Long-term effects of experiencing childhood parental death on mental and physical health: A NESDA study

Experiencing parental death during childhood is an adverse, potentially traumatic experience that may have substantial long-term effects on mental and physical well-being. The current study was based on data of the Netherlands Study of Depression and Anxiety to investigate mental health (i.e., depressive symptoms, anxiety symptoms, and suicidal ideation) and physical health outcomes (i.e., metabolic syndrome, telomere length, and perceived physical health) as well as health behaviour (i.e., smoking status, alcohol use, and physical activity) to provide more insight into the long-term outcomes after experiencing childhood parental death (CPD). For individuals who experienced CPD, we also investigated the role of loss-related factors in these associations, namely the age of the child when their parent passed away and gender of the deceased parent. Interviews and questionnaires were completed by adults between 18 and 65 years; 177 participants experienced CPD (mean age = 45.19, 61.6% female) and 2463 did not (mean age = 41.38, 66.6% female). Results showed no overall association between the experience of CPD and mental and physical health indices and health behaviour. Within the CPD group, experiencing CPD at a younger age was related to a higher likelihood of suicidal ideation. These findings seem to illustrate a general positive adjustment with regard to long-term health functioning after experiencing such an impactful life event. Future research should focus on individual differences in terms of adaptation, especially elucidating on contextual factors after the loss, such as the kind of support that is or is not provided by the surviving parent and/or other important individuals.

Facilitating Evaluation of Hemolytic Uremic Syndrome Long-Term Health Outcomes Through Social Media Support Groups

Individual burden and cost of hemolytic uremic syndrome (HUS)-a medical condition characterized by acute kidney failure-can be substantial when accounting for long-term health outcomes (LTHOs). Because of the low incidence of HUS, evaluation of associated LTHOs is often restricted to physician and outbreak cohorts, both of which may not be representative of all HUS cases. This exploratory study recruited participants from private social media support groups for families of HUS cases to identify potential LTHOs and costs of HUS that are not currently measured. Additionally, this study sought to identify case characteristics that may confound or modify these LTHOs and costs of HUS. Respondents self-selected to complete an online cross-sectional survey on acute and chronic illness history, treatments, and public health follow-up for HUS cases. Posttraumatic stress among respondents (typically case parents) was also evaluated. Responses were received for 74 HUS cases from 71 families representing all geographic regions, and levels of urbanicity within the US self-reported symptoms were typical for HUS, while 35.1% of cases reported antibiotic treatment at any point during the acute illness. Hospital transfers were reported by 71.6% of cases introducing possible delays to care. More than 70% of cases reported experiencing at least one LTHO, with 45% of cases reporting renal sequelae. Posttraumatic stress symptoms were frequently reported by respondents indirectly affected by HUS. Potentially large economic costs that are not addressed in existing analyses were identified including both financial and more general welfare losses (lost utility). While biases in the study design limit the generalizability of results to all HUS cases, this study provides new insights into unmeasured LTHOs and costs associated with HUS. These results suggest that robustly designed cohort studies on HUS should include measures of psychosocial impacts on both the affected individual and their family members.

Long-term health outcomes in offspring born to women with diabetes in pregnancy

In this review, we critically assess recent evidence from human studies regarding the potential implications of exposure to maternal diabetes in-utero for long-term adiposity, cardiometabolic outcomes, and cognitive ability of the offspring. Evidence supports a direct causal role for exposure to maternal diabetes in utero in determining offspring long-term greater adiposity and adverse cardiometabolic health. Although a majority of observational studies report associations of exposure to maternal pregnancy diabetes with lower cognitive ability, there is also evidence supporting an opposite 'protective' intrauterine effect of exposure to maternal pregnancy diabetes on offspring cognitive ability. Epigenetic modification has been suggested as a mediator on the pathways from maternal pregnancy diabetes to long-term offspring outcomes and several recent studies that are reviewed here lend some support to this notion, but research in this area is still too novel to be conclusive.