Implications For Adult Health Research Articles

The Relationship of School Connectedness to Adolescents' Engagement in Co-Occurring Health Risks: A Meta-Analytic Review.

School connectedness is an important factor in the lives of youth and are a leverage point for optimizing youth's social, emotional, and physical health. This study presents a meta-analysis examining the relationship between school connectedness and four health domains that are prevalent in adolescence, have implications for adult health, and often co-occur: mental health, sexual health, violence, and high-risk substance use. Ninety articles published between 2009 and 2019 were included in the analysis. The study found that school connectedness had a protective average effect size across all health domains (Hedges' g = -0.345, p-value<0.001). When examined separately, school connectedness had a significant protective relationship with substance use (g = -0.379, p < 0.001), mental health (Hedges' g = -0.358, p < 0.001), violence (Hedges' g = -0.318, p < 0.001), sexual health (Hedges' g = -0.145, p < 0.001), and with co-occurring risks (Hedges' g = -0.331, p < 0.001). These results provide strong evidence that school connectedness has the potential to prevent and mitigate multiple health risks during adolescence.

Differing trajectories of adversity over the life course: Implications for adult health and well-being

BackgroundAdverse childhood experiences (ACE), can give rise to long-term mental and physical health consequences as well as additional stressors later in the life course. This study aims to examine differing profiles of trajectories of adversity over the life course and investigate their association with socioeconomic and health outcomes. MethodsWe used population representative data from the Washington State 2011 Behavioral Risk Factor Surveillance System BRFSS survey n = 7953. Six ACE items were paired with six Adverse Adulthood Experience AAE items in respondents’ adulthood that parallel the ACE e.g. physical abuse in childhood and physical victimization in adulthood. We applied latent class analysis to identify distinct trajectories of adversity; then tested for differences across trajectories in terms of demographic, socioeconomic, and health measures. ResultsSix latent classes were identified: individuals with high AAE: (1. Consistently High, 2. Substance Abuse and Incarceration, 3. Adult Interpersonal Victimization) and individuals with low AAE (4. Repeat Sexual Victimization, 5. High to Low, and 6. Consistently Low). The Consistently High group had the highest prevalence of ACE and AAE and fared poorly across wide ranging outcomes. Other groups displayed specific patterns of ACE and AAE exposures (including salient subgroups such as those with incarceration exposure) as well as differences in demographic characteristics, illustrating disparities. ConclusionsSubgroup analyses such as this are complementary to population generalized findings. Understanding differences in life course patterns of adversity can shed light on interventions in earlier life and better target service provision to promote health and well-being.

Intrauterine metformin exposure and offspring cardiometabolic risk factors (PedMet study): a 5–10 year follow-up of the PregMet randomised controlled trial

Metformin is increasingly used to treat gestational diabetes and type 2 diabetes in pregnancy, and in attempts to improve pregnancy outcomes in polycystic ovary syndrome and obesity. It passes across the placenta with possible long-term consequences for the offspring. We previously explored the effect of metformin, given to women with polycystic ovary syndrome during pregnancy, on children's growth up to 4 years of age. In this 5-10 year follow-up, we examined the cardiometabolic risk factors in these children. This is a follow-up of children from the PregMet study, a double-blind, randomised controlled trial comparing metformin with placebo in polycystic ovary syndrome pregnancies. In the PregMet study, between Feb 4, 2005, and Jan 27, 2009, 257 pregnant women aged 18-45 years with polycystic ovary syndrome according to the Rotterdam criteria were included with 274 singleton pregnancies at 5-12 weeks of gestation at 11 study centres in Norway. 17 women participated twice. Pregnant women were randomised to metformin (2000 mg/day) or placebo from inclusion in the first trimester to birth. Randomisation was stratified according to metformin use at conception. In this follow-up, the primary endpoint was body-mass index (BMI) in the offspring at 5-10 years of age assessed by the standard deviation score (Z score). The primary endpoint was analysed with independent sample t tests. ClinicalTrials.gov number NCT00159536. Of the 255 invited children from the PregMet study, 141 (55%) consented to participate and were included between April 29, 2014, and July 12, 2016. Maternal baseline characteristics in the first trimester were similar between groups. Children in the metformin group had a higher BMI Z score than those in the placebo group (difference in means=0·41, 95% CI 0·03-0·78, p=0·03). The increased BMI in metformin-exposed children might indicate a potential risk of inferior cardiometabolic health. Implications for adult health cannot be excluded. The Research Council of Norway, Novo Nordisk Foundation, St Olavs University Hospital, and the Norwegian University of Science and Technology.

Intrauterine Metformin Exposure and Offspring Cardiometabolic Risk Factors at 5-10 Year Follow-Up: The PedMet Study

Background: Metformin is increasingly used in pregnancy. It passes the placenta with possible long-term consequences for the offspring. We explored potential effects of intrauterine metformin exposure on cardiometabolic risk factors, in 5-10 year old children of women with polycystic ovary syndrome (PCOS). Methods: Follow-up of children from the PregMet-study - a randomized controlled trial comparing metformin (2000 mg) to placebo in PCOS pregnancies. The primary endpoint was Body Mass Index (BMI) standard deviation score (z-score). Secondary endpoints included weight-related anthropometric measurement z-scores, bioelectrical impedance measurements, biochemical analyses (adiponectin, alanine transaminase (ALT), lipids, fasting glucose, insulin C-peptide, HbA1c), HOMA2-IR, blood pressure, and heart rate. Findings: From 2014 to 2016, we included 141 (55%) of 255 invited children. Maternal baseline characteristics in first trimester were comparable between groups. The BMI z-score was higher in the metformin group than in the placebo group (difference in means (d)=0·41, 95% CI 0·03-0·78, p=0·03). Metformin-exposed children had higher waist-to-height ratio z-score (d=0·36, 95% CI 0·06-0·67, p=0·02), waist circumference zscore (d=0·40, 95% CI 0·08-0·71, p=0·01), weight z-score (d=0·43, 95% CI 0·04-0·82, p=0·03), and borderline significantly higher body-fat (kg) (d= 1·8, 95% CI 0·0-3·6, p=0·05). Height z-score, head circumference z-score, muscle-mass (kg), biochemical analyses, blood pressure, and heart rate were comparable between groups. Interpretation: The increased BMI, waist circumference, and waist-to-height ratio in metformin-exposed children may indicate potential risk of inferior cardiometabolic health. Implications for adult health cannot be excluded. Clinical Trial Number: ClinicalTrials.gov-number:NCT00159536 Funding Statement: The Research Council of Norway, Novo Nordisk Foundation, St. Olavs University Hospital and the Norwegian University of Science and Technology. Declaration of Interests: The authors report no financial or personal conflicts of interest in this work. Ethics Approval Statement: The PregMet-study (project number 145.04) and the PedMet-study (project number 2014/96) were approved by the Committee for Medical Research Ethics of Health Region IV, Norway. Written, informed consent was obtained from each child’s parent or guardian before inclusion in the PedMet-study. The declaration of Helsinki and the Good Clinical Practice guidelines were followed throughout the studies.

Faster ticking rate of the epigenetic clock is associated with faster pubertal development in girls

ABSTRACTEpigenetic age is an indicator of biological aging, capturing the impact of environmental and behavioral influences across time on cellular function. Deviance between epigenetic age and chronological age (AgeAccel) is a predictor of health. Pubertal timing has similarly been associated with cancer risk and mortality rate among females. We examined the association between AgeAccel and pubertal timing and adolescent breast composition in the longitudinal Growth and Obesity Cohort Study. AgeAccel was estimated in whole blood using the Horvath method at breast Tanner 2 (B2) and 4 (B4). Total breast volume, absolute fibro-glandular volume (FGV), and %FGV were evaluated at B4 using dual X-ray absorptiometry. The impact of AgeAccel (mean: 0; SD: 3.78) across puberty on the time to breast development (thelarche), menarche, and pubertal tempo (thelarche to menarche) was estimated using accelerated failure time models; generalized estimating equations were used to evaluate associations with breast density. A five-year increase in average adolescent AgeAccel was associated with a significant decrease in time to menarche [hazard ratio (HR): 1.37; 95% confidence interval (CI): 1.04, 1.80] adjusting for birth weight, maternal pre-pregnancy body mass index, maternal height, maternal education, B2 height, fat percentage, and cell composition. AgeAccel displayed a stronger inverse association with pubertal tempo (HR: 1.48; 95% CI: 1.10, 1.99). A five-year increase in AgeAccel was associated with 5% greater %FGV, adjusting for B4 percent body fat, and maternal traits (95% CI: 1.01, 1.10). Our study provides unique insight into the influence of AgeAccel on pubertal development in girls, which may have implications for adult health.

Neighborhood and Family Environment of Expectant Mothers May Influence Prenatal Programming of Adult Cancer Risk: Discussion and an Illustrative DNA Methylation Example

Childhood stressors including physical abuse predict adult cancer risk. Prior research portrays this finding as an indirect mechanism that operates through coping behaviors, including adult smoking, or through increased toxic exposures during childhood. Little is known about potential direct causal mechanisms between early-life stressors and adult cancer. Because prenatal conditions can affect gene expression by altering DNA methylation, with implications for adult health, we hypothesize that maternal stress may program methylation of cancer-linked genes during gametogenesis. To illustrate this hypothesis, we related maternal social resources to methylation at the imprinted MEG3 differentially methylated regulatory region, which has been linked to multiple cancer types. Mothers (n = 489) from a diverse birth cohort (Durham, North Carolina) provided newborns’ cord blood and completed a questionnaire. Newborns of currently married mothers showed lower (−0.321 SD, p < .05) methylation compared to newborns of never-married mothers, who did not differ from newborns whose mothers were cohabiting and others (adjusted for demographics). MEG3 DNA methylation levels were also lower when maternal grandmothers co-resided before pregnancy (−0.314 SD, p < .05). A 1-SD increase in prenatal neighborhood disadvantage also predicted higher methylation (−0.137 SD, p < .05). In conclusion, we found that maternal social resources may result in differential methylation of MEG3, which demonstrates a potential partial mechanism priming socially disadvantaged newborns for later risk of some cancers.

Exposure to Violence during Childhood: Implications for Adult Health in the United States of America.

Exposure to Violence during Childhood: Implications for Adult Health in the United States of America.

Is hyperemesis gravidarum associated with placental weight and the placental weight-to-birth weight ratio? A population-based Norwegian cohort study

IntroductionStudies have suggested a link between placental weight, placental weight-to-birth weight ratio (PW/BW) and adult health. Hyperemesis gravidarum (HG) may also have implications for adult health. No studies on HG and placental characteristics have been identified. We therefore explored the relationship between HG, placental weight and the PW/BW-ratio in a population-based cohort. MethodsSingleton births to primiparous women between 1999 and 2009 with data on HG, placental weight and birth weight in the Medical Birth Registry of Norway (MBRN) comprised the study base (n = 200,390). HG was defined through ICD-10 code 021.0, 021.1 and 021.9. Gender and gestational age specific percentile curves for placenta weight and PW/BW ratio were used to define those below the 10th and above the 90th percentile of both outcomes. Associations between HG and dichotomous outcomes were studied by multiple logistic regression. Multiple linear regression was applied to study placental weight as a continuous variable. Male and female offspring were analyzed separately. ResultsThe prevalence of HG was 1.2%. Women with HG and female offspring had significantly higher risk of a PW/BW-ratio above the 90th percentile (OR = 1.17, 95% CI: 1.03–1.34). HG and PW/BW-ratio below the 10th percentile were inversely associated (OR = 0.70, 95% CI: 0.56–0.89). For male offspring no association was observed for HG and PW/BW-ratio below the 10th or above the 90th percentile. Discussion/conclusionsWe observed positive associations between HG and high PW/BW ratio limited to female offspring only. The high PW/BW-ratio suggests that there may be a possible link between HG and adult health.

The health implications of birth by Caesarean section

Since the first mention of fetal programming of adult health and disease, a plethora of programming events in early life has been suggested. These have included intrauterine and postnatal events, but limited attention has been given to the potential contribution of the birth process to normal physiology and long-term health. Over the last 30 years a growing number of studies have demonstrated that babies born at term by vaginal delivery (VD) have significantly different physiology at birth to those born by Caesarean section (CS), particularly when there has been no exposure to labour, i.e. pre-labour CS (PLCS). This literature is reviewed here and the processes involved in VD that might programme post-natal development are discussed. Some of the effects of CS are short term, but longer term problems are also apparent. We suggest that VD initiates important physiological trajectories and the absence of this stimulus in CS has implications for adult health. There are a number of factors that might plausibly contribute to this programming, one of which is the hormonal surge or "stress response" of VD. Given the increasing incidence of elective PLCS, an understanding of the effects of VD on normal development is crucial.

Effects of periconceptional undernutrition on maternal taurine concentrations in sheep

Taurine has an important role in numerous physiological processes, including many aspects of fetal development such as development of the pancreas and brain, and requirements increase during pregnancy. Periconceptional undernutrition has long-term effects on pancreas and brain function of the offspring, but the effects on maternal taurine economy are unknown. We, therefore, studied the effects of different periods of periconceptional undernutrition on maternal plasma and urine taurine concentrations before and during pregnancy. Four groups of singleton-bearing ewes were studied (n 10-11): controls fed ad libitum, and groups undernourished from 60d before until mating (PreC), from 2d before mating until 30d after mating (PostC) or from 60d before until 30d after mating (Pre+PostC). In PreC ewes, plasma taurine concentrations remained at control levels for the first 30d, and then decreased through the remainder of undernutrition, but recovered by 30d after mating; urinary taurine excretion was low at mating, but recovered similarly. In PostC ewes, plasma taurine concentrations recovered after 2 weeks despite ongoing undernutrition; urinary taurine excretion had recovered by 30d after mating. Pre+PostC ewes followed the same pattern as PreC for the first 60d, but plasma taurine concentrations and urinary excretion recovered slowly, and did not reach the control levels until 97d. These data suggest that different periods of mild periconceptional undernutrition in sheep have different but substantial effects on maternal taurine homoeostasis. These effects may be one mechanism by which maternal periconceptional undernutrition alters development of the offspring with implications for adult health.

Greek children's perception of illness and drugs

The way in which drugs are used is a result of structural factors, such as the pharmaceutical market and the system of professional health care, and of ideological ones, such as definitions of health and sickness, and perceptions about drugs and symbolic meanings attached to them. The foundations for ideological factors related to drug use are suspected to be created in childhood through personal and culturally shaped experiences related to health and sickness, with implications for adult health and illness behaviour. It is therefore important to explore the perceptions that children themselves have of medications, including the role that they play in children's ideas about therapeutic measures to be taken when they are sick. Sixty healthy Greek children, aged six and seven years, were individually interviewed about drawings they had made depicting themselves the last time they had been sick or not felt well. The content of their narratives was analysed for references to medications according to words which they used (e.g., by general description, by type of medication, by brand name), the spontaneity of their responses, attitudes expressed about the necessity of drugs for recovery, and descriptions of the process of being sick (ideas of causation, necessary behavioural changes, therapeutic measures etc.). Almost half of the children depicted and described themselves as alone while sick, often feeling isolated or denied access to regular activity; medications were seen as a way to resume normal activities and responsibilities.(ABSTRACT TRUNCATED AT 250 WORDS)