1
|
Yu APL, Zeng W, Lopez K, Magaña S. Reducing Depressive Symptoms Among Latina Mothers of Autistic Children: A Randomized Controlled Trial. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:294-307. [PMID: 38917994 DOI: 10.1352/1944-7558-129.4.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/30/2024] [Indexed: 06/27/2024]
Abstract
This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children. In this two-site randomized waitlist-control study (n = 109 mother-child dyads), a peer-to-peer mentoring (promotora) model was used to deliver an intervention that was designed to increase mothers' self-efficacy and use of evidence-based strategies. We assessed mothers' depressive symptom (CES-D) scores at three time points and used linear mixed models to determine whether their scores significantly changed from baseline to postintervention (Time 2) and at 4 months postintervention (Time 3). Results show that mothers in the intervention group reported a significant decrease in mean depressive symptom scores at Time 2 and that the effect was maintained at Time 3 with intermediate to medium effect sizes. There were no differences in results across sites. Findings suggest that Parents Taking Action, a culturally tailored intervention led by peer mentors, showed a significant effect both immediately after the intervention and 4 months postintervention in reducing depressive symptoms among Latina mothers of autistic children.
Collapse
Affiliation(s)
- Amy Pei-Lung Yu
- Amy Pei-Lung Yu, The University of Texas at Austin, Steve Hicks School of Social Work
| | - Weiwen Zeng
- Weiwen Zeng, Brandeis University, The Lurie Institute for Disability Policy
| | - Kristina Lopez
- Kristina Lopez, Arizona State University, School of Social Work
| | - Sandy Magaña
- Sandy Magaña, The University of Texas at Austin, Steve Hicks School of Social Work
| |
Collapse
|
2
|
Chang R, Li C, Wei M, Jiang Y, Zhang J. Roles of caregiver-child interaction on the association of socioeconomic status with early childhood development: a population-based study in rural China. BMC Public Health 2024; 24:1604. [PMID: 38880881 PMCID: PMC11181537 DOI: 10.1186/s12889-024-18803-4] [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: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVE Socioeconomic status (SES) has been previously associated with children's early development, health, and nutrition; however, evidence about the potential role of caregiver-child interaction in such associations was limited. This study aimed to explore the effect of caregiver-child interaction on the associations of SES with child developmental outcomes, including early neurodevelopment and social-emotional behavior. METHODS A cross-sectional survey was conducted among 2078 children aged 0-6 in a rural county that just lifted out of poverty in 2020 in Central China. The Ages & Stages Questionnaires-Chinese version (ASQ-C) and the Social-Emotional (ASQ: SE) questionnaire were used to assess children's early neurodevelopment and social-emotional behavior, respectively. Caregiver-child interaction was evaluated with the Brigance Parent-Child Interactions Scale. Regression-based statistical mediation and moderation effect were conducted with the PROCESS macro of SPSS. RESULTS Children with low SES had an increased risk of suspected neurodevelopmental delay [OR = 1.92, 95% CI: 1.50, 2.44] and social-emotional developmental delay [OR = 1.31, 95% CI: 1.04, 1.66]. The caregiver-child interaction partially mediated the associations of SES with child developmental outcomes; the proportion of the indirect effect was 14.9% for ASQ-C total score and 32.1% for ASQ: SE score. Moreover, the caregiver-child interaction had a significant moderation effect on the association of SES with ASQ-C total score (P < 0.05). A weaker association was observed in children with high-level caregiver-child interaction than in medium and low ones. Similar moderating effects were found among boys but not girls. CONCLUSION Caregiver-child interaction plays a vital role in the relationship between SES and child development. Children with low SES households will benefit more in terms of their early development from intervention programs strengthening caregiver-child interaction.
Collapse
Affiliation(s)
- Rui Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengna Wei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanfen Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
3
|
Jiang Q, Feldman N, Koire A, Ma C, Mittal L, Lin HC, Erdei C, Roffman JL, Liu CH. Infant neurodevelopment during the COVID-19 pandemic: Associations with maternal pandemic-related experiences, parenting stress, and self-efficacy. Early Hum Dev 2024; 193:106018. [PMID: 38703424 DOI: 10.1016/j.earlhumdev.2024.106018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/27/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Although pandemic-related experiences have been linked to the psychological well-being of mothers, the effects of the COVID-19 pandemic on infant neurodevelopmental outcomes have not been sufficiently studied. AIMS To assess whether maternal COVID-19-related experiences (i.e., COVID-19-related health, risk, resource worries, and feelings of grief), parenting stress, and maternal self-efficacy are associated with infant neurodevelopment as measured by the Ages and Stages Questionnaire, Third Edition (ASQ-3) maternal report when infants were between 8 to 10 months of age. Furthermore, this study examined the moderating effect of maternal self-efficacy between maternal COVID-19-related experiences and infant neurodevelopment. METHODS This cross-sectional study included 122 women who were drawn from the Perinatal Experiences and COVID-19 Effects (PEACE) Study, with online surveys administered between November 2020 and August 2022. RESULTS After controlling for maternal anxiety and depression symptoms and demographic factors, hierarchical regression analysis indicated that parenting stress showed no effect on ASQ-3 scores. However, more adverse COVID-19-related experiences and higher levels of maternal self-efficacy were associated with better infant neurodevelopment. Moreover, there was a significant interaction effect between maternal self-efficacy and COVID-19-related experiences on infant neurodevelopment. For mothers with moderate to high levels of self-efficacy, more adverse COVID-19-related experiences were associated with better infant neurodevelopment. For mothers with low levels of self-efficacy, more adverse COVID-19-related experiences were associated with poorer developmental outcomes in infants. CONCLUSIONS Under adverse conditions, confidence in caregiving may afford more optimal infant neurodevelopment. Interventions aimed at fostering maternal self-efficacy and addressing specific stressors can be valuable in promoting positive developmental trajectories for infants born during the pandemic.
Collapse
Affiliation(s)
- Qingyu Jiang
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | - Natalie Feldman
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Candice Ma
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Hung-Chu Lin
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Carmina Erdei
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Cindy H Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
4
|
Dennis CL, Singla DR, Brown HK, Savel K, Clark CT, Grigoriadis S, Vigod SN. Postpartum Depression: A Clinical Review of Impact and Current Treatment Solutions. Drugs 2024; 84:645-659. [PMID: 38811474 DOI: 10.1007/s40265-024-02038-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
Depression during the first year postpartum (postpartum depression) impacts millions of women and their families worldwide. In this narrative review, we provide a summary of postpartum depression, examining the etiology and consequences, pharmacological and psychological treatments, and potential mechanisms of change and current barriers to care. Psychological treatments are effective and preferred by many perinatal patients over medications, but they often remain inaccessible. Key potential mechanisms underlying their effectiveness include treatment variables (e.g., dosage and therapeutic alliance) and patient behaviors (e.g., activation and avoidance and emotional regulation). Among pharmacological treatments, the selective serotonin reuptake inhibitor (SSRI) sertraline is generally the first-line antidepressant medication recommended to women in the postpartum period due to its minimal passage into breastmilk and the corresponding decades of safety data. Importantly, most antidepressant drugs are considered compatible with breastfeeding. Neurosteroids are emerging as an effective treatment for postpartum depression, although currently this treatment is not widely available. Barriers to widespread access to treatment include those that are systematic (e.g., lack of specialist providers), provider-driven (e.g., lack of flexibility in treatment delivery), and patient-driven (e.g., stigma and lack of time for treatment engagement). We propose virtual care, task-sharing to non-specialist treatment providers, and collaborative care models as potential solutions to enhance the reach and scalability of effective treatments to address the growing burden of postpartum depression worldwide and its negative impact on families and society.
Collapse
Affiliation(s)
- Cindy-Lee Dennis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Rm 280, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Daisy R Singla
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Hilary K Brown
- Department of Health and Society, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| | - Katarina Savel
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Crystal T Clark
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Simone N Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| |
Collapse
|
5
|
Ladak Z, Grewal N, Kim MO, Small S, Leber A, Hemani M, Sun Q, Hamza DM, Laur C, Ivers NM, Falenchuk O, Volpe R. Equity in prenatal healthcare services globally: an umbrella review. BMC Pregnancy Childbirth 2024; 24:191. [PMID: 38468220 PMCID: PMC10926563 DOI: 10.1186/s12884-024-06388-0] [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: 11/30/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Timely, appropriate, and equitable access to quality healthcare during pregnancy is proven to contribute to better health outcomes of birthing individuals and infants following birth. Equity is conceptualized as the absence of differences in healthcare access and quality among population groups. Healthcare policies are guides for front-line practices, and despite merits of contemporary policies striving to foster equitable healthcare, inequities persist. The purpose of this umbrella review is to identify prenatal healthcare practices, summarize how equities/inequities are reported in relation to patient experiences or health outcomes when accessing or using services, and collate equity reporting characteristics. METHODS For this umbrella review, six electronic databases were searched (Medline, EMBASE, APA PsychInfo, CINAHL, International Bibliography of the Social Sciences, and Cochrane Library). Included studies were extracted for publication and study characteristics, equity reporting, primary outcomes (prenatal care influenced by equity/inequity) and secondary outcomes (infant health influenced by equity/inequity during pregnancy). Data was analyzed deductively using the PROGRESS-Plus equity framework and by summative content analysis for equity reporting characteristics. The included articles were assessed for quality using the Risk of Bias Assessment Tool for Systematic Reviews. RESULTS The search identified 8065 articles and 236 underwent full-text screening. Of the 236, 68 systematic reviews were included with first authors representing 20 different countries. The population focus of included studies ranged across prenatal only (n = 14), perinatal (n = 25), maternal (n = 2), maternal and child (n = 19), and a general population (n = 8). Barriers to equity in prenatal care included travel and financial burden, culturally insensitive practices that deterred care engagement and continuity, and discriminatory behaviour that reduced care access and satisfaction. Facilitators to achieve equity included innovations such as community health workers, home visitation programs, conditional cash transfer programs, virtual care, and cross-cultural training, to enhance patient experiences and increase their access to, and use of health services. There was overlap across PROGRESS-Plus factors. CONCLUSIONS This umbrella review collated inequities present in prenatal healthcare services, globally. Further, this synthesis contributes to future solution and action-oriented research and practice by assembling evidence-informed opportunities, innovations, and approaches that may foster equitable prenatal health services to all members of diverse communities.
Collapse
Affiliation(s)
- Zeenat Ladak
- University of Toronto, Toronto, Canada.
- Women's College Hospital Institute for Health System Solutions & Virtual Care, Toronto, Canada.
| | | | | | | | | | | | - Qiuyu Sun
- University of Alberta, Edmonton, Canada
| | | | - Celia Laur
- University of Toronto, Toronto, Canada
- Women's College Hospital Institute for Health System Solutions & Virtual Care, Toronto, Canada
| | - Noah M Ivers
- University of Toronto, Toronto, Canada
- Women's College Hospital Institute for Health System Solutions & Virtual Care, Toronto, Canada
- Women's College Hospital, Toronto, Canada
| | | | | |
Collapse
|
6
|
Matsuo R, Matsumoto N, Mitsuhashi T, Yorifuji T. COVID-19 pandemic and language development in children at 18 months: a repeated cross-sectional study over a 6-year period in Japan. Arch Dis Child 2024; 109:158-164. [PMID: 37918897 DOI: 10.1136/archdischild-2023-325926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the impact of the COVID-19 pandemic experience on language development among children, we compared language development at 18 months of age, before and during the pandemic in Japan, where strict control measures continued over a long period. METHODS This was a repeated cross-sectional study and we included children who attended the 18-month health check-up provided by the Okayama City Public Health Center between January 2017 and December 2022 (n=33 484). We compared indicators of language development before (from January 2017 to February 2020) and during (from March 2020 to December 2022) the pandemic. Our primary outcome was the proportion of children who required follow-up for language development by the Public Health Center. The secondary outcome was the proportion of children who could not say three or more meaningful words. We estimated risk ratios (RRs) and their 95% CIs, adjusted for potential confounders. RESULTS The prevalence of the primary outcome was 33.5% before the pandemic and 36% during the pandemic. Compared with before the pandemic, increased RRs for the primary and secondary outcomes were observed during the pandemic, with RRs (95% CIs) of 1.09 (1.06-1.13) for the primary outcome and 1.11 (1.05-1.17) for the secondary outcome. Although the statistical interactions were not significant, the RRs were higher for children cared for at home than those in nursery schools and with ≤3 family members than those with ≥4 family members. CONCLUSIONS The COVID-19 pandemic was associated with an increased risk of impaired language development in children at 18 months. More extensive support is needed for higher risk families, as well as follow-up of long-term language development in children affected by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Rumi Matsuo
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Naomi Matsumoto
- Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| |
Collapse
|
7
|
Marti-Castaner M, Hvidtfeldt C, Fredsted Villadsen S, Pagh Pedersen T, Elsenburg LK, Norredam M. Infants born to first-time mothers with a refugee background faced an increased risk of regulatory problems. Acta Paediatr 2023; 112:2541-2550. [PMID: 37548569 DOI: 10.1111/apa.16938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/23/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
AIM This study investigated the association between mothers' migration background and infant regulatory problems and analysed the mediating role of maternal mental health. We also explored whether the child's sex, parity and length of residence moderated the effect of a maternal migrant background. METHODS Child health surveillance data from the Danish home visiting programme were used. Community health nurses followed infants from birth to 12 months of age. The source population comprised 103 813 infants born between 1 January 2008 and 31 December 2018. The final sample comprised 62 964 infants, including 3.4% with a refugee background. A maternal migrant background was the primary exposure. The results are presented as risk ratios (RR) and 95% confidence intervals (CI). RESULTS A maternal refugee background increased the risk of regulatory problems in offspring (RR 1.34, 95% CI: 1.18-1.51). The effect was partially mediated by maternal postpartum mental health concerns. The association between maternal refugee background and infant regulatory problems was more pronounced in first-time mothers (RR 1.80, 95% CI: 1.51-2.15). CONCLUSION The risk of infant regulatory problems was higher in the first-born children of refugee mothers. First-time refugee parents may need tailored support to identify mental health needs and infants with regulatory problems.
Collapse
Affiliation(s)
- Maria Marti-Castaner
- Department of Public Health, Section of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Sarah Fredsted Villadsen
- Department of Public, Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Leonie K Elsenburg
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Marie Norredam
- Department of Public Health, Section of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
Williams RC. Des expériences négatives de l'enfance à la santé relationnelle précoce : les conséquences pour la pratique clinique. Paediatr Child Health 2023; 28:377-393. [PMID: 37744761 PMCID: PMC10517240 DOI: 10.1093/pch/pxad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/20/2023] [Indexed: 09/26/2023] Open
Abstract
Les enfants grandissent et se développent dans un environnement de relations. Des relations sécuritaires, stables et bienveillantes contribuent à consolider la résilience et à atténuer les répercussions des expériences négatives. La promotion de la santé relationnelle en pratique clinique recentre l'attention accordée aux expériences négatives de l'enfance sur les expériences positives de l'enfance. Cette approche, qui évalue les forces et les atouts d'une famille, peut être intégrée à la fois aux rendez-vous réguliers de l'enfant en santé et aux soins surspécialisés. Il est optimal de réaliser de telles interventions pendant la période prénatale ou le plus rapidement possible avant l'âge de trois ans, mais il n'est jamais trop tard pour les entreprendre. Le présent document de principes décrit comment les cliniciens peuvent adopter une approche de santé relationnelle lors de chacune de leurs rencontres médicales s'ils comprennent ce qu'est le stress toxique et ses effets sur le cerveau en développement, les relations familiales et le développement de l'enfant; à quel point les relations, expériences et comportements positifs peuvent en atténuer les effets et renforcer la résilience; quels sont les signes observables de la santé relationnelle et des risques relationnels dans les interactions entre les parents et l'enfant; quelles sont les caractéristiques de relations thérapeutiques de confiance avec les familles et comment en optimiser les avantages par les échanges et la pratique clinique.
Collapse
Affiliation(s)
- Robin C Williams
- Société canadienne de pédiatrie, groupe de travail de la petite enfance, Ottawa (Ontario), Canada
| |
Collapse
|
9
|
Williams RC. From ACEs to early relational health: Implications for clinical practice. Paediatr Child Health 2023; 28:377-393. [PMID: 37744756 PMCID: PMC10517248 DOI: 10.1093/pch/pxad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/20/2023] [Indexed: 09/26/2023] Open
Abstract
Children grow and develop in an environment of relationships. Safe, stable, nurturing relationships help build resilience and buffer the negative impact of adverse experiences. Promoting relational health in clinical practice shifts the focus from adverse childhood experiences (ACEs) to positive childhood experiences (PCEs). This approach evaluates a family's strengths and assets, and can be incorporated into both well-child and subspecialty care. While the optimal window for such interventions is in the prenatal period or as early as possible within the first 3 years of life, it is never too late to start. This statement describes how clinicians can bring a relational health approach to any medical encounter by understanding: what toxic stress is and how it can affect the developing brain, family relationships, and child development; how positive relationships, experiences, and behaviours can help buffer such effects and build resilience; observable signs of relational health and risk in parent-child interactions; the attributes of trustful, therapeutic relationships with families; and how to optimize these benefits through conversation and clinical practice.
Collapse
Affiliation(s)
- Robin C Williams
- Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario, Canada
| |
Collapse
|
10
|
Metwally AM, Nassar MS, Salah El-Din EM, Abdallah AM, Khadr Z, Abouelnaga MW, Ashaat EA, El-Saied MM, Elwan AM, Bassiouni RI, Monir ZM, Badawy HY, Dewdar EM, El-Hariri HM, Aboulghate A, Hanna C, Rabah TM, Mohsen A, Elabd MA. National screening for developmental delays and their determinants among Egyptian school age children: A step towards implementing life skills programs. PLoS One 2023; 18:e0287315. [PMID: 37725608 PMCID: PMC10508607 DOI: 10.1371/journal.pone.0287315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/03/2023] [Indexed: 09/21/2023] Open
Abstract
AIM This study aimed to estimate the national prevalence of developmental delays (DDs) and their determinants among Egyptian children aged 6 to 12 years. Such estimation is a prerequisite step toward the application of Life Skill Education (LSE) programs that will potentiate children's future capabilities. METHODS Vineland Adaptive Behavior Scales" was used as a reliable and diagnostic test for DDs screening during this national cross sectional study. Gross motor (GM), fine motor (FM), daily living skills, communication, and socialization skills were assessed. The multivariate logistic regression analysis was used to identify factors associated with DDs. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was estimated to indicate the strength of association. A p-value of <0.05 was used to declare statistical significance. RESULTS Out of the 20324 surveyed school-aged children, 7.4% were found to have at least one delay. Communication deficits were the most common (6.4%) followed by delay in daily living skills (2.0%). The final model of logistic regression had a good fit for seven variables out of the sociodemographic, epidemiological characteristics, maternal and perinatal problems that were associated with a higher likelihood of at least one DD: Children suffering from any convulsions (AOR = 4.32; 95% CI: 3.18-5.88), male gender (AOR = 1.86; 95% CI: 1.65-2.09), birth weight less than 2.5 kg (AOR = 1.77; 95% CI: 1.40-2.24), history of maternal health problem during pregnancy (AOR = 1.64; 95% CI:1.34-2.01), children staying in an incubator for more than two days (AOR = 1.57, 95% CI: 1.29-1.91), having less educated fathers (AOR = 1.55, 95% CI: 1.24-1.95) and belonging to the middle social class (AOR = 1.40, 95% CI: 1.24-1.58). CONCLUSION The identified types and determinants for each DD are allowing for the implementation of tailored programs for school children's life skills promotion for achieving the most sustainable effects on children's biological and psychological health and well-being.
Collapse
Affiliation(s)
- Ammal M. Metwally
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Maysa S. Nassar
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Ebtissam M. Salah El-Din
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Ali M. Abdallah
- Quantitative Methods Department, Aswan University, Tingar, Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt
- The Social Research Center of the American University in Cairo, New Cairo, Egypt
| | - Marwa W. Abouelnaga
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Engy A. Ashaat
- Clinical Genetics Dept., Human Genetics and Genome Research Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Mostafa M. El-Saied
- Child with Special Needs Dept., Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Ahmed M. Elwan
- Child with Special Needs Dept., Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Randa I. Bassiouni
- Clinical Genetics Dept., Human Genetics and Genome Research Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Zeinab M. Monir
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Hala Y. Badawy
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Eman M. Dewdar
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Hazem M. El-Hariri
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Ahmed Aboulghate
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Carine Hanna
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Thanaa M. Rabah
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Amira Mohsen
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| | - Mona A. Elabd
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, Egypt
| |
Collapse
|
11
|
Metwally AM, Nassar MS, Salah El-Din EM, Abdallah AM, Khadr Z, Abouelnaga MW, Ashaat EA, El-Saied MM, Elwan AM, Bassiouni RI, Monir ZM, Badawy HY, Dewdar EM, El-Hariri HM, Aboulghate A, Hanna C, Rabah TM, Mohsen A, Elabd MA. National screening for developmental delays and their determinants among Egyptian school age children: A step towards implementing life skills programs. PLoS One 2023; 18:e0287315. [DOI: https:/doi.org/10.1371/journal.pone.0287315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Aim
This study aimed to estimate the national prevalence of developmental delays (DDs) and their determinants among Egyptian children aged 6 to 12 years. Such estimation is a prerequisite step toward the application of Life Skill Education (LSE) programs that will potentiate children’s future capabilities.
Methods
Vineland Adaptive Behavior Scales” was used as a reliable and diagnostic test for DDs screening during this national cross sectional study. Gross motor (GM), fine motor (FM), daily living skills, communication, and socialization skills were assessed. The multivariate logistic regression analysis was used to identify factors associated with DDs. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was estimated to indicate the strength of association. A p-value of <0.05 was used to declare statistical significance.
Results
Out of the 20324 surveyed school-aged children, 7.4% were found to have at least one delay. Communication deficits were the most common (6.4%) followed by delay in daily living skills (2.0%). The final model of logistic regression had a good fit for seven variables out of the sociodemographic, epidemiological characteristics, maternal and perinatal problems that were associated with a higher likelihood of at least one DD: Children suffering from any convulsions (AOR = 4.32; 95% CI: 3.18–5.88), male gender (AOR = 1.86; 95% CI: 1.65–2.09), birth weight less than 2.5 kg (AOR = 1.77; 95% CI: 1.40–2.24), history of maternal health problem during pregnancy (AOR = 1.64; 95% CI:1.34–2.01), children staying in an incubator for more than two days (AOR = 1.57, 95% CI: 1.29–1.91), having less educated fathers (AOR = 1.55, 95% CI: 1.24–1.95) and belonging to the middle social class (AOR = 1.40, 95% CI: 1.24–1.58).
Conclusion
The identified types and determinants for each DD are allowing for the implementation of tailored programs for school children’s life skills promotion for achieving the most sustainable effects on children’s biological and psychological health and well-being.
Collapse
|
12
|
Cohenour TL, Gulsrud A, Kasari C. Heterogeneity of autism symptoms in community-referred infants and toddlers at elevated or low familial likelihood of autism. Autism Res 2023; 16:1739-1749. [PMID: 37408377 PMCID: PMC10527623 DOI: 10.1002/aur.2973] [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: 01/17/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
Evidence suggests autistic individuals at elevated familial likelihood of autism spectrum disorder (by virtue of having an autistic sibling) have stronger cognitive abilities on average than autistic individuals with no family history of the condition, who have a low familial likelihood of autism. Investigating phenotypic differences between community-referred infants and toddlers with autism symptoms at elevated or low familial likelihood of autism may provide important insight into heterogeneity in the emerging autism phenotype. This study compared behavioral, cognitive, and language abilities of community-referred infants and toddlers with confirmed autism symptoms at elevated (EL) or low familial likelihood of autism (LL). Participants were 121 children aged 12 to 36 months who participated in two larger randomized trials of parent-mediated interventions for children with autism symptoms. Behavioral phenotypes were compared across three groups: children with at least one autistic sibling (EL-Sibs, n = 30), those with at least one older, non-autistic sibling and no family history of autism (LL-Sibs, n = 40), and first-born children with no family history of autism (LL-FB, n = 51). EL-Sibs had less severe autism symptoms and stronger cognitive abilities than children in LL groups. While the rate of receptive language delay was similar across groups, the rate of expressive language delay was markedly lower among EL-Sibs. After controlling for age and nonverbal cognitive ability, EL-Sibs were significantly less likely to present with expressive language delay than LL-Sibs. Familial likelihood of autism may play an important role in shaping the emerging autism phenotype in infancy and toddlerhood.
Collapse
Affiliation(s)
| | - Amanda Gulsrud
- University of California, Los Angeles, Los Angeles, California, USA
| | - Connie Kasari
- University of California, Los Angeles, Los Angeles, California, USA
| |
Collapse
|
13
|
Francisco ASPG, Graciosa MD, Pacheco SCDS, Sonza A, Sanada LS. Does premature birth affect Brazilian parents' practices related to infant positioning? REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2022163. [PMID: 37493671 PMCID: PMC10365550 DOI: 10.1590/1984-0462/2024/42/2022163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/21/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. METHODS Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. RESULTS The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). CONCLUSIONS The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.
Collapse
Affiliation(s)
| | | | | | - Anelise Sonza
- Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | | |
Collapse
|
14
|
Delagneau G, Twilhaar ES, Testa R, van Veen S, Anderson P. Association between prenatal maternal anxiety and/or stress and offspring's cognitive functioning: A meta-analysis. Child Dev 2023; 94:779-801. [PMID: 36582056 PMCID: PMC10952806 DOI: 10.1111/cdev.13885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This meta-analysis examined the relationship between prenatal maternal stress and/or anxiety and the outcomes of children aged 3 months to 9 years. Of the 8754 studies published before June 2021 that were synthesized, 17 conducted in Western countries were included in the meta-analysis (Ntotal = 23,307; Mmales 54%; Methnicity White 77%, Pacific 15%, African American/Black 10%, Middle Eastern 7%, Eastern 8%). Effect sizes ranged from -0.41 to 0.15. A weak negative association was found between prenatal stress and/or anxiety exposure and children's general intellectual development. Associations varied based on the type of exposure. Findings are limited to developed counties and cannot be generalized to low- and middle-income countries. Directions for maternal prenatal intervention and future studies are discussed.
Collapse
Affiliation(s)
- Garance Delagneau
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| | - E. Sabrina Twilhaar
- Obstetrical Perinatal and Pediatric Epidemiology Research TeamInstitute of Health and Medical ResearchCentre of Research in Epidemiology and StatisticsUniversité Paris CitéParisFrance
| | - Renee Testa
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
- Murdoch Children's Research InstituteRoyal Children's Hospital (Dept of Mental Health)ParkvilleVictoriaAustralia
| | - Sarit van Veen
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| | - Peter Anderson
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| |
Collapse
|
15
|
Hentschel E, Tomlinson H, Hasan A, Yousafzai A, Ansari A, Tahir-Chowdhry M, Zamand M. Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone Survey. INTERNATIONAL JOURNAL OF EARLY CHILDHOOD = REVUE INTERNATIONALE DE L'ENFANCE PRESCOLAIRE = REVISTA INTERNACIONAL DE LA INFANCIA PRE-ESCOLAR 2023:1-39. [PMID: 37360191 PMCID: PMC9994389 DOI: 10.1007/s13158-023-00353-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 06/28/2023]
Abstract
This paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted in the midst of a global pandemic, between December 2021 and February 2022, we present the first nationally representative estimates of child development for children under 3 years of age and school readiness for children 3-6 years of age, using internationally validated instruments. The paper examines how risk factors that were exacerbated due to the COVID-19 pandemic, such as parental distress, lack of psychosocial stimulation, food insecurity, low maternal education, no enrollment in early childhood education, and living in a rural area, are associated with children's outcomes. The data indicate that more than half (57 percent) of parents with children under age 3 were distressed and that 61 percent of households reported cutting down on the size of or skipping meals since the start of the pandemic. The data reveal that over half of parents fail to engage in adequate psychosocial stimulation with their child and enrollment in early childhood education is very low (39 percent). The paper finds that child development outcomes decline rapidly as the number of risks increase. Specifically, for children under 3 years, lack of psychosocial stimulation at home and higher levels of parental distress were most significantly associated with lower child development levels. For a child aged 3-6 years, early childhood education enrollment and the amount of psychosocial stimulation the child received at home had the strongest association with school readiness scores.
Collapse
Affiliation(s)
- Elizabeth Hentschel
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
- Education Global Practice, World Bank, Washington, USA
| | | | - Amer Hasan
- Education Global Practice, World Bank, Washington, USA
| | - Aisha Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - Amna Ansari
- Education Global Practice, World Bank, Washington, USA
| | | | - Mina Zamand
- Education Global Practice, World Bank, Washington, USA
| |
Collapse
|
16
|
MacKinnon AL, Sell H, Silang K, Xie EB, Jung JW, Tough S, Tomfohr-Madsen L. Neighbourhood characteristics, lifestyle factors, and child development: Secondary analysis of the All our families cohort study. FRONTIERS IN EPIDEMIOLOGY 2023; 2:1073666. [PMID: 38455286 PMCID: PMC10910961 DOI: 10.3389/fepid.2022.1073666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/09/2022] [Indexed: 03/09/2024]
Abstract
Background Neighbourhood characteristics have been found to influence child development, but little is known about lifestyle factors that may moderate this relationship, which can provide modifiable targets for policies and programing. This study investigated the association between neighbourhood characteristics (e.g., deprivation, disorder) during pregnancy and child development at age 5 in relation to various lifestyle factors (e.g., physical activity, parent-child reading, community resource use) during early childhood. Methods A secondary analysis was conducted using multilevel modeling of data from the All Our Families cohort, recruited in Canada from 2008 to 2010. Participants self-reported on demographics during pregnancy, lifestyle factors at 3 years, and child development at 5 years using the Ages and Stages Questionnaire (ASQ-3). Neighbourhood deprivation was evaluated using the Vancouver Area Deprivation Index (VANDIX), while disorder was measured using police services' community crime reports. Results Geocoded information was available for 2,444 participants. After adjusting for covariates, multilevel modeling indicated a significant negative association between neighbourhood deprivation and overall child development (b = -.726, 95% CI: -1.344, -.120). Parent-child reading was found to be a significant moderator of the effect of neighbourhood disorder (b = .005, 95% CI: .001, .009). There were no statistically significant moderation effects for physical activity or community resource use. Conclusion Neighbourhood deprivation during pregnancy is associated with early child development. Parent-child reading may function as a protective factor in the presence of higher neighbourhood disorder. Overall, neighbourhood-level effects should be considered in policies and community programs that promote family and child well-being.
Collapse
Affiliation(s)
- A. L. MacKinnon
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Montréal, QC, Canada
| | - H. Sell
- Immunization Programs and Vaccine Preventable Diseases Service, BC Centre for Disease Control, Vancouver, BC, Canada
| | - K. Silang
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - E. B. Xie
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - J. W. Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - S. Tough
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - L. Tomfohr-Madsen
- Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
17
|
Islam MM, Khan MN. Early childhood development and its association with maternal parity. Child Care Health Dev 2023; 49:80-89. [PMID: 35384014 PMCID: PMC10084392 DOI: 10.1111/cch.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children and their development. This paper estimates the Early Childhood Development Index (ECDI) of 3- and 4-year-old children in Bangladesh and examines the relationship between maternal parity and early childhood development. METHODS The study analysed nationally representative data from the Bangladesh Multiple Indicator Cluster Survey 2019. The dataset had 9453 children aged from 36 to 59 months. The ECDI was computed following the UNICEF's approach involving psychometric computation of four domains of development: physical, literacy-numeracy, learning and social-emotional. Since the dataset has a hierarchical structure, we used multilevel logistic regression. RESULTS A quarter (25%) of the children were not on track in their early childhood development. Seventy-one percent were not developmentally on track in the literacy-numeracy domain, 27% were not in the social-emotional and smaller percentages were not in learning (9%) and physical (1%) domains. There was a significant negative association between maternal parity and ECDI (adjusted odds ratio [AOR] 0.95; 95% CI: 0.91-0.99). Attendance at early childhood education programmes was significantly associated with early childhood development (AOR 1.73; 95% CI: 1.47-2.03). Also, female children, those who were not stunted, located in rural areas, received parental stimulation activities, lived in relatively wealthy households or had mothers who had received secondary or further education were more likely than others to be on track of early childhood development. CONCLUSIONS Early childhood development is negatively correlated with maternal parity. The literacy-numeracy domain constitutes the major developmental delay. Programmes for parental awareness should be widely expanded.
Collapse
Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Victoria
| | - Md Nuruzzaman Khan
- Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| |
Collapse
|
18
|
Davidson C, Raouna A, Malcolm R, Ibrahim R, MacBeth A. "There's more love between us": The parental experience of attending Mellow Babies, a targeted, early intervention program for parents and their babies. Infant Ment Health J 2023; 44:100-116. [PMID: 36519512 PMCID: PMC10107458 DOI: 10.1002/imhj.22029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
It is recognized that parenthood in the context of psychosocial adversity can have negative implications for infant development. Parenting programs are the first line of intervention to improve outcomes for families; however, evidence for the effectiveness of group-based, targeted early interventions is still scarce. Preliminary findings indicate Mellow Babies (MB) as a promising group-based parenting program for families at risk for parenting difficulties. Using thematic analysis, we aimed to understand: (i) the aspects of the intervention that enabled parents to complete the program and (ii) the relational and behavioral changes perceived as valuable for parents and their babies post-intervention. In total, 68 parents residing in the United Kingdom were interviewed after completing MB (49 mothers and 19 fathers; 88% self-identified as British). Three themes and six subthemes were generated from the data. Parents identified several intervention components as beneficial, including the facilitators' interpersonal skills and multi-dimensional, group-based approach. Participant reflections highlighted three underlying mechanisms that enabled positive change: (i) the sense of community cultivated within the group, (ii) the process of formulating and re-conceptualizing one's difficulties, and (iii) the opportunity to reshape interpersonal interactions. Findings are discussed within the context of perinatal and infant mental health.
Collapse
Affiliation(s)
- Ciera Davidson
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Aigli Raouna
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK.,Mellow Parenting, Glasgow, UK
| | | | | | - Angus MacBeth
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
19
|
Byrne S, Sledge H, Franklin R, Boland F, Murray DM, Hourihane J. Social communication skill attainment in babies born during the COVID-19 pandemic: a birth cohort study. Arch Dis Child 2023; 108:20-24. [PMID: 36220496 PMCID: PMC9763171 DOI: 10.1136/archdischild-2021-323441] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 08/29/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The SARS-CoV-2 (COVID-19) pandemic was managed with sustained mass lockdowns to prevent spread of COVID-19 infection. Babies born during the early stages of the pandemic missed the opportunity of meeting a normal social circle of people outside the family home. METHODS We compared 10 parentally reported developmental milestones at 12-month assessment in a cohort of 309 babies born at the onset of the pandemic (CORAL cohort) and 1629 babies from a historical birth cohort (BASELINE cohort recruited between 2008 and 2011). RESULTS Compared with a historical cohort, babies born into lockdown appeared to have some deficits in social communication. Fewer infants in the pandemic cohort had one definite and meaningful word (76.6% vs 89.3%), could point (83.8% vs 92.8%) or wave bye-bye (87.7% vs 94.4%) at 12-month assessment. Adjusted log-binomial regression analyses demonstrated significant differences in social communication in the CORAL cohort compared with the BASELINE cohort: one definite and meaningful word (relative risk (RR): 0.86 (95% CI: 0.80 to 0.92)), pointing (RR: 0.91 (95% CI: 0.86 to 0.96)) and waving bye-bye (RR: 0.94 (95% CI: 0.90 to 0.99)). DISCUSSION Parentally reported developmental outcomes in a birth cohort of babies born into lockdown during the COVID-19 pandemic may indicate some potential deficits in early life social communication. It must be noted that milestones are parentally reported and comparison is with a historical cohort with associated limitations. Further studies with standardised testing is required to validate these findings. CONCLUSION Pandemic-associated social isolation may have impacted on the social communication skills in babies born during the pandemic compared with a historical cohort. Babies are resilient and inquisitive by nature, and it is hoped that with societal re-emergence and increase in social circles, their social communication skills will improve.
Collapse
Affiliation(s)
- Susan Byrne
- Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland .,FutureNeuro SFI Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,Children's Health Ireland, Dublin, Ireland
| | - Hailey Sledge
- Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ruth Franklin
- Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre M Murray
- INFANT Centre, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Jonathan Hourihane
- Department of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Dublin, Ireland,Children's Health Ireland, Dublin, Ireland,INFANT Centre, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | | |
Collapse
|
20
|
Barra L, Coo S. Preterm‐born children's development: A bioecological perspective. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lisseth Barra
- School of Psycholy Universidad del Desarrollo Santiago Chile
- Deparment of Physical Therapy, Faculty of Medicine University of Chile Santiago Chile
| | - Soledad Coo
- School of Psycholy Universidad del Desarrollo Santiago Chile
| |
Collapse
|
21
|
Serván-Mori E, Ramírez-Baca MI, Fuentes-Rivera E, García-Martínez A, Quezada-Sánchez AD, Del Carmen Hernández-Chávez M, Olvera-Flores F, Pineda-Pérez D, Zelocuatecatl-Aguilar A, Orozco-Núñez E, Schnaas L. Predictors of maternal knowledge on early childhood development in highly marginalized communities in Mexico: Implications for public policy. Acta Psychol (Amst) 2022; 230:103743. [PMID: 36130413 DOI: 10.1016/j.actpsy.2022.103743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Efforts to identify the predictors of maternal knowledge on Early Child Development (ECD) have proven inconclusive thus far, particularly with respect to socially deprived contexts in Low- and Middle-Income Countries (LMICs). We quantified the extent of ECD knowledge among mothers who were the primary caregivers of 0-38-month-old infants in marginalized communities in Mexico. We also explored the characteristics of the children, both individually and with regard to their households, given the influence of these factors on childhood development. METHODS We analyzed primary data obtained through a questionnaire administered to mothers who were the primary caregivers of 1045 girls and boys 0-38 months of age. The instrument was specifically designed for our study in order to explore the knowledge of participants about physical, neurological and psycho-affective development during childhood. We performed fractional regression analysis to assess the predictors of ECD knowledge. RESULTS The mean score of maternal ECD knowledge increased with their age and schooling as well as with their levels of cognitive ability and self-esteem. Irrespective of age at first birth, mean knowledge was relatively high for women with high school education and low for women with elementary or no formal education, a gradient with respect to age at fist birth was more marked among women with middle school education. ECD knowledge scores increased among mothers from households enjoying higher socioeconomic levels and from households with health insurance. Scores were lower for indigenous households regardless of their participation in social programs. CONCLUSION Public policies on ECD should promote programs that are not only adapted to specific contexts, but also designed to improve shared child-rearing, early childhood care and as well as psycho-emotional education skills as a pathway to healthier ECD. The participation of families and communities in sensitive childhood care should form part of multisectoral programs involving education, health and wellbeing.
Collapse
Affiliation(s)
- Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martín I Ramírez-Baca
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Evelyn Fuentes-Rivera
- Center for Demographic, Urban and Environmental Studies, College of Mexico A.C., Mexico City, Mexico
| | - Angélica García-Martínez
- Lucy Family Institute for Data and Society, University of Notre Dame, Notre Dame, IN, United States of America
| | - Amado D Quezada-Sánchez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | | | - Emanuel Orozco-Núñez
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lourdes Schnaas
- Department of Developmental Neurobiology, National Institute of Perinatology Isidro Espinosa de los Reyes, Mexico City, Mexico
| |
Collapse
|
22
|
Motoki N, Inaba Y, Shibazaki T, Misawa Y, Ohira S, Kanai M, Kurita H, Tsukahara T, Nomiyama T. Impact of maternal dyslipidemia on infant neurodevelopment: The Japan Environment and Children's Study. Brain Dev 2022; 44:520-530. [PMID: 35643833 DOI: 10.1016/j.braindev.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Various genetic and environmental influences have been studied for developmental disorders; however, the precise cause remains unknown. This study assessed the impact of maternal serum total cholesterol (TC) level in early pregnancy on early childhood neurodevelopment. METHODS The fixed data of 31,797 singleton births from a large national birth cohort study that commenced in 2011 were used to identify developmental disorders as estimated by Ages and Stages Questionnaire, third edition (ASQ-3) scores of less than -2 standard deviations at 12 months of age. Multiple logistic regression analysis was employed to search for correlations between possibility of developmental disorders and maternal TC levels in early pregnancy classified into 4 groups based on quartile (Q1-Q4) values. RESULTS After controlling for potential confounding factors in 27,836 participants who ultimately underwent multivariate analysis, we observed that elevated TC levels were significantly associated with a higher risk of screen positive status for communication (Q4: adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.05-1.37) and gross motor (aOR 1.13, 95% CI 1.03-1.25) ASQ-3 domain scores. CONCLUSION This large nationwide survey revealed a possible deleterious effect of hypercholesterolemia in early pregnancy on infant neurodevelopment and age-appropriate skill acquisition at 12 months age.
Collapse
Affiliation(s)
- Noriko Motoki
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yuji Inaba
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan; Department of Neurology, Nagano Children's Hospital, Azumino, Nagano, Japan; Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano, Japan.
| | - Takumi Shibazaki
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yuka Misawa
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan; Department of Rehabilitation, Nagano Children's Hospital, Azumino, Nagano, Japan
| | - Satoshi Ohira
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Makoto Kanai
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hiroshi Kurita
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Teruomi Tsukahara
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan; Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Tetsuo Nomiyama
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan; Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | | |
Collapse
|
23
|
Brito APA, Silva CM, Riesco ML, McArthur A. Experiences of health professionals in screening for postpartum depressive symptoms: a qualitative systematic review protocol. JBI Evid Synth 2022; 20:2329-2335. [DOI: 10.11124/jbies-21-00329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
24
|
Vrabic SC, Herbers JE, Davis M, Thomas C. Perceptions of support in shelter environments for caregivers and young children experiencing family homelessness. Child Care Health Dev 2022; 48:588-594. [PMID: 35023211 DOI: 10.1111/cch.12963] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 11/17/2021] [Accepted: 01/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Young children who stay with their families in homeless shelters face chronic challenges related to extreme poverty and acute risks from stressful events surrounding the loss of housing and move to shelter. These adversities increase the likelihood of a range of poor developmental outcomes. Consistent with the risk and resilience perspective, however, many children who experience family homelessness succeed, functioning as well or better than their non-homeless peers. As such, efforts to support resilience should consider how best to enhance protective factors, such as supportive environments within shelter settings. METHODS With data from 60 caregivers of children ages birth to 5 years recruited from family shelters, we assessed caregivers' perceptions of community support as well as child and family well-being in terms of recent adverse experiences, parenting stress, access to social support, and child social-emotional functioning. RESULTS Many caregivers experiencing family homelessness perceived negative aspects of the shelters where they were staying with their children. Furthermore, children whose caregivers had more negative perceptions of the shelter environment displayed worse social-emotional functioning, even when accounting for differences in parenting stress, recent family adversity, and other sources of social support. CONCLUSIONS Because young children rely on their caregivers as primary resources for nurturance and support, we encourage family homelessness service providers to work in partnership with caregivers to create more inclusive and empowering practices within the shelter context. Doing so is likely to improve children's developmental outcomes and the overall well-being of the families.
Collapse
Affiliation(s)
- Sarah C Vrabic
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA, USA
| | - Janette E Herbers
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA, USA
| | - Mariah Davis
- College of Education and Human Development, Temple University, Philadelphia, PA, USA
| | - Courtney Thomas
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA
| |
Collapse
|
25
|
Farmer G, Lowe SAJ, McDonald S, Yamamoto SS, Chari R, Pabayo R. Do social support and community engagement act as mechanisms in the association between neighbourhood income inequality and the mental health of mothers in Calgary, Canada? A mediation analysis. Health Place 2022; 76:102851. [PMID: 35779324 DOI: 10.1016/j.healthplace.2022.102851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE According to the social determinants of health framework, income inequality is a potential risk factor for adverse mental health. However, few studies have explored the mechanisms suspected to mediate this relationship. The current study addresses this gap through a mediation analysis to determine if social support and community engagement act as mediators linking neighbourhood income inequality to maternal anxiety and depressive symptoms within a cohort of new mothers living in the City of Calgary, Canada. METHODS Data collected at three years postpartum from mothers belonging to the All Our Families (AOF) cohort were used in the current study. Maternal data were collected between 2012 and 2015 and linked to neighbourhood socioeconomic data from the 2006 Canadian Census. Income inequality was measured using Gini coefficients derived from 2006 after-tax census data. Generalized structural equation models were used to quantify the associations between income inequality and mental health symptoms, and to assess the potential direct and indirect mediating effects of maternal social support and community engagement. RESULTS Income inequality was not significantly associated with higher depressive symptoms (β = 0.32, 95%CI = -0.067, 0.70), anxiety symptoms (β = 0.11, 95%CI = -0.39, 0.60), or lower social support. Income inequality was not associated with community engagement. For the depression models, higher social support was significantly associated with lower depressive symptoms (β = -0.13, 95%CI = -0.15, -0.097), while community engagement was not significantly associated with depressive symptoms (β = 0.059, 95%CI = -0.15, 0.27). Similarly, for the anxiety models, lower anxiety symptoms were significantly associated with higher levels of social support (β = -0.17, 95%CI = -0.20, -0.13) but not with higher levels of community engagement (β = 0.14, 95%CI = -0.14, 0.41). CONCLUSION The current study did not find clear evidence for social support or community engagement mediating the relationship between neighbourhood income inequality and maternal mental health. Future investigations should employ a broader longitudinal approach to capture changes in income inequality, potential mediators, and mental health symptomatology over time.
Collapse
Affiliation(s)
- G Farmer
- School of Public Health, University of Alberta, Edmonton, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada
| | - S A J Lowe
- School of Public Health, University of Alberta, Edmonton, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada.
| | - S McDonald
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - S S Yamamoto
- School of Public Health, University of Alberta, Edmonton, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada
| | - R Chari
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, 8440 112 Street NW, Edmonton, Alberta, T6G 2R7, Canada
| | - R Pabayo
- School of Public Health, University of Alberta, Edmonton, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada
| |
Collapse
|
26
|
Jiwani Z, Drylewski G, Sharma S, Ahun M, Thapa S, Steele M. Adverse childhood experiences and maternal self-efficacy: Examining the mediating role of intimate partner violence and the moderating role of caste membership in rural India. Infant Ment Health J 2022; 43:546-557. [PMID: 35665944 DOI: 10.1002/imhj.21997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 02/15/2022] [Indexed: 11/09/2022]
Abstract
Maternal self-efficacy (MSE) is associated with healthy functioning in mothers and children globally. Maternal exposure to adverse childhood experiences (ACEs) and intimate partner violence (IPV) is known to negatively impact MSE in high-income countries; however, the association has not been examined in low-and-middle-income countries, such as India, which face socioeconomic risks including poverty, illiteracy, and discrimination based on caste membership. The present study examines the mediating role of IPV in the association between ACEs (specifically-emotional, physical, and sexual abuse, neglect, household dysfunction, and discrimination) and MSE and tests caste membership as a moderator. A community-based, cross-sectional survey was performed with 316 mothers with at least one child between 0 and 24 months in a rural area in the North Indian state of Uttar Pradesh. A structural equation framework was used to test the moderated-mediation model. Results from the moderated-mediation model indicate that greater ACEs exposure was associated with lower MSE and this association was mediated by IPV exposure for low-caste but not high-caste mothers, even after controlling for wealth and literacy. These findings add to existing evidence on ACEs exposure as a significant burden for rural Indian mothers, negatively impacting parenting outcomes such as MSE. The critical role of caste membership is also highlighted, providing implications for future research.
Collapse
Affiliation(s)
- Zishan Jiwani
- Department of psychology, New School for Social Research, New York City, New York, USA.,University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Grace Drylewski
- Department of psychology, New School for Social Research, New York City, New York, USA
| | | | - Marilyn Ahun
- University of Montreal, Montreal, Quebec, Canada
| | - Shobhali Thapa
- Department of psychology, New School for Social Research, New York City, New York, USA
| | - Miriam Steele
- Department of psychology, New School for Social Research, New York City, New York, USA
| |
Collapse
|
27
|
Bogavac I, Jeličić L, Nenadović V, Subotić M, Janjić V. The speech and language profile of a child with Turner Syndrome- a case study. CLINICAL LINGUISTICS & PHONETICS 2022; 36:565-578. [PMID: 34309455 DOI: 10.1080/02699206.2021.1953610] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Turner syndrome is a genetic disorder that affects only females. It has specific cognitive characteristics, but speech and language data are scarce. METHODS AND PROCEDURES Prospective case report; we report a girl aged seven's cognitive and speech and language profile. RESULTS Cognitive assessment shows higher performance IQ (PIQ), and atypical cognitive profile for Turner syndrome. Speech and language assessment show a significant difference between receptive and expressive language levels. Although the girl did comprehend most of the language structure, there was a lack of it in spontaneous speech. She demonstrated inconsistency in the use of language morphology and complex linguistic structures, primarily because of significant inconsistency in her sound production. Although she produced the majority of phonemes correctly in isolation, her spontaneous speech production was incomprehensible. CONCLUSION Case studies of speech and language development may reveal a specific characteristic in the cases with Turner syndrome to delineate genetic factors from individual developmental variabilities.
Collapse
Affiliation(s)
- Ivana Bogavac
- Cognitive Neuroscience Department, Research and Development Institute "Life Activities Advancement Center", Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute "Life Activities Advancement Center", Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Vanja Nenadović
- Cognitive Neuroscience Department, Research and Development Institute "Life Activities Advancement Center", Belgrade, Serbia
- Department of Speech, Language, and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute "Life Activities Advancement Center", Belgrade, Serbia
| | - Vladimir Janjić
- Department of Psychiatry, University of Kragujevac, Faculty of Medicine, Kragujevac, Serbia
- Clinic of Psychiatry, Clinical Center Kragujevac, Kragujevac, Serbia
| |
Collapse
|
28
|
Modelling Maternal Depression: An Agent-Based Model to Examine the Complex Relationship between Relative Income and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074208. [PMID: 35409890 PMCID: PMC8998540 DOI: 10.3390/ijerph19074208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
Depression is a major public health concern among expectant mothers in Canada. Income inequality has been linked to depression, so interventions for reducing income inequality may reduce the prevalence of maternal depression. The current study aims to simulate the effects of government transfers and increases to minimum wage on depression in mothers. We used agent-based modelling techniques to identify the predicted effects of income inequality reducing programs on maternal depression. Model parameters were identified using the All Our Families cohort dataset and the existing literature. The mean age of our sample was 30 years. The sample was also predominantly white (78.6%) and had at least some post-secondary education (89.1%). When income was increased by just simulating an increase in minimum wage, the proportion of depressed mothers decreased by 2.9% (p < 0.005). Likewise, simulating the Canada Child Benefit resulted in a 5.0% decrease in the prevalence of depression (p < 0.001) and Ontario’s Universal Basic Income pilot project resulted in a simulated 5.6% decrease in the prevalence of depression (p < 0.001). We also assessed simulated changes to the mother’s social networks. Progressive income policies and increasing social networks are predicted to decrease the probability of depression.
Collapse
|
29
|
Ecological factors influencing parenting self-efficacy among working mothers with a child under 36 month old in South Korea: a cross-sectional and correlational study. BMC Womens Health 2022; 22:62. [PMID: 35248024 PMCID: PMC8898444 DOI: 10.1186/s12905-022-01639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parenting self-efficacy is an essential component for parents to successfully perform their role and is important for mother and child well-being. To support parenting self-efficacy amongst working mothers, it is necessary to understand the factors influencing parenting self-efficacy amongst this group. However, the majority of previous studies regarding factors influencing parenting self-efficacy did not focus on working mothers. Therefore, this study aimed to identify the factors influencing parenting self-efficacy of working mothers using an ecological framework. METHODS The research design was a cross-sectional, correlational study. The participants were 298 working mothers with a child under 3 years of age, who were recruited from ten nurseries. Data were collected from August 8 to September 22, 2017 using structured questionnaires, including the Parenting Sense of Competency scale, a one-item Short Form Health Survey scale, the Maternal Role Satisfaction scale, the Parenting Stress Inventory, the Work and Parent Role Conflict scale, the Parenting Alliance Inventory, the Social Support scale, and the Childbirth and Parenting Friendly System scale. The study process of this study was approved by the Institutional Review Board. Collected data were analyzed by SPSS 23.0 Win program with descriptive statistics, t-test, one way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression. RESULTS Working mothers who were the primary caregiver had higher parenting self-efficacy compared to those who were not the primary caregiver (β = .13, p = .022). At the individual level, the higher maternal role satisfaction, the higher parenting self-efficacy of working mothers (β = .27, p < .001). In the micro-system level, higher parenting support by a spouse was associated with higher parenting self-efficacy of working mothers (β = .19, p = .002). CONCLUSIONS Educational interventions for increasing the awareness and satisfaction of maternal role and various strategies for fathers' active participation in parenting should be developed. In addition, practical interventions that reduce the burden of parenting while supporting parenting self-efficacy of working mothers who are the primary caregiver should also be considered.
Collapse
|
30
|
Santos JAT, Ayupe KMA, Lima ALO, Albuquerque KAD, Morgado FFDR, Gutierres Filho PJB. [Psychometric properties of the Brazilian version of the Denver II: developmental screening test]. CIENCIA & SAUDE COLETIVA 2022; 27:1097-1106. [PMID: 35293447 DOI: 10.1590/1413-81232022273.40092020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/07/2021] [Indexed: 05/31/2023] Open
Abstract
The scope of the Denver II Developmental Screening Test is to assess the development of children between 0 and 6 years of age. The aim of this study was to verify evidence of intra- and inter-examiner reliability, concurrent validity, sensitivity and specificity of the Brazilian version of Denver II. It involved a cross-sectional methodological study. A total of 254 children, between 0 and 72 months with risk of developmental delay, participated in the study. Two examiners verified the Denver II intra- and inter-examiner reliability. Concurrent validity, sensitivity and specificity were checked against the Brazilian version of the Ages & Stages Questionnaires as a criterion-referenced test. Statistical analysis used the Intraclass Correlation Coefficient, Spearman's Correlation Test and Contingency Table, the level of significance being α=0.05. The results identified that intra and inter examiner reliability was excellent in all age groups. Concurrent validity showed moderate to very strong rates in the 13-to-60-month age group. The sensitivity and specificity indices ranged from 73-99% and 58-92%, respectively. The Brazilian version of Denver II has good rates of psychometric properties and is a reliable and valid instrument to be applied to Brazilian children at risk of developmental delay.
Collapse
Affiliation(s)
- Janaina Araujo Teixeira Santos
- Programa de Pós-Graduação em Educação Física, Universidade de Brasília. Campus Universitário Darcy Ribeiro, Faculdade de Educação Física. 70910-900 Brasília DF Brasil.
| | | | | | | | | | - Paulo José Barbosa Gutierres Filho
- Programa de Pós-Graduação em Educação Física, Universidade de Brasília. Campus Universitário Darcy Ribeiro, Faculdade de Educação Física. 70910-900 Brasília DF Brasil.
| |
Collapse
|
31
|
Does Where You Live Predict What You Say? Associations between Neighborhood Factors, Child Sleep, and Language Development. Brain Sci 2022; 12:brainsci12020223. [PMID: 35203986 PMCID: PMC8870121 DOI: 10.3390/brainsci12020223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 02/01/2023] Open
Abstract
Language ability is strongly related to important child developmental outcomes. Family-level socioeconomic status influences child language ability; it is unclear if, and through which mechanisms, neighborhood-level factors impact child language. The current study investigated the association between neighborhood factors (deprivation and disorder) assessed before birth and child language outcomes at age 5, with sleep duration as a potential underlying pathway. Secondary analysis was conducted on data collected between 2008 and 2018 on a subsample of 2444 participants from the All Our Families cohort study (Calgary, Canada) for whom neighborhood information from pregnancy could be geocoded. Neighborhood deprivation was determined using the Vancouver Area Neighborhood Deprivation Index (VANDIX), and disorder was assessed using crime reports. Mothers reported on their children’s sleep duration and language ability. Multilevel modeling indicated that greater neighborhood deprivation and disorder during pregnancy were predictive of lower scores on the Child Communication Checklist–2 (CCC–2) at 5 years. Path analyses revealed an indirect effect of neighborhood disorder on language through child sleep duration at 12 months. These results add to growing evidence that child development should be considered within the context of multiple systems. Sleep duration as an underlying link between environmental factors and child language ability warrants further study as a potential target for intervention.
Collapse
|
32
|
Stienwandt S, Cameron EE, Soderstrom M, Casar M, Le C, Roos LE. Family Factors Associated with Hands-On Play and Screen Time During the COVID-19 Pandemic. CHILD & YOUTH CARE FORUM 2022; 51:1091-1115. [PMID: 35013660 PMCID: PMC8731198 DOI: 10.1007/s10566-021-09668-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
Background Parent–child interactions are crucial for child development. The COVID-19 pandemic has negatively affected mental health and increased parenting challenges impacting parent–child functioning. Objective This study examined parent factors related to more and less enriching child activities during the pandemic through Bronfenbrenner’s Ecological Systems framework. Methods A convenience sample of parents (N = 708), primarily mothers (n = 610; 87.4%) aged 35.59 years old (SD = 5.59; range = 21–72), with children ages 2–8 years completed an online questionnaire between April 14-June 1, 2020. Participants mostly resided in Canada, had an income of > $100,000, and identified as White (82.4%). Parent–child activities were measured as total weekly time and combined time across activities within two categories: hands-on play and screen time. Bivariate correlations informed blockwise linear regression models. Results For families with childcare needs, parental anxiety was associated with higher total hands-on play, combined hands-on play, and combined screen time. Families without childcare needs indicated parenting stress was associated with lower total hands-on play and combined hands-on play, and higher supervised screen time. Family structure and indices of socioeconomic status were also predictive of activities across childcare needs and child ages. Conclusions To promote high-quality parent–child interactions and positive developmental outcomes during the pandemic, childcare needs and parent wellbeing should be supported, while evidence-based guidelines for child screen time should be further researched in this context.
Collapse
Affiliation(s)
- Shaelyn Stienwandt
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada
| | - Emily E Cameron
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada
| | - Melanie Soderstrom
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada
| | - Mercedes Casar
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada
| | - Cindy Le
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2 Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| |
Collapse
|
33
|
Insufficient maternal gestational weight gain and infant neurodevelopment at 12 months of age: the Japan Environment and Children's Study. Eur J Pediatr 2022; 181:921-931. [PMID: 34642790 PMCID: PMC8897327 DOI: 10.1007/s00431-021-04232-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Abnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children's Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal-social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09-1.34), gross motor (OR 1.14, 95% CI 1.05-1.24), fine motor (OR 1.13, 95% CI 1.04-1.24), problem-solving (OR 1.09, 95% CI 1.01-1.18), and personal-social (OR 1.15, 95% CI 1.07-1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children's Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known: • Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes. • Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New: • This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age. • Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.
Collapse
|
34
|
Kolker S, Biringer A, Bytautas J, Blumenfeld H, Kukan S, Carroll JC. Pregnant during the COVID-19 pandemic: an exploration of patients' lived experiences. BMC Pregnancy Childbirth 2021; 21:851. [PMID: 34972506 PMCID: PMC8718994 DOI: 10.1186/s12884-021-04337-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Infectious outbreaks are known to cause fear and panic. Exploration of pregnant individuals' psychosocial condition using a qualitative lens during an infectious outbreak is limited. In this study we explore pregnant individuals' lived experiences as well as their psychological and behavioural responses during COVID-19 with the goal of providing useful strategies from the patient's perspective to enable health care providers to help pregnant patients navigate this and future pandemics. METHODS Pregnant individuals between 20-weeks gestation and 3 months postpartum who received maternity care from an urban academic interprofessional teaching unit in Toronto, Canada were invited to participate. Semi-structured 60 min interviews were audio-recorded, transcribed and analyzed using descriptive thematic analysis. Interview questions probed psychological responses to the pandemic, behavioural and lifestyle changes, strategies to mitigate distress while pregnant during COVID-19 and advice for other patients and the healthcare team. RESULTS There were 12 participants, mean age 35 years (range 30-43 years), all 1 to 6 months postpartum. Six main themes emerged: 1) Childbearing-related challenges to everyday life; 2) Increased worry, uncertainty and fear; 3) Pervasive sense of loss; 4) Challenges accessing care; 5) Strategies for coping with pandemic stress; 6) Reflections and advice to other pregnant people and health care professionals. Pregnant individuals described lack of social support due to COVID-19 pandemic restrictions and a profound sense of loss of what they thought their pregnancy and postpartum period should have been. Advice to healthcare providers included providing mental health support, clear and up to date communication as well as more postpartum and breastfeeding support. CONCLUSIONS These participants described experiencing psychosocial distress during their pregnancies and postpartum. In a stressful situation such as a global pandemic, health care providers need to play a pivotal role to ensure pregnant individuals feel supported and receive consistent care throughout the pregnancy and postpartum period. The health care provider should ensure that mental health concerns are addressed and provide postpartum and breastfeeding support. Without addressing this need for support, parental mental health, relationships, parent-infant bonding, and infant development may be negatively impacted.
Collapse
Affiliation(s)
- Sabrina Kolker
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada.
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
| | - Anne Biringer
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica Bytautas
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Haley Blumenfeld
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
| | - Sahana Kukan
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
| | - June C Carroll
- Ray D. Wolfe Department of Family Medicine, Sinai Health, 60 Murray Street, Box 25, Toronto, ON, M5T 3L9, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
35
|
Lowe SA, McDonald S, Senthilselvan A, Nykiforuk CI, Chari R, Pabayo R. Is neighbourhood income inequality associated with maternal mental health? A longitudinal analysis of pregnant and new mothers living in Calgary, Alberta. BMJ Open 2021; 11:e049220. [PMID: 34937713 PMCID: PMC8704958 DOI: 10.1136/bmjopen-2021-049220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Rising income inequality is a potential risk factor for poor mental health, however, little work has investigated this link among mothers. Our goal was to determine if neighbourhood-level income inequality was associated with maternal mental health over time. DESIGN Secondary data analysis using a retrospective cohort study design. SETTING AND PARTICIPANTS Data from the All Our Families (AOF) ongoing cohort study in the city of Calgary (Canada) were used, with our sample including 2461 mothers. Participant data were collected at six time points from 2008 to 2014, corresponding to <25 weeks of pregnancy to 3 years post partum. AOF mothers were linked to 196 geographically defined Calgary neighbourhoods using postal code information and 2006 Canada Census data. MAIN OUTCOME MEASURES Anxiety symptoms measured using the Spielberger State Anxiety Inventory, and depressive symptoms measured using the Edinburgh Postnatal Depression Scale and the Centre for Epidemiologic Studies-Depression Scale. RESULTS Multilevel regression modelling was used to quantify the associations between neighbourhood-level income inequality and continuous mental health symptoms over time. For anxiety symptoms, the interaction term between neighbourhood Gini and time was significant (β=0.0017, 95% CI=0.00049 to 0.0028, p=0.005), indicating an excess rate of change over time. Specifically, a SD increase in Gini (Z-score) was associated with an average monthly rate increase in anxiety symptom scores of 1.001% per month. While depressive symptom scores followed similar longitudinal trajectories across levels of income inequality, we did not find significant evidence for an association between inequality and depressive symptoms. There was no evidence of a cross-level interaction between inequality and household income on either outcome. CONCLUSION Income inequality within neighbourhoods appears to adversely impact the mental health trajectories of pregnant and new mothers. Further research is needed to understand the mechanisms that explain this relationship, and how interventions to reduce income inequality could benefit mental health.
Collapse
Affiliation(s)
- Samuel Aj Lowe
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila McDonald
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Radha Chari
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
36
|
Saptarini I, Rizkianti A, Arfines PP, Suparmi, Maisya IB. Associations Between Parental Depression and Early Childhood Development in Indonesia: A Cross-sectional Study. J Prev Med Public Health 2021; 54:451-460. [PMID: 34875828 PMCID: PMC8655375 DOI: 10.3961/jpmph.21.158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/24/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives This study aimed to determine the associations between parental depression and early childhood development among children aged 36 months to 59 months in Indonesia. Methods From Indonesia’s Basic Health Survey (RISKESDAS) 2018, this study included 6433 children aged 36 months to 59 months and their parents. Maternal and paternal depression was examined using the Mini International Neuropsychiatric Interview survey instrument, which was previously translated into Indonesian. The study also used the Early Child Development Index to measure child development and its 4 domains (cognitive, physical, socio-emotional, and learning). Multivariate logistic regression analysis was performed to determine the association between parental depression and early childhood development. Results Overall, 10.3% of children aged 36 months to 59 months were off-track for development. After adjusting for biological, parental, and social characteristics, children born to parents with depression were found to be 4.72 times more likely to be off-track for development (95% confidence interval, 1.83 to 12.15). Conclusions Children of depressed parents were more likely to be off-track for development. The findings highlight the need for early diagnosis and timely intervention for parental depression to promote early childhood development.
Collapse
Affiliation(s)
- Ika Saptarini
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| | - Anissa Rizkianti
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| | - Prisca Petty Arfines
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| | - Suparmi
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| | - Iram Barida Maisya
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Jakarta, Indonesia
| |
Collapse
|
37
|
The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey. PLoS One 2021; 16:e0246725. [PMID: 34699530 PMCID: PMC8547691 DOI: 10.1371/journal.pone.0246725] [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: 03/23/2020] [Accepted: 09/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. Methods We used data from the Indonesia National Health Survey 2013, including 46,315 children 6–59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting. Results Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%). Conclusions Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.
Collapse
|
38
|
Juntarawijit Y, Chaichanawirote U, Rakmeesri P, Chairattanasakda P, Pumyim V, Juntarawijit C. Chlorpyrifos and other pesticide exposure and suspected developmental delay in children aged under 5 years: a case-control study in Phitsanulok, Thailand. F1000Res 2021; 9:1501. [PMID: 34557296 PMCID: PMC8442115 DOI: 10.12688/f1000research.27874.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Developmental delay among children under 5 years of age is a serious global public health problem and much research has been carried out to find potential causes. Pesticides - especially organophosphates - are suspected to be one of the main causes of the problem. This study aimed to investigate the association between pesticide use by the mother during pregnancy and preschool children development using a case-control study. Methods: Data on prenatal and postnatal pesticide exposure of 442 children with suspected developmental delay, and 413 controls with normal development were included for analysis. The children were matched for gender, age, and residency. Data on pesticide exposure were collected via interview with the mother, and data on pregnancy outcomes abstracted from hospital records. Results: Chlorpyrifos exposure significantly increased the risk of developmental delay with an odds ratio (OR) of 3.71 (95% CI 1.03-13.36) for ever use of the pesticide, and an OR of 5.92 (95% CI 1.01-34.68) for postnatal exposure (p <0.05). Some other pesticides also had a positive association with developmental delay but none were statistically significant (p <0.05). Those pesticides were insecticide, fungicide, herbicide, and molluscicide. Individual pesticides with a positive association were glyphosate, paraquat, butachlor, methyl parathion (pholidon), savin, methomyl, endosulfan, carbosulfan, methamidophos, monochrotofos, mancozeb, and bordeaumixture. Conclusions: This case-control study found that chlorpyrifos and some other pesticides exposure during pregnancy were positively associated with developmental delay in children aged under 5 years. Further research should be conducted to better understand this potential effects of pesticides on child neurodevelopment, and the public - especially those who plan to have families - should be informed.
Collapse
Affiliation(s)
| | | | - Paphada Rakmeesri
- Faculty of Nursing, Kamphaeng Phet Rajabhat University, Kamphaeng Phet, 62000, Thailand
| | | | - Varintorn Pumyim
- Jomthong Health Promoting Hospital, Muang District Health Office, Phitsanulok, 65000, Thailand
| | - Chudchawal Juntarawijit
- Faculty of Natural Resources and Environment, Naresuan University, Phitsanulok, 65000, Thailand
| |
Collapse
|
39
|
Influence of Prevalence of Psychoactive Substance Use in Mexican Municipalities on Early Childhood Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910027. [PMID: 34639329 PMCID: PMC8507637 DOI: 10.3390/ijerph181910027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
Children's early development is influenced by characteristics of the child, family, and environment, including exposure to substance abuse. The aim was to examine the association of early childhood development (ECD) with the prevalence of psychoactive substance use in Mexican municipalities. We obtained ECD data from the 2015 Survey of Boys, Girls, and Women (ENIM, for its Spanish acronym), measured with the ECD Index. The prevalence of psychoactive substance use was estimated at the municipal level, using the 2016 National Survey of Drug, Alcohol, and Tobacco Use (ENCODAT, for its Spanish acronym). Multilevel logistic models were fitted to evaluate the association between drug use and inadequacies in ECD overall and in four specific ECD domains: socio-emotional, literacy-numeric, learning, and physical. Inadequate ECD was directly associated with illegal drug use (OR = 1.10; 95% CI: 1.03, 1.17). For the specific ECD domains, inadequate socio-emotional development was directly associated with illegal drug use (OR = 1.08; 95% CI: 1.01, 1.15). These findings suggest that exposure to illegal drug use may influence ECD, and especially can lead to socio-emotional problems, although this cannot be considered the unanimous determinant of the problems presented. The implementation of evidence-based interventions to prevent drug abuse is necessary.
Collapse
|
40
|
Ruyak SL, Kivlighan KT. Perinatal Behavioral Health, the COVID-19 Pandemic, and a Social Determinants of Health Framework. J Obstet Gynecol Neonatal Nurs 2021; 50:525-538. [PMID: 34146480 PMCID: PMC8256336 DOI: 10.1016/j.jogn.2021.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 12/01/2022] Open
Abstract
The United States has greater prevalence of mental illness and substance use disorders than other developed countries, and pregnant women are disproportionately affected. The current global COVID-19 pandemic, through the exacerbation of psychological distress, unevenly affects the vulnerable population of pregnant women. Social distancing measures and widespread closures of businesses secondary to COVID-19 are likely to continue for the foreseeable future and to further magnify psychosocial risk factors. We propose the use of a social determinants of health framework to integrate behavioral health considerations into prenatal care and to guide the implementation of universal and comprehensive psychosocial assessment in pregnancy. As the most numerous and well-trusted health care professionals, nurses are ideally positioned to influence program and policy decisions at the community and regional levels and to advocate for the full integration of psychosocial screening and behavioral health into prenatal and postpartum care as core components.
Collapse
|
41
|
Riggs E, Yelland J, Mensah FK, Gold L, Szwarc J, Kaplan I, Small R, Middleton P, Krastev A, McDonald E, East C, Homer C, Nesvadba N, Biggs L, Braithwaite J, Brown SJ. Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design. BMJ Open 2021; 11:e048271. [PMID: 34281928 PMCID: PMC8291298 DOI: 10.1136/bmjopen-2020-048271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework. METHODS AND ANALYSIS The evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation. ETHICS AND DISSEMINATION Ethics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
Collapse
Affiliation(s)
- Elisha Riggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Yelland
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Ida Kaplan
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Rhonda Small
- Judith Lumely Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Philippa Middleton
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann Krastev
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Christine East
- School of Nursing and Midwifery/Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Natalija Nesvadba
- Multicultural Services, Mercy Hospitals Victoria Ltd, Melbourne, Victoria, Australia
| | - Laura Biggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| |
Collapse
|
42
|
Huang P, Zhou F, Guo Y, Yuan S, Lin S, Lu J, Tu S, Lu M, Shen S, Guedeney A, Xia H, Qiu X. Association Between the COVID-19 Pandemic and Infant Neurodevelopment: A Comparison Before and During COVID-19. Front Pediatr 2021; 9:662165. [PMID: 34692602 PMCID: PMC8527007 DOI: 10.3389/fped.2021.662165] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 09/10/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: To investigate the association between the experience of the coronavirus disease 2019 (COVID-19) pandemic and neurodevelopment of 6-month-old and 1-year-old children and explore the differences in the association by birth order. Methods: This comparison study was embedded in the Born in Guangzhou Cohort Study in China. The exposed group included 546 6-month-old and 285 1-year-old children who attended neurodevelopment assessments between March 1 and May 15, 2020, and the non-exposed group included 3,009 6-month-old and 2,214 1-year-old children during the same months from 2015 to 2019. Neurodevelopment at age 6 months and 1 year was assessed by trained clinical staff using the Ages and Stages Questionnaires, third edition (ASQ-3) and the Gesell Developmental Schedules (GDS). Results: The experience of the pandemic in 2020 was associated with a higher risk of delay in the fine motor (adjusted OR: 2.50, 95% CI: 1.25, 4.99; estimated by logistic regression) and communication (adjusted RR [aRR]: 1.13, 95% CI: 1.02, 1.25; estimated by log-binomial regression) domains at age 1 year. The association between the experience of the pandemic and communication delay at age 1 year only existed in first-born children (aRR: 1.15, 95% CI: 1.03, 1.30) but not in later-born children (aRR: 1.02, 95% CI: 0.84, 1.25). No associations were observed in any domain among 6-month-olds. Conclusion: Experiencing the COVID-19 pandemic and related public health strategies might be associated with a higher risk of delay in the development of fine motor and communication in 1-year-old children; the association observed in the communication domain only existed in first-born children.
Collapse
Affiliation(s)
- Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Fengjuan Zhou
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Shanshan Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Shanshan Lin
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Si Tu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Bichat Claude Bernard Hospital, Paris University, Paris, France
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
| |
Collapse
|
43
|
Juntarawijit Y, Chaichanawirote U, Rakmeesri P, Chairattanasakda P, Pumyim V, Juntarawijit C. Chlorpyrifos and other pesticide exposure and suspected developmental delay in children aged under 5 years: a case-control study in Phitsanulok, Thailand. F1000Res 2020; 9:1501. [PMID: 34557296 PMCID: PMC8442115 DOI: 10.12688/f1000research.27874.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 08/12/2023] Open
Abstract
Background: Developmental delay among children under 5 years of age is a serious global public health problem and much research has been carried out to find potential causes. Pesticides - especially organophosphates - are suspected to be one of the main causes of the problem. This study aimed to investigate the association between pesticide use by the mother during pregnancy and preschool children development using a case-control study. Methods: Data on prenatal and postnatal pesticide exposure of 442 children with suspected developmental delay, and 413 controls with normal development were included for analysis. The children were matched for gender, age, and residency. Data on pesticide exposure were collected via interview with the mother, and data on pregnancy outcomes abstracted from hospital records. Results: Chlorpyrifos exposure significantly increased the risk of developmental delay with an odds ratio (OR) of 3.71 (95% CI 1.03-13.36) for ever use of the pesticide, and an OR of 5.92 (95% CI 1.01-34.68) for postnatal exposure (p <0.05). Some other pesticides also had a positive association with developmental delay but none were statistically significant (p <0.05). Those pesticides were insecticide, fungicide, herbicide, and molluscicide. Individual pesticides with a positive association were glyphosate, paraquat, butachlor, methyl parathion (pholidon), savin, methomyl, endosulfan, carbosulfan, methamidophos, monochrotofos, mancozeb, and bordeaumixture. Conclusions: This case-control study found that chlorpyrifos and some other pesticides exposure during pregnancy were positively associated with developmental delay in children aged under 5 years. Further research should be conducted to better understand this potential effects of pesticides on child neurodevelopment, and the public - especially those who plan to have families - should be informed.
Collapse
Affiliation(s)
| | | | - Paphada Rakmeesri
- Faculty of Nursing, Kamphaeng Phet Rajabhat University, Kamphaeng Phet, 62000, Thailand
| | | | - Varintorn Pumyim
- Jomthong Health Promoting Hospital, Muang District Health Office, Phitsanulok, 65000, Thailand
| | - Chudchawal Juntarawijit
- Faculty of Natural Resources and Environment, Naresuan University, Phitsanulok, 65000, Thailand
| |
Collapse
|
44
|
The Effect of Parenting Quality on Child Development at 36-48 Months in China's Urban Area: Evidence from a Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238962. [PMID: 33276498 PMCID: PMC7731234 DOI: 10.3390/ijerph17238962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 01/18/2023]
Abstract
Environmental exposures, especially parenting quality, are critical for later child development. This study aimed to determine the status of parenting quality and suspected development delay of preschool children in China's urban area and explore the associations between these two factors. The research was based on a birth cohort study conducted in Changsha, Hunan province, China. We used the Parenting Assessment Tool and Ages and Stages Questionnaires, Third Edition (ASQ-3), to measure parenting quality and child development status, respectively. Other data were collected from maternal health manuals and self-administered questionnaires during the follow-up period. The generalized estimating equation was used to examine whether parenting quality was significantly associated with child development outcomes. In the study, good parenting quality was 33.6% measured at 18 months, and suspected development delay was below 10% at 36-48 months among urban China; we observed negative associations between parenting quality scores and child development scores; poor parenting quality had a negative association with suspected development delay [OR and 95% CI: 2.74 (1.17, 6.40)], girls [OR and 95% CI: 0.33 (0.16, 0.69)] and maternal education years (>12 years) [OR and 95% CI: 0.27 (0.12, 0.64)] were protective factors for suspected development delay. Our findings highlighted the importance of good parenting quality among children in urban areas of China through a birth cohort study and may be used to reduce the children at high risk of developmental delay as a future intervention program.
Collapse
|
45
|
Zumbach J, Oster A. [Parenting capacity: Definitions, indicators, and assessment]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 49:37-50. [PMID: 33243078 DOI: 10.1024/1422-4917/a000770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Parenting capacity: Definitions, indicators, and assessment Abstract. Parenting capacity is a broadly defined term that refers to the ability of parents to meet their children's needs. The assessment of parenting capacity is crucial to child-protection concerns and often an essential task in psychological evaluations for family law proceedings. Despite the relevance of the construct as a factor influencing child development and its frequent use in normative legal decisions, there is little consensus in the psychological literature regarding the definition of the construct. This literature review identifies, analyzes, and systemizes the national and international definitions of parenting capacity and the associated indicators. Following a comprehensive literature search, we included the work of 12 authors in this analysis. After checking for overlaps in content, we were able to categorize 58 indicators of parenting capacity into 29 different groups of indicators. The literature review also identifies German instruments that assess the construct of parenting capacity and its limitation. No instrument exists in the German literature which explicitly measures the parenting capacity as a construct. We did, however, identify five instruments that measure related constructs. We evaluated these instruments for their psychometric quality and their applicability in the context of psychological evaluation in family law. We discuss the diagnostic relevance of the identified definitions and indicators of parenting capacity as well as the practicality of the assessment instruments for psychological evaluations in family law proceedings.
Collapse
Affiliation(s)
- Jelena Zumbach
- Psychologische Hochschule Berlin.,Die Autorinnen haben zu gleichen Teilen zu diesem Beitrag beigetragen
| | - Anna Oster
- Psychologische Hochschule Berlin.,Die Autorinnen haben zu gleichen Teilen zu diesem Beitrag beigetragen
| |
Collapse
|
46
|
Romero-Gonzalez B, Caparros-Gonzalez RA, Cruz-Martinez M, Gonzalez-Perez R, Gallego-Burgos JC, Peralta-Ramirez MI. Neurodevelopment of high and low-risk pregnancy babies at 6 months of age. Midwifery 2020; 89:102791. [PMID: 32645601 DOI: 10.1016/j.midw.2020.102791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/06/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE to compare neurodevelopment differences between babies born from low-risk pregnancies and babies born from high-risk pregnancies. STUDY DESIGN Longitudinal design SETTING: Spain PARTICIPANTS: A total of 91 women participated in the study, divided into two groups: 49 women in the low-risk pregnancy group and 42 women in the high-risk group. MEASUREMENT AND FINDINGS The average amount of cortisol in pregnant mothers' hair was determined in both groups. Following their birth, the babies' neurodevelopment was evaluated using the Bayley-III instrument at 6 months of age and a new sample of cortisol was obtained from both the baby and the mother. The results showed that pregnancy risk group could predict cognitive, fine motor, gross motor and general motor neurodevelopment. KEY CONCLUSIONS These results seem to show that an appropriate treatment tailored to the needs of individualised pregnancies may favor babies' neurodevelopment, including that of babies born from high-risk pregnancies. IMPLICATIONS FOR RESEARCH It is essential to take special care of pregnant women no matter their medical condition and offer them the best medical care available.
Collapse
Affiliation(s)
- Borja Romero-Gonzalez
- Mind, Brain and Behaviour Centre (CIMCYC). Faculty of Psychology, University of Granada, Granada, Spain; Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| | | | - Milagros Cruz-Martinez
- Obstetrics and Gynaecology Department, University Hospital San Cecilio, Granada, Granada, Spain
| | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | - Maria Isabel Peralta-Ramirez
- Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain
| |
Collapse
|
47
|
Wedderburn CJ, Subramoney S, Yeung S, Fouche JP, Joshi SH, Narr KL, Rehman AM, Roos A, Ipser J, Robertson FC, Groenewold NA, Gibb DM, Zar HJ, Stein DJ, Donald KA. Neuroimaging young children and associations with neurocognitive development in a South African birth cohort study. Neuroimage 2020; 219:116846. [PMID: 32304884 PMCID: PMC7443699 DOI: 10.1016/j.neuroimage.2020.116846] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/14/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022] Open
Abstract
Magnetic resonance imaging (MRI) is an indispensable tool for investigating brain development in young children and the neurobiological mechanisms underlying developmental risk and resilience. Sub-Saharan Africa has the highest proportion of children at risk of developmental delay worldwide, yet in this region there is very limited neuroimaging research focusing on the neurobiology of such impairment. Furthermore, paediatric MRI imaging is challenging in any setting due to motion sensitivity. Although sedation and anesthesia are routinely used in clinical practice to minimise movement in young children, this may not be ethical in the context of research. Our study aimed to investigate the feasibility of paediatric multimodal MRI at age 2–3 years without sedation, and to explore the relationship between cortical structure and neurocognitive development at this understudied age in a sub-Saharan African setting. A total of 239 children from the Drakenstein Child Health Study, a large observational South African birth cohort, were recruited for neuroimaging at 2–3 years of age. Scans were conducted during natural sleep utilising locally developed techniques. T1-MEMPRAGE and T2-weighted structural imaging, resting state functional MRI, diffusion tensor imaging and magnetic resonance spectroscopy sequences were included. Child neurodevelopment was assessed using the Bayley-III Scales of Infant and Toddler Development. Following 23 pilot scans, 216 children underwent scanning and T1-weighted images were obtained from 167/216 (77%) of children (median age 34.8 months). Furthermore, we found cortical surface area and thickness within frontal regions were associated with cognitive development, and in temporal and frontal regions with language development (beta coefficient ≥0.20). Overall, we demonstrate the feasibility of carrying out a neuroimaging study of young children during natural sleep in sub-Saharan Africa. Our findings indicate that dynamic morphological changes in heteromodal association regions are associated with cognitive and language development at this young age. These proof-of-concept analyses suggest similar links between the brain and cognition as prior literature from high income countries, enhancing understanding of the interplay between cortical structure and function during brain maturation. MRI data are challenging to acquire in the early years of life. Paediatric MRI without sedation is feasible in sub-Saharan Africa, with 77% success. The Drakenstein Child Health study has novel MRI data of South African children. Morphological features of the cortex associate with neurocognitive development. Structure-cognition relationships in heteromodal association regions at 2–3 years.
Collapse
Affiliation(s)
- Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, UK; Neuroscience Institute, University of Cape Town, South Africa.
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Shunmay Yeung
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, UK
| | | | - Shantanu H Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | - Andrea M Rehman
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa; SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Jonathan Ipser
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa
| | - Frances C Robertson
- Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Cape Universities Brain Imaging Centre (CUBIC), Cape Town, South Africa
| | - Nynke A Groenewold
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa
| | - Diana M Gibb
- MRC Clinical Trials Unit, University College, London, UK
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; SAMRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa; SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa
| |
Collapse
|
48
|
Monteiro S, Nassr AA, Yun PS, Voigt R, Koh CJ, Roth DR, Braun M, Angelo J, Moscardo I, Espinoza J, Shamshirsaz AA, Belfort M, Ruano R, Sanz Cortes M. Neurodevelopmental Outcome in Infants with Lower Urinary Tract Obstruction Based on Different Degrees of Severity. Fetal Diagn Ther 2020; 47:587-596. [PMID: 32146466 DOI: 10.1159/000504977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/25/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine postnatal neurodevelopmental (ND) outcomes for children with congenital lower urinary tract obstruction (LUTO) based on disease severity. METHODS Twenty male infants with LUTO were classified prenatally as Stage 1 (normal amniotic fluid and renal function; n = 5), Stage 2 (signs of obstruction with preserved renal function; n = 13), and Stage 3 (signs of severe renal damage; n = 2). ND status was assessed using the Developmental Profile-3 test in 5 developmental domains (physical, adaptive behavior, social-emotional, cognitive, and communication). Each domain was considered to be delayed if standard scores were 2 or more SD below the mean. ND outcomes were compared between cases with an expected normal renal function (LUTO Stage 1) and those with impaired renal function (LUTO Stages 2 and 3). Results from cases with Stage 2 were also compared to those from Stage 3. ORs were calculated to predict risk for adverse ND outcome for each domain considering prenatal and postnatal factors. RESULTS Gestational age (GA) at the diagnosis of LUTO was similar between both groups (Stage 1: 24.85 ± 7.87 vs. Stages 2 and 3: 21.4 ± 4.31 weeks; p = 0.24). Twelve of 15 cases with Stage 2 or 3 underwent vesicoamniotic shunt placement compared to none of Stage 1 fetuses (p < 0.01). No differences in GA at delivery were detected between the groups (37.9 ± 1.6 vs. 35.1 ± 3.6 weeks; p = 0.1). One of the infants in the Stage 2 and 3 groups received a kidney transplant during follow-up. One case (20%) from Stage 1 group required dialysis during the first 6 months of life, and 1 case from Stage 2 to 3 group required it during the first 6 months (p = 1.0), whereas 3 additional cases needed dialysis from 6 to 24 months (p = 0.6). Mean age at Developmental Profile 3 (DP-3) testing was 20.3 ± 12.3 months (Stage 1: 11.2 ± 8.6 vs. Stages 2 and 3: 23.4 ± 13.4 months; p = 0.07). Fifteen of the 20 patients (75%) had no ND delays. Of the 5 patients with ND delays, 4 received dialysis. No differences in ND outcomes between infants with LUTO Stage 1 and those with Stages 2 and 3 were detected except for a trend toward better physical development in Stage 1 (102.6 ± 11.6 vs. 80.7 ± 34.9; p = 0.05). Infants diagnosed with LUTO Stage 3 showed significantly lower adaptive scores than those diagnosed with Stage 2 (Stage 2: 101.9 ± 22.3 vs. Stage 3: 41.5 ± 30.4; p = 0.04) and a nonsignificant trend for lower results in physical (85.8 ± 33.0 vs. 47.5 ± 38.9; p = 0.1) and socio-emotional (94.7 ±17.9 vs. 73.5 ± 13.4; p = 0.1) domains. Infants who received dialysis showed 15-fold increased risk (95% CI 0.89-251) for delayed socio-emotional development (p = 0.06). Diagnosis of fetal renal failure increased the risk for delays in the adaptive domain 30-fold (95% CI 1.29-93.1; p = 0.03). Infants with abnormal renal function had 19 times (95% CI 1.95-292) increased risk for delays in the physical domain (p = 0.03). CONCLUSIONS While most patients with LUTO do not exhibiting ND delays, our results support the importance of ND monitoring, especially in severe forms of LUTO, as increased severity of this condition may be associated with poorer ND outcomes.
Collapse
Affiliation(s)
- Sonia Monteiro
- Department of Developmental Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Ahmed A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Peter S Yun
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Robert Voigt
- Department of Developmental Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Chester J Koh
- Division of Urology, Department of Surgery, Texas Children's Hospital, and Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | - David R Roth
- Division of Urology, Department of Surgery, Texas Children's Hospital, and Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | - Michael Braun
- Department of Nephrology, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph Angelo
- Department of Nephrology, Baylor College of Medicine, Houston, Texas, USA
| | - Isabel Moscardo
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.,Department of Obstetrics and Gynecology, Hospital Clinic, Valencia, Spain
| | - Jimmy Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Alireza A Shamshirsaz
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Michael Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Rodrigo Ruano
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, New York, USA
| | - Magdalena Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA,
| |
Collapse
|
49
|
Risk and protective factors for child development: An observational South African birth cohort. PLoS Med 2019; 16:e1002920. [PMID: 31560687 PMCID: PMC6764658 DOI: 10.1371/journal.pmed.1002920] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Approximately 250 million (43%) children under the age of 5 years in low- and middle-income countries (LMICs) are failing to meet their developmental potential. Risk factors are recognised to contribute to this loss of human potential. Expanding understanding of the risks that lead to poor outcomes and which protective factors contribute to resilience in children may be critical to improving disparities. METHODS AND FINDINGS The Drakenstein Child Health Study is a population-based birth cohort in the Western Cape, South Africa. Pregnant women were enrolled between 20 and 28 weeks' gestation from two community clinics from 2012 to 2015; sociodemographic and psychosocial data were collected antenatally. Mothers and children were followed through birth until 2 years of age. Developmental assessments were conducted by trained assessors blinded to background, using the Bayley-III Scales of Infant and Toddler Development (BSID-III), validated for use in South Africa, at 24 months of age. The study assessed all available children at 24 months; however, some children were not able to attend, because of loss to follow-up or unavailability of a caregiver or child at the correct age. Of 1,143 live births, 1,002 were in follow-up at 24 months, and a total of 734 children (73%) had developmental assessments, of which 354 (48.2%) were girls. This sample was characterised by low household employment (n = 183; 24.9%) and household income (n = 287; 39.1% earning <R1,000 per month), and high prevalence of maternal psychosocial risk factors including alcohol use in pregnancy (n = 95; 14.5%), smoking (n = 241; 34.7%), depression (n = 156; 23.7%), lifetime intimate partner violence (n = 310; 47.3%), and history of maternal childhood trauma (n = 228; 34.7%). A high proportion of children were categorised as delayed (defined by scoring < -1 standard deviation below the mean scaled score calculated using the BSID-III norms from a United States population) in different domains (369 [50.5%] cognition, 402 [55.6%] receptive language, 389 [55.4%] expressive language, 169 [23.2%] fine motor, and 267 [38.4%] gross motor). Four hundred five (55.3%) children had >1 domain affected, and 75 (10.2%) had delay in all domains. Bivariate and multivariable analyses revealed several factors that were associated with developmental outcomes. These included protective factors (maternal education, higher birth weight, and socioeconomic status) and risk factors (maternal anaemia in pregnancy, depression or lifetime intimate partner violence, and maternal HIV infection). Boys consistently performed worse than girls (in cognition [β = -0.74; 95% CI -1.46 to -0.03, p = 0.042], receptive language [β = -1.10; 95% CI -1.70 to -0.49, p < 0.001], expressive language [β = -1.65; 95% CI -2.46 to -0.84, p < 0.001], and fine motor [β = -0.70; 95% CI -1.20 to -0.20, p = 0.006] scales). There was evidence that child sex interacted with risk and protective factors including birth weight, maternal anaemia in pregnancy, and socioeconomic factors. Important limitations of the study include attrition of sample from birth to assessment age and missing data in some exposure areas from those assessed. CONCLUSIONS This study provides reliable developmental data from a sub-Saharan African setting in a well-characterised sample of mother-child dyads. Our findings highlight not only the important protective effects of maternal education, birth weight, and socioeconomic status for developmental outcomes but also sex differences in developmental outcomes and key risk and protective factors for each group.
Collapse
|
50
|
Sim F, Thompson L, Marryat L, Law J, Wilson P. Preschool developmental concerns and adjustment in the early school years: Evidence from a Scottish birth cohort. Child Care Health Dev 2019; 45:719-736. [PMID: 31209912 DOI: 10.1111/cch.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 04/29/2019] [Accepted: 06/07/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preschool language and behavioural difficulties impact on multiple domains of the child's early life and can endure into adulthood, predicting poor educational, social, and health outcomes. Highlighting risk factors associated with poor outcomes following language and behavioural difficulties raised in early childhood may facilitate early identification and intervention. METHODS Data from the Growing Up in Scotland national birth cohort study were used. Language and behavioural difficulties were assessed at age 4 years using parent-reported language concerns and the Strengths and Difficulties Questionnaire. Measures of adjustment were collated into four key outcome domains: attitude to school life, language and general development, behaviour, and general health at age 6 years. Both univariate and multivariate logistic regression models were fitted in order to explore independent associations between language and behavioural difficulties at age 4 years and adjustment to life circumstances at age 6 years, whilst controlling for other risk factors. RESULTS Language difficulties at age 4 years increased the odds of the child experiencing difficulty with language and general development, poorer health outcomes, and behavioural difficulties at age 6 years. Behavioural difficulties alone at age 4 years were associated with increased odds of the child experiencing all of the aforementioned outcomes and difficulties in early school life. Lone parent family, low income, and male gender were identified as risk factors for poorer outcomes in the domains measured. At age 4 years, there was no additive effect found with the presence of behaviour difficulties on the relationship between language difficulties and language and developmental outcomes at 6 years. CONCLUSIONS This paper demonstrates language and behavioural difficulties are associated with poor social, educational, health, and behavioural outcomes. Taking seriously parent-reported concerns and identifying risk factors could limit negative outcomes for the child, their family, and society.
Collapse
Affiliation(s)
- Fiona Sim
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
| | - Lucy Thompson
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
| | - Louise Marryat
- Farr Institute/Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, UK
- Institute of Health and Wellbeing, College of Medical, Veterinary and Health Sciences, University of Glasgow, Glasgow, UK
| | - James Law
- School of Education, Communication and Language Sciences, University of Newcastle, Newcastle, UK
| | - Philip Wilson
- Centre for Rural Health, Centre for Health Sciences, University of Aberdeen, Inverness, UK
| |
Collapse
|