Family Ruptures, Stress, and the Mental Health of the Next Generation: Comment

2018 ◽  
Vol 108 (4-5) ◽  
pp. 1253-1255 ◽  
Author(s):  
Brett Matsumoto

The empirical methodology used by Persson and Rossin-Slater (2018) to estimate the causal effect of in utero exposure to stress contains a potentially significant flaw. They define the control group in a way that may bias their causal estimates and can lead to the finding of a significant relationship when there is none. In this note, I describe the source of the bias and suggest an alternative specification of the control group. (JEL I12, J12, J13)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1511.2-1511
Author(s):  
M. G. Lazzaroni ◽  
F. Crisafulli ◽  
I. Debeni ◽  
C. Nalli ◽  
L. Andreoli ◽  
...  

Background:A possible increase in neurodevelopmental (ND) and learning disorders (LD) in the offspring of mothers affected by SLE have been suggested in some studies, along with the identification of different possible risk factors. Azathioprine (AZA) is commonly used during pregnancy, based on its non-teratogenicity and extended experience in women with different diseases. However, a few small studies suggested an association between in utero exposure to AZA and possible increased frequency of ND/LD in children, indirectly derived from increased request of supportive educational services.Objectives:To evaluate the medium-long term outcome in terms of ND/LD in children of school age (≥6 years) born to SLE women treated with AZA during pregnancy, as compared to that of children born to SLE mothers not treated with AZA during pregnancy.Methods:Data from our Pregnancy Clinic registry were collected for prospectively followed pregnancies of SLE women treated with AZA (cases) and compared to pregnancies of SLE women not treated with AZA (controls), that were matched for age at pregnancy, presence of renal involvement and aPL positivity. SLE patients (cases and controls) were interviewed by phone to collect data about their children, focusing on the presence of ND/LD certified by Neuropsychiatrists.Results:Data were collected for 14 SLE mothers in the AZA group and 31 in the control group, with similar age at pregnancy (30.3±5.21 vs 31.4±4.70 years, p:0.45) and frequency of renal involvement (50.0% vs 44.1%, p:0.77), aPL positivity (33.3% vs 29.4%, p:0.76) and anti-Ro/SSA positivity (27.8% vs. 26.5%, p:0.55). A SLE flare during pregnancy was more frequently recorded in the AZA group (27.8% vs. 2.94%, p:0.02). Other medications included HCQ (55.6% vs. 70.6%, p:0.36) and corticosteroids (100% vs 79.4%, p:0.08).We collected data for 18 children in the AZA group and 34 children in the control group, that had a similar mean age at the time of the interview (12.7±4.80 vs. 12.9±5.61 years, p:0.91). The two groups had also similar gestational age (37.4±2.20 weeks vs. 38.0±1.29 weeks, p:0.23), birth weight (3003±433 g vs 3011±453 g, p:0.95) and rate of male sex (61.1% vs 44.1%, p:0.38).We recorded similar frequency of ND/LD in the two groups. In particular, a ND was present in 2/18 (11.1%) of children exposed to AZA vs. 2/34 (5.88%) in the control group (p:0.60). A LD was present in 1/18 cases (5.56%) and 6/34 controls (17.6%) (p:0.40).Conclusion:The medium-long term outcome of children born to SLE mothers in the whole cohort was characterized by the presence of ND in 4/54 (7.69%) and LD in 7/52 (13.5%). ND/LD do not seem to be related to in utero exposure to AZA.Disclosure of Interests:None declared


2018 ◽  
Vol 89 (7) ◽  
pp. 736-740 ◽  
Author(s):  
Arron S Lacey ◽  
William Owen Pickrell ◽  
Rhys H Thomas ◽  
Mike P Kerr ◽  
Cathy P White ◽  
...  

ObjectiveSmall prospective studies have identified that children exposed to valproate in utero have poorer scores on cognitive testing. We wanted to identify whether children exposed to antiepileptic drugs (AEDs) in utero have poorer school performance.MethodsWe used anonymised, linked, routinely collected healthcare records to identify children born to mothers with epilepsy. We linked these children to their national attainment Key Stage 1 (KS1) tests in mathematics, language and science at the age of 7 and compared them with matched children born to mothers without epilepsy, and with the national KS1 results. We used the core subject indicator (CSI) as an outcome measure (the proportion of children achieving a minimum standard in all subjects) and the results in individual subjects.ResultsWe identified 440 children born to mothers with epilepsy with available KS1 results. Compared with a matched control group, fewer children with mothers being prescribed sodium valproate during pregnancy achieved the national minimum standard in CSI (−12.7% less than the control group), mathematics (−12.1%), language (−10.4%) and in science (−12.2%). Even fewer children with mothers being prescribed multiple AEDs during pregnancy achieved a national minimum standard: CSI (by −20.7% less than the control group), mathematics (−21.9%), language (−19.3%) and science (−19.4%). We did not observe any significant difference in children whose mothers were prescribed carbamazepine or were not taking an AED when compared with the control group.ConclusionsIn utero exposure to AEDs in combination, or sodium valproate alone, is associated with a significant decrease in attainment in national educational tests for 7-year-old children compared with both a matched control group and the all-Wales national average. These results give further support to the cognitive and developmental effects of in utero exposure to sodium valproate as well as multiple AEDs, which should be balanced against the need for effective seizure control for women during pregnancy.


2012 ◽  
Vol 28 (8) ◽  
pp. 752-758 ◽  
Author(s):  
Pere Soler-Palacín ◽  
Andrea Martín-Nalda ◽  
Xavier Martínez-Gómez ◽  
Susana Melendo ◽  
Encarnació Riudor ◽  
...  

Author(s):  
Deepa Singal

IntroductionBenzodiazepine (BZD) prescribing rates during pregnancy have risen over the last two decades. There is little research into the potential relationship between in utero exposure to BZD and offspring risk of attention deficit/hyperactivity disorder (ADHD), although there is some evidence of negative neurodevelopmental outcomes. Objectives and ApproachWe used comprehensive linked administrative data to investigate the association between maternal use of prescription BZDs during pregnancy and ADHD in offspring. We included mother-newborn dyads in Manitoba born from 1996-2012, with follow-up through 2017. BZD exposure was defined as 2+ prescriptions between conception and delivery. We matched exposed children to unexposed children to account for differences in characteristics between women who used BZDs during pregnancy versus non-users. Several sensitivity analyses addressed the potential for residual confounding, including a negative control group and a group made entirely of recent users of BZDs. Cox Proportional Hazard Regression Models were used to estimate the risk of ADHD among offspring. ResultsAmong 495 children with at least two BZD exposures throughout pregnancy, 25.4% (n=452) had a diagnosis of ADHD compared with 18.0% (n=68) of children not exposed (adjusted HR 1.91, 95% CI 1.35-2.69). However, the association was unchanged in the negative control group analyses (aHR 1.76, 1.09-2.86), and not significant in the recent users of BZD (aHR 0.91, 0.63-1.30). Mother’s history of ADHD and teen births were also associated with ADHD in offspring. ConclusionsIn a large population-level analysis, in utero exposure to prescription BZDs during pregnancy appeared to increase risk of ADHD. However, sensitivity analyses suggest this relationship was likely due to residual confounding. The power to link data for the whole population and across generations enabled powerful sensitivity analyses that alter the initial inference.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Masoud Hatefi ◽  
Lida Nouri

Background: Myofascial pain syndrome (MPS) is a non-inflammatory disorder with muscle stiffness and pain that occurs with the appearance of palpable and irritating nodules in the muscular system. Stroke is one of the most common neurological diseases that in many cases leads to disability and reduction of quality of life (QOL). Objectives: This study aimed to evaluate the relationship between MPS and physical and mental health (MH) status in patients with stroke. Methods: Using available sampling method, this case-control study included 260 patients with stroke. To collect data, demographic characteristics, Visual Analogue Scale (VAS), 36-item Short Form Survey (SF-36), and Depression, Anxiety and Stress Scale (DASS-21) were used. Data analysis was performed using SPSS 16. Mean and standard deviation were used for descriptive statistics and independent t-test, paired t-test, and analysis of variance (ANOVA) were used for inferential tests. Results: While the pain score was 6.35 (1.39), QOL score was 38.86 (11.69), and MH score was 16.26 (2.75) in the intervention group, these scores were 2.15 (0.96), 63.96 (17.52), and 9.02 (4.63), respectively, in the control group. The results showed no statistically significant relationship between MPS and QOL. But there was a statistically significant relationship between MPS and MH, so that the MH status of patients with MPS was lower than the MH status of other patients. Conclusions: Necessary interventions have been done to improve the health status of patients with MPS, which will lead to an increase in the health status of these patients.


2018 ◽  
Vol 108 (4-5) ◽  
pp. 1256-1263 ◽  
Author(s):  
Petra Persson ◽  
Maya Rossin-Slater

Persson and Rossin-Slater (2018) find that prenatal exposure to family ruptures affects childhood and adult mental health, as well as infant physical health. We compare children whose relatives die within 280 days post-conception to children whose relatives die in the year after birth. Matsumoto correctly notes that defining the control group using actual birth dates can bias our estimates. Here, we redefine our control group using expected birth dates. The effects on mental health in childhood and adulthood are statistically indistinguishable from those in our original paper. The infant health impacts are attenuated, but statistically significant in our main specifications. (JEL I12, J12, J13)


2006 ◽  
Vol 175 (4S) ◽  
pp. 165-165
Author(s):  
Michael H. Hsieh ◽  
Erin Cheasty ◽  
Emily J. Willingham ◽  
Benchun Liu ◽  
Laurence S. Baskin
Keyword(s):  
In Utero ◽  

2010 ◽  
Vol 69 (3) ◽  
pp. 131-139 ◽  
Author(s):  
Félix Neto

This study investigated mental health problems and their predictors among adolescents from returned immigrant families. The sample consisted of 360 returned adolescents (mean age = 16.8 years; SD = 1.9). The mean duration of a sojourn in Portugal for the sample was 8.2 years (SD = 4.5). A control group of 217 Portuguese youths were also included in the study. Adolescents from immigrant families reported mental health levels similar to those of Portuguese adolescents who have never migrated. Girls showed more mental health problems than boys. Younger adolescents showed fewer mental health problems than older adolescents. Adaptation variables contributed to mental health outcomes even after acculturation variables were accounted for. Implications of the study for counselors are discussed.


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