Is Prenatal Stress Bad for Babies? It Depends on Maternal Perception

Background: Maternal experiences of distress during pregnancy have been found to affect fetal development, showing an impact on both child developmental and behavioural outcomes later in. Aims: To explore whether (1) psychological and physiological indicators of maternal prenatal stress during pregnancy predict infant state-regulation and (2) if these factors can have positive effects on infant development. Study Design: Data from a prospective cohort was gathered from mothers during pregnancy and their children at 3 months of age. Using an ecological momentary assessment technique, we collected diurnal salivary cortisol, salivary alpha-amylase (sAA) and self-reported mood information over 3 consecutive days during pregnancy. Mother’s reported on their infant’s temperament (Infant Behaviour Questionnaire-Revised), amount of crying (Crying Patterns Questionnaire) and sleep (Brief Infant Sleep Questionnaire). Data Analysis: Mother-infant pairs were divided into groups based on level of maternal psychological distress (Profile of Mood States). Separate bivariate and partial correlations between maternal indicators of physiological stress (cortisol and sAA) and infant outcomes were calculated for mother-infant pairs in the highest and lowest quartiles of psychological distress. Results: Mothers with the highest levels of psychological and physiological distress had infants with poorest temperament, crying and sleep outcomes. In contrast, mothers with the lowest levels of psychological distress, but who had high levels of cortisol and sAA had the best infant outcomes. Conclusion: The effects of prenatal cortisol and autonomic function (as indicated by sAA) on infant development are different for mothers high and low in psychological distress.

Heterostructures of skutterudites and germanium antimony tellurides – structure analysis and thermoelectric properties of bulk samples

Heterostructures of germanium antimony tellurides with skutterudite-type precipitates are promising thermoelectric materials due to low thermal conductivity and multiple ways of tuning their electronic transport properties. Materials with the nominal composition [CoSb2(GeTe)_(0.5)]_x(GeTe)_(10.5)Sb_2Te_3 (x = 0–2) contain nano- to microscale precipitates of skutterudite-type phases which are homogeneously distributed. Powder X-ray diffraction reveals that phase transitions of the germanium antimony telluride matrix depend on its GeTe content. These are typical for this class of materials; however, the phase transition temperatures are influenced by heterostructuring in a beneficial way, yielding a larger existence range of the intrinsically nanostructured pseudocubic structure of the matrix. Using microfocused synchrotron radiation in combination with crystallite pre-selection by means of electron microscopy, single crystals of the matrix as well as of the precipitates were examined. They show nano-domain twinning of the telluride matrix and a pronounced structure distortion in the precipitates caused by GeTe substitution. Thermoelectric figures of merit of 1.4 ± 0.3 at 450 °C are observed. In certain temperature ranges, heterostructuring involves an improvement of up to 30% compared to the homogeneous material

Harmonization of data from cohort studies– potential challenges and opportunities

Introduction Pooling data from cohort studies can be used to increase sample size. However, individual datasets may contain variables that measure the same construct differently, posing challenges in the usefulness of combined datasets. Variable harmonization (an effort that provides comparable view of data from different studies) may address this issue. Objectives and Approach This study harmonized existing datasets from two prospective pregnancy cohort studies in Alberta Canada (All Our Families (n=3,351) and Alberta Pregnancy Outcome and Nutrition (n=2,187)). Given the comparability of the characteristics of the two cohorts and similarities of the core data elements of interest, data harmonization was justifiable. Data harmonization was performed considering multiple factors, such as complete or partial variable matching regarding question asked/responded, the response coded (value level, value definition, data type), the frequency of measurement, the pregnancy time-period of measurement, and missing values. Multiple imputation was used to address missing data resulting from the data harmonization process. Results Several variables such as ethnicity, income, parity, gestational age, anxiety, and depression were harmonized using different procedures. If the question asked/answered and the response recorded was the same in both datasets, no variable manipulation was done. If the response recorded was different, the response was re-categorized/re-organized to optimize comparability of data from both datasets. Missing values were created for each resulting unmatched variables and were replaced using multiple imputation if the same construct was measured in both datasets but using different ways/scales. A scale that was used in both datasets was identified as a reference standard. If the variables were measured in multiple times and/or different time-periods, variables were synchronized using pregnancy trimesters data. Finally, harmonized datasets were then combined/pooled into a single dataset (n=5,588). Conclusion/Implications Variable harmonization is an important aspect of conducting research using multiple datasets. It provides an opportunity to increase study power through maximizing sample size, permitting more sophisticated statistical analyses, and to answer novel research questions that could not be addressed using a single study

Evaluating treatments in health care: The instability of a one-legged stool

<p>Abstract</p> <p>Background</p> <p>Both scientists and the public routinely refer to randomized controlled trials (RCTs) as being the 'gold standard' of scientific evidence. Although there is no question that placebo-controlled RCTs play a significant role in the evaluation of new pharmaceutical treatments, especially when it is important to rule out placebo effects, they have many inherent limitations which constrain their ability to inform medical decision making. The purpose of this paper is to raise questions about <it>over-reliance </it>on RCTs and to point out an additional perspective for evaluating healthcare evidence, as embodied in the Hill criteria. The arguments presented here are generally relevant to all areas of health care, though mental health applications provide the primary context for this essay.</p> <p>Discussion</p> <p>This article first traces the history of RCTs, and then evaluates five of their major limitations: they often lack external validity, they have the potential for increasing health risk in the general population, they are no less likely to overestimate treatment effects than many other methods, they make a relatively weak contribution to clinical practice, and they are excessively expensive (leading to several additional vulnerabilities in the quality of evidence produced). Next, the nine Hill criteria are presented and discussed as a richer approach to the evaluation of health care treatments. Reliance on these multi-faceted criteria requires more analytical thinking than simply examining RCT data, but will also enhance confidence in the evaluation of novel treatments.</p> <p>Summary</p> <p>Excessive reliance on RCTs tends to stifle funding of other types of research, and publication of other forms of evidence. We call upon our research and clinical colleagues to consider additional methods of evaluating data, such as the Hill criteria. Over-reliance on RCTs is similar to resting all of health care evidence on a one-legged stool.</p

Cross-Sectional Study Protocol for the COVID-19 Impact Survey of Mothers and Their 7–11 Year Old Children in Alberta, Canada

Objectives: Our aim is to understand the effect of the COVID-19 pandemic on families who have been followed longitudinally in two cohorts studied in Alberta, Canada. We will examine household infections during the COVID-19 pandemic, financial impact, domestic violence, substance use, child school and daily life and relationships in the home. We will identify risk and protective factors for maternal mental health outcomes using longitudinal data that can inform policy and government resource allocation in future disasters.Methods: Mothers who are currently participating in two longitudinal studies, Alberta Pregnancy Outcomes and Nutrition (APrON; N = 1,800) and All Our Families (AOF: N = 2,534) were eligible to participate. Mothers were invited to complete the baseline COVID-19 Impact Survey (20–30 min) within 4 months of March 15, 2020, which was when the province of Alberta, Canada, implemented school closures and physical-distancing measures to prevent the spread of COVID-19. Mothers were asked to report on their own, their child's and their family's functioning. Mothers were re-surveyed at 6 months after completion of the initial COVID-19 Impact Survey, and will be re-surveyed again at 12 months.Results: Responses from participants in both cohorts will be examined in harmonized analyses as well as separately. Descriptive, multivariable analysis will be undertaken to examine risk and resiliency over time and factors that predict mental health and well-being.Conclusions: This study will provide timely information on the impact of COVID-19 for Albertan families. It will identify risk and protective factors for mental health and well-being among contemporary urban families supported by a publicly funded health care system to inform allocation of resources to support those most vulnerable during a global pandemic

Methodological and Epistemological Issues in the Interpretation of Infant Cognitive Development

Article deposited according to publisher policies: http://olabout.wiley.com/WileyCDA/Section/id-820227.htmlThis commentary on J. Kagan (2008) addresses 2 issues. The first concerns the importance of studying developmental sequences and processes of change. The second concerns epistemological differences between contemporary neonativist approaches and classical theories of development. The commentary argues that classical theories of infant cognition and contemporary neonativist theories fundamentally differ in terms of how they conceptualize the workings of the mind. These differences affect the meaning of terms such as representation and reasoning. Also discussed are implications of epistemological differences for developmental explanations. The commentary concludes that epistemological differences must be articulated more fully in order to improve understanding of different theories and in order to evaluate the relative merits and shortcomings of those theories.Ye

The Psychobiology of Stress and its relationship to Maternal Sleep during Pregnancy

Alberta Children's Hospital Research Institute for Child and Maternal Health, APrON Study Team & Undergraduate Student Research Program in Health and WellnessYe

Cognitive and emotional aspects of self-regulation in preschoolers

Author's accepted manuscript deposited according to Elsevier sharing policies http://www.elsevier.com/about/company-information/policies/policy-faq November 20, 2015The goal of the present study was to examine the contribution of executive function (EF) and social cognition to individual differences in emotion regulation (ER) in preschool children. Sixty 3-, 4-, and 5-year-old children were administered a battery of EF tasks, two theory of mind tasks, a measure of verbal ability, and an ER task. In addition, parents completed the Behavior Rating Inventory of Executive Functioning—Preschool Version (BRIEF-P). Performance on the theory of mind tasks as well as parental ratings of executive function was not related to performance on the ER task. However, a component of EF (i.e., inhibition) approached significance with children’s displays of positive behaviors during the ER task. Verbal ability was related to the regulation of positive but not negative emotions. Parental ratings of shifting accounted for a significant amount of variance in parental ratings of ER, even after controlling for verbal ability. The findings are discussed in the context of different conceptualizations of the developmental relation between ER and EF.Ye

Sexually dimorphic adaptations in basal maternal stress physiology during pregnancy and implications for fetal development

Author's accepted manuscript deposited according to Elsevier sharing policies http://www.elsevier.com/about/company-information/policies/policy-faq October 21, 2015There is clear evidence of reciprocal exchange of information between the mother and fetus during pregnancy but the majority of research in this area has focussed on the fetus as a recipient of signals from the mother. Specifically, physiological signals produced by the maternal stress systems in response to the environment may carry valuable information about the state of the external world. Prenatal stress produces sex-specific adaptations within fetal physiology that have pervasive and long-lasting effects on development. Little is known, however, about the effects of sex-specific fetal signals on maternal adaptations to pregnancy. The current prospective study examined sexually dimorphic adaptations within maternal stress physiology, including the hypothalamic-adrenal-pituitary (HPA) axis and the autonomic nervous system (ANS) and associations with fetal growth. Using diurnal suites of saliva collected in early and late pregnancy, we demonstrate that basal cortisol and salivary alpha-amylase (sAA) differ by fetal sex. Women carrying female fetuses displayed greater autonomic arousal and flatter (but more elevated) diurnal cortisol patterns compared to women carrying males. Women with flatter daytime cortisol trajectories and more blunted sAA awakening responses also had infants with lower birth weight. These maternal adaptations are consistent with sexually dimorphic fetal developmental/evolutionary adaptation strategies that favor growth for males and conservation of resources for females. The findings provide new evidence to suggest that the fetus contributes to maternal HPA axis and ANS regulation during pregnancy and that these systems also contribute to the regulation of fetal growth.Ye