Childhood Risk Research Articles

Causes of Childhood Cancer: A Review of the Recent Literature: Part I-Childhood Factors.

To review the childhood risk factors for pediatric cancer (diagnosis before age 20). We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 3 March 2021. Strong evidence indicates that an array of genetic and epigenetic phenomena, structural birth defects, and chromosomal anomalies are associated with an increased risk of various childhood cancers. Increased risk is also associated with prior cancer, likely due to previous treatment agents and therapeutic ionizing radiation. Convincing evidence supports associations between several pediatric cancers and ionizing radiation, immunosuppression, and carcinogenic virus infection both in healthy children and in association with immune suppression following organ transplantation. Breastfeeding and a childhood diet rich in fruits and vegetables appears to reduce the risk of pediatric leukemia but the evidence is less strong. Childhood vaccination against carcinogenic viruses is associated with a lower risk of several cancers; there is less strong evidence that other childhood vaccinations more broadly may also lower risk. Ultraviolet (UV) radiation is associated with increased melanoma risk, although most melanomas following childhood UV exposure occur later, in adulthood. Evidence is weak or conflicting for the role of body mass index, other childhood infections, allergies, and certain treatments, including immunomodulator medications and human growth therapy.

Assessing Sarcopenic Obesity Risk in Children During the COVID-19 Pandemic: Grip-to-BMI Ratio

Aim: The present investigation aimed to examine the prevalence of sarcopenic obesity in Turkish children aged 6-10 years during the COVID-19 pandemic, while also conducting a comparison of diagnostic methods. Methods: A total of 431 healthy children (230 females, 201 males) were recruited for this study. Various anthropometric measurements, including height, weight, and body mass index (BMI), were collected. Furthermore, body composition was assessed through the utilization of bioelectrical impedance analysis (BIA) to ascertain fat mass, skeletal muscle mass, and the muscle-to-fat ratio (MFR). Additionally, grip strength was measured to determine the grip strength-to-BMI ratio. McCarthy's framework was employed to define sarcopenic obesity based on MFR cut-offs. Receiver operating characteristic curves were implemented to evaluate the efficacy of the grip strength-to-BMI ratio in identifying the risk of sarcopenic obesity. Results: The prevalence of sarcopenic obesity was found to be 8.7% in females and 10.4% in males. In comparison to the MFR, the grip strength-to-BMI ratio exhibited considerable sensitivity in detecting the risk of sarcopenic obesity. The correlation between the ratio of grip strength to BMI and the muscle-to-fat ratio (MFR) was found to be weak among boys and girls aged 6-8 years (r=0.363, r=0.458, p

Adverse Childhood Experiences and Prescription Stimulant Use in Adults: A Systematic Review.

Nonmedical prescription stimulant use (NPSU) is an ongoing public health crisis in the United States. There exists, however, a dearth of research investigating specific childhood risk factors that may contribute to this illicit use. Adverse childhood experiences (ACEs) may be a significant risk factor to address in the prevention and treatment of NPSU, as research has provided evidence for increased substance use, potentially including prescription stimulant misuse, among individuals who have experienced trauma. A systematic review of the literature was conducted to gather and synthesize research articles specifically examining the relationship between nonmedical prescription stimulant use in adults and the experience of adverse childhood experiences (ACEs). Four studies met all inclusion criteria and were included in the review. The results demonstrated that the nonmedical use of prescription stimulants in adults is significantly associated with ACEs, with a higher numerical count of ACEs associated with a greater likelihood of nonmedical prescription stimulant use. Gaps in the literature were identified, specifically noting a lack of information available regarding the relationship between ACEs and NPSU within gender- and racially diverse populations. The findings have implications for informing interventions related to ACEs and the misuse of prescription stimulant medication in adults.

Association between cardiovascular risk and maternal perception of BMI in Peruvian schoolchildren.

In the modern era, the maternal perception of children's nutritional status has emerged as a critical area of study, given its potential influence on nutritional interventions and long-term child health. The relationship between this perception and children's Body Mass Index (BMI) by age is particularly intriguing, as it may reveal discrepancies between perception and reality. The aim of this study was to evaluate Peruvian mothers' perception of their children's Body Mass Index (BMI) in relation to age and to determine how this perception associates with the children's cardiovascular risk. The study also analyzed sociodemographic factors that might influence this perception. The study included 130 mothers of schoolchildren aged 5 to 11 from a school in Lima. Mothers' perceptions of their children's weight were assessed using pictograms, and sociodemographic characteristics were collected through a questionnaire. Weight and height measurements were taken to calculate BMI, and waist circumference was measured to classify cardiovascular risk. A total of 57.4% of the schoolchildren presented with excess malnutrition, and 51.5% of the mothers incorrectly classified the actual BMI/Age of their children (kappa 0.11; p ≤ 0.05). Additionally, it was found that the schoolchild's age is associated with the mother's failure to accurately perceive her child's weight (OR 1.59). Lastly, there was a significant association between maternal perception and cardiovascular risk (p ≤ 0.05). There is a significant discrepancy between maternal perception and the actual nutritional status of children, which can increase cardiovascular risk. It is necessary to implement intervention and education strategies targeted at parents to enhance the recognition and management of childhood overweight and obesity.

Childhood obesity and risk of Alzheimer's disease: a Mendelian randomization study.

Midlife obesity is a modifiable risk factor for Alzheimer's disease. However, the association between childhood obesity and Alzheimer's disease remains largely unknown. Therefore, we conducted a mendelian randomization analysis (MR) to assess the causal link between childhood obesity and Alzheimer's disease. Using summary statistics from publicly available genome-wide association studies (GWAS) database, we explored the genetic link between childhood obesity and Alzheimer's disease through a two-sample MR. The primary analysis employed the inverse-variance weighted (IVW) method. To complement our findings, we also employed MR-Egger, weighted median, simple model, and weighted model methods for MR estimates. Furthermore, we conducted Cochrane's Q-statistic test, Egger intercept test, and a leave-one-out sensitivity test to ensure the robustness and reliability of our results. The IVW analysis yielded non-significant results, indicating no significant genetic association between childhood obesity and Alzheimer's disease (OR = 0.958, 95% CI = 0.910-1.008, p = 0.095). Consistent with this, the results from MR-Egger, the weighted median, simple model, and weighted model approaches all supported these findings. Furthermore, we did not detect any signs of heterogeneity or pleiotropy, and our leave-one-out analysis confirmed that no single nucleotide polymorphisms had a substantial impact on the reliability of our results. The evidence from our MR analyses suggests that there is no causal effect of childhood obesity on the risk of Alzheimer's disease.

Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study

Purpose Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. Materials and methods This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6–18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27–29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. Results In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027). Conclusions These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.

Identifying childhood malaria hotspots and risk factors in a Nigerian city using geostatistical modelling approach

Malaria ranks high among prevalent and ravaging infectious diseases in sub-Saharan Africa (SSA). The negative impacts, disease burden, and risk are higher among children and pregnant women as part of the most vulnerable groups to malaria in Nigeria. However, the burden of malaria is not even in space and time. This study explores the spatial variability of malaria prevalence among children under five years (U5) in medium-sized rapidly growing city of Akure, Nigeria using model-based geostatistical modeling (MBG) technique to predict U5 malaria burden at a 100 × 100 m grid, while the parameter estimation was done using Monte Carlo maximum likelihood method. The non-spatial logistic regression model shows that U5 malaria prevalence is significantly influenced by the usage of insecticide-treated nets—ITNs, window protection, and water source. Furthermore, the MBG model shows predicted U5 malaria prevalence in Akure is greater than 35% at certain locations while we were able to ascertain places with U5 prevalence > 10% (i.e. hotspots) using exceedance probability modelling which is a vital tool for policy development. The map provides place-based evidence on the spatial variation of U5 malaria in Akure, and direction on where intensified interventions are crucial for the reduction of U5 malaria burden and improvement of urban health in Akure, Nigeria.

Once in NEET, always in NEET? Childhood and adolescent risk factors for different NEET patterns.

Young adults in Neither in Employment, Education nor Training (NEET) are at risk of adverse labour market outcomes. Earlier studies often measured NEET status at one time point or compared persistent NEETs with non-NEETs, neglecting other patterns of NEET status. Evidence on early life factors associated with NEET patterns is lacking. This study aims to (i) identify patterns of NEET status over time and (ii) examine whether factors in childhood and adolescence are associated with these patterns. Data were used from 1499 participants of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up. NEET status was assessed at ages 19, 22 and 26. Socioeconomic status of parents (SES), intelligence and negative life events were measured at age 11, educational attainment at age 26 and mental health problems at ages 11, 13.5 and 16. Data were analyzed using multinomial logistic regression analysis. Four NEET patterns were identified: (i) non-NEETs (85.2%), (ii) early NEETs (4.5%), (iii) late NEETs (5.7%) and (iv) persistent NEETs (4.5%). Reporting internalizing problems at age 11 was a risk factor for early and late NEETs [odds ratio (OR) 2.77, 95% confidence interval (CI) 1.16-6.62; OR 5.00, 95% CI 2.22-11.3, respectively]. Low parental SES, lower intelligence scores and negative life events (≥3) were risk factors for persistent NEETs (OR 4.45, 95% CI 2.00-9.91; OR 0.96, 95% CI 0.94-0.98; OR 4.42, 95% CI 1.62-12.08, respectively). The results highlight the importance of timing and duration of NEET status and emphasize the need for tailored interventions to prevent specific NEET patterns.

Factors associated with young children being overweight on entry to primary school

Childhood obesity is a serious public health challenge, and there is limited evidence to show which pre-school interventions may prevent its occurrence. This study assessed whether selected factors, including contact with the Starting Well 0–19 service for children aged 1–3 years in north-west England, influenced children's risk of being overweight at primary school entry. It found that families with the most contact with the service (an integrated health visitor and children's centre offer) were more at risk. The findings show that the focus of these contacts does not positively influence risk factors for later overweight prevalence. The study findings replicate a known association between deprivation and children being overweight. Families having the highest contact levels with the Starting Well service had a significant association with their children being overweight at entry to primary school. This provides an opportunity to target these families with healthy lifestyle interventions and reduce the potential risk of childhood obesity.

Traditional bullying and cyberbullying at schools in Germany: Results of the HBSC study 2022 and trends from 2009/10 to 2022.

Bullying is a form of violence that is carried out repeatedly, with the intention of causing harm and with an imbalance of power between those involved. Bullying has serious negative effects on the mental health of adolescents and thus represents a significant health risk in childhood and adolescence. Based on data from the Health Behaviour in School-aged Children (HBSC) study from the survey year 2022 in Germany (N = 6,475), the prevalence of school bullying and cyberbullying among 11-, 13- and 15-year-olds in Germany was analysed. In addition, the prevalence of school bullying and cyberbullying was analysed as a trend from 2009/10 to 2022 (bullying) and from 2017/18 to 2022 (cyberbullying). Around 14 % of the learners surveyed reported direct experience of bullying at school, and around 7 % reported cyberbullying experiences as bullied and/or bullying victims. Adolescents who identified as gender diverse were particularly likely to report bullying experiences. School bullying decreased over time, but remained stable between 2017/18 and 2022. Cyberbullying, on the other hand, increased in 2022 compared to 2017/18. Experiencing bullying at school and online is an everyday experience for many children and young people, so there is still a need for the broad implementation of effective anti-bullying measures in schools.

Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity.

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

Gestational Exposure to Maternal Systemic Glucocorticoids and Childhood Risk of CKD

Background & ObjectivesThe potential effects of antenatal glucocorticoid exposure on the health of children are unclear. We examined the association of gestational exposure to maternal systemic glucocorticoids (SG) and the risk of developing chronic kidney disease (CKD) in childhood. Study designRetrospective cohort study. Setting & ParticipantsNewborns cared for at the largest healthcare delivery system in Taiwan between 2004 and 2018. ExposureMaternal prescriptions for SG between the last menstrual period and birth as a proxy for gestational exposure. OutcomeIncidence of childhood CKD, including congenital anomalies of the kidney and urinary tract (CAKUT) and other kidney diseases (non-CAKUT) over 10 years. Analytical ApproachCox proportional hazards models with stabilized inverse probability of treatment weighting and robust sandwich estimator were used to estimate the average association between SG and incident CKD after adjustment for offspring characteristics (aHR). ResultsAmong 23,363 singleton-born children, gestational SG exposure was significantly associated with a higher risk of childhood CKD (aHR, 1.69 [95% CI, 1.01–2.84]). Stratified analyses showed stronger associations between SG and childhood CKD within the strata of birth <37 weeks gestational age (aHR, 2.38 [95% CI, 1.19–4.78]), male sex (aHR, 1.89 [95% CI, 1.00–3.55]), gestational exposure in the second trimester (aHR, 6.70 [95% CI, 2.17–20.64]), and total dose >24 mg hydrocortisone equivalent (aHR, 1.91 [95% CI, 1.05–3.47). LimitationsStudy was limited to the Taiwan healthcare delivery system and childhood CKD events through age 10 years. ConclusionsThe findings of this study suggest that gestational exposure to systemic glucocorticoids is associated with the occurrence of kidney disease in childhood. If these findings are confirmed, they may inform clinicians who are considering prescribing SG during pregnancy.

Prenatal Exposure to Antiseizure Medications and Risk of Epilepsy in Children of Mothers With Epilepsy

Use of valproate and certain other antiseizure medications (ASMs) in pregnancy is associated with abnormal fetal brain development with potential long-term implications for the child. To examine whether use of valproate and other ASMs in pregnancy among mothers with epilepsy is associated with epilepsy risk in their children. This prospective, population-based register cohort study included singletons born to mothers with epilepsy in Denmark, Finland, Iceland, Norway, and Sweden from January 1, 1996, to December 31, 2017. Data analysis was performed from October 2022 to December 2023. Redeemed prescription for an ASM from 30 days before pregnancy until birth. The main outcome was epilepsy in children, assessed using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses from hospital care. Adjusted hazard ratios (AHRs) and 95% CIs were estimated using Cox proportional hazards regression. Secondary analyses included dose-response analyses, analyses using children of mothers who discontinued ASM prior to pregnancy as the reference, and sibling analyses. This cohort study included 38 663 children of mothers with epilepsy (19 854 [51.4%] boys). Children were followed up from birth; the mean length of follow-up was 7.2 years (range 0-22 years). Compared with 22 207 children of mothers not using an ASM in pregnancy, increased risks of epilepsy in children of mothers who used valproate in pregnancy (monotherapy: AHR, 2.18; 95% CI, 1.70-2.79; polytherapy: AHR, 2.10; 95% CI, 1.49-2.96) were observed. However, there was no dose-dependent association, and there was a similar risk of epilepsy in siblings who were exposed and unexposed to valproate (AHR, 0.95; 95% CI, 0.50-1.82). Prenatal exposure to topiramate monotherapy was associated with increased risk of epilepsy (AHR, 2.32; 95% CI, 1.30-4.16), and the risk was greater for higher doses, but the risk attenuated in comparisons with children of mothers who discontinued topiramate before pregnancy (AHR, 1.19; 95% CI, 0.26-5.44). Prenatal exposure to clonazepam monotherapy was also associated with increased epilepsy risk (AHR, 1.90; 95% CI, 1.16-3.12), but limited follow-up and low numbers precluded further analyses. No associations were observed for prenatal exposure to lamotrigine (AHR, 1.18; 95% CI, 0.95-1.47), levetiracetam (AHR, 1.28; 95% CI, 0.77-2.14), carbamazepine (AHR, 1.13; 95% CI, 0.85-1.50), or oxcarbazepine (AHR, 0.68; 95% CI, 0.44-1.05). In this cohort study of children born to mothers with epilepsy, the associations found between prenatal exposure to certain ASMs and the child's risk of epilepsy did not persist in sensitivity analyses, suggesting that maternal ASM use in pregnancy may not increase epilepsy risk in children beyond that associated with the maternal epilepsy itself. These findings are reassuring for women in need of treatment with ASM in pregnancy.

Impact of household income on the risk of overweight and obesity over time among preschool-aged children: a population-based cohort study

BackgroundThe temporality of household income level with overweight/obesity in children has not been extensively studied. Little research has been conducted to determine the impact of household income on the risk of childhood overweight/obesity over time. This population-based cohort study aimed to investigate the impact of household income on the risk of overweight/obesity over time among preschool-aged children in Taiwan.MethodsFrom 2009 to 2018, we recruited 1,482 preschool-aged children ( ≦ 7 y of age) from low-income households and selected age- and sex-matched controls from non-low-income households for comparison; All participants were selected from those who consistently participated in the Taipei Child Development Screening Program and were monitored for overweight/obesity using body mass index (BMI) until December 31, 2018. Low-income households were defined as those with an average monthly disposable income < 60% of the minimum standard of living expense in Taiwan. The primary outcome was childhood overweight or obesity in study participants, defined as BMI (kg/m2) ≥ 85th percentile or ≥ 95th percentile, respectively. The generalized estimating equations (GEE) model was used to determine the impact of low-income households on the risk of overweight/obesity in study participants.ResultsOver 21,450 person-years of follow-up, 1,782 participants developed overweight /obesity, including 452 (30.5%) and 1,330 (22.4%) children from low- and non-low-income households, respectively. The GEE model showed that the first group had a significantly higher risk of becoming overweight/obese than the other during the follow-up period (adjusted odds ratio [aOR] = 1.44, 95% CI: 1.29–1.60). Moreover, children of foreign mothers had a higher risk of becoming overweight/obese than those of Taiwanese mothers during the follow-up period (aOR = 1.51, 95% CI: 1.24–1.8). The subgroup analysis revealed a significant association between low-income households and an increased risk of overweight/obesity in children aged 2–7 years (P =.01). However, this association was not observed in children aged 0–1 years (P >.999).ConclusionsDuring the follow-up period, there was a notable correlation between low-income households and an increased risk of preschool-aged children developing overweight or obesity. Implementing health promotion initiatives aimed at reducing overweight and obesity in this demographic is crucial.

The intergenerational transmission of risk and trust attitudes: Replicating and extending “Dohmen, Falk, Huffman and Sunde 2012” using genetically informed twin data

This replication revisits an influential contribution on the intergenerational transmission of risk and trust attitudes, which, based on data from the German Socioeconomic Panel (GSOEP), reveals a positive correlation between parents' and children's attitudes. The authors of the original study argue that socialization in the family is important in the transmission process. The replication is motivated by mounting evidence indicating that within-family transmission has a considerable genetic component, which calls into question socialization as the main transmission pathway. To consider genetic transmission in addition to social transmission, the replication relies on the German twin family panel TwinLife. The findings reveal that, first, most of the variation in children's risk and social trust attitudes is attributable to differences in the non-shared environment, followed by genetic differences, whereas differences in the shared family environment – the main candidate for social transmission – do not matter. Second, correlations between parents' and children's attitudes essentially involve genetic similarity. Third, family conditions do not moderate these relationships. Thus, the findings do not support the socialization assumption.

Self-Reported Adverse Childhood Experiences and Risk for Internalizing and Externalizing Difficulties among Adolescent Custodial Grandchildren

Despite custodial grandchildren’s (CG) traumatic histories and risk for psychological difficulties, knowledge is scant regarding the frequencies, types, and consequences of adverse childhood experiences (ACEs) they have encountered. We examined self-reported ACEs via online surveys with 342 CG (ages 12 to 18) who were recruited to participate in an RCT of a social intelligence training program. ACEs were assessed by 14 widely used items, and risk for internalizing (ID) and externalizing (ED) difficulties were measured using 80th percentile cut-offs on the Strengths and Difficulties Questionnaire. Classification and regression tree analyses included all 14 ACEs (along with CG gender and age) as predictors of ID and ED risk separately. Given possible comorbidity, analyses were run with and without the other risk type as a predictor. Less than 9% of CG self-reported no ACEs, 48.6% reported two to five ACEs, and 30.5% reported ≥6. Irrespective of ED risk, bullying from peers strongly predicted ID risk. ED risk was peak among CG who also had risk for ID. Without ID risk as a predictor, ED risk was highest among CG who were emotionally abused, not lived with a substance abuser, and encountered neighborhood violence. The frequency and types of ACEs observed were alarmingly higher than those among the general population, suggesting that many CG have histories of trauma and household dysfunction. That a small number of ACEs among the 14 studied here were significant predictors of ID and ED risk challenges the widespread belief of a cumulative dose ACE effect.

What's next for the field of multigenerational mental health? The need for deep behavioral phenotyping via a prenatal mental health registry.

From its inception, development and psychopathology theorists have sought to uncover the earliest forms of risk for mental health challenges in children, to prevent the development of more severe, intractable manifestations of psychopathology. Large familial risk registries have advanced our understanding of early, potentially modifiable factors that could prevent or mitigate the expression of challenging symptoms of neurodevelopmental conditions, and similar registries have been proposed to advance understanding of ADHD and related phenotypes. Data from single-site studies, largely focused on perinatal exposure to maternal mood disorders, reveal that a robust predictor of child psychopathology is parental psychopathology. However, early developmental trajectories of psychopathology risk may be better captured using transdiagnostic approaches in pregnancy, capturing the full range of mental health symptoms. We describe here the need for a parental mental health registry that begins prenatally that includes deep behavioral phenotyping across a range of transdiagnostic indicators of mental health risk to prevent psychopathology in children. This registry has the potential to uncover pathways to psychopathology risk in childhood and support the discovery of novel mechanisms to be targeted for prevention and intervention.

To risk or not: The impact of socioeconomic status on preschoolers' risky decision-making for gains and losses.

Disparities in socioeconomic status (SES) may affect individuals' risk preferences, which have important developmental consequences across the lifespan. Yet, previous research has shown inconsistent associations between SES and risky decision-making, and little is known about how this link develops from a young age. The current research is among the first to examine how SES influences preschoolers' risky decisions in both gain and loss frames. Across two studies, children aged 5 to 6 years (total N=309, 154 boys) were asked to choose between certain and risky options. The risky option was more advantageous, equal to, or less advantageous than the certain option. Study 1 revealed that in the loss frame, high-SES children (n=84, 44 boys) chose more risky options and were more sensitive to the expected value compared to low-SES children (n=78, 42 boys), especially when the risk was more advantageous. However, this SES difference was not significant in the gain frame. Supporting the potential causal link between SES and risky decision-making, Study 2 further found that experimentally increasing low-SES children's (n=68, 30 boys) status by providing additional resources increased their risk-seeking behavior in the loss frame. Overall, our findings suggest an interaction between environmental cues (gain vs. loss) and early life circumstances (SES) in shaping children's risk preferences. RESEARCH HIGHLIGHTS: This research is among the first to examine how school backgrounds and experimentally manipulated SES influence preschoolers' risk preferences in gain and loss frames. Children were more risk-seeking for losses than for gains; this framing effect was stronger in higher-SES than lower-SES children. Lower-SES children exhibited fewer risk-seeking behaviors and decreased sensitivity to the expected value of options for losses, but not for gains. A temporary boost in SES increased children's risk-seeking behavior, but not sensitivity to expected values.

Childhood maltreatment and risk of endocrine diseases: an exploration of mediating pathways using sequential mediation analysis

BackgroundAdverse childhood experiences (ACEs), including childhood maltreatment, have been linked with increased risk of diabetes and obesity during adulthood. A comprehensive assessment on the associations between childhood maltreatment and all major endocrine diseases, as well as the relative importance of different proposed mechanistic pathways on these associations, is currently lacking.MethodsBased on the UK Biobank, we constructed a cohort including 151,659 participants with self-reported data on childhood maltreatment who were 30 years of age or older on/after January 1, 1985. All participants were followed from the index date (i.e., January 1, 1985, or their 30th birthday, whichever came later) until the first diagnosis of any or specific (12 individual diagnoses and 9 subtypes) endocrine diseases, death, or the end of follow-up (December 31, 2019), whichever occurred first. We used Cox models to examine the association of childhood maltreatment, treated as continuous (i.e., the cumulative number of experienced childhood maltreatment), ordinal (i.e., 0, 1 and ≥ 2), or binary (< 2 and ≥ 2) variable, with any and specific endocrine diseases, adjusted for multiple covariates. We further examined the risk of having multiple endocrine diseases using Linear or Logistic Regression models. Then, sequential mediation analyses were performed to assess the contribution of four possible mechanisms (i.e., suboptimal socioeconomic status (SES), psychological adversities, unfavorable lifestyle, and biological alterations) on the observed associations.ResultsDuring an average follow-up of 30.8 years, 20,885 participants received a diagnosis of endocrine diseases. We observed an association between the cumulative number of experienced childhood maltreatment and increased risk of being diagnosed with any endocrine disease (adjusted hazard ratio (HR) = 1.10, 95% confidence interval 1.09–1.12). The HR was 1.26 (1.22–1.30) when comparing individuals ≥ 2 with those with < 2 experienced childhood maltreatment. We further noted the most pronounced associations for type 2 diabetes (1.40 (1.33–1.48)) and hypothalamic–pituitary–adrenal (HPA)-axis-related endocrine diseases (1.38 (1.17–1.62)), and the association was stronger for having multiple endocrine diseases, compared to having one (odds ratio (95% CI) = 1.24 (1.19–1.30), 1.35 (1.27–1.44), and 1.52 (1.52–1.53) for 1, 2, and ≥ 3, respectively). Sequential mediation analyses showed that the association between childhood maltreatment and endocrine diseases was consistently and most distinctly mediated by psychological adversities (15.38 ~ 44.97%), while unfavorable lifestyle (10.86 ~ 25.32%) was additionally noted for type 2 diabetes whereas suboptimal SES (14.42 ~ 39.33%) for HPA-axis-related endocrine diseases.ConclusionsOur study demonstrates that adverse psychological sequel of childhood maltreatment constitutes the main pathway to multiple endocrine diseases, particularly type 2 diabetes and HPA-axis-related endocrine diseases. Therefore, increased access to evidence-based mental health services may also be pivotal in reducing the risk of endocrine diseases among childhood maltreatment-exposed individuals.

Tobacco Smoke Exposure in Early Childhood and Later Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study.

To examine the association between early-life smoking exposure and later risk of inflammatory bowel disease [IBD]. We followed 115663 participants from the Norwegian Mother, Father and Child [MoBa] and All Babies in Southeast Sweden [ABIS] cohorts from birth [1997-2009] through 2021. IBD was identified through national patient registers. Validated questionnaire data defined maternal smoking during pregnancy, maternal environmental tobacco smoke [ETS] exposure during pregnancy, and child ETS exposure by ages 12 and 36 months. Cox regression was used to estimate adjusted hazard ratios [aHRs] for sex, maternal age, education level, parental IBD, and origin. Cohort-specific estimates were pooled using a random-effects model. During 1 987 430 person-years of follow-up, 444 participants developed IBD [ABIS, 112; MoBa, 332]. Any vs no maternal smoking during pregnancy yielded a pooled aHR of 1.30 [95% CI = 0.97-1.74] for offspring IBD. Higher level of maternal smoking during pregnancy (compared with no smoking, average ≥6 cigarettes/day: pooled aHR = 1.60 [95% CI = 1.08-2.38]) was associated with offspring IBD, whereas a lower smoking level was not (average 1-5 cigarettes/day: pooled aHR = 1.09 [95% CI = 0.73-1.64]). Child ETS exposure in the first year of life was associated with later IBD (any vs no ETS, pooled aHR = 1.32 [95% CI = 1.03-1.69]). Estimates observed for child ETS exposure by 36 months were similar but not statistically significant. In this prospective Scandinavian cohort study, children exposed to higher levels of maternal smoking during pregnancy or ETS during the first year of life were at increased risk of later IBD.