Effet du stress parental sur la relation entre la prématurité et les comportements internalisés de l'enfant né à moins de 29 semaines de gestation

Les enfants nés prématurément sont à risque de problèmes de comportement. Le stress parental semble être un des facteurs pouvant influencer le développement de ces difficultés. L’objectif principal de ce mémoire est de contribuer à une meilleure compréhension des mécanismes explicatifs du stress parental dans la relation entre la prématurité et les comportements internalisés d’enfants de 5 ans nés à moins de 29 semaines de gestation. Deux modèles statistiques ont été confrontés, premièrement le stress parental est posé comme un médiateur puis ensuite comme un modérateur de la relation entre la prématurité et les comportements internalisés de l’enfant. Le second objectif est de comparer la valeur prédictive de deux indicateurs de la sévérité de la prématurité, l’âge gestationnel et l’état physiologique néonatal évalué par le Score for Neonatal Acute Physiology-II (SNAP-II). Les analyses portent sur une cohorte de 118 enfants âgés de 5 ans et nés à moins de 29 semaines de gestation et leurs parents. Le stress parental a été évalué par l’Inventaire de stress parental (ISP) et les comportements internalisés ont été évalués par le Child Behavior Checklist (CBCL). Les résultats démontrent qu’aucun des modèles testés n’est parvenu à prédire les difficultés ultérieures de l’enfant : le stress parental n’est ni un médiateur ni un modérateur de la relation entre la prématurité et les comportements internalisés. De plus, ni l’âge gestationnel ni l'état physiologique néonatal n'est associé aux comportements internalisés. Le stress parental s’est avéré significativement associé aux comportements internalisés de l’enfant. Ce mémoire supporte l’idée que les pratiques parentales, notamment le stress des parents, ont une influence sur les problèmes de comportement des enfants, mais pas l’hypothèse voulant que le stress parental fasse partie du processus explicatif liant la prématurité et aux comportements internalisés. Les résultats permettent de souligner l’importance de détecter, tôt dans le développement des enfants, les pratiques parentales à risque d’influencer négativement leur développement.Preterm children are at risk of behavioral problems, and parenting stress may influence the development of these difficulties. The main goal of this study is to contribute to a better understanding of the role of parenting stress in the process that links preterm birth and internalizing behaviors in very preterm children. Two statistical models were compared to see whether parenting stress is a mediator or a moderator of the relationship between preterm birth and internalizing behaviors. The second goal was to compare the value of two indicators of prematurity severity, gestational age and neonatal acute physiology evaluated by the Score for Neonatal Acute Physiology-II (SNAP-II) score, as predictors of later internalizing problems. A cohort of 118 children born at less than 29 weeks of gestational age and their parents was recruited. Parenting stress was evaluated by the French version on the Parenting Stress Index (PSI) and internalizing behaviors were evaluated by the internalizing scale of the Child Behavior Checklist (CBCL). These measures were obtained by parental report when the children turned 5 years. The results showed that parenting stress was neither a mediator nor a moderator of the relationship between prematurity and internalizing behaviors. Moreover, Both gestational age and SNAP-II score failed to predict internalizing behaviors at 5 years. However, parenting stress was positively associated with higher internalizing behaviors. This study shows that parenting stress did not participate in the association between prematurity and internalizing problems, but showed a direct association with internalizing problems. Our findings highlight the importance of family environment in the resilience of preterm children

La prématurité modérée et tardive : les trajectoires du fonctionnement comportemental chez l'enfant et de la surprotection parentale

Les naissances prématurées modérées et tardives, qui surviennent entre 32 et 36 semaines de gestation, représentent environ 85% des naissances prématurées. Bien que nombreux, les enfants nés prématurés modérés et tardifs (PMT) ont longtemps été considérés comme n'étant pas plus à risque de présenter des difficultés que les enfants nés à terme. Ainsi, leurs trajectoires développementales à long terme sont peu documentées. Un nombre restreint mais croissant d'études suggèrent que les enfants PMT sont plus à risque de développer des problèmes de comportement. Peu d'entre elles se sont toutefois penchées sur l'évolution de ces problèmes dans le temps et sur les facteurs familiaux associés à cette évolution. Par ailleurs, les études dans le domaine obtiennent des résultats divergents. Ainsi, la thèse avait pour premier objectif de mieux comprendre les relations entre la prématurité modérée et tardive et la trajectoire du fonctionnement comportemental des enfants. Dans un premier temps, une recension des écrits a été effectuée afin de mieux comprendre l'état de la littérature actuelle concernant le fonctionnement comportemental des enfants PMT. Cette recension révèle qu'il n'y a pas de consensus clair en ce qui concerne les difficultés comportementales des enfants PMT. Une majorité d'études réalisées en âge scolaire rapportent que les enfants PMT présentent davantage de difficultés comportementales caractérisées par des comportements d'hyperactivité, d'impulsivité, d'inattention, d'anxiété et de dépression. Certaines études rapportent toutefois une absence de différence entre les enfants PMT et ceux nés à terme sur le plan comportemental. La recension a permis de mettre en lumière les divergences méthodologiques entre les études de même que le manque d'études longitudinales dans ce domaine. Elle souligne également le manque d'information sur l'évolution de ces enfants et de leur fonctionnement comportemental au fil du temps. Afin de pallier ces lacunes, le deuxième objectif de la thèse était d'examiner les relations entre la prématurité modérée et tardive et les trajectoires des comportements d'hyperactivité-impulsivité, d'inattention, d'anxiété-dépression et d'agression entre l'âge de 4 et 10 ans au sein d'un échantillon populationnel. Les résultats ont permis de démontrer que la naissance prématurée modérée et tardive est associée à une trajectoire plus élevée de problèmes d'hyperactivité-impulsivité, lorsqu'évaluée par le parent, mais pas par l'enseignant. Par ailleurs, les trajectoires d'inattention, d'anxiété-dépression et d'agression étaient similaires entre les enfants PMT et ceux nés à terme. Afin de mieux comprendre les mécanismes permettant d'expliquer la trajectoire d'hyperactivité-impulsivité des enfants PMT, la thèse avait ensuite pour objectif d'examiner les pratiques de surprotection des parents durant l'âge préscolaire et les relations entre celles-ci, la prématurité modérée et tardive et la trajectoire d'hyperactivité-impulsivité et d'inattention des enfants. Certaines études démontrent que les parents d'enfants prématurés ont plus tendance à surprotéger leurs enfants que les parents d'enfants nés à terme, mais ces études ont essentiellement été réalisées auprès d'enfants de moins de 37 semaines de gestation (incluant tous les enfants prématurés) ou auprès d'enfants grands prématurés (nés à moins de 32 semaines de gestation). Les pratiques parentales spécifiques des parents d'enfants PMT demeurent méconnues. La relation entre la prématurité modérée et tardive et la trajectoire de surprotection parentale entre l'âge de 5 et 29 mois a d'abord été examinée. Ensuite, le rôle de la surprotection parentale et de son interaction avec la naissance prématurée modérée et tardive dans la prédiction de la trajectoire des comportements d'hyperactivité-impulsivité et d'inattention de l'enfant a été examiné. Les résultats démontrent que la surprotection parentale diminue à mesure que les enfants vieillissent au sein de la population et que la prématurité modérée et tardive est associée à une diminution plus lente de la surprotection parentale. Ainsi, plus l'enfant vieillit, plus les parents qui ont un enfant PMT tendent à se distinguer des parents d'enfants nés à terme en adoptant plus de pratiques surprotectrices. De façon cohérente, la naissance prématurée modérée et tardive était associée à un niveau plus élevé de surprotection parentale à 29 mois, mais pas à 5 mois. Les résultats démontrent par ailleurs que la naissance PMT et la surprotection parentale sont indépendamment associées à une trajectoire plus élevée d'hyperactivité-impulsivité pendant l'enfance. Aucune interaction entre la naissance prématurée modérée et tardive et la surprotection parentale n'a été observée. Les résultats suggèrent que les enfants PMT, de même que les enfants exposés à plus de pratiques parentales surprotectrices, tendent à présenter davantage de comportements d'hyperactivité impulsivité. Globalement, les résultats de cette thèse démontrent que les enfants PMT présentent des niveaux légèrement plus élevés d'hyperactivité et d'impulsivité pendant l'enfance et que leurs parents tendent à avoir davantage de pratiques surprotectrices au fil du temps. Les résultats soulignent l'importance d'intervenir tant auprès des parents que des enfants afin de favoriser un fonctionnement comportemental optimal pendant l'enfance.Moderate to late preterm (MLP) births occur between 32 and 36 gestational weeks. MLP births have been less extensively studied than very preterm births despite the fact that they represent up to 85% of all preterm deliveries. A growing body of research suggests that behavioral problems are not limited to children born very preterm. Indeed, there is some evidence to suggest that MLP births may similarly be associated with behavioral problems, however, studies following MLP children over time using a prospective longitudinal design with repeated measures are scarce. The first aim of this thesis was to better understand the relations between MLP birth status and children's behavioral trajectories across childhood. First, a review of the literature was conducted regarding behavioral functioning of MLP children. In this review, a lack of convergence between studies was observed. Some studies revealed that these children had higher levels of behavioral problems, including hyperactivity, impulsivity, inattention and anxiety-depression, compared to full-term children. However, some studies reported no differences between MLP and full-term children. This review highlighted a limited understanding of the developmental trajectories of MLP children across time, in particular with regards to the course and persistence of behavioral problems in this population. Due to the dearth of research, the goal of this thesis was next to examine the relation between MLP birth status and the overall developmental trajectories of multiple behavioral problems (hyperactivity-impulsivity, inattention, anxiety-depression, and aggression) measured repeatedly from ages 4 to 10 years using reports from primary caregivers and teachers. Results indicated that MLP children were more likely to exhibit hyperactive and impulsive behaviors compared to full-term peers during early childhood, according to parents. However, this relation was small and was not confirmed by teacher evaluations. Moreover, MLP children did not differ from full-term children regarding the overall trajectories of inattention, anxiety-depression, and aggression problems. In order to better understand the underlying mechanisms of the relation between MLP birth status and parent-reported trajectory of hyperactivity-impulsivity, the relations between overprotective parenting during the preschool period, MLP birth and children's hyperactivity-impulsivity and inattention behaviors were examined. While overprotective behaviors were documented among parents of very preterm children, it is difficult to confirm that these behaviors also characterize parents of children born in the period near to term. Thus, the third aim of the present thesis was to examine the effects of MLP birth on the trajectory of overprotective parenting practices during preschool years. This thesis also aimed to determine if parental overprotection might explain the documented relation between MLP birth status and children's hyperactivity-impulsivity and inattention symptoms, and whether this parental behavior interacts with the child's birth status in the prediction of these symptoms. First, the overall trajectory of parental overprotection from 5 to 29 months revealed a small decrease across time. The results also indicated that MLP birth was associated with a slower decrease in parental overprotection across the preschool period and that both MLP birth and parental overprotection were independent predictors of the overall trajectory of children's hyperactivity-impulsivity. Interestingly, there was no evidence of an interaction between MLP birth status and parental overprotection in the prediction of the trajectories of children's hyperactivity-impulsivity and inattention. Results suggested that children born MLP and those exposed to high levels of overprotective parenting presented higher levels of hyperactivity and impulsivity. Overall, the results of this thesis suggested that MLP children were more likely to exhibit hyperactive and impulsive behaviors during childhood, and that their parents were more likely to present higher levels of overprotective behaviors overtime. These results highlight the need to provide interventions for both parents and children to promote optimal behavioral functioning during childhood

Associations of prenatal maternal depressive symptoms with cord blood glucocorticoids and child hair cortisol levels in the project viva and the generation R cohorts:a prospective cohort study

Background: Prior studies have reported conflicting results regarding the association of prenatal maternal depression with offspring cortisol levels. We examined associations of high levels of prenatal depressive symptoms with child cortisol biomarkers. Methods:In Project Viva (n = 925, Massachusetts USA), mothers reported their depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy, cord blood glucocorticoids were measured at delivery, and child hair cortisol levels were measured in mid-childhood (mean (SD) age: 7.8 (0.8) years) and early adolescence (mean (SD) age: 13.2 (0.9) years). In the Generation R Study (n = 1644, Rotterdam, The Netherlands), mothers reported depressive symptoms using the Brief Symptom Inventory (BSI) during pregnancy, and child hair cortisol was measured at a mean (SD) age of 6.0 (0.5) years. We used cutoffs of ≥ 13 for the EPDS and &gt; 0.75 for the BSI to indicate high levels of prenatal depressive symptoms. We used multivariable linear regression models adjusted for child sex and age (at outcome), and maternal pre-pregnancy BMI, education, social support from friends/family, pregnancy smoking status, marital status, and household income to assess associations separately in each cohort. We also meta-analyzed childhood hair cortisol results from both cohorts. Results: 8.0% and 5.1% of women respectively experienced high levels of prenatal depressive symptoms in Project Viva and the Generation R Study. We found no associations between high levels of maternal depressive symptoms during pregnancy and child cortisol biomarkers in either cohort. Conclusions: The present study does not find support for the direct link between high levels of maternal depressive symptoms and offspring cortisol levels.</p

Prenatal maternal antidepressants, anxiety, and depression and offspring DNA methylation: epigenome-wide associations at birth and persistence into early childhood

Background Maternal mood disorders and their treatment during pregnancy may have effects on the offspring epigenome. We aim to evaluate associations of maternal prenatal antidepressant use, anxiety, and depression with cord blood DNA methylation across the genome at birth and test for persistence of associations in early and mid-childhood blood DNA. Methods A discovery phase was conducted in Project Viva, a prospective pre-birth cohort study with external replication in an independent cohort, the Generation R Study. In Project Viva, pregnant women were recruited between 1999 and 2002 in Eastern Massachusetts, USA. In the Generation R Study, pregnant women were recruited between 2002 and 2006 in Rotterdam, the Netherlands. In Project Viva, 479 infants had data on maternal antidepressant use, anxiety, depression, and cord blood DNA methylation, 120 children had DNA methylation measured in early childhood (~ 3 years), and 460 in mid-childhood (~ 7 years). In the Generation R Study, 999 infants had data on maternal antidepressants and cord blood DNA methylation. The prenatal antidepressant prescription was obtained from medical records. At-mid pregnancy, symptoms of anxiety and depression were assessed with the Pregnancy-Related Anxiety Scale and the Edinburgh Postnatal Depression Scale in Project Viva and with the Brief Symptom Inventory in the Generation R Study. Genome-wide DNA methylation was measured using the Infinium HumanMethylation450 BeadChip in both cohorts. Results In Project Viva, 2.9% (14/479) pregnant women were prescribed antidepressants, 9.0% (40/445) experienced high pregnancy-related anxiety, and 8.2% (33/402) reported symptoms consistent with depression. Newborns exposed to antidepressants in pregnancy had 7.2% lower DNA methylation (95% CI, − 10.4, − 4.1; P = 1.03 × 10−8) at cg22159528 located in the gene body of ZNF575, and this association replicated in the Generation R Study (β = − 2.5%; 95% CI − 4.2, − 0.7; P = 0.006). In Project Viva, the association persisted in early (β = − 6.2%; 95% CI − 10.7, − 1.6) but not mid-childhood. We observed cohort-specific associations for maternal anxiety and depression in Project Viva that did not replicate. Conclusions The ZNF575 gene is involved in transcriptional regulation but specific functions are largely unknown. Given the widespread use of antidepressants in pregnancy, as well as the effects of exposure to anxiety and depression, implications of potential fetal epigenetic programming by these risk factors and their impacts on development merit further investigation

Effets psychosociaux des activités visant à soutenir les jeunes adultes en situation de handicap : une recension des écrits

Contexte : À la fin de l’adolescence, les jeunes en situation de handicap vivent une transition entre la sortie du système scolaire et l’adaptation à la vie adulte. Certaines activités semblent promouvoir le développement d’habiletés personnelles pendant cette période de développement. Objectif : Documenter les effets psychosociaux des activités visant à soutenir les jeunes adultes en situation de handicap. Méthode : Une revue de littérature a été réalisée dans les bases de données PubMed, ERIC, CINAHL et Social Work. Résultats : Un total de 35 articles a été conservé. Cinq types d’activités ont été abordés : l’activité physique, le travail, les loisirs, l’école et la thérapie par la musique. Les activités ont des conséquences sur la qualité de vie générale, et plus particulièrement sur la perception de soi et les relations interpersonnelles. Conclusion : Les activités ont généralement des effets psychosociaux positifs. Toutefois il importe de prendre en compte le contexte de leur réalisation, par exemple offrir un contexte d’activités compétitives plutôt que récréatives, afin de mettre en place des conditions optimales au développement d’habiletés.Introduction: In late adolescence, young people with disabilities live a transition between end of school and adaptation to adulthood. Some activities appear to promote the development of skills that foster the transition to adulthood. Objective: To document the psychosocial effects and the context of activities aiming to support young adults with disabilities. Methods: A literature review was conducted in four databases: PubMed, ERIC, CINAHL and Social Work. Results: A total of 35 articles were selected. Five types of activities were discussed: physical activity, work, recreation, school and music therapy. The activities have an impact on three indicators of general quality of life, self-perception and interpersonal relationships. Conclusion: The activities generally have positive psychosocial effects; however it is important to consider the context of their implementation in order to establish optimal conditions for critical skills development to prepare young people in transition to adult life

Associations of Prenatal and Postnatal Maternal Depressive Symptoms with Offspring Cognition and Behavior in Mid-Childhood: A Prospective Cohort Study

Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive symptoms in association with child development using reports from teachers and mothers. This study is based on 1225 mother&#8211;child pairs from Project Viva, a prospective pre-birth cohort study. Mothers reported depressive symptoms on the Edinburgh Postpartum Depression Scale (EPDS) in mid-pregnancy as well as at 6 months and 12 months postpartum. Teachers and mothers reported child executive functions using the Behavioral Rating Inventory of Executive Function (BRIEF) and behavior using the Strengths and Difficulties Questionnaire (SDQ). Children completed the Kaufman Brief Intelligence Test (KBIT-2), the Wide Range Assessment of Visual Motor Abilities (WRAVMA), and the Visual Memory Index of the Wide Range Assessment of Memory and Learning (WRAML). We used multivariable linear regression models to examine associations of prenatal and postpartum depressive symptoms with outcomes. Many of the crude associations observed were attenuated after adjusting for demographic factors and maternal IQ, yet some remained significant. For example, high prenatal maternal depressive symptoms were associated with poorer scores on the BRIEF Behavior Regulation Index and some SDQ scales based on reports from teachers and mothers. High prenatal maternal depressive symptoms were associated with poorer behavioral development. Postpartum symptoms did not show strong associations with outcomes once we adjusted for the prenatal period

<i>SERPINE1</i> DNA Methylation Levels Quantified in Blood Cells at Five Years of Age Are Associated with Adiposity and Plasma PAI-1 Levels at Five Years of Age

Plasminogen activator inhibitor (PAI-1) expression has been associated with a higher risk of development of obesity. DNA methylation (DNAm) is an epigenetic mechanism regulating gene transcription and likely involved in the fetal programming of childhood obesity. Our study aimed to assess the associations between PAI-1 gene (SERPINE1) DNAm, plasma PAI-1 levels, and adiposity at five years of age. We analyzed DNAm and anthropometric data from 146 girls and 177 boys from the Gen3G prospective birth cohort. We assessed adiposity using BMI z-scores, waist circumference, total skinfolds, and percentages of total, android, and trunk fat measured by dual-energy radiography (DXA). We estimated blood cell DNAm levels at 15 CpG sites within SERPINE1 using the methylationEPIC array. After correction for multiple testing, we found that lower DNAm in SERPINE1 intron 3 (cg11353706) was associated with greater adiposity levels in girls (waist circumference: r = −0.258, p = 0.002; skinfolds: r = −0.212, p = 0. 013; android fat: r = −0.215, p = 0.015; BMI z-score: r = −0.278, p SERPINE1 promoter (cg19722814) was associated with higher plasma PAI-1 levels in boys (r = −0.178, p = 0.021). Our study suggests that DNAm levels at the SERPINE1 gene locus are negatively correlated with adiposity, but not with plasma PAI-1 levels, in young girls only

Trajectories of depressive symptoms among mothers of preterm and full-term infants in a national sample.

To examine postpartum depressive symptom trajectories from birth to age 5 and their risk factors in a national sample of mothers of preterm and full-term infants. The racially and ethnically diverse sample comprised 11,320 maternal participants (Mage = 29; SD = 5.9) in the Environmental influences on Child Health Outcomes (ECHO) Program in the USA with data on newborn gestational age at birth (≥ 22&nbsp;weeks) and maternal depression symptoms during the first 5&nbsp;years following childbirth. Growth mixture models determined the number and trajectory of postpartum depression classes among women in the preterm and full-term groups, and we examined predictors of class membership. Five trajectories described depressive symptoms for both groups; however, notable differences were observed. One in 5 mothers of preterm infants developed clinically relevant depressive symptoms over time compared with 1 in 10 mothers of full-term infants. Among women who delivered preterm compared with those who delivered full-term, symptoms were more likely to increase over time and become severe when offspring were older. Distinct subgroups describe mothers depressive symptom trajectories through 5&nbsp;years following childbirth. Mild to moderate depressive symptoms may onset or persist for many women beyond the initial postpartum period regardless of newborn gestational age at birth. For women with preterm infants, initially mild symptoms may increase to high levels of severity during the preschool and toddler years

Prenatal maternal antidepressants, anxiety, and depression and offspring DNA methylation: epigenome-wide associations at birth and persistence into early childhood.

BACKGROUND:Maternal mood disorders and their treatment during pregnancy may have effects on the offspring epigenome. We aim to evaluate associations of maternal prenatal antidepressant use, anxiety, and depression with cord blood DNA methylation across the genome at birth and test for persistence of associations in early and mid-childhood blood DNA. METHODS:A discovery phase was conducted in Project Viva, a prospective pre-birth cohort study with external replication in an independent cohort, the Generation R Study. In Project Viva, pregnant women were recruited between 1999 and 2002 in Eastern Massachusetts, USA. In the Generation R Study, pregnant women were recruited between 2002 and 2006 in Rotterdam, the Netherlands. In Project Viva, 479 infants had data on maternal antidepressant use, anxiety, depression, and cord blood DNA methylation, 120 children had DNA methylation measured in early childhood (~ 3 years), and 460 in mid-childhood (~ 7 years). In the Generation R Study, 999 infants had data on maternal antidepressants and cord blood DNA methylation. The prenatal antidepressant prescription was obtained from medical records. At-mid pregnancy, symptoms of anxiety and depression were assessed with the Pregnancy-Related Anxiety Scale and the Edinburgh Postnatal Depression Scale in Project Viva and with the Brief Symptom Inventory in the Generation R Study. Genome-wide DNA methylation was measured using the Infinium HumanMethylation450 BeadChip in both cohorts. RESULTS:In Project Viva, 2.9% (14/479) pregnant women were prescribed antidepressants, 9.0% (40/445) experienced high pregnancy-related anxiety, and 8.2% (33/402) reported symptoms consistent with depression. Newborns exposed to antidepressants in pregnancy had 7.2% lower DNA methylation (95% CI, - 10.4, - 4.1; P = 1.03 × 10-8) at cg22159528 located in the gene body of ZNF575, and this association replicated in the Generation R Study (β = - 2.5%; 95% CI - 4.2, - 0.7; P = 0.006). In Project Viva, the association persisted in early (β = - 6.2%; 95% CI - 10.7, - 1.6) but not mid-childhood. We observed cohort-specific associations for maternal anxiety and depression in Project Viva that did not replicate. CONCLUSIONS:The ZNF575 gene is involved in transcriptional regulation but specific functions are largely unknown. Given the widespread use of antidepressants in pregnancy, as well as the effects of exposure to anxiety and depression, implications of potential fetal epigenetic programming by these risk factors and their impacts on development merit further investigation

Women’s perceived social support: Associations with postpartum weight retention, health behaviors and depressive symptoms

Background Social support may promote healthful behaviors that prevent excess weight at critical periods in women’s life. Our objective was to investigate associations of social support at 6 months postpartum with women’s health behaviors that have previously been shown to predict weight retention at 1 year postpartum. Methods At 6 months postpartum in Project Viva, a pre-birth prospective cohort in Massachusetts, women reported social support using the Turner Support Scale, depressive symptoms using the Edinburgh Postnatal Depression Scale, diet using PrimeScreen, average number of hours walking, light/moderate and vigorous physical activity, television viewing, and sleeping each day. Results Among 1356 women, greater partner support was associated with higher levels of walking (OR 1.36, 95% CI [1.01, 1.82]) and intake of fiber (OR 1.43, 95% CI [1.06, 1.91]) and lower intake of trans-fat (OR 1.49, 95% CI [1.11, 2.01]). Support from family/friends was marginally related to healthful levels of light/moderate physical activity (OR 1.26, 95% CI [0.96, 1.65]) and television viewing (OR 1.29, 95% CI [0.99, 1.69]). Both sources of support were strongly associated with lower odds of incident depression (OR 0.33, 95% CI [0.20, 0.55] and OR 0.49, 95% CI [0.30, 0.79], respectively). We did not find associations with vigorous physical activity or sleep duration. Conclusions Social support is important to the physical and mental health of new mothers and may promote behaviors that limit postpartum weight retention