Parental Risk Research Articles

Gender differences in the risk of depressive disorders following the loss of a young child: a nationwide population-based longitudinal study

BackgroundLosing a child to death is one of the most stressful life events experienced in adulthood. The aim of the current study is to investigate parental risk of seeking treatment for major depression disorders (MDD) after a child’s death and to explore whether such connection may operate differentially by parents’ prior medical condition.MethodsWe studied a retrospective cohort of 7245 parents (2987 mothers and 4258 fathers) identified in the National Health Insurance Research Database of Taiwan (NHIRD) who had lost a child with age between 1 and 12 years. For comparison, the parents of 1:4 birth year- and gender-matched non-deceased children were retrieved (16,512 mothers and 17,753 fathers). Gender-specific Cox regression analyses were performed to estimate risk.ResultsNearly 5.0% and 2.4% of bereaved mothers and fathers sought treatment for MDD within three years after a child’s death, significantly higher than 0.8% and 0.5% in the non-bereaved parents. With covariate adjustment, the hazard ratio (HR) for maternal and paternal seeking treatment for MDD was estimated 4.71 (95% confidence interval [CI]: 3.35–6.64) and 1.93 (95% CI: 1.27–2.95), respectively. The increased risk of MDD varied by prior disease history; specifically, the increased risk of seeking treatment for MDD was especially prominent for those without chronic physical condition (CPC) (e.g., mothers with CPC: aHR = 2.38, 95% CI: 1.56–3.65 vs. no CPC: aHR = 9.55, 95% CI: 6.17–14.79).ConclusionsAfter the death of a child, parental elevated risk of MDD was especially prominent for the women and those without prior medical condition. Effective strategies addressing bereavement may require family-based, integrated physical and mental healthcare and even extended counseling service.

Self-Compassion and Rumination Type Mediate the Relation between Mindfulness and Parental Burnout.

The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through mindfulness practice: trait mindfulness, self-compassion, and concrete vs. abstract ruminations. A total of 459 parents (Mage = 40; 98.7% female) completed self-reported questionnaires at two-time points to assess the predictive role of mindfulness on parental burnout, self-compassion and rumination type, and the mediating role of self-compassion and rumination type in the relation between mindfulness and parental burnout. Results showed that trait mindfulness, self-compassion, and rumination type at Time 1 predicted levels of parental burnout at Time 2. Self-compassion (indirect effects: b = − 22, 95% CI = [−38, −05], p < 0.01), concrete ruminations (indirect effects: b = −20, 95% CI = [−32, −09], p < 0.001), and abstract ruminations (indirect effects: b = −0.54, 95% CI = [−71, −37], p < 0.001) partially mediated the relation between trait-mindfulness and parental burnout. These findings showed that trait mindfulness, self-compassion, and concrete (vs. abstract) ruminations may help prevent parental burnout in the context of the COVID-19 pandemic. These results contribute to the field of research on parental burnout prevention and will allow for the development of effective approaches to mental health promotion in parents.

Risk of hypertension in school-aged children with different parental risk: a longitudinal study from childhood to young adulthood

BackgroundAlthough previous studies have shown the relationship between different parental factors and children’s blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic characteristics, the current study aimed to distinguish parental risk clusters and their impact on the incidence of hypertension in school-age children over 13 years.MethodsParental characteristics of 1669 children, including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status, and diabetes were considered to categorize parents into low and high-risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal cluster. Using Cox proportional hazard model, results on the association between parental risk clusters and HTN incidence in children were reported in five different models.ResultsMean age of children was 13.96 ± 2.89 years, and 51.2% (n = 854) were girls. MetS, HTN, and weight status were the most important factors distinguishing low and high-risk parental clusters, respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71–106) and 38 (95% CI, 29–52) in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI, 40–63) and 80 (95% CI, 64–102) in maternal low and high-risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high-risk clusters were 53 (95% CI, 41–70) and 68 (95% CI, 56–84), respectively.ConclusionOur findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.

Family and individual risk factors for triangulation: Evaluating evidence for emotion coaching buffering effects.

Adolescents who are triangulated into interparental conflict are at increased risk for psychological maladjustment. However, little is known about factors that may predict family risk for triangulating adolescents, or protective factors that can off-set this risk. In this study, we conducted longitudinal tests of family, parent, and adolescent factors that might predict increases in triangulation over time. The sample included 174 adolescents and their mother figures from two-parent families (58% female; Mage =14.75years) who provided data on two occasions, six months apart. Hierarchical linear regression models evaluated family, parent, and adolescent risk factors for triangulation into interparental conflict, and subsequently parent's emotion coaching and adolescent gender as potential moderators of risk for triangulation. Findings revealed that low family cohesion, parent depression, and adolescent difficulties with emotion regulation represented risks for triangulation. Parent emotion coaching moderated the association between low interparental love and triangulation differentially based on adolescent gender.

From late fatherhood to prenatal screening of monogenic disorders: evidence and ethical concerns.

With the help of ART, an advanced parental age is not considered to be a serious obstacle for reproduction anymore. However, significant health risks for future offspring hide behind the success of reproductive medicine for the treatment of reduced fertility associated with late parenthood. Although an advanced maternal age is a well-known risk factor for poor reproductive outcomes, understanding the impact of an advanced paternal age on offspring is yet to be elucidated. De novo monogenic disorders (MDs) are highly associated with late fatherhood. MDs are one of the major sources of paediatric morbidity and mortality, causing significant socioeconomic and psychological burdens to society. Although individually rare, the combined prevalence of these disorders is as high as that of chromosomal aneuploidies, indicating the increasing need for prenatal screening. With the help of advanced reproductive technologies, families with late paternity have the option of non-invasive prenatal testing (NIPT) for multiple MDs (MD-NIPT), which has a sensitivity and specificity of almost 100%. The main aims of the current review were to examine the effect of late paternity on the origin and nature of MDs, to highlight the role of NIPT for the detection of a variety of paternal age-associated MDs, to describe clinical experiences and to reflect on the ethical concerns surrounding the topic of late paternity and MD-NIPT. An extensive search of peer-reviewed publications (1980-2021) in English from the PubMed and Google Scholar databases was based on key words in different combinations: late paternity, paternal age, spermatogenesis, selfish spermatogonial selection, paternal age effect, de novo mutations (DNMs), MDs, NIPT, ethics of late fatherhood, prenatal testing and paternal rights. An advanced paternal age provokes the accumulation of DNMs, which arise in continuously dividing germline cells. A subset of DNMs, owing to their effect on the rat sarcoma virus protein-mitogen-activated protein kinase signalling pathway, becomes beneficial for spermatogonia, causing selfish spermatogonial selection and outgrowth, and in some rare cases may lead to spermatocytic seminoma later in life. In the offspring, these selfish DNMs cause paternal age effect (PAE) disorders with a severe and even life-threatening phenotype. The increasing tendency for late paternity and the subsequent high risk of PAE disorders indicate an increased need for a safe and reliable detection procedure, such as MD-NIPT. The MD-NIPT approach has the capacity to provide safe screening for pregnancies at risk of PAE disorders and MDs, which constitute up to 20% of all pregnancies. The primary risks include pregnancies with a paternal age over 40 years, a previous history of an affected pregnancy/child, and/or congenital anomalies detected by routine ultrasonography. The implementation of NIPT-based screening would support the early diagnosis and management needed in cases of affected pregnancy. However, the benefits of MD-NIPT need to be balanced with the ethical challenges associated with the introduction of such an approach into routine clinical practice, namely concerns regarding reproductive autonomy, informed consent, potential disability discrimination, paternal rights and PAE-associated issues, equity and justice in accessing services, and counselling. Considering the increasing parental age and risks of MDs, combined NIPT for chromosomal aneuploidies and microdeletion syndromes as well as tests for MDs might become a part of routine pregnancy management in the near future. Moreover, the ethical challenges associated with the introduction of MD-NIPT into routine clinical practice need to be carefully evaluated. Furthermore, more focus and attention should be directed towards the ethics of late paternity, paternal rights and paternal genetic guilt associated with pregnancies affected with PAE MDs.

Family-based eHealth interventions to reduce cardiovascular disease risk: a systematic review

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Department for the Economy, Northern Ireland Background Family-based eHealth interventions have potential to reduce cardiovascular disease (CVD) risk and improve health of parents and children. Purpose To evaluate the effectiveness of family-based eHealth interventions to reduce parent and child CVD risk. Methods Systematic review. Five electronic databases were searched (CENTRAL; MEDLINE; CINAHL; EMBASE; PsycINFO) up to April 2020. Data extraction included: study design, setting, methodology, eHealth technology, experiment/control group constituents, risk factors, outcomes, incentivisation and limitations. Data were synthesised narratively. Cochrane methodology was used to assess risk of bias and reporting quality. Results In total, 2193 articles were screened and seven trials included for review. The most consistently improved CVD risk factor across parents and children was reduced alcohol use, whilst reduction in BMI the least consistently improved. Behaviour-change theoretical underpinning, extended follow-up duration, interactivity and incentivisation were identified as effective components of these interventions. Four studies were assessed as overall ‘low risk’ of bias and three studies had concerns with randomisation and intention-to-treat analysis. Conclusions: This is the first systematic review to evaluate family-based eHealth interventions to reduce CVD risk. Despite a paucity in high-quality trials, there is evidence of their potential effectiveness. Recommended, more high quality, behaviour-change-theory-based, clearly reported interventions with explicit outcomes.

Factors Associated with Stunting among 24–35-Month-Old Kalinga Indigenous Children in Pinukpuk, Kalinga, Philippines: A Case-Control Study

The study identified the risk factors associated with stunting among 24.35 months indigenous children in Pinukpuk, Kalinga using case control design; 174 children (87 cases and 87 controls) were randomly selected and information were collected through interview and anthropometric measurements. Odds ratio and 95% confidence interval were used to measure association. Low birth weight, child drinking brewed or commercial coffee, no nutrient supplement intake since birth, and incomplete immunization were child risk factors of stunting. Exclusive breastfeeding from 0.6 months and weaning at >12 months have protective effect. Antenatal visits <4 times, fatherfs height <5 feet, parentfs education below secondary level were parental risk factors. Nuclear household and size of less than five members have protective effect against stunting. Having food restrictions among lactating mothers was cultural risk factors. Mothersf insufficient knowledge on exclusive breastfeeding, frequency of and proper way of breastfeeding, continuance of breastfeeding beyond 6 months, benefit of exclusive breastfeeding for six months to mothers and low self-confidence in preparing complementary food were all associated with stunting. Motherfs positive attitude on benefits of frequent feeding was found to have protective effect against stunting. Thus, these family factors could be used when designing an action plan to address the problem of stunting among the indigenous Kalinga children.

The LongSTEP approach: Theoretical framework and intervention protocol for using parent-driven infant-directed singing as resource-oriented music therapy

ABSTRACT Introduction: Despite medical advances, preterm birth and neonatal intensive care (NICU) hospitalization are demanding and pose risks for infants and parents. Various music therapy (MT) models have suggested parental singing to promote healthy bonding and development in premature infants, but evidence on long-term effects is lacking. Method: We present the theoretical framework and intervention protocol of a resource-oriented MT approach for premature infants and their caregivers used in the international LongSTEP trial (ClinicalTrials.gov NCT03564184). We illustrate how guiding principles manifest in MT sessions, describe frames for phases of intervention, discuss prerequisites and present hypothesized mechanisms of change. Results: The LongSTEP MT approach is resource-oriented, emphasizes parental voice and parent-infant mutual regulation, builds on family-centered care principles, and is relevant in the NICU and beyond. Essential elements include: observation and dialogue on infant and parent needs; voice as the main musical source, with parental voice as the most prominent; active parental participation; modification of music in response to infant states and cues; and integration of the family’s culture and music preferences. The music therapist facilitates and supports interaction between parents and infant. Parents learn how to adapt principles in relation to infant development across NICU hospitalization and post-discharge phases. Discussion: The LongSTEP approach is feasible in culturally diverse countries where consistent parental presence is available, but requires tailoring to local circumstances and culture, particularly in the post-discharge phase. The emphasis on parent-led infant-directed singing places a higher demand on parents than other MT approaches, and requires sufficient psychosocial and musical support for parents.

Social-Ecological Predictors of Opioid Use Among Adolescents With Histories of Substance Use Disorders.

Adolescent opioid misuse is a public health crisis, particularly among clinical populations of youth with substance misuse histories. Given the negative and often lethal consequences associated with opioid misuse among adolescents, it is essential to identify the risk and protective factors underlying early opioid misuse to inform targeted prevention efforts. Understanding the role of parental risk and protective factors is particularly paramount during the developmental stage of adolescence. Using a social-ecological framework, this study explored the associations between individual, peer, family, community, and school-level risk and protective factors and opioid use among adolescents with histories of substance use disorders (SUDs). Further, we explored the potential moderating role of poor parental monitoring in the associations between the aforementioned risk and protective factors and adolescent opioid use. Participants included 294 adolescents (Mage = 16 years; 45% female) who were recently discharged from substance use treatment, and their parents (n = 323). Results indicated that lifetime opioid use was significantly more likely among adolescents endorsing antisocial traits and those whose parents reported histories of substance abuse. Additionally, adolescents reporting more perceived availability of substances were significantly more likely to report lifetime opioid use compared to those reporting lower perceived availability of substances. Results did not indicate any significant moderation effects of parental monitoring on any associations between risk factors and lifetime opioid use. Findings generally did not support social-ecological indicators of opioid use in this high-risk population of adolescents, signaling that the social-ecological variables tested may not be salient risk factors among adolescents with SUD histories. We discuss these findings in terms of continuing care options for adolescents with SUD histories that target adolescents’ antisocial traits, perceived availability of substances, and parent histories of substance abuse, including practical implications for working with families of adolescents with SUD histories.

Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China

BackgroundPreconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners.MethodsA cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception.ResultsOf the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45–4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48–5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03–4.39, P = 0.041] before conception.ConclusionsUtilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.

Parental Beliefs About Causes of Autism Spectrum Disorder: An Investigation of a Research Measure Using Principal Component Analysis

BackgroundParents’ perceptions about cause of autism spectrum disorder (ASD) influences their behaviors (e.g., treatment selection, vaccinations). The Revised Illness Perception Questionnaire for ASD (IPQ-R-ASD) offers a systematic way to measure parent parents’ perceptions of ASD cause, but further study is needed. MethodUsing principal component analysis (PCA), we investigated the factor structure of the IPQ-R-ASD Cause scale, which was administered online, in a sample of 326 North American parents (287 mothers [88 %], 39 fathers) raising children with confirmed ASD diagnoses. ResultsSix factors emerged on the Cause subscale and were labeled Personal Attributions, Parental Risk Factors, Environmental Risk Factors, Utero/Birth Stress, Biophysiological, and Metaphysical. Together, these factors accounted for a cumulative variance of 61.4 %. All items exceeded the minimum loading to be considered robust, and all but one loaded positively (i.e., “Will of God). ConclusionsUnderstanding parental perceptions about the cause of their children’s ASD may help researchers and clinicians understand important aspects of raising a child with ASD, such as stress and coping responses, treatment selection and implementation, or shared decision-making about service use. Since measurement of causal beliefs is an important initial step in this direction, the current study is helpful in establishing the viability of a measure that may extend this line of research and, ultimately, the instrument’s clinical utility.

An Evaluation of Parental and Perinatal Characteristics and Risk of Langerhans Cell Histiocytosis in Texas Identifies Risk Disparities By Racial/Ethnic Group

Introduction: Langerhans cell histiocytosis (LCH) is a myeloid neoplasia with a median diagnosis age of 30 months. As with many pediatric cancers, few well-established risk factors for LCH exist. Maternal and neonatal infections and lack of childhood vaccinations are suspected to increase risk, and LCH incidence has been suggested to differ by racial/ethnic group in United States-based assessments. In studies of other pediatric hematologic malignancies, parental and perinatal characteristics have been successfully evaluated to determine the impact of inborn variation on disease risk. We have reviewed registry data to determine if parental and perinatal characteristics influence LCH development.Methods: We performed a case-control study to investigate the association between parental and perinatal characteristics and pediatric LCH. Information on Texas-born LCH cases (n = 162) for the period 1995-2011 was obtained from the United States (U.S.) Texas Cancer Registry. Birth certificate controls were randomly selected at a ratio of 10:1 for the same period matched on birth year. First, we generated odds ratios (OR) and 95% confidence intervals (CI) to estimate the association between each characteristic and LCH, adjusting for only the matching variable: year of birth. We then calculated an adjusted OR (aOR) including other independent variables if they were: a) differentially distributed between cases and controls at P < 0.05; and b) identified as important predictors of LCH in the literature.Results: Our findings indicate specific characteristics influence LCH risk. LCH cases in our study population were predominantly male (56.2%), whereas controls were distributed evenly with respect to sex. Over 40% of cases had two Hispanic parents (42.6%), while only a quarter of cases had two NHW parents (25.9%). Non-Hispanic Black mothers were suggested as less likely to give birth to offspring who developed LCH compared to non-Hispanic White (NHW) mothers (aOR: 0.50; 95% CI: 0.24-1.02). Hispanic mothers were at increased risk of giving birth to offspring who developed LCH compared to NHW mothers (aOR: 1.51; 95% CI: 1.02-2.25). Children born of two Hispanic parents were at a significantly increased risk of developing LCH compared to children born of two non-Hispanic White parents (aOR: 1.76; 95% CI: 1.10-2.80). Children with one non-Hispanic White parent and one non-Hispanic Asian parent were also at increased risk of developing LCH (aOR: 3.68; 95% CI: 1.10-12.33). Mothers who were born in Mexico compared to the U.S. were marginally suggested as less likely to give birth to offspring who developed LCH after adjusting for maternal race/ethnicity (aOR: 0.69; 95% CI: 0.43-1.11). Further, mothers who resided in 1 of 14 Texas counties along the U.S.-Mexico border at time of infant birth were suggested as less likely to give birth to offspring who developed LCH (aOR: 0.56; 95% CI: 0.31-1.03).Conclusion: In this population-based evaluation, maternal and parental race/ethnicity were strongly associated with LCH risk. Furthermore, mothers who resided along the U.S.-Mexico border at time of infant birth may be less likely to give birth to offspring who develop LCH. While no perinatal characteristics were identified that strongly influenced LCH risk, females were marginally suggested as less likely to develop LCH which aligns with previous studies. These findings suggest specific subgroups that may be more susceptible to pediatric LCH, and highlight novel risk factors that warrant assessment in future studies. DisclosuresNo relevant conflicts of interest to declare.

Distress and the Long-Stay Pediatric Intensive Care Unit Admission: A Longitudinal Study of Parents and the Medical Team.

Prolonged critical illness in children has emotional consequences for both parents and providers. In this observational cohort study, we longitudinally surveyed anxiety and depression in parents and moral distress in pediatric intensive care unit (PICU) providers (attendings, fellows, and bedside registered nurses) and explored their trajectories and relationships. Anxiety/depression and provider moral distress were measured using the Hospital Anxiety and Depression Scale and the Moral Distress Thermometer, respectively. The relationships of parental and provider distress were evaluated using Spearman's correlations, and their trajectories and potentially associated variables were explored using quadratic random slope and intercept models. Predetermined associated factors included demographic and clinical factors, including parent psychosocial risk and intubation status. We found parental anxiety and depression decreased over their child's admission, and parental psychosocial risk was significantly associated with anxiety (coefficient = 4.43, p < 0.001). Clinicians in different roles had different mean levels and trajectories of moral distress, with fellows reporting greater distress early in admissions and nurses later in admissions. Parental anxiety/depression and provider distress were significantly, though moderately, correlated. We conclude that anxiety and depression in parents of children with prolonged PICU admissions and the moral distress of their clinicians correlate and vary over time and by provider role.

Parental suicide attempts and offspring's risk of attempting or dying by suicide: does the timing of a parental suicide attempt matter?

Studies on the transmission of suicide risk have focused on parental history of suicide attempts (SAs), overlooking when the attempt happened. This study examined how the offspring's risk of attempting or dying by suicide varied by the timing of a first parental SA and the sex of the parent who attempted suicide. Participants were 59 469 members of the 1987 Finnish Birth Cohort. The Finnish Hospital Discharge and Cause of Death Registers were the sources for parental and offspring SAs and offspring suicide. Timing of parental SA was coded as before (pre-pregnancy and pregnancy) and after the child's birth [infant/toddler years (0-2 years), childhood (3-11 years), adolescence (12-17 years), and young adulthood (18-26 years)]. In the multivariate models, having a parent who attempted suicide increased the offspring's risk of attempting suicide (odds ratio (OR) = 1.77, 95% confidence interval (CI) 1.39-2.25), but not of dying by suicide. Compared to unexposed offspring, those exposed after child's birth were at higher risk of attempting suicide (OR = 1.90, 95% CI 1.46-2.47), specifically when the parent attempted during offspring's childhood, adolescence, and young adulthood. A first maternal SA increased offspring's risk of attempting suicide regardless of the timing. The impact of a parental SA on offspring's risk of attempting suicide differed depending on the timing and sex of the parent who attempted suicide, suggesting that the transmission of suicide risk may occur through genetic as well as environmental factors. Our findings call for an intergenerational approach in suicide risk assessment.

Depression and social anxiety mediate the relationship between parenting styles and risk of eating disorders: A study among Arab adolescents.

In multicultural Israel, the prevalence of eating disorders (EDs), a common chronic disorder among Western adolescents (especially females), has risen for Arab adolescents, who belong to an Eastern collectivist society. The study examines family and psychological factors that may increase the risk of EDs among Muslim Arab adolescents. We expected social anxiety and depressive symptoms to mediate the association between parenting styles and risk of EDs, with possible gender differences in the mediation model. Participants were 613 Muslim adolescents (394 females and 219 males); mean age=15.4 ± 1.6; range=12-19. The analyses revealed that the severity of depressive symptoms and especially social anxiety mediate the relationship between authoritarian parenting style and risk of EDs. Females reported higher levels of risk of EDs, social anxiety, depression and authoritative parenting style than males; no differences appeared for authoritarian or permissive parenting styles. The research sheds new light on risk factors for EDs and the likelihood of authoritarian parenting style and social anxiety being involved in the aetiology of EDs among Arab adolescents. The outcomes meaningfully add to understanding of specific psychological processes that may be associated with the risk of EDs in this population.

Parental risk factors for congenital diaphragmatic hernia \u2013 a large German case-control study

BackgroundEvidence for periconceptional or prenatal environmental risk factors for the development of congenital diaphragmatic hernia (CDH) is still scarce. Here, in a case-control study we investigated potential environmental risk factors in 199 CDH patients compared to 597 healthy control newborns.MethodsThe following data was collected: time of conception and birth, maternal BMI, parental risk factors such as smoking, alcohol or drug intake, use of hairspray, contact to animals and parental chronic diseases. CDH patients were born between 2001 and 2019, all healthy control newborns were born in 2011. Patients and control newborns were matched in the ratio of three to one.ResultsPresence of CDH was significantly associated with maternal periconceptional alcohol intake (odds ratio = 1.639, 95% confidence interval 1.101–2.440, p = 0.015) and maternal periconceptional use of hairspray (odds ratio = 2.072, 95% confidence interval 1.330–3.229, p = 0.001).ConclusionOur study suggests an association between CDH and periconceptional maternal alcohol intake and periconceptional maternal use of hairspray. Besides the identification of novel and confirmation of previously described parental risk factors, our study underlines the multifactorial background of isolated CDH.

Consanguineous Marriage and the Risk of Parents Having Children with Cleft Lip and Palate

Consanguineous Marriage and the Risk of Parents Having Children with Cleft Lip and Palate

The Association of Cardiometabolic Risk Factors in Parent-Child Dyads in Guam: PICCAH Study

Abstract Objectives To determine metabolic syndrome (MetS) prevalence among adults and children at-risk in Guam as part of the larger Pacific Island's Cohort for Cardiometabolic Health (PICCAH) study during 2017–2020. Embedded in the primary objective is to evaluate the associations of parent and child risk factors and identify prevalent modifiable risk factors in children. Methods Preliminary data from 338 adults (21–50 y) and 214 children (3–9 y) who completed lifestyle surveys, anthropometric and (fasting) biochemical measures were analyzed. The prevalence of MetS and MetS risk factors were calculated for adults and children, respectively, and MetS severity Z-scores for both. Pearson correlation and multiple linear regression was used to estimate the linear association between parent and child MetS Z-scores. Demographic data and metabolic lifestyle factors such as sleep, sedentary and physical activity, and stress were evaluated. Results The majority of adults (92.3%) had abdominal obesity. Metabolic factors in adults and children (respectively) were high serum triglycerides (18.5% and 2.7%) and high glucose (25% and 1.8%) and, in adults only, were high blood pressure (31.8%) and low level of HDL (60.4%). Adults and children in this study did not meet sleep (57.3% and 50.0%), screen time for children (83.8%), sedentary activity (e.g., time spent sitting) for adults (61.9%), and physical activity for adults (52.4%) recommendations. Adults reported low-level stress (Mean = 19.3, SD = 5.7 on 12–48 scale) on the Depression Anxiety Stress Scale (DASS21). Using the International Diabetes Federation criteria, 38.7% of adults had MetS and 8.2% children were at-risk for MetS. Children MetS Z-scores were significantly correlated with parent MetS Z-scores (Pearson correlation = 0.288, P &amp;lt; 0.001). The multiple regression model showed that child MetS Z-score can be predicted by using parent MetS Z-score even after adjusting for parent education level and income, and child's age (F(4190) = 4.82, P = .001). Conclusions Guam is an island in the Western Pacific with the highest diabetes prevalence in the world. This is the first study in Guam to describe MetS and its risk factors in child-parent dyads. Findings will support intervention programs for MetS and diabetes prevention in Guam and the Western Pacific. Funding Sources NIH/NIMHD (1U24MD011201–01).

539-P: Parental Anxiety and Accuracy of Risk Perception upon Receipt of Positive Results of Screening for Presymptomatic Type 1 Diabetes: Autoimmunity Screening for Kids (ASK)

Screening for islet autoantibodies (IAb) followed by education and monitoring of children at high risk for type 1 diabetes (T1D) substantially reduces incidence of diabetic ketoacidosis at diagnosis. We assess parental anxiety and accuracy of risk perception as part of ASK screening, education and monitoring program. The 10-y risk of clinical diabetes is 70% in children positive for multiple IAb, 50% with single high-affinity, and 2% with single low-affinity (confirmed twice). As of March 2020, ASK had screened for IAb 23,847 general population children and further monitored 280, including 136 with 50-70% high risk and 144 with 2% lower risk; 9% had a first degree relative (FDR) with T1D. At each visit, parental risk perception and anxiety were assessed using the State Anxiety Inventory (SAI), with a score &amp;gt;40 denoting elevated anxiety. Reported here are results from the 1st visit (N=280) and for those with a 2nd visit (N=119). At the 1st visit, parental anxiety was elevated (mean SAI=46.1) with no difference by child’s risk status, family history, or by which parent responded. SAI was significantly higher in ethnic minorities than in non-Hispanic whites (p&amp;lt;0.0001). Anxiety decreased between the 1st and 2nd education and monitoring visit from a mean of 46.1 to 43.8 (p=0.024), most notably in parents of high risk children (44.9 to 42.7 p=0.009) and FDRs (44.6 to 38.6, p=0.059). Accuracy of risk perception was low at 49% and did not improve at the 2nd visit. FDR compared to non-FDR (83% vs. 46%, p=0.004) and parents of high risk compared to low risk children had a more accurate risk perception (61% vs. 37% p &amp;lt;0.0001). Parental anxiety after learning of a child’s positive screening result decreased rapidly in families enrolled in monitoring. However, accurate perception of T1D risk appears less malleable during the initial 3-6 months of the monitoring. Tailored intervention for parents with inaccurate risk perception may be warranted. Disclosure C. Geno rasmussen: None. J. Baxter: None. F. Dong: None. K. A. Bautista: None. F. Sepulveda: None. D. Felipe-morales: None. M. Rewers: Advisory Panel; Self; Provention Bio, Inc., Consultant; Self; RTI, Research Support; Self; Janssen Research &amp; Development, LLC, JDRF. Funding JDRF (3-SRA-2018-564-M-N)

Children\u2019s experiences of participating in a school-based health promotion parental support programme \u2013 a qualitative study

BackgroundChildren’s voices are seldom heard in process evaluations concerning health promotion programmes. A Healthy School Start Plus (HSSP) is a parental support programme, conducted in Sweden, with the aim of promoting healthy diet, physical activity and preventing obesity in preschool class children. The 6-month programme includes: (1) Health information to parents; (2) Motivational Interviewing with parents by school nurses; (3) Classroom activities and home assignments for children; (4) A self-test of type-2 diabetes risk for parents. We aimed to describe children’s experiences of the third component regarding barriers and facilitators of participating in and learning from the classroom activities in the HSSP.MethodsIn total 36 children from 7 schools in Sweden, mean age 6 years, participated in 7 focus group discussions. Purposeful sampling with maximum variation was used to collect the data. The focus groups were audio-recorded, transcribed and analysed using qualitative content analysis.ResultsFour categories were identified; (1) Time available to work on intervention activities; (2) Others’ interest; (3) Abilities and interests in intervention activities; and (4) Practicing the concept of health.ConclusionsThe findings may improve the HSSP and other similar interventions that include classroom-based learning regarding health by highlighting the following points to consider: aiming for homework to be an integrated part of the school-setting to enhance parental involvement; using flexible material, tailored to the children’s abilities and giving children adequate time to finish the intervention activities; and making teachers and parents aware of the importance of verbal and body language regarding intervention activities.Trial registrationThe Healthy School Start Plus trial was retrospectively registered in the International Standard Randomised Controlled Trial Number Registry on January 4, 2018 and available online at ClinicalTrials.gov: No. NCT03390725.