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Shinohara S, Shinohara R, Kojima R, Otawa S, Kushima M, Miyake K, Yui H, Ooka T, Akiyama Y, Horiuchi S, Yokomichi H, Yamagata Z. Neonatal transfer and duration of hospitalization of newborns as potential risk factors for impaired mother-infant bonding: The Japan Environment and Children's Study. J Affect Disord 2024; 360:314-321. [PMID: 38838787 DOI: 10.1016/j.jad.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 04/19/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Currently, there is no consensus regarding the relationship between neonatal transfer and duration of hospitalization in cases of impaired mother-infant bonding (MIB). This study aimed to determine whether neonatal transfer and duration of hospitalization of newborns increase the risk for impaired MIB. METHODS The MIB Scale was used to assess impaired MIB 1 year after delivery, using data from the Japan Environment and Children's Study. A score ≥ 5 points indicated impaired MIB. Multiple logistic regression analyses were performed to estimate the association between neonatal transfer and duration of hospitalization of newborns with the risk of impaired MIB. RESULTS A total of 66,402 pregnant women were included in the study. The overall incidence rate of impaired MIB was 11.2 %. The mean duration of hospitalization of newborns was 7.1 ± 6.4 days. After adjusting for potential confounders, neonatal transfer (adjusted odd ratio (OR): 1.13 [95 % confidence interval (CI)), 1.01-1.27]) and duration of hospitalization of newborns (adjusted OR 1.007; 95 % CI 1.003-1.010) were associated with impaired MIB. The area under the receiver operating characteristic curve for the duration of hospitalization of newborns for impaired MIB was 0.53. LIMITATIONS Maternal childhood abuse and neglect history were not evaluated, and information regarding whether the infants were admitted to the neonatal intensive care unit was unavailable. CONCLUSIONS Japanese women whose newborns underwent neonatal transfer should be followed up for at least 1 year after delivery, regardless of the duration of hospitalization of newborns.
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Affiliation(s)
- Satoshi Shinohara
- Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi 400-8506, Japan.
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Reiji Kojima
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Kunio Miyake
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hideki Yui
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Tadao Ooka
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Sayaka Horiuchi
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Zentaro Yamagata
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan; Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
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Nakić Radoš S, Hairston I, Handelzalts JE. The concept analysis of parent-infant bonding during pregnancy and infancy: a systematic review and meta-synthesis. J Reprod Infant Psychol 2024; 42:142-165. [PMID: 36588501 DOI: 10.1080/02646838.2022.2162487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/20/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Despite the emerging body of literature on mother-to-infant bonding and the associated variables, there are various definitions of bonding construct. Also, there is a lack of a comprehensive conceptual framework of antecedents and consequences of bonding that would guide empirical work. OBJECTIVE Aim of the study was to provide a systematic review and synthesis of concept analysis studies on maternal-foetal, mother-infant, or father-infant bonding. METHOD A systematic search was performed in PubMed, EBSCOHost (including PsycINFO), ProQuest, and CINAHL. In addition, a hand search was conducted. Papers were eligible for inclusion if they conducted concept analyses on mother or father to foetus/infant bonding. A qualitative meta-synthesis was applied to synthesise the findings. RESULTS Eight papers on concept analyses were eligible for inclusion. In meta-synthesis, six aspects of parent-to-(unborn) child bonding emerged, including direction, domain, process, timing, endurance, and parental gender. Defining attributes are (i) a close relationship, (ii) filled with positive parental affection, (iii) manifested during pregnancy as monitoring foetal development and behaviour and after childbirth in proximity and interaction. Antecedents, affecting factors, and consequences of the parent-child bonding have been summarised. CONCLUSION Parent-infant bonding refers to an emotional, behavioural, cognitive, and neurobiological tie of the parent to the (unborn) child, as a process from intention to have a child throughout infancy. This is a parental-driven process which can continue to evolve throughout child's and parent's life, characterised as enduring, committed, and engaged. Based on meta-synthesis, a conceptual structure of parent-infant bonding has been provided, which needs further empirical testing.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Ilana Hairston
- Tel-Hai Academic College, Tel-Hai, Israel
- The Institute of Information Processing and Decision Making (IIPDM), Haifa University, Haifa, Israel
| | - Jonathan Eliyahu Handelzalts
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Ortega LA, Aragon-Carvajal DM, Cortes-Corso KT, Forero-Castillo F. Early developmental risks for tobacco addiction: A probabilistic epigenesis framework. Neurosci Biobehav Rev 2024; 156:105499. [PMID: 38056543 DOI: 10.1016/j.neubiorev.2023.105499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Considerable progress has been made in elucidating the relationships between early life psychobiological and environmental risk factors and the development of tobacco addiction. However, a comprehensive understanding of the heterogeneity in tobacco addiction phenotypes requires integrating research findings. The probabilistic epigenesis meta-theory offers a valuable framework for this integration, considering systemic, multilevel, developmental, and evolutionary perspectives. In this paper, we critically review relevant research on early developmental risks associated with tobacco addiction and highlight the integrative heuristic value of the probabilistic epigenesis framework for this research. For this, we propose a four-level systems approach as an initial step towards integration, analyzing complex interactions among different levels of influence. Additionally, we explore a coaction approach to examine key interactions between early risk factors. Moreover, we introduce developmental pathways to understand interindividual differences in tobacco addiction risk during development. This integrative approach holds promise for advancing our understanding of tobacco addiction etiology and informing potentially effective intervention strategies.
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Affiliation(s)
- Leonardo A Ortega
- Facultad de Psicologia, Fundacion Universitaria Konrad Lorenz, Colombia.
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Jackson MA, Buykx P, Brown AL, Baker AL, Dunlop AJ, Gould GS. Using mixed methods to establish tobacco treatment acceptability from the perspective of clients and clinicians of antenatal substance use services. Addict Sci Clin Pract 2022; 17:56. [PMID: 36195932 PMCID: PMC9531520 DOI: 10.1186/s13722-022-00337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Up to 95% of pregnant women with alcohol and other drug (AOD) problems also smoke tobacco. Challenging psychosocial circumstances and a lack of targeted tobacco interventions contribute to low rates of prenatal abstinence and more effective treatment strategies are required. This study explores smoking in pregnant clients of AOD treatment services from a consumer and healthcare provider perspective to examine characteristics of behaviour change and the acceptability of evidence-based tobacco treatment strategies. Outcomes will support the design and implementation of a comprehensive tobacco intervention. Methods A mixed methods triangulated design was used. Thirteen women who smoked and attended antenatal AOD services in New South Wales, Australia, were interviewed and 28 clinicians from the same services were surveyed. Domains including experiences of tobacco smoking in pregnancy, motivators and barriers to cessation and evidence-based strategies to assist cessation during pregnancy were explored. Interviews were analysed using Iterative Categorization, with interpretation guided by Qualitative Description. Online surveys were analysed descriptively. A convergent-parallel mixed methods analysis was performed. Results Women and clinicians agreed that improving baby’s health outcomes was the primary motivation to stop smoking. Negative experiences with nicotine replacement therapy (NRT), financial constraints and maternal contraindications restricted its uptake and effectiveness during pregnancy. Both groups agreed that other AOD use, stopping multiple substances concurrently, difficulty coping with stress and the influence of partners who smoke had the biggest impacts on cessation efforts. Clinicians favoured harm-reduction rather than abstinence-based tobacco interventions and women appeared satisfied with reduction efforts. Both views may influence the attainment of prenatal abstinence-based goals. Although previous evidence suggested the contrary, clinicians were willing to encourage simultaneous cessation of tobacco and other substances. Non-judgmental treatment approaches that provide extra support, education and motivation were important for women. Women and clinicians supported use of NRT despite concerns. Financial incentives, counselling, partner support and offering tobacco treatment with antenatal AOD care were considered acceptable treatment options. Conclusions NRT, incentives, counselling and partner support could be utilized in a tobacco intervention for pregnant women with substance use concerns. Non-judgmental education, motivation, and provision of NRT including instruction for correct use are important considerations. Supplementary Information The online version contains supplementary material available at 10.1186/s13722-022-00337-y.
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Affiliation(s)
- Melissa A Jackson
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia.
| | - Penny Buykx
- School of Humanities, Creative Industries and Social Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Amanda L Brown
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Adrian J Dunlop
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia
| | - Gillian S Gould
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
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The structure and correlates of the 20-item Maternal-Fetal Attachment Scale in a population-based sample of Hungarian expectant women. Midwifery 2022; 112:103422. [DOI: 10.1016/j.midw.2022.103422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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Massey SH, Estabrook R, Lapping-Carr L, Newmark RL, Decety J, Wisner KL, Wakschlag LS. Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention. Soc Sci Med 2022; 305:115071. [PMID: 35660692 DOI: 10.1016/j.socscimed.2022.115071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/19/2022] [Accepted: 05/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy. METHODS Participants were 154 pregnant women (M = 12.4 weeks gestation, SD = 4.6) who were smoking cigarettes immediately prior to pregnancy recognition (85 had quit and 69 were still smoking at enrollment). Empathy-related processes were measured with performance-based paradigms (affect sharing, empathic concern, and theory of mind) and a speech sample (expressed emotion). Smoking was assessed with timeline follow back interviews and urine cotinine assays. Using zero-inflated Poisson regression models, we tested direct and interactive effects of empathy-related processes with respect to biologically verified smoking cessation (zero portion); and mean cigarettes/day smoked after pregnancy recognition among persistent smokers (count portion). RESULTS Affect sharing was inversely related to post-recognition cigarettes/day (B(SE) = -0.17(0.07), 95%C.I. -0.30,-0.04, p = .011) and moderated the relationship between pre-recognition smoking and post-recognition smoking consistent with a buffering effect (B(SE) = -.17(0.05); 95%C.I. - 0.28,-0.06; p = .002). Other empathy related processes showed neither direct nor interactive effects on smoking outcomes. CONCLUSIONS Further research is recommended to clarify the role of empathy in pregnancy smoking.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA.
| | - Ryne Estabrook
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison Street, 1018D, Chicago, IL, 60607, USA
| | - Leiszle Lapping-Carr
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Rebecca L Newmark
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA; University of California San Francisco School of Medicine, 513 Parnassus Ave, Suite S-224, San Francisco, CA, 94143, USA
| | - Jean Decety
- Department of Psychology, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5848 South University Avenue, Chicago, IL, 60637, USA
| | - Katherine L Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair Street, Suite 1000, Chicago, IL, 60611, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, 19th Floor, Chicago, IL, 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan, Suite 2100, Chicago, IL, 60611, USA
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The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries. J Affect Disord 2021; 295:612-619. [PMID: 34509077 DOI: 10.1016/j.jad.2021.08.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 08/02/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergenerational transmission of risk associated with maternal ACEs. However, the extent to which prenatal depressive symptoms mediate the association between maternal ACEs and foetal attachment is unknown. METHODS Data on foetal attachment, ACEs, and prenatal depression came from mothers in their third trimester of pregnancy (n = 1,185) located across eight MICs, participating in the prospective birth cohort Evidence for Better Lives Study - Foundational Research (EBLS-FR). Data were from the baseline measurement. RESULTS Full-sample path mediation analyses, adjusting for relevant covariates, suggested a full mediating effect of prenatal depression. However, at the individual-country level, both positive and negative effects of ACEs on foetal attachment were observed after the inclusion of depressive symptoms as a mediator, suggesting cultural and geographical factors may influence a mother's empathic development after ACE exposure. LIMITATIONS As no follow-up measurements of depressive symptoms or postnatal attachment were included in the analyses, the findings cannot be extrapolated to the postnatal period and beyond. Further, causality cannot be inferred as the study was observational. CONCLUSIONS The findings reinforce the importance of screening for prenatal depression during antenatal care in MICs. Addressing prenatal depression within maternal health care may support foetal attachment and contribute to reducing the intergenerational transmission of disadvantage.
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Faisal-Cury A, Matijasevich A. The Relationship Between Bonding Impairment and Maternal Postpartum Smoking. Matern Child Health J 2021; 26:1246-1254. [PMID: 34846606 DOI: 10.1007/s10995-021-03306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Maternal postpartum smoking is associated with several negative outcomes for mother and child. The relationship between bonding impairment (BI) and maternal postpartum smoking is less known. The aim of the present study was to assess the relationship between BI and maternal postpartum smoking at 6 to 8 months after childbirth in a primary care sample of low-income mothers who had depression during the previous pregnancy. METHODS We performed a cross-sectional, secondary analysis from a community trial with 356 postpartum women from public primary care clinics in São Paulo, Brazil. The main outcome measure was maternal postpartum smoking. The main exposure variable was BI assessed with the Postpartum Bonding Questionnaire. A socio-demographic questionnaire evaluated maternal and obstetric characteristics. Postpartum depression was assessed with the Patient Health Questionnaire. Crude and adjusted prevalence ratios (PR) of the association between BI and maternal postpartum smoking, with 95% confidence intervals (CI), were calculated using Poisson regression. Multivariate analysis was performed using three models (Model 1 adjusted for randomization during pregnancy, Model 2 adjusted for Model 1 plus mother's socioeconomic and obstetric characteristics, and Model 3 adjusted for Model 2 plus postpartum depression). RESULTS Maternal postpartum smoking occurred in 16.7% of our sample. In the multivariable analysis, BI was associated with maternal postpartum smoking (PR:2.04; CI 95% 1.08:3.84). CONCLUSIONS FOR PRACTICE Women presenting bonding problems are at higher risk of smoking after childbirth. Intervention to enhance mother-child bonding may have the potential to decrease maternal postpartum smoking.
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Affiliation(s)
- Alexandre Faisal-Cury
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil. .,University of Sao Paulo, Av Dr Arnaldo 455, Room 2214, São Paulo, 01246-903, Brazil.
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Arafah D, Thomas B, Fenton TR, Sabr Y, Metcalfe A. Validity and reliability of the Arabic version of Muller's prenatal attachment inventory. J Psychosom Obstet Gynaecol 2021; 42:212-220. [PMID: 31948333 DOI: 10.1080/0167482x.2020.1713083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Maternal fetal attachment (MFA) is the bond between the mother and her unborn baby. Presently no tools measuring MFA are available in Arabic. The aim of this study was to translate Muller's Prenatal Attachment Inventory (PAI) from English to Arabic, examine the cultural appropriateness of this tool, and test its psychometric properties with pregnant women in an Arab country. MATERIALS AND METHODS The PAI was translated from English into Arabic using the Universal Translation Approach (modified tool) and assessed for content validity. During this process four additional items were identified for measurement relevance and cultural acceptability resulting in the revised tool. The psychometric properties of the modified and revised tools were assessed after 250 pregnant Arab women completed the PAI. Factor analysis was conducted to assess construct validity, while reliability was assessed using Cronbach's alpha coefficient. RESULTS Both tools were shown to be unidimensional with excellent reliability (Cronbach's alpha = 0.88 for the modified tool and 0.89 for the revised tool). Nulliparity, planning to breastfeed the baby, feeling fetal movements, and downloading a smartphone app to follow the baby's growth were associated with increased MFA in the PAI, while only planning to breastfeed the baby, feeling fetal movements, and downloading a smartphone app to follow the baby's growth were associated with increased MFA in the revised PAI. CONCLUSION The Arabic version of the PAI is a culturally appropriate tool to measure MFA amongst Arabic-speaking women.
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Affiliation(s)
- Dima Arafah
- Qatar Research and Leadership Program, Qatar Foundation, Doha, Qatar.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Bejoy Thomas
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Tanis R Fenton
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Yasser Sabr
- Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada.,Department of Medicine, University of Calgary, Calgary, AB, Canada
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Ekblad MO, Wallin HP, Pajulo M, Korhonen PE. Design of a prospective follow-up study on early parenthood and smoking behaviour during pregnancy in Finnish primary healthcare. Scand J Public Health 2021; 49:970-980. [PMID: 34148504 PMCID: PMC8573631 DOI: 10.1177/14034948211022433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aims: The primary aim of the study is to explore different factors affecting parents’ smoking behaviour, and especially how smoking may be connected with individual differences in the psychological process of becoming a parent. In the current paper, we present the study design together with basic information on the study population. Methods: The Central Satakunta Maternity and Child Health Clinic (KESALATU) Study is an ongoing prospective follow-up study in primary healthcare of the Satakunta region of southwest Finland. Families were recruited during their first maternity clinic visit between 1 September 2016 and 31 December 2019, and participation will continue until the child is 1.5 years of age. The study combines different sources and types of data: e.g. routine data obtained from primary healthcare clinic records, specific parental self-report data and data from a new exhaled carbon monoxide meter indicating maternal smoking. The data are collected using frequently repeated assessments both during pregnancy and postnatally. The methods cover the following areas of interest: family background factors (including smoking and alcohol use), self-reported parental–foetal/infant attachment and mentalization, self-reported stress, depression and quality of life. Results: 589 pregnant women and their partners were asked to participate in the study during the collection time period. The final study population consisted of 248 (42.1%) pregnant women and 160 (27.1%) partners. Conclusions: The new methods and study design have the potential to increase our understanding about the link between early parenting psychology, prenatal psychosocial risk factors and parental health behaviour.
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Affiliation(s)
- Mikael O Ekblad
- Department of General Practice, University of Turku and Turku University Hospital, Finland
| | - Hanna P Wallin
- Department of General Practice, University of Turku and Turku University Hospital, Finland.,Central Satakunta Federation of Municipalities, Finland
| | - Marjukka Pajulo
- Department of Child Psychiatry, University of Turku, Finland
| | - Päivi E Korhonen
- Department of General Practice, University of Turku and Turku University Hospital, Finland
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11
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Guggenheim FG, Lieberman PB, Farris SG. Cigarette Smoking in an Acute Partial Hospital Program. J Nerv Ment Dis 2021; 209:415-420. [PMID: 33966016 DOI: 10.1097/nmd.0000000000001362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This study explored demographic and clinical features, plus clinical outcomes, in a smoke-free acute partial hospital (PH) among current smokers, former smokers, and those who had never smoked (nonsmokers). Compared with nonsmokers, current smokers were younger and more likely to be unmarried and unpartnered, unemployed, or receiving disability benefits. They had more prior inpatient (IP) and PH episodes. They also had more problems with interpersonal relationships, mood lability, psychosis, and substance use. Compared with nonsmokers, current smokers were more likely to miss PH treatment days and drop out. They also had longer time to readmission to PH or IP. Former smokers resembled nonsmokers, except that former smokers also had a high rate of dropout. Changes in symptoms and functioning for patients who completed PH were the same among all groups. In an acute PH setting, smoking is a marker for psychiatric and psychosocial impairment plus treatment interruption.
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Affiliation(s)
| | - Paul B Lieberman
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Samantha G Farris
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
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12
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Vieira AC, Pité H, Morais-Almeida M. Asthma and pregnancy in the 2020 decade: still a matter of concern. J Matern Fetal Neonatal Med 2021; 35:6498-6504. [PMID: 33926358 DOI: 10.1080/14767058.2021.1916462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Asthma is a fairly common health problem for pregnant women and a potentially serious medical condition that may complicate pregnancy. Most complications are related to lack of disease control, which can adversely affect both maternal quality of life and perinatal outcomes. In this article, we review recent literature concerning asthma in pregnancy, describing the course of the disease and associated complications. Furthermore, we review and discuss asthma monitoring and management during pregnancy, labor and post-partum. The course of asthma symptoms during pregnancy is unpredictable but exacerbations are more common during the second trimester. The causes are multifactorial and asthma phenotype may have a role. It has been proposed that combined use of CARAT (Control of Allergic Rhinitis and Asthma Test) and lung function tests can be used to monitor and adjust therapy during pregnancy in patients with asthma. As a complement, an approach that considers airway inflammation assessment using fractional exhaled nitric oxide (FeNO), a noninvasive marker of inflammation, may improve asthma control during pregnancy. It is important to consider a few but relevant differences in asthma management and treatment regarding pregnancy and the peri-partum period to safely achieve optimal management of asthma during all these phases for both mother and offsprings.
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Affiliation(s)
- Ana Cláudia Vieira
- Pulmonology Department, Egas Moniz Hospital, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Helena Pité
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal.,CEDOC, Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Mário Morais-Almeida
- Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal
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Modjadji P, Pitso M. Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis. CHILDREN-BASEL 2021; 8:children8020133. [PMID: 33670265 PMCID: PMC7918556 DOI: 10.3390/children8020133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.
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Jussila H, Pelto J, Korja R, Ekholm E, Pajulo M, Karlsson L, Karlsson H. The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study. BMC Pregnancy Childbirth 2020; 20:741. [PMID: 33256653 PMCID: PMC7708161 DOI: 10.1186/s12884-020-03393-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/04/2020] [Indexed: 11/20/2022] Open
Abstract
Background Smoking in pregnancy constitutes a preventable risk factor for fetal/child development and maternal-fetal attachment (MFA) seems to contain a momentum that can break the chain of adverse outcomes by promoting maternal prenatal health practices. This study aimed to explore the association of MFA with smoking at any time during pregnancy and smoking cessation in early pregnancy, and the modifying role of MFA on the expected effects of education and prenatal psychological distress (PPD) on prenatal smoking behavior. Methods The pregnant women (n = 3766) participated in the The FinnBrain Birth Cohort Study in Finland between December 2011 and April 2015. The binary outcomes, smoking at any time during pregnancy and smoking cessation in early pregnancy, were obtained from self-reports at gestational weeks (gwks) 14 and 34 and The Finnish Medical Birth Register. MFA was assessed with the Maternal-Fetal Attachment Scale (MFAS) at gwks 24 and 34. Logistic regression analyses were used to determine the association between MFA and maternal prenatal smoking behavior. Findings The prevalence of smoking was 16.5%, and 58.1% of the smokers quit smoking during pregnancy. The independent associations of total MFA scores with prenatal smoking behavior were not established (aOR = 1.00-1.02, multiplicity adjusted p > 0.05). A higher score in the altruistic subscale of MFA, Giving of self, associated with a higher probability of smoking cessation (24 gwks: aOR = 1.13, 95% CI [1.04, 1.24], p = 0.007, multiplicity adjusted p = 0.062; 34 gwks: aOR = 1.17, 95% CI [1.07, 1.29], p < 0.001, multiplicity adjusted p = 0.008). The modifying effect of MFA on the observed associations between PPD and smoking in pregnancy and between maternal education and smoking in pregnancy / smoking cessation in early pregnancy was not demonstrated. Conclusions The altruistic dimension of maternal-fetal attachment associates with an increased probability of smoking cessation during pregnancy and therefore strengthening altruistic maternal-fetal attachment may constitute a promising novel approach for interventions aiming at promoting smoking cessation during pregnancy.
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Affiliation(s)
- Heidi Jussila
- Doctoral Programme of Clinical Investigation, Department of Child Psychiatry, University of Turku, Turku, Finland. .,FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Psychology , University of Turku , Turku, Finland
| | - Eeva Ekholm
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Obstetrics and Gynecology , Turku University Hospital , Turku, Finland
| | - Marjukka Pajulo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Child Psychiatry , University of Turku , Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Centre for Population Health Research , University of Turku and Turku University Hospital , Turku, Finland.,Department of Child Psychiatry , Turku University Hospital and University of Turku , Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.,Department of Psychiatry , Turku University Hospital and University of Turku , Turku, Finland
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Topal S, Çaka SY, Yuvacı HU, Çınar N. Factors Affecting Paternal Fetal Attachment. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-19-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMThere are very few studies examining how the prenatal attachment of the father to the fetus affects father–infant attachment, while there are numerous studies on maternal–fetal, maternal–infant attachment. The pregnancy period is a potential opportunity to increase the paternal attachment of fathers whose wives are expecting a baby. The aim of this study was to determine paternal–fetal attachment and the factors with an effect.METHODSThe sample group of this descriptive (comparative) study consisted of expectant fathers accompanied by their wives at 24–36 weeks of pregnancy (n = 182). Ethics committee approval and the necessary permissions were obtained from the relevant institution. The data were collected by the researchers using the Question Form and Paternal Fetal Attachment Scale. The data collected were analyzed using percentage distribution, the Independent samples t test and the one-way analysis of variance (ANOVA) test.RESULTSThe results of the study showed that the participants who experienced fatherhood for the first time and felt ready to be a father had higher paternal attachment scores than experienced fathers.CONCLUSIONFor the establishment of healthy attachment starting in the prenatal period and continuing thereafter, there are important tasks for healthcare professionals to ensure that fathers can cope with the new roles and responsibilities just as well as the mothers.
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Godleski SA, Shisler S, Eiden RD, Schuetze P. Maternal Smoking and Psychosocial Functioning: Impact on Subsequent Breastfeeding Practices. Breastfeed Med 2020; 15:246-253. [PMID: 32150684 PMCID: PMC7175616 DOI: 10.1089/bfm.2019.0148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Breastfeeding is a protective factor for women and children. Women who smoke cigarettes during pregnancy are less likely to initiate or persist in breastfeeding. However, less is known about why this is the case. Materials and Methods: The present study (n = 247) prospectively examined maternal/child factors that influence breastfeeding in a low-income, racially diverse at-risk sample of smoking and nonsmoking women. Pregnant women were recruited at their first prenatal appointment in an urban hospital and followed through 24-month postnatally. Women reported on the average number of cigarettes smoked/day during pregnancy, psychopathology, breastfeeding behavior, and infant reactivity. Results: Although a greater number of cigarettes smoked/day during pregnancy was associated with a lower likelihood of initiating or persisting in breastfeeding, maternal age, education, and infant reactivity offered predictive utility above and beyond maternal smoking. Conclusion: Smokers were less likely to initiate breastfeeding and breastfed for shorter duration than demographically similar nonsmokers; however, one of the mechanisms for reduced breastfeeding may be the psychosocial factors of younger age and lower education. Further, infant reactivity was also found to reduce the likelihood of initiating and persisting with breastfeeding.
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Affiliation(s)
- Stephanie A. Godleski
- Department of Psychology, College of Liberal Arts, Rochester Institute of Technology, Rochester, New York
| | - Shannon Shisler
- Clinical and Research Institute on Addictions and Department of Pediatrics, University at Buffalo, The State University of New York, Buffalo, New York
| | - Rina D. Eiden
- Department of Psychology, Consortium for Combating Substance Abuse, Pennsylvania State University, State College, Pennsylvania
| | - Pamela Schuetze
- Department of Psychology, Buffalo State College, The State University of New York, Buffalo, New York
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Mallma P, Carcamo C, Kaufman JS. The impact of anti-tobacco legislation on birth weight in Peru. Glob Health Res Policy 2020; 5:5. [PMID: 32161814 PMCID: PMC7048150 DOI: 10.1186/s41256-020-00136-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/19/2020] [Indexed: 12/17/2022] Open
Abstract
Background Tobacco exposure remains a significant issue for public health, especially for pregnant women. It increases the risk for premature labor, low birth weight and small for gestational age (SGA), among other effects. To reduce these risks, many countries have enacted public policies to curb tobacco exposure. Peru enacted anti-tobacco laws that forbid smoking in public places, require prevention text and images in products and publicity, along with restriction of sales to adults. We evaluated the effect of the implementation of this law on newborn outcomes: birth weight, prematurity and SGA. Methods This was a quasi-experimental study that utilized data from the Peruvian Live Birth Registry. Children born to mothers from urban areas were the intervention group, while children born to mothers from rural areas were considered the control group. Only singletons with information on birth weight and gestational age, born to mothers aged 12 to 49 years were included in the study. In addition, newborns with birth weights greater than + 4 standard deviations (SD) or less than - 4 SD from the gestational age-specific mean were excluded. To measure the effect of legislation on birth weight we performed a difference in differences analysis. Results A total of 2,029,975 births were included in the analysis. After adjusting for characteristics of the mother and the child, and contextual variables, the anti-tobacco law in Peru reduced the incidence of prematurity by 30 cases per 10,000 live births (95% CI: 19 to 42). Conclusions The reform had negligible effects on overall birth weights and on the incidence of SGA. This modest result suggests the need for a more aggressive fight against tobacco, prohibiting all types of advertising and promotion of tobacco products, among others measures.
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Affiliation(s)
- Patricia Mallma
- Epidemiology, HIV and STD Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar Carcamo
- Epidemiology, HIV and STD Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
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Coté JJ, Badura-Brack AS, Walters RW, Dubay NG, Bredehoeft MR. Randomized Controlled Trial of the Effects of 3D-Printed Models and 3D Ultrasonography on Maternal-Fetal Attachment. J Obstet Gynecol Neonatal Nurs 2020; 49:190-199. [PMID: 32045565 DOI: 10.1016/j.jogn.2020.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To determine whether the addition of 3D-printed models improves maternal-fetal attachment in healthy pregnancies more than 3D ultrasonography alone. DESIGN Randomized, parallel-group, controlled trial. SETTING University- and clinic system-affiliated locations in Omaha, Nebraska. PARTICIPANTS Between May 2018 and February 2019, 857 pregnant women were screened for inclusion in the study, and 96 women (11%) were randomly assigned to an ultrasonography group (n = 48) or to an ultrasonography plus 3D-printed model group (n = 48). METHODS Participants completed the Maternal Antenatal Attachment Scale (MAAS) questionnaire before they received third trimester 3D ultrasonography. Participants were randomly allocated to receive 3D ultrasonography only or 3D ultrasonography plus 3D-printed models of the fetus's face. All participants completed a second MAAS questionnaire approximately 14 days after the study ultrasonography. The primary outcome was the global MAAS score. Secondary outcomes included the MAAS subscale scores. RESULTS The time-by-group interaction effect indicated that change in MAAS global score from baseline for the 3D-printed model group was 3.75 points greater than the score for the ultrasonography only group (95% confidence interval [1.40, 6.10], p = .002). Similar results were observed for the subscales with regard to quality of attachment and time spent thinking about the fetus. CONCLUSIONS The use of fetal facial models resulted in greater increases in maternal-fetal attachment than the use of ultrasonography only. Future research into this new technology to enhance pregnancy outcomes is clearly warranted.
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Jussila H, Ekholm E, Pajulo M. A New Parental Mentalization Focused Ultrasound Intervention for Substance Using Pregnant Women. Effect on Self-reported Prenatal Mental Health, Attachment and Mentalization in a Randomized and Controlled Trial. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractThe effect of a novel mentalization-based parenting intervention was explored on prenatal self-reported mentalization (P-PRFQ), attachment (MFAS), depression (EPDS) and anxiety (STAI) among women with substance use problems. The participants were 90 pregnant women referred to obstetric outpatient care due to recent or current substance use and randomized into intervention (n = 46) and control (n = 44) groups. The intervention group received three interactive 4D ultrasound sessions and a week-by-week pregnancy diary. The control condition was constituted of treatment-as-usual in obstetric care. Unfortunately, the efficacy of the intervention on maternal prenatal mental health, attachment, and parental mentalization was not substantiated. The negative results may be related to the small sample size, the patient-reported outcomes, or insufficient efficacy within this high-risk group. In the context of high psychosocial risks and follow-up by Child Welfare Services, the patient-reported outcomes may have underestimated prenatal adversity. The role of the research context, methodology, and possible sources of bias in the outcome assessment are discussed.The trial registration number in the ClinicalTrials.gov: NCT03413631
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20
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Martin-Willett R, Helmuth T, Abraha M, Bryan AD, Hitchcock L, Lee K, Bidwell LC. Validation of a multisubstance online Timeline Followback assessment. Brain Behav 2020; 10:e01486. [PMID: 31793226 PMCID: PMC6955818 DOI: 10.1002/brb3.1486] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/26/2019] [Accepted: 11/01/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The Timeline Followback (TLFB) was originally developed to assess alcohol consumption patterns (American Journal of Public Health, 86, 1996, 966) and has been increasingly modified for Web-based use. Additionally, new modes of substance use administration have emerged, creating a need for an adaptable TLFB tool than can capture data such as cannabis product potency or prescription drug use. Our goal was to validate an online TLFB that reliably assesses a wide range of substances in greater detail. METHODS Using a within-subjects counterbalanced design, daily substance use data were collected from 50 college students over a 14-day retrospective period using both the traditional in-person TLFB and online TLFB (O-TLFB). RESULTS All substance use variables, including detailed measures of cannabis metrics, correlated significantly (r's ranged from .653 to .944, p < .001) between TLFB versions. Further, results demonstrated that both the online TLFB and in-person TLFB demonstrated concurrent validity with both the Alcohol Use Disorders Identification Test (AUDIT) and Marijuana Dependence Scale (MDS). CONCLUSION Overall, the data suggest that this new O-TLFB demonstrates strong reliability and delivers a versatile and secure tool for substance use assessment that is relevant to a variety of biomedical and psychological research contexts.
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Affiliation(s)
| | | | - Median Abraha
- The University of Colorado Boulder, Boulder, Colorado
| | | | | | - Kaitlyn Lee
- The University of Colorado Boulder, Boulder, Colorado
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Jackson MA, Brown AL, Baker AL, Gould GS, Dunlop AJ. The Incentives to Quit tobacco in Pregnancy (IQuiP) protocol: piloting a financial incentive-based smoking treatment for women attending substance use in pregnancy antenatal services. BMJ Open 2019; 9:e032330. [PMID: 31753890 PMCID: PMC6886985 DOI: 10.1136/bmjopen-2019-032330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION While tobacco smoking prevalence is falling in many western societies, it remains elevated among high-priority cohorts. Rates up to 95% have been reported in women whose pregnancy is complicated by other substance use. In this group, the potential for poor pregnancy outcomes and adverse physical and neurobiological fetal development are elevated by tobacco smoking. Unfortunately, few targeted and effective tobacco dependence treatments exist to assist cessation in this population. The study will trial an evidence-based, multicomponent tobacco smoking treatment tailored to pregnant women who use other substances. The intervention comprises financial incentives for biochemically verified abstinence, psychotherapy delivered by drug and alcohol counsellors, and nicotine replacement therapy. It will be piloted at three government-based, primary healthcare facilities in New South Wales (NSW) and Victoria, Australia. The study will assess the feasibility and acceptability of the treatment when integrated into routine antenatal care offered by substance use in pregnancy antenatal services. METHODS AND ANALYSIS The study will use a single-arm design with pre-post comparisons. One hundred clients will be recruited from antenatal clinics with a substance use in pregnancy service. Women must be <33 weeks' gestation, ≥16 years old and a current tobacco smoker. The primary outcomes are feasibility, assessed by recruitment and retention and the acceptability of addressing smoking among this population. Secondary outcomes include changes in smoking behaviours, the comparison of adverse maternal outcomes and neonatal characteristics to those of a historical control group, and a cost-consequence analysis of the intervention implementation. ETHICS AND DISSEMINATION Protocol approval was granted by Hunter New England Human Research Ethics Committee (Reference 17/04/12/4.05), with additional ethical approval sought from the Aboriginal Health and Medical Research Council of NSW (Reference 1249/17). Findings will be disseminated via academic conferences, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER Australia New Zealand Clinical Trial Registry (Ref: ACTRN12618000576224).
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Affiliation(s)
- Melissa A Jackson
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amanda L Brown
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Gillian S Gould
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Adrian J Dunlop
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
- Drug & Alcohol Clinical Research & Improvement Network, Sydney, New South Wales, Australia
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Jackson MA, Baker AL, McCarter KL, Brown AL, Gould GS, Dunlop AJ. Interventions for pregnant women who use tobacco and other substances: a systematic review protocol. BMJ Open 2019; 9:e032449. [PMID: 31719091 PMCID: PMC6858244 DOI: 10.1136/bmjopen-2019-032449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/02/2019] [Accepted: 09/26/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The prevalence of tobacco smoking in pregnancy remains elevated in some disadvantaged populations of women. One group is those who use alcohol and/or other psychoactive substances during pregnancy, with tobacco use prevalence estimates ranging from 71% to 95%. Although effective evidence-based cessation treatments exist, few women with co-occurring substance use problems successfully stop smoking during pregnancy. There is limited information about treatments that specifically target this group and a summary of the available research is required to assist and enhance the development of innovative cessation interventions. This article describes a protocol for a comprehensive review of studies that have trialled behavioural and/or pharmacological tobacco cessation interventions in populations of pregnant women who are nicotine dependent and use alcohol and/or other psychoactive substances. METHODS AND ANALYSIS The review will undertake literature searches in MEDLINE, PsycINFO, CINAHL, EMBASE and ProQuest databases, as well as the grey literature. Studies of any design methodology will be included if they describe changes to tobacco smoking behaviours in quantitative terms. No restriction on year of publication or published language will apply. Participants include pregnant women of any age, who smoke tobacco, who are seeking or having treatment, or in post-treatment recovery for the use of psychoactive substances. Interventions are any psychological, behavioural or pharmacological treatments used to treat tobacco use. Outcome measures are any that quantitatively report abstinence or reductions in participant tobacco consumption. Key details and tobacco-related outcomes from included studies will be extracted and tabulated before being narratively synthesised. The systematic review protocol has been developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. ETHICS AND DISSEMINATION Ethics approval is not required. Findings will be disseminated via peer-reviewed literature, conference presentations, media and social media. PROSPERO REGISTRATION NUMBER CRD42018108777.
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Affiliation(s)
- Melissa A Jackson
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kristen L McCarter
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Amanda L Brown
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Gillian S Gould
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Adrian J Dunlop
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, New South Wales, Australia
- Drug & Alcohol Clinical Research & Improvement Network, Sydney, New South Wales, Australia
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Rutherford HJV, Mayes LC. Parenting stress: A novel mechanism of addiction vulnerability. Neurobiol Stress 2019; 11:100172. [PMID: 31193862 PMCID: PMC6543178 DOI: 10.1016/j.ynstr.2019.100172] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/10/2019] [Accepted: 05/15/2019] [Indexed: 02/03/2023] Open
Abstract
Addiction remains a significant public health concern. Despite numerous public health initiatives, many parents continue to use substances during the prenatal and postpartum period. While stress has been implicated in the maintenance of substance use disorders more generally, we propose that parenting stress specifically increases vulnerability to substance use in adults caring for young children. To explore this notion, we first consider the neurobiology of the adult transition to parenthood and the value of adopting a parenting-specific approach to understanding addictive processes. Next, we consider the neurobiology of addiction and parenting before directly addressing parenting stress in the context of addiction. Finally, we describe current interventions with parents that incorporate the management of negative affect to enhance caregiving quality and decrease substance use. Taken together, this article proposes that the unique demands of caring for a developing child may be more stressful above and beyond other forms of stress. As a consequence, intervention approaches that target stress in the parenting role hold promise for decreasing parental substance abuse.
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O'Malley EG, Walsh MC, Reynolds CM, Kennelly M, Sheehan SR, Turner MJ. A cross-sectional study of maternal-fetal attachment and perceived stress at the first antenatal visit. J Reprod Infant Psychol 2019; 38:271-280. [PMID: 31271307 DOI: 10.1080/02646838.2019.1637516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Maternal-fetal attachment (MFA) psychologically is well described. Suboptimal attachment may have negative consequences particularly if it is associated with unhealthy maternal behaviour that may potentially increase the risk of adverse pregnancy outcomes. The perception of stress or anxiety is also associated with potential adverse outcomes including preterm birth. OBJECTIVE This cross-sectional study examined MFA and perceived stress at the time of the first ultrasound examination in early pregnancy. METHODS Convenience sampling was used to recruit women after they presented to the Ultrasound Department for a routine dating ultrasound at their first antenatal visit. Informed consent was obtained and clinical and sociodemographic details were recorded. Women were invited to complete validated Cranley MFA and Perceived Stress Scale (PSS) questionnaires. RESULTS Of the 90 women recruited, 80 completed the questionnaires successfully. No association was found between the MFA score and maternal age, parity, education, marital status, previous pregnancy loss or smoking behaviour. An unplanned pregnancy was associated with a lower mean MFA score (p < 0.01) and a higher mean PSS score (p < 0.005). These relationships persisted in a multiple regression analysis controlling for maternal age and parity. CONCLUSION In early pregnancy, an unplanned pregnancy is associated with a lower MFA and higher PSS score. Additional research is required to assess if this persists as pregnancy advances. ABBREVIATIONS Maternal-Fetal Attachment (MFA), Maternal-Fetal Attachment Scale (MFAS), Perceived stress scale (PSS), Maternal Antenatal Attachment Scale (MAAS), Standard Deviation (SD), Central Statistics Office (CSO), Body Mass Index (BMI), Relative Risk (RR).
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Affiliation(s)
- Eimer G O'Malley
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Mary Catherine Walsh
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Ciara Me Reynolds
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
| | - Mairead Kennelly
- Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital , Dublin, Ireland
| | - Sharon R Sheehan
- Department of Obstetrics and Gynaecology, Coombe Women and Infants University Hospital , Dublin, Ireland
| | - Michael J Turner
- Centre for Human Reproduction, University College Dublin (UCD) , Dublin, Ireland
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Martin-Willett R, McCormick Z, Newman W, Larsen LD, Ortiz Torres MA, Bidwell LC. The transformation of a gold standard in-person substance use assessment to a web-based, REDCap integrated data capture tool. J Biomed Inform 2019; 94:103186. [PMID: 31022466 PMCID: PMC7299305 DOI: 10.1016/j.jbi.2019.103186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 10/27/2022]
Abstract
The adoption of computer systems for gathering, managing, and analyzing health data is resulting in the replacement of pen-and-paper methods for collecting data and managing health records by computerized methods. One classic "pen-and-paper" assessment in health and substance use research is the Timeline Follow-Back (TLFB), the gold standard in self-reported substance use developed in 1996 by Sobell et al. to assess alcohol consumption patterns and later other substances such as marijuana or tobacco over discreet timeframes [1-7]. The TLFB has been modified by some research groups for use as a web-based assessment [8-10], but not without significant limitations. As such, this paper describes the team-oriented, interdisciplinary process by which a new online TLFB (O-TLFB) was conceptualized, the technical details of development towards a dynamic data capture tool fully integrated with REDCap via application programming interface (API), and the potential for this optimized O-TLFB to be leveraged broadly across the domains of substance use, health, and behavioral research.
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Affiliation(s)
| | - Z McCormick
- Trailblazing Technology, New York, NY, United States
| | - W Newman
- The University of Colorado Boulder, Boulder, CO, United States
| | - L D Larsen
- The University of Colorado Boulder, Boulder, CO, United States
| | | | - L C Bidwell
- The University of Colorado Boulder, Boulder, CO, United States
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Upadhyaya S, Chudal R, Luntamo T, Sinkkonen J, Hinkka-Yli-Salomäki S, Kaneko H, Sourander A. Parental Risk Factors among Children with Reactive Attachment Disorder Referred to Specialized Services: A Nationwide Population-Based Study. Child Psychiatry Hum Dev 2019; 50:546-556. [PMID: 30594970 PMCID: PMC6589152 DOI: 10.1007/s10578-018-00861-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This nationwide population-based register study examined the family and parental risk factors associated with offspring reactive attachment disorder (RAD). We identified 614 children diagnosed with RAD from the Finnish Care Register for Health Care and each case was matched with four controls. Univariate and multivariate models examined the associations between risk factors and RAD. In the multivariate model, offspring RAD was associated with only mother, only father and both parents having psychiatric diagnoses. Increased odds were observed for maternal smoking during pregnancy, single motherhood and paternal age ≥ 45 years. This study provides information on several parental adversities and offspring RAD that have important implications for public health, when planning early prevention and interventions in infant mental health.
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Affiliation(s)
- Subina Upadhyaya
- Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540, Turku, Finland.
| | - Roshan Chudal
- 0000 0001 2097 1371grid.1374.1Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540 Turku, Finland
| | - Terhi Luntamo
- 0000 0001 2097 1371grid.1374.1Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540 Turku, Finland
| | - Jari Sinkkonen
- 0000 0001 2097 1371grid.1374.1Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540 Turku, Finland
| | - Susanna Hinkka-Yli-Salomäki
- 0000 0001 2097 1371grid.1374.1Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540 Turku, Finland
| | - Hitoshi Kaneko
- 0000 0001 0943 978Xgrid.27476.30Psychological Support and Research Center for Human Development, Nagoya University, Nagoya, Japan
| | - Andre Sourander
- 0000 0001 2097 1371grid.1374.1Department of Child Psychiatry, Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/ Teutori 3rd Floor, 20540 Turku, Finland ,0000 0004 0628 215Xgrid.410552.7Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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Stroud LR, McCallum M, Salisbury AL. Impact of maternal prenatal smoking on fetal to infant neurobehavioral development. Dev Psychopathol 2018; 30:1087-1105. [PMID: 30068428 PMCID: PMC6541397 DOI: 10.1017/s0954579418000676] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite recent emphasis on the profound importance of the fetal environment in "programming" postnatal development, measurement of offspring development typically begins after birth. Using a novel coding strategy combining direct fetal observation via ultrasound and actocardiography, we investigated the impact of maternal smoking during pregnancy (MSDP) on fetal neurobehavior; we also investigated links between fetal and infant neurobehavior. Participants were 90 pregnant mothers and their infants (52 MSDP-exposed; 51% minorities; ages 18-40). Fetal neurobehavior at baseline and in response to vibro-acoustic stimulus was assessed via ultrasound and actocardiography at M = 35 weeks gestation and coded via the Fetal Neurobehavioral Assessment System (FENS). After delivery, the NICU Network Neurobehavioral Scale was administered up to seven times over the first postnatal month. MSDP was associated with increased fetal activity and fetal limb movements. Fetal activity, complex body movements, and cardiac-somatic coupling were associated with infants' ability to attend to stimuli and to self-regulate over the first postnatal month. Furthermore, differential associations emerged by MSDP group between fetal activity, complex body movements, quality of movement, and coupling, and infant attention and self-regulation. The present study adds to a growing literature establishing the validity of fetal neurobehavioral measures in elucidating fetal programming pathways.
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28
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Harpel T. Pregnant Women Sharing Pregnancy-Related Information on Facebook: Web-Based Survey Study. J Med Internet Res 2018; 20:e115. [PMID: 29567636 PMCID: PMC5887042 DOI: 10.2196/jmir.7753] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/31/2017] [Accepted: 11/04/2017] [Indexed: 12/05/2022] Open
Abstract
Background Research indicates expectant and new mothers use the Internet, specifically social media, to gain information and support during the transition to parenthood. Although parents regularly share information about and photos of their child or children on Facebook, researchers have neither explored the use of Facebook to share pregnancy-related information nor investigated factors that influence such sharing. Objective The aim of this study was to address a gap in the literature by exploring the use of Facebook by pregnant women. Specifically, the study examined the use of Facebook to share pregnancy-related information, as well as any association between prenatal attachment and the aforementioned aspects of sharing pregnancy-related information on Facebook. Methods Pregnant women who were at least 18 years of age were recruited for participation in the study through posts and paid advertisements on Facebook and posts to professional organization listservs. Individuals interested in participating were directed to a secure Web-based survey system where they completed the consent form and the survey that focused on their current pregnancy. Participants completed the Maternal Antenatal Attachment Scale and answered questions that assessed how often they shared pregnancy-related information on Facebook, who they shared it with, why they shared it, and what they shared. Results A total of 117 pregnant women completed the survey. Descriptive statistics indicated that the pregnancy announcement was most commonly shared (75/108, 69.4%), with most women sharing pregnancy-related information on Facebook less than monthly (52/117, 44.4%) with only family and friends (90/116, 77.6% and 91/116, 78.4%, respectively) and for the purpose of involving others or sharing the experience (62/107, 57.9%). Correlation and regression analyses showed that prenatal attachment, in general, was positively and significantly related to all aspects of sharing pregnancy-related information at the P<.05 level, with the exception of sharing because of expectations. Quality of attachment, which involves the positive feelings the woman has about her unborn child, was significantly associated with sharing to involve others or share the pregnancy (t8,93=2.654 , P=.009). In contrast, after controlling for other variables, the strength or preoccupation component of prenatal attachment was significantly associated with frequency of sharing (t8,100=2.554 , P=.01), number to types of information shared (t8,97=2.605 , P=.01), number of groups with whom shared (t8,99=3.467, P=.001), and sharing to get advice (χ28=5.339 , P=.02). Conclusions Pregnant women in this study used Facebook for a variety of reasons, demonstrating the use of the social media platform during pregnancy for supportive and informational purposes. Overall, the results of this study are likely to be useful to professionals who are seeking alternative methods for providing intervention, information, and support to pregnant women via social media in our technology-driven society.
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Affiliation(s)
- Tammy Harpel
- Department of Family & Consumer Sciences, Illinois State University, Normal, IL, United States
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Massey SH, Decety J, Wisner KL, Wakschlag LS. Specification of Change Mechanisms in Pregnant Smokers for Malleable Target Identification: A Novel Approach to a Tenacious Public Health Problem. Front Public Health 2017; 5:239. [PMID: 28975128 PMCID: PMC5610685 DOI: 10.3389/fpubh.2017.00239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/23/2017] [Indexed: 12/20/2022] Open
Abstract
Maternal smoking during pregnancy (MSDP) continues to be a leading modifiable risk factor for perinatal complications and a range of neurodevelopmental and cardio-metabolic outcomes across the lifespan. Despite 40 years of intervention research less than one in five pregnant smokers who receive an intervention quit by delivery. Within this context, recognition of pregnancy is commonly associated with abrupt suspension or reduction of smoking in the absence of intervention, yet has not been investigated as a volitional target. The goal of this article is to provide the empirical foundation for a novel direction of research aimed at identifying malleable targets for intervention through the specification of behavior change mechanisms specific to pregnant women. To do so, we: (1) summarize progress on MSDP in the United States generated from conventional empirical approaches to health behavior change; (2) discuss the phenomenon of spontaneous change in the absence of intervention among pregnant smokers to illustrate the need for mechanistic specification of behavior change motivated by concern for fetal well-being; (3) summarize component processes in neurobiological models of parental and non-parental social behaviors as a conceptual framework for understanding change mechanisms during pregnancy; (4) discuss the evidence for the malleability of these processes to support their translational relevance for preventive interventions; and (5) propose a roadmap for validating the proposed change mechanism using an experimental medicine approach. A greater understanding of social and interpersonal processes that facilitate health behavior change among expectant mothers and how these processes differ interindividually could yield novel volitional targets for prenatal interventions. More broadly, explicating other-oriented mechanisms of behavior change during pregnancy could serve as a paradigm for understanding how social and interpersonal processes positively influence health behaviors across the lifespan.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
| | - Jean Decety
- Department of Psychology, University of Chicago, Chicago, IL, United States
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren S. Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Ekblad M, Lehtonen L, Korkeila J, Gissler M. Maternal Smoking During Pregnancy and the Risk of Psychiatric Morbidity in Singleton Sibling Pairs. Nicotine Tob Res 2017; 19:597-604. [PMID: 28403473 PMCID: PMC5441922 DOI: 10.1093/ntr/ntx001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 01/24/2017] [Indexed: 11/14/2022]
Abstract
Introduction Maternal smoking during pregnancy has been associated with an increased risk for psychiatric morbidity. We further studied this with Finnish siblings to control for genetic/familial factors. Methods From the Finnish Medical Birth Register, sibling pairs were selected as the first two children born 1987-1995 to the same mother (n = 150 168 pairs), along with information on maternal smoking (no smoking/smoking). Information on the children's psychiatric diagnoses related to outpatient care visits (1998-2013) and inpatient care (1987-2013), and the mothers' psychiatric morbidity (1969-2013) was derived from the Finnish Hospital Discharge Register. The first pair analysis compared siblings of mothers who only smoked in the first pregnancy (Quitters, 4.7%) and mothers who smoked in both pregnancies (Smokers, 9.6%); the second analysis included mothers who smoked only in the second pregnancy (Starters, 3.3%) and mothers who did not smoke in either pregnancy (Nonsmokers, 77.5%). Smoking information was missing for 5.0% of pairs. Psychiatric morbidity of the siblings and mother was included in the statistical analyses. Results The risk of psychiatric diagnoses was significantly lower for the second child of quitters (adjusted OR 0.77, 95% CI 0.72-0.83) compared to the risk among smokers. A higher risk for psychiatric diagnoses was found for the second child of starters (1.39, 1.30-1.49) compared to the risk among nonsmokers. The effect of smoking was more robust for externalizing diagnoses. Conclusions Maternal smoking was independently associated with a higher risk for psychiatric morbidity in children, even when controlling thoroughly for genetic and familial factors. Implications Maternal smoking during pregnancy has an independent effect on the risk of psychiatric morbidity in children, even after controlling for non-measurable genetic/familial factors by using a sibling pair design. The effect of maternal smoking was robust for externalizing diagnoses. Maternal smoking during pregnancy had an effect on diagnoses both in outpatient and inpatient care.
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Affiliation(s)
- Mikael Ekblad
- Department of General Practice, Turku University Hospital, Turku, Finland.,Institute of Medicine, University of Turku, Turku, Finland.,Central Satakunta Federation of Municipalities, Harjavalta, Finland
| | - Liisa Lehtonen
- Institute of Medicine, University of Turku, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Jyrki Korkeila
- Department of Psychiatry, Institute of Medicine, University of Turku, Turku, Finland.,Harjavalta Hospital, Harjavalta, Finland
| | - Mika Gissler
- Information Services Department, THL National Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
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31
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Kim Y, Cho KC. Critical Discussion on Smoking During Pregnancy as a Form of Fetal Abuse: An Approach to Advocate for Fetal Right to Life. CHILD HEALTH NURSING RESEARCH 2016. [DOI: 10.4094/chnr.2016.22.4.317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Jung AN, Park JH, Kim J, Kim SH, Jee BC, Cha BH, Sull JW, Jun JH. Detrimental Effects of Higher Body Mass Index and Smoking Habits on Menstrual Cycles in Korean Women. J Womens Health (Larchmt) 2016; 26:83-90. [PMID: 27603944 DOI: 10.1089/jwh.2015.5634] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Alteration of menstrual cycle by individual lifestyles and unfavorable habits may cause menstrual irregularity. We aimed to investigate the relationship between lifestyle factors and menstrual irregularity in Korean women using data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012. MATERIALS AND METHODS This cross-sectional study included 3779 nondiabetic Korean women aged 19-49 years who did not take any oral contraceptives or sex hormonal compounds. We examined the association of menstrual irregularity with age, body mass index (BMI), drinking experience, and smoking habits. RESULTS Age, Asian BMI, marriage status, age at menarche, and smoking habits were significantly associated with menstrual cycle irregularity (p < 0.01). The prevalence of menstrual irregularity was significantly increased at younger ages: 18.4%, 10.3%, and 10.5% at 19-29, 30-39, and 40-49 years, respectively. Moreover, obesity groups, defined as per Asian BMI using modified WHO criteria, were strongly associated with menstrual irregularity. BMI 25.0-29.9 [obesity class I] (adjusted odds ratios [OR], 1.94; 95% confidence intervals [CI], 1.37-2.74) and ≥30.0 [obesity class II] (adjusted OR, 2.18; 95% CI, 1.22-3.91) presented significantly higher risk of menstrual irregularity compared with BMI 18.5-22.9 [normal weight]. Multivariable analysis revealed that high BMI in younger women aged 19-29 years (p < 0.001) and smoking habits in middle-aged women aged 30-39 years (p < 0.005) significantly predicted menstrual irregularity. CONCLUSION This study substantiated that menstrual irregularity was closely associated with higher BMI and smoking habits in nondiabetic Korean women. Weight loss and smoking cessation should be recommended to promote women's reproductive health.
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Affiliation(s)
- An Na Jung
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,2 Samkwang Medical Laboratories , Seoul, Korea
| | - Ju Hwan Park
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,3 Hankook Institute of Life Science , Seoul, Korea
| | - Jihyun Kim
- 4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea
| | - Seok Hyun Kim
- 5 Department of Obstetrics and Gynecology, Seoul National University College of Medicine , Seoul, Korea
| | - Byung Chul Jee
- 6 Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital , Seongnam-si, Gyeonggi-do, Korea
| | - Byung Heun Cha
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea
| | - Jae Woong Sull
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea
| | - Jin Hyun Jun
- 1 Department of Biomedical Laboratory Science, Graduate School, Eulji University , Seongnam-si, Gyeonggi-do, Korea.,4 Department of Senior Healthcare, BK21 Plus Program, Graduated School, Eulji University , Daejeon, Korea.,7 Eulji Medi-Bio Research Institute (EMBRI), Eulji University , Seongnam-si, Gyeonggi-do, Korea
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Parolin M, Simonelli A. Attachment Theory and Maternal Drug Addiction: The Contribution to Parenting Interventions. Front Psychiatry 2016; 7:152. [PMID: 27625612 PMCID: PMC5004230 DOI: 10.3389/fpsyt.2016.00152] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/18/2016] [Indexed: 12/31/2022] Open
Abstract
Children's emotional and relational development can be negatively influenced by maternal substance abuse, particularly through a dysfunctional caregiving environment. Attachment Theory offers a privileged framework to analyze how drug addiction can affect the quality of adult attachment style, parenting attitudes and behaviors toward the child, and how it can have a detrimental effect on the co-construction of the attachment bond by the mother and the infant. Several studies, as a matter of fact, have identified a prevalence of insecure patterns among drug-abusing mothers and their children. Many interventions for mothers with Substance Use Disorders have focused on enhancing parental skills, but they have often overlooked the emotional and relational features of the mother-infant bond. Instead, in recent years, a number of protocols have been developed in order to strengthen the relationship between drug-abusing mothers and their children, drawing lessons from Attachment Theory. The present study reviews the literature on the adult and infant attachment style in the context of drug addiction, describing currently available treatment programs that address parenting and specifically focus on the mother-infant bond, relying on Attachment Theory.
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Affiliation(s)
- Micol Parolin
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
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34
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Inoue S, Naruse H, Yorifuji T, Kato T, Murakoshi T, Doi H, Subramanian S. Impact of maternal and paternal smoking on birth outcomes. J Public Health (Oxf) 2016; 39:1-10. [DOI: 10.1093/pubmed/fdw050] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sachiko Inoue
- Department of Nursing Science , Okayama Prefectural University , Okayama , Japan
| | - Hiroo Naruse
- Department of Obstetrics , Kaba Memorial Hospital , Shizuoka , Japan
| | - Takashi Yorifuji
- Department of Human Ecology , Okayama University Graduate School of Environmental and Life Science , Okayama , Japan
| | - Tsuguhiko Kato
- Department of Social Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Takeshi Murakoshi
- Department of Obstetrics and Gynecology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Shizuoka , Japan
| | - Hiroyuki Doi
- Department of Epidemiology , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan
| | - S.V. Subramanian
- Department of Social and Behavioral Sciences , Harvard School of Public Health , Boston, MA , USA
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Baghdari N, Sadeghi Sahebzad E, Kheirkhah M, Azmoude E. The Effects of Pregnancy-Adaptation Training on Maternal-Fetal Attachment and Adaptation in Pregnant Women With a History of Baby Loss. Nurs Midwifery Stud 2016; 5:e28949. [PMID: 27556052 PMCID: PMC4993030 DOI: 10.17795/nmsjournal28949] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 12/04/2015] [Accepted: 12/06/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies have shown that educating mothers can improve their adaptation to pregnancy and motherhood roles. There are also studies that have investigated the effects of certain interventions on maternal-fetal attachment. However, studies on the effects of maternal adaptation training on maternal-fetal attachment in mothers with a history of fetal or baby loss are rare. OBJECTIVES The aim of this study was to determine the effects of a pregnancy adaptation training package on maternal-fetal attachment in pregnant women with a history of baby loss. PATIENTS AND METHODS This quasi-experimental study was conducted on 60 pregnant women with previous fetal or neonatal death in 2014. The women were randomly divided into an experimental group (n = 30) and a control group (n = 30). The pregnant women in the experimental group received routine prenatal education in addition to four sessions of a pregnancy adaption training package. The control group received only routine prenatal education. The data were collected using a demographic questionnaire, Cranley's maternal-fetal attachment scale, and a prenatal self-evaluation questionnaire at the beginning and at the end of the study. The data analysis was conducted using the Mann-Whitney U, Wilcoxon, chi-square, Fisher's exact, and spearman correlation coefficient tests. RESULTS Before the intervention, there were no statistically significant differences between the study and control groups in terms of maternal-fetal attachment (P = 0.280) and adaptation to pregnancy (P = 0.883). However, following the intervention, the mean score of the maternal-fetal attachment was significantly higher in the experimental group, when compared with the control (77.57 ± 7.23 vs. 61.53 ± 2.62; P = 0.001). In addition, the mean post-intervention adaptation to pregnancy score was significantly lower in the experimental group than in the control group (118.89 ± 8.12 vs. 126.38 ± 4.17; P = 0.001). CONCLUSIONS The pregnancy adaptation training package increased the adaptation and maternal-fetal attachment scores in pregnant women with a history of baby loss.
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Affiliation(s)
- Nasrin Baghdari
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Elahe Sadeghi Sahebzad
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Masoomeh Kheirkhah
- Department of Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran
| | - Elham Azmoude
- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, IR Iran
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36
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Abstract
Perinatal substance use remains a major public health problem and is associated with a number of deleterious maternal and fetal effects. Polysubstance use in pregnancy is common and can potentiate adverse maternal and fetal outcomes. Tobacco is the most commonly used substance in pregnancy, followed by alcohol and illicit substances. The treatments for perinatal substance use are limited and consist mostly of behavioral and psychosocial interventions. Of these, contingency management has shown the most efficacy. More recently, novel interventions such as progesterone for postpartum cocaine use have shown promise. The purpose of this review is to examine the recent literature on the use of tobacco, alcohol, cannabis, stimulants, and opioids in the perinatal period, their effects on maternal and fetal health, and current treatments.
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Affiliation(s)
- Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, 40 Temple Street, Suite 6B, New Haven, CT, 06510, USA.
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Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli G, Lassandro C, Verduci E. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med 2015; 13:327. [PMID: 26472248 PMCID: PMC4608184 DOI: 10.1186/s12967-015-0690-y] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/07/2015] [Indexed: 01/19/2023] Open
Abstract
A great deal of attention has been focused on adverse effects of tobacco smoking on conception, pregnancy, fetal, and child health. The aim of this paper is to discuss the current evidence regarding short and long-term health effects on child health of parental smoking during pregnancy and lactation and the potential underlying mechanisms. Studies were searched on MEDLINE(®) and Cochrane database inserting, individually and using the Boolean ANDs and ORs, 'pregnancy', 'human lactation', 'fetal growth', 'metabolic outcomes', 'obesity', 'cardiovascular outcomes', 'blood pressure', 'brain development', 'respiratory outcomes', 'maternal or paternal or parental tobacco smoking', 'nicotine'. Publications coming from the reference list of studies were also considered from MEDLINE. All sources were retrieved between 2015-01-03 and 2015-31-05. There is overall consistency in literature about negative effects of fetal and postnatal exposure to parental tobacco smoking on several outcomes: preterm birth, fetal growth restriction, low birth weight, sudden infant death syndrome, neurodevelopmental and behavioral problems, obesity, hypertension, type 2 diabetes, impaired lung function, asthma and wheezing. While maternal smoking during pregnancy plays a major role on adverse postnatal outcomes, it may also cumulate negatively with smoking during lactation and with second-hand smoking exposure. Although this review was not strictly designed as a systematic review and the PRISMA Statement was not fully applied it may benefit the reader with a promptly and friendly readable update of the matter. This review strengthens the need to plan population health policies aimed to implement educational programs to hopefully minimize tobacco smoke exposure during pregnancy and lactation.
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Affiliation(s)
- G Banderali
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - A Martelli
- U.O.C. Pediatria Presidio Ospedaliero Garbagnate Milanese Azienda Ospedaliera G. Salvini, Milan, Italy.
| | - M Landi
- Pediatrician Primary Care, Institute of Biomedicine and Molecular Immunology, National Research Council, CNR, Palermo, Italy.
| | - F Moretti
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
- Nutritional Sciences, University of Milan, Milan, Italy.
| | - F Betti
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - G Radaelli
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - C Lassandro
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
- Nutritional Sciences, University of Milan, Milan, Italy.
| | - E Verduci
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
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Lehti V, Gissler M, Suvisaari J, Manninen M. Induced abortions and birth outcomes of women with a history of severe psychosocial problems in adolescence. Eur Psychiatry 2015; 30:750-5. [PMID: 26117381 DOI: 10.1016/j.eurpsy.2015.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To increase knowledge on the reproductive health of women who have been placed in a residential school, a child welfare facility for adolescents with severe psychosocial problems. METHODS All women (n=291) who lived in the Finnish residential schools on the last day of the years 1991, 1996, 2001 and 2006 were included in this study and compared with matched general population controls. Register-based information on induced abortions and births was collected until the end of the year 2011. RESULTS Compared to controls, women with a residential school history had more induced abortions. A higher proportion of their births took place when they were teenagers or even minors. They were more often single, smoked significantly more during pregnancy and had a higher risk of having a preterm birth or a baby with a low birth weight. CONCLUSIONS The findings have implications for the planning of preventive and supportive interventions that aim to increase the well-being of women with a residential school history and their offspring.
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Affiliation(s)
- V Lehti
- Department of Psychiatry, Helsinki University Central Hospital, P.O. Box 442, 00029 HUS, Finland.
| | - M Gissler
- National Institute for Health and Welfare (THL), Department of Information Services, P.O. Box 30, 00271 Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden
| | - J Suvisaari
- National Institute for Health and Welfare (THL), Mental Health Unit, P.O. Box 30, 00271 Helsinki, Finland
| | - M Manninen
- National Institute for Health and Welfare (THL), Mental Health Unit, P.O. Box 30, 00271 Helsinki, Finland
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Massey SH, Bublitz MH, Magee SR, Salisbury A, Niaura RS, Wakschlag LS, Stroud LR. Maternal-fetal attachment differentiates patterns of prenatal smoking and exposure. Addict Behav 2015; 45:51-6. [PMID: 25644587 DOI: 10.1016/j.addbeh.2015.01.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/14/2014] [Accepted: 01/14/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers. METHODS Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers. RESULTS At 30 weeks, pregnancy quitters scored higher on the 'giving of self' subscale compared to persistent smokers (21.6±2.4 versus 19.9±2.9; p=.004). Maternal 'giving of self' also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9±2.9 versus 21.2±2.2; p=.002). Controlling for age, income, unemployment, gravida, and father's smoking status, 'giving of self' differentiated pregnancy quitters from persistent smokers [OR=5.144; 95% C.I. 1.509 - 17.538; B (SE)=1.638 (.626); p=.009]. CONCLUSIONS Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA,; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA.
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
| | - Susanna R Magee
- Department of Family Medicine, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Amy Salisbury
- Department of Pediatrics, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, USA.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
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Melchior M, Hersi R, van der Waerden J, Larroque B, Saurel-Cubizolles MJ, Chollet A, Galéra C. Maternal tobacco smoking in pregnancy and children's socio-emotional development at age 5: The EDEN mother-child birth cohort study. Eur Psychiatry 2015; 30:562-8. [PMID: 25843027 DOI: 10.1016/j.eurpsy.2015.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is debate as to whether maternal tobacco use in pregnancy is related to offspring behaviour later on. We tested this association examining multiple aspects of children's behaviour at age 5 and accounting for parental smoking outside of pregnancy, as well as child and family characteristics. METHODS Data come from a prospective community based birth cohort study (EDEN; n=1113 families in France followed since pregnancy in 2003-2005 until the child's 5th birthday). Maternal tobacco use in pregnancy was self-reported. Children's socio-emotional development (emotional symptoms, conduct problems, symptoms of hyperactivity/inattention, peer relationship problems, prosocial behaviour) was assessed by mothers using the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Logistic regression analyses controlled for Inverse Probability Weights (IPW) of maternal tobacco use calculated based on study center, children's characteristics (sex, premature birth, low birth weight, breastfeeding), maternal characteristics (age at the child's birth, psychological difficulties and alcohol use in pregnancy, post-pregnancy depression, and smoking), paternal smoking in and post-pregnancy, parental educational attainment, family income, parental separation, and maternal negative life events. RESULTS Maternal smoking in pregnancy only predicted children's high symptoms of hyperactivity/inattention (sex and study center-adjusted ORs: maternal smoking in the 1st trimester: 1.95, 95%CI: 1.13-3.38; maternal smoking throughout pregnancy: OR=2.11, 95%CI: 1.36-3.27). In IPW-controlled regression models, only children of mothers who smoked throughout pregnancy had significantly elevated levels of hyperactivity/inattention (OR=2.20, 95%CI: 1.21-4.00). CONCLUSIONS Maternal tobacco smoking in pregnancy may contribute directly or through epigenetic mechanisms to children's symptoms of hyperactivity/inattention.
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Affiliation(s)
- M Melchior
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France.
| | - R Hersi
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - J van der Waerden
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - B Larroque
- INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University, 75020 Paris, France; UMR-S 953, UPMC - Université Paris 06, 75020 Paris, France
| | - M-J Saurel-Cubizolles
- INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University, 75020 Paris, France; UMR-S 953, UPMC - Université Paris 06, 75020 Paris, France
| | - A Chollet
- INSERM, UMR-S 1136, Department of Social Epidemiology, Pierre-Louis Institute of Epidemiology and Public Health, 75013 Paris, France; UMR-S 1136, Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, UPMC - Université Paris 06, 75013 Paris, France
| | - C Galéra
- Department of Child and Adolescent Psychiatry, Charles-Perrens Hospital, University of Bordeaux, 33076 Bordeaux, France; INSERM U897, Center for Research in Epidemiology and Biostatistics, prévention et prise en charge des traumatismes, Bordeaux, France
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Salihu HM, Pradhan A, King L, Paothong A, Nwoga C, Marty PJ, Whiteman V. Impact of intrauterine tobacco exposure on fetal telomere length. Am J Obstet Gynecol 2015; 212:205.e1-8. [PMID: 25173189 DOI: 10.1016/j.ajog.2014.08.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 08/12/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We sought to investigate whether maternal smoking during pregnancy affects telomere length of the fetus. STUDY DESIGN Pregnant women were recruited on hospital admission at delivery. A self-report questionnaire and salivary cotinine test were used to confirm tobacco exposure. Neonatal umbilical cord blood samples were collected, and genomic DNA was isolated from cord blood leukocytes and was analyzed for fetal telomere length based on quantitative polymerase chain reaction. A ratio of relative telomere length was determined by telomere repeat copy number and single copy gene copy number (T/S ratio) and used to compare the telomere length of active, passive, and nonsmokers. Bootstrap and analysis of variance statistical methods were used to evaluate the relationship between prenatal smoking status and fetal telomere length. RESULTS Of the 86 women who were included in this study, approximately 69.8% of the participants were covered by Medicaid, and 55.8% of the participants were black or Hispanic. The overall mean T/S ratio was 0.8608 ± 1.0442. We noted an inverse relationship between smoking and fetal telomere length in a dose-response pattern (T/S ratio of nonsmokers that was more than passive smokers that was more than active smokers). Telomere length was significantly different for each pairwise comparison, and the greatest difference was between active and nonsmokers. CONCLUSION Our results provide the first evidence to demonstrate a positive association between shortened fetal telomere length and smoking during pregnancy. Our findings suggest the possibility of early intrauterine programming for accelerated aging that is the result of tobacco exposure.
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Akerman SC, Brunette MF, Green AI, Goodman DJ, Blunt HB, Heil SH. Treating tobacco use disorder in pregnant women in medication-assisted treatment for an opioid use disorder: a systematic review. J Subst Abuse Treat 2014; 52:40-7. [PMID: 25592332 DOI: 10.1016/j.jsat.2014.12.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 12/05/2014] [Accepted: 12/07/2014] [Indexed: 02/07/2023]
Abstract
Smoking is associated with adverse effects on pregnancy and fetal development, yet 88-95% of pregnant women in medication-assisted treatment for an opioid use disorder smoke cigarettes. This review summarizes existing knowledge about smoking cessation treatments for pregnant women on buprenorphine or methadone, the two forms of medication-assisted treatment for opioid use disorder indicated for prenatal use. We performed a systematic review of the literature using indexed terms and key words to capture the concepts of smoking, pregnancy, and opioid substitution and found that only three studies met search criteria. Contingency management, an incentive based treatment, was the most promising intervention: 31% of participants achieved abstinence within the 12-week study period, compared to 0% in a non-contingent behavior incentive group and a group receiving usual care. Two studies of brief behavioral interventions resulted in reductions in smoking but not cessation. Given the growing number of pregnant women in medication-assisted treatment for an opioid use disorder and the negative consequences of smoking on pregnancy, further research is needed to develop and test effective cessation strategies for this group.
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Affiliation(s)
- Sarah C Akerman
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon NH, 03756, USA.
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon NH, 03756, USA
| | - Alan I Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon NH, 03756, USA
| | - Daisy J Goodman
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon NH 03756, USA
| | - Heather B Blunt
- Biomedical Libraries, Geisel School of Medicine at Dartmouth, Hanover NH, 03755, USA
| | - Sarah H Heil
- Vermont Center on Behavior and Health, Department of Psychiatry and Department of Psychology, University of Vermont, Burlington, VT, 05401, USA
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Heidari T, Ziaei S, Ahmadi F, Mohammadi E. Powerful leverages and counter-currents in the unborn child spiritual care: a qualitative study. Glob J Health Sci 2014; 7:122-32. [PMID: 25560343 PMCID: PMC4796445 DOI: 10.5539/gjhs.v7n1p122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 07/23/2014] [Accepted: 07/09/2014] [Indexed: 12/02/2022] Open
Abstract
In different cultures, pregnancy, birth and motherhood are perceived as spiritual events through their miraculous processes and create an ideal context for spiritual enrichment. However, studies on spirituality and birth are at very early stages. The purpose of this study was to understand the facilitators and barriers of the unborn child spiritual care in Iranian women. Twenty-two mothers with live pregnancy experience who were willing and able to share their life stories were selected purposefully in Tehran (Iran) from May 2012 to April 2013. Qualitative content analysis was used to analyze 27 interviews. Active and passive acquisition of information, inner inspirational messages, receiving effective support from the people around as well as modeling of self and significant others created “powerful leverages” to accelerate mother for caring her unborn child. “Counter-currents” in the form of unsuitable physical conditions during pregnancy, poor economic and social conditions, unsuitable psychological and cognitive conditions and finally understanding unsuitable ideological conditions of the self and care giver were identified as barriers. Iranian cultural and religious perspective on the unborn child physical and mental influence from mother has an important role in mother’s self-care behaviors during pregnancy. It seems that using interdisciplinary professionals’ skills based on understanding facilitators and barriers of mother care of the unborn child can lead to providing comprehensive prenatal care according to mothers’ cultural, religious and social context.
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Affiliation(s)
| | - Saeideh Ziaei
- Correspondence: Saeedeh Ziaei, Professor, Department of Midwifery & Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran. E-mail: .
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