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Ayano G, Betts K, Maravilla JC, Alati R. The risk of anxiety disorders in children of parents with severe psychiatric disorders: a systematic review and meta-analysis. J Affect Disord 2021; 282:472-487. [PMID: 33422825 DOI: 10.1016/j.jad.2020.12.134] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Several studies have investigated the association between parental severe psychiatric disorders and anxiety disorder risk in offspring, but the findings across these studies have been inconsistent. METHODS Using the PRISMA guideline, a rigorous electronic and manual search was conducted in four electronic databases EMBASE, PubMed, PsychINFO, and Scopus to identify relevant studies. All observation studies (cohort and case-control studies) that examined the association between parental severe psychiatric disorders and the risk of offspring anxiety disorders were identified. Summary risk ratios (RRs) and 95% confidence intervals (95%CI) were synthesized using a fixed and random effect meta-analysis. RESULTS Twenty-five studies were included in the final analysis (14 cohort and 11 case-control studies). The meta-analysis showed that parental severe psychiatric disorder was associated with a higher risk of social phobia, panic, obsessive-compulsive, post-traumatic stress, separation anxiety, and generalized anxiety disorders in the offspring. When considering specific severe psychiatric disorders in parents as exposure, parental bipolar disorder was associated with an increased risk of obsessive-compulsive and generalized anxiety disorders in the offspring, whereas parental depressive disorder was associated with an increased risk of social phobia, separation anxiety, and generalized anxiety disorders in the offspring. Conversely, parental schizophrenia was not associated with offspring anxiety disorder CONCLUSION: This review suggests that the offspring of parents with severe psychiatric, bipolar, and depressive disorders are at an increased risk of developing a range of anxiety disorders. These findings suggest that targeted early screening and intervention programs are imperative in exposed offspring.
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Affiliation(s)
- Getinet Ayano
- School of public health, Curtin University, WA, Perth, Australia; Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
| | - Kim Betts
- School of public health, Curtin University, WA, Perth, Australia.
| | | | - Rosa Alati
- School of public health, Curtin University, WA, Perth, Australia; Institute of social science research, The University of Queensland, Brisbane, Australia.
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Ayano G, Betts K, Maravilla JC, Alati R. A Systematic Review and Meta-Analysis of the Risk of Disruptive Behavioral Disorders in the Offspring of Parents with Severe Psychiatric Disorders. Child Psychiatry Hum Dev 2021; 52:77-95. [PMID: 32291561 DOI: 10.1007/s10578-020-00989-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inconsistent results of the association between severe psychiatric disorders (SPD) in parents and the risk of disruptive behavioral disorders (DBD) including conduct disorders (CD) and oppositional defiant disorders (ODD) in the offspring have been found by previous epidemiologic studies. PubMed, EMBASE, PsycINFO, and Scopus were searched for relevant studies. Fourteen studies met the predefined criteria for inclusion. A meta-analysis of the included studies revealed an elevated risk of DBD in the offspring of parents with SPD, bipolar, and depressive disorders. Our further analysis considering the specific DBD as an outcome showed that parents with SPD are at an increased risk of having a child with ODD as well as CD. Moreover, the current meta-analysis found that the children of parents with bipolar disorder were also at increased risk of ODD and CD. Parental schizophrenia and depressive disorders were not associated with higher risks of ODD and CD in the offspring.
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Affiliation(s)
- Getinet Ayano
- School of Public Health, Curtin University, Perth, WA, Australia.
| | - Kim Betts
- School of Public Health, Curtin University, Perth, WA, Australia
| | | | - Rosa Alati
- School of Public Health, Curtin University, Perth, WA, Australia.,School of Social Sciences, The University of Queensland, Brisbane, QLD, Australia
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Maravilla JC, Betts K, Adair L, Alati R. Stunting of children under two from repeated pregnancy among young mothers. Sci Rep 2020; 10:14265. [PMID: 32868833 PMCID: PMC7459341 DOI: 10.1038/s41598-020-71106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/05/2020] [Indexed: 11/08/2022] Open
Abstract
Repeated pregnancy leaves young mothers nutritionally deprived which may in turn lead to poor infant growth. We measure the occurrence and persistence of stunting among offspring of young mothers who experienced repeated pregnancies using data from the Cebu Longitudinal Health and Nutrition Survey. We selected mothers aged 14-24 years (n = 1,033) with singleton birth. We determined the length-for-age z scores (LAZ) at 12 and 24 months of the index child using the World Health Organisation 2007 growth standard. We fitted LAZ, stunting occurrence (i.e. LAZ < - 2) and persistence from 12 to 24 months into regression models and tested for the mediating effect of low birthweight and feeding practices. In these models, repeated pregnancy was analysed in an ordinal approach using number of past pregnancies of young mothers at birth of the index child. Compared to infants born to young mothers aged 14-24 years who had no previous pregnancies, those born to young mothers with repeated pregnancies have at least 0.15 (95% CI - 0.23, - 0.08) LAZ lower and are at higher chance of stunting by at least 40% (95% CI 1.19, 1.67) at 12 and 24 months. Similar cohorts of infants showed an elevated risk of persistent stunting from 12 through 24 months with a relative risk ratio of 1.51 (95% CI 1.21, 1.88). Optimal feeding practices substantially mediated stunting outcomes by further reducing the effects of repeated pregnancy to stunting occurrence and persistence by 19.95% and 18.09% respectively. Mediation tests also showed low birthweight in the causal pathway between repeated pregnancy and stunting. Repeated pregnancy in young mothers is a predictor of stunting among children under 2 years. Secondary pregnancy prevention measures and addressing suboptimal feeding practices are beneficial to mitigate the negative impact of repeated adolescent pregnancy on children.
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Affiliation(s)
- Joemer Calderon Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia.
- Life Course Centre, Australian Research Council Centre of Excellence for Children and Families Over the Life Course, Brisbane, Australia.
- Institute of Nursing, Far Eastern University, Manila, Philippines.
| | - Kim Betts
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
- School of Public Health, Curtin University, Perth, Australia
| | - Linda Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rosa Alati
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
- Life Course Centre, Australian Research Council Centre of Excellence for Children and Families Over the Life Course, Brisbane, Australia
- School of Public Health, Curtin University, Perth, Australia
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Ayano G, Maravilla JC, Alati R. Risk of autistic spectrum disorder in offspring with parental mood disorders: A systematic review and meta-analysis. J Affect Disord 2019; 248:185-197. [PMID: 30739049 DOI: 10.1016/j.jad.2019.01.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 01/18/2019] [Accepted: 01/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The association between mood disorders in parents and autism spectrum disorder (ASD) risk in offspring has been investigated in several studies, but the evidence is inconclusive. This systematic review and meta-analysis will explore whether an association exists between parental mood disorders and ASD risk in offspring. METHODS A literature search was performed using the electronic databases PubMed, EMBASE, PsycINFO, and Scopus. We also reviewed reference lists from retrieved articles. Meta-analysis was conducted, and combined effect values and their 95% confidence intervals were calculated. Study-specific risk ratios (RRs) were pooled using a random effect model. The risk of publication bias was assessed by funnel plot and Egger's regression asymmetry test. RESULTS Nine observational studies (two cohort and seven case-control studies) were included for analysis. Our meta-analysis found a greater risk of ASD in children exposed to parental affective, depressive, and bipolar disorders [(RRs 1.65 (95%CI 1.45-1.88); 1.37 (95%CI 1.04-1.81) and 1.87; 95%CI 1.69-2.07) respectively]. We also found increased ASD risk in children of mothers who experienced affective and depressive disorders [(RRs 1.67 (95%CI 1.34-2.09) and 1.62 (95%CI 1.32-1.99) respectively]. We found no increased risk of ASD in children exposed to paternal affective and depressive disorders. Subgroup and sensitivity analysis confirmed the robustness of our main analysis. CONCLUSION The evidence from the present study suggests parental affective, depressive and bipolar, as well as maternal affective and depressive disorders increased the risk of ASD in offspring. Exposure to affective and depressive disorders in fathers only was not linked with ASD risk in children.
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Affiliation(s)
- Getinet Ayano
- School of Social Sciences, The University of Queensland, 80 Meiers Rd, Indooroopilly, Queensland 4068Australia.
| | - Joemer Calderon Maravilla
- School of Social Sciences, The University of Queensland, 80 Meiers Rd, Indooroopilly, Queensland 4068Australia.
| | - Rosa Alati
- School of Social Sciences, The University of Queensland, 80 Meiers Rd, Indooroopilly, Queensland 4068Australia; School of public Heath, Curtin University, Western Australia, Australia.
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Abstract
BACKGROUND Evidence about the effect of intrauterine exposure to pre-eclampsia on offspring autism-spectrum disorder (ASD) is not well established. Aims To examine the association between pre-eclampsia and ASD. METHOD PubMed, Embase and PsycINFO databases were searched. Pooled relative risks (RR) with 95% confidence intervals were calculated. Subgroup and sensitivity analyses were performed. Heterogeneity was assessed using Cochran's Q- and the I 2-test. The presence of publication bias was evaluated by Egger's test and visual inspection of the symmetry in funnel plots. RESULTS Ten studies meet the inclusion criteria. The risk of ASD was 32% higher in offspring who had intrauterine exposure to pre-eclampsia compared with those not exposed (RR = 1.32, 95% CI 1.20-1.45). Sensitivity analysis revealed consistent pooled estimates ranging from RR = 1.30 (95% CI 1.17-1.44) to RR = 1.37 (95% CI 1.26-1.48). We found no significant heterogeneity and evidence of publication bias. CONCLUSION Pre-eclampsia increased the risk of ASD in offspring. The finding suggests a need for early screening for ASD in offspring of women with pre-eclampsia. Declaration of interest None.
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Affiliation(s)
- Berihun Assefa Dachew
- Institute for Social Science Research and School of Public Health,The University of Queensland,Brisbane,Australia and Department of Epidemiology and Biostatistics,Institute of Public Health,University of Gondar,Ethiopia
| | - Abdullah Mamun
- Institute for Social Science Research and School of Public Health,The University of Queensland,Brisbane,Australia
| | | | - Rosa Alati
- Institute for Social Science Research,The University of Queensland,Brisbane,Australia
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Dachew BA, Mamun A, Maravilla JC, Alati R. Association between hypertensive disorders of pregnancy and the development of offspring mental and behavioural problems: A systematic review and meta-analysis. Psychiatry Res 2018; 260:458-467. [PMID: 29272731 DOI: 10.1016/j.psychres.2017.12.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/06/2017] [Accepted: 12/11/2017] [Indexed: 11/29/2022]
Abstract
Hypertensive disorders of pregnancy are a major cause of maternal and offspring morbidity and mortality worldwide. However, its effect on offspring mental and behavioural disorders is unclear. The aim of this study is to provide the best scientific evidence on the association between hypertensive disorders of pregnancy and offspring mental and behavioural problems. We systematically searched Scopus, PubMed, Cochrane, EMBASE, CINAH and PsycINFO databases. A total of 23 studies (11 included in meta-analysis) were identified. Of the 23 studies included in this review, 15 studies found that hypertensive disorders of pregnancy had a negative impact for at least one mental or behavioural disorder. The pooled effect of 11 studies included in the meta-analysis showed that preeclampsia was associated with increased risk of offspring schizophrenia. However, we found inconclusive finding on the effect of hypertensive disorders of pregnancy and other mental and behavioural disorders. Further high quality, large sample, birth cohort studies are needed to further progress this area of research.
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Affiliation(s)
- Berihun Assefa Dachew
- The University of Queensland, Institute for Social Science Research, Indooroopilly, Qld 4068, Australia; The University of Queensland, School of Public Health, Herston, Qld 4006, Australia; Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Ethiopia.
| | - Abdullah Mamun
- The University of Queensland, Institute for Social Science Research, Indooroopilly, Qld 4068, Australia; The University of Queensland, School of Public Health, Herston, Qld 4006, Australia.
| | - Joemer Calderon Maravilla
- The University of Queensland, Institute for Social Science Research, Indooroopilly, Qld 4068, Australia; The University of Queensland, School of Public Health, Herston, Qld 4006, Australia.
| | - Rosa Alati
- The University of Queensland, Institute for Social Science Research, Indooroopilly, Qld 4068, Australia; The University of Queensland, School of Public Health, Herston, Qld 4006, Australia.
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Abajobir AA, Kisely S, Maravilla JC, Williams G, Najman JM. Gender differences in the association between childhood sexual abuse and risky sexual behaviours: A systematic review and meta-analysis. Child Abuse Negl 2017; 63:249-260. [PMID: 27908449 DOI: 10.1016/j.chiabu.2016.11.023] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 10/09/2016] [Accepted: 11/22/2016] [Indexed: 05/20/2023]
Abstract
This meta-analytic review examines the association between childhood sexual abuse and risky sexual behaviours with sub-group analyses by gender. Systematic searches of electronic databases including MEDLINE, PubMed, EMBASE, and PsycINFO were performed using key terms. We used a priori criteria to include high quality studies and control for heterogeneities across eligible studies. The review was registered with PROSPERO and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The final meta-analysis applied fixed-effects model to generate pooled odds ratio (OR). Subgroup analyses were conducted to identify potential methodological moderators. The meta-analysis included 8 eligible studies (N=38,989, females=53.1%). The overall syndemic of risky sexual behaviors at adulthood was 1.59 times more common in childhood sexual abuse victims. There was a similar association between childhood sexual abuse in general and subsequent risky sexual behaviors in both females and males. However, in cases of substantiated childhood sexual abuse, there was a greater odds of risky sexual behaviors in females (OR=2.72) than males (OR=1.69). The magnitude of association of childhood sexual abuse and risky sexual behaviors was similar for males and females regardless of study time, study quality score and method of childhood sexual abuse measurement. There were nonsignificant overall and subgroup differences between males and females. Childhood sexual abuse is a significant risk factor for a syndemic of risky sexual behaviors and the magnitude is similar both in females and males. More research is needed to explore possible mechanisms of association.
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Affiliation(s)
- Amanuel Alemu Abajobir
- School of Public Health, The University of Queensland, Public Health Building, Herston, 4006, Queensland, Australia.
| | - Steve Kisely
- School of Medicine, University of Queensland, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba 4102, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada
| | - Joemer Calderon Maravilla
- School of Public Health, The University of Queensland, Public Health Building, Herston, 4006, Queensland, Australia
| | - Gail Williams
- School of Public Health, The University of Queensland, Public Health Building, Herston, 4006, Queensland, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston, 4006, Queensland, Australia; School of Social Sciences, The University of Queensland, St Lucia 4072 Queensland, Australia; Queensland Alcohol and Drug Research and Education Centre, The University of Queensland, Herston, 4006, Queensland, Australia
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Maravilla JC, Betts KS, Abajobir AA, Couto E Cruz C, Alati R. The Role of Community Health Workers in Preventing Adolescent Repeat Pregnancies and Births. J Adolesc Health 2016; 59:378-90. [PMID: 27474526 DOI: 10.1016/j.jadohealth.2016.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 04/14/2016] [Accepted: 05/13/2016] [Indexed: 11/28/2022]
Abstract
Intervention by community health workers (CHWs) is believed to prevent repeated childbearing among teenagers. This review investigated the effectiveness of CHWs in reducing repeated pregnancies and births among adolescents aged <20 years, 2 years after the delivery of their first child. Through electronic database and hand searching, experimental and/or observational studies were screened with their results undergoing systematic review and meta-analyses. Subgroup analyses were performed to further assess how study characteristics affected the pooled estimates and heterogeneity. A total of 11 eligible articles, from January 1980 to May 2015, were included. Seven studies evaluated repeated births and eight measured repeated pregnancies. Studies showed relevant disparities in terms of selected methodological aspects and program characteristics. Although most studies (n = 9) were either of "strong" or of "moderate" quality, only two of five finding a significant reduction exhibited a high level of quality as the other three failed to adjust results for confounders. Random effects modeling revealed an overall 30% decrease in repeated adolescent births (odds ratio = .70, confidence interval = .49-.99) among CHW-visited areas relative to nonvisited sites. On the other hand, no significant association was detected in terms of repeated pregnancies (odds ratio = .96, confidence interval = .70-1.28).
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Affiliation(s)
| | - Kim S Betts
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Camila Couto E Cruz
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Rosa Alati
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia; Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Queensland, Australia
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Abajobir AA, Maravilla JC, Alati R, Najman JM. A systematic review and meta-analysis of the association between unintended pregnancy and perinatal depression. J Affect Disord 2016; 192:56-63. [PMID: 26707348 DOI: 10.1016/j.jad.2015.12.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/03/2015] [Accepted: 12/10/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is a growing interest in exploring maternal mental health effects of unintended pregnancies carried to term. However, the evidence base from a small number of available studies is characterised by considerable variability, inconsistency and inconclusive findings. We present a systematic review and meta-analysis of all available studies on unintended pregnancy as these are related to maternal depression. METHODS Using PRISMA guideline, we systematically reviewed and meta-analysed studies reporting an association between unintended pregnancy and maternal depression from PubMed, EMBASE, PsychINFO and Google Scholar. We used a priori set criteria and included details of quality and magnitude of effect sizes. Sample sizes, adjusted odds ratios and standard errors were extracted. Random effects were used to calculate pooled estimates in Stata 13. Cochran's Q, I(2) and meta-bias statistics assessed heterogeneity and publication bias of included studies. RESULTS Meta-bias and funnel plot of inverse variance detected no publication bias. Overall prevalence of maternal depression in unintended pregnancy was 21%. Unintended pregnancy was significantly associated with maternal depression. Despite statistically significant heterogeneities of included studies, sub-group analyses revealed positive and significant associations by types of unintended pregnancies, timing of measurements with respect to pregnancy and childbirth, study designs and settings. CONCLUSIONS The prevalence of perinatal depression is two-fold in women with unintended pregnancy. Perinatal care settings may screen pregnancy intention and depression of women backed by integrating family planning and mental health services.
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Affiliation(s)
| | | | - Rosa Alati
- School of Public Health, The University of Queensland, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, Australia
| | - Jackob Moses Najman
- School of Public Health, The University of Queensland, Australia; School of Social Sciences, The University of Queensland, Australia
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