The impact of paternal alcohol, tobacco, caffeine use and physical activity on offspring mental health: a systematic review and meta-analysis

Plain language summary More research has focused on the impact mothers’ behaviours (such as smoking or alcohol use) during and around pregnancy may have on their children’s health, with less research investigating the role paternal health behaviours may play. This review captured what research was currently available that investigated the impact of paternal alcohol, tobacco, caffeine use, and physical activity during pregnancy on children’s mental health. We showed that this area is currently under researched, finding only eight studies. However, of the research that was already published we found evidence of paternal health behaviours having an impact on children’s mental health. The strongest evidence was shown for paternal smoking during pregnancy having a negative impact on children’s hyperactivity/ADHD. No studies measured paternal caffeine use or physical activity around pregnancy. This review highlights the lack of research that has investigated the association between paternal modifiable health behaviours around pregnancy and offspring mental health. Despite including four different types of paternal health behaviours and a broad definition of offspring mental health across any age, only eight studies were shown. This review suggests further research within this area is needed which may influence health warnings to potential fathers to be both before conception and during pregnancy

Comprehensive data analysis to study parturition

Our limited understanding of the molecular mechanisms driving the onset of normal human parturition makes it difficult to identify ‘what goes wrong’ in conditions such as preterm labour (PTL), preterm prelabour rupture of membranes (PPROM) and postpartum haemorrhage (PPH). This incomplete understanding seriously hampers the development of effective ways to predict, prevent and treat parturition complications, which are a cause of significant neonatal and maternal morbidity. Two principal barriers to improving our understanding are 1) the great complexity of both the molecular interactions initiating parturition and the aetiology of parturition complications, and 2) the difficulty in generating relevant high quality molecular and epidemiological data. To help make sense of this complexity, data should be analysed comprehensively to maximise the amount of useful information gleaned from it. This thesis aimed to explore the use of specialist methods to analyse novel and previously published data to study the molecular mechanisms initiating human parturition and the epidemiology of parturition complications. The molecular mechanisms initiating parturition were explored through a gene expression microarray of labouring and non-labouring myometrial tissue. This is the largest microarray of its kind to date. Functional analysis and a network graph approach were used to reveal genes and molecular pathways associated with labour. The first ever meta-analysis of similar myometrial microarray datasets was also conducted to assess the reliability and generalisability of the results. This work supported the hypothesis that labour is associated with inflammatory events in the myometrium. A computer model of an inflammatory signalling pathway associated with infection-induced PTL was then built to provide proof of concept that such models can be used to study parturition. The model was based on published data and described lipopolysaccharide-induced activation of the transcription factor Nuclear Factor kappa B (NF-κB). This is the first attempt to generate a dynamic kinetic model that has relevance to the molecular mechanisms of PTL, and the first model of this pathway to explicitly include molecular interactions upstream of NF-κB activation. The epidemiology of complications at parturition was explored using three methods. Firstly, a novel approach was developed to use network graphs to visualise and analyse a dataset of nearly 50,000 birth records. The approach provided a quick and effective way to preliminarily explore relationships between exposures and pregnancy outcomes in an unbiased data-driven manner. Secondly, a record-linkage study of two datasets of birth records was conducted to determine risk factors for PPH, including intergenerational transmission of risk. This confirmed several known risk factors of PPH and showed that women whose mothers or grandmothers had PPH do not appear to be at increased risk themselves. Finally, a systematic review and meta-analysis of three randomised controlled trials investigated the effectiveness of fetal assessment methods in improving maternal and neonatal outcomes following PPROM. The review concluded that there is currently insufficient evidence on the benefits and harms of any method of fetal assessment, and further randomised controlled trials are required

The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities

International audienceSince the beginning of the COVID-19 pandemic, discussions on social media and blogs have indicated that women have experienced menstrual changes, including altered menstrual duration, frequency, regularity, and volume (heavier bleeding and clotting), increased dysmenorrhea, and worsened premenstrual syndrome. There have been a small number of scientific studies of variable quality reporting on menstrual cycle features during the pandemic, but it is still unclear whether apparent changes are due to COVID-19 infection/illness itself, or other pandemic-related factors like increased psychological stress and changes in health behaviours. It is also unclear to what degree current findings are explained by reporting bias, recall bias, selection bias and confounding factors. Further research is urgently needed. We provide a list of outstanding research questions and potential approaches to address them. Findings can inform policies to mitigate against gender inequalities in health and society, allowing us to build back better post-COVID

The relationships between women’s reproductive factors:a Mendelian randomisation analysis

BACKGROUND: Women’s reproductive factors include their age at menarche and menopause, the age at which they start and stop having children and the number of children they have. Studies that have linked these factors with disease risk have largely investigated individual reproductive factors and have not considered the genetic correlation and total interplay that may occur between them. This study aimed to investigate the nature of the relationships between eight female reproductive factors. METHODS: We used data from the UK Biobank and genetic consortia with data available for the following reproductive factors: age at menarche, age at menopause, age at first birth, age at last birth, number of births, being parous, age first had sexual intercourse and lifetime number of sexual partners. Linkage disequilibrium score regression (LDSC) was performed to investigate the genetic correlation between reproductive factors. We then applied Mendelian randomisation (MR) methods to estimate the causal relationships between these factors. Sensitivity analyses were used to investigate directionality of the effects, test for evidence of pleiotropy and account for sample overlap. RESULTS: LDSC indicated that most reproductive factors are genetically correlated (r(g) range: |0.06–0.94|), though there was little evidence for genetic correlations between lifetime number of sexual partners and age at last birth, number of births and ever being parous (r(g) < 0.01). MR revealed potential causal relationships between many reproductive factors, including later age at menarche (1 SD increase) leading to a later age at first sexual intercourse (beta (B) = 0.09 SD, 95% confidence intervals (CI) = 0.06,0.11), age at first birth (B = 0.07 SD, CI = 0.04,0.10), age at last birth (B = 0.06 SD, CI = 0.04,0.09) and age at menopause (B = 0.06 SD, CI = 0.03,0.10). Later age at first birth was found to lead to a later age at menopause (B = 0.21 SD, CI = 0.13,0.29), age at last birth (B = 0.72 SD, CI = 0.67, 0.77) and a lower number of births (B = −0.38 SD, CI = −0.44, −0.32). CONCLUSION: This study presents evidence that women’s reproductive factors are genetically correlated and causally related. Future studies examining the health sequelae of reproductive factors should consider a woman’s entire reproductive history, including the causal interplay between reproductive factors. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02293-5

Potential in-class strategies to increase children’s vegetable consumption

Objective: The Crunch&Sip programme is a school-based nutrition initiative designed to increase the fruit, vegetable and water intakes of primary-school children. In recognition of the notable deficits in children’s vegetable consumption, the present study explored the receptivity of school staff to a realignment of the Crunch&Sip programme to feature a primary focus on vegetable consumption. This involved investigating school staff members’ perceptions of relevant barriers, motivators and facilitators. Design: A multi-method approach was adopted that involved four focus groups and a survey (administered in paper and online formats) containing a mixture of open- and closed-ended items. Setting: Western Australia. Subjects: Staff from Western Australian schools participated in the focus groups (n 37) and survey (n 620). Results: School staff were strongly supportive of modifying the Crunch&Sip programme to focus primarily on children’s vegetable consumption and this was generally considered to be a feasible change to implement. Possible barriers identified included children’s taste preferences and a perceived lack of parental support. Suggested strategies to overcome these barriers were education sessions for parents and children, teachers modelling vegetable consumption for their students and integrating vegetable-related topics into the school curriculum. Conclusions: School staff are likely to support the introduction of school-based nutrition programmes that specifically encourage the consumption of vegetables. Potential barriers may be overcome through strategies to engage parents and children