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

Background Evidence 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. Methods The 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. Results Presence 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). Conclusion Our 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.

Parental Risk Factors and Child Birth Data in a Matched Year and Sex Group Cleft Population: A Case-Control Study

(1) Background: The etiology of orofacial cleft (OC) is not completely known but several genetic and environmental risk factors have been identified. Moreover, a knowledge gap still persists regarding neonatal characteristics. This study evaluated the effect of parental age and mothers’ body mass index on the risk of having an OC child, in a matched year and sex group (cleft/healthy control). Additionally, birth data were analyzed between groups. (2) Methods: 266 individuals born between 1995 to 2015 were evaluated: 133 OC individuals (85 males/48 females) and 133 control (85 males/48 females). A logistic model was used for the independent variables. ANOVA or Kruskal-Wallis tests were used for comparison between the OC phenotypes. (3) Results: Regarding statistically significant parental related factors, the probability of having a cleft child decreases for each maternal year increase (odds ratio = 0.903) and increases for each body mass index unit (kg/m2) increase (odds ratio = 1.14). On the child data birth, for each mass unit (kg) increase, the probability of having a cleft child decrease (odds ratio = 0.435). (4) Conclusions: In this study, only maternal body mass index and maternal age found statistical differences in the risk of having a cleft child. In the children’s initial data, the cleft group found a higher risk of having a lower birth weight but no relation was found regarding length and head circumference.

The impact of parental risk factors on the risk of stroke in type 1 diabetes

Background Individuals with type 1 diabetes have a markedly increased risk of stroke. In the general population, genetic predisposition has been linked to increased risk of stroke, but this has not been assessed in type 1 diabetes. Our aim was, therefore, to study how parental risk factors affect the risk of stroke in individuals with type 1 diabetes. Methods This study represents an observational follow-up of 4011 individuals from the Finnish Diabetic Nephropathy Study, mean age at baseline 37.6 ± 11.9 years. All strokes during follow-up were verified from medical records or death certificates. The strokes were classified as either ischemic or hemorrhagic. All individuals filled out questionnaires concerning their parents’ medical history of hypertension, diabetes, stroke, and/or myocardial infarction. Results During a median follow-up of 12.4 (10.9–14.2) years, 188 individuals (4.6%) were diagnosed with their first ever stroke; 134 were ischemic and 54 hemorrhagic. In Cox regression analysis, a history of maternal stroke increased the risk of hemorrhagic stroke, hazard ratio 2.86 (95% confidence interval 1.27–6.44, p = 0.011) after adjustment for sex, age, BMI, retinal photocoagulation, and diabetic kidney disease. There was, however, no association between maternal stroke and ischemic stroke. No other associations between parental risk factors and ischemic or hemorrhagic stroke were observed. Conclusion A history of maternal stroke increases the risk of hemorrhagic stroke in individuals with type 1 diabetes. Other parental risk factors seem to have limited impact on the risk of stroke.

Recognition of child maltreatment in emergency departments in Europe: Should we do better?

Objectives To evaluate the different policies to recognize child maltreatment in emergency departments (EDs) in Europe in order to define areas of improvement. Methods A survey was conducted on the recognition of child maltreatment in EDs in European countries with a focus on screening methods, parental risk factors, training and hospital policies. The survey was distributed through different key members from the EUSEM, REPEM and the EuSEN. A summary score based on the NICE guideline (4 questions on child characteristics, 4 questions on parental characteristics and 5 questions on hospital policy) was calculated. Results We analysed 185 completed surveys, representing 148 hospitals from 29 European countries. Of the respondents, 28.6% used a screening tool, and 31.8% had guidelines on parental risk factors. A total of 42.2% did not follow training based on child characteristics, and 57.6% did not follow training on parental characteristics. A total of 71.9% indicated that there was a need for training. 50.8% of the respondents reported a standardized policy for the detection of child maltreatment. Translating the survey results to NICE summary scores of the EDs in Europe, we found that 25.6% (34/133) met most, 22.6% (30/133) met some and 51.9% (69/133) met few of the NICE guideline recommendations. More specifically, with respect to hospital policies, 33.8% (45/133) met most, 15.0% (20/133) met some and 51.1% (68/133) met few of the NICE guideline recommendations. Conclusion There is high variability regarding policies for child maltreatment detection and only a quarter of the EDs met most of the NICE guideline recommendations for child maltreatment. There is a need for the use of screening tools, training of ED staff and implementation of local hospital policies.

The epidemiology of child maltreatment and its association with mental and somatic health in Norwegian teenagers – a national survey among 9240 12-16-year olds

Background Child maltreatment has emerged as a key public health issue because of its serious consequences and long-term costs. Still, there are few large epidemiological studies on the prevalence of child maltreatment in adolescents, despite being a crucial transitional period making it particularly important to study. Aims We aimed to estimate the prevalence of physical, emotional, and sexual abuse in Norwegian adolescents, as well as health and daily functioning in abused versus non-abused youth. Methods A representative sample of 9240 Norwegian 12-16-year olds (response rate of 86.6%) completed a web-based survey designed to measure lifetime and last-year prevalence of physical and emotional abuse, sexual abuse by adults or peers, and neglect. We also assessed mental and physical health, and daily functioning, including sleep, school absence. Results Four percent of the sample (no sex difference) reported at least one episode of severe physical abuse from a caregiver during their childhood, while an additional 15% percent reported less severe abuse episodes. While 6% reported sexual abuse by an adult, 22% had experienced sexual abuse by a peer, the latter escalating significantly during adolescence. There was a large overlap in exposure types; more than 50% of those experiencing physical abuse, had also experienced emotional abuse. Conclusions Severe maltreatment was strongly associated with parental risk factors such as low SES, substance abuse, and immigrant status, while less severe violence was more randomly distributed. Somatic and mental health and daily functioning were significantly more negatively affected in maltreated youth compared to non-abused peers.

A combined in vivo and in silico model shows specific predictors of individual trans-generational diabetic programming

Diabetic pregnancies are cleary associated with maternal type 2 diabetes and metabolic syndrome as well as atherosclerotic diseases in the offspring. The global prevalence of hyperglycemia in pregnancy was estimated as 15.8% of live births to women in 2019, with an upward trend. Numerous parental risk factors as well as trans-generational mechanisms targeting the utero-placental system, leading to diabetes, dysmetabolic and atherosclerotic conditions in the next generation, seem to be involved within this pathophysiological context. To focus on the predictable impact of trans-generational diabetic programming, we studied age- and gender-matched offspring of diabetic and nondiabetic mothers. The offspring generation consists of three groups: C57BL/6-J-Ins2 Akita (positive control group), wild-type C57BL/6-J-Ins2 Akita (experimental group), and C57BL/6-J mice (negative control group). We undertook intraperitoneal glucose tolerance tests at 3 and 11 weeks of age. Moreover, this in vivo model was complemented by a corresponding in silico model. Although at 3 weeks of age, no significant effects could be observed, we could demonstrate at 11 weeks of age characteristic and significant differences in relation to maternal diabetic imprinting based on the in silico model-based predictors. These predictors allow the generation of a concise classification tree assigning maternal diabetic imprinting correctly in 91% of study cases. Our data show that hyperglycemic in utero milieu contributes to trans-generational diabetic programming leading to impaired glucose tolerance in the offspring of diabetic mothers early on. These observations can be clearly and early distinguished from genetically determined diabetes, for example, type 1 diabetes, in which basal glucose values are significantly raised.

EXPLORING PARENTAL RISK FACTORS IN THE DEVELOPMENT OF DELINQUENCY AMONG CHILDREN

Purpose of the study: To explore and analyze the influence of various parental risk factors contributing to the development of delinquency in children. Methodology: A total of hundred and sixteen juvenile delinquents (100 boys and 16 girls) in the age range of 11- 18 years, residing in the four Government-run Observation and Special Homes (O&SHs) of Odisha. Descriptive statistics (i.e., percent) and qualitative method (i.e. narrative) have been used to analyze the data. Main Findings: Absence of proper parental guidance and supervision is found to be the major cause of delinquency in children. Parental rejection and deprivation i.e. mother’s love and emotional support is the major cause of delinquency in girls. Lack of parental involvement and less quality time spent by parents with boys are the main reasons behind their delinquency. Applications of this study: The results of this study imply the need to conduct further research about parenting behavior and their attitude towards their children from a gender-based perspective. It also implies the need for a greater number of studies to be carried out on Indian parents and their attitude and behavior towards their children in general and based on the child’s gender in particular. Novelty/Originality of this study: The present study tries to address one of the many gaps existing in the literature regarding the matter of parenting style adopted by parents leading to delinquency in children. It further shows the difference in parental attitude and behavior towards their son’s and daughter’s leading to delinquency.