Dataset Information

Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study.

ABSTRACT: OBJECTIVE:To prospectively assess whether the infant psychosocial environment was associated with cardiometabolic risk as early as adolescence. STUDY DESIGN:Participants were recruited in Santiago, Chile, and have been followed from infancy. Inclusion criteria included healthy infants with birth weight ?3 kg and a stable caregiver. The psychosocial environment, including depressive symptoms, stressful life events, poor support for child development, father absence, and socioeconomic status, was reported by mothers at 6-12 months. Body mass index (BMI) z score was assessed at 5 and 10 years. BMI z score, waist-to-hip ratio, systolic and diastolic blood pressure, fat mass and body fat percentage, fasting glucose, total and high-density lipoprotein cholesterol, and homeostatic model of insulin resistance were tested in adolescence. RESULTS:Adolescents ranged from 16 to 18 years of age (n = 588; 48.1% female). A poorer infant psychosocial environment was associated with BMI z score at 10 years (? = 0.10, 95% CI = 0.00-0.19) and in adolescence (? = 0.15, 95% CI = 0.06-0.24) but not at 5 years. A poorer infant psychosocial environment was associated with higher blood pressure (? = 0.15, 95% CI = 0.05-0.24), greater anthropometric risk (? = 0.13, 95% CI = 0.03-0.22), greater biomarker (triglycerides, homeostatic model assessment of insulin resistance, total cholesterol) risk (? = 0.12, 95% CI = 0.02-0.22), and a higher likelihood of metabolic syndrome in adolescence (aOR = 1.50; 95% CI = 1.06-2.12). CONCLUSIONS:These findings demonstrate that a poorer infant psychosocial environment was associated with greater adolescent cardiometabolic risk. The results support screening for infants' psychosocial environments and further research into causality, mechanisms, prevention, and intervention.

SUBMITTER: Doom JR

PROVIDER: S-EPMC6535359 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study.

Doom Jenalee R JR Reid Brie M BM Blanco Estela E Burrows Raquel R Lozoff Betsy B Gahagan Sheila S

The Journal of pediatrics 20190312

<h4>Objective</h4>To prospectively assess whether the infant psychosocial environment was associated with cardiometabolic risk as early as adolescence.<h4>Study design</h4>Participants were recruited in Santiago, Chile, and have been followed from infancy. Inclusion criteria included healthy infants with birth weight ≥3 kg and a stable caregiver. The psychosocial environment, including depressive symptoms, stressful life events, poor support for child development, father absence, and socioeconom ...[more]

PMID: 30876752

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Project description:BackgroundBinge eating disorder is bidirectionally associated with obesity and with metabolic syndrome. It is less clear whether overeating and binge eating, or overeating with loss of control, also predicts metabolic risk, and if so, whether these associations are solely attributable to greater weight. The goal of this study was to examine longitudinal associations of overeating and binge eating behavior with cardiometabolic risk markers in adolescence.MethodsAdolescents (n = 619) in the Project Viva research study self-reported overeating and binge eating behavior in early adolescence (median 12.9 years, "baseline"). In late adolescence (median 17.4 years, "follow-up"), we assessed outcomes of adiposity and blood pressure, and in a subset of participants (n = 270-424), biomarkers of dyslipidemia, insulin resistance, liver dysfunction, inflammation, and adipokine homeostasis. We conducted multivariable linear regression analyses adjusted for socio-demographics and prenatal obesogenic exposures, and additionally for baseline body mass index (BMI) z-score.ResultsAt baseline, 58 (9%) participants reported overeating behavior, and of those, 24 (41%) had binge eating behavior (e.g., overeating accompanied by loss of control). In adjusted models, adolescents with overeating had higher adiposity at follow-up ~ 5 years later (e.g., % body fat 4.03; 95% confidence interval (CI) 1.76, 6.31) than those not reporting overeating behavior; additional adjustment for baseline BMI z-score attenuated associations generally except for % body fat (2.95; 95% CI 1.03, 4.87). Overeating behavior was also associated with higher inflammation and greater adipokine dysfunction, remaining positively associated with interleukin-6 (IL-6) (log-transformed β = 0.42 pg/mL; 95% CI 0.12, 0.73) and negatively with adiponectin (log-transformed β = -0.28 ug/mL; 95% CI - 0.47, - 0.08) even after adjusting for baseline BMI z-score. Overeating behavior was not consistently associated with other outcomes. Adolescents reporting binge eating behavior generally had the greatest adiposity, (e.g., % body fat 5.00; 95% CI 1.74, 8.25) as compared to those without overeating.ConclusionsAdolescents reporting overeating and binge eating behavior had higher adiposity and poorer inflammatory and adipokine profiles, but no difference in other outcomes, than adolescents who did not endorse these behaviors. These associations were only partially accounted for by higher baseline BMI z-score. These differences may signal increased risk for future cardiovascular disease.

Project description:BackgroundExisting studies evaluating the association between maternal risk factors and specific infant outcomes such as birthweight, injury admissions, and mortality have mostly focused on single risk factors. We aimed to identify routinely recorded psychosocial characteristics of pregnant women most at risk of adverse infant outcomes to inform targeting of early intervention.MethodsWe created a cohort using administrative hospital data (Hospital Episode Statistics) for all births to mothers aged 15-44 years in England, UK, who gave birth on or after April 1, 2010, and who were discharged before or on March 31, 2015. We used generalised linear models to evaluate associations between psychosocial risk factors recorded in hospital records in the 2 years before the 20th week of pregnancy (ie, teenage motherhood, deprivation, pre-pregnancy hospital admissions for mental health or behavioural conditions, and pre-pregnancy hospital admissions for adversity, including drug or alcohol abuse, violence, and self-harm) and infant outcomes (ie, birthweight, unplanned admission for injury, or death from any cause, within 12 months from postnatal discharge).FindingsOf 2 520 501 births initially assessed, 2 137 103 were eligible and were included in the birth outcome analysis. Among the eligible births, 93 279 (4·4%) were births to teenage mothers (age <20 years), 168 186 (7·9%) were births to previous teenage mothers, 51 312 (2·4%) were births to mothers who had a history of hospital admissions for mental health or behavioural conditions, 58 107 (2·7%) were births to mothers who had a history of hospital admissions for adversity, and 580 631 (27·2%) were births to mothers living in areas of high deprivation. 1 377 706 (64·5%) of births were to mothers with none of the above risk factors. Infants born to mothers with any of these risk factors had poorer outcomes than those born to mothers without these risk factors. Those born to mothers with a history of mental health or behavioural conditions were 124 g lighter (95% CI 114-134 g) than those born to mothers without these conditions. For teenage mothers compared with older mothers, 3·6% (95% CI 3·3-3·9%) more infants had an unplanned admission for injury, and there were 10·2 (95% CI 7·5-12·9) more deaths per 10 000 infants.InterpretationHealth-care services should respond proactively to pre-pregnancy psychosocial risk factors. Our study demonstrates a need for effective interventions before, during, and after pregnancy to reduce the downstream burden on health services and prevent long-term adverse effects for children.FundingWellcome Trust.

Dataset Information

Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study.

Publications

Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study.

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