The impact of early life stress on risk of tobacco smoking initiation by adolescents

BACKGROUND: Early life stress is known to be associated with increased propensity to substance abuse. The present study seeks to confirm the association between early life stress and tobacco smoking initiation by adolescents. METHODS: This study is based on the data of the Family and Children of Ukraine Study, which is a part of the cohort study in Europe for pregnancy and childhood “ELSPAC”. Main exposures were stressful life event scores at 3 and 7 years that were calculated by summing the perceived impact score reported by mothers for each life event. Smoking status of the adolescent and age of smoking initiation, reported at the 16-years-old follow-up, were outcome measures. Data were analyzed using multivariate binary logistic regression models separately for boys and girls controlling for socio-demographic characteristics and mother’s smoking. RESULTS: Stressful life events score was available for 898 participants at age 3 years and for 840 participants at age 7 years and varied from 0 to 48 points, with mean equal 4.69 and 5.96 respectively. In the gender-stratified analysis, current smoking by boys or girls was not associated with early life stress measured at 3 years old. Association between smoking and early life stress at age 7 years was not observed for boys. However, girls who experienced much stress at 7 years (more than 12 points) had 3 times higher odds of smoking (OR=2.94, 95% CI=1.26-6.83). Girls who had scored more than 12 points for stressful life events at 3 or 7 years old were respectively three times (OR=3.34, 95% CI=1.50-7.42) or two times (OR=2.19, 95% CI=1.01-4.74) more likely to start smoking at 13 years old or younger. CONCLUSIONS: Early life stress may have effect on vulnerability to tobacco smoking by adolescents. However, this effect was significant only for girls at high incidence of stressful life events. KEYWORDS: early life stress, smoking, adolescents

Health Risks of Limited-Contact Water Recreation

Background: Wastewater-impacted waters that do not support swimming are often used for boating, canoeing, fishing, kayaking, and rowing. Little is known about the health risks of these limited-contact water recreation activities

Оптимальне шкалювання для вимірювання стресу раннього періоду життя

BACKGROUND: Early life stress is associated with high risk for both negative psychological and physical health outcomes. However, many of the stressful life events inventories that have been used in epidemiological research have not been validated or checked for reliability or consistency. The aim of our study is to use optimal scaling and correspondence analysis that employ categorical principal components analysis (CATPCA) algorithm to consider the internal structure and the geometry of the space of variables obtained through the questions measuring early life stress. This approach was chosen because it allows quantification of categorical (both nominal and ordinal) scales and reduction of initial number of variables with interval quantification of the resulting dimensions. METHODS: A questionnaire for measuring early life stress was applied to the participants of the Ukrainian component of European Longitudinal Study of Pregnancy and Childhood at the age of three and seven years. CATPCA algorithm was used to elaborate a tool for estimating related integral quantified characteristics.RESULTS: Application of quantification and dimension reduction techniques to the categorical variables measuring stress in three- and seven-year-old children resulted in two dimensions. The first dimension that accounts for a major part of initial variance and is associated with all the collected variables can be interpreted as the overall value of stress. The second dimension accounts for smaller but still considerable part of variance and can be related to child’s attachment to mother and acquiring new experience as the route of development.CONCLUSIONS: Application of optimal scaling to the empirical data of early life stress measurement resulted in construction of two integral indicators – first measuring overall stress and second contrasting security related to child’s attachment to mother and new experiences – consistent across age groups of three and seven-year-old children.АКТУАЛЬНОСТЬ: Стресс в ранний период жизни связан с высоким риском как психологических, так и физиологических проблем. При этом многие инструменты, используемые для регистрации стрессовых событий в жизни в эпидемиологических исследованиях, не прошли проверку на валидность, надежность и согласованность. Целью нашего исследования было использование оптимального шкалирования и анализа соответствий по методу главных компонент для категориальных признаков с целью рассмотрения внутренней структуры и пространственной геометрии переменных, полученных из вопросника по измерению стресса в ранний период жизни. Выбор такого подхода был обусловлен тем, что он делает возможным количественное выражение категориальных (номинальных и порядковых) переменных и уменьшение размерности данных с интервальным выражением выявленных размерностей.  МЕТОДЫ: Вопросник по измерению стресса в ранние периоды жизни был предложен участникам украинской компоненты Европейского лонгитюдного исследования беременности и детства, когда их дети достигли 3-х и 7-ми лет. Алгоритм анализа соответствий по методу главных компонент для категориальных величин использовался для оценки соответствующих интегральных характеристик.РЕЗУЛЬТАТЫ: Применение количественного выражения и сокращения размерностей к категориальным переменным, измеряющим стресс у 3-х и 7-ми-летних детей, позволило выделить две размерности.Первая размерность, которая учитывает основную часть дисперсии и связана со всеми переменными в исследовании, может быть интерпретирована как общий уровень стресса. Вторая размерность, которая учитывает меньшую, но все же значительную часть дисперсии, сопоставляет привязанность ребенка к матери и получение нового опыта как важные элементы развития. ВЫВОДЫ: Применение оптимального шкалирования к эмпирическим данным по стрессу в ранний период жизни позволило сконструировать два интегральных индикатора. Первый индикатор служит для измерения общего стресса, а второй – для противопоставления ощущения безопасности, выражаемой в привязанности к матери, и получения нового опыта. Оба индикатора были выявлены как в возрастной группе 3-х-летних, так и 7-ми-летних детей.АКТУАЛЬНІСТЬ: Стрес у ранній період життя пов’язаний з високим ризиком як психологічних, так і фізіологічних проблем. Однак, інструменти, що використовують для реєстрації стресових подій у житті в епідеміологічних дослідженнях, не пройшли перевірку на валідність, надійність та узгодженість. Метою нашого дослідження було використання оптимального градуювання і аналізу відповідностей за методом головних компонент для категоріальних величин з метою виявлення внутрішньої структури і просторової геометрії змінних, отриманих з опитувальника, що вимірює стрес у ранній період життя. Вибір такого підходу був зумовлений його здатністю квантифікації категоріальних (номінальних і порядкових) шкал і зменшення розмірності даних з їх інтервальним визначенням.МЕТОДИ: Опитувальник стресу у ранні періоди життя був запропонований учасникам української компоненти Європейського лонгітюдного дослідження вагітності і дитинства, коли їх діти досягли 3-х і 7-ми років. Алгоритм аналізу відповідностей за методом головних компонент для категоріальних величин використовували для оцінки відповідних інтегральних характеристик.РЕЗУЛЬТАТИ: Використання вирахування і скорочення розмірностей щодо категоріальних змінних, які вимірюють стрес в 3-х і 7-ми-літніх дітей, дозволило виділити дві розмірності.Перша розмірність, яка враховує основну частину дисперсії і пов’язана з усіма змінними у дослідженні, може бути проінтерпретована як загальний рівень стресу. Друга розмірність, яка враховує меншу, але все ж значну частину дисперсії, співставляє прив’язаність дитини до матері й отримання нового досвіду як елементи процесу розвитку. ВИСНОВКИ: Використання оптимального градуювання до емпіричних даних зі стресу у ранній період життя дозволило сконструювати два інтегральні індикатори. Перший індикатор служить для вимірювання загального рівня стресу, а другий – для визначення відчуття безпеки, що проявляється через прив’язаність до матері, і отримання нового досвіду. Обидва індикатора були виявлені як у віковій групі 3-х-річних, так і 7-ми-річних дітей.  

Urinary 1-Hydroxypyrene as a Biomarker of PAH Exposure in 3-Year-Old Ukrainian Children

Urinary 1-hydroxypyrene (1-OHP) is a biomarker of polycyclic aromatic hydrocarbon (PAH) exposure. We measured urinary 1-OHP in 48 children 3 years of age in Mariupol, Ukraine, who lived near a steel mill and coking facility and compared these with 1-OHP concentrations measured in 42 children of the same age living in the capital city of Kiev, Ukraine. Children living in Mariupol had significantly higher urinary 1-OHP and creatinine-adjusted urinary 1-OHP than did children living in Kiev (adjusted: 0.69 vs. 0.34 μmol/mol creatinine, p < 0.001; unadjusted: 0.42 vs. 0.30 ng/mL, p = 0.002). Combined, children in both cities exposed to environmental tobacco smoke in their homes had higher 1-OHP than did children not exposed (0.61 vs. 0.42 μmol/mol creatinine; p = 0.04; p = 0.07 after adjusting for city). In addition, no significant differences were seen with sex of the children. Our sample of children in Mariupol has the highest reported mean urinary 1-OHP concentrations in children studied to date, most likely due to their proximity to a large industrial point source of PAHs

Mother's education and offspring asthma risk in 10 European cohort studies

Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European countries. Data on 47,099 children were obtained from prospective birth cohort studies across 10 European countries. We calculated cohort-specific prevalence difference in asthma outcomes using the relative index of inequality (RII) and slope index of inequality (SII). Results from all countries were pooled using random-effects meta-analysis procedures to obtain mean RII and SII scores at the European level. Final models were adjusted for child sex, smoking during pregnancy, parity, mother's age and ethnicity. The higher the score the greater the magnitude of relative (RII, reference 1) and absolute (SII, reference 0) inequity. The pooled RII estimate for asthma risk across all cohorts was 1.46 (95% CI 1.26, 1.71) and the pooled SII estimate was 1.90 (95% CI 0.26, 3.54). Of the countries examined, France, the United Kingdom and the Netherlands had the highest prevalence's of childhood asthma and the largest inequity in asthma risk. Smaller inverse associations were noted for all other countries except Italy, which presented contradictory scores, but with small effect sizes. Tests for heterogeneity yielded significant results for SII scores. Overall, offspring of mothers with a low level of education had an increased relative and absolute risk of asthma compared to offspring of high-educated mothers

Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America : An individual participant data meta-analysis of 229,000 singleton births

Author summaryWhy was this study done? Maternal smoking during pregnancy is an important risk factor for various birth complications and childhood overweight. It is not clear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy. The associations of paternal smoking with birth and childhood outcomes also remain unknown. What did the researchers do and find? We conducted an individual participant data meta-analysis using data from 229,158 families from 28 pregnancy and birth cohorts from Europe and North America to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. We observed that smoking in the first trimester only did not increase the risk of preterm birth and small size for gestational age but was associated with a higher risk of childhood overweight, as compared to nonsmoking. Reducing the number of cigarettes during pregnancy, without quitting, was still associated with higher risks of these adverse outcomes. Paternal smoking seems to be associated, independently of maternal smoking, with the risks of childhood overweight. What do these findings mean? Population strategies should focus on parental smoking prevention before or at the start of, rather than during, pregnancy. Future studies are needed to assess the specific associations of smoking in the preconception and childhood periods with offspring outcomes. Background Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers' median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02-1.35],Pvalue = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02-1.15],Pvalue = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07-2.23],Pvalue <0.001), and childhood overweight (OR 1.42 [95% CI 1.35-1.48],Pvalue <0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52-2.34] instead of OR 2.20 [95% CI 2.02-2.42] when reducing from 5-9 to = 10 to 5-9 andPeer reviewe

Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood : An individual participant data meta-analysis

Background Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. Methods and findings We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestylerelated characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p <0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations. Conclusions In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.Peer reviewe