Longitudinal Study Of Pregnancy Research Articles

Birth weight rather than birth length is associated with childhood behavioural problems in a Czech ELSPAC cohort.

Many physical and psychological characteristics are influenced by prenatal development. Some studies have located links between low birth parameters and behavioural problems, with the latter in turn associated with educational progress, career success, overall health, and subsequent life events. However, few studies have investigated whether this association also applies to children in the normal birth growth range. This study thus investigates the relationship between normal-range birth length, weight, and behavioural problems at the age of seven. We use data from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) cohort, which provides comprehensive insight into a post-communist country undergoing a period of economic transition. Childhood behavioural problems were measured in 1,796 children using the Strengths and Difficulties Questionnaire. Associations were modelled using weighted logistic regression. Birth weight was found to be linked to the total difficulties score, hyperactivity, and peer relationship problems subscales in a fully adjusted model while birth length was not significantly associated with any subscale in the fully adjusted model. We thus conclude that normal-range birth weight is associated with behavioural problems. It can therefore be assumed that the odds of behavioural problems and their consequences can be mitigated by preventive programs targeting pregnant women and children with lower but still normal weight.

Approximate Bayesian inference for joint linear and partially linear modeling of longitudinal zero-inflated count and time to event data.

Joint modeling of zero-inflated count and time-to-event data is usually performed by applying the shared random effect model. This kind of joint modeling can be considered as a latent Gaussian model. In this paper, the approach of integrated nested Laplace approximation (INLA) is used to perform approximate Bayesian approach for the joint modeling. We propose a zero-inflated hurdle model under Poisson or negative binomial distributional assumption as sub-model for count data. Also, a Weibull model is used as survival time sub-model. In addition to the usual joint linear model, a joint partially linear model is also considered to take into account the non-linear effect of time on the longitudinal count response. The performance of the method is investigated using some simulation studies and its achievement is compared with the usual approach via the Bayesian paradigm of Monte Carlo Markov Chain (MCMC). Also, we apply the proposed method to analyze two real data sets. The first one is the data about a longitudinal study of pregnancy and the second one is a data set obtained of a HIV study.

Positive cognitive appraisal “buffers” the long-term effect of peritraumatic distress on maternal anxiety: The Queensland Flood Study

BackgroundLimited research has evaluated distinct aspects of disaster experience as predictors of affective symptoms. In this study, we examined the extent to which maternal depression and anxiety over time were predicted by (1) objective hardship from a flood during pregnancy, (2) peritraumatic distress and (3) cognitive appraisal of the flood's consequences. MethodsData were drawn from the 2011 Queensland Flood Study, a prospective, longitudinal study of pregnancy (n = 183). Mothers’ disaster experience was measured within 1 year after the flood. Their levels of depression, anxiety and stress were measured at 16 months, 30 months, 4 years and 6 years after childbirth. Linear mixed models were employed to evaluate symptom trajectories. ResultsThere were no time-dependent effects of disaster-related variables. Objective hardship did not predict outcomes. Peritraumatic distress significantly predicted depression and anxiety symptoms when cognitive appraisal was negative. Conversely, when cognitive appraisal was neutral or positive, the effect of peritraumatic distress was “buffered”. For anxiety, but not depression, this interaction survived Bonferroni correction. Neutral/positive cognitive appraisal similarly moderated the effect of peritraumatic dissociation. LimitationsThe generalizability of our findings is limited by overall low levels of depression and anxiety, along with a predominantly Caucasian, higher socioeconomic status sample. Potential confounders such as pre-disaster anxiety were not controlled for. ConclusionIn line with previous evidence, this study supports the predictive validity of peritraumatic distress for post-disaster depression and anxiety. Our findings suggest that cognitive appraisal could be a relevant target for interventions aimed at fostering maternal resilience.

Childhood Sleep Functioning as a Developmental Precursor of Adolescent Adjustment Problems.

Sleep has been linked to adjustment difficulties in both children and adolescents; yet little is known about the long-term impact of childhood sleep on subsequent development. This study tested whether childhood sleep problems, sleep quantity, and chronotype predicted internalizing and externalizing problems during adolescence. Latent Growth Modeling using the Czech portion of the European Longitudinal Study of Pregnancy and Childhood (N = 4393) was utilized to test the developmental trajectories of sleep characteristics (from 1.5 to 7years) as predictors of adjustment problems trajectories (from 11 to 18years). Findings provided evidence that children with higher levels of sleep problems at 1.5years (and throughout childhood) reported higher levels of internalizing and externalizing problems at age 11. Additionally, greater eveningness at age 1.5 predicted a greater increase in externalizing problems from ages 11 to 18years. The results emphasize the importance of childhood sleep problems in evaluating the risk of future adjustment difficulties.

Labour room violence in Uttar Pradesh, India: evidence from longitudinal study of pregnancy and childbirth

ObjectivesThe major objective of this study was to investigate the prevalence of labour room violence (LRV) (one of the forms of obstetric violence) faced by the women during the time...

Subjective Health Complaints in Fifteen-Year-Old Czech Adolescents: The Role of Self-Esteem, Interparental Conflict, and Gender

This cross-sectional study aims to 1) investigate the factor structure and measurement invariance of subjective health complaints inventory in terms of gender, 2) examine the role of selfesteem, interparental conflict and gender in Czech adolescents’ subjective health complaints, and 3) examine a possible moderating effect of gender in these relationships. Czech adolescents (N = 1602, 51% girls) from an epidemiological part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) completed questionnaires at home and a psychological sub-sample of ELSPAC (n = 343, 46% girls) completed questionnaires during individual psychological examinations in the years 2006 and 2007. The subjective health complaints inventory used in this study is a unidimensional and scalar invariant for sex. Girls reported more subjective health symptoms than boys. Self-esteem may play a protective role for the adolescents’ subjective health symptoms, especially in boys, whereas self-blame and threat in an interparental conflict may serve as a risk factor similarly for both sexes.

23-Prenatal stress, mood, and gray matter volume in young adulthood

This study aimed to determine whether prenatal stress, measured by the number of stressful life events during the first 20 weeks of pregnancy, might relate to mood dysregulation and altered brain structure in young adulthood. Participants included 93 mother – offspring pairs from a community-based birth cohort from the Czech Republic (European Longitudinal Study of Pregnancy and Childhood; ELSPAC-CZ). MRI analyses focused on overall cortical gray matter (GM) volume and GM volume of cortical regions previously associated with major depression. Higher prenatal stress predicted more mood dysregulation, particularly higher anxiety, fatigue and anger, lower overall cortical GM volume (corrected for brain size) and lower GM volume in mid-dorsolateral frontal cortex, anterior cingulate cortex and precuneus in young adulthood. We observed no Prenatal Stress by Sex interactions for any of the above relationships. We conclude that prenatal stress is an important risk factor that relates to worse mood states and altered brain structure in young adulthood irrespective of sex. Our results point to the importance and long lasting effects of prenatal programming and suggest that offspring of mothers who went through substantial stress during pregnancy might benefit from early intervention that would reduce the odds of mental illness in later life.

Estimated dietary iodine intake as a predictor of placental size: evidence from the ELSPAC study

BackgroundThe relationship between low iodine status and pregnancy-associated comorbidities has been known for decades. The relationship between iodine intake and placental pathologies is, however, far less clear. This study was designed to examine the relationship between dietary iodine intake and placental size while also focusing on typical adverse pregnancy outcomes.MethodThe dietary iodine intake of 4711 pregnant women enrolled in the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) in 1990–1991 was established using a 145-item food frequency questionnaire. Multivariate linear regression models were used to estimate the relationship between dietary iodine intake during pregnancy and placental weight. Additional models were constructed to investigate the relationship between estimated dietary iodine intake and adverse birth outcomes.ResultsThe estimated average iodine intake in the ELSPAC cohort was 106.6 μg/day. In the fully adjusted model, estimated dietary iodine intake was found to be significantly negatively associated with placental weight (β = −0.025, 95% CI: -0.044; −0.006, p = 0.011). Moreover, estimated dietary iodine intake was found to be significantly positively associated with the birth weight / placental weight ratio in the fully adjusted model (β = −0.024, 95% CI: 0.004; 0.043, p = 0.016).ConclusionsThis study provides evidence of a relationship between estimated dietary iodine intake and placental weight and the birth weight / placental weight ratio. Additional research is warranted to provide more insight into the role of iodine in early as well as late placentation.

Interparental conflict appraisal and general fearfulness in middle adolescence

The purpose of this study is to analyze relationships between interparental conflict and experienced fears in middle adolescents. A total of 534 fifteen-year-old adolescents from the European Longitudinal Study of Pregnancy and Childhood (49% girls) completed measures of interparental conflict (Children's Perceptions of Interparental Conflict Scale) and their subjective experienced fears (free-response method Cake of Fear). Multiple linear regression analyses indicate that sex significantly predicted the number of reported fears as did feelings of own efficacy in coping with interparental conflict. Girls tend to report more fears and higher conflict frequency, intensity, and threat than boys; the growing feeling of coping efficacy with parental conflict decreases the amount of reported fears only in the group of boys.

Cohort Profile: The Isle of Man Birth Cohort Study

The Isle of Man is a self-governing British Crown Dependency situated equidistantly from England, Scotland and Ireland. In 1991, its population of ∼75,000 comprised ∼50% indigenous Manx and 50% immigrants, mainly from the surrounding countries. It was invited to join the European Longitudinal Study of Pregnancy and Childhood. The aim of the study was to enrol all pregnant women resident on the Island with an expected date of delivery in the 18-month period of January 1991-June 1992. A total of 1314 livebirths formed the eligible cohort. Questionnaires were completed by mothers and their partners during pregnancy and subsequently at 6 weeks, 6 months, 18 months, 3, 5, 7 and 15/16 years. Hands-on examination of the children occurred at age 7 years, when biological samples were collected. Teachers completed questionnaires at 7 and 15 years; medical records were extracted for the obstetric and childhood periods. Response rates varied from >80% from teachers and children at 15 years to only 23% from partners when their children were aged 7 years. Selected data sets are available to collaborators, although many of the data need funds for further collaboration.

Predictors of post-partum weight retention in a prospective longitudinal study.

Post-partum weight retention (WR) occurs in 60-80% of women with some retaining ≥10 kg with contributing factors reported as pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and breastfeeding. A longitudinal study of pregnancy, with 12-month post-partum follow-up was conducted to determine factors associated with WR. Pregnant women (n = 152) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Pre-pregnancy weight was self-reported; weight was measured four times during pregnancy (for GWG) and in the first 12 months post-partum. Infant feeding data were obtained via questionnaires. Breastfeeding was categorised as exclusive, predominant, complementary or not breastfeeding. Linear mixed models tested the predictors of WR, with and without adjustment for potential confounders. Compared with pre-pregnancy weight, 68% of women retained weight at 12 months, median (interquartile range) [4.5 kg (2.1-8.9)]. After adjustment, GWG was positively associated with WR (P < 0.01), but pre-pregnancy weight did not predict WR. For each additional week of any breastfeeding, 0.04 kg less weight was retained. Compared with women who retained weight, those women who did retain had higher rates of exclusive breastfeeding at three months (P < 0.05), but the number of weeks of exclusive breastfeeding failed to predict WR for all women. WR following childbirth is common and associated with GWG, while the number of weeks of 'any' breastfeeding contributed to post-partum weight loss. Whether these factors are modifiable strategies to optimise the weight status of women at this life stage requires further research.

Environmental risk factors for injuries in UK primary school aged children

AimFactors previously associated with the risk of unintentional injury in primary school aged children include a range of child and family variables. Risk factors in the environment have been seldom...

Risk factors for wheezing in Ukrainian children: Ukraine European Longitudinal Study of Pregnancy and Childhood Group

The prevalence of wheezing in children varies widely around the world. The reasons for this geographic variability remain unclear but may be related in part to exposures in the home environment during pregnancy and early childhood. We investigated the prenatal and early childhood risk factors for wheezing symptoms among 2127 children aged 6-8 years who were participants in the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Cases included the 169 children whose parents answered yes to the International Study of Asthma and Allergy in Children (ISAAC) question: 'Has your child had wheezing or whistling in the chest in the past 12 months' during the ELSPAC assessment of the children at age 7. These were compared with the 1861 children in the cohort whose parents answered 'no' to this question. Factors significantly associated with increased risk of wheezing illness at age 7 in adjusted analyses included mother's asthma [adjusted odds ratio (OR) 3.46, 95% confidence interval (CI) 1.22, 9.85]; mother's allergy problems (OR 1.43, [1.00, 2.05]); rarely playing with other children at age 3 (OR 1.84, [1.09, 3.11]); water intrusion (OR 1.62, [1.09, 2.39]) and inadequate heating of the home (OR 1.52, [1.06, 2.16]) during pregnancy. Factors protective of wheezing at age 7 included being first-born (adjusted OR 0.70, 95% CI 0.50, 0.98); living in the city of Dniprodzerzynsk as compared with Kyiv (OR 0.36, [0.24, 0.54]) and weekly contact with furry animals (OR 0.44, [0.20, 0.97]) before age 3. The constellation of risk factors for wheezing in Ukrainian children is similar to that of children in other parts of the world. Known risk factors do not account for the significant between-city variability of wheezing in Ukrainian children.

Male employment in some printing trades is associated with prolonged time to conception.

We investigated whether male employment in defined occupational groups was associated with decreased fecundity as revealed by prolonged time to conception. The analysis was carried out on data from questionnaires completed over a period of 21 months by 4808 couples with a planned pregnancy and collected as part of the Avon Longitudinal Study of Pregnancy and Childhood. Previously logistic regression had identified nine non-occupational factors associated with taking >6 or >12 months to conceive and this model was used to analyse the association of the fathers ever having worked in defined occupational groups with delayed conception. If the man had worked in 'Printing and related trades' (OPCS code 56), couples had a statistically significantly increased odds ratio (OR) of taking >6 [1.86 (1.21, 2.94)] or >12 months [1.96 (1.13, 3.39)] to conceive [OR (95% confidence intervals)] after adjustment for non-occupational factors. The association with time to conception was stronger in the subgroup 'Other printing related trades' (OPCS code 569) but no statistically significant associations after adjustment for other factors were found for other printing jobs.

Carriage of antibiotic-resistant bacteria by healthy children.

The frequency of carriage of antibiotic-resistant bacteria in healthy 7- and 8-year-old children in Bristol was studied. Children born in Avon between 1 April 1991 and 31 December 1992, attending the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) 7 year follow-up clinic, formed the study population. Carriage was estimated using mouth and stool samples. None of 105 children on whom information was available had received tetracycline, chloramphenicol, ciprofloxacin or an extended-spectrum cephalosporin in the previous year. Staphylococcus aureus was isolated from mouthwashes from 200 (37.1%) of 539 children sampled. Six (3%) of the isolates were resistant to chloramphenicol or tetracycline and four (2%) were methicillin resistant. Haemophilus spp. were isolated from 369 (72%) of 513 samples and 63 (17%) were ampicillin resistant, 49 (13.3%) were erythromycin resistant and seven (1.9%) were tetracycline resistant. Branhamella catarrhalis was isolated from 333 (74%) of 450 samples. Twenty-eight (8.4%) were erythromycin resistant and 14 (4.2%) strains were tetracycline resistant. Group A beta-haemolytic streptococci were isolated from 17 of 507 children sampled. One (5.9%) was tetracycline resistant. Stool samples were returned from 335 (62%) of 539 children from whom they were requested. Eleven per cent of samples yielded Gram-negative bacilli with high-level resistance to chloramphenicol, which was frequently linked to resistance to ampicillin, spectinomycin and streptomycin. Isolates demonstrating resistance to the third-generation cephalosporin ceftazidime were recovered from 17 subjects (3.2%). Six (35%) of 17 isolates possessed extended-spectrum beta-lactamases. Healthy children carry bacteria resistant to antibiotics to which children are not usually exposed. Resistance to ceftazidime, chloramphenicol and tetracycline may be co-selected by exposure to other antibiotics used in children or may be acquired from family members, pets, other children or food. These results suggest that antibiotic-resistant bacteria are widely disseminated and may be acquired by children before exposure to specific selection pressure.

Stress and pregnancy among African-American women.

Research on stress tends to support an adverse effect on pregnancy outcomes, and suggests that the impact of these stressors is modified by social class and/or race. This study explicitly examined social factors such as experiences of discrimination, either racial or sexual, and neighbourhood crime as predictors of stress. We also examined cortisol and stress as predictors of blood pressure. A subsample of 94 African-American pregnant women, aged 18-39 years, who were enrolled in a longitudinal study of pregnancy and exposure to lead in the environment were used in this analysis. The women were patients at an obstetrics clinic at Magee Women's Hospital in Pittsburgh, PA, USA. Younger age, higher income, lower education and experiences of discrimination, both racial and sexual, were related to greater perceived stress; however, life events were not related to perceived stress. Higher income and urinary cortisol adjusted for creatinine were related to systolic blood pressure after the 36th week. As a body of evidence suggests that stress can have deleterious effects in both pregnant and non-pregnant women, future research should examine these forms of discrimination, especially racial discrimination, as a possible reason for the disparity in adverse pregnancy outcomes between African-American and white women.

Collaborative research and research training through the "Family and Children of Ukraine" research program.

Family and Children of Ukraine, the Ukrainian component of the European Longitudinal Study of Pregnancy and Childhood, is a prospective, geographically-based study to evaluate pregnancy outcomes in 8,000 women in five cities in Ukraine and follow the cohort of births through 7 years of age. Family and Children in Ukraine has been the major collaborative research project for the University of Illinois' Fogarty-funded program, International Training and Research in Environmental and Occupational Health. This Fogarty program includes graduate training, U.S.-based training of visiting scientists, in-country training, and collaborative in-country research. Factors that have contributed to the success of the collaboration include: 1) its focus on the environmental health of mothers and children, which is a priority goal for both countries; 2) the adoption of an internationally-endorsed research protocol with strict quality-control criteria, specifically designed for international collaboration; 3) the establishment of an in-country data management center; and 4) the investment in a long-term research program rather than a short-term study. The major obstacles have been the difficult economic situation in Ukraine, which limits in-country research investment, and the difficulty in obtaining U.S. funding for an international research program.

Employment, parity and single parenthood: Their impact on health in pregnancy

This study examined the relationship between employment status and mental and physical health in pregnancy and identified variations in this relationship that were associated with parity and single parenthood. The sample of 12,169 women was drawn from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Employment status was measured at 18 and 32 weeks gestation as were the two main health outcomes: depression (using the Edinburgh Postnatal Depression Scale) and self report of nausea. A woman's parenthood status, socio-economic status, age, educational level, ethnic group membership and smoking behaviour were also recorded. Separate analyses were carried out for primiparous and for multiparous women. Within these parity groups, × 2 tests were used to determine the relationship between employment status and the social, demographic and behavioural variables outlined above. Logistic regression analyses established how employment and parenthood status were associated with the health of each group of women, after controlling for potential confounding factors. These analyses showed that for depression, primiparous women were at reduced risk if they worked in pregnancy when compared with women who were not working; primiparous women who gave up work in early pregnancy were most likely to be depressed. Single parents in each employment status category were more likely to be depressed than women with partners. For nausea, primiparous women with partners who gave up work early in pregnancy were more likely to report this condition; for single parents the reverse was the case. There was no significant association between employment and either mental or physical health for multiparous women. Results were discussed in terms of whether they demonstrated the effect of work itself on pregnancy, or whether they were the consequence of health selection in and out of the labour market.

Working women, their emotional well-being and pregnancy in Greece

The study investigates the relationship between occupational status during preg-nancy and depression in the post-partum period. A sample of 2831 married women, physically healthy during pregnancy and of Greek nationality, was drawn from the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Three to four days post-partum, women answered a questionnaire exploring retrospectively their own and their partners' lifestyle and physical and psychosocial well-being. Taking parental status into account, the study examined whether age, education, perceived social support, locus of control, impact of stressful life events, activity level and perceived satisfaction with work, moderated the relationship between occupational status during pregnancy and psychological well-being post-partum. The results showed that employment status only explains depression in multiparous women. Social support, internal locus of control, decreased impact of life events and increased activity during pregnancy have a beneficial effect on depression of both multiparous and primiparous women. Giving up work during pregnancy did not appear to differentiate between the two groups of women in terms of depression. Reasons for stopping work or the time of doing so were not found to predict depression. Results are discussed with reference to the current Greek sociocultural context.

Nitrogen Dioxide in Infants' Bedrooms: A Feasibility Study for Household Based Measurements

To determine the feasibility of postal methods to measure indoor and outdoor levels of nitrogen dioxide without technical intervention of trained staff. Postal distribution of Palmes diffusion tubes to the householder to measure nitrogen dioxide levels inside the baby's bedroom and outside homes followed by a questionnaire ascertaining possible sources of nitrogen dioxide. Setting: Three health districts in Avon during two weeks in November 1992; 100 women, randomly selected from those with infants 4–6 months of age, currently participating in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Outcome measures: Response rate and evidence of understanding and implementation of the method by the householder; the comparability of results to those obtained from studies using visits by trained staff, for ratios of nitrogen dioxide outdoors/indoors and in homes with and without a gas cooker. There was a 91% response rate with all but one family carrying out the measurements successfully. The ratio...