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Baranowska-Rataj A, Barclay K, Costa-Font J, Myrskylä M, Özcan B. Preterm birth and educational disadvantage: Heterogeneous effects. POPULATION STUDIES 2023; 77:459-474. [PMID: 35670431 DOI: 10.1080/00324728.2022.2080247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/05/2022] [Indexed: 10/18/2022]
Abstract
Although preterm birth is the leading cause of perinatal morbidity and mortality in advanced economies, evidence about the consequences of prematurity in later life is limited. Using Swedish registers for cohorts born 1982-94 (N = 1,087,750), we examine the effects of preterm birth on school grades at age 16 using sibling fixed effects models. We further examine how school grades are affected by degree of prematurity and the compensating roles of family socio-economic resources and characteristics of school districts. Our results show that the negative effects of preterm birth are observed mostly among children born extremely preterm (<28 weeks); children born moderately preterm (32-<37 weeks) suffer no ill effects. We do not find any evidence for a moderating effect of parental socio-economic resources. Children born extremely preterm and in the top decile of school districts achieve as good grades as children born at full term in an average school district.Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2022.2080247.
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Affiliation(s)
| | - Kieron Barclay
- Max Planck Institute for Demographic Research
- London School of Economics and Political Science
- Stockholm University
| | | | - Mikko Myrskylä
- Max Planck Institute for Demographic Research
- London School of Economics and Political Science
- University of Helsinki
| | - Berkay Özcan
- London School of Economics and Political Science
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2
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Launbo N, Davidsen E, Granich-Armenta A, Bygbjerg IC, Sánchez M, Ramirez-Silva I, Avila-Jimenez L, Christensen DL, Rivera-Dommarco JA, Cantoral A, Nielsen KK, Grunnet LG. Overlooked paradox of the coexistence of overweight/obesity and anaemia during pregnancy. Nutrition 2022; 99-100:111650. [DOI: 10.1016/j.nut.2022.111650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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3
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Mikkonen J, Remes H, Moustgaard H, Martikainen P. Evaluating the Role of Parental Education and Adolescent Health Problems in Educational Attainment. Demography 2021; 57:2245-2267. [PMID: 33001417 PMCID: PMC7732787 DOI: 10.1007/s13524-020-00919-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article reconsiders the role of social origin in health selection by examining whether parental education moderates the association between early health and educational attainment and whether health problems mediate the intergenerational transmission of education. We used longitudinal register data on Finns born in 1986–1991 (n = 352,899). We measured the completion of secondary and tertiary education until age 27 and used data on hospital care and medication reimbursements to assess chronic somatic conditions, frequent infections, and mental disorders at ages 10–16. We employed linear probability models to estimate the associations between different types of health problems and educational outcomes and to examine moderation by parental education, both overall in the population and comparing siblings with and without health problems. Finally, we performed a mediation analysis with g-computation to simulate whether a hypothetical eradication of health problems would weaken the association between parental and offspring education. All types of health problems reduced the likelihood of secondary education, but mental disorders were associated with the largest reductions. Among those with secondary education, there was further evidence of selection to tertiary education. High parental education buffered against the negative impact of mental disorders on completing secondary education but exacerbated it in the case of tertiary education. The simulated eradication of health problems slightly reduced disparities by parental education in secondary education (up to 10%) but increased disparities in tertiary education (up to 2%). Adolescent health problems and parental education are strong but chiefly independent predictors of educational attainment.
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Affiliation(s)
- Janne Mikkonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland.
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland
| | - Heta Moustgaard
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland.,Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,The Max Planck Institute for Demographic Research, Rostock, Germany
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4
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Cozzani M, Aradhya S, Goisis A. The cognitive development from childhood to adolescence of low birthweight children born after medically assisted reproduction-a UK longitudinal cohort study. Int J Epidemiol 2021; 50:1514-1523. [PMID: 33693716 PMCID: PMC8580276 DOI: 10.1093/ije/dyab009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background Previous research has documented that children conceived through medically assisted reproduction (MAR) are at increased risk of poor birth outcomes, such as low birthweight (LBW), which are risk factors for stunted longer-term cognitive development. However, parents who undergo MAR to conceive have, on average, advantaged socioeconomic backgrounds which could compensate for the negative effects of being born LBW. Previous studies have not analysed whether the negative effects of LBW are attenuated among MAR conceived children. Methods We draw on the UK Millennium Cohort Study (sweeps 1–6) which contains a sub-sample of (N = 396) MAR-conceived children. The dependent variable measures cognitive ability at around ages 3, 5, 7, 11 and 14. We examine the cognitive development of four groups of children: MAR-conceived low birthweight (MAR LBW); MAR-conceived non-low birthweight (MAR NLBW); naturally conceived low birthweight (NC LBW); naturally conceived non-low birthweight (NC NLBW). We estimate the two following linear regression models for each sweep: (i) a baseline model to examine the unadjusted association between cognitive development and low birthweight by mode of conception; and (ii) a model adjusted by socio-demographic family characteristics. Results In baseline models, MAR LBW children [age 3: β = 0.021, 95% confidence interval (CI): -0.198, 0.241; age 5: β = 0.21, 95% CI: 0.009, 0.418; age 7: β = 0.163, 95% CI: -0.148, 0.474; age 11: β = 0.003, 95% CI: -0.318, 0.325; age 14: β = 0.156, 95% CI: -0.205, 0.517], on average perform similarly in cognitive ability relative to NC NLBW at all ages, and display higher cognitive scores than NC LBW children until age 7. When we account for family characteristics, differences are largely attenuated and become close to zero at age 14. Conclusions Despite the higher incidence of LBW among MAR compared with NC children, they do not seem to experience any disadvantage in their cognitive development compared with naturally conceived children. This finding is likely explained by the fact that, on average, MAR children are born to socioeconomically advantaged parents.
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Affiliation(s)
- Marco Cozzani
- Department of Social and Political Science, European University Institute, San Domenico di Fiesole, Italy
| | - Siddartha Aradhya
- Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Stockholm, Sweden
| | - Alice Goisis
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK.,Max Planck Institute for Demographic Research, Rostock, Germany
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5
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McGee G, Perkins NJ, Mumford SL, Kioumourtzoglou MA, Weisskopf MG, Schildcrout JS, Coull BA, Schisterman EF, Haneuse S. Methodological Issues in Population-Based Studies of Multigenerational Associations. Am J Epidemiol 2020; 189:1600-1609. [PMID: 32608483 DOI: 10.1093/aje/kwaa125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/25/2022] Open
Abstract
Laboratory-based animal research has revealed a number of exposures with multigenerational effects-ones that affect the children and grandchildren of those directly exposed. An important task for epidemiology is to investigate these relationships in human populations. Without the relative control achieved in laboratory settings, however, population-based studies of multigenerational associations have had to use a broader range of study designs. Current strategies to obtain multigenerational data include exploiting birth registries and existing cohort studies, ascertaining exposures within them, and measuring outcomes across multiple generations. In this paper, we describe the methodological challenges inherent to multigenerational studies in human populations. After outlining standard taxonomy to facilitate discussion of study designs and target exposure associations, we highlight the methodological issues, focusing on the interplay between study design, analysis strategy, and the fact that outcomes may be related to family size. In a simulation study, we show that different multigenerational designs lead to estimates of different exposure associations with distinct scientific interpretations. Nevertheless, target associations can be recovered by incorporating (possibly) auxiliary information, and we provide insights into choosing an appropriate target association. Finally, we identify areas requiring further methodological development.
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Härkönen J, Lindberg M, Karlsson L, Karlsson H, Scheinin NM. Education is the strongest socio-economic predictor of smoking in pregnancy. Addiction 2018; 113:1117-1126. [PMID: 29333764 PMCID: PMC5969298 DOI: 10.1111/add.14158] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/21/2017] [Accepted: 01/05/2018] [Indexed: 11/30/2022]
Abstract
AIMS To investigate socio-economic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class and current economic conditions. DESIGN Cross-sectional analysis with linked survey and register data. SETTING South-western Finland. PARTICIPANTS A total of 2667 pregnant women [70% of the original sample (n = 3808)] from FinnBrain, a prospective pregnancy cohort study. MEASUREMENTS The outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register. Education and occupational class were linked from population registers. Income support recipiency and subjective economic wellbeing were questionnaire-based measures of current economic conditions. These were adjusted for age, partnership status, residential area type, parental separation, parity, childhood socio-economic background, childhood adversities (the Trauma and Distressing Events During Childhood scale) and antenatal stress (Edinburgh Postnatal Depression Scale). Logistic regressions and attributable fractions (AF) were estimated. FINDINGS Mother's education was the strongest socio-economic predictor of SIP. Compared with university education, adjusted odds ratios (aORs) of SIP were: 2.2 [95% confidence interval (CI) = 1.2-3.9; P = 0.011] for tertiary vocational education, 4.4 (95% CI = 2.1-9.0; P < 0.001) for combined general and vocational secondary education, 2.9 (95% CI = 1.4-6.1; P = 0.006) for general secondary education, 9.5 (95% CI 5.0-18.2; P < 0.001) for vocational secondary education and 14.4 (95% CI = 6.3-33.0; P < 0.001) for compulsory schooling. The total AF of education was 0.5. Adjusted for the other variables, occupational class and subjective economic wellbeing did not predict SIP. Income support recipiency was associated positively with SIP (aOR = 1.8; 95% CI = 1.1-3.1; P = 0.022). Antenatal stress predicted SIP (aOR = 2.0; 95% CI = 1.4-2.8; P < 0.001), but did not attenuate its socio-economic disparities. CONCLUSIONS In Finland, socio-economic disparities in smoking in pregnancy are attributable primarily to differences in the mother's educational level (low versus high) and orientation (vocational versus general).
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Affiliation(s)
- Juho Härkönen
- Department of SociologyStockholm UniversityStockholmSweden
- Department of Political and Social SciencesEuropean University InstituteSan Domenico di FiesoleFiesoleItaly
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
| | - Matti Lindberg
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
| | - Linnea Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Institute of Clinical Medicine, Department of Child PsychiatryUniversity of TurkuTurkuFinland
- Department of Child PsychiatryTurku University HospitalTurkuFinland
| | - Hasse Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Department of PsychiatryTurku University HospitalTurkuFinland
- Department of PsychiatryUniversity of TurkuTurkuFinland
| | - Noora M. Scheinin
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Department of PsychiatryTurku University HospitalTurkuFinland
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7
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Jelenkovic A, Mikkonen J, Martikainen P, Latvala A, Yokoyama Y, Sund R, Vuoksimaa E, Rebato E, Sung J, Kim J, Lee J, Lee S, Stazi MA, Fagnani C, Brescianini S, Derom CA, Vlietinck RF, Loos RJF, Krueger RF, McGue M, Pahlen S, Nelson TL, Whitfield KE, Brandt I, Nilsen TS, Harris JR, Cutler TL, Hopper JL, Tarnoki AD, Tarnoki DL, Sørensen TIA, Kaprio J, Silventoinen K. Association between birth weight and educational attainment: an individual-based pooled analysis of nine twin cohorts. J Epidemiol Community Health 2018; 72:832-837. [PMID: 29848580 DOI: 10.1136/jech-2017-210403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is evidence that birth weight is positively associated with education, but it remains unclear whether this association is explained by familial environmental factors, genetic factors or the intrauterine environment. We analysed the association between birth weight and educational years within twin pairs, which controls for genetic factors and the environment shared between co-twins. METHODS The data were derived from nine twin cohorts in eight countries including 6116 complete twin pairs. The association between birth weight and educational attainment was analysed both between individuals and within pairs using linear regression analyses. RESULTS In between-individual analyses, birth weight was not associated with educational years. Within-pairs analyses revealed positive but modest associations for some sex, zygosity and birth year groups. The greatest association was found in dizygotic (DZ) men (0.65 educational years/kg birth weight, p=0.006); smaller effects of 0.3 educational years/kg birth weight were found within monozygotic (MZ) twins of both sexes and opposite-sex DZ twins. The magnitude of the associations differed by birth year in MZ women and opposite-sex DZ twins, showing a positive association in the 1915-1959 birth cohort but no association in the 1960-1984 birth cohort. CONCLUSION Although associations are weak and somewhat inconsistent, our results suggest that intrauterine environment may play a role when explaining the association between birth weight and educational attainment.
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Affiliation(s)
- Aline Jelenkovic
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Janne Mikkonen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Antti Latvala
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Reijo Sund
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Esther Rebato
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Joohon Sung
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, The Republic of Korea.,Institute of Health and Environment, Seoul National University, Seoul, The Republic of Korea
| | - Jina Kim
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Jooyeon Lee
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Sooji Lee
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, The Republic of Korea
| | - Maria A Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Sonia Brescianini
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Catherine A Derom
- Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Ghent University Hospitals, Ghent, Belgium
| | | | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shandell Pahlen
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tracy L Nelson
- Department of Health and Exercise Sciencies and Colorado School of Public Health, Colorado State University, Fort Collins, Colorado, USA
| | - Keith E Whitfield
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Ingunn Brandt
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas S Nilsen
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Jennifer R Harris
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Tessa L Cutler
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - John L Hopper
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, The Republic of Korea.,The Australian Twin Registry, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adam D Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - David L Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary.,Hungarian Twin Registry, Budapest, Hungary
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research (Section of Metabolic Genetics), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland.,Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
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8
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Parra GR, Smith GL, Mason WA, Savolainen J, Chmelka MB, Miettunen J, Järvelin MR, Moilanen I, Veijola J. Profiles of Contextual Risk at Birth and Adolescent Substance Use. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:717-724. [PMID: 29861618 PMCID: PMC5979268 DOI: 10.1007/s10826-017-0935-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examined whether there are subgroups of families with distinct profiles of prenatal/birth contextual risk, and whether subgroup membership was differentially related to adolescent substance use. Data from the Northern Finland Birth Cohort 1986 were used. A five-class model provided the most meaningful solution. Large Family Size (7.72%) and Low Risk (69.69%) groups had the lowest levels of alcohol, cigarette, and illegal drug use. Similar high levels for each of the three substance-related outcomes were found for Parent Substance Misuse (11.20%), Maternal School Dropout (4.66%), and Socioeconomic Disadvantage (6.72%) groups. Maternal smoking and drinking while pregnant and paternal heavy alcohol use were found to be key prenatal risk factors that tended to cluster together and co-occur with other prenatal risk factors differently for different subgroups of youth.
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Affiliation(s)
- Gilbert R. Parra
- Deparment of Child, Youth and Family Studies, University of Nebraska-Lincoln, 135 Mable Lee Hall, Lincoln, NE 68588 US
| | - Gail L. Smith
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE
| | - W. Alex Mason
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE
| | - Jukka Savolainen
- Institute for Social Research, University of Michigan, ICPSR, Ann Arbor, MI
| | - Mary B. Chmelka
- Boys Town National Research Institute for Child and Family Studies, 14100 Crawford Street, Boys Town, NE
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC PHE Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Irma Moilanen
- PEDEGO Research Center, University of Oulu, Oulu, Finland
- Department of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
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9
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Taka-Eilola Née Riekki T, Miettunen J, Mäki P. Schizotypal and affective traits in the offspring of antenatally depressed mothers - Relationship to family history of psychosis in the Northern Finland 1966 Birth Cohort. Eur Psychiatry 2017; 42:36-43. [PMID: 28192768 DOI: 10.1016/j.eurpsy.2016.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/10/2016] [Accepted: 12/11/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Maternal depression is relatively common during pregnancy. However, follow-ups of the adult offspring of antenatally depressed mothers are scarce. Previously we found the risk of schizophrenia to be higher in the adult offspring with antenatally depressed mothers and parents with psychosis than in subjects with only one or neither of these risk factors. The aim was to study whether the risk of schizotypal or affective traits differ among adult offspring with antenatally depressed mothers with or without a parental history of psychosis when compared with offspring without antenatally depressed mothers and without parental psychosis. METHODS In the general population-based Northern Finland 1966 Birth Cohort (NFBC 1966), the mothers of the cohort members were asked at mid-gestation whether they felt depressed. Parental psychosis (Familial Risk, FR) was detected using the Finnish Care Register for Health Care. In the 31-year field study, seven psychometric questionnaires surveyed schizotypal and affective traits in the offspring. The final sample included 4928 individuals (2203 males). RESULTS There were no statistically significant differences in mean scores on the schizotypal and affective scales between offspring with and without antenatally depressed mothers, or between subjects with and without parental psychosis. The scores were not highest in the subjects with both maternal antenatal depressed mood and FR. CONCLUSION Surprisingly, maternal depressed mood during pregnancy was unlikely to increase the risk of schizotypy or affective traits in adult offspring, and not even with parental psychosis (FR) in this general population-based birth cohort with about 5000 subjects.
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Affiliation(s)
| | - J Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Center for Life Course Health Research, University of Oulu, Finland
| | - P Mäki
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Länsi-Pohja Healthcare District, Finland; Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Soite, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland; Mental Health Services, Basic Health Care District of Kallio and Oulaskangas-Visala Hospital, the Northern Ostrobothnia Hospital District, Finland
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10
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Ramsay H, Barnett JH, Murray GK, Mäki P, Hurtig T, Nordström T, Miettunen J, Kiviniemi V, Niemelä S, Pausova Z, Paus T, Veijola J. Smoking in pregnancy, adolescent mental health and cognitive performance in young adult offspring: results from a matched sample within a Finnish cohort. BMC Psychiatry 2016; 16:430. [PMID: 27908296 PMCID: PMC5133752 DOI: 10.1186/s12888-016-1142-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 11/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between prenatal exposure to maternal cigarette smoking (PEMCS) and adult cognition is debated, including if there are differences according to sex. We aimed to determine if there are associations between PEMCS and cognition in early adulthood in men and women and examine if observed associations were mediated by adolescent mental health factors that are associated with cognition, namely psychotic-like experiences (PLEs), inattention and hyperactivity, and other externalizing behaviors. METHODS Participants were 471 individuals drawn from the general population-based Northern Finland 1986 Birth Cohort (NFBC 1986) followed up from pregnancy and birth to early adulthood; individuals with PEMCS were matched with those without PEMCS by socioeconomic and demographic factors. Cognitive performance in adulthood was assessed with a range of tests and their association with PEMCS was measured by sex using hierarchical linear regression, unadjusted and then controlling for potential confounders, mediators and moderators, including adolescent mental health factors. RESULTS There were no associations between PEMCS and cognitive scores in females. In males, there were associations with vocabulary (beta = -0.444, 95% CI: -0.783, -0.104) and matrix reasoning (beta = -0.379, 95% CI: -0.711, -0.047). CONCLUSIONS While associations between PEMCS and cognition were limited, observed findings with measures of general intelligence in males contribute to suggestions of differences in response to PEMCS by sex. Furthermore, observed associations may be partly mediated by earlier inattention and hyperactivity. Findings add support to efforts aimed to eliminate smoking in pregnancy.
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Affiliation(s)
- Hugh Ramsay
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland. .,St. Michael's House, Dublin, Ireland.
| | - Jennifer H. Barnett
- Department of Psychiatry, University of Cambridge, Cambridge, UK ,Cambridge Cognition Ltd, Cambridge, UK
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pirjo Mäki
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Department of Psychiatry, Länsi-Pohja Healthcare District, Kemi, Finland ,Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Kiuru, Finland ,Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Raahe, Finland ,Mental Health Services, Basic Health Care District of Kallio, Helsinki, Finland ,Visala Hospital, the Northern Ostrobothnia Hospital District, Oulu, Finland
| | - Tuula Hurtig
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Department of Radiology, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Tanja Nordström
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Vesa Kiviniemi
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Department of Radiology, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Solja Niemelä
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland ,Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Tomas Paus
- Rotman Research Institute, Baycrest, Toronto, ON Canada ,Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON Canada ,Child Mind Institute, New York, NY USA
| | - Juha Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
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Feldman I, Eurenius E, Häggström J, Sampaio F, Lindkvist M, Pulkki-Brännström AM, Ivarsson A. Effectiveness and cost-effectiveness of the Salut Programme: a universal health promotion intervention for parents and children-protocol of a register-based retrospective observational study. BMJ Open 2016; 6:e011202. [PMID: 27491668 PMCID: PMC4985974 DOI: 10.1136/bmjopen-2016-011202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/10/2016] [Accepted: 07/14/2016] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION There is inadequate evidence for the effectiveness and cost-effectiveness of health promotion interventions. The Salut Programme aims to reach all parents and children in the Västerbotten County of Sweden with a combination of health promotion interventions initiated during pregnancy and continued over the childhood period. This study protocol describes an effectiveness study and an economic evaluation study, where the ongoing Salut Programme is compared to care-as-usual over the periods of pregnancy, delivery and the child's first 2 years of life. METHODS A register-based retrospective observational study design will be used with existing data sources with respect to exposures and outcomes. Outcomes of interest are clustered at 3 points: around the child's birth, 1 month after the child's birth and 2 years after the child's birth. We will simulate an experiment by retrospectively identifying and comparing children and their parents in the geographical areas where the Salut Programme was implemented since 2006 and onwards, and the areas where the Programme was not implemented before 2009. Outcomes will be analysed and compared for the premeasure period, and the postmeasure period for both groups. Our analysis combines difference-in-difference estimation with matching. A complementary analysis will be carried out on the longitudinal subsample of mothers who gave birth at least once during each of the time periods. The economic evaluation aims to capture the wider societal costs and benefits of the Salut Programme for the first 2 years of the children's lives. Incremental costs will be compared with incremental health gains and the results will be presented as a cost-consequence analysis. ETHICS AND DISSEMINATION The Regional Ethical Review Board in Umeå has given clearance for the Salut Programme research (2010-63-31M). No individual's identity will be revealed when presenting results. This study will provide information that can guide decision-makers to allocate resources optimally.
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Affiliation(s)
- Inna Feldman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Eva Eurenius
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Jenny Häggström
- Department of Statistics, USBE, Umeå University, Umeå, Sweden
| | - Filipa Sampaio
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Lindkvist
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Statistics, USBE, Umeå University, Umeå, Sweden
| | - Anni-Maria Pulkki-Brännström
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Anneli Ivarsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
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12
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Cohen AK, Lê-Scherban F. Invited Commentary: Multigenerational Social Determinants of Health—Opportunities and Challenges. Am J Epidemiol 2015; 182:579-82. [PMID: 26283087 DOI: 10.1093/aje/kwv145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/07/2015] [Indexed: 11/13/2022] Open
Abstract
An emerging area of social epidemiology examines the relationship between grandparental education and grandchild health. In an accompanying article, Huang et al. (Am J Epidemiol. 2015;182(7):568-578) join the small but growing body of research on this topic. It is useful to contextualize Huang et al.'s work within the much larger body of research examining relationships between education and health within a single generation or across 2 generations. These investigators have generally concluded that higher educational attainment is robustly associated with better health. There are many potential mechanisms through which education and other social exposures may affect health outcomes in a single generation or across generations, and estimating direct and indirect effects can be helpful for assessing specific mechanisms. Researchers conducting multigenerational analyses are faced with several challenges, including limited availability of data for some measures (e.g., educational attainment, and sometimes for 1 grandparent only), limited age ranges of participants, disparate social and political contexts in which study participants of different generations have lived, and patterns of social class reproduction. We encourage future researchers to weave together the careful analytical considerations illustrated by Huang et al. with a rich understanding of the social context for each of the generations studied to help overcome these challenges and advance our understanding of multigenerational social determinants of health.
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Abstract
For the 22% of American children who live below the federal poverty line, and the additional 23% who live below twice that level, nutritional policy is part of the safety net against hunger and its negative effects on children's development. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides steadily available food from the food groups essential for physical and cognitive development. The effects of WIC on dietary quality among participating women and children are strong and positive. Furthermore, there is a strong influence of nutrition on cognitive development and socioeconomic inequality. Yet, research on the non-health effects of U.S. child nutritional policy is scarce, despite the ultimate goal of health policies directed at children-to enable productive functioning across multiple social institutions over the life course. Using two nationally representative, longitudinal surveys of children-the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) and the Child Development Supplement (CDS) of the Panel Study of Income Dynamics-I examine how prenatal and early childhood exposure to WIC is associated in the short-term with cognitive development, and in the longer-term with reading and math learning. Results show that early WIC participation is associated with both cognitive and academic benefits. These findings suggest that WIC meaningfully contributes to children's educational prospects.
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Affiliation(s)
- Margot I Jackson
- Brown University, Department of Sociology, Box 1916, Providence, RI 02912, USA.
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Heshmati A, Mishra G, Koupil I. Childhood and adulthood socio-economic position and hypertensive disorders in pregnancy: the Uppsala Birth Cohort Multigenerational Study. J Epidemiol Community Health 2013; 67:939-46. [PMID: 23729327 DOI: 10.1136/jech-2012-202149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Childhood and adulthood socio-economic position (SEP) is associated with cardiovascular disease in later life, but associations with hypertensive disorders in pregnancy are not well established. OBJECTIVE The aim of this study was to investigate the association of childhood and adulthood SEP with hypertensive disorders in pregnancy (chronic hypertension, gestational hypertension and pre-eclampsia/eclampsia). METHOD Study participants were Swedish women (n=9507) from generation 3 of the Uppsala Birth Cohort Multigenerational Study (UBCoS Multigen) who delivered a live singleton offspring between 1982 and 2008. Social and health data were obtained from routine Swedish registers. Associations of own education (adulthood SEP), and parental education and social class (childhood SEP) with hypertensive disorders were studied using logistic regression with adjustments for age, calendar period, parity, smoking and body mass index. RESULTS Low own education was associated with chronic hypertension, but not with gestational hypertension or pre-eclampsia/eclampsia. Increased risk of chronic hypertension was seen in women whose mothers had medium education compared with women whose mothers had high education (OR 2.18, 95% CI 1.03 to 4.62). Women from a manual social class during childhood had twice the risk of chronic hypertension compared with those from non-manual backgrounds (OR 2.19, 95% CI 1.28 to 3.75). Childhood SEP was not associated with gestational hypertension or pre-eclampsia/eclampsia. CONCLUSIONS Childhood and adulthood SEP was associated with chronic hypertension in pregnancy. In contrast, no association with childhood or adulthood SEP was seen for gestational hypertension or pre-eclampsia/eclampsia.
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Affiliation(s)
- Amy Heshmati
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, , Stockholm, Sweden
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