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Schuijers M, Greenwood CJ, McIntosh JE, Youssef G, Letcher P, Macdonald JA, Spry E, Le Bas G, Teague S, Biden E, Elliott E, Allsop S, Burns L, Olsson CA, Hutchinson DM. Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study. Arch Womens Ment Health 2024:10.1007/s00737-024-01473-x. [PMID: 38819645 DOI: 10.1007/s00737-024-01473-x] [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: 11/10/2023] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life. METHODS This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies: The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and The Triple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age. RESULTS In ATP, social support was associated with lower offspring problems (pregnancy: β = -0.15; post-birth: β = -0.12) and greater competencies (pregnancy: β = 0.12; post-birth: β = 0.16) at 12 months. In Triple B, social support also predicted lower offspring problems (pregnancy: β = -0.11; post-birth: β = -0.07) and greater competencies (pregnancy: β = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (β = 0.06). CONCLUSIONS Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.
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Affiliation(s)
- Melanie Schuijers
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | | | - Jennifer E McIntosh
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- The Bouverie Centre, La Trobe University, Bundoora, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Primrose Letcher
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Elizabeth Spry
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Genevieve Le Bas
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Samantha Teague
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia
| | - Ebony Biden
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Elizabeth Elliott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
- The Children's Hospital at Westmead, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University New South Wales, Sydney, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Delyse M Hutchinson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, Australia.
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
- National Drug and Alcohol Research Centre, University New South Wales, Sydney, Australia.
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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.
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Affiliation(s)
- Robin C Williams
- Société canadienne de pédiatrie, groupe de travail de la petite enfance, Ottawa (Ontario), Canada
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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.
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Affiliation(s)
- Robin C Williams
- Canadian Paediatric Society, Early Years Task Force, Ottawa, Ontario, Canada
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4
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Burger M, Einspieler C, Jordaan ER, Unger M, Niehaus DJH. Persistent Maternal Mental Health Disorders and Toddler Neurodevelopment at 18 Months: Longitudinal Follow-up of a Low-Income South African Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6192. [PMID: 37372776 DOI: 10.3390/ijerph20126192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
One of the biggest threats to early childhood development in Africa is poor maternal mental health. The present study reports on the relationships between clinical diagnoses of persistent maternal mental health disorders (at 3- and/or 6- and 18-month post-term age) and toddler neurodevelopment at 18 months of age. Eighty-three mother-toddler dyads from low socio-economic status settings in Cape Town, South Africa, were included. At the 3-, 6- and 18-month postnatal visits, clinician-administered structured diagnostic assessments were carried out according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria. Toddler neurodevelopment at 18 months corrected age was assessed with the Bayley Scales of Infant and Toddler Development (BSID-III). No significant differences (p > 0.05) were found between toddlers with exposure to persistent mood or psychotic disorders in the different BSID-III domains compared to toddlers with no exposure. Toddlers exposed to persistent comorbid anxiety and mood disorders scored significantly higher on the cognitive (p = 0.049), motor (p = 0.013) and language (p = 0.041) domains and attained significantly higher fine motor (p = 0.043) and gross motor (p = 0.041) scaled scores compared to toddlers with no maternal mental health disorder exposure. Future investigations should focus on the role of protective factors to explain the pathways through which maternal mental health status is associated with positive toddler neurodevelopmental outcomes.
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Affiliation(s)
- Marlette Burger
- Faculty of Medicine and Health Sciences, Physiotherapy Division, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town 8000, South Africa
| | - Christa Einspieler
- Research Unit iDN-Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8010 Graz, Austria
| | - Esme R Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town 7500, South Africa
- Statistics and Population Studies, University of the Western Cape, Cape Town 8000, South Africa
| | - Marianne Unger
- Faculty of Medicine and Health Sciences, Physiotherapy Division, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town 8000, South Africa
| | - Dana J H Niehaus
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town 8000, South Africa
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Child and family factors associated with positive outcomes among youth born extremely preterm. Pediatr Res 2023:10.1038/s41390-022-02424-x. [PMID: 36639518 DOI: 10.1038/s41390-022-02424-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/22/2022] [Accepted: 11/19/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND To analyze the relationship of child behavioral and communication disorders, and adverse family events, to later-in-life child health and cognitive function among youth born extremely preterm. METHODS The study participants were 694 children enrolled in the Extremely Low Gestational Age Newborn Study. At ages 2 and 10, we assessed internalizing and externalizing behaviors, and at age 10, we assessed adverse life events within the family. Associations were evaluated between these child and family factors and positive child health at age 10 years, and global health and cognitive function at age 15 years. RESULTS Lower T-scores for internalizing or externalizing behaviors at age 2 were associated with more positive health at age 10. The absence of internalizing behaviors at age 10 was associated with better global child health and better cognitive function at age 15. The absence of communication deficits at age 10 was associated with better cognitive function at age 15. The absence of parent job loss was associated with better global child health at age 15. CONCLUSION Among individuals born extremely preterm, child health and cognitive outcomes might be improved by timely interventions to address child behavioral symptoms and the impact of adverse life events in the family. IMPACT The absence of child behavioral and communication disorders, and adverse family events, were associated with more positive health, higher global health, and better cognitive function among youth born extremely preterm. Interventions to address behavioral disorders in early childhood, and to reduce the impact of adverse life events on the family, might promote improved health and developmental outcomes for adolescents born extremely preterm.
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Aranbarri A, Aizpitarte A, Arranz-Freijo E, Fano E, de Miguel MS, Stahmer AC, Ibarluzea JM. What influences early cognitive development? Family context as a key mediator. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2022.101480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Early life circadian rhythm disruption in mice alters brain and behavior in adulthood. Sci Rep 2022; 12:7366. [PMID: 35513413 PMCID: PMC9072337 DOI: 10.1038/s41598-022-11335-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/15/2022] [Indexed: 11/08/2022] Open
Abstract
Healthy sleep supports robust development of the brain and behavior. Modern society presents a host of challenges that can impair and disrupt critical circadian rhythms that reinforce optimal physiological functioning, including the proper timing and consolidation of sleep. While the acute effects of inadequate sleep and disrupted circadian rhythms are being defined, the adverse developmental consequences of disrupted sleep and circadian rhythms are understudied. Here, we exposed mice to disrupting light–dark cycles from birth until weaning and demonstrate that such exposure has adverse impacts on brain and behavior as adults. Mice that experience early-life circadian disruption exhibit more anxiety-like behavior in the elevated plus maze, poorer spatial memory in the Morris Water Maze, and impaired working memory in a delayed match-to-sample task. Additionally, neuron morphology in the amygdala, hippocampus and prefrontal cortex is adversely impacted. Pyramidal cells in these areas had smaller dendritic fields, and pyramidal cells in the prefrontal cortex and hippocampus also exhibited diminished branching orders. Disrupted mice were also hyperactive as adults, but otherwise exhibited no alteration in adult circadian locomotor rhythms. These results highlight that circadian disruption early in life may have long lasting and far-reaching consequences for the development of behavior and the brain.
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Saha SR, Khan MMH. Risk factors for early childhood disability in Bangladesh: Evidence from Multiple Indicator Cluster Survey 2019. PLoS One 2021; 16:e0259532. [PMID: 34735527 PMCID: PMC8568190 DOI: 10.1371/journal.pone.0259532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Early childhood is a vital part of human life because most of the brain developments occur in this particular period. Early childhood disability is a significant global public health burden, which can negatively impact the children's quality of life and their overall productivity. It is also a major social and economic problem in Bangladesh. Therefore, it is very important to understand the associated factors for early childhood disability, which may help disability prevention, better management and policy formulation. The main objective of this study is to investigate the child, family, and community-level factors associated with early childhood disability in Bangladesh. METHODS A cross sectional nationally representative data was derived from Multiple Indicator Cluster Survey (MICS), 2019. A total of 14,072 Bangladeshi children under five years of age were selected for this study. Various types of statistical analysis (simple, bivariate, multivariable) were performed. To assess the bivariate relationship between chosen categorical variables (independent) and early childhood disability (dependent), a chi-square test was used. The multivariable ordinal logistic regression was used to find out the association of disability with child, family, and community-level factors. RESULTS The results show that 2.0% of the children have at least one disability and 0.8% have more disabilities. Several factors namely not attending in early childhood education [Odds Ratio (OR) = 0.65; 95% confidence interval (CI) = 0.13-1.17 Ρ = 0.01], having mother's functional difficulty (OR = 1.23; 95% (CI) = 0.58-1.88 Ρ <0.001), unhappy mother's life (OR = 0.85; 95% CI = 0.30-1.39 Ρ <0.001), parents without internet access (OR = 0.68; 95% CI = 0.06-1.29 Ρ = 0.03) and parents using mobile phone (OR = 0.52; 95% CI = 0.09-0.95 Ρ = 0.02) were found to be important for early childhood disability in Bangladesh. CONCLUSION Early childhood disability is still neglected in Bangladesh and further epidemiological studies are recommended. The findings of this study may help policy makers and relevant stakeholders to develop interventions for reducing the overall burden of early childhood disability.
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Affiliation(s)
- Shilpi Rani Saha
- Bangladesh University of Professionals, Dhaka, Bangladesh
- * E-mail:
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9
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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MacKinnon AL, Tomfohr-Madsen L, Tough S. Neighborhood Socio-Economic Factors and Associations with Infant Sleep Health. Behav Sleep Med 2021; 19:458-470. [PMID: 32571082 DOI: 10.1080/15402002.2020.1778478] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED Background: Sleep health is important for development and improves overall health. There are large socioeconomic gradients in sleep health, from childhood through adulthood. Recent findings suggest that children from neighborhoods with poorer socioeconomic conditions have more sleep problems. The current study aimed to investigate the associations between neighborhood factors and infant sleep health. PARTICIPANTS AND METHODS Secondary data analysis using Multilevel Modeling (MLM) was conducted for a subsample of 2445 women from the All our Families longitudinal cohort study, for whom early pregnancy neighborhood data could be geocoded. The Vancouver Area Neighborhood Deprivation Index (VANDIX) was calculated using census data to assess neighborhood SES. Neighborhood disorder was measured using community crime reports from police services. Mothers rated the perceived safety of their neighborhood and reported on their infants' nighttime sleep consolidation, awakenings, and onset latency at 12 months postpartum. RESULTS MLM indicated that neighborhood disorder and maternal perceptions of unsafety predicted less consolidated sleep after accounting for individual and family-level factors including maternal ethnicity, household income, breastfeeding duration, and co-sleeping. Neighborhood deprivation was indirectly related to less consolidated sleep among 12-month-old infants through more reports of disorder and maternal perceptions of less safety. CONCLUSIONS Consistent with the socio-ecological model of sleep, neighborhood-level, family, and individual factors influence infant sleep health. Policy efforts to increase neighborhood safety and public health initiatives to increase awareness of the importance of sleep could help improve infant sleep health.
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Affiliation(s)
- Anna L MacKinnon
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary.,Alberta Children's Hospital Research Institute.,Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Suzanne Tough
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Canada
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Dovel K, Kalande P, Udedi E, Temelkovska T, Hubbard J, Mbalanga C, Bruns L, Mulungu S, Gupta S, Richter L, Coates TJ. Integrated early childhood development services improve mothers' experiences with prevention of mother to child transmission (PMTCT) programs in Malawi: a qualitative study. BMC Health Serv Res 2021; 21:348. [PMID: 33858394 PMCID: PMC8048322 DOI: 10.1186/s12913-021-06342-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV-positive mothers who face the dual burden of HIV-positive status and motherhood, may benefit from holistic services that include early childhood development (ECD). We evaluated the acceptability and impact of integrated ECD-PMTCT interventions for mothers and their children. METHODS We implemented an integrated ECD-PMTCT intervention in 4 health facilities in Malawi for HIV-positive mothers and their infants. WHO/UNICEF Care for Child Development (CCD) education and counseling sessions were offered during routine PMTCT visits between infant age 1.5-24 months. From June-July 2019, we conducted in-depth interviews with 29 mothers enrolled in the intervention for ≥6 months across 4 health facilities. The interview guide focused on perceived impact of the intervention on mothers' ECD and PMTCT practices, including barriers and facilitators, and unmet needs related to the program. Data were coded and analyzed using constant comparison methods in Atlas ti.8. RESULTS The vast majority of mothers believed the ECD-PMTCT intervention improved their overall experience with the PMTCT services, strengthened their relationship with providers, and excited and motivated them to attend PMTCT services during the postpartum period. Unlike prior experience, mothers felt more welcome at the health facility, and looked forward to the next visit in order to interact with other mothers and learn new ECD skills. Mothers formed new social support networks with other mothers engaged in ECD sessions, and they provided emotional and financial support to one another, including encouragement regarding ART adherence. Mothers believed their infants reached developmental milestones faster compared to non-intervention children they observed at the same age, and they experienced improved engagement in caregiving activities among male caregivers. Nearly half of women requested additional support with depression or anxiety, coping mechanisms to deal with the stresses of life, or support in building positive dynamics with their male partner. CONCLUSION The integrated ECD-PMTCT intervention improved mother's experiences with PMTCT programs and health care providers, increased ECD practices such as responsive and stimulating parenting, and created social support networks for women with other PMTCT clients.
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Affiliation(s)
- Kathryn Dovel
- Partners in Hope, Lilongwe, Malawi.
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | | | | | - Tijana Temelkovska
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
| | - Julie Hubbard
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Laurie Bruns
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- University of California Global Health Institute, San Francisco, USA
| | | | - Sundeep Gupta
- Partners in Hope, Lilongwe, Malawi
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Thomas J Coates
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- University of California Global Health Institute, San Francisco, USA
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Wan MW, Fitch-Bunce C, Heron K, Lester E. Infant screen media usage and social-emotional functioning. Infant Behav Dev 2020; 62:101509. [PMID: 33249357 DOI: 10.1016/j.infbeh.2020.101509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/08/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022]
Abstract
There has been little research on whether and how screen media usage affects social-emotional (SE) function prior to two years of age, even though early SE development is understood to be nurtured through interpersonal experience, mainly withthe primary caregiver. This study sought to characterise infant screen media usage and understand how it may link with concurrent SE function by testing associated effects on reducing parent-infant interaction and of parent psychological factors. Questionnaire responses from 327 UK-based parents of infants aged 6-24 months showed diverse usage in the amount of time spent on screen media ('screen time') and amount of parental involvement (co-sharing and co-referencing). Infants with possible SE delay experienced more screen time than those at low risk. The study tested three mediation models and found support for the displacement and not distancing hypothesis based on this community sample. While screen time predicted both SE competence and SE problems, reduced parent-infant play partially mediated the effect on SE competence. Parent depressed mood was positively linked with infant SE problems, but there was little evidence that increased screen time mediated this effect. Also, parent reflective function and attitudes toward parent-infant play were unrelated to screen time. Though longitudinal study is warranted, the findings implicate screen media usage as potentially directly and indirectly relevant when addressing infant mental health.
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Affiliation(s)
- Ming Wai Wan
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK.
| | - Clem Fitch-Bunce
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Kate Heron
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Ellie Lester
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK
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Wigert H, Nilsson C, Dencker A, Begley C, Jangsten E, Sparud-Lundin C, Mollberg M, Patel H. Women's experiences of fear of childbirth: a metasynthesis of qualitative studies. Int J Qual Stud Health Well-being 2020; 15:1704484. [PMID: 31858891 PMCID: PMC6968519 DOI: 10.1080/17482631.2019.1704484] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose: Women’s experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women’s experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women’s experiences of fear of childbirth interpreted through the metaphor “being at a point of no return”. Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other’s experiences will not happen to them.
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Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Nilsson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Anna Dencker
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Chair of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Elisabeth Jangsten
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Margareta Mollberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Harshida Patel
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Russell MJ, Premji S, Mcdonald S, Zwicker JD, Tough S. Health care service for families with children at early risk of developmental delay: an All Our Families cohort study. Dev Med Child Neurol 2020; 62:338-345. [PMID: 31469170 PMCID: PMC7028137 DOI: 10.1111/dmcn.14343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 12/15/2022]
Abstract
AIM This study examined children's health care service use, mothers' workforce participation, and mothers' community engagement based on children's risk of developmental delay. METHOD We used data from the All Our Families study, a prospective pregnancy cohort. Ages and Stages Questionnaire (ASQ) scores at year 2 indicated risk of developmental delay. To investigate the impact of risk of developmental delay when children were not diagnosed, a sensitivity analysis excluded reports of neurodevelopmental disorder (NDD) diagnosis at year 3. Outcomes were maternal reports of children's health and allied health visits (and estimated costs), and maternal workforce participation and community engagement from year 2 to 3. RESULTS Among 1314 mother-child dyads, 209 (16%) children were classified as being at risk of developmental delay by the ASQ, and 42 (3%) had a reported diagnosis of NDD. Risk of developmental delay was related to increased use of allied health care services (incidence risk ratio 5.04 [year 3]; 95% confidence interval 2.49-10.2) and health visits (incidence risk ratio 1.33 [year 3]; 95% confidence interval 1.14-1.54). The average expected allied health costs were greater for children at risk versus not at risk of developmental delay. However, when excluding children with reported diagnoses of an NDD from this analysis, increased service use and costs in the remaining at-risk population were not observed. Community engagement and workplace participation among families did not differ on the basis of risk of developmental delay. INTERPRETATION These results suggest increased health care service use by families of children at risk of developmental delay is driven by those receiving a diagnosis of an NDD in the subsequent year. WHAT THIS PAPER ADDS Early developmental delay risk was related to health care service use and costs. Diagnosis of neurodevelopmental disorder drove increased health care service use and costs. Early developmental delay risk did not relate to parental workforce participation. Early developmental delay risk did not relate to community engagement participation.
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Affiliation(s)
- Matthew J Russell
- Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
- School of Public PolicyUniversity of CalgaryCalgaryABCanada
- PolicyWise for Children & FamiliesUniversity of CalgaryCalgaryABCanada
| | - Shainur Premji
- Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
- School of Public PolicyUniversity of CalgaryCalgaryABCanada
| | - Sheila Mcdonald
- Paediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Jennifer D Zwicker
- School of Public PolicyUniversity of CalgaryCalgaryABCanada
- Department of KinesiologyUniversity of CalgaryCalgaryABCanada
| | - Suzanne Tough
- Community Health Sciences, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Paediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
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15
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Maharlouei N, Alibeigi H, Rezaianzadeh A, Keshavarz P, Raeisi Shahraki H, Nemati H, B Lankarani K. The relationship between maternal mental health and communication skills in children in Shiraz, Iran. Epidemiol Health 2019; 41:e2019035. [PMID: 31319652 PMCID: PMC6759496 DOI: 10.4178/epih.e2019035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/19/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children. METHODS This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children. RESULTS The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01). CONCLUSIONS The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Alibeigi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pedram Keshavarz
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamid Nemati
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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16
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Premji S, McDonald SW, Metcalfe A, Faris P, Quan H, Tough S, McNeil DA. Examining postpartum depression screening effectiveness in well child clinics in Alberta, Canada: A study using the All Our Families cohort and administrative data. Prev Med Rep 2019; 14:100888. [PMID: 31193116 PMCID: PMC6517566 DOI: 10.1016/j.pmedr.2019.100888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 12/20/2022] Open
Abstract
Affecting 10-15% of women, postpartum depression (PPD) can be debilitating and costly. While early identification has the potential to improve timely care, recommendations regarding the implementation of routine screening are inconsistent. In Alberta, screening is completed using the Edinburgh Postnatal Depression Scale during public health well child clinic visits. The objective of this study was to examine the effectiveness of screening in identifying, diagnosing and treating women at increased risk for PPD over the first year postpartum, compared to those unscreened. The All Our Families prospective pregnancy cohort was linked to public health, inpatient, outpatient, physician claims and community pharmaceutical data over the first year postpartum. Descriptive statistics and bivariate analyses examined differences in sample characteristics and PPD and non-PPD related utilization by screening category. Odds ratios and 95% confidence intervals for PPD diagnosis and mental health drugs dispensed were generated using crude and multivariable logistic regression models. Within our sample, 87% of the eligible population were screened, with 3% receiving a high-risk score, and 13% were unscreened. Compared to those unscreened, women screened high-risk had higher odds of being diagnosed with PPD (OR: 3.88, 95% CI: 2.18-6.92) and women screened low/moderate-risk had reduced odds of receiving a diagnosis (OR: 0.51, 95% CI: 0.35-0.74). High-risk women had an increased likelihood of diagnosis, higher PPD-related utilization and drugs dispensed compared to those unscreened. This information suggests that screening was effective at streamlining resources in Alberta. Future work should focus on evaluating the cost-effectiveness of PPD screening.
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Key Words
- 1H2P, 1 hospitalization, 2 physician claims
- ANOVA, analysis of variance
- AOF, All Our Families
- CI, confidence interval
- EPDS, Edinburgh Postnatal Depression Scale
- Evaluation
- IQR, interquartile range
- OR, odds ratio
- PPD, postpartum depression
- Perinatal depression
- Public health
- SD, standard deviation
- Screening
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Affiliation(s)
- Shainur Premji
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada
| | - Sheila W McDonald
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Department of Obstetrics and Gyneacology, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Peter Faris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Suzanne Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Deborah A McNeil
- Alberta Health Services, 10101 Southport Road SW, Calgary, AB T2W3N2, Canada.,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N1N4, Canada
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17
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Miadich SA, Doane LD, Davis MC, Lemery-Chalfant K. Early parental positive personality and stress: Longitudinal associations with children's sleep. Br J Health Psychol 2019; 24:629-650. [PMID: 31004419 DOI: 10.1111/bjhp.12372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/04/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The current study examined the influence of early parental stress and positive parent personality during infancy on sleep in middle childhood. Further, the role of positive parent personality as a buffer of the association between parental stress and sleep was considered. METHODS Participants included 381 twins and their primary caregivers who were recruited from birth records in the United States. Primary caregivers completed survey assessments via phone when twins were 12 and 30 months of age to assess multiple dimensions of parental stress and positive parent personality. Approximately 6 years later (M = 5.78, SD = 0.42), twins participated in an intensive assessment that included wearing actigraph watches to provide an objective measurement of sleep, while primary caregivers completed daily diaries regarding twins' sleep. RESULTS Positive parent personality was associated prospectively with longer actigraphy sleep duration and higher parent-reported sleep quality/daytime functioning. Parental stress was associated prospectively with greater variability in sleep duration. Positive parent personality moderated the parental stress - sleep-timing relation, such that greater parental stress was associated with a later midpoint of the sleep period only for children with parents low on positive personality (e.g., low optimism). All other findings were non-significant. CONCLUSIONS Findings suggest that both positive attributes and stress may influence sleep in middle childhood and that low parent positive personality may exacerbate associations between parental stress and later timing of sleep periods in children. Early interventions to promote healthy sleeping may consider focusing on decreasing parental stress and increasing parental empathy and optimism as early as infancy. Statement of contribution What is already known on this subject? Early-life experiences, especially adversity, have been related to health outcomes among adults and children, such that negative experiences are associated with poor health outcomes. Poor sleep (e.g., short duration, poor quality) among children is associated with negative outcomes including poorer cognitive performance and higher adiposity. What does this study add? This study used a prospective design to understand relations between early parent-related factors and child sleep. Early parental stress and positive parent personality were associated with objective sleep quality. Positive parent personality during infancy may have promotive/protective influences on sleep later in childhood.
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Affiliation(s)
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Mary C Davis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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18
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Islam S, Small N, Bryant M, Bridges S, Hancock N, Dickerson J. Assessing community readiness for early intervention programmes to promote social and emotional health in children. Health Expect 2019; 22:575-584. [PMID: 30972905 PMCID: PMC6543141 DOI: 10.1111/hex.12887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 11/27/2022] Open
Abstract
Objective Evidence for early intervention and prevention‐based approaches for improving social and emotional health in young children is robust. However, rates of participation in programmes are low. We explored the dynamics which affect levels of community readiness to address the issues of social and emotional health for pregnant women, young children (0‐4 years) and their mothers. Setting A deprived inner‐city housing estate in the north of England. The estate falls within the catchment area of a project that has been awarded long‐term funding to address social and emotional health during pregnancy and early childhood. Methods We interviewed key respondents using the Community Readiness Model. This approach applies a mixed methodology, incorporating readiness scores and qualitative data. A mean community readiness score was calculated enabling the placement of the community in one of nine possible stages of readiness. Interview transcripts were analysed using a qualitative framework approach to generate contextual information to augment the numerical scores. Results An overall score consistent with vague awareness was achieved, indicating a low level of community readiness for social and emotional health interventions. This score suggests that there will be a low likelihood of participation in programmes that address these issues. Conclusion Gauging community readiness offers a way of predicting how willing and prepared a community is to address an issue. Modifying implementation plans so that they first address community readiness may improve participation rates.
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Affiliation(s)
- Shahid Islam
- Faculty of Health Studies, University of Bradford, Bradford, UK.,Better Start Bradford Innovation Hub, Born in Bradford, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Maria Bryant
- Diet, Obesity & Lifestyle Portfolio lead, Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Sally Bridges
- Better Start Bradford Innovation Hub, Born in Bradford, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Josie Dickerson
- Better Start Bradford Innovation Hub, Born in Bradford, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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19
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Römer P, Reinelt T, Petermann F, Teickner C. Alkoholkonsum während der Schwangerschaft. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Kinder sind bereits im Mutterleib sensitiv für Umwelteinflüsse. Pränataler Alkoholkonsum zählt dabei zu den einflussreichsten Risikofaktoren für die frühkindliche Entwicklung. Das Ziel ist es, einen Überblick über die aktuelle Forschungslage zum Thema Alkoholkonsum während der Schwangerschaft zu geben. Darüber hinaus wird der Forschungsstand zu Belastungen und Folgeschäden für die frühkindliche Entwicklung durch pränatale Alkoholexposition, aber auch zu weiteren Risikofaktoren zusammengefasst. Es wird gezeigt, dass das Wissen um die Prävalenz für Alkoholkonsum während der Schwangerschaft sowohl für die Erforschung der Folgen als auch für das Umsetzen von präventiven Maßnahmen ausschlaggebend ist. Die Prävalenzen unterscheiden sich nicht nur regional, sondern können auch durch andere Faktoren beeinflusst werden. Es wird deutlich, dass der Risikofaktor Alkohol und dessen mögliche Auswirkungen auf die frühkindliche Entwicklung nicht isoliert, sondern in Abhängigkeit von weiteren genetischen und Umweltfaktoren betrachtet werden müssen. Denn auch Folgen von weiteren perinatalen Risikofaktoren machen sich in den ersten beiden Lebensjahren bemerkbar. Beispiele für Entwicklungsstörungen in dieser Entwicklungsspanne sind externalisierendes Verhalten und kognitive Beeinträchtigungen. Inwieweit sich perinatale Risikofaktoren jedoch auf Entwicklungsverläufe von Kindern, die durch pränatalen Alkoholkonsum belastet sind, auswirken, erfasst eine umfassende Diskussion. Diese Lücke gilt es zu schließen um das Zusammenspiel perinataler Risiken genauer zu verstehen und adäquat entgegenwirken zu können.
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Affiliation(s)
- Pia Römer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Tilman Reinelt
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Claudia Teickner
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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20
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Risk and Protective Factors for Externalizing Behavior at 3 Years: Results from the All Our Families Pregnancy Cohort. J Dev Behav Pediatr 2018; 39:547-554. [PMID: 29794888 DOI: 10.1097/dbp.0000000000000586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study examines risk and protective factors for externalizing behavior in children aged 3 years to inform early interventions and enhance school readiness. METHOD A total of 1314 mothers participating in a longitudinal study completed questionnaires when their children turned 2 years and again at the age of 3 years. Externalizing behavior was assessed using a short version of the Child Behavior Checklist. Risk and protective factors included the child's characteristics, maternal mental health and disposition, socioeconomic status, and community engagement and child care. Logistic regression models produced crude and adjusted odds ratios (AORs). RESULTS Poor maternal mental health and high levels of maternal neuroticism were associated with an increased risk for externalizing problems at 3 years (AOR, 1.66; 95% confidence interval [CI], 1.16-2.40 and AOR, 2.28; 95% CI, 1.58-3.30). Care by their mother, relative, or a nanny (compared with being in child care) also conferred an increased risk (AOR, 1.38; 95% CI, 1.01-1.90). Mothers' community engagement modified the risk for boys, such that boys whose mothers did not participate in community activities were 4 times more likely to have externalizing problems than did boys whose mothers engaged in community activities. CONCLUSION Families in which mothers experience mental health challenges or have dispositional traits that increase the risk of externalizing behaviors can be identified early. Identification provides the opportunity to promote engagement with parenting supports to improve the outcomes of the child and family. Providing opportunities for children to practice their self-regulation skills through participation in child care and community activities promotes development and mitigates the risk of externalizing behavior.
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21
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Risk and Protective Factors for Mental Health and Community Cohesion After the 2013 Calgary Flood. Disaster Med Public Health Prep 2017; 12:470-477. [PMID: 28770699 DOI: 10.1017/dmp.2017.91] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine mental health and community cohesion in women living in Calgary after a natural disaster considering previously collected mental health data. METHODS Data from an ongoing longitudinal cohort, the All Our Families study, were used to examine mental health and community cohesion 5 months after a major flood in Calgary, Canada. Participants who had completed a baseline questionnaire before the flood were eligible for inclusion in this study (N=923). Four multivariable logistic regression models were built to examine predictors of post-traumatic stress, depression, anxiety, and community cohesion. RESULTS Elevated anxiety before the flood was associated with 2.49 (95% CI: 1.17, 5.26) increased odds of experiencing high levels of post-traumatic stress, regardless of whether respondents lived in a flood-risk community or not. Women who experienced damage to property, or who provided help to others, were more likely to perceive an increased sense of community cohesion (adjusted ods ratio (AOR): 1.67; 95% CI: 1.09, 2.54 and AOR: 1.68; 95% CI: 1.13, 2.52, respectively). CONCLUSIONS Women with underlying mental health conditions may be more vulnerable to the psychological impacts of a natural disaster regardless of their level of exposure. Natural disasters may bring communities together, especially those who were more tangibly impacted. (Disaster Med Public Health Preparedness. 2018;12:470-477).
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22
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Renz H, Holt PG, Inouye M, Logan AC, Prescott SL, Sly PD. An exposome perspective: Early-life events and immune development in a changing world. J Allergy Clin Immunol 2017; 140:24-40. [DOI: 10.1016/j.jaci.2017.05.015] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 02/09/2023]
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23
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Chen PJ, Yang L, Chou CC, Li CC, Chang YC, Liaw JJ. Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial. Complement Ther Med 2017; 31:109-117. [PMID: 28434463 DOI: 10.1016/j.ctim.2017.03.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/18/2016] [Accepted: 03/06/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks' gestation between women receiving prenatal yoga and those receiving routine prenatal care. DESIGN For this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks' gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n=48) or control (n=46) groups using Clinstat block randomization. INTERVENTION The 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care. MAIN OUTCOME MEASURES In both groups, participants' salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks' gestation. RESULTS The intervention group had lower salivary cortisol (p<0.001) and higher immunoglobulin A (p<0.001) levels immediately after yoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p=0.018), and infants born to women in the intervention group weighed more than those born to the control group (p<0.001). CONCLUSION Prenatal yoga significantly reduced pregnant women's stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function.
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Affiliation(s)
- Pao-Ju Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, 11490, Taiwan, ROC; Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, ROC.
| | - Luke Yang
- Department of Social Welfare, Hsuan Chuang University, Hsinchu, 30092, Taiwan, ROC.
| | - Cheng-Chen Chou
- School of Nursing, Taipei Medical University, Taipei, 110, Taiwan, ROC.
| | - Chia-Chi Li
- School of Nursing, National Defense Medical Center, Taipei, 11490, Taiwan, ROC.
| | - Yu-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei, 25137, Taiwan, ROC.
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei, 11490, Taiwan, ROC.
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