Dimension- and context-specific expression of preschoolers' disruptive behaviors associated with prenatal tobacco exposure

Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention

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.

Perinatal and birth correlates of childhood irritability in Taiwan's national epidemiological study

BACKGROUND

Childhood irritability, characterized by low frustration tolerance and developmentally-inappropriate temper outbursts, is a transdiagnostic symptom in child psychiatry. Little is known regarding the influences of early experience and environmental exposure on irritability from a perinatal perspective. This study examined the associations between irritability and multiple perinatal and birth factors.

METHODS

Drawn Taiwan's National Epidemiological Study of Child Mental Disorders, 5124 children (2591 females) aged 7.7 to 14.6 years (mean 11.2 years) and their parents completed the Affective Reactivity Index, a well-established irritability measure. Parents completed a survey on parental, perinatal, and birth characteristics. Multiple linear regression models were performed to examine the associations between perinatal and birth characteristics and child irritability reported across informants.

RESULTS

Maternal smoking, vaginal bleeding, and pre-eclampsia during pregnancy and phototherapy for jaundice >3 days were associated with high irritability after adjusting for child's age, sex, and parental characteristics. Findings were consistent across parent- and child-rated irritability.

LIMITATIONS

Retrospective assessment of early exposures may be subject to recall bias despite previously-established validity and reliability. Longitudinal research with prospective assessments of early life exposures is recommended to confirm our findings. This exploratory approach of multiple survey items also precludes more in-depth assessments of perinatal risks for developing irritability.

CONCLUSIONS

This study provides novel evidence suggesting a perinatal link with irritability in a national sample of youths. Given that irritability predicts adverse mental health and life outcomes, identifying its perinatal and birth predictors may inform early etiology, guiding timely assessment and intervention.

Impact of prenatal exposure characterization on early risk detection: Methodologic insights for the HEALthy Brain and Child Development (HBCD) study

BACKGROUND

A major challenge in prenatal drug exposure research concerns the balance of measurement quality with sample sizes necessary to address confounders. To inform the selection of optimal exposure measures for the HEALthy Brain and Child Development (HBCD) Study, we employed integrated analysis to determine how different methods used to characterize prenatal tobacco exposure influence the detection of exposure-related risk, as reflected in normal variations in birth weight.

METHODS

Participants were N = 2323 mother-infant dyads derived from 7 independent developmental cohorts harmonized on measures of exposure, outcome (birthweight), and covariates. We compared estimates of PTE-related effects on birthweight derived from linear regression models when PTE was categorized dichotomously based on any fetal exposure (30% exposed; 69% not exposed); versus categorically, based on common patterns of maternal smoking during pregnancy (never smoked 69%; quit smoking 16%; smoked intermittently 2%; smoked persistently 13%). We secondarily explored sex differences in PTE-birthweight associations across these categorization methods.

RESULTS

When PTE was categorized dichotomously, exposure was associated with a - 125-g difference in birthweight (95% C.I. -173.7 - -76.6, p < .0001). When PTE was characterized categorically based on maternal smoking patterns, however, exposure was associated with either no difference in birthweight if mothers quit smoking by the end of the first trimester (B = -30.6, 95% C.I. -88.7-27.4, p = .30); or a - 221.8 g difference in birthweight if mothers did not [95% C.I. (-161.7 to -282.0); p < .001]. Qualitative sex differences were also detected though PTE x sex interactions did not reach statistical significance. Maternal smoking cessation during pregnancy was associated with a 239.3 g increase in birthweight for male infants, and a 114.0 g increase in birthweight for females infants (p = .07).

CONCLUSIONS

Categorization of PTE based on patterns of maternal smoking rather than the presence or absence of exposure alone revealed striking nuances in estimates of exposure-related risk. The described method that captures both between-individual and within-individual variability in prenatal drug exposure is optimal and recommended for future developmental investigations such as the HBCD Study.

Principles for Guiding the Selection of Early Childhood Neurodevelopmental Risk and Resilience Measures: HEALthy Brain and Child Development Study as an Exemplar

The vast individual differences in the developmental origins of risk and resilience pathways combined with sophisticated capabilities of big data science increasingly point to the imperative of large, neurodevelopmental consortia to capture population heterogeneity and key variations in developmental trajectories. At the same time, such large-scale population-based designs involving multiple independent sites also must weigh competing demands. For example, the need for efficient, scalable assessment strategies must be balanced with the need for nuanced, developmentally sensitive phenotyping optimized for linkage to neural mechanisms and specification of common and distinct exposure pathways. Standardized epidemiologic batteries designed for this purpose such as PhenX (consensus measures for Phenotypes and eXposures) and the National Institutes of Health (NIH) Toolbox provide excellent "off the shelf" assessment tools that are well-validated and enable cross-study comparability. However, these standardized toolkits can also constrain ability to leverage advances in neurodevelopmental measurement over time, at times disproportionately advantaging established measures. In addition, individual consortia often expend exhaustive effort "reinventing the wheel," which is inefficient and fails to fully maximize potential synergies with other like initiatives. To address these issues, this paper lays forth an early childhood neurodevelopmental assessment strategy, guided by a set of principles synthesizing developmental and pragmatic considerations generated by the Neurodevelopmental Workgroup of the HEALthy Brain and Child Development (HBCD) Planning Consortium. These principles emphasize characterization of both risk- and resilience-promoting processes. Specific measurement recommendations to HBCD are provided to illustrate application. However, principles are intended as a guiding framework to transcend any particular initiative as a broad neurodevelopmentally informed, early childhood assessment strategy for large-scale consortia science.