Childhood Trajectories Research Articles

Feasibility and ethics of using data from the Scottish newborn blood spot archive for research

BackgroundNewborn heel prick blood spots are routinely used to screen for inborn errors of metabolism and life-limiting inherited disorders. The potential value of secondary data from newborn blood spot archives merits ethical consideration and assessment of feasibility for public benefit. Early life exposures and behaviours set health trajectories in childhood and later life. The newborn blood spot is potentially well placed to create an unbiased and cost-effective population-level retrospective birth cohort study. Scotland has retained newborn blood spots for all children born since 1965, around 3 million in total. However, a moratorium on research access is currently in place, pending public consultation.MethodsWe conducted a Citizens’ Jury as a first step to explore whether research use of newborn blood spots was in the public interest. We also assessed the feasibility and value of extracting research data from dried blood spots for predictive medicine.ResultsJurors delivered an agreed verdict that conditional research access to the newborn blood spots was in the public interest. The Chief Medical Officer for Scotland authorised restricted lifting of the current research moratorium to allow a feasibility study. Newborn blood spots from consented Generation Scotland volunteers were retrieved and their potential for both epidemiological and biological research demonstrated.ConclusionsThrough the Citizens’ Jury, we have begun to identify under what conditions, if any, should researchers in Scotland be granted access to the archive. Through the feasibility study, we have demonstrated the potential value of research access for health data science and predictive medicine.

Longitudinal exposure to neighborhood poverty and obesity risk in emerging adulthood

This study uses data from the longitudinal Panel Study of Income Dynamics data and its Transition to Adulthood (TA) Study (2005–2017), in conjunction with decades of neighborhood-level data from the U.S. decennial census and American Community Survey, to examine the relationship between individuals’ neighborhood poverty exposure trajectories in childhood and the likelihood of obesity in emerging adulthood. Latent growth mixture models reveal that exposure to neighborhood poverty differs considerably for white and nonwhite individuals over their childhood life course. Durable exposure to neighborhood poverty confers greater subsequent obesity risks in emerging adulthood than transitory experiences of neighborhood poverty. Racial differences in the changing and persistent trajectories of neighborhood poverty help explain part of the racial differences in obesity risks. Among nonwhites, and compared to consistent nonpoor neighborhood conditions, both durable and transitory neighborhood poverty exposures are significantly associated with higher obesity risks. This study suggests that a theoretical framework that integrates key elements of the life-course perspective is helpful to uncover the individual and structural pathways through which neighborhood histories in poverty shape population health in general.

Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood.

Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.

Body mass index trajectories in childhood and incidence rates of type 2 diabetes and coronary heart disease in adulthood: A cohort study

AimsWe examined associations between five body mass index (BMI) trajectories from ages 6–15 years and register-based adult-onset type 2 diabetes mellitus (T2D) and coronary heart disease (CHD) with and without adjustment for adult BMI. MethodsChild and adult BMI came from two Danish cohorts and 13,205 and 13,438 individuals were included in T2D and CHD analyses, respectively. Trajectories were estimated by latent class modelling. Incidence rate ratios (IRRs) were estimated with Poisson regression. ResultsIn models without adult BMI, compared to the lowest trajectory, among men the T2D IRRs were 0.92 (95 %CI:0.77–1.09) for the second lowest trajectory and 1.51 (95 %CI:0.71–3.20) for the highest trajectory. The corresponding IRRs in women were 0.92 (95 %CI:0.74–1.16) and 3.58 (95 %CI:2.30–5.57). In models including adult BMI, compared to the lowest trajectory, T2D IRRs in men were 0.57 (95 %CI:0.47–0.68) for the second lowest trajectory and 0.26 (95 %CI:0.12–0.56) for the highest trajectory. The corresponding IRRs in women were 0.60 (95 %CI:0.48–0.75) and 0.59 (95 %CI:0.36–0.96). The associations were similar in direction, but not statistically significant, for CHD. ConclusionsIncidence rates of adult-onset T2D were greater for a high child BMI trajectory than a low child BMI trajectory, but not in models that included adult BMI.

Association of BMI trajectories with cardiometabolic risk among low-income Mexican American children.

BackgroundThe aim of this study was to identify distinct trajectories of BMI growth from 2 to 7.5 years and examine their associations with markers of cardiometabolic risk at age 7.5 years among a sample of low-income Mexican American children.MethodsThis longitudinal cohort study recruited 322 mother–child dyads to participate prenatally and at child age 2, 3, 4.5, 6, and 7.5 years. Child height/weight, waist circumference, and blood pressure were assessed at each time point. Blood was collected from child at 7.5 years.ResultsCovarying for birthweight, three BMI trajectories were identified: Low-Stable BMI (73% of the sample), High-Stable BMI (5.6% of the sample), and Increasing BMI over time (21.4% of the sample). The High-Stable and Increasing BMI classes had higher waist circumference and systolic blood pressure and lower HDL-c than the Low-Stable BMI class (ps < 0.05). Among children with BMIs below the 85th percentile, 16% had three or more cardiometabolic risk indicators.ConclusionsBMI classes were consistent with existing literature. For youth, standard medical practice is to examine cardiometabolic risk indicators when BMI is high; however, this practice would miss 16% of youth in our sample who exhibit cardiometabolic risk but do not screen in based on BMI.Impact Research indicates Mexican American youth are at risk for cardiometabolic dysregulation relative to other ethnic groups, yet there is a paucity of longitudinal research.An Increasing BMI and a High-Stable BMI class were associated with larger waist circumference, higher systolic blood pressure, and lower HDL cholesterol than the Low-Stable BMI class.BMI trajectories in childhood predict cardiometabolic risk indicators. As the sole screener for deciding when to test cardiometabolic indicators, BMI alone will miss some children exhibiting cardiometabolic dysregulation.

Maternal depression trajectories in childhood, subsequent maltreatment, and adolescent emotion regulation and self-esteem: the 2004 Pelotas birth cohort.

This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents’ self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent–Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents’ emotion regulation are partly mediated by child maltreatment at age 11.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-022-02022-6.

Internalizing symptoms in adolescence are modestly affected by symptoms of anxiety, depression, and neurodevelopmental disorders in childhood

BackgroundInternalizing disorders, such as anxiety and depressive disorders, are common mental disorders in young people, but a detailed understanding of the symptom continuity from childhood to adolescence that additionally includes a variety of neurodevelopmental disorder (NDD) symptoms is lacking. We therefore aimed to assess the extent to which parent-reported anxiety, depression, and NDD symptoms in childhood predict parent-reported internalizing symptoms in adolescence.MethodsWe used the nation-wide population-based Child and Adolescent Twin Study in Sweden, comprising 4492 twins born in Sweden between 1998 and 2003 that were assessed at age 9, and then again at age 15. Linear regression in a structural equation modelling framework was used to analyze the data.ResultsOverall, our results indicate that 15.9% of the variance in internalizing symptoms at age 15 can be predicted by anxiety, depression, and NDD symptoms at age 9. Anxiety and NDD symptoms in childhood predicted the largest amount of internalizing symptoms in adolescence.ConclusionsAdolescent internalizing symptoms are modestly affected by childhood symptoms of anxiety, depression, and NDDs, suggesting that they may represent different constructs across age. Future studies should further empirically investigate differences in etiology and trajectories of childhood versus adolescent internalizing symptoms.

Postnatal exposure to PM2.5 and weight trajectories in early childhood.

Background:Inconsistent evidence has assessed the impact of air pollution exposure on children’s growth trajectories. We investigated the role of 90-day average postnatal fine particulate matter (PM2.5) exposures by estimating the magnitude of effects at different ages, and the change in child weight trajectory by categories of exposure.Methods:We obtained weight values from electronic health records at each hospital visit (males = 1859, females = 1601) from birth to 6 years old children recruited into the Boston-based Children’s HealthWatch cohort (2009–2014). We applied mixed models, adjusting for individual and maternal confounders using (1) varying-coefficient models allowing for smooth non-linear interaction between age and PM2.5, (2) factor-smooth interaction between age and PM2.5 quartiles. Additionally, we stratified by sex and low birthweight (LBW) status (≤2500 g).Results:Using varying-coefficient models, we found that PM2.5 significantly modified the association between age and weight in males, with a positive association in children younger than 3 years and a negative association afterwards. In boys, for each 10 µg/m3 increase in PM2.5 we found a 2.6% increase (95% confidence interval = 0.8, 4.6) in weight at 1 year of age and a −0.6% (95% confidence interval = −3.9, 2.9) at 5 years. We found similar but smaller changes in females, and no differences comparing growth trajectories across quartiles of PM2.5. Most of the effects were in LBW children and null for normal birthweight children.Conclusions:This study suggests that medium-term postnatal PM2.5 may modify weight trajectories nonlinearly in young children, and that LBW babies are more susceptible than normal-weight infants.

Low length/weight growth trajectories of early-term infants during the first year: evidence from a longitudinal study in China

ObjectiveTo identify common length, weight and body mass index (BMI) growth trajectories of term infants during infancy, and to determine their association with early-term infants.DesignProspective longitudinal study.SettingWuhan, China.PatientsA total of...

Conceptualizing and Measuring Appetite Self-Regulation Phenotypes and Trajectories in Childhood: A Review of Person-Centered Strategies.

This review uses person-centered research and data analysis strategies to discuss the conceptualization and measurement of appetite self-regulation (ASR) phenotypes and trajectories in childhood (from infancy to about ages 6 or 7 years). Research that is person-centered provides strategies that increase the possibilities for investigating ASR phenotypes. We first examine the utility of examining underlying phenotypes using latent profile/class analysis drawing on cross-sectional data. The use of trajectory analysis to investigate developmental change is then discussed, with attention to phenotypes using trajectories of individual behaviors as well as phenotypes based on multi-trajectory modeling. Data analysis strategies and measurement approaches from recent examples of these person-centered approaches to the conceptualization and investigation of appetite self-regulation and its development in childhood are examined. Where relevant, examples from older children as well as developmental, clinical and educational psychology are drawn on to discuss when and how person-centered approaches can be used. We argue that there is scope to incorporate recent advances in biological and psychoneurological knowledge about appetite self-regulation as well as fundamental processes in the development of general self-regulation to enhance the examination of phenotypes and their trajectories across childhood (and beyond). The discussion and conclusion suggest directions for future research and highlight the potential of person-centered approaches to progress knowledge about the development of appetite self-regulation in childhood.

In utero exposure to parabens and early childhood BMI z-scores - Associations between placental ethyl paraben, longitudinal BMI trajectories and cord blood metabolic biomarkers.

Parabens are used as antimicrobial preservatives in personal care products. Few studies have dealt with adverse health outcomes, transplacental transfer, and obesogenic effects of prenatal exposure to parabens. We examined the association between placental paraben levels and cord blood metabolic biomarkers, considering modulating effects of maternal pre-pregnancy BMI and underlying epigenetic mechanisms, and investigated longitudinal effects of in utero paraben exposure on early childhood trajectories of BMI z-scores. Placental concentrations of four parabens [methyl (MeP), ethyl (EtP), propyl (PrP), and butyl (BuP)] were measured by ultra-performance liquid chromatography/tandem mass spectrometry in 229 placentas of the ENVIRONAGE birth cohort. The association with cord blood metabolic biomarkers [glucose, insulin, γ-glutamyltransferase (GGT), high-density and low-density lipoprotein (HDL and LDL)] was analyzed in multiple regression models with two different sets of, a priori selected potential confounders, additionally stratified for different maternal BMI groups and assessed by causal mediation analysis. The association between placental paraben concentration and differential DNA methylation of CpGs annotated to GGT and longitudinal measurements of BMI z-scores were investigated with adjusted linear mixed models. The geometric means of placental MeP, EtP, PrP, and BuP levels above the limit of detection (LOD) were 4.42, 1.32, 1.51, and 0.35ng/g respectively, with only EtP showing sufficient (88%) measurements above LOD for further analyses. An interquartile ratio (IQR) increase in placental EtP was associated with an increase of 12.61 % (95% CI: 1.80 24.57) in the geometric mean of cord GGT activity, and with a decrease of -3.64 % (95% CI: -6.80 to -0.39) in the geometric mean of cord glucose. Placental EtP levels were significantly associated with hypermethylation of cg08612779 annotated to GGT7 after correcting for multiple testing (ß = 0.0017, p=0.049). An interquartile ratio (IQR) increment in placental EtP was associated with a decrease in longitudinal BMI z-score of 0.27 points (95% CI: -0.46 to -0.088). Prenatal EtP exposure may affect early childhood BMI. The association of placental EtP with cord blood GGT and glucose levels provides a starting point for further research on mechanisms of paraben-related metabolic processes in utero.

“Encarnado vem de dentro, das Vísceras”: Entrevista Com Teka Potiguara E Marlúcia Potiguara

This interview aims to disseminate the genealogies of self and the embodied thoughts of two Indigenous women, bringing their looks and ways of existence to the political-epistemological discussion of embodied feminisms. For this, we interviewed two female leaders of the Potiguatapuia Movement/Ceara, who are part of different generations, in order to listen to them about their existence and becoming as Indigenous women inside and outside the villages. Thus, Dona Teka Potiguara and Dona Marlucia Potiguara recovered their childhood trajectories, life in the village, world readings on being born, dying, and caring, transits to the city, studies, and social relations. We also heard them bring into the dialogue the particularities of their intersections with other women's movements, sharing their thoughts about territory, belonging, spirituality, and about how ancestry offers them an embodied genealogy that “comes from within” is “red” and comes from “flesh”. We were four university women and a young Indigenous Tupi/Nheengatu scholar involved in the interview process, so our identification will not appear in the body of the interview.

Ability-grouping and problem behavior trajectories in childhood and adolescence: Results from a U.K. population-based sample.

Ability-grouping has been studied extensively in relation to children's academic, but not emotional and behavioral outcomes. The sample comprised 7259 U.K. children (50% male) with data on between-class and within-class ability-grouping at age 7. Peer, emotional, hyperactivity, and conduct problems were measured at ages 7, 11, and 14 years. Children in low within-class ability groups showed more hyperactivity and emotional problems across the study period compared to non-grouped children, after adjustments for the different types of ability grouping and confounding. Additionally, children in the middle within-class ability groups showed more, and those in the top within-class groups less, hyperactivity compared to non-grouped children, after adjustment. Children in lower within-class groups should be monitored closely to ensure that their well-being is not compromised.

Physical Activity as Both Predictor and Outcome of Emotional Distress Trajectories in Middle Childhood.

This prospective longitudinal study assesses the reciprocal relationship between physical activity, including sport participation, and depressive and anxiety symptoms, conceptualized as emotional distress, over time. Boys and girls are from the Quebec Longitudinal Study of Child Development birth cohort (N = 1428). Trajectories of emotional distress symptoms from ages 6 to 10 years, assessed by teachers, were generated using latent class analysis. Multinomial logistic regression analyses examined sport participation at age 5 years, measured by parents, as a predictor of emotional distress trajectory outcomes. Analyses of covariance compared physical activity, measured by children at age 12 years, across different trajectories of emotional distress. We identified 3 emotional distress trajectories: "low" (77%), "increasing" (12%), and "declining" (11%). Boys who never participated in sport at age 5 years were more likely to be in the "increasing" (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.01-2.63) or "declining" (adjusted OR = 2.19, 95% CI = 1.28-3.75) emotional distress trajectories compared with boys who participated in any sporting activity. Furthermore, boys in the "low" emotional distress trajectory demonstrated better physical activity outcomes at age 12 years (F(2, 1438) = 6.04, p < 0.05). These results, exclusively for boys, are above and beyond pre-existing individual and family factors. This study supports the relevance of enhancing current public health strategies to understand and promote physical activity and emotional adjustment in early childhood to achieve better a more active lifestyle and overall health across development. We underscore male needs for physical activity for health promotion.

Early life and socio-economic determinants of dietary trajectories in infancy and early childhood \u2013 results from the HSHK birth cohort study

BackgroundEarly childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes.MethodsMother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on ‘weekly frequency of core and discretionary foods intake’ using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for ‘core’ and ‘discretionary’ foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories.ResultsThe intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27–0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47–0.91) and having a single mother (RR: 0.40, 95%CI: 0.18–0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01–1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00–1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47–4.70), low maternal education (RR 3.01, 95%CI: 1.61–5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31–5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97–0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15–0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood.ConclusionChildren’s frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.

566Ear infection trajectories and academic, behavioural and quality of life outcomes: A population-based longitudinal study

Abstract Background Middle ear infection is a common disease in childhood. Outcomes might vary by its patterns and persistence over time. We aimed to investigate 1) typical trajectories of ear infections throughout childhood and 2) their associations with child outcomes. Methods Design &amp; Participants: Two parallel cohorts assessed biennially from 2004 to 2014 spanning ages 0-1 to 10-11 years (B cohort, n = 3721) and ages 4-5 to 14-15 years (K cohort, n = 3489) in the Longitudinal Study of Australian Children. Ear infection: Parent-reported ongoing ear infections (B: waves 1-6; K: waves 1, 2, 4, 5). Outcomes (wave 6): National academic standardized test, teacher-reported learning, parent and teacher-reported behaviour and self-reported quality of life. Analysis: Latent class models identified ear infection trajectories. Linear regression quantified associations between trajectories and outcomes. Results Four probability trajectories of ear infection emerged in both cohorts: “consistently low” (B 86.2%, K 87.0%), “moderate to low” (5.5%, 9.7%), “low to moderate” (7.0%, 1.5%), and “consistently high” (1.4%, 1.8%). In K cohort, the “consistently high” group had the worst outcomes (effect sizes 0.2-0.8 SDs), with effect sizes largest for psychosocial and language outcomes. “Moderate to low” and “low to moderate” groups showed no to marginal academic associations, but behaviour and quality of life were 0.2-0.3 SDs poorer than the “consistently low” group. Similar but attenuated associations were seen in B cohort. Conclusions Sizable adverse outcomes followed the consistently high trajectory, suggesting cumulative rather than age-dependent burden. Additional information about comorbidities, predictors and objective presence of ear infections could inform causal relationships. Key messages Parent-reported ear infections follow four childhood trajectories (consistently low, moderate to low, low to moderate, consistently high). Sizable adverse outcomes follow the consistently high trajectory.

EVIDENCE-BASED PEDIATRIC COPING STRATEGIES FOR THE COVID-19 PANDEMIC

While minimally susceptible to COVID-19, the pediatric population is most vulnerable to the psychosocial repercussions of this pandemic as they have faced setbacks and struggle to maintain normality in nearly every aspect of their lives. Duration of quarantine, fear of infection, limited social interaction, and more have had a significant positive correlation with poorer mental health, PTSD, anxiety, and anger. Young people have been burdened mentally and emotionally by the stressors of the COVID-19 pandemic. They have been thrown off their regular course and expected to quickly adapt to new parameters, restrictions, and limitations. The pandemic has undoubtedly had a significant impact on shaping their childhood trajectory as it has interrupted regular milestones and life checkoffs. In an aim to heal and ameliorate COVID-related anxiety, stress, and negative mental health consequences, utilization of appropriate coping strategies is encouraged and particularly important for disadvantaged groups who report multiple obstacles to pursuing treatment for mental health issues.

Childhood Trajectories of Hyperactivity/Inattention Symptoms and Diurnal Cortisol in Middle Adolescence: Results from a UK Birth Cohort

Objective Children with attention-deficit/hyperactivity disorder (ADHD) show hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Whether the association between hyperactivity/inattention symptoms with HPA axis dysfunction holds in the general child population too is not clear. Method We assessed associations between longitudinal trajectories of hyperactivity/inattention symptoms during ages 4 to 13 years and basal cortisol profiles at age 15 in a British general population cohort. Results Adolescents with persistently high levels of hyperactivity/inattention symptoms since childhood showed lower total morning cortisol and a smaller diurnal decline, even after adjusting for confounders. No associations were found between any of the symptom trajectories and cortisol awakening response, diurnal slope or daily output of cortisol. Conclusion This study provides evidence for hypocortisolism among adolescents with chronic hyperactivity/inattention symptoms in the general population.

BMI trajectory in childhood is associated with asthma incidence at young adulthood mediated by DNA methylation

PurposeBody mass index (BMI) is associated with asthma but associations of BMI temporal patterns with asthma incidence are unclear. Previous studies suggest that DNA methylation (DNAm) is associated with asthma status and variation in DNAm is a consequence of BMI changes. This study assessed the direct and indirect (via DNAm) effects of BMI trajectories in childhood on asthma incidence at young adulthood.MethodsData from the Isle of Wight (IoW) birth cohort were included in the analyses. Group-based trajectory modelling was applied to infer latent BMI trajectories from ages 1 to 10 years. An R package, ttscreening, was applied to identify differentially methylated CpGs at age 10 years associated with BMI trajectories, stratified for sex. Logistic regressions were used to further exclude CpGs with DNAm at age 10 years not associated with asthma incidence at 18 years. CpGs discovered via path analyses that mediated the association of BMI trajectories with asthma incidence in the IoW cohort were further tested in an independent cohort, the Avon Longitudinal Study of Children and Parents (ALSPAC).ResultsTwo BMI trajectories (high vs. normal) were identified. Of the 442,474 CpG sites, DNAm at 159 CpGs in males and 212 in females were potentially associated with BMI trajectories. Assessment of their association with asthma incidence identified 9 CpGs in males and 6 CpGs in females. DNAm at 4 of these 15 CpGs showed statistically significant mediation effects (p-value < 0.05). At two of the 4 CpGs (cg23632109 and cg10817500), DNAm completely mediated the association (i.e., only statistically significant indirect effects were identified). In the ALSPAC cohort, at all four CpGs, the same direction of mediating effects were observed as those found in the IoW cohort, although statistically insignificant.ConclusionThe association of BMI trajectory in childhood with asthma incidence at young adulthood is possibly mediated by DNAm.

Association of Emotion Regulation Trajectories in Childhood With Anorexia Nervosa and Atypical Anorexia Nervosa in Early Adolescence

People with anorexia nervosa often experience difficulties regulating their emotions. There is no longitudinal evidence as to whether these differences are already present in childhood or when they begin to emerge. To investigate the association between emotion regulation trajectories from 3 to 7 years of age and symptoms of anorexia nervosa and atypical anorexia nervosa in adolescence. This cohort study included all children with complete exposure data in the Millennium Cohort Study, a UK general population birth cohort. Data were acquired from June 2001 to March 2016 and analyzed from June to November 2020. Mothers reported on their children's emotion regulation skills at 3, 5, and 7 years of age using the Children's Social Behavior Questionnaire. Multilevel models were used to derive early childhood emotion regulation scores (ie, predicted intercept) and within-child changes in emotion regulation scores from 3 to 7 years of age (ie, predicted slope). Symptoms consistent with a DSM-5 diagnosis of anorexia nervosa or atypical anorexia nervosa at 14 years of age, defined using a range of questions relative to body image, weight perception, and dieting behaviors (hereinafter referred to as broad anorexia nervosa). Univariable and multivariable logistic regression models tested the association between exposures and outcome. Regression models were adjusted for child and family sociodemographic and socioeconomic characteristics and mental health difficulties, prenatal and perinatal factors, child's cognitive development, and maternal attachment. A total of 15 896 participants (85.7% of total sample; 51.0% boys; 84.5% White individuals) had complete data on the exposure and were included in the main analyses. Among those with complete exposure and outcome data (9912 of the analytical sample [62.4%]), 97 participants (1.0%; 86 [88.7%] girls and 85 [87.6%] White individuals) had symptoms consistent with a diagnosis of broad anorexia nervosa at 14 years of age. No evidence suggested that children with lower emotion regulation ability at 3 years of age had greater odds of later reporting symptoms of broad anorexia nervosa (odds ratio [OR], 1.21; 95% CI, 0.91-1.63). However, children whose emotion regulation skills did not improve over childhood and who had greater problems regulating emotions at 7 years of age had higher odds of having broad anorexia nervosa at 14 years of age (OR, 1.45; 95% CI, 1.16-1.83). These findings suggest that difficulties in developing age-appropriate emotion regulation skills in childhood are associated with experiencing broad anorexia nervosa in adolescence. Interventions to support the development of emotion regulation skills across childhood may help reduce the incidence of anorexia nervosa.