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Vidal AC, Sosnowski DW, Marchesoni J, Grenier C, Thorp J, Murphy SK, Johnson SB, Schlief W, Hoyo C. Maternal adverse childhood experiences (ACEs) and offspring imprinted gene DMR methylation at birth. Epigenetics 2024; 19:2293412. [PMID: 38100614 PMCID: PMC10730185 DOI: 10.1080/15592294.2023.2293412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
Adverse childhood experiences (ACEs) contribute to numerous negative health outcomes across the life course and across generations. Here, we extend prior work by examining the association of maternal ACEs, and their interaction with financial stress and discrimination, with methylation status within eight differentially methylated regions (DMRs) in imprinted domains in newborns. ACEs, financial stress during pregnancy, and experience of discrimination were self-reported among 232 pregnant women. DNA methylation was assessed at PEG10/SGCE, NNAT, IGF2, H19, PLAGL1, PEG3, MEG3-IG, and DLK1/MEG3 regulatory sequences using pyrosequencing. Using multivariable linear regression models, we found evidence to suggest that financial stress was associated with hypermethylation of MEG3-IG in non-Hispanic White newborns; discrimination was associated with hypermethylation of IGF2 and NNAT in Hispanic newborns, and with hypomethylation of PEG3 in non-Hispanic Black newborns. We also found evidence that maternal ACEs interacted with discrimination to predict offspring PLAGL1 altered DMR methylation, in addition to interactions between maternal ACEs score and discrimination predicting H19 and SGCE/PEG10 altered methylation in non-Hispanic White newborns. However, these interactions were not statistically significant after multiple testing corrections. Findings from this study suggest that maternal ACEs, discrimination, and financial stress are associated with newborn aberrant methylation in imprinted gene regions.
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Affiliation(s)
- Adriana C. Vidal
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - David W. Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joddy Marchesoni
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Carole Grenier
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - John Thorp
- Department of Obstetrics and Gynecology, Maternal and Child Health, UNC Gillings School of Public Health, UNC, Chapel Hill, NC, USA
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Sara B. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William Schlief
- Johns Hopkins All Children’s Pediatric Biorepository, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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Gennaro S, Melnyk BM, Szalacha LA, Gibeau AM, Hoying J, O'Connor CM, Cooper AR, Aviles MM. Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT. Am J Prev Med 2024; 66:797-808. [PMID: 38323949 PMCID: PMC11197933 DOI: 10.1016/j.amepre.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. STUDY DESIGN This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. SETTING/PARTICIPANTS Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. INTERVENTION Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. MAIN OUTCOME MEASURES Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. RESULTS There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. CONCLUSIONS Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. TRIAL REGISTRATION This study is registered with clinicaltrials.gov NCT03416010.
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Affiliation(s)
- Susan Gennaro
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | | | - Laura A Szalacha
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | | | | | - Caitlin M O'Connor
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.
| | - Andrea R Cooper
- College of Nursing, The Ohio State University, Columbus, Ohio
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Mudiyanselage SB, Wanni Arachchige Dona S, Angeles MR, Majmudar I, Marembo M, Tan EJ, Price A, Watts JJ, Gold L, Abimanyi-Ochom J. The impact of maternal health on child's health outcomes during the first five years of child's life in countries with health systems similar to Australia: A systematic review. PLoS One 2024; 19:e0295295. [PMID: 38457392 PMCID: PMC10923423 DOI: 10.1371/journal.pone.0295295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/19/2023] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION The first five years of life is an important developmental period that establishes the foundation for future health and well-being. Mothers play a primary role in providing emotional and physical nourishment during early childhood. This systematic review aims to explore the association between maternal health and child health in the first five years of the child's life. MATERIALS AND METHODS As primary aims, we systematically synthesised published evidence relating to the first five years of life for associations between maternal health exposures (mental, physical and Health-Related Quality of Life (HRQoL) and child health outcomes (physical health, mental health, HRQoL and Health Service Use (HSU) /cost). As a secondary aim, we explored how the above associations vary between disadvantaged and non-disadvantaged populations. The search was limited to studies that published and collected data from 2010 to 2022. The systematic review was specific to countries with similar health systems to Australia. The search was conducted in MEDLINE, CINAHL, APA PsycINFO, GLOBAL HEALTH, and EMBASE databases. The quality of the included studies was assessed by The Effective Public Health Practice Project (EPHPP) tool. RESULTS Thirteen articles were included in the final synthesis from the identified 9439 articles in the primary search. Six (46%) explored the association between maternal mental health and child's physical health, two (15%) explored maternal and child's physical health, one (8%) explored maternal and child's mental health, one (8%) explored maternal physical health and child's HRQoL, and three (23%) explored maternal mental health and child's HSU. We found an association between maternal health and child health (physical and mental) and HSU outcomes but no association between maternal health and child's overall HRQoL. The results for disadvantaged communities did not show any difference from the general population. DISCUSSION AND CONCLUSION Our review findings show that maternal health influences the child's health in the first five years. However, the current evidence is limited, and the findings were primarily related to a specific maternal or child's health condition. There was no evidence of associations of child health outcomes in healthy mothers. There is an extensive research gap investigating maternal health exposures and child outcomes in quality of life and overall health.
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Affiliation(s)
- Shalika Bohingamu Mudiyanselage
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Sithara Wanni Arachchige Dona
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Mary Rose Angeles
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Ishani Majmudar
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Miriam Marembo
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
- Department of Education, Victoria, Melbourne, Australia
| | - Eng Joo Tan
- Monash University Health Economics Group (MUHEG), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anna Price
- Centre for Community Child Health, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Population Health, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer J. Watts
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lisa Gold
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Julie Abimanyi-Ochom
- School of Health and Social Development and Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
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Zhuang S, Chen M, Ma X, Jiang J, Xiao G, Zhao Y, Hou J, Wang Y. The needs of women experiencing perinatal loss: A qualitative systematic review and meta-synthesis. Women Birth 2023; 36:409-420. [PMID: 37024379 DOI: 10.1016/j.wombi.2023.03.007] [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: 11/03/2022] [Revised: 02/23/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
PROBLEM There have been some studies on the needs of women experiencing perinatal loss in various socio-cultural contexts, but there is no research that systematically and comprehensively synthesizes these needs. BACKGROUND Perinatal loss has profound psychosocial effects. The misconceptions and prejudices existing in the public, the lack of satisfactory clinical care, and the available social support may all increase the negative impact. AIM To synthesize evidence for the needs of women experiencing perinatal loss, attempt to explain the findings, and provide insights into the application of evidence. METHODS Published papers were searched in seven electronic databases until 26 March 2022. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of the included studies. Through meta-aggregation, the data was extracted, rated, and synthesized, resulting in new categories and findings. The credibility and dependability of the synthesized evidence were evaluated by ConQual. FINDINGS Thirteen studies that fulfilled the inclusion criteria and quality assessment were included in the meta-synthesis. Five synthesized findings were identified, covering information needs, emotional needs, social needs, clinical care needs, as well as spiritual and religious needs. CONCLUSION Women's perinatal bereavement needs were individualized and diverse. There is a necessity to understand, identify, and respond to their needs in a sensitive and personalized way. Families, communities, healthcare institutions, and society form a coordinated whole and provide accessible resources to improve recovery from perinatal loss and a satisfactory outcome in the subsequent pregnancy.
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Affiliation(s)
- Simin Zhuang
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Mengyun Chen
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Ximei Ma
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Jingjing Jiang
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Guanghong Xiao
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Yanan Zhao
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Jiawen Hou
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China
| | - Yanhong Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730011, China.
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Puosi E, Korhonen LS, Karlsson L, Kataja EL, Lukkarinen H, Karlsson H, Lukkarinen M. Maternal prenatal psychological distress associates with offspring early-life wheezing - FinnBrain Birth Cohort. Pediatr Allergy Immunol 2022; 33:e13706. [PMID: 34845769 PMCID: PMC9299775 DOI: 10.1111/pai.13706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Exposure to prenatal maternal psychological distress may contribute to the development of childhood atopic disorders. Little is known about the importance of distress severity and its duration for the risk. Our aim was to investigate how chronic maternal depressive and anxiety symptoms across gestation influence the risk of wheezing and eczema at child age 24 months. METHODS The study population was drawn from the FinnBrain Birth Cohort Study, including 1305 mother-infant dyads followed across gestation until the child age of 24 months when the outcomes were mother-reported wheezing ever and doctor-diagnosed eczema. To investigate the risk of wheezing phenotypes, wheezing with and without eczema was separated. Maternal distress was assessed with the Edinburgh Postnatal Depression Scale for depressive and the Symptom Checklist-90 for anxiety symptoms three times during pregnancy, and the chronicity was demonstrated using symptom trajectories composed by latent growth mixture modeling. RESULTS Of the children, 219/1305 (17%) had wheezing ever and 285/1276 (22%) had eczema. Risk of wheezing ever was elevated with maternal consistently high depressive symptoms (adjusted odds ratio 2.74; 95% confidence interval 1.37-5.50) or moderate and increasing anxiety symptoms (1.94; 1.06-3.54, respectively). Similarly, wheezing without eczema was associated with consistently high depressive (3.60; 1.63-7.94, respectively) and moderate and increasing anxiety symptoms (2.43; 1.21-4.91, respectively). CONCLUSIONS Maternal chronic psychological distress across gestation was associated with toddler wheezing and especially wheezing without other atopic features (eczema). This finding supports the theory of intrauterine programming effect by maternal psychological distress on offspring immune system and respiratory morbidity.
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Affiliation(s)
- Emma Puosi
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,The Department of Pediatrics and Adolescent Medicine, University of Turku, and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Laura S Korhonen
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,The Department of Pediatrics and Adolescent Medicine, University of Turku, and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland.,The Department of Psychiatry, University of Turku, and Turku University Hospital, Turku, Finland
| | - Eeva-Leena Kataja
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland.,The Department of Psychology, University of Turku, Turku, Finland
| | - Heikki Lukkarinen
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,The Department of Pediatrics and Adolescent Medicine, University of Turku, and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland.,The Department of Psychiatry, University of Turku, and Turku University Hospital, Turku, Finland
| | - Minna Lukkarinen
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,The Department of Pediatrics and Adolescent Medicine, University of Turku, and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
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Lund RJ, Kyläniemi M, Pettersson N, Kaukonen R, Konki M, Scheinin NM, Karlsson L, Karlsson H, Ekholm E. Placental DNA methylation marks are associated with maternal depressive symptoms during early pregnancy. Neurobiol Stress 2021; 15:100374. [PMID: 34401410 PMCID: PMC8353413 DOI: 10.1016/j.ynstr.2021.100374] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/13/2021] [Accepted: 07/29/2021] [Indexed: 01/02/2023] Open
Abstract
Maternal depressive symptoms during pregnancy are a significant risk factor for adverse developmental and health outcomes of the offspring. The molecular mechanisms mediating the long-term effects of this exposure are not well understood. Previous studies have found association between prenatal exposure to maternal psychological distress and placental DNA methylation of candidate genes, which can influence placental barrier function and development of the fetus. Our objective in this study was to determine epigenome wide association of maternal depressive symptoms in early pregnancy with the placental DNA methylation. For this purpose we examined DNA methylomes of 92 placental samples by using reduced representation bisulfite sequencing. The placental samples were collected after deliveries of 39 girls and 59 boys, whose mothers had Edinburgh Postnatal Depression Score ranging from 0 to 19 at gestational week 14. According to our results maternal depressive symptoms are associated with DNA methylation of 2833 CpG sites, which are particularly over-represented in genic enhancers. The genes overlapping or nearest to these sites are functionally enriched for development of neurons and show expression enrichment in several regions of developing brain. The genomic regions harboring the DNA methylation marks are enriched for single nucleotide polymorphisms associated with mental disease trait class. Potential cellular signaling cascades mediating the effects include inflammatory and hormonal pathways. As a conclusion our results suggest that maternal depressive symptoms during early pregnancy are associated with DNA methylation marks in placenta in genes, which are important for the development and long-term health of the brain. Whether similar marks can be detected in exposed children remains to be elucidated in further studies.
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Affiliation(s)
- Riikka J. Lund
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Minna Kyläniemi
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Nina Pettersson
- Department of Obstetrics and Gynecology, Turku University Central Hospital and University of Turku, Turku, Finland
| | - Riina Kaukonen
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Mikko Konki
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Noora M. Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Pediatrics, University of Turku, Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
- Department of Psychiatry and Turku Brain and Mind Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Eeva Ekholm
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Central Hospital and University of Turku, Turku, Finland
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Auger N, Monnier M, Low N, Lee GE, Bilodeau-Bertrand M, Luu TM. Maternal Mental Disorders and Pediatric Infectious Diseases: A Retrospective Cohort Study. Pediatr Infect Dis J 2021; 40:697-703. [PMID: 33657596 DOI: 10.1097/inf.0000000000003108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Maternal stress and depression are associated with infections in offspring, but there is a paucity of data for other mental disorders. METHODS We conducted a retrospective cohort study of 832,290 children born between 2006 and 2016 in hospitals of Quebec, Canada. We identified maternal mental disorders before and during pregnancy, and admissions for otitis media, pneumonia, infectious enteritis and other infections in children before 13 years of age. We used Cox proportional hazards regression to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for the association between maternal mental disorders and the risk of pediatric infectious diseases, adjusted for maternal age, comorbidity, socioeconomic disadvantage, and other confounders. RESULTS The incidence of pediatric infection hospitalization was higher for maternal mental disorders compared with no disorder (66.1 vs. 41.1 cases per 1000 person-years). Maternal mental disorders were associated with 1.38 times the risk of otitis media (95% CI: 1.35-1.42), 1.89 times the risk of bronchitis (95% CI: 1.68-2.12), and 1.65 times the risk of infectious enteritis in offspring (95% CI: 1.57-1.74). Stress and anxiety disorders (HR 1.49, 95% CI: 1.46-1.53) and personality disorders (HR 1.55, 95% CI: 1.49-1.61) were more strongly associated with the risk of pediatric infection hospitalization than other maternal mental disorders. Associations were prominent in the first year of life and weakened with age. CONCLUSIONS Maternal mental disorders are risk factors for infectious disease hospitalization in offspring. Women with mental disorders may benefit from psychosocial support to reduce the risk of serious infections in their children.
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Affiliation(s)
- Nathalie Auger
- From the University of Montreal Hospital Research Centre
- Institut national de santé publique du Québec
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Maëva Monnier
- Institut national de santé publique du Québec
- Institute of Public Health, Epidemiology and Development, University of Bordeaux, Bordeaux, New-Aquitaine, France
| | - Nancy Low
- Department of Psychiatry, McGill University
| | - Ga Eun Lee
- From the University of Montreal Hospital Research Centre
- Institut national de santé publique du Québec
| | | | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
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Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126333. [PMID: 34208074 PMCID: PMC8296154 DOI: 10.3390/ijerph18126333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022]
Abstract
During pregnancy, a woman's enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be "Decreased then Increased" (56.8%). Other noticeable patterns were "Continuously Increased" (28.4%), "Increased then Decreased" (10.5%) and "Continuously Decreased" (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants' major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the "moderately distressful" level. This study provides evidence that could be used to predict women's pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.
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Katila M, Saarenpää-Heikkilä O, Saha MT, Vuorela N, Huhtala H, Korhonen LS, Lukkarinen M, Tuulari JJ, Karlsson L, Karlsson H, Paavonen EJ. Prevalence and evolution of snoring and the associated factors in two-year-old children. Sleep Med 2021; 84:275-282. [PMID: 34186453 DOI: 10.1016/j.sleep.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors. STUDY DESIGN The study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors. RESULTS The combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5-3.1), which is markedly lower than reported previously. Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2-12.5) or asthma (FB OR 4.3, 1.4-13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2-9.0) and father's (CS OR 3.4, 1.4-8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1-6.8), the mother's lower level of education (CS ORa 2.9, 1.2-7.5, FB ORa 2.1, 1.0-4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3-6.3) associated with the child's habitual snoring. CONCLUSIONS The prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.
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Affiliation(s)
- Maija Katila
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Outi Saarenpää-Heikkilä
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Marja-Terttu Saha
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Nina Vuorela
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Laura S Korhonen
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Minna Lukkarinen
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, UK (Sigrid Juselius Fellowship), United Kingdom
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - E Juulia Paavonen
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland
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Korhonen LS, Lukkarinen M, Kantojärvi K, Räty P, Karlsson H, Paunio T, Peltola V, Karlsson L. Interactions of genetic variants and prenatal stress in relation to the risk for recurrent respiratory infections in children. Sci Rep 2021; 11:7589. [PMID: 33828172 PMCID: PMC8027646 DOI: 10.1038/s41598-021-87211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 03/17/2021] [Indexed: 12/24/2022] Open
Abstract
Genetic variants may predispose children to recurrent respiratory infections (RRIs) but studies on genotype-environment interaction are rare. We hypothesized that the risk for RRIs is elevated in children with innate immune gene variants, and that prenatal exposure to maternal psychological distress further increases the risk. In a birth cohort, children with RRIs (n = 96) were identified by the age of 24 months and compared with the remaining cohort children (n = 894). The risk for RRIs in children with preselected genetic variants and the interaction between maternal distress during pregnancy and child genotype were assessed with logistic regression. The IL6 minor allele G was associated with elevated risk for RRIs (OR 1.55; 95% CI 1.14-2.12). Overall, there was no interaction between maternal psychological distress and child genotype. Exploratory analyses showed that, the association between the variant type of IL6 and the risk for RRIs was dependent on prenatal exposure to maternal psychological distress in males (OR 1.96; 95% CI 1.04-3.67). Our study didn't find genotype-environment interaction between prenatal maternal distress and child genotype. Exploratory analyses suggest sex differences in gene-environment interaction related to susceptibility to RRIs.
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Affiliation(s)
- Laura S Korhonen
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland. .,Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, P.O. Box 52, 20521, Turku, Finland.
| | - Minna Lukkarinen
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, P.O. Box 52, 20521, Turku, Finland
| | - Katri Kantojärvi
- Genomics and Biobank Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Panu Räty
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Tiina Paunio
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Genomics and Biobank Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ville Peltola
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, P.O. Box 52, 20521, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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11
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Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring. PLoS One 2021; 16:e0245747. [PMID: 33513152 PMCID: PMC7845992 DOI: 10.1371/journal.pone.0245747] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/07/2021] [Indexed: 12/27/2022] Open
Abstract
Background Maternal stressful life events during pregnancy have been associated with immune dysregulation and increased risk for asthma and atopy in offspring. Few studies have investigated whether prenatal stress is associated with increased overall or specific infectious diseases in childhood, nor explored sex differences. We sought to examine the relationship between the nature and timing of maternal stress in pregnancy and hospitalisation with infection in offspring. Methods Between 1989 and 1992, exposure data on stressful life events were collected from pregnant women (Gen1) in the Raine Study at 18 and 34 weeks’ gestation and linked to statutory state-wide hospital morbidity data. We examined associations between the number, category and timing of maternal prenatal stress events and overall and clinical groups of offspring (Gen2) infection-related hospitalisation until age 16 years, adjusting for maternal age, education, and smoking in pregnancy in addition to the presence of siblings at birth. Results Of 2,141 offspring with complete stress in pregnancy data available, 1,089 had at least one infection-related hospitalisation, with upper respiratory tract infections the most common (n = 556). Each additional stressful life event during pregnancy was associated with increased risk in male offspring for hospitalisation with all infection types. There was little evidence of these associations in girls. Conclusions Increased exposure to stressful life events in utero is associated with sex-specific infection-related hospitalisations in childhood. Prenatal stress may adversely affect early immune development for boys and increase the risk of more severe infections. Mechanistic understanding would inform preventative interventions.
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Korhonen LS, Kortesluoma S, Lukkarinen M, Peltola V, Pesonen H, Pelto J, Tuulari JJ, Lukkarinen H, Vuorinen T, Karlsson H, Karlsson L. Prenatal maternal distress associates with a blunted cortisol response in rhinovirus-positive infants. Psychoneuroendocrinology 2019; 107:187-190. [PMID: 31146139 PMCID: PMC7172058 DOI: 10.1016/j.psyneuen.2019.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Prenatal exposure to maternal psychological distress (PD) may have programming effects on the fetus/infant hypothalamic-pituitary-adrenal (HPA) axis and subsequently on the development of the fetus' immune function. Therefore, our aim was to study whether prenatal exposure to PD is related to early infant HPA axis reactivity in the context of a subclinical rhinovirus infection that challenges infants HPA axis postnatally. METHODS This study included 336 10-week-old infants from the nested case control Focus Cohort of the FinnBrain Birth Cohort Study. The outcome was infant HPA axis reactivity in a stress test. The acute stressor comprised of pediatric examination with venipuncture and nasal swabs for virus assessment. Saliva cortisol samples were collected at 5 time points: baseline, 0, 15, 25 and 35 min after the stressor. HPA axis reactivity was defined by the cumulative post-stressor cortisol concentration. RESULTS HPA axis reactivity was blunted in the PD/rhinovirus + group compared to the average of control/rhinovirus+, PD/rhinovirus-, and control/rhinovirus- groups (difference: 14.7 ln [nmol/L] × min, 95% confidence interval 3.8-25.6, p = .008). HPA axis reactivity was significantly blunted only in boys with rhinovirus detected when separately tested for boys and girls (p = .04). CONCLUSION Our finding of PD-exposed rhinovirus-positive infants having blunted cortisol secretion gives rise to a hypothesis that maternal PD during pregnancy influences infant HPA axis functioning and the functioning of the immune system. Future studies are needed to test whether this suppression of the HPA axis that co-occurs with rhinovirus infection associates with later disease development (e.g., asthma).
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Affiliation(s)
- Laura S. Korhonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland,Corresponding author at: Department of Paediatrics and Adolescent Medicine, Turku University Hospital, P.O. Box 52, 20521, Turku, Finland.
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Minna Lukkarinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland
| | - Ville Peltola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland
| | - Henri Pesonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland
| | - Jetro J. Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Building 11B, 20520, Turku, Finland
| | - Heikki Lukkarinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland
| | - Tytti Vuorinen
- Department of Clinical Microbiology, Turku University Hospital, and Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, Building 11B, 20520, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Lemminkäisenkatu 3A, Teutori building, 2ndfloor, 20520 Turku, Finland,Department of Child Psychiatry, University of Turku and Turku University Hospital, Building 10, Kiinamyllynkatu 4-8, 20521, Turku, Finland
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