Prenatal exposure to gestational diabetes is associated with anxiety and physical inactivity in children during COVID-19

Prenatal Exposure to Gestational Diabetes Mellitus is Associated with Mental Health Outcomes and Physical Activity has a Modifying Role

Background

Studies suggest a link between prenatal gestational diabetes mellitus (GDM) exposure and poor mental health outcomes. We examined associations between prenatal GDM exposure and depressive and anxiety symptoms in children and assessed physical activity as a potential modifier of these associations.

Method

Seventy children (AgeM(SD): 12(2.0), 56% GDM, 59% female) and their parents completed surveys: Center for Epidemiological Studies Depression Scale for Children (CES-DC), State-Trait Anxiety Inventory for Children (STAIC), Child Behavior Checklist (CBCL), and 3-day physical activity recall (3DPAR). Associations between mental health measures with GDM exposure and interactions between GDM exposure and child moderate-to-vigorous physical activity (MVPA) were assessed using regression.

Results

GDM-exposed children had higher anxiety (p = 0.03) and internalizing symptoms (CBCL) (p = 0.04) than unexposed children. There was an interaction between GDM exposure and child MVPA on anxiety (p = 0.02), internalizing (p = 0.04) and externalizing symptoms (p = 0.004). In the low MVPA group, GDM exposed children had more depressive (p = 0.03), anxiety (p = 0.003), and internalizing symptoms (p = 0.03) than unexposed children. In the high MVPA group, there were no group differences except with externalizing symptoms (p = 0.04).

Conclusion

Prenatal GDM is associated with higher anxiety and internalizing symptoms in children. Child MVPA modified the relationship between GDM exposure and mental health outcomes suggesting that physical activity during childhood could mitigate the negative mental health outcomes associated with prenatal GDM exposure.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

Youth physical activity and the COVID-19 pandemic: A systematic review

•

Numerous studies examined youth physical activity (PA) during the COVID-19 pandemic.

•

Overall decreases in youth PA were seen during the first 1.5 years of the pandemic.

•

There were differences in PA by sub-populations (e.g., age, sex/gender)

•

There were also differences in PA by location/type (e.g., outdoor, play)

•

Programming and policy should focus on evolving PA promotion for youth.

The purpose of the systematic review was to identify, evaluate, and synthesize evidence from available published literature examining the impact of the coronavirus disease 2019 (COVID-19) pandemic on youth physical activity (PA). A systematic review of the literature was conducted for years 2020–2021. Published articles were searched in eight databases. Inclusion criteria included: availability of full-text, written in English language, and reported quantitative or qualitative results of original or secondary data on PA and COVID-19 related factors among youth (ages 5–17 years). A standard quality assessment tool assessed risk of bias and quality of included articles. The search retrieved 2,899 articles with 51 articles ultimately meeting inclusion criteria. The majority of articles (65 %) investigated change in PA from before to during the pandemic. Most evidence indicated an overall decrease in youth PA levels during the pandemic with differences observed among sub-populations (e.g., age, sex or gender), type, and location. Findings suggest pandemic-related closures hindered PA participation due to a high reliance on school- and sport-based PA. Programmatic strategies (e.g., activity breaks, active curriculum, free online activities/lessons) should include aligning intervention measures and geared towards evolving and ongoing PA promotion based on the latest findings.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

PURPOSE

The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019 (COVID-19) pandemic and movement behaviors (physical activity, sedentary behavior, and sleep) of school-aged children (aged 5-11 years) and youth (aged 12-17 years) in the first year of the COVID-19 outbreak.

METHODS

Searches for published literature were conducted across 6 databases on 2 separate search dates (November 25, 2020, and January 27, 2021). Results were screened and extracted by 2 reviewers (DCP and KR) independently, using Covidence. Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.

RESULTS

A total of 1486 records were extracted from database searches; of those, 150 met inclusion criteria and were included for analysis. Of 150 articles, 110 were empirical studies examining physical activity (n = 77), sedentary behavior/screen time (n = 58), and sleep (n = 55). Results consistently reported declines in physical-activity time, increases in screen time and total sedentary behavior, shifts to later bed and wake times, and increases in sleep duration. The reported impacts on movement behaviors were greater for youth than for children.

CONCLUSION

The COVID-19 pandemic is related to changes in the quantity and nature of physical activity, sedentary behavior, and sleep among children and youth. There is an urgent need for policy makers, practitioners, and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.

The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

COVID-19 was declared a pandemic in March 2020, resulting in many countries worldwide calling for lockdowns. This study aimed to review the existing literature on the effects of the lockdown measures established as a response to the COVID-19 pandemic on the mental health of children and adolescents. Embase, Ovid, Global Health, PsycINFO, Web of Science, and pre-print databases were searched in this PRISMA-compliant systematic review (PROSPERO: CRD42021225604). We included individual studies reporting on a wide range of mental health outcomes, including risk and protective factors, conducted in children and adolescents (aged ≤ 19 years), exposed to COVID-19 lockdown. Data extraction and quality appraisal were conducted by independent researchers, and results were synthesised by core themes. 61 articles with 54,999 children and adolescents were included (mean age = 11.3 years, 49.7% female). Anxiety symptoms and depression symptoms were common in the included studies and ranged 1.8-49.5% and 2.2-63.8%, respectively. Irritability (range = 16.7-73.2%) and anger (range = 30.0-51.3%), were also frequently reported by children and adolescents. Special needs and the presence of mental disorders before the lockdown, alongside excessive media exposure, were significant risk factors for anxiety. Parent-child communication was protective for anxiety and depression. The COVID-19 lockdown has resulted in psychological distress and highlighted vulnerable groups such as those with previous or current mental health difficulties. Supporting the mental health needs of children and adolescents at risk is key. Clinical guidelines to alleviate the negative effects of COVID-19 lockdown and public health strategies to support this population need to be developed.

The Cross-Talk Between Atopic Dermatitis and Diabetes Mellitus: A Meta-Analysis

INTRODUCTION

Atopic dermatitis (AD) is associated with various systemic diseases. However, its association with diabetes mellitus (DM) was discussed controversially. Few researchers reviewed the association of these two common morbid disorders. This meta-analysis aimed to assess the relationship between AD and DM.

METHODS

We systematically searched PubMed including Epub and ahead of print (198 articles identified) and Cochrane (13 articles) databases. The searching engine was set to include case-control, prospective and retrospective cohorts, and cross-sectional studies from the first published up to February 12, 2021. Two hundred and eleven were identified, eighteen full texts were screened; of them, six were included in the final meta-analysis. The keywords used were AD, diabetes mellitus, type 1 diabetes, and type 2 diabetes. A datasheet was used to record the author's name, year of publication, country and type of the studies, number of events, and total number in the two arms (patients and controls).

RESULTS

Out of the 211 references identified, six studies were pooled to test the association between diabetes mellitus and AD. The studies showed that AD is lower among patients with DM, odds ratio, 0.69, 95% CI, and 0.67-0.72. No heterogeneity was observed (Chi-Square, 4.12, degree of freedom (df.)= 5, and I² = 0%, P-value), 0.53 and P-value for overall effect, <0.001. The included studies were published in Europe (five) and Canada (one study) and included 162,882 patients and 12,164 events, four of the studied articles were case-control studies, one retrospective, and one cross-sectional.

CONCLUSION

AD was lower among patients with DM compared to their counterparts without the disease. Further studies focusing on the genetic and environmental factors linking AD and diabetes are needed.