The association between history of prenatal loss and maternal psychological state in a subsequent pregnancy: an ecological momentary assessment (EMA) study.

BACKGROUND: Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life. METHOD: This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models. RESULTS: Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group. CONCLUSION: Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.

Maternal Psychological Resilience During Pregnancy and Newborn Telomere Length: A Prospective Study.

OBJECTIVE: In the context of the importance of elucidating the determinants of the initial, newborn setting of telomere length (TL), it is increasingly evident that maternal stress and stress-related processes during pregnancy play a major role. Although psychological resilience may function as a buffer, research in this area has not yet examined its potential role vis-à-vis that of stress. The authors examined the relationship between maternal psychological resilience during pregnancy and newborn TL. METHODS: In a sample of 656 mother-child dyads from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort, multiple serial assessments were conducted over the course of pregnancy to quantify maternal stress, negative and positive emotional responses to pregnancy events, positive affect, and perceived social support. Principal component analysis identified two latent factors: stress and positivity. A measure of resilience was computed by regressing the positivity factor on the stress factor, in order to quantify positivity after accounting for stress. TL was measured using quantitative polymerase chain reaction in leukocytes extracted from cord blood shortly after birth. Linear regression was used to predict newborn TL from maternal resilience during pregnancy, adjusting for other potential determinants. RESULTS: Maternal stress significantly predicted shorter newborn TL (ß=-0.079), and positivity significantly predicted longer TL (ß=0.135). Maternal resilience (positivity accounting for stress) was significantly and positively associated with newborn TL (ß=0.114, 95% CI=0.035, 0.189), with each standard deviation increase in resilience predicting 12% longer newborn TL. CONCLUSIONS: The results indicate that maternal psychological resilience may exert a salubrious effect on offspring telomere biology and highlight the importance of enhancing maternal mental health and well-being during pregnancy.

Climate change and human health: what are the research trends? A scoping review protocol.

INTRODUCTION: For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been assessing the potential risks associated with anthropogenic climate change. Although interest in climate change and health is growing, the implications arising from their interaction remain understudied. Generating a greater understanding of the health impacts of climate change could be key step in inciting some of the changes necessary to decelerate global warming. A long-term and broad overview of the existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. In this paper we outline our methods to conduct a scoping review of the published peer-reviewed literature on climate change and health between 1990 and 2015. METHODS AND ANALYSIS: A detailed search strategy will be used to search the PubMed and Web of Science databases. Specific inclusion and exclusion criteria will be applied in order to capture the most relevant literature in the time frame chosen. Data will be extracted, categorised and coded to allow for statistical analysis of the results. ETHICS AND DISSEMINATION: No ethical approval was required for this study. A searchable database of climate change and health publications will be developed and a manuscript will be complied for publication and dissemination of the findings. We anticipate that this study will allow us to map the trends observed in publications over the 25-year time period in climate change and health research. It will also identify the research areas with the highest volume of publications as well as highlight the research trends in climate change and health.

Health in climate change research from 1990 to 2014: positive trend, but still underperforming.

BACKGROUND: Climate change has been recognized as both one of the biggest threats and the biggest opportunities for global health in the 21st century. This trend review seeks to assess and characterize the amount and type of scientific literature on the link between climate change and human health. DESIGN: We tracked the use of climate-related terms and their co-occurrence with health terms during the 25 years since the first Intergovernmental Panel on Climate Change (IPCC) report, from 1990 to 2014, in two scientific databases and in the IPCC reports. We investigated the trends in the number of publications about health and climate change through time, by nature of the health impact under study, and by geographic area. We compared the scientific production in the health field with that of other sectors on which climate change has an impact. RESULTS: The number of publications was extremely low in both databases from 1990 (325 and 1,004, respectively) until around 2006 (1,332 and 4,319, respectively), which has since then increased exponentially in recent years (6,079 and 17,395, respectively, in 2014). However, the number of climate change papers regarding health is still about half that of other sectors. Certain health impacts, particularly malnutrition and non-communicable diseases (NCDs), remain substantially understudied. Approximately two-thirds of all published studies were carried out in OECD countries (Organization for Economic Cooperation and Development), predominantly in Europe and North America. CONCLUSIONS: There is a clear need for further research on the links between climate change and health. This pertains particularly to research in and by those countries in which health will be mostly affected and capacity to adapt is least. Specific undertreated topics such as NCDs, malnutrition, and mental health should gain the priority they deserve. Funding agencies are invited to take note of and establish calls for proposals accordingly. Raising the interest in this research area in young scientists remains a challenge and should lead to innovative courses for large audiences, such as Massive Open Online Courses.