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Airikka A, Lahti-Pulkkinen M, Tuovinen S, Heinonen K, Lahti J, Girchenko P, Lähdepuro A, Pyhälä R, Czamara D, Villa P, Laivuori H, Kajantie E, Binder EB, Räikkönen K. Maternal exposure to childhood maltreatment and mental and behavioral disorders in children. Eur Child Adolesc Psychiatry 2023; 32:2463-2475. [PMID: 36181574 PMCID: PMC10682113 DOI: 10.1007/s00787-022-02090-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022]
Abstract
Exposure to maltreatment in childhood is associated with lifelong risk of mental and behavioral disorders. Whether the effects extend to the next generation remains unclear. We examined whether maternal exposure to childhood abuse and neglect in her own childhood were associated with mental and behavioral disorders and psychiatric symptoms in her children, and whether maternal lifetime mental and behavioral disorders or lower education level mediated or added to the effects. Mothers (n = 2252) of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort study completed the Childhood Trauma Questionnaire and reported on their education and their 7.0-12.1-year-old children's psychiatric symptoms using the Strengths and Difficulties Questionnaire. We identified lifetime mental and behavioral disorder diagnoses for the mothers and diagnoses for their children from birth (2006-2010) until 8.4-12.8 years (12/31/2018) from Care Register for Health Care. We found that maternal exposure to childhood abuse, but not neglect, was associated with higher hazards of mental and behavioral disorders (hazard ratio 1.20, 95% confidence interval 1.06-1.37) in children. These associations were partially mediated by maternal mental and behavioral disorders and education (proportion of effect size mediated: 23.8% and 15.1%, respectively), which together with maternal exposure to childhood abuse added to the hazard of mental and behavioral disorders in children. Similar associations were found for maternal exposure to childhood abuse and neglect with psychiatric symptoms in children. To conclude, maternal exposure to childhood maltreatment is associated with mental and behavioral disorders and psychiatric symptoms in children. Our findings call for interventions to prevent intergenerational transmission.
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Affiliation(s)
- Aino Airikka
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland.
- The Finnish Institute for Health and Welfare, Helsinki, Finland.
- University of Edinburgh, Edinburgh, UK.
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Anna Lähdepuro
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Pia Villa
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Center for Child, Adolescent and Maternal Health Research, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eero Kajantie
- The Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014, Helsinki, Finland
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2
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Pham C, Desmarais E, Jones V, French BF, Wang Z, Putnam S, Casalin S, Linhares MBM, Lecannelier F, Tuovinen S, Heinonen K, Raikkonen K, Montirosso R, Giusti L, Park SY, Han SY, Lee EG, Huitron B, de Weerth C, Beijers R, Majdandžić M, Gonzalez-Salinas C, Acar I, Slobodskaya H, Kozlova E, Ahmetoglu E, Benga O, Gartstein MA. Relations between bedtime parenting behaviors and temperament across 14 cultures. Front Psychol 2022; 13:1004082. [PMID: 36507001 PMCID: PMC9731114 DOI: 10.3389/fpsyg.2022.1004082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives The present study examined parental sleep-supporting practices during toddlerhood in relation to temperament across 14 cultures. We hypothesized that passive sleep-supporting techniques (e.g., talking, cuddling), but not active techniques (e.g., walking, doing an activity together), would be associated with less challenging temperament profiles: higher Surgency (SUR) and Effortful Control (EC) and lower Negative Emotionality (NE), with fine-grained dimensions exhibiting relationships consistent with their overarching factors (e.g., parallel passive sleep-supporting approach effects for dimensions of NE). Methods Caregivers (N = 841) across 14 cultures (M = 61 families per site) reported toddler (between 17 and 40 months of age; 52% male) temperament and sleep-supporting activities. Utilizing linear multilevel regression models and group-mean centering procedures, we assessed the role of between- and within-cultural variance in sleep-supporting practices in relation to temperament. Results Both within-and between-culture differences in passive sleep-supporting techniques were associated with temperament attributes, (e.g., lower NE at the between-culture level; higher within-culture EC). For active techniques only within-culture effects were significant (e.g., demonstrating a positive association with NE). Adding sleep-supporting behaviors to the regression models accounted for significantly more between-culture temperament variance than child age and gender alone. Conclusion Hypotheses were largely supported. Findings suggest parental sleep practices could be potential targets for interventions to mitigate risk posed by challenging temperament profiles (e.g., reducing active techniques that are associated with greater distress proneness and NE).
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Affiliation(s)
- Christie Pham
- Department of Psychology, Washington State University, Pullman, WA, United States,*Correspondence: Christie Pham,
| | - Eric Desmarais
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Victoria Jones
- Department of Psychology, Washington State University, Pullman, WA, United States
| | - Brian F. French
- College of Education, Washington State University, Pullman, WA, United States
| | - Zhengyan Wang
- College of Psychology, Capital Normal University, Beijing, China
| | | | - Sara Casalin
- Department of Psychology, University of Leuven, Leuven, Belgium
| | | | | | - Soile Tuovinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Department of Social Sciences, University of Tampere, Tampere, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Department of Social Sciences, University of Tampere, Tampere, Finland
| | - Katri Raikkonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Lorenzo Giusti
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Seong-Yeon Park
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea
| | - Sae-Young Han
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea
| | - Eun Gyoung Lee
- Department of Child Development, Ewha Woman’s University, Seoul, South Korea,Ewha Social Science Research Institute, Seoul, South Korea
| | - Blanca Huitron
- Department of Psychology, National Autonomous University of Mexico, México City, Mexico
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roseriet Beijers
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands,Department of Developmental Psychology, Radboud University, Nijmegen, Netherlands
| | - Mirjana Majdandžić
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | | | - Ibrahim Acar
- Department of Psychology, Özyeğin University, Istanbul, Turkey
| | - Helena Slobodskaya
- Research Institute of Neuroscience and Medicine, Novosibirsk State University, Novosibirsk, Russia
| | - Elena Kozlova
- Research Institute of Neuroscience and Medicine, Novosibirsk State University, Novosibirsk, Russia
| | - Emine Ahmetoglu
- Department of Early Childhood Education, Trakya University in Edirne, Edirne, Turkey
| | - Oana Benga
- Department of Psychology, Babes Bolyai University, Cluj-Napoca, Romania
| | - Maria A. Gartstein
- Department of Psychology, Washington State University, Pullman, WA, United States
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3
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Lähdepuro A, Lahti-Pulkkinen M, Pyhälä R, Tuovinen S, Lahti J, Heinonen K, Laivuori H, Villa PM, Reynolds RM, Kajantie E, Girchenko P, Räikkönen K. Positive maternal mental health during pregnancy and mental and behavioral disorders in children: A prospective pregnancy cohort study. J Child Psychol Psychiatry 2022; 64:807-816. [PMID: 35524467 DOI: 10.1111/jcpp.13625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Accepted: 04/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health. METHODS Among 3,378 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children's mental and behavioral disorder diagnoses as well, from birth until 8.4-12.8 (Median = 10.2, Interquartile Range 9.7-10.8) years of age. RESULTS A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 - 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 - 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55-0.86]. These associations were independent of covariates. CONCLUSIONS Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.
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Affiliation(s)
- Anna Lähdepuro
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Hannele Laivuori
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pia M Villa
- Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.,Hyvinkää Hospital, Helsinki and Uusimaa Hospital District, Helsinki, Finland
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Polina Girchenko
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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4
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Tuovinen S, Räikkönen K, Holmlund-Suila E, Hauta-alus H, Helve O, Rosendahl J, Enlund-Cerullo M, Kajantie E, Valkama S, Viljakainen H, Mäkitie O, Andersson S, Heinonen K. Effect of High-Dose vs Standard-Dose Vitamin D Supplementation on Neurodevelopment of Healthy Term Infants: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2124493. [PMID: 34495336 PMCID: PMC8427371 DOI: 10.1001/jamanetworkopen.2021.24493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 01/04/2023] Open
Abstract
Importance Vitamin D may be important for neurodevelopment. The optimal daily dose of vitamin D for early brain development is not known. Objectives To test whether a higher (1200 IU) vs standard (400 IU) dose of vitamin D3 has beneficial effects on neurodevelopment in the first 2 years of life and whether serum 25-hydroxyvitamin D concentration is associated with neurodevelopment. Design, Setting, and Participants This double-blind, interventional randomized clinical trial involved healthy infants born full-term between January 1, 2013, and June 30, 2014, at a maternity hospital in Helsinki, Finland, at the 60th northern latitude. Two-year follow-up was conducted by May 30, 2016. Data analysis was by the intention-to-treat principle. Data were analyzed from November 1, 2020, to May 31, 2021. Interventions Randomization of 404 infants to receive 400 IU of oral vitamin D3 supplementation daily and 397 infants to receive 1200 IU of oral vitamin D3 supplementation daily from 2 weeks to 24 months of age. Main Outcomes and Measures Primary outcomes were child total developmental milestone scores at 12 and 24 months of age measured using the Ages and Stages Questionnaire (total score is calculated as a mean of the 5 subscale scores: total score range, 0-60, where 0 indicates delay in all developmental domains and 60 indicates that the child can master all age-specific skills) as well as externalizing, internalizing, and dysregulation problems and competencies scores at 24 months measured using the Infant-Toddler Social and Emotional Assessment (range 0-2, where 0 indicates no problems or no competencies and 2 indicates a high level of problems or a high level of competencies; variables were standardized to the mean [SD] of 0 [1]). Secondary outcomes were specific skills, problems, and competencies derived from these questionnaires. Results Of the 987 families recruited, 495 children were randomly assigned to receive 400 IU of vitamin D3, and 492 children were randomly assigned to receive 1200 IU of vitamin D3. A total of 801 families participated in the follow-up at 12 and/or 24 months, with 404 children (207 girls [51.2%]) in the 400-IU group and 397 children (198 girls [49.9%]) in the 1200-IU group. All children were of Northern European ethnicity. No differences were found between the 400-IU group and the 1200-IU group in the mean (SD) adjusted Ages and Stages Questionnaire total score at 12 months (45.0 [7.1] vs 46.2 [7.9]; mean difference [MD], 1.17 [95% CI, -0.06 to 2.38]) or 24 months (50.9 [5.3] vs 51.5 [5.5]; MD, 0.48 [95% CI, -0.40 to 1.36]). No differences were found between the 400-IU group and the 1200-IU group at 24 months in the mean (SD) adjusted Infant-Toddler Social and Emotional Assessment externalizing domain score (-0.07 [1.00] vs 0.07 [0.98]; MD, 0.15 [95% CI, -0.01 to 0.31]), internalizing domain score (0.04 [1.06] vs -0.02 [0.98]; MD, -0.07 [95% CI, -0.24 to 0.1.0]), dysregulation domain score (-0.00 [1.04] vs 0.02 [0.96]; MD, 0.02 [95% CI, -0.14 to 0.18]), or competencies score (-0.02 [1.02] vs 0.01 [1.02]; MD, 0.03 [95% CI, -0.13 to 0.20]). The 1200-IU group did have a higher risk in the adjusted model of scoring 1.5 SDs or more on the externalizing domain score (odds ratio, 2.33 [95% CI, 1.19-4.56]; P = .01). Levels of serum 25-hydroxyvitamin D were not associated with the primary outcomes. Conclusions and Relevance Higher-than-standard vitamin D3 doses provide no systematic benefits for child neurodevelopment up to 2 years of age. However, the potential disadvantageous effects of higher doses could not be fully excluded; even if minimal, the potential nonbeneficial effects of higher-than-standard doses warrant further studies in which both safety and benefits should be evaluated. Trial Registration ClinicalTrials.gov Identifier: NCT01723852.
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Affiliation(s)
- Soile Tuovinen
- Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elisa Holmlund-Suila
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Helena Hauta-alus
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology, and Ophthalmology, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Otto Helve
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Rosendahl
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eero Kajantie
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology, and Ophthalmology, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Saara Valkama
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | | | - Outi Mäkitie
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Sture Andersson
- Children’s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Kati Heinonen
- Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Desmarais EE, French BF, Ahmetoglu E, Acar I, Gonzalez-Salinas C, Kozlova E, Slobodskaya H, Benga O, Majdandžić M, Beijers R, de Weerth C, Huitron B, Lee EG, Han SY, Park SY, Giusti L, Montirosso R, Tuovinen S, Heinonen K, Raikkonen K, Wang Z, Lecannelier F, Linhares MBM, Casalin S, Putnam SP, Gartstein MA. Cultural contributors to negative emotionality: A multilevel analysis from the Joint Effort Toddler Temperament Consortium. International Journal of Behavioral Development 2021. [DOI: 10.1177/01650254211020128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study advances the cross-cultural temperament literature by comparing temperament ratings of toddlers from 14 nations. Multilevel modeling (MLM) procedures were utilized to regress negative emotionality (NE) and component subscales on Hofstede’s cultural value dimensions while controlling for age and gender. More individualistic values were associated with lower NE, and component discomfort, fear, motor activity, perceptual sensitivity, and soothability scales. The discomfort subscale was negatively associated with power distance and positively associated with masculine cultural values. Higher ratings of shyness were related to a more long-term cultural orientation. Results illustrate the feasibility of an MLM approach to cross-cultural research and provide a new perspective on the intersection of culture and temperament development. Limitations and future implications are discussed.
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Affiliation(s)
| | | | | | | | | | - Elena Kozlova
- Research Institute of Physiology and Basic Medicine, Novosibirsk State University, Russia
| | - Helena Slobodskaya
- Research Institute of Physiology and Basic Medicine, Novosibirsk State University, Russia
| | | | | | - Roseriet Beijers
- Radboud University the Netherlands
- Radboud University Medical Center, the Netherlands
| | | | | | - Eun Gyoung Lee
- Ewha Social Science Research Institute, Ewha Womans University, South Korea
| | | | | | - Lorenzo Giusti
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Italy
| | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Italy
| | - Soile Tuovinen
- University of Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences; Tampere University; Finland
| | - Kati Heinonen
- University of Helsinki, Finland
- Welfare Sciences, Faculty of Social Sciences; Tampere University; Finland
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6
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Robinson R, Lähdepuro A, Tuovinen S, Girchenko P, Rantalainen V, Heinonen K, Lahti J, Räikkönen K, Lahti-Pulkkinen M. Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review. Curr Hypertens Rep 2021; 23:30. [PMID: 33982182 PMCID: PMC8116290 DOI: 10.1007/s11906-021-01141-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 12/19/2022]
Abstract
Purpose of Review We review here recent original research and meta-analytic evidence on the associations of maternal hypertensive pregnancy disorders and mental and behavioral disorders in the offspring. Recent Findings Seven meta-analyses and 11 of 16 original research studies published since 2015 showed significant associations between maternal hypertensive pregnancy disorders and offspring mental and behavioral disorders. Evidence was most consistent in meta-analyses and high-quality cohort studies. The associations, independent of familial confounding, were observed on different mental and behavioral disorders in childhood and schizophrenia in adulthood. Preterm birth and small-for-gestational age birth emerged as possible moderators and mediators of the associations. Cross-sectional and case-control studies yielded inconsistent findings, but had lower methodological quality. Summary Accumulating evidence from methodologically sound studies shows that maternal hypertensive pregnancy disorders are associated with an increased risk of mental and behavioral disorders in the offspring in childhood. More studies on adult mental disorders are needed. Supplementary Information The online version contains supplementary material available at 10.1007/s11906-021-01141-w.
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Affiliation(s)
- Rachel Robinson
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Anna Lähdepuro
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Ville Rantalainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland. .,National Institute for Health and Welfare, Helsinki, Finland. .,Queens Medical Research Unit, University of Edinburgh, Edinburgh, UK.
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7
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Desmarais E, Brown K, Campbell K, French BF, Putnam SP, Casalin S, Linhares MBM, Lecannelier F, Wang Z, Raikkonen K, Heinonen K, Tuovinen S, Montirosso R, Provenzi L, Park SY, Han SY, Lee EG, Huitron B, de Weerth C, Beijers R, Majdandžić M, Benga O, Slobodskaya H, Kozlova E, Gonzalez-Salinas C, Acar I, Ahmetoglu E, Gartstein MA. Links between television exposure and toddler dysregulation: Does culture matter? Infant Behav Dev 2021; 63:101557. [PMID: 33878597 DOI: 10.1016/j.infbeh.2021.101557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 01/19/2021] [Accepted: 03/20/2021] [Indexed: 10/21/2022]
Abstract
Television exposure in early childhood has increased, with concerns raised regarding adverse effects on social-emotional development, and emerging self-regulation in particular. The present study addressed television exposure (i.e., amount of time watching TV) and its associations with toddler behavioral/emotional dysregulation, examining potential differences across 14 cultures. The sample consisted of an average of 60 toddlers from each of the 14 countries from the Joint Effort Toddler Temperament Consortium (JETTC; Gartstein & Putnam, 2018). Analyses were conducted relying on the multi-level modeling framework (MLM), accounting for between- and within-culture variability, and examining the extent to which TV exposure contributions were universal vs. variable across sites. Effects of time watching TV were evaluated in relation to temperament reactivity and regulation, as well as measures of emotional reactivity, attention difficulties, and aggression. Results indicated that more time spent watching TV was associated with higher ratings on Negative Emotionality, emotional reactivity, aggression, and attention problems, as well as lower levels of soothability. However, links between TV exposure and both attention problems and soothability varied significantly between cultures. Taken together, results demonstrate that increased time spent watching television was generally associated with dysregulation, although effects were not consistently uniform, but rather varied as a function of culturally-dependent contextual factors.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Kati Heinonen
- University of Helsinki, Finland; Tampere University, Finland
| | | | | | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | | | | | - Eun Gyoung Lee
- Ewha Social Science Research Institute, Ewha Womans University, Republic of Korea
| | | | | | - Roseriet Beijers
- Radboud University and Radboud University Medical Center, the Netherlands
| | | | | | - Helena Slobodskaya
- Research Institute of Physiology and Basic Medicine, Novosibirsk State University, Russia
| | - Elena Kozlova
- Research Institute of Physiology and Basic Medicine, Novosibirsk State University, Russia
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8
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Tuovinen S, Lahti-Pulkkinen M, Girchenko P, Heinonen K, Lahti J, Reynolds RM, Hämäläinen E, Villa PM, Kajantie E, Laivuori H, Raikkonen K. Maternal antenatal stress and mental and behavioral disorders in their children. J Affect Disord 2021; 278:57-65. [PMID: 32950844 DOI: 10.1016/j.jad.2020.09.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Maternal antenatal stress, including symptoms of depression, anxiety and perceived stress, is associated with mental and behavioral problems in children. Whether it is associated with child mental and behavioral disorders remains uncertain. We examined if maternal antenatal symptoms of depression, anxiety and perceived stress were associated with mental and behavioral disorders in their children, if the associations varied according to gestational week, stress type, fluctuating or consistently high symptoms, and if they were driven by maternal or paternal lifetime mood or anxiety disorders. METHODS 3365 mothers participating in the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study completed the Center for Epidemiologic Studies Depression Scale, the State Anxiety Inventory and the Perceived Stress Scale up to 14 times throughout pregnancy. The Care Register for Health Care provided data on mental and behavioral (including neurodevelopmental) disorders for their children from birth (11/07/2006-07/24/2010) until 12/31/2016 and for parental lifetime mood and anxiety disorders until 12/31/2016. RESULTS The hazard of any childhood mental and behavioral disorder (HR=1.91, 95% CI: 1.39-2.51) was significantly higher for children whose mothers reported consistently high in comparison to consistently low levels of all types of stress throughout pregnancy. The associations remained significant when adjusted for maternal and paternal lifetime mood and anxiety disorders (and their comorbidity and timing and mood disorder type). CONCLUSION Maternal antenatal stress is associated with higher risk of childhood mental and behavioral disorders. Efforts to reduce maternal antenatal stress should be given a high priority to improve child mental health.
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Affiliation(s)
- Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pia M Villa
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Katri Raikkonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
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9
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Lahti-Pulkkinen M, Girchenko P, Tuovinen S, Sammallahti S, Reynolds RM, Lahti J, Heinonen K, Lipsanen J, Hämäläinen E, Villa PM, Kajantie E, Laivuori H, Räikkönen K. Maternal Hypertensive Pregnancy Disorders and Mental Disorders in Children. Hypertension 2020; 75:1429-1438. [DOI: 10.1161/hypertensionaha.119.14140] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The associations of maternal hypertensive pregnancy disorders with offspring mental disorders remain unclear. We examined whether maternal hypertensive disorders and maximum blood pressure during pregnancy predict offspring childhood mental disorders, whether the associations are independent of maternal and paternal mental disorders and paternal hypertensive disorders, independent of or additive with maternal early pregnancy overweight/obesity and diabetes mellitus disorders, and mediated or moderated by preterm birth, small-for-gestational-age birth and neonatal intensive care unit admission. Our prospective study comprised 4743 mother-child dyads of Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. Women were recruited to the study in early pregnancy at Finnish maternity hospitals. Children were born 2006 to 2010 and followed-up until December 31, 2016, to ages 6.4 to 10.8 years. Hypertensive pregnancy disorders were identified from medical records, Medical Birth Register, and Care Register for Health Care. Systolic and diastolic blood pressure were measured at antenatal clinics and hospital visits. Mental disorder diagnoses were identified from Care Register for Health Care. Maternal gestational and chronic hypertension, preeclampsia and its severity increased offspring hazard of any childhood mental disorder. The associations of preeclampsia (hazard ratio=1.66 [95% CI, 1.14–2.42]) and severe preeclampsia (hazard ratio=2.01 [95% CI, 1.08–3.73]) were independent of all covariates. Maternal hypertensive and diabetes mellitus disorders and overweight/obesity also additively increased offspring hazard of mental disorders. Preterm and small-for-gestational-age births and neonatal intensive care unit admission partially mediated the effects of any and severe preeclampsia on offspring mental disorders. To conclude, maternal hypertensive pregnancy disorders carry adverse consequences for offspring mental health.
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Affiliation(s)
- Marius Lahti-Pulkkinen
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
- National Institute for Health and Welfare, Helsinki, Finland (M.L.-P., S.S., E.K.)
- University of Edinburgh, United Kingdom (M.L.-P., R.M.R.)
| | - Polina Girchenko
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
| | - Soile Tuovinen
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
| | - Sara Sammallahti
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
- National Institute for Health and Welfare, Helsinki, Finland (M.L.-P., S.S., E.K.)
- Erasmus Medical Center, Rotterdam, the Netherlands (S.S.)
| | | | - Jari Lahti
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
- University of Turku, Finland (J. Lahti)
| | - Kati Heinonen
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
| | - Jari Lipsanen
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
| | - Esa Hämäläinen
- University of Helsinki and Helsinki University Hospital, Finland (E.H., P.M.V., E.K., H.L.)
| | - Pia M. Villa
- University of Helsinki and Helsinki University Hospital, Finland (E.H., P.M.V., E.K., H.L.)
- Hyvinkää Hospital, Finland (P.M.V.)
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland (M.L.-P., S.S., E.K.)
- University of Helsinki and Helsinki University Hospital, Finland (E.H., P.M.V., E.K., H.L.)
- Oulu University Hospital and University of Oulu, Finland (E.K.)
- Norwegian University for Science and Technology, Trondheim, Norway (E.K.)
| | - Hannele Laivuori
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
- University of Helsinki and Helsinki University Hospital, Finland (E.H., P.M.V., E.K., H.L.)
- University of Tampere, Finland (H.L.)
| | - Katri Räikkönen
- From the Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Finland (M.L.-P., P.G., S.T., S.S., J. Lahti, K.H., J. Lipsanen, H.L., K.R.)
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10
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Wolford E, Lahti-Pulkkinen M, Girchenko P, Lipsanen J, Tuovinen S, Lahti J, Heinonen K, Hämäläinen E, Kajantie E, Pesonen AK, Villa PM, Laivuori H, Reynolds RM, Räikkönen K. Associations of antenatal glucocorticoid exposure with mental health in children. Psychol Med 2020; 50:247-257. [PMID: 30688183 DOI: 10.1017/s0033291718004129] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Synthetic glucocorticoids, to enhance fetal maturation, are a standard treatment when preterm birth before 34 gestational weeks is imminent. While morbidity- and mortality-related benefits may outweigh potential neurodevelopmental harms in children born preterm (<37 gestational weeks), this may not hold true when pregnancy continues to term (⩾37 gestational weeks). We studied the association of antenatal betamethasone exposure on child mental health in preterm and term children. METHODS We included 4708 women and their children, born 2006-2010, from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction Study with information on both antenatal betamethasone treatment and child mental and behavioral disorders from the Finnish Hospital Discharge Register from the child's birth to 31 December 2016. Additional follow-up data on mother-reported psychiatric problems and developmental milestones were available for 2640 children at 3.5 (s.d. = 0.07) years-of-age. RESULTS Of the children, 187 were born preterm (61 betamethasone-exposed) and 4521 at term (56 betamethasone-exposed). The prevalence of any mental and behavioral, psychological development, emotional and behavioral, and comorbid disorders was higher in the betamethasone-exposed, compared to non-exposed children [odds ratio 2.76 (95% confidence interval 1.76-4.32), 3.61 (2.19-5.95), 3.29 (1.86-5.82), and 6.04 (3.25-11.27), respectively]. Levels of psychiatric problems and prevalence of failure to meet the age-appropriate development in personal-social skills were also higher in mother-reports of betamethasone-exposed children. These associations did not vary significantly between preterm and term children. CONCLUSIONS Antenatal betamethasone exposure may be associated with mental health problems in children born preterm and in those who end up being born at term.
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Affiliation(s)
- Elina Wolford
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pia M Villa
- Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hannele Laivuori
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Rebecca M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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11
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Lähdepuro A, Savolainen K, Lahti-Pulkkinen M, Eriksson JG, Lahti J, Tuovinen S, Kajantie E, Pesonen AK, Heinonen K, Räikkönen K. The Impact of Early Life Stress on Anxiety Symptoms in Late Adulthood. Sci Rep 2019; 9:4395. [PMID: 30867476 PMCID: PMC6416302 DOI: 10.1038/s41598-019-40698-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 02/21/2019] [Indexed: 11/30/2022] Open
Abstract
Early life stress (ELS) may increase the risk of anxiety throughout the life course. Whether this effect extends to late adulthood is poorly known. In our study comprising 1872 participants from the Helsinki Birth Cohort Study born in 1934–1944, we investigated the association of various forms of ELS and their accumulation with self-reported anxiety symptoms at the age of 65–77 years. Data on childhood socioeconomic status and separation from parents were based on national registers for all participants. Information on self-reported emotional and physical trauma, parental divorce, and death of a family member in childhood was obtained from 1277 participants. We found that experiencing emotional trauma, physical trauma, and low socioeconomic status in childhood were associated with increased anxiety symptoms in late adulthood [B = 0.44 (95% CI = 0.31–0.58); B = 0.33 (95% CI = 0.20–0.46); B = 0.10 (95% CI = 0.01–0.19), respectively]. These associations remained significant even after controlling for other forms of ELS. Accumulation of early life stress also increased the levels of late-adulthood anxiety symptoms and the risk of anxiety regarded as clinically significant. Screening for potentially stressful childhood experiences in elderly populations may help identifying individuals with increased anxiety symptoms and planning preventive and therapeutic interventions for those exposed to ELS.
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Affiliation(s)
- Anna Lähdepuro
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Katri Savolainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.,Chronic Disease Prevention Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Chronic Disease Prevention Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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12
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Girchenko P, Lahti M, Tuovinen S, Savolainen K, Lahti J, Binder EB, Reynolds RM, Entringer S, Buss C, Wadhwa PD, Hämäläinen E, Kajantie E, Pesonen AK, Villa PM, Laivuori H, Räikkönen K. Cohort Profile: Prediction and prevention of preeclampsia and intrauterine growth restriction (PREDO) study. Int J Epidemiol 2019; 46:1380-1381g. [PMID: 27639277 DOI: 10.1093/ije/dyw154] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Marius Lahti
- Institute of Behavioral Sciences.,Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | | | - Jari Lahti
- Institute of Behavioral Sciences.,Helsinki Collegium of Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Sonja Entringer
- Institut für Medizinische Psychologie Charité Centrum für Human- und Gesundheitswissenschaften Charité Universitätsmedizin, Berlin, Germany
| | - Claudia Buss
- Institut für Medizinische Psychologie Charité Centrum für Human- und Gesundheitswissenschaften Charité Universitätsmedizin, Berlin, Germany
| | - Pathik D Wadhwa
- University of California Irvine, School of Medicine, Irvine, CA, USA
| | - Esa Hämäläinen
- HUSLAB and Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki and Oulu, Finland.,Children's Hospital
| | | | - Pia M Villa
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics and Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
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13
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Toffol E, Rantalainen V, Lahti-Pulkkinen M, Girchenko P, Lahti J, Tuovinen S, Lipsanen J, Villa PM, Laivuori H, Hämäläinen E, Kajantie E, Pesonen AK, Räikkönen K. Infant regulatory behavior problems during first month of life and neurobehavioral outcomes in early childhood. Eur Child Adolesc Psychiatry 2019; 28:847-859. [PMID: 30392118 PMCID: PMC6555774 DOI: 10.1007/s00787-018-1243-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/20/2018] [Indexed: 12/31/2022]
Abstract
Whether infant regulatory behavior problems already in the first month of life indicate an increased risk of childhood neurobehavioral problems, and whether maternal depression in the postpartum and early childhood underpins these associations remain unclear. Altogether, 2049-2364 mothers from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study completed the Neonatal Perception Inventory on regulatory behavior problems at the infant's age of 15.6 days (SD 3.2, range 1-30), the Infant Behavior Questionnaire-Revised on temperament at 6.5 months (SD 0.9, range 4.2-12.4), and the Ages and Stages Questionnaire-3 on developmental milestones and the Child Behavior Checklist on behavioral problems at 3.5 years (SD 0.7, range 1.9-6.0). Maternal depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (infancy follow-ups) and Beck Depression Inventory-II (childhood follow-up). Father-rated infant temperament and paternal depressive symptoms were also available (n = 1474). Higher levels of infant regulatory behavior problems predicted higher levels of mother- and father-rated negative affectivity temperament (0.13 SD units per SD unit, 95% confidence interval 0.09-0.17; and 0.09, 0.04-0.14, respectively), lower levels of mother-rated orienting/regulation temperament (- 0.09, - 0.13 to - 0.05) and problem-solving skills (- 0.12, - 0.21 to - 0.04), and higher levels of Externalizing (0.07, 0.03-0.11) and Total behavioral problems (0.07, 0.03-0.11). Regulatory behaviors partially mediated the effect of maternal depressive symptoms. Regulatory behavior problems already during the first month of life predict neurobehavioral outcomes, and partially mediate the effect of maternal depressive symptoms. Our study may inform design of interventions aimed at timely prevention in children at risk.
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Affiliation(s)
- Elena Toffol
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland ,National Institute for Health and Welfare, Helsinki, Finland
| | - Ville Rantalainen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014, Helsinki, Finland. .,National Institute for Health and Welfare, Helsinki, Finland. .,University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
| | - Polina Girchenko
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland ,Helsinki Collegium for Advance Studies, University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
| | - Pia M. Villa
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ,Institute for Molecular Medicine Finland/Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland ,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland ,Department of Obstetrics and Gynaecology, Tampere University Hospital, Tampere, Finland
| | - Esa Hämäläinen
- HUSLAB and Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland ,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland ,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014 Helsinki, Finland
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14
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Kumpulainen SM, Girchenko P, Lahti-Pulkkinen M, Reynolds RM, Tuovinen S, Pesonen AK, Heinonen K, Kajantie E, Villa PM, Hämäläinen E, Laivuori H, Räikkönen K. Maternal early pregnancy obesity and depressive symptoms during and after pregnancy. Psychol Med 2018; 48:2353-2363. [PMID: 29338797 DOI: 10.1017/s0033291717003889] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous studies have linked maternal obesity with depressive symptoms during and after pregnancy. It remains unknown whether obesity associates with consistently elevated depressive symptoms throughout pregnancy, predicts symptoms postpartum when accounting for antenatal symptoms, and if co-morbid hypertensive and diabetic disorders add to these associations. We addressed these questions in a sample of Finnish women whom we followed during and after pregnancy. METHODS Early pregnancy body mass index, derived from the Finnish Medical Birth Register and hospital records in 3234 PREDO study participants, was categorized into underweight (<18.5 kg/m2), normal weight (18.5-24.99 kg/m2), overweight (25-29.99 kg/m2), and obese (⩾30 kg/m2) groups. The women completed the Center for Epidemiological Studies Depression Scale biweekly during pregnancy, and at 2.4 (s.d. = 1.2) and/or 28.2 (s.d. = 4.2) weeks after pregnancy. RESULTS In comparison to normal weight women, overweight, and obese women reported higher levels of depressive symptoms and had higher odds of clinically significant depressive symptoms during (23% and 43%, respectively) and after pregnancy (22% and 36%, respectively). Underweight women had 68% higher odds of clinically significant depressive symptoms after pregnancy. Overweight and obesity also predicted higher depressive symptoms after pregnancy in women not reporting clinically relevant symptomatology during pregnancy. Hypertensive and diabetic disorders did not explain or add to these associations. CONCLUSIONS Maternal early pregnancy overweight and obesity and depressive symptoms during and after pregnancy are associated. Mental health promotion should be included as an integral part of lifestyle interventions in early pregnancy obesity and extended to benefit also overweight and underweight women.
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Affiliation(s)
- Satu M Kumpulainen
- Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland
| | | | - Rebecca M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh,Edinburgh,UK
| | - Soile Tuovinen
- Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland
| | | | - Kati Heinonen
- Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland
| | - Eero Kajantie
- Department of Chronic Disease Prevention,National Institute for Health and Welfare,Helsinki and Oulu,Finland
| | - Pia M Villa
- Obstetrics and Gynaecology, University of Helsinki, and Helsinki University Hospital,Helsinki,Finland
| | - Esa Hämäläinen
- HUSLAB, University of Helsinki and Helsinki University Hospital,Helsinki,Finland
| | - Hannele Laivuori
- Obstetrics and Gynaecology, University of Helsinki, and Helsinki University Hospital,Helsinki,Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics,University of Helsinki,Helsinki,Finland
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15
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Tuovinen S, Lahti-Pulkkinen M, Girchenko P, Lipsanen J, Lahti J, Heinonen K, Reynolds RM, Hämäläinen E, Kajantie E, Laivuori H, Pesonen AK, Villa PM, Räikkönen K. Maternal depressive symptoms during and after pregnancy and child developmental milestones. Depress Anxiety 2018; 35:732-741. [PMID: 29667739 DOI: 10.1002/da.22756] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [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: 09/06/2017] [Revised: 01/24/2018] [Accepted: 03/08/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Maternal depressive symptoms during and after pregnancy predict poorer child neurodevelopment. The effects of timing, symptom severity, and additive influences remain unclear. METHODS A total of 2,231 mothers of the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study completed the Center for Epidemiological Studies Depression Scale biweekly up to 14 times during pregnancy and twice up to 12 months after pregnancy. At child's age 1.9-5.7 years, the mothers completed the Beck Depression Inventory-II on their concurrent depressive symptoms and Ages and Stages Questionnaire on child developmental milestones. RESULTS Higher mean maternal depressive symptoms, each biweekly score, and consistently clinically relevant symptomatology during pregnancy predicted lower total developmental milestones, fine and gross motor, communication, problem solving, and personal/social skills scores in children. Although maternal depressive symptoms up to 12 months after pregnancy and in early childhood also predicted lower developmental milestones scores, developmental milestones scores were the lowest in children whose mothers' depressive symptoms were above the clinical cutoff either only during pregnancy, both during and up to 12 months after pregnancy, or at each three time-points. CONCLUSION Maternal depressive symptoms during pregnancy, in the first year postpartum and in early childhood are associated with poorer child neurodevelopment. Our findings further suggest that antenatal and postpregnancy depression have additive effects on neurodevelopment. Children of mothers with the most chronic and severe depressive symptoms during pregnancy had the most neurodevelopmental disadvantages. Our findings emphasize the adverse effects of maternal depression during and after pregnancy and in early childhood on child neurodevelopment.
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Affiliation(s)
- Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.,National Institute for Health and Welfare, Helsinki, Finland
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rebecca M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Esa Hämäläinen
- Department of Clinical Chemistry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland/HiLIFE, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pia M Villa
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Wolford E, Lahti M, Tuovinen S, Lahti J, Lipsanen J, Savolainen K, Heinonen K, Hämäläinen E, Kajantie E, Pesonen AK, Villa PM, Laivuori H, Reynolds RM, Räikkönen K. Maternal depressive symptoms during and after pregnancy are associated with attention-deficit/hyperactivity disorder symptoms in their 3- to 6-year-old children. PLoS One 2017; 12:e0190248. [PMID: 29267405 PMCID: PMC5739495 DOI: 10.1371/journal.pone.0190248] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/11/2017] [Indexed: 01/21/2023] Open
Abstract
Maternal depressive symptoms during pregnancy have been associated with child behavioural symptoms of attention-deficit/hyperactivity disorder (ADHD) in early childhood. However, it remains unclear if depressive symptoms throughout pregnancy are more harmful to the child than depressive symptoms only during certain times, and if maternal depressive symptoms after pregnancy add to or mediate any prenatal effects. 1,779 mother-child dyads participated in the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study. Mothers filled in the Center of Epidemiological Studies Depression Scale biweekly from 12+0-13+6 to 38+0-39+6 weeks+days of gestation or delivery, and the Beck Depression Inventory-II and the Conners' Hyperactivity Index at the child's age of 3 to 6 years (mean 3.8 years, standard deviation [SD] 0.5). Maternal depressive symptoms were highly stable throughout pregnancy, and children of mothers with consistently high depressive symptoms showed higher average levels (mean difference = 0.46 SD units, 95% Confidence Interval [CI] 0.36, 0.56, p < 0.001 compared to the low group), and proportion (32.1% vs. 14.7%) and odds (odds ratio = 2.80, 95% CI 2.20, 3.57, p < 0.001) of clinically significant ADHD symptoms. These associations were not explained by the effects of maternal depressive symptoms after pregnancy, which both added to and partially mediated the prenatal effects. Maternal depressive symptoms throughout pregnancy are associated with increased ADHD symptomatology in young children. Maternal depressive symptoms after pregnancy add to, but only partially mediate, the prenatal effects. Preventive interventions suited for the pregnancy period may benefit both maternal and offspring mental health.
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Affiliation(s)
- Elina Wolford
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marius Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Soile Tuovinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Savolainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pia M. Villa
- Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Rebecca M. Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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17
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Räikkönen K, Martikainen S, Pesonen AK, Lahti J, Heinonen K, Pyhälä R, Lahti M, Tuovinen S, Wehkalampi K, Sammallahti S, Kuula L, Andersson S, Eriksson JG, Ortega-Alonso A, Reynolds RM, Strandberg TE, Seckl JR, Kajantie E. Maternal Licorice Consumption During Pregnancy and Pubertal, Cognitive, and Psychiatric Outcomes in Children. Am J Epidemiol 2017; 185:317-328. [PMID: 28158597 DOI: 10.1093/aje/kww172] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 09/19/2016] [Indexed: 12/15/2022] Open
Abstract
Earlier puberty, especially in girls, is associated with physical and mental disorders. Prenatal glucocorticoid exposure influences the timing of puberty in animal models, but the human relevance of those findings is unknown. We studied whether voluntary consumption of licorice, which contains glycyrrhizin (a potent inhibitor of placental 11β-hydroxysteroid dehydrogenase type 2, the "barrier" to maternal glucocorticoids), by pregnant women was associated with pubertal maturation (height, weight, body mass index for age, difference between current and expected adult height, Tanner staging, score on the Pubertal Development Scale), neuroendocrine function (diurnal salivary cortisol, dexamethasone suppression), cognition (neuropsychological tests), and psychiatric problems (as measured by the Child Behavior Checklist) in their offspring. The children were born in 1998 in Helsinki, Finland, and examined during 2009-2011 (mean age = 12.5 (standard deviation (SD), 0.4) years; n = 378). Girls exposed to high maternal glycyrrhizin consumption (≥500 mg/week) were taller (mean difference (MD) = 0.4 SD, 95% confidence interval (CI): 0.1, 0.8), were heavier (MD = 0.6 SD, 95% CI: 0.2, 1.9), and had higher body mass index for age (MD = 0.6 SD, 95% CI: 0.2, 0.9). They were also 0.5 standard deviations (95% CI: 0.2, 0.8) closer to adult height and reported more advanced pubertal development (P < 0.04). Girls and boys exposed to high maternal glycyrrhizin consumption scored 7 (95% CI: 3.1, 11.2) points lower on tests of intelligence quotient, had poorer memory (P < 0.04), and had 3.3-fold (95% CI: 1.4, 7.7) higher odds of attention deficit/hyperactivity disorder problems compared with children whose mothers consumed little to no glycyrrhizin (≤249 mg/week). No differences in cortisol levels were found. Licorice consumption during pregnancy may be associated with harm for the developing offspring.
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18
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Räikkönen K, Martikainen S, Pesonen AK, Lahti J, Heinonen K, Pyhälä R, Lahti M, Tuovinen S, Wehkalampi K, Sammallahti S, Kuula L, Andersson S, Eriksson JG, Ortega-Alonso A, Reynolds RM, Strandberg TE, Seckl JR, Kajantie E. Räikkönen et al. Respond to "Maternal Stress and Offspring Health". Am J Epidemiol 2017; 185:333-334. [PMID: 28158390 DOI: 10.1093/aje/kww174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/11/2016] [Indexed: 01/16/2023] Open
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19
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Lahti M, Savolainen K, Tuovinen S, Pesonen AK, Lahti J, Heinonen K, Hämäläinen E, Laivuori H, Villa PM, Reynolds RM, Kajantie E, Räikkönen K. Maternal Depressive Symptoms During and After Pregnancy and Psychiatric Problems in Children. J Am Acad Child Adolesc Psychiatry 2017; 56:30-39.e7. [PMID: 27993226 DOI: 10.1016/j.jaac.2016.10.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/11/2016] [Accepted: 10/18/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Maternal depressive symptoms during pregnancy are associated with increased risk of psychiatric problems in children. A more precise understanding of the timing of the symptoms during pregnancy and their independence of other prenatal and postnatal factors in predicting child psychopathology risk is needed. We examined whether maternal depressive symptoms during pregnancy predict child psychiatric problems, whether these associations are trimester- or gestational-week-specific and/or independent of pregnancy disorders, and whether maternal depressive symptoms after pregnancy mediate or add to the prenatal effects. METHOD The study sample comprised 2,296 women and their children born in Finland between 2006-2010, participating in the prospective pregnancy cohort study Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) and followed up from 1.9 to 5.9 years of age. The women completed the Center for Epidemiologic Studies Depression Scale biweekly between gestational weeks+days 12+0/13+6 and 38+0/39+6 or delivery. In the follow-up, they completed the Beck Depression Inventory-II and Child Behavior Checklist 1½-5. RESULTS Maternal depressive symptoms during pregnancy predicted significantly higher internalizing (0.28 SD unit per SD unit increase [95% CI = 0.24-0.32]), externalizing (0.26 [0.23-0.30]), and total problems (0.31 [0.27-0.35]) in children. These associations were nonspecific to gestational week and hence pregnancy trimester, independent of pregnancy disorders, and independent of, although partially mediated by, maternal depressive symptoms after pregnancy. Psychiatric problems were greatest in children whose mothers reported clinically significant depressive symptoms across pregnancy trimesters and during and after pregnancy. CONCLUSION Maternal depressive symptoms during pregnancy predict increased psychiatric problems in young children. Preventive interventions from early pregnancy onward may benefit offspring mental health.
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Affiliation(s)
- Marius Lahti
- Institute of Behavioural Sciences, University of Helsinki, Finland; Queen's Medical Research Institute, University of Edinburgh, UK.
| | - Katri Savolainen
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Soile Tuovinen
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | | | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Finland
| | - Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Esa Hämäläinen
- Helsinki University Hospital and University of Helsinki, Finland
| | - Hannele Laivuori
- Helsinki University Hospital and University of Helsinki, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Finland
| | - Pia M Villa
- Helsinki University Hospital and University of Helsinki, Finland
| | | | - Eero Kajantie
- Helsinki University Hospital and University of Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland and Oulu University Hospital and University of Oulu, Finland
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Finland
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20
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Räikkönen K, Pesonen AK, O'Reilly JR, Tuovinen S, Lahti M, Kajantie E, Villa P, Laivuori H, Hämäläinen E, Seckl JR, Reynolds RM. Maternal depressive symptoms during pregnancy, placental expression of genes regulating glucocorticoid and serotonin function and infant regulatory behaviors. Psychol Med 2015; 45:3217-3226. [PMID: 26096463 DOI: 10.1017/s003329171500121x] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Glucocorticoids and serotonin may mediate the link between maternal environment, fetal brain development and 'programming' of offspring behaviors. The placenta regulates fetal exposure to maternal hormonal signals in animal studies, but few data address this in humans. We measured prospectively maternal depressive symptoms during pregnancy and mRNAs encoding key gene products determining glucocorticoid and serotonin function in term human placenta and explored associations with infant regulatory behaviors. METHOD Bi-weekly self-ratings of the Center for Epidemiologic Studies Depression Scale from 12th to 13th gestational week onwards and term placental mRNAs of 11beta-hydroxysteroid dehydrogenase type 2 (HSD2B11), type 1 (HSD1B11), glucocorticoid (NR3C1), mineralocorticoid receptors (NR3C2) and serotonin transporter (SLC6A4) were obtained from 54 healthy mothers aged 32.2 ± 5.3 years with singleton pregnancies and without pregnancy complications. Infant regulatory behaviors (crying, feeding, spitting, elimination, sleeping and predictability) were mother-rated at 15.6 ± 4.2 days. RESULTS Higher placental mRNA levels of HSD2B11 [0.41 standard deviation (s.d.) unit increase per s.d. unit increase; 95% confidence interval (CI) 0.13-0.69, p = 0.005], HSD1B11 (0.30, 0.03-0.57, p = 0.03), NR3C1 (0.44, 0.19-0.68, p = 0.001) and SLC6A4 (0.26, 0.00-0.53, p = 0.05) were associated with more regulatory behavioral challenges of the infant. Higher placental NR3C1 mRNA partly mediated the association between maternal depressive symptoms during pregnancy and infant regulatory behaviors (p < 0.05). CONCLUSIONS Higher placental expression of genes regulating feto-placental glucocorticoid and serotonin exposure is characteristic of infants with more regulatory behavioral challenges. Maternal depression acts, at least partly, via altering glucocorticoid action in the placenta to impact on offspring regulatory behaviors.
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Affiliation(s)
- K Räikkönen
- Institute of Behavioral Sciences,University of Helsinki,Helsinki,Finland
| | - A-K Pesonen
- Institute of Behavioral Sciences,University of Helsinki,Helsinki,Finland
| | - J R O'Reilly
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science,Queen's Medical Research Institute,Edinburgh,UK
| | - S Tuovinen
- Institute of Behavioral Sciences,University of Helsinki,Helsinki,Finland
| | - M Lahti
- Institute of Behavioral Sciences,University of Helsinki,Helsinki,Finland
| | - E Kajantie
- National Institute for Health and Welfare,Helsinki,Finland
| | - P Villa
- Research Programmes Unit,Women's Health,University of Helsinki,Helsinki,Finland
| | - H Laivuori
- Haartman Institute,Medical Genetics,University of Helsinki,Helsinki,Finland
| | - E Hämäläinen
- HUSLAB and Department of Clinical Chemistry,Helsinki University Central Hospital, University of Helsinki,Helsinki,Finland
| | - J R Seckl
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science,Queen's Medical Research Institute,Edinburgh,UK
| | - R M Reynolds
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science,Queen's Medical Research Institute,Edinburgh,UK
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Reynolds RM, Pesonen AK, O'Reilly JR, Tuovinen S, Lahti M, Kajantie E, Villa PM, Laivuori H, Hämäläinen E, Seckl JR, Räikkönen K. Maternal depressive symptoms throughout pregnancy are associated with increased placental glucocorticoid sensitivity. Psychol Med 2015; 45:2023-2030. [PMID: 25628053 DOI: 10.1017/s003329171400316x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Maternal prenatal depression predicts post-partum depression and increases risk of prematurity and low birth weight. These effects may be mediated by altered placental function. We hypothesized that placental function would be influenced by the gestational week of experiencing depressive symptoms and aimed to examine associations between maternal depressive symptoms during pregnancy and placental expression of genes involved in glucocorticoid and serotonin transfer between mother and fetus. METHOD We studied women participating in a prospective pregnancy cohort: the Prediction and Prevention of Preeclampsia (PREDO) Study, Helsinki, Finland. Maternal depressive symptoms were assessed at 2-week intervals throughout pregnancy in 56 healthy women with singleton, term pregnancies. Messenger ribonucleic acid (mRNA) levels of glucocorticoid (GR) and mineralocorticoid (MR) receptors and serotonin transporter (SLC6A4), 11β-hydroxysteroid dehydrogenase type 1 (HSD1) and 2 (HSD2) were quantified in placental biopsies. RESULTS In adjusted analyses women who reported higher depressive symptoms across the whole pregnancy had higher mRNA levels of GR [effect size 0.31 s.d. units, 95% confidence interval (CI) 0.01-0.60, p = 0.042] and MR (effect size 0.34 s.d. units, 95% CI 0.01-0.68, p = 0.047). These effects were significant for symptoms experienced in the third trimester of pregnancy for GR; findings for MR were also significant for symptoms experienced in the second trimester. GR and MR mRNA levels increased linearly by having the trimester-specific depressive symptoms scores 0, 1 or 2-3 times above the clinical cut-off for depression (p = 0.003, p = 0.049, respectively, and p = 0.004, p = 0.15 in adjusted analyses). CONCLUSIONS Our findings offer potential gestational-age-specific mechanisms linking maternal depressive symptoms during pregnancy via placental biology. Future studies will test whether these also link with adverse offspring outcomes.
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Affiliation(s)
- R M Reynolds
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK
| | - A-K Pesonen
- Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland
| | - J R O'Reilly
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK
| | - S Tuovinen
- Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland
| | - M Lahti
- Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland
| | - E Kajantie
- National Institute for Health and Welfare,00271 Helsinki,Finland
| | - P M Villa
- Department of Obstetrics and Gynaecology,University of Helsinki and Helsinki University Central Hospital,Helsinki,Finland
| | - H Laivuori
- Haartman Institute, Medical Genetics, University of Helsinki,00014 University of Helsinki,Helsinki,Finland
| | - E Hämäläinen
- HUSLAB and Department of Clinical Chemistry,Helsinki University Central Hospital,00014 University of Helsinki,Helsinki,Finland
| | - J R Seckl
- Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK
| | - K Räikkönen
- Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland
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22
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Heinonen K, Eriksson JG, Lahti J, Kajantie E, Pesonen AK, Tuovinen S, Osmond C, Raikkonen K. Late preterm birth and neurocognitive performance in late adulthood: a birth cohort study. Pediatrics 2015; 135:e818-25. [PMID: 25733746 DOI: 10.1542/peds.2014-3556] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [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] [Accepted: 01/14/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We studied if late preterm birth (34 weeks 0 days-36 weeks 6 days of gestation) is associated with performance on the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) in late adulthood and if maximum attained lifetime education moderated these associations. METHODS Participants were 919 Finnish men and women born between 1934 and 1944, who participated in the Helsinki Birth Cohort Study. They underwent the CERAD-NB at a mean age of 68.1 years. Data regarding gestational age (late preterm versus term) were extracted from hospital birth records, and educational attainment data were gathered from Statistics Finland. RESULTS After adjustment for major confounders, those born late preterm scored lower on word list recognition (mean difference: -0.33 SD; P = .03) than those born at term. Among those who had attained a basic or upper secondary education, late preterm birth was associated with lower scores on word list recognition, constructional praxis, constructional praxis recall, clock drawing, Mini-Mental State Examination, and memory total and CERAD total 2 compound scores (mean differences: >0.40 SD; P values <.05), and had a 2.70 times higher risk of mild cognitive impairment (Mini-Mental State Examination score: <26 points) (P = .02). Among those with tertiary levels of education, late preterm birth was not associated with CERAD-NB scores. CONCLUSIONS Our findings offer new insight into the lifelong consequences of late preterm birth, and they add late preterm birth as a novel risk factor to the list of neurocognitive impairment in late adulthood. Our findings also suggest that attained lifetime education may mitigate aging-related neurocognitive impairment, especially among those born late preterm.
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Affiliation(s)
| | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Vasa Central Hospital, Vasa, Finland; Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland
| | | | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; and
| | | | | | - Clive Osmond
- MRC Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, United Kingdom
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Lahti M, Eriksson JG, Heinonen K, Kajantie E, Lahti J, Wahlbeck K, Tuovinen S, Pesonen AK, Mikkonen M, Osmond C, Barker DJP, Räikkönen K. Late preterm birth, post-term birth, and abnormal fetal growth as risk factors for severe mental disorders from early to late adulthood. Psychol Med 2015; 45:985-999. [PMID: 25191989 DOI: 10.1017/s0033291714001998] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Late preterm births constitute the majority of preterm births. However, most evidence suggesting that preterm birth predicts the risk of mental disorders comes from studies on earlier preterm births. We examined if late preterm birth predicts the risks of severe mental disorders from early to late adulthood. We also studied whether adulthood mental disorders are associated with post-term birth or with being born small (SGA) or large (LGA) for gestational age, which have been previously associated with psychopathology risk in younger ages. METHOD Of 12 597 Helsinki Birth Cohort Study participants, born 1934-1944, 664 were born late preterm, 1221 post-term, 287 SGA, and 301 LGA. The diagnoses of mental disorders were identified from national hospital discharge and cause of death registers from 1969 to 2010. In total, 1660 (13.2%) participants had severe mental disorders. RESULTS Individuals born late preterm did not differ from term-born individuals in their risk of any severe mental disorder. However, men born late preterm had a significantly increased risk of suicide. Post-term birth predicted significantly increased risks of any mental disorder in general and particularly of substance use and anxiety disorders. Individuals born SGA had significantly increased risks of any mental and substance use disorders. Women born LGA had an increased risk of psychotic disorders. CONCLUSIONS Although men born late preterm had an increased suicide risk, late preterm birth did not exert widespread effects on adult psychopathology. In contrast, the risks of severe mental disorders across adulthood were increased among individuals born SGA and individuals born post-term.
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Affiliation(s)
- M Lahti
- Institute of Behavioural Sciences, University of Helsinki,Finland
| | - J G Eriksson
- National Institute for Health and Welfare,Helsinki,Finland
| | - K Heinonen
- Institute of Behavioural Sciences, University of Helsinki,Finland
| | - E Kajantie
- National Institute for Health and Welfare,Helsinki,Finland
| | - J Lahti
- Institute of Behavioural Sciences, University of Helsinki,Finland
| | - K Wahlbeck
- National Institute for Health and Welfare,Helsinki,Finland
| | - S Tuovinen
- Institute of Behavioural Sciences, University of Helsinki,Finland
| | - A-K Pesonen
- Institute of Behavioural Sciences, University of Helsinki,Finland
| | - M Mikkonen
- National Institute for Health and Welfare,Helsinki,Finland
| | - C Osmond
- MRC Lifecourse Epidemiology Unit,University of Southampton,UK
| | | | - K Räikkönen
- Institute of Behavioural Sciences, University of Helsinki,Finland
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Lahti M, Eriksson JG, Heinonen K, Kajantie E, Lahti J, Wahlbeck K, Tuovinen S, Pesonen AK, Mikkonen M, Osmond C, Räikkönen K. Maternal Grand Multiparity and the Risk of Severe Mental Disorders in Adult Offspring. PLoS One 2014; 9:e114679. [PMID: 25493431 PMCID: PMC4262418 DOI: 10.1371/journal.pone.0114679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 11/12/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Previous studies have shown that maternal grand multiparity may predict an increased risk of mental disorders in young adult offspring, but whether such effects persist throughout adulthood remains unknown. The current study examined if maternal grand multiparity predicts the risks of severe mental disorders, suicides, suicide attempts and dementias throughout adult life. METHODS Our study sample comprised 13243 Helsinki Birth Cohort Study 1934-1944 participants (6905 men and 6338 women). According to hospital birth records, 341 offspring were born to grand multiparous mothers. From Finnish national hospital discharge and causes of death registers, we identified 1682 participants diagnosed with mental disorders during 1969-2010. RESULTS Maternal grand multiparity predicted significantly increased risks of mood disorders (Hazard Ratio = 1.64, p = 0.03), non-psychotic mood disorders (Hazard Ratio = 2.02, p = 0.002), and suicide attempts (Hazard Ratio = 3.94, p = 0.01) in adult offspring. Furthermore, women born to grand multiparous mothers had significantly increased risks of any severe mental disorder (Hazard Ratio = 1.79, p = 0.01), non-psychotic substance use disorders (Hazard Ratio = 2.77, p = 0.02) schizophrenia, schizotypal and delusional disorders (Hazard Ratio = 2.40, p = 0.02), mood disorders (Hazard Ratio = 2.40, p = 0.002), non-psychotic mood disorders (Hazard Ratio = 2.91, p<0.001), and suicide attempts (Hazard Ratio = 5.05, p = 0.01) in adulthood. The effects of maternal grand multiparity on offspring psychopathology risk were independent of maternal age and body mass index at childbirth, and of year of birth, sex, childhood socioeconomic position, and birth weight of the offspring. In contrast, no significant effects were found among men. CONCLUSIONS Women born to grand multiparous mothers are at an increased risk of severe mental disorders and suicide attempts across adulthood. Our findings may inform the development of preventive interventions for mental disorders.
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Affiliation(s)
- Marius Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Johan G. Eriksson
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland
- Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
- Vaasa Central Hospital, Vaasa, Finland
- Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Kati Heinonen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland
- Children’s Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Kristian Wahlbeck
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland
- The Finnish Association for Mental Health, Helsinki, Finland
| | - Soile Tuovinen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | | | - Maiju Mikkonen
- National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
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Tuovinen S, Eriksson JG, Kajantie E, Räikkönen K. Maternal hypertensive pregnancy disorders and cognitive functioning of the offspring: a systematic review. ACTA ACUST UNITED AC 2014; 8:832-47.e1. [PMID: 25455009 DOI: 10.1016/j.jash.2014.09.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/13/2014] [Accepted: 09/01/2014] [Indexed: 11/28/2022]
Abstract
Hypertensive pregnancy disorders may affect the fetal developmental milieu and thus hint at mechanisms that link prenatal conditions with later developmental outcomes of the offspring. Here, we systematically review studies that have tested whether maternal pre-eclampsia, gestational hypertension, and hypertensive pregnancy disorders as a single diagnostic entity are associated with cognitive functioning of the offspring. Twenty-six studies were eligible for this review. Of them, 19 provided detailed methodological information deemed necessary to be included for a more detailed review. An overall conclusion is that, in the general population, maternal hypertensive disorders may be associated with lower cognitive ability of the offspring. Studies that extend to adulthood show the most consistent pattern of findings. It is possible that the associations arise during the lifetime or that the findings reflect improvements in management of these disorders. Evidence is, however, insufficient to conclude whether these associations are dissimilar in the offspring exposed to maternal pre-eclampsia and gestational hypertension, due to the varied criteria used across the different studies to distinguish between these conditions. The existing studies also vary in the definition of control groups, and very few have taken into account important confounding factors, including maternal pre-pregnancy obesity and lifestyle behaviors. Given the mixed pattern of findings and limitations related to internal and external validity, further studies are clearly warranted to clarify the associations.
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Affiliation(s)
- Soile Tuovinen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
| | - Johan G Eriksson
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; Vasa Central Hospital, Vasa, Finland
| | - Eero Kajantie
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland; Hospital for Children and Adolescents, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; Department of Obstetrics and Gynecology, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
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Tuovinen S, Aalto-Viljakainen T, Eriksson JG, Kajantie E, Lahti J, Pesonen AK, Heinonen K, Lahti M, Osmond C, Barker DJP, Räikkönen K. Maternal hypertensive disorders during pregnancy: adaptive functioning and psychiatric and psychological problems of the older offspring. BJOG 2014; 121:1482-91. [DOI: 10.1111/1471-0528.12753] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2014] [Indexed: 01/29/2023]
Affiliation(s)
- S Tuovinen
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
| | | | - JG Eriksson
- Department of Chronic Disease Prevention; National Institute for Health and Welfare; Helsinki Finland
- Department of General Practice and Primary Health Care; University of Helsinki; Helsinki Finland
| | - E Kajantie
- Department of Chronic Disease Prevention; National Institute for Health and Welfare; Helsinki Finland
- Hospital for Children and Adolescents; Institute of Clinical Medicine; University of Helsinki; Helsinki Finland
| | - J Lahti
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
| | - A-K Pesonen
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
| | - K Heinonen
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
| | - M Lahti
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
| | - C Osmond
- MRC Lifecourse Epidemiology Unit; University of Southampton; Southampton UK
| | - DJP Barker
- MRC Lifecourse Epidemiology Unit; University of Southampton; Southampton UK
| | - K Räikkönen
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
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Tuovinen S, Eriksson JG, Kajantie E, Lahti J, Pesonen AK, Heinonen K, Osmond C, Barker DJ, Räikkönen K. Maternal hypertensive disorders in pregnancy and self-reported cognitive impairment of the offspring 70 years later: the Helsinki Birth Cohort Study. Am J Obstet Gynecol 2013; 208:200.e1-9. [PMID: 23246316 DOI: 10.1016/j.ajog.2012.12.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/23/2012] [Accepted: 12/07/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We tested whether maternal hypertensive disorders during pregnancy predict self-reported cognitive impairment, which is one of the earliest behavioral markers of dementia, of the offspring 70 years later. STUDY DESIGN We included 876 participants of the Helsinki Birth Cohort Study 1934-44 who were born after normotensive, preeclamptic, or hypertensive pregnancies that were defined by the use of the mother's blood pressure and urinary protein measurements at maternity clinics and birth hospitals. The participants completed a psychological questionnaire that included questions on cognitive failures and dysexecutive functioning at an average age of 69.3 ± 3.1 (SD) years. RESULTS In comparison with the offspring who were born after normotensive pregnancies, the offspring who were born after preeclamptic pregnancies reported more frequent complaints of cognitive failures, distractibility, and false triggering. Further, among women we found maternal hypertension without proteinuria that was associated with more frequent complaints of cognitive failures, forgetfulness, and false triggering. CONCLUSION Hypertensive disorders during pregnancy are associated with more frequent subjective complaints of cognitive failures of the offspring in old age.
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Raikkonen K, Kajantie E, Pesonen AK, Heinonen K, Alastalo H, Leskinen JT, Nyman K, Henriksson M, Lahti J, Lahti M, Pyhälä R, Tuovinen S, Osmond C, Barker DJP, Eriksson JG. Early life origins cognitive decline: findings in elderly men in the Helsinki Birth Cohort Study. PLoS One 2013; 8:e54707. [PMID: 23382945 PMCID: PMC3559835 DOI: 10.1371/journal.pone.0054707] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/14/2012] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To examine whether the adverse effects of slow prenatal and postnatal growth on cognitive function persist to old age and predict age related cognitive decline. DESIGN AND SETTING A longitudinal birth cohort study of men born in Helsinki, Finland 1934-44. PARTICIPANTS Nine-hundred-thirty-one men of the Helsinki Birth Cohort Study, with detailed data on growth from birth to adulthood, aged 20.1 (SD = 1.4) at the first and 67.9 (SD = 2.5) years at the second cognitive testing. MAIN OUTCOME MEASURES The Finnish Defense Forces Basic Intellectual Ability Test assessed twice over nearly five decades apart. RESULTS Lower weight, length and head circumference at birth were associated with lower cognitive ability at 67.9 years (1.04-1.55 points lower ability per each standard deviation [SD] unit decrease in body size, 95% Confidence Interval [95%CI]: 0.05 to 2.72) and with cognitive decline after 20.1 years (0.07-0.11 SD decline over time per each SD decrease in body size, 95%CI:0.00 to 0.19). Men who were born larger were more likely to perform better in the cognitive ability test over time (1.22-1.43 increase in odds to remain in the top relative to the lower two thirds in ability over time per each SD increase in body size, 95%CI:1.04 to 1.79) and were more resilient to cognitive decline after 20.1 years (0.69 to 0.76 decrease in odds to decline from than remain in the top third of ability over time per each SD increase in body size, 95%CI:0.49 to 0.99). Slower growth between birth and two years in weight, height and body mass index was associated with lower cognitive ability at 67.9 years, but not with cognitive decline. CONCLUSIONS Poorer lifetime cognitive ability is predicted by slower growth before and after birth. In predicting resilience to age related cognitive decline, the period before birth seems to be more critical.
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Affiliation(s)
- Katri Raikkonen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
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Pesonen AK, Eriksson JG, Heinonen K, Kajantie E, Tuovinen S, Alastalo H, Henriksson M, Leskinen J, Osmond C, Barker DJP, Räikkönen K. Cognitive ability and decline after early life stress exposure. Neurobiol Aging 2013; 34:1674-9. [PMID: 23337341 DOI: 10.1016/j.neurobiolaging.2012.12.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 11/30/2012] [Accepted: 12/18/2012] [Indexed: 01/08/2023]
Abstract
We examined the effects of early life stress on cognitive ability and decline among men of the Helsinki Birth Cohort Study, 10% of whom were separated temporarily (mean age at separation = 4.1 years) from their parent(s) during World War II. The men underwent the Finnish Defense Forces Basic Intellectual Ability Test twice, at 20 years and retest at 70 years. Compared with the men without childhood separation and matched for year of birth (n = 186), men separated from their parents (n = 93) scored lower by 5.5 (95% confidence interval [CI], -9.2 to -1.7), 4.2 (95% CI, -8.1 to -0.3), 3.1 (95% CI, -7.0 to 0.8), and 4.5 (95% CI, -10.5 to -1.4) standardized points (SD = 15) on verbal, visuospatial, arithmetic, and general cognitive ability, respectively, at 70 years. Longer duration of separation was associated with lower test scores. Though early life stress was also associated significantly with weaker cognitive performance at the ages 20 and 70 years, it was not associated with cognitive decline over the 50-year period within this sample.
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Tuovinen S, Räikkönen K, Kajantie E, Henriksson M, Leskinen JT, Pesonen AK, Heinonen K, Lahti J, Pyhälä R, Alastalo H, Lahti M, Osmond C, Barker DJP, Eriksson JG. Hypertensive disorders in pregnancy and cognitive decline in the offspring up to old age. Neurology 2012; 79:1578-82. [PMID: 23035059 DOI: 10.1212/wnl.0b013e31826e2606] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We tested whether maternal hypertensive disorders in pregnancy predict age-related change in cognitive ability in the offspring up to old age. METHODS Using mothers' blood pressure and urinary protein measurements from the maternity clinics and birth hospitals, we defined normotensive or hypertensive pregnancies in mothers of 398 men, who participated in the Helsinki Birth Cohort 1934-1944 Study. The men underwent the Finnish Defence Forces basic ability test twice: first during compulsory military service at age 20.1 (SD = 1.4) years and then in a retest at age 68.5 (SD = 2.9) years. The test yields a total score and subscores for tests measuring verbal, arithmetic, and visuospatial reasoning. RESULTS Men born after pregnancies complicated by a hypertensive disorder, compared with men born after normotensive pregnancies, scored 4.36 (95% confidence interval, 1.17-7.55) points lower on total cognitive ability at 68.5 years and displayed a greater decline in total cognitive ability (2.88; 95% confidence interval, 0.07-5.06) after 20.1 years. Of the subscores, associations were strongest for arithmetic reasoning. CONCLUSION Maternal hypertensive disorders in pregnancy predict lower cognitive ability and greater cognitive decline up to old age. A propensity to lower cognitive ability and decline up to old age may have prenatal origins.
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Affiliation(s)
- Soile Tuovinen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
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Tuovinen S, Räikkönen K, Kajantie E, Henriksson M, Leskinen J, Pesonen AK, Heinonen K, Lahti J, Pyhälä R, Alastalo H, Lahti M, Osmond C, Barker D, Eriksson J. OS103. Hypertensive disorders during pregnancy and cognitive decline of the offspring up to old age: the helsinki birth cohort study. Pregnancy Hypertens 2012; 2:235-6. [DOI: 10.1016/j.preghy.2012.04.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tuovinen S, Räikkönen K, Kajantie E, Leskinen JT, Henriksson M, Pesonen AK, Heinonen K, Osmond C, Barker D, Eriksson JG. Hypertensive disorders in pregnancy and intellectual abilities in the offspring in young adulthood: the Helsinki Birth Cohort Study. Ann Med 2012; 44:394-403. [PMID: 21495787 DOI: 10.3109/07853890.2011.573497] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertensive disorders may affect the fetal developmental milieu and thus hint at mechanisms by which prenatal adversity associates with poorer intellectual ability in subsequent life. AIM We tested if hypertensive disorders in pregnancy are associated with intellectual ability in the offspring in young adulthood and if any potential associations between hypertensive disorders and intellectual abilities differ according to length of gestation, birth-weight, parity, and childhood socio-economic background. METHODS Using mothers' blood pressure and urinary protein measurements at maternity clinics and birth hospitals, we defined normotensive or hypertensive pregnancies in mothers of 1,196 men who participated in the Helsinki Birth Cohort 1934-1944 Study. At age 20 years the men completed a test on intellectual abilities during compulsory military service. RESULTS Participants born after pregnancies complicated by hypertensive disorders scored lower on intellectual abilities compared to those born after normotensive pregnancies. The effects of hypertensive disorders were most obvious in men born preterm or after a primiparous pregnancy and in men of higher childhood socio-economic background. CONCLUSION Hypertensive disorders in pregnancy are, albeit weakly, associated with lower intellectual abilities in the offspring. These findings are compatible with the concept of adverse fetal 'programming' by a suboptimal prenatal environment.
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Affiliation(s)
- Soile Tuovinen
- Institute of Behavioral Sciences, University of Helsinki, Finland
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Tuovinen S, Räikkönen K, Pesonen AK, Lahti M, Heinonen K, Wahlbeck K, Kajantie E, Osmond C, Barker DJP, Eriksson JG. Hypertensive disorders in pregnancy and risk of severe mental disorders in the offspring in adulthood: the Helsinki Birth Cohort Study. J Psychiatr Res 2012; 46:303-10. [PMID: 22169528 DOI: 10.1016/j.jpsychires.2011.11.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [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: 08/29/2011] [Revised: 11/08/2011] [Accepted: 11/23/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hypertensive disorders may affect the fetal developmental milieu and thus hint at mechanisms by which prenatal adversity associates with mental disorders in later life. We examined if hypertension without proteinuria and preeclampsia in pregnancy predict serious mental disorders in the offspring, and if sex, childhood socioeconomic status, length of gestation and parity modify these associations. METHODS We included 5970 women and men born after a normotensive, hypertensive or preeclamptic pregnancy defined by using mother's blood pressure and urinary protein measurements at maternity clinics and birth hospitals. Mental disorders requiring hospitalization or contributing to death were identified from the Finnish Hospital Discharge and Causes of Death Registers between years 1969 and 2004. RESULTS In comparison to the offspring born after normotensive pregnancies, offspring born after pregnancies complicated by hypertension without proteinuria were at 1.19-fold (CI: 1.01-1.41, P-value = 0.04) higher risk of any mental disorder and 1.44- (CI: 1.11-1.88, P-value < 0.01) and 1.39-fold (CI: 0.99-1.93, P-value = 0.05) higher risk of mood and anxiety disorder, respectively. In contrast, preeclampsia was associated, with a lower risk of any mental disorder in the male offspring (P-value = 0.02; P-value = 0.04 for interaction 'sex × normotension/preeclampsia'). CONCLUSIONS Hypertension without proteinuria in pregnancy was associated with a higher risk of serious mental disorders in the offspring in adulthood. Preeclampsia seems to, in turn, associate with lower risk of severe mental disorders in male offspring.
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Affiliation(s)
- Soile Tuovinen
- Department of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
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Tuovinen S, Räikkönen K, Pesonen AK, Lahti M, Heinonen K, Wahlbeck K, Kajantie E, Osmond C, Barker DJ, Eriksson JG. O27. Hypertensive disorders in pregnancy and risk of severe mental disorders in the offspring in adulthood: The Helsinki Birth Cohort study. Pregnancy Hypertens 2011; 1:271. [DOI: 10.1016/j.preghy.2011.08.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Tuovinen S, Räikkönen K, Pesonen AK, Lahti M, Heinonen K, Wahlbeck K, Kajantie E, Osmond C, Barker D, Eriksson J. P42. Hypertensive disorders in pregnancy and risk of severe mental disorders in the offspring in adulthood: The Helsinki Birth Cohort Study. Pregnancy Hypertens 2011; 1:292-3. [DOI: 10.1016/j.preghy.2011.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tuovinen S, Räikkönen K, Kajantie E, Pesonen AK, Heinonen K, Osmond C, Barker DJP, Eriksson JG. Depressive symptoms in adulthood and intrauterine exposure to pre-eclampsia: the Helsinki Birth Cohort Study. BJOG 2010; 117:1236-42. [DOI: 10.1111/j.1471-0528.2010.02634.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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