102 research outputs found
Correlates of life-time history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation
No full textBackground. Commercial sex workers (CSW) in Russian Federation are at high risk of HIV infection and transmission as a result of unsafe sexual and injecting behaviors. Their clients might be at increased risk of acquiring HIV; however, little is known about the population of men purchasing sex services. This study’s goal is to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation
Obesity and co-morbid hypertensive and diabetic disorders in pregnancy and early manifestations of neurodevelopmental adversity in the offspring : Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) Study
No full textThe prevalence of women entering pregnancy with overweight and obesity is growing worldwide reaching epidemic proportions. Apart from the risks of maternal and fetal morbidity associated with overweight and obesity, excessive weight is also an essential risk factor for diabetic and hypertensive disorders occurring before and during pregnancy. Maternal obesity and co-morbid hypertensive and diabetic disorders affect fetal development and have been linked with compromised neurodevelopment of the offspring; however, previous findings are not entirely consistent. Further, due to high co-morbidity between maternal overweight/obesity and hypertensive and diabetic disorders, it is difficult to disentangle their individual effects on child neurodevelopment. In addition, the mechanisms underlying associations between maternal overweight/obesity and co-morbid disorders and child neurodevelopment remain elusive.
This thesis examines the effects of maternal overweight/obesity and co-morbid hypertensive and diabetic disorders on early manifestations of neurodevelopmental adversity and on developmental delay in early childhood. It also examines whether DNA methylation (DNAm) biomarker of gestational age (GA) at birth reflects prenatal exposure to maternal overweight/obesity and co-morbid hypertensive and diabetic disorders, and hence, has a potential to identify individuals at risk for neurodevelopmental adversity already at birth.
This thesis capitalizes on the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) birth cohort comprising 4777 women and their singleton children born in Finland between 2006 and 2010. Data on maternal early pregnancy BMI, pre-pregnancy and gestational hypertension, pre-eclampsia, type 1 diabetes and gestational diabetes mellitus (GDM) were derived from the Finnish Medical Birth Register (MBR). DNAm gestational age (DNAm GA) was calculated using the method based on the methylation profile of 148 selected cytosine-phosphate-guanine (CpG) sites on DNA. Regulatory behavior problems in infancy were measured using Neonatal Perception Inventory (NPI) at the infant’s mean age of 16.9 (SD=7.6) days. Developmental milestones were measured using Ages and Stages Questionnaire (ASQ) Third edition at the child’s mean age of 42.1 (SD=8.2) months.
In comparison to the infants born to normal weight mothers, infants born to overweight/obese mothers displayed more regulatory behavior problems and were more likely to display regulatory behavior problems in multiple areas of self-regulation. These effects were independent of the co-morbid hypertensive and diabetic disorders (Study II). Children of overweight and obese mothers were more likely to display more severe and pervasive developmental delay in comparison to the children on normal weight mothers. The effects of maternal overweight and obesity on severity and pervasiveness of developmental delay in early childhood were also independent of the co-morbid hypertensive and diabetic disorders (Study III). Infant regulatory behavior problems partially mediated the association between maternal overweight/obesity and child neurodevelopmental milestones (Study II). Maternal pre-eclampsia was marginally associated with infant regulatory problems in multiple areas of self-regulation in normal weight non-diabetic women, but its effect was not significant in overweight/obese women and/or women with GDM (Study II). Maternal pre-eclampsia increased the odds of more severe and pervasive developmental delay in early childhood, and these effects were lower in the presence of overweight/obesity and diabetic disorders (Study III). GDM was not associated with infant regulatory behavior problems (Study II). The effect of GDM on severity and pervasiveness of developmental delay in early childhood was partially driven by maternal overweight/obesity and/or pre-eclampsia (Study III). Gestational and chronic hypertension were not associated with infant regulatory behavior problems and developmental delay(Studies II and III). Maternal BMI was not associated with variation in DNAm GA (Study IV). Maternal pre-eclampsia was associated with DNAm GA acceleration (Study IV). GDM in index pregnancy was not associated with variation in DNAm GA, however, insulin treated GDM in previous pregnancy was associated with DNAm GA deceleration (Study IV).
These study findings suggest that maternal overweight and obesity affect child neurodevelopment independently of the co-morbid hypertensive and diabetic disorders, and that the trajectory of this effect can partially be traced from infant regulatory behavior problems to developmental delay in early childhood. Hence, infant regulatory behavior problems may represent an early manifestation of neurodevelopmental adversity due to prenatal exposure to maternal overweight/obesity. Pre-eclampsia increases the risk of developmental delay in early childhood independently of maternal overweight, obesity and diabetic disorders and its adverse effects on child neurodevelopment have a potential to be detected already at birth by assessing DNAm GA. Adverse effects of gestational diabetes on child neurodevelopment can be partially accounted for by highly co-morbid maternal overweight/ obesity and pre-eclampsia. Efforts aimed at weight management among women of reproductive age and prevention of pre-eclampsia during pregnancy are likely to reduce the burden of neurological morbidity in the future.Yhä useampi hedelmällisessä iässä oleva nainen ympäri maailmaa on ylipainoinen tai lihava. Ylipaino on tärkeä diabeteksen ja verenpainesairauksien riskitekijä sekä yleisesti että raskauden aikana, ja näitä häiriöitä voidaankin kuvata ylipainon ja lihavuuden liitännäissairauksiksi. Aiempien tutkimusten perusteella äidin lihavuus ja nämä liitännäissairaudet vaikuttavat sikiön kehitykseen ja voivat mahdollisesti lisätä lapsen käytös- ja tunnehäiriöiden ja muiden kehityksellisten ongelmien riskiä, mutta nämä aiemmat tulokset ovat osin ristiriidassa keskenään. Lisäksi on vaikeaa arvioida, mikä on yksittäisten riskitekijöiden itsenäinen merkitys lapsen kehityksen kannalta, sillä äidin lihavuus ja ylipaino, diabetes ja verenpainesairaudet esiintyvät usein yhdessä. On myös huomattava, että mekanismit, jotka selittävät äidin ylipainon tai lihavuuden ja sen liitännäissairauksien yhteyttä lapsen kehitykseen ovat edelleen varsin epäselviä.
Tässä väitöskirjassa tarkastellaan äidin ylipainon ja lihavuuden sekä diabeteksen ja verenpainehäiriöiden vaikutusta lapsen varhaisiin käytös- ja tunnehäiriöiden ilmentymiin sekä kehitysviivästymiin. Lisäksi väitöskirjassa tarkastellaan vastasyntyneen perimäaineksen epigeneettisiä muutoksia, eli DNA:ssa ennen syntymää tapahtuneita muokkauksia, joiden johdosta emäsjärjestys ei muutu, mutta jotka voivat vaikuttaa solujen toimintaan. Epigeneettisten muutosten osalta selvitetään, ovatko ne yhteydessä äidin raskauden aikaiseen lihavuuteen, ylipainoon ja liitännäissairauksiin. Lisäksi selvitetään, voitaisiinko epigeneettisiä muutoksia tutkimalla auttaa tunnistamaan mahdollisimman varhaisessa vaiheessa ne lapset, joilla on kohonnut kehityksen häiriöiden riski.
Väitöskirja on toteutettu osana suomalaista Predo-tutkimusta. Predo (Pre-eklampsian ennustaminen ja ehkäisy) on seurantatutkimus, johon kuuluu 4777 äitiä sekä heidän lastaan, jotka syntyivät Suomessa 2006-2010. Äidin varhaisraskauden painoindeksiä, diabetesta ja verenpainesairauksia koskeva tieto kerättiin Terveyden ja Hyvinvoinnin laitoksen ylläpitämästä kansallisesta Syntyneiden lasten rekisteristä. Epigeneettisten muutosten osalta tarkasteltiin syntymän yhteydessä otettuja napanuoran verinäytteitä, joista on mahdollista tutkia vastasyntyneen soluja. Tutkimuksessa valittiin vastasyntyneen DNA:sta 148 sytosiini-fosfaatti-guaniini-kohtaa, joiden metylaatioaste heijastelee raskauden kestoa, ja näiden kohtien metylaatioastetta tarkasteltiin suhteessa äidin painoon, sairauksiin sekä lapsen kehitykseen. Itsesäätelyvaikeuksia imeväisiässä mitattiin Neonatal Perception Inventory -kyselylomakkeella, jonka vastasyntyneiden äidit täyttivät keskimäärin 17 päivää synnytyksen jälkeen. Kehitysviivästymiä arvioitiin Ages and Stages -kyselylomakkeella, jonka äidit täyttivät lapsen ollessa keskimäärin 42 kuukauden ikäinen.
Tutkimuksessa havaittiin, että äidin ylipaino ja lihavuus vaikuttavat lapsen kehitykseen riippumatta liitännäissairauksista eli myös silloin, kun diabeteksen ja verenpainesairauksien vaikutus lapseen on huomioitu. Äidin ylipaino ja lihavuus olivat tutkimuksessa yhteydessä sekä vastasyntyneen varhaisiin itsesäätelyn vaikeuksiin että kehitysviivästymiin varhaislapsuudessa. Tutkimuslöydösten perusteella vastasyntyneen itsesäätelyvaikeudet voivat olla äidin ylipainon ja lihavuuden haittavaikutusten varhainen ilmentymä lapsessa. Tutkimuksessa havaittiin lisäksi, että pre-eklampsia – raskaushäiriö, joka aiheuttaa muun muassa verenpaineen nousua ja jota on kutsuttu Suomessa myös raskausmyrkytykseksi – lisää lapsen varhaisen kehitysviivästymän riskiä riippumatta äidin ylipainosta, lihavuudesta tai diabeteksesta. Tulosten perusteella on mahdollista, että pre-eklampsian haitalliset vaikutukset lapsen kehitykseen voidaan havaita jo varhain tutkimalla vastasyntyneen perimäaineksessa tapahtuneita epigeneettisiä muutoksia. Hedelmällisessä iässä olevien naisten painonhallintaan ja pre-eklampsian ehkäisyyn tähtäävät toimet voisivat vähentää psykiatristen ja neurologisten sairauksien kuormaa tulevaisuudessa.ei saavutettav
Correlates of Double Risk of HIV Acquisition and Transmission Among Women who Inject Drugs in St. Petersburg, Russia
No full textRaskaudenaikaiseen äitien ahdistukseen liittyvät metaboliset muutokset : pitkittäistutkimus
No full textLahti-Pulkkinen et al. respond to the letter to the editor: Maternal depression and inflammation during pregnancy by Fujitake and Chen
No full textMaternal Antenatal Depression Is Associated With Metabolic Alterations That Predict Birth Outcomes and Child Neurodevelopment and Mental Health
No full textBackground: Evidence regarding metabolic alterations associated with maternal antenatal depression (AD) is limited, and their role as potential biomarkers that improve the prediction of AD and adverse childbirth, neurodevelopmental, and mental health outcomes remains unexplored. Methods: In a cohort of 331 mother-child dyads, we studied associations between AD (a history of medical register diagnoses and/or a Center for Epidemiological Studies Depression Scale score during pregnancy ≥ 20) and 95 metabolic measures analyzed 3 times during pregnancy. We tested whether the AD-related metabolic measures increased variance explained in AD over its risk factors and in childbirth, neurodevelopmental, and mental health outcomes over AD. We replicated the findings in a cohort of 416 mother-child dyads. Results: Elastic net regression identified 15 metabolic measures that collectively explained 25% (p < .0001) of the variance in AD, including amino and fatty acids, glucose, inflammation, and lipids. These metabolic measures increased the variance explained in AD over its risk factors (32.3%, p < .0001 vs. 12.6%, p = .004) and in child gestational age (9.0%, p < .0001 vs. 0.7%, p = .34), birth weight (9.0%, p = .03 vs. 0.7%, p = .33), developmental milestones at the age of 2.3 to 5.7 years (21.0%, p = .002 vs. 11.6%, p < .001), and any mental or behavioral disorder by the age of 13.1 to 16.8 years (25.2%, p = .03 vs. 5.0%, p = .11) over AD, child sex, and age. These findings were replicated in the independent cohort. Conclusions: AD was associated with alterations in 15 metabolic measures, which collectively improved the prediction of AD over its risk factors and birth, neurodevelopmental, and mental health outcomes in children over AD. These metabolic measures may become biomarkers that can be used to identify at-risk mothers and children for personalized interventions.Peer reviewe
Vitamin D Levels and Depressive Symptoms during Pregnancy: A Prospective Pregnancy Cohort Study
No full textAbstract
Objective. Depressive symptoms during pregnancy increase the risk for adverse outcomes in women and children. Lower vitamin D levels are suggested to be associated with higher depressive symptoms in nonpregnant populations. We studied if the level of or change in serum of 25-hydroxyvitamin D (25(OH)D) concentration was associated with the levels of depressive symptoms during pregnancy. Methods. The participants of this prospective longitudinal study came from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study. The analytic sample comprised 307 women (mean age = 32.5 (range 20.3–44.3)) who reported depressive symptoms concurrently with serum 25(OH)D measurements at a median of 13.0, 19.3, and 27.0 gestational weeks. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Linear and mixed-model regression analyses were used to study the associations. Results. The 25(OH)D levels were not associated with depressive symptoms cross-sectionally (p values > 0.58) or across the three assessment points during pregnancy (B = −0.05; 95% CI, −0.12, 0.01; and p = 0.12). Yet, a higher increase in 25(OH)D during pregnancy was associated with lower levels of depressive symptoms (B = −1.41; 95% CI, −2.75, −0.07; and p = 0.04) but not after adjusting for covariates (p = 0.08). Conclusions. The 25(OH)D levels and depressive symptoms were not associated among pregnant women throughout the pregnancy. However, there is a need for randomized controlled trials to fully exclude the possibility of vitamin D supplementation in the prevention of depression during pregnancy.Abstract
Objective. Depressive symptoms during pregnancy increase the risk for adverse outcomes in women and children. Lower vitamin D levels are suggested to be associated with higher depressive symptoms in nonpregnant populations. We studied if the level of or change in serum of 25-hydroxyvitamin D (25(OH)D) concentration was associated with the levels of depressive symptoms during pregnancy. Methods. The participants of this prospective longitudinal study came from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study. The analytic sample comprised 307 women (mean age = 32.5 (range 20.3–44.3)) who reported depressive symptoms concurrently with serum 25(OH)D measurements at a median of 13.0, 19.3, and 27.0 gestational weeks. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Linear and mixed-model regression analyses were used to study the associations. Results. The 25(OH)D levels were not associated with depressive symptoms cross-sectionally (p values > 0.58) or across the three assessment points during pregnancy (B = −0.05; 95% CI, −0.12, 0.01; and p = 0.12). Yet, a higher increase in 25(OH)D during pregnancy was associated with lower levels of depressive symptoms (B = −1.41; 95% CI, −2.75, −0.07; and p = 0.04) but not after adjusting for covariates (p = 0.08). Conclusions. The 25(OH)D levels and depressive symptoms were not associated among pregnant women throughout the pregnancy. However, there is a need for randomized controlled trials to fully exclude the possibility of vitamin D supplementation in the prevention of depression during pregnancy
Early childhood multiple or persistent regulatory problems and diurnal salivary cortisol in young adulthood
No full textVitamin D Levels and Depressive Symptoms during Pregnancy: A Prospective Pregnancy Cohort Study
No full textAssociations of polymetabolic risk of high maternal pre-pregnancy body mass index with pregnancy complications, birth outcomes, and early childhood neurodevelopment : findings from two pregnancy cohorts
No full text- …
