1
|
Hemady CL, Speyer LG, Murray AL, Brown RH, Meinck F, Fry D, Do H, Sikander S, Madrid B, Fernando A, Walker S, Dunne M, Foley S, Hughes C, Osafo J, Baban A, Taut D, Ward CL, Van Thang V, Fearon P, Tomlinson M, Valdebenito S, Eisner M. Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: a latent class analysis. BMC Pregnancy Childbirth 2022; 22:505. [PMID: 35733125 PMCID: PMC9215006 DOI: 10.1186/s12884-022-04839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). METHODS A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. RESULTS Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes. CONCLUSION Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.
Collapse
Affiliation(s)
- Chad Lance Hemady
- Social Work Department, University of Edinburgh, Edinburgh, UK. .,School of Social and Political Science, 15a George Square, Edinburgh, EH8 9LD, UK.
| | | | | | | | - Franziska Meinck
- Social Work Department, University of Edinburgh, Edinburgh, UK.,Faculty of Humanities, North-West University, Potchefstroom, South Africa
| | - Deborah Fry
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Huyen Do
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Siham Sikander
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.,Global Institute of Human Development, Shifa Tameer-E-Millat University, Islamabad, Pakistan
| | - Bernadette Madrid
- Child Protection Unit, University of the Philippines, Manila, Philippines
| | - Asvini Fernando
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Susan Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Michael Dunne
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Sarah Foley
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Vo Van Thang
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Pasco Fearon
- Division of Psychology & Language Sciences, University College London, London, UK
| | - Mark Tomlinson
- Department of Global Health, Institute of Life Course Health Research, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, UK.,Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Kohlasch KL, Cioffredi LA, Lenninger C, Stewart E, Vatalaro T, Garavan H, Graham A, Heil SH, Krans EE, Robakis T, Rommel A, Sullivan EL, Thomason M, Potter A. Factors associated with parent views about participation in infant MRI research provide guidance for the design of the Healthy Brain and Child Development (HBCD) study. Dev Cogn Neurosci 2021; 50:100986. [PMID: 34242880 PMCID: PMC8267558 DOI: 10.1016/j.dcn.2021.100986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/04/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The National Institutes of Health announced the Healthy Brain and Child Development (HBCD) study to further understanding of infant brain development. This study examined perceptions and knowledge about research among the demographic groups to be studied in HBCD. METHOD 1164 participants (n = 548 pregnant people and 616 mothers of infants < 12 months) completed anonymous, on-line surveys. Domains included research literacy, MRI knowledge, and attitudes about research incentives and biospecimen collection. Logistic regression was used to examine factors related to outcome variables. RESULTS Knowledge of MRI safety was low and research literacy was high across participants. Likelihood of participation given various incentives differed between participants. Those with lower education were less likely to rate any items as increasing likelihood of participation. Substance use during pregnancy improved the model fit only for items about alternate visit structures (home and telephone visits) and confidentiality. CONCLUSION Overall results support the feasibility of infant imaging studies, such as HBCD with respondents having high research literacy and interest in learning about their baby's development. Educating potential participants about MRI safety and providing flexible incentives for participation will improve the success of infant MRI studies.
Collapse
Affiliation(s)
- Kaelyn L Kohlasch
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Leigh-Anne Cioffredi
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Carly Lenninger
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Ellen Stewart
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States.
| | - Tessa Vatalaro
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Hugh Garavan
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
| | - Sarah H Heil
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
| | - Elizabeth E Krans
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, United States.
| | - Thalia Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Anna Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, 505 N W 185th Avenue, Beaverton, OR 97006, United States.
| | - Moriah Thomason
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Alexandra Potter
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States; Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
| |
Collapse
|
3
|
Maes HH, Neale MC, Lonn SL, Lichtenstein P, Sundquist J, Sundquist K, Kendler KS. Modeling Etiology of Smoking During Pregnancy in Swedish Twins, Full-, and Half-Siblings, Reared Together and Apart. Nicotine Tob Res 2021; 22:1736-1743. [PMID: 32386311 DOI: 10.1093/ntr/ntaa076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/07/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Using Swedish nationwide registry data, we investigated the contribution of genetic and environmental risk factors to the etiology of smoking status across stages of pregnancy with increasing degrees of social and psychological pressure to reduce or quit smoking, by twin and sibling modeling. AIMS AND METHODS Smoking status was available before, and during early and late pregnancy from the Medical Birth Register. Twin, full-, and half-sibling pairs, both reared together and apart, born between 1960 and 1990 were obtained from national twin and genealogical registers. Genetic structural equation modeling in OpenMx was applied to the population-based data to estimate shared genetic and/or environmental covariance across stages of pregnancy, accounting for maternal birth cohort and age at pregnancy. RESULTS Analyses of paired data on 258 749 individuals suggested that risk factors for smoking status changed across stages of pregnancy. Results predicted substantial heritability (60-70%) and moderate contributions of shared environmental factors (10-15%) for smoking status. Whilst the same shared environmental factors were amplified from before pregnancy to late pregnancy, new primarily unique environmental factors explained ~10% of the variance during early pregnancy which was carried forward to late pregnancy. CONCLUSIONS Using registry data on women across pregnancy, we replicated that smoking status is highly heritable. Furthermore, we found support for increased impact of shared environmental factors during pregnancy of factors already present prior to pregnancy, and an independent set of mostly new unique environmental factors that may be triggered by increased social pressure to reduce or quit smoking during pregnancy. IMPLICATIONS As new factors partially explain smoking status during pregnancy and the effects of familial factors increase across pregnancy, efforts to prevent or reduce smoking during pregnancy should receive continued attention, with a focus on both the individual and the family unit.
Collapse
Affiliation(s)
- Hermine H Maes
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.,Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| | - Michael C Neale
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.,Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Sara Larsson Lonn
- Family Medicine and Clinical Epidemiology, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Jan Sundquist
- Family Medicine and Clinical Epidemiology, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Family Medicine and Clinical Epidemiology, Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kenneth S Kendler
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.,Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
4
|
Kalkbrenner AE, Meier SM, Madley-Dowd P, Ladd-Acosta C, Fallin MD, Parner E, Schendel D. Familial confounding of the association between maternal smoking in pregnancy and autism spectrum disorder in offspring. Autism Res 2019; 13:134-144. [PMID: 31464107 DOI: 10.1002/aur.2196] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Evidence supports no link between maternal smoking in pregnancy and autism spectrum disorder (autism) overall. To address remaining questions about the unexplained heterogeneity between study results and the possibility of risk for specific autism sub-phenotypes, we conducted a whole-population cohort study in Denmark. We followed births 1991-2011 (1,294,906 persons, including 993,301 siblings in 728,271 families), from 1 year of age until an autism diagnosis (13,547), death, emigration, or December 31, 2012. Autism, with and without attention deficit hyperactivity disorder (ADHD) and with and without intellectual disability (ID) were based on ICD-8 and ICD-10 codes from Danish national health registers, including 3,319 autism + ADHD, 10,228 autism - no ADHD, 2,205 autism + ID, and 11,342 autism - no ID. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) between any maternal smoking (from birth records) and autism (or sub-phenotypes) using survival models with robust standard errors, stratifying by birth year and adjusting for child sex, parity, and parental age, education, income, and psychiatric history. To additionally address confounding using family designs, we constructed a maternal cluster model (adjusting for the smoking proportion within the family), and a stratified sibling model. Associations with maternal smoking and autism were elevated in conventional adjusted analyses (HR of 1.17 [1.13-1.22]) but attenuated in the maternal cluster (0.98 [0.88-1.09]) and sibling (0.86 [0.64-1.15]) models. Similarly, risks of autism sub-phenotypes with maternal smoking were attenuated in the family-based models. Together these results support that smoking in pregnancy is not linked with autism or select autism comorbid sub-phenotypes after accounting for familial confounding. Autism Res 2020, 13: 134-144. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Smoking during pregnancy has many harmful impacts, which may include harming the baby's developing brain. However, in a study of thousands of families in Denmark, it does not appear that smoking in pregnancy leads to autism or autism in combination with intellectual problems or attention deficits, once you account for the way smoking patterns and developmental disabilities run in families.
Collapse
Affiliation(s)
- Amy E Kalkbrenner
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Sandra M Meier
- Child and Adolescent Mental Health Centre-Mental Health Services Capital Region, Copenhagen Region, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Paul Madley-Dowd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Margaret Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Erik Parner
- Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus, Denmark
| | - Diana Schendel
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| |
Collapse
|
5
|
Marceau K, Rolan E, Leve LD, Ganiban JM, Reiss D, Shaw DS, Natsuaki M, Egger H, Neiderhiser JM. Parenting and prenatal risk as moderators of genetic influences on conduct problems during middle childhood. Dev Psychol 2019; 55:1164-1181. [PMID: 30843708 PMCID: PMC6533149 DOI: 10.1037/dev0000701] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examines interactions of heritable influences, prenatal substance use, and postnatal parental warmth and hostility on the development of conduct problems in middle childhood for boys and girls. Participants are 561 linked families, collected in 2 cohorts, including birth parents, adoptive parents, and adopted children. Heritable influences on internalizing and externalizing (including substance use) problems were derived from birth mothers' and fathers' symptoms, diagnoses, and age of onset from diagnostic interviews, and the proportion of first-degree relatives with the same type of problems. Smoking during pregnancy (SDP) and alcohol use during pregnancy were assessed retrospectively from birth mothers at 5 months postpartum. Earlier externalizing problems and parental warmth and hostility and were assessed at 1 assessment prior to the outcome (Cohort II: 4.5 years; Cohort I: 7 years). Conduct problems were symptoms from a diagnostic interview assessed at age 6 (Cohort II) or 8 (Cohort I). Findings from regression analyses suggest that (a) SDP plays an important role for the development of conduct problems, (b) some relatively well-accepted effects (e.g., parental hostility) were less important when simultaneously considering multiple factors influencing the development of conduct problems, and (c) main effects of genetic risk and SDP, and interactions among genetic risk and postnatal warmth, SDP and postnatal warmth, and genetic risk, SDP, and postnatal hostility for conduct problems were important for boys' but not girls' conduct problems. Replication is needed, but the current results provide preliminary but empirically grounded hypotheses for future research testing complex developmental models of conduct problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Kristine Marceau
- Department of Human Development and Family Studies, Purdue University
| | - Emily Rolan
- Department of Human Development and Family Studies, Purdue University
| | | | | | | | | | - Misaki Natsuaki
- Department of Psychology, University of California, Riverside
| | | | | |
Collapse
|
6
|
Tzoumakis S, Carr VJ, Dean K, Laurens KR, Kariuki M, Harris F, Green MJ. Prenatal maternal smoking, maternal offending, and offspring behavioural and cognitive outcomes in early childhood. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2018; 28:397-408. [PMID: 30256470 DOI: 10.1002/cbm.2089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/16/2018] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Maternal smoking during pregnancy and parental offending are both linked to adverse offspring outcomes. Few studies have examined how these exposures together influence diverse offspring outcomes in early childhood. AIMS To examine associations between quantity of prenatal maternal smoking and frequency of maternal offending and offspring behavioural and cognitive outcomes at age 5 years. METHODS Over 66,000 Australian children (mean age 5.6 years) were drawn from an intergenerational data linkage study. Unadjusted and adjusted logistic regressions were conducted for the two key exposures (maternal prenatal smoking and mother having at least two criminal convictions) and offspring behavioural and cognitive vulnerabilities. Population attributable fractions (PAFs) were also estimated for each outcome for the two exposures. RESULTS Prenatal smoking and maternal offending were, separately and together, associated with most of the developmental vulnerabilities examined, even after adjusting for other familial and prenatal risk factors. PAFs for prenatal smoking ranged from 5.3% to 15.8%, and PAFs for maternal offending ranged from 3.4% to 11.8% across the offspring outcomes. CONCLUSIONS Maternal smoking during pregnancy and maternal offending were uniquely associated with a range of offspring vulnerabilities, but mothers who smoked during pregnancy tended to experience multiple problems that should also be considered as indicators of child vulnerabilities. While early behavioural difficulties were evident in these children, it was striking that they were also likely to have cognitive vulnerabilities. Early intervention to support cognitive development in these children may minimise their risk of academic underachievement, long-term disadvantage, and even offending.
Collapse
Affiliation(s)
- Stacy Tzoumakis
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Kimberlie Dean
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Kristin R Laurens
- School of Psychiatry, University of New South Wales, Sydney, Australia
- School of Psychology, Australian Catholic University, Banyo, Queensland, Australia
| | - Maina Kariuki
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Felicity Harris
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| |
Collapse
|
7
|
Micalizzi L, Knopik VS. Maternal smoking during pregnancy and offspring executive function: What do we know and what are the next steps? Dev Psychopathol 2018; 30:1333-1354. [PMID: 29144227 PMCID: PMC6028309 DOI: 10.1017/s0954579417001687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Children exposed to maternal smoking during pregnancy (MSDP) exhibit difficulties in executive function (EF) from infancy through adolescence. Due to the developmental significance of EF as a predictor of adaptive functioning throughout the life span, the MSDP-EF relation has clear public health implications. In this paper, we provide a comprehensive review of the literature on the relationship between MSDP and offspring EF across development; consider brain-based assessments, animal models, and genetically informed studies in an effort to elucidate plausible pathways of effects; discuss implications for prevention and intervention; and make calls to action for future research.
Collapse
Affiliation(s)
- Lauren Micalizzi
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital
- Department of Psychiatry and Human Behavior, The Warren Alpert School of Medicine, Brown University
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University
| | - Valerie S. Knopik
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital
- Department of Psychiatry and Human Behavior, The Warren Alpert School of Medicine, Brown University
- Department of Human Development and Family Studies, Purdue University
| |
Collapse
|
8
|
Biederman J, Martelon M, Woodworth KY, Spencer TJ, Faraone SV. Is Maternal Smoking During Pregnancy a Risk Factor for Cigarette Smoking in Offspring? A Longitudinal Controlled Study of ADHD Children Grown Up. J Atten Disord 2017; 21:975-985. [PMID: 25416463 DOI: 10.1177/1087054714557357] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study examined whether exposure to maternal smoking during pregnancy in children with and without ADHD is associated with smoking in offspring and whether this association is selective to ADHD children. METHOD Ninety-six exposed and 400 unexposed participants were derived from two longitudinal studies of boys and girls with and without ADHD. Maternal smoking during pregnancy was defined by interviews with participants' mothers. RESULTS A significant association was observed between exposure to maternal smoking in pregnancy and cigarette smoking in offspring ( p = .02). Exposed offspring were also more likely to have higher rates of major depression ( p = .04), bipolar disorder ( p = .04), and conduct disorder ( p = .04), and lower IQ ( p = .01), lower Global Assessment of Functioning (GAF) score ( p = .02), and more impaired Social Adjustment Inventory for Children and Adolescents (SAICA) scores versus unexposed offspring, adjusting for social class. CONCLUSION Maternal smoking during pregnancy was found to increase the risk for smoking and a wide range of adverse psychiatric, cognitive, and functional outcomes in youth.
Collapse
Affiliation(s)
- Joseph Biederman
- 1 Massachusetts General Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
| | | | | | - Thomas J Spencer
- 1 Massachusetts General Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Stephen V Faraone
- 3 State University of New York Upstate Medical University, Syracuse, NY, USA
| |
Collapse
|
9
|
Meier SM, Plessen KJ, Verhulst F, Mors O, Mortensen PB, Pedersen CB, Agerbo E. Familial confounding of the association between maternal smoking during pregnancy and internalizing disorders in offspring. Psychol Med 2017; 47:1417-1426. [PMID: 28100290 DOI: 10.1017/s0033291716003627] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Maternal smoking has consistently been associated with multiple adverse childhood outcomes including externalizing disorders. In contrast the association between maternal smoking during pregnancy (MSDP) and internalizing (anxiety and depressive) disorders in offspring has received less investigation. METHOD We conducted a nationwide cohort study including 957635 individuals born in Denmark between 1991 and 2007. Data on MSDP and diagnoses of depression or anxiety disorders were derived from national registers and patients were followed up from the age of 5 years to the end of 2012. Hazard rate ratios (HRRs) were estimated using stratified Cox regression models. Sibling data were used to disentangle individual- and familial-level effects of MSDP and to control for unmeasured familial confounding. RESULTS At the population level, offspring exposed to MSDP were at increased risk for both severe depression [HRR 1.29, 95% confidence interval (CI) 1.22-1.36] and severe anxiety disorders (HRR 1.26, 95% CI 1.20-1.32) even when controlling for maternal and paternal traits. However, there was no association between MSDP and internalizing disorders when controlling for the mother's propensity for MSDP (depression: HRR 1.11, 95% CI 0.94-1.30; anxiety disorders: HRR 0.94, 95% CI 0.80-1.11) or comparing differentially exposed siblings (depression: HRR 1.18, 95% CI 0.75-1.89; anxiety disorders: HRR 0.87, 95% CI 0.55-1.36). CONCLUSIONS The results suggest that familial background factors account for the association between MSDP and severe internalizing disorders not the specific exposure to MSDP.
Collapse
Affiliation(s)
- S M Meier
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- Child and Adolescent Mental Health Centre - Mental Health Services Capital Region, Copenhagen Region,Denmark
| | - K J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- Child and Adolescent Mental Health Centre - Mental Health Services Capital Region, Copenhagen Region,Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - F Verhulst
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov,Denmark
| | - P B Mortensen
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
| | - C B Pedersen
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
| | - E Agerbo
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
| |
Collapse
|
10
|
Quinn PD, Rickert ME, Weibull CE, Johansson ALV, Lichtenstein P, Almqvist C, Larsson H, Iliadou AN, D’Onofrio BM. Association Between Maternal Smoking During Pregnancy and Severe Mental Illness in Offspring. JAMA Psychiatry 2017; 74:589-596. [PMID: 28467540 PMCID: PMC5539841 DOI: 10.1001/jamapsychiatry.2017.0456] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
IMPORTANCE Several recent population-based studies have linked exposure to maternal smoking during pregnancy to increased risk of severe mental illness in offspring (eg, bipolar disorder, schizophrenia). It is not yet clear, however, whether this association results from causal teratogenic effects or from confounding influences shared by smoking and severe mental illness. OBJECTIVE To examine the association between smoking during pregnancy and severe mental illness in offspring, adjusting for measured covariates and unmeasured confounding using family-based designs. DESIGN, SETTING, AND PARTICIPANTS This study analyzed population register data through December 31, 2013, for a cohort of 1 680 219 individuals born in Sweden from January 1, 1983, to December 31, 2001. Associations between smoking during pregnancy and severe mental illness in offspring were estimated with adjustment for measured covariates. Cousins and siblings who were discordant on smoking during pregnancy and severe mental illness were then compared, which helped to account for unmeasured genetic and environmental confounding by design. EXPOSURES Maternal self-reported smoking during pregnancy, obtained from antenatal visits. MAIN OUTCOMES AND MEASURES Severe mental illness, with clinical diagnosis obtained from inpatient and outpatient visits and defined using International Classification of Diseases codes for bipolar disorder and schizophrenia spectrum disorders. RESULTS Of the 1 680 219 offspring included in the analysis, 816 775 (48.61%) were female. At the population level, offspring exposed to moderate and high levels of smoking during pregnancy had greater severe mental illness rates than did unexposed offspring (moderate smoking during pregnancy: hazard ratio [HR], 1.25; 95% CI, 1.19-1.30; high smoking during pregnancy: HR, 1.51; 95% CI, 1.44-1.59). These associations decreased in strength with increasing statistical and methodologic controls for familial confounding. In sibling comparisons with within-family covariates, associations were substantially weaker and nonsignificant (moderate smoking during pregnancy: HR, 1.09; 95% CI, 0.94-1.26; high smoking during pregnancy: HR, 1.14; 95% CI, 0.96-1.35). The pattern of associations was consistent across subsets of severe mental illness disorders and was supported by further sensitivity analyses. CONCLUSIONS AND RELEVANCE This population- and family-based study failed to find support for a causal effect of smoking during pregnancy on risk of severe mental illness in offspring. Rather, these results suggest that much of the observed population-level association can be explained by measured and unmeasured factors shared by siblings.
Collapse
Affiliation(s)
- Patrick D. Quinn
- Department of Psychological and Brain Sciences, Indiana University, Bloomington
| | - Martin E. Rickert
- Department of Psychological and Brain Sciences, Indiana University, Bloomington
| | - Caroline E. Weibull
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna L. V. Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Anastasia N. Iliadou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M. D’Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington
| |
Collapse
|
11
|
Bagshaw ATM, Horwood LJ, Fergusson DM, Gemmell NJ, Kennedy MA. Microsatellite polymorphisms associated with human behavioural and psychological phenotypes including a gene-environment interaction. BMC MEDICAL GENETICS 2017; 18:12. [PMID: 28158988 PMCID: PMC5291968 DOI: 10.1186/s12881-017-0374-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/25/2017] [Indexed: 02/05/2023]
Abstract
Background The genetic and environmental influences on human personality and behaviour are a complex matter of ongoing debate. Accumulating evidence indicates that short tandem repeats (STRs) in regulatory regions are good candidates to explain heritability not accessed by genome-wide association studies. Methods We tested for associations between the genotypes of four selected repeats and 18 traits relating to personality, behaviour, cognitive ability and mental health in a well-studied longitudinal birth cohort (n = 458-589) using one way analysis of variance. The repeats were a highly conserved poly-AC microsatellite in the upstream promoter region of the T-box brain 1 (TBR1) gene and three previously studied STRs in the activating enhancer-binding protein 2-beta (AP2-β) and androgen receptor (AR) genes. Where significance was found we used multiple regression to assess the influence of confounding factors. Results Carriers of the shorter, most common, allele of the AR gene’s GGN microsatellite polymorphism had fewer anxiety-related symptoms, which was consistent with previous studies, but in our study this was not significant following Bonferroni correction. No associations with two repeats in the AP2-β gene withstood this correction. A novel finding was that carriers of the minor allele of the TBR1 AC microsatellite were at higher risk of conduct problems in childhood at age 7-9 (p = 0.0007, which did pass Bonferroni correction). Including maternal smoking during pregnancy (MSDP) in models controlling for potentially confounding influences showed that an interaction between TBR1 genotype and MSDP was a significant predictor of conduct problems in childhood and adolescence (p < 0.001), and of self-reported criminal behaviour up to age 25 years (p ≤ 0.02). This interaction remained significant after controlling for possible confounders including maternal age at birth, socio-economic status and education, and offspring birth weight. Conclusions The potential functional importance of the TBR1 gene’s promoter microsatellite deserves further investigation. Our results suggest that it participates in a gene-environment interaction with MDSP and antisocial behaviour. However, previous evidence that mothers who smoke during pregnancy carry genes for antisocial behaviour suggests that epistasis may influence the interaction. Electronic supplementary material The online version of this article (doi:10.1186/s12881-017-0374-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Andrew T M Bagshaw
- Department of Pathology, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand.
| | - L John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - David M Fergusson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Neil J Gemmell
- Department of Anatomy, University of Otago, Dunedin, New Zealand.,Gravida - National Centre for Growth and Development, University of Otago, Dunedin, New Zealand
| | - Martin A Kennedy
- Department of Pathology, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| |
Collapse
|
12
|
Babchishin KM, Seto MC, Sariaslan A, Lichtenstein P, Fazel S, Långström N. Parental and perinatal risk factors for sexual offending in men: a nationwide case-control study. Psychol Med 2017; 47:305-315. [PMID: 27733213 PMCID: PMC5217130 DOI: 10.1017/s003329171600249x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/23/2016] [Accepted: 08/25/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Prior studies suggest parental and perinatal risk factors are associated with later offending. It remains uncertain, however, if such risk factors are similarly related to sexual offending. METHOD We linked socio-demographic, family relations, and perinatal (obtained at birth) data from the nationwide Swedish registers from 1973 to 2009 with information on criminal convictions of cases and control subjects. Male sex offenders (n = 13 773) were matched 1:5 on birth year and county of birth in Sweden to male controls without sexual or non-sexual violent convictions. To examine risk-factor specificity for sexual offending, we also compared male violent, non-sexual offenders (n = 135 953) to controls without sexual or non-sexual violent convictions. Predictors included parental (young maternal or paternal age at son's birth, educational attainment, violent crime, psychiatric disorder, substance misuse, suicide attempt) and perinatal (number of older brothers, low Apgar score, low birth weight, being small for gestational age, congenital malformations, small head size) variables. RESULTS Conditional logistic regression models found consistent patterns of statistically significant, small to moderate independent associations of parental risk factors with sons' sexual offending and non-sexual violent offending. For perinatal risk factors, patterns varied more; small for gestational age and small head size exhibited similar risk effects for both offence types whereas a higher number of older biological brothers and any congenital malformation were small, independent risk factors only for non-sexual violence. CONCLUSIONS This nationwide study suggests substantial commonalities in parental and perinatal risk factors for the onset of sexual and non-sexual violent offending.
Collapse
Affiliation(s)
- K. M. Babchishin
- Royal's Institute of Mental Health
Research, University of Ottawa,
Ottawa, Canada
- Department of Medical Epidemiology and
Biostatistics, Karolinska Institutet,
Stockholm, Sweden
| | - M. C. Seto
- Royal's Institute of Mental Health
Research, University of Ottawa,
Ottawa, Canada
| | - A. Sariaslan
- Department of Psychiatry,
University of Oxford, Oxford,
UK
| | - P. Lichtenstein
- Department of Medical Epidemiology and
Biostatistics, Karolinska Institutet,
Stockholm, Sweden
| | - S. Fazel
- Department of Psychiatry,
University of Oxford, Oxford,
UK
| | - N. Långström
- Department of Medical Epidemiology and
Biostatistics, Karolinska Institutet,
Stockholm, Sweden
- Department of Neuroscience,
Uppsala University, Sweden
| |
Collapse
|
13
|
Godleski SA, Eiden RD, Schuetze P, Colder CR, Huestis MA. Tobacco exposure and maternal psychopathology: Impact on toddler problem behavior. Neurotoxicol Teratol 2016; 57:87-94. [PMID: 27498223 PMCID: PMC6059373 DOI: 10.1016/j.ntt.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/03/2016] [Accepted: 07/29/2016] [Indexed: 02/07/2023]
Abstract
Prenatal exposure to tobacco has consistently predicted later problem behavior for children. However, little is known about developmental mechanisms underlying this association. We examined a conceptual model for the association between prenatal tobacco exposure and child problem behavior in toddlerhood via indirect paths through fetal growth, maternal depression, and maternal aggressive disposition in early infancy and via maternal warmth and sensitivity and infant negative affect in later infancy. The sample consisted of 258 mother-child dyads recruited during pregnancy and assessed periodically at 2, 9, and 16months of child age. Pathways via maternal depression and infant negative affect to toddler problem behavior were significant. Further, combined tobacco and marijuana exposure during pregnancy and reduced fetal growth also demonstrated important associations with infant negative affect and subsequent problem behavior. These results highlight the importance of considering the role of maternal negative affect and poor fetal growth as risk factors in the context of prenatal exposure.
Collapse
Affiliation(s)
| | - Rina D Eiden
- Research Institute of Addictions, University at Buffalo, State University of New York, United States
| | - Pamela Schuetze
- Psychology Department, Buffalo State College, State University of New York, United States
| | - Craig R Colder
- Psychology Department, University at Buffalo, State University of New York, United States
| | | |
Collapse
|
14
|
O'Brien JW, Hill SY. Effects of prenatal alcohol and cigarette exposure on offspring substance use in multiplex, alcohol-dependent families. Alcohol Clin Exp Res 2015; 38:2952-61. [PMID: 25581650 DOI: 10.1111/acer.12569] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/08/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Prenatal exposures to alcohol, cigarettes, and other drugs of abuse are associated with numerous adverse consequences for affected offspring, including increased risk for substance use and abuse. However, maternal substance use during pregnancy appears to occur more often in those with a family history of alcohol dependence. Utilizing a sample that is enriched for familial alcohol dependence and includes controls selected for virtual absence of familial alcohol dependence could provide important information on the relative contribution of familial risk and prenatal exposures to offspring substance use. METHODS A sample of multigenerational families specifically ascertained to be at either high or low risk for developing alcohol dependence (AD) provided biological offspring for a longitudinal prospective study. High-risk families were selected based on the presence of 2 alcohol-dependent sisters. Low-risk families were selected on the basis of minimal first and second-degree relatives with AD. High-risk (HR = 99) and Low-risk offspring (LR = 110) were assessed annually during childhood and biennially in young adulthood regarding their alcohol, drug, and cigarette use. At the first childhood visit, mothers were interviewed concerning their prenatal use of substances. RESULTS High-risk mothers were more likely to use alcohol, cigarettes, and other drugs during pregnancy than low-risk control mothers, and to consume these substances in greater quantities. Across the sample, prenatal exposure to alcohol was associated with increased risk for both offspring cigarette use and substance use disorders (SUD), and prenatal cigarette exposure was associated with increased risk for offspring cigarette use. Controlling for risk status by examining patterns within the HR sample, prenatal cigarette exposure remained a specific predictor of offspring cigarette use, and prenatal alcohol exposure was specifically associated with increased risk for offspring SUD. CONCLUSIONS Women with a family history of SUD are at increased risk for substance use during pregnancy. Both familial loading for alcohol dependence and prenatal exposure to alcohol or cigarettes are important risk factors in the development of offspring substance use. An inadequate assessment of family history may obscure important interactions between familial risk and prenatal exposures on offspring outcomes.
Collapse
Affiliation(s)
- Jessica W O'Brien
- Department of Psychiatry , School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychology , University of Pittsburgh, Pittsburgh, Pennsylvania
| | | |
Collapse
|
15
|
Lehti V, Gissler M, Suvisaari J, Manninen M. Induced abortions and birth outcomes of women with a history of severe psychosocial problems in adolescence. Eur Psychiatry 2015; 30:750-5. [PMID: 26117381 DOI: 10.1016/j.eurpsy.2015.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To increase knowledge on the reproductive health of women who have been placed in a residential school, a child welfare facility for adolescents with severe psychosocial problems. METHODS All women (n=291) who lived in the Finnish residential schools on the last day of the years 1991, 1996, 2001 and 2006 were included in this study and compared with matched general population controls. Register-based information on induced abortions and births was collected until the end of the year 2011. RESULTS Compared to controls, women with a residential school history had more induced abortions. A higher proportion of their births took place when they were teenagers or even minors. They were more often single, smoked significantly more during pregnancy and had a higher risk of having a preterm birth or a baby with a low birth weight. CONCLUSIONS The findings have implications for the planning of preventive and supportive interventions that aim to increase the well-being of women with a residential school history and their offspring.
Collapse
Affiliation(s)
- V Lehti
- Department of Psychiatry, Helsinki University Central Hospital, P.O. Box 442, 00029 HUS, Finland.
| | - M Gissler
- National Institute for Health and Welfare (THL), Department of Information Services, P.O. Box 30, 00271 Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden
| | - J Suvisaari
- National Institute for Health and Welfare (THL), Mental Health Unit, P.O. Box 30, 00271 Helsinki, Finland
| | - M Manninen
- National Institute for Health and Welfare (THL), Mental Health Unit, P.O. Box 30, 00271 Helsinki, Finland
| |
Collapse
|
16
|
Moylan S, Gustavson K, Øverland S, Karevold EB, Jacka FN, Pasco JA, Berk M. The impact of maternal smoking during pregnancy on depressive and anxiety behaviors in children: the Norwegian Mother and Child Cohort Study. BMC Med 2015; 13:24. [PMID: 25644294 PMCID: PMC4314755 DOI: 10.1186/s12916-014-0257-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 12/12/2014] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Maternal smoking during pregnancy (MSDP) is associated with multiple adverse childhood outcomes including externalizing behaviors. However, the association between MSDP and internalizing (anxiety and depressive) behaviors in offspring has received less investigation. We aimed to assess the association between MSDP and childhood internalizing (anxiety and depressive) behaviors in a very large, well-characterized cohort study. METHODS We assessed the association between MSDP and internalizing behaviors in offspring utilizing information drawn from 90,040 mother-child pairs enrolled in the Norwegian Mother and Child Cohort Study. Mothers reported smoking information, including status and frequency of smoking, twice during pregnancy. Mothers also reported their child's internalizing behaviors at 18 months, 36 months, and 5 years. Associations between MSDP and childhood internalizing behaviors, including dose-response and timing of smoking in pregnancy, were assessed at each time point. RESULTS MSDP was associated with increased internalizing behaviors when offspring were aged 18 months (B = 0.11, P <0.001) and 36 months (B = 0.06, P <0.01), adjusting for numerous potential confounders. Higher rates of smoking (e.g., >20 cigarettes per day) were associated with higher levels of internalizing behaviors. Maternal smoking during early pregnancy appeared to be the critical period for exposure. CONCLUSIONS We found evidence supporting a potential role for MSDP in increasing internalizing (anxiety and depressive) behaviors in offspring. We also found evidence supportive of a possible causal relationship, including dose-dependency and support for a predominant role of early pregnancy exposure. Further investigation utilizing genetically informed designs are warranted to assess this association.
Collapse
Affiliation(s)
- Steven Moylan
- School of Medicine, Deakin University, Geelong 3220, Victoria, Australia.
| | | | | | | | | | | | | |
Collapse
|
17
|
Marceau K, Laurent HK, Neiderhiser JM, Reiss D, Shaw DS, Natsuaki MN, Fisher PA, Leve LD. Combined Influences of Genes, Prenatal Environment, Cortisol, and Parenting on the Development of Children's Internalizing Versus Externalizing Problems. Behav Genet 2014; 45:268-82. [PMID: 25355319 DOI: 10.1007/s10519-014-9689-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 10/14/2014] [Indexed: 01/08/2023]
Abstract
Research suggests that genetic, prenatal, endocrine, and parenting influences across development individually contribute to internalizing and externalizing problems in children. The present study tests the combined contributions of genetic risk for psychopathology, prenatal environments (maternal drug use and internalizing symptoms), child cortisol at age 4.5 years, and overreactive parenting influences across childhood on 6-year-old children's internalizing and externalizing problems. We used data from an adoption design that included 361 domestically adopted children and their biological and adopted parents prospectively followed from birth. Only parenting influences contributed (independently) to externalizing problems. However, genetic influences were indirectly associated with internalizing problems (through increased prenatal risk and subsequent morning cortisol), and parenting factors were both directly and indirectly associated with internalizing problems (through morning cortisol). Results suggest that prenatal maternal drug use/symptoms and children's morning cortisol levels are mechanisms of genetic and environmental influences on internalizing problems, but not externalizing problems, in childhood.
Collapse
Affiliation(s)
- Kristine Marceau
- Center for Alcohol and Addiction Studies, Brown University, 121 S. Main St., Providence, RI, 02903, USA,
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Kuja-Halkola R, D'Onofrio BM, Larsson H, Lichtenstein P. Maternal smoking during pregnancy and adverse outcomes in offspring: genetic and environmental sources of covariance. Behav Genet 2014; 44:456-67. [PMID: 25117564 DOI: 10.1007/s10519-014-9668-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 07/18/2014] [Indexed: 01/14/2023]
Abstract
Maternal smoking during pregnancy (SDP) has been associated with several psychiatric outcomes in the offspring; studies have questioned whether the associations are causal, however. We analyzed all children born in Sweden between 1983 and 2009 to investigate the effect of SDP on multiple indicators of adverse outcomes in three areas: pregnancy outcomes (birth weight, preterm birth and being born small for gestational age), long-term cognitive abilities (low academic achievement and general cognitive ability) and externalizing behaviors (criminal conviction, violent criminal conviction and drug misuse). SDP was associated with all outcomes. Within-family analyses of the pregnancy outcomes were consistent with a causal interpretation as the associations persisted when siblings discordant for SDP were compared. For the cognitive and externalizing outcomes, the results were not consistent with causal effects; when comparing differentially exposed siblings none of the associations remained significant. In quantitative genetic models genetic factors explained the majority of the associations between SDP and cognitive and externalizing outcomes. The results suggest that the associations between SDP in mothers and cognition and externalizing behaviors in their offspring is primarily due to genetic effects that influence the behaviors in both generations.
Collapse
Affiliation(s)
- Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, 171 77, Stockholm, Sweden,
| | | | | | | |
Collapse
|
19
|
Ljung T, Sandin S, Långström N, Runeson B, Lichtenstein P, Larsson H. Offspring death and subsequent psychiatric morbidity in bereaved parents: addressing mechanisms in a total population cohort. Psychol Med 2014; 44:1879-1887. [PMID: 24176129 DOI: 10.1017/s0033291713002572] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is unclear if psychiatric morbidity among parents bereaved of a child is related to major loss in general or if the cause of death matters. Whether such a link is consistent with a causal explanation also remains uncertain. METHOD We identified 3,114,564 parents through linkage of Swedish nationwide registers. Risk of psychiatric hospitalization was assessed with log-linear Poisson regression and family-based analyses were used to explore familial confounding. RESULTS A total of 3284 suicides and 14,095 any-cause deaths were identified in offspring between 12 and 25 years of age. Parents exposed to offspring suicide had considerably higher risk of subsequent psychiatric hospitalization than unexposed parents [relative risk (RR) 1.90, 95% confidence interval (CI) 1.72-2.09], higher than parents exposed to offspring non-suicide death relative to controls (RR 1.18, 95% CI 1.11-1.26). We found no risk increase among stepfathers differentially exposed to biologically unrelated stepchildren's death or suicide, and the relative risk was notably lower among full siblings differentially exposed to offspring death or suicide. CONCLUSIONS Parental psychiatric hospitalization following offspring death was primarily found in offspring suicide. Familial (e.g. shared genetic) effects seemed important, judging from both lack of psychiatric hospitalization in bereaved stepfathers and attenuated risk when bereaved parents were contrasted to their non-bereaved siblings. We conclude that offspring suicide does not 'cause' psychiatric hospitalization in bereaved parents.
Collapse
Affiliation(s)
- T Ljung
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - S Sandin
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - N Långström
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - B Runeson
- Department of Clinical Neuroscience,Karolinska Institutet,Stockholm,Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - H Larsson
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| |
Collapse
|
20
|
Skoglund C, Chen Q, D´Onofrio BM, Lichtenstein P, Larsson H. Familial confounding of the association between maternal smoking during pregnancy and ADHD in offspring. J Child Psychol Psychiatry 2014; 55:61-8. [PMID: 25359172 PMCID: PMC4217138 DOI: 10.1111/jcpp.12124] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Maternal Smoking During Pregnancy (SDP) has consistently been associated with increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring, but recent studies indicate that this association might be due to unmeasured familial confounding. METHODS A total of 813,030 individuals born in Sweden between 1992 and 2000 were included in this nationwide population-based cohort study. Data on maternal SDP and ADHD diagnosis were obtained from national registers and patients were followed up from the age of 3 to the end of 2009. Hazard Ratios (HRs) were estimated using stratified Cox regression models. Cousin and sibling data were used to control for unmeasured familial confounding. RESULTS At the population level maternal SDP predicted ADHD in offspring (HR(ModerateSDP) = 1.89; HR(HighSDP)= 2.50). This estimate gradually attenuated toward the null when adjusting for measured confounders (HR(ModerateSDP)= 1.62; HR(HighSDP)= 2.04), unmeasured confounders shared within the extended family (i.e., cousin comparison) (HR(ModerateSDP)= 1.45; HR(HighSDP)= 1.69), and unmeasured confounders within the nuclear family (i.e., sibling comparison) (HR(ModerateSDP)= 0.88; HR(HighSDP)= 0.84). CONCLUSIONS Our results suggest that the association between maternal SDP and offspring ADHD are due to unmeasured familial confounding.
Collapse
Affiliation(s)
- Charlotte Skoglund
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Brian M D´Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
21
|
Ellingson JM, Goodnight JA, Van Hulle CA, Waldman ID, D'Onofrio BM. A sibling-comparison study of smoking during pregnancy and childhood psychological traits. Behav Genet 2013; 44:25-35. [PMID: 24085497 DOI: 10.1007/s10519-013-9618-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 09/18/2013] [Indexed: 12/22/2022]
Abstract
Prenatal exposure to substances of abuse is associated with numerous psychological problems in offspring, but quasi-experimental studies controlling for co-occurring risk factors suggest that familial factors (e.g., genetic and environmental effects shared among siblings) confound many associations with maternal smoking during pregnancy (SDP). Few of the quasi-experimental studies in this area have explored normative psychological traits in early childhood or developmental changes across the lifespan, however. The current study used multilevel growth curve models with a large, nationally-representative sample in the United States to investigate for potential effects of SDP on the developmental trajectories of cognitive functioning, temperament/personality, and disruptive behavior across childhood, while accounting for shared familial confounds by comparing differentially exposed siblings and statistically controlling for offspring-specific covariates. Maternal SDP predicted the intercept (but not change over time) for all cognitive and externalizing outcomes. Accounting for familial confounds, however, attenuated the association between SDP exposure and all outcomes, except the intercept (age 5) for reading recognition. These findings, which are commensurate with previous quasi-experimental research on more severe indices of adolescent and adult problems, suggest that the associations between SDP and developmental traits in childhood are due primarily to confounding factors and not a causal association.
Collapse
Affiliation(s)
- Jarrod M Ellingson
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO, 65201, USA,
| | | | | | | | | |
Collapse
|
22
|
Talati A, Bao Y, Kaufman J, Shen L, Schaefer CA, Brown AS. Maternal smoking during pregnancy and bipolar disorder in offspring. Am J Psychiatry 2013; 170:1178-85. [PMID: 24084820 PMCID: PMC4086419 DOI: 10.1176/appi.ajp.2013.12121500] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Maternal smoking during pregnancy is associated with a number of adverse externalizing outcomes for offspring from childhood to adulthood. The relationship between maternal smoking and bipolar disorder in offspring, which includes externalizing symptoms among its many manifestations, has not been investigated in depth. The authors examined whether offspring exposed to maternal smoking in utero would be at increased lifetime risk for bipolar disorder after accounting for other factors related to maternal smoking. METHOD Individuals with bipolar disorder (N=79) were ascertained from the birth cohort of the Child Health and Development Study. Case subjects were identified by a combination of clinical, database, and direct mailing sources; all case subjects were directly interviewed and diagnosed using DSM-IV criteria. Comparison subjects (N=654) were matched to case subjects on date of birth (±30 days), sex, membership in the cohort at the time of illness onset, and availability of maternal archived sera. RESULTS After adjusting for potential confounders, offspring exposed to in utero maternal smoking exhibited a twofold greater risk for bipolar disorder (odds ratio=2.014, 95% confidence interval=1.48-2.53, p=0.01). The associations were noted primarily among bipolar offspring without psychotic features. CONCLUSIONS Prenatal tobacco exposure may be one suspected cause of bipolar disorder. However, it will be necessary to account for other unmeasured familial factors before causal teratogenic effects can be suggested.
Collapse
|
23
|
D'Onofrio BM, Lahey BB, Turkheimer E, Lichtenstein P. Critical need for family-based, quasi-experimental designs in integrating genetic and social science research. Am J Public Health 2013; 103 Suppl 1:S46-55. [PMID: 23927516 DOI: 10.2105/ajph.2013.301252] [Citation(s) in RCA: 237] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Researchers have identified environmental risks that predict subsequent psychological and medical problems. Based on these correlational findings, researchers have developed and tested complex developmental models and have examined biological moderating factors (e.g., gene-environment interactions). In this context, we stress the critical need for researchers to use family-based, quasi-experimental designs when trying to integrate genetic and social science research involving environmental variables because these designs rigorously examine causal inferences by testing competing hypotheses. We argue that sibling comparison, offspring of twins or siblings, in vitro fertilization designs, and other genetically informed approaches play a unique role in bridging gaps between basic biological and social science research. We use studies on maternal smoking during pregnancy to exemplify these principles.
Collapse
Affiliation(s)
- Brian M D'Onofrio
- Brian M. D'Onofrio is with Indiana University, Bloomington. Benjamin B. Lahey is with the University of Chicago, Chicago, IL. Eric Turkheimer is with the University of Virginia, Charlottesville. Paul Lichtenstein is with the Karolinska Institutet, Solna, Sweden
| | | | | | | |
Collapse
|