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Campbell SA, Bradley HA, Mulder RT, Henderson JMT, Dixon L, Haslett LC, Rucklidge JJ. Effect of antenatal micronutrient or antidepressant exposure on Brazelton neonatal behavioral assessment scale (NBAS) performance within one-month of birth. Early Hum Dev 2024; 190:105948. [PMID: 38367590 DOI: 10.1016/j.earlhumdev.2024.105948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/17/2023] [Accepted: 01/21/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Antenatal depression is a risk factor for poor infant outcomes. Broad-spectrum-micronutrients (vitamins and minerals) have shown efficacy in treating psychiatric symptoms in non-pregnant populations and are associated with reduced incidence of adverse birth outcomes, and improvements in neonatal development. We investigated the effects of treatment of antenatal depression with micronutrients above the Recommended Dietary Allowance on infant development compared to treatment with antidepressant medications and controls. METHOD One-hundred-and-three infants were assessed using the Brazelton Neonatal Behavioral Assessment Scale (NBAS) within 28 days of birth: 37 exposed to micronutrients in-utero (50-182 days exposure), 18 to antidepressants in-utero (exposure for full gestation), and 48 controls whose mothers received neither treatment nor experienced depressive symptoms. RESULTS Controlling for gestational age and parity, there were significant group differences on habituation, orientation, motor, state regulation, autonomic stability and reflexes (p < .05). Micronutrient-exposed performed better than antidepressant-exposed and controls on habituation, motor and autonomic stability (p < .05), effect sizes ranged 1.0-1.7 and 0.5-1.0, respectively. Antidepressant-exposed performed significantly worse on orientation and reflexes compared to micronutrient-exposed and controls. Micronutrient-exposed had significantly better state regulation compared to antidepressant-exposed. There was an association between micronutrient exposure length and better habituation (r = 0.41, p = .028). Micronutrient exposure was generally identified as a stronger predictor of neonatal performance over maternal depression, social adversity, gestational age and infant sex. CONCLUSION In-utero micronutrient exposure appears to mitigate risks of depression on infant outcomes showing positive effects on infant behavior, on par with or better than typical pregnancies and superior to antidepressants. Limitations include differential exposure to micronutrients/antidepressants and lack of group blinding.
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Affiliation(s)
- S A Campbell
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - H A Bradley
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - R T Mulder
- Department of Psychological Medicine, University of Otago, New Zealand
| | - J M T Henderson
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - L Dixon
- New Zealand College of Midwives, Christchurch, New Zealand
| | - L C Haslett
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand
| | - J J Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, New Zealand.
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D'Souza S, Milne BJ, Li C, Anns F, Gardner A, Lumley T, Morton SMB, Murphy IR, Verhagen E, Wright C, Quarrie K. Kumanu Tāngata: the aftermatch study - protocol to examine the health outcomes of high-level male rugby union players using linked administrative data. BMJ Open Sport Exerc Med 2024; 10:e001795. [PMID: 38362564 PMCID: PMC10868174 DOI: 10.1136/bmjsem-2023-001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tāngata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.
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Affiliation(s)
- Stephanie D'Souza
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J Milne
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Chao Li
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
| | - Francesca Anns
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrew Gardner
- Sydney School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Research Institute for Innovative Solutions for Well-being and Health (INSIGHT), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ian R Murphy
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Evert Verhagen
- Department of Public and Occupational Health, EMGO, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Craig Wright
- Social Wellbeing Agency, Wellington, New Zealand
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Marr K, Maguet C, Scarlett H, Dray-Spira R, Dubertret C, Gressier F, Sutter-Dallay AL, Melchior M, van der Waerden J. Social determinants in prenatal antidepressant use and continuation: Systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 38145902 DOI: 10.1111/acps.13647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Depression is one of the most common co-morbidities during pregnancy; with severe symptoms, antidepressants are sometimes recommended. Social determinants are often linked with antidepressant use in the general population, and it is not known if this is the case for pregnant populations. Our objective was to determine if social determinants are associated with prenatal antidepressant intake via a systematic review and meta-analysis. METHODS A systematic search of five databases was conducted to identify publications from inception to October 2022 that reported associations with prenatal antidepressant intake (use/continuation) and one or more social determinants: education, race, immigration status, relationship, income, or employment. Eligible studies were included in random effects meta-analyses. RESULTS A total of 23 articles describing 22 studies were included. Education was significantly and positively associated with prenatal antidepressant continuation and heterogeneity was moderate. (Odds ratio = 0.83; 95% CI, 0.78 to 0.89; p < 0.00001; I2 = 53%). Meta-analyses of antidepressant use and education, race, and relationship status, and antidepressant continuation and income were not significant with high levels of heterogeneity. DISCUSSION While most social determinants in this review were not linked with prenatal antidepressant intake, lower maternal education level does seem to be associated with lower rates of prenatal antidepressant continuation. CONCLUSIONS Education appears to be linked with prenatal antidepressant intake. The low number of included studies precludes conclusive evidence for other social determinants.
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Affiliation(s)
- Ketevan Marr
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Charlotte Maguet
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Honor Scarlett
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Rosemary Dray-Spira
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
- EPI-PHARE Scientific Interest Group in Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Caroline Dubertret
- AP-HP, Groupe Hospital-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
- Faculté de Médecine, Université de Paris, Paris, France
| | - Florence Gressier
- CESP, Inserm UMR1178, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Anne-Laure Sutter-Dallay
- Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux University, Bordeaux, France
- University Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Judith van der Waerden
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Équipe de Recherche en Épidémiologie Sociale, Paris, France
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Morton SMB, Napier C, Morar M, Waldie K, Peterson E, Atatoa Carr P, Meissel K, Paine SJ, Grant CC, Bullen P, Fenaughty J, Bird A, Underwood L, Wall C, Exeter D, Prickett K, Kingi TK, Liang R, Fa’alili-Fidow J, Gerritsen S, Marks E, Walker C, Langridge F, Evans R, Neumann D, Grant M, Lai H, Taufa S, Smith A, Cha J. Mind the gap – unequal from the start: evidence from the early years of the Growing Up in New Zealand longitudinal study. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2058026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Susan M. B. Morton
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Carin Napier
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Manisha Morar
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Karen Waldie
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Psychology and the Centre for Brain Research, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Elizabeth Peterson
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Polly Atatoa Carr
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Kane Meissel
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Sarah-Jane Paine
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Cameron C. Grant
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Pat Bullen
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - John Fenaughty
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Counselling, Human Services and Social Work, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Amy Bird
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Waikato, Hamilton, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- COMPASS, Faculty of Arts, University of Auckland, Auckland, New Zealand
| | - Clare Wall
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Department of Nutrition, School of Medical Science, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Daniel Exeter
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kate Prickett
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Roy McKenzie Centre for Study of Families and Children School of Government, Victoria University, Wellington, New Zealand
| | - Te Kani Kingi
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Māori Health, Te Whare Wānanga o Awanuiārangi, Whakatāne, New Zealand
| | - Renee Liang
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Auckland District Health Board, Auckland, New Zealand
| | - Jacinta Fa’alili-Fidow
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Moana Research, Auckland, New Zealand
| | - Sarah Gerritsen
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Emma Marks
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Caroline Walker
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Fiona Langridge
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rebecca Evans
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Denise Neumann
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Molly Grant
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Hakkan Lai
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Seini Taufa
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Moana Research, Auckland, New Zealand
| | - Ash Smith
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jane Cha
- Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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