly demonstrate the importance of considering prenatal environment influences on functioning in offspring across the lifespan while also underscoring the importance of using genetically informed designs as a means to clarify causality.