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Background: The perseverative cognition hypothesis stipulates that rumination (repetitive, passive, uncontrollable negative thinking) prolongs the experience of a stressor which impacts stress physiology. In line with this hypothesis, we proposed that in response to real-life experiences of social rejection, adolescent girls who ruminate would show a blunted diurnal cortisol slope the next day relative to girls who do not ruminate. We also examined the effects of social rejection and rumination on waking cortisol levels and the cortisol awakening response. Method: Participants were (n = 50) adolescent girls (mean age = 13.30, SD = 2.34) who varied on psychiatric risk and provided saliva samples 4 times a day for 3 days, as well as, daily diary reports of social rejection and rumination. A lagged multilevel model was utilized to examine the interactive effects of rejection and rumination on diurnal cortisol. Results: There was a significant interaction between social rejection and rumination. Specifically, rumination following social rejection was associated with a flatter diurnal cortisol slope. In the absence of rumination, social rejection was marginally associated with a steeper diurnal cortisol slope. The effects for waking cortisol levels and the cortisol awakening response were null. Conclusion: Findings support the perseverative cognition hypothesis and suggest that cognitive mechanisms such as rumination can impact stress physiology.
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The science of developmental psychopathology has made outstanding progress over the past 40 years in understanding adaptive and maladaptive developmental processes across the life span. Yet most of this work has been researcher driven with little involvement of community partners in the research process, limiting the potential public health significance of our work. To continue to advance the field we must move beyond the physical and conceptual walls of our research laboratories and into the real world. In this article, we define and describe the importance of community-engaged research, and present our overarching principles for engaging the community including practicing respect, shared power and decision-making, prioritizing the needs of the community, and engaging in consistent and transparent communication. We present several associated recommendations for best practice and highlight examples from our own research that is grounded in a developmental psychopathology perspective to illustrate these practices. Recommendations for the future of the discipline of development and psychopathology, with emphasis on training and continuing education, are described.
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BACKGROUND: Postpartum depression affects 14% of pregnant individuals and is a leading cause of preventable maternal mortality. Complications of pregnancy, such as preterm labor or pre-eclampsia, may require hospitalization for close monitoring and management. The impact of an antenatal hospitalization during pregnancy on postnatal depression remains understudied. OBJECTIVE: To evaluate whether hospital admission during pregnancy was associated with postpartum depressive symptoms in individuals who were enrolled in a collaborative care model and to evaluate whether enrollment in the collaborative care model during pregnancy mitigated this association. STUDY DESIGN: This secondary analysis of a prospective cohort study included perinatal people enrolled in a collaborative care model at a quaternary academic center between 2017-2021. The primary outcome was presence of moderately severe or severe postpartum depressive symptoms at 6 weeks postpartum defined as a score of 15 or greater on a PHQ-9. The prevalence of symptoms of this severity was compared between those who experienced an antepartum hospitalization and those who did not using bivariable and multivariable analyses. A Breslow Day test was used to evaluate whether any observed association between antepartum hospitalization and postpartum depressive symptoms differed based on timing of enrollment in the collaborative care model. RESULTS: During the study period, 1897 individuals met inclusion criteria. Of these, 162 (8.5%) were admitted to the hospital during pregnancy. Of those with an antepartum hospitalization, 20 (12.4%) developed moderately severe to severe postpartum depressive symptoms compared to 136 (7.8%) of those who were not hospitalized (p=0.046). After adjustment for confounders identified through use of a directed acyclic graph, this difference did not persist in multivariable analysis (aOR 1.55, 95% CI [0.87-2.75]). A Breslow Day test demonstrated heterogeneity across enrollment timing, so subgroup analyses were performed for those enrolled during pregnancy (n=930) vs postpartum (n=967). Hospital admission was associated with higher rates of moderately severe to severe postpartum depressive symptoms in those enrolled in the collaborative care model postpartum (19.7% vs 10.6%, p=0.015, aOR 2.25, 95% CI [1.07-4.71]), but not those enrolled antenatally (5.8% vs 5.0%, p=0.735, aOR 1.09, 95% CI [0.38-3.19]). CONCLUSIONS: Antepartum hospital admission was associated with higher rates of moderately severe to severe depressive symptoms. This association did not exist among individuals enrolled in collaborative care model during pregnancy, suggesting a potential protective effect afforded by engagement in a mental health support programming.
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Background: Preterm birth (birth at <37 completed weeks gestation) is a significant public heatlh concern worldwide. Important health, and developmental consequences of preterm birth include altered temperament development, with greater dysregulation and distress proneness. Aims: The present study leveraged advanced quantitative techniques, namely machine learning approaches, to discern the contribution of narrowly defined and broadband temperament dimensions to birth status classification (full-term vs. preterm). Along with contributing to the literature addressing temperament of infants born preterm, the present study serves as a methodological demonstration of these innovative statistical techniques. Study design: This study represents a metanalysis conducted with multiple samples (N = 19) including preterm (n = 201) children and (n = 402) born at term, with data combined across investigations to perform classification analyses. Subjects: Participants included infants born preterm and term-born comparison children, either matched on chronological age or age adjusted for prematurity. Outcome measures: Infant Behavior Questionnaire-Revised Very Short Form (IBQ-R VSF) was completed by mothers, with factor and item-level data considered herein. Results and conclusions: Accuracy estimates were generally similar regardless of the comparison groups. Results indicated a slightly higher accuracy and efficiency for IBQR-VSF item-based models vs. factor-level models. Divergent patterns of feature importance (i.e., the extent to which a factor/item contributed to classification) were observed for the two comparison groups (chronological age vs. adjusted age) using factor-level scores; however, itemized models indicated that the two most critical items were associated with effortful control and negative emotionality regardless of comparison group.
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Peer victimization and bullying behaviors are prevalent during adolescence and have been linked to depression. This study examined whether peer rejection reactivity, defined as physiological responses to peer exclusion, moderated the associations of victimization and bullying behaviors with depressive symptoms 12 months later in a sample of female youths (N = 79, Mage = 13.37 ± 2.31). Participants underwent the Yale Interpersonal Stressor-Child, during which systolic and diastolic blood pressure and heart rate were continuously measured. Parent and youth reports of the youth's depressive symptoms were utilized. Our results demonstrate that peer rejection reactivity moderates the relationship between victimization and subsequent depressive symptoms but does not moderate the relationship between bullying behaviors and subsequent depressive symptoms. Higher victimization was associated with increased youth-reported depressive symptoms among girls with high reactivity but decreased depressive symptoms among girls with low reactivity. Future research can explore whether reducing emotional and physiological reactivity to peer rejection, as well as increasing interpersonal effectiveness in peer relationships, can reduce depressive symptoms in adolescent girls experiencing victimization.
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Description Burnout among academic physicians, who navigate multiple roles beyond the clinical environment, is a pressing issue. However, the factors driving burnout among academic physicians are not fully understood. Prior research has revealed differences in burnout dimensions between clinical and basic science faculty, but the impact of balancing research, education, and clinical demands on academic physicians is still unclear. This knowledge gap negatively affects the clinical, translational science, research, and medical education workforces and has particular implications for minoritized and marginalized groups working in academic medical centers. Creating a culture of well-being has been vital in addressing burnout. Further research is needed to explore the unique experiences and demands of academic physicians- particularly those from minoritized and marginalized backgrounds-and to develop effective strategies to promote well-being as they balance diverse roles and contexts. This commentary highlights gaps in understanding burnout among academic physicians and proposes guidelines for future research as well as strategies to improve well-being at academic medical centers.
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BACKGROUND: Although socio-environmental factors are known to contribute to the maintenance of smoking behavior, few studies have examined the impact of family functioning on smoking during pregnancy. OBJECTIVE: The current study examined the relationship between perceptions of family functioning and smoking during pregnancy. METHODS: Pregnant women (N = 345, 59% ethnic/racial minority) completed the Family Assessment Device, a gold-standard assessment examining perceptions of family functioning in seven domains. Multinomial logistic regressions analyzed associations between clinically determined suboptimal levels of family functioning by domain and smoking status during pregnancy (smoking, ≥28 continuous days quit, nonsmoking), with stratified analyses exploring ethnic/racial differences (non-Hispanic/White vs. racial/ethnic minority). RESULTS: Participants who reported suboptimal levels of family functioning in domains of Affective Involvement, Affective Responsiveness, Behavioral Control, and Roles were significantly more likely to have been smoking than nonsmoking during pregnancy. Stratified analyses revealed differing effects by ethnic/racial identity, with perceptions of Roles remaining the only significant effect on smoking outcomes for both groups. No significant effects were found regarding the impact of family functioning on whether participants were smoking vs. quit during pregnancy. CONCLUSIONS: Suboptimal family functioning may contribute to smoking during pregnancy, but effects may differ based on domain of family functioning and by ethnic/racial identity.
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Perinatal stress is associated with altered placental methylation, which plays a critical role in fetal development and infant outcomes. This proof-of-concept pilot study investigated the impact of lifetime trauma exposure and perinatal PTSD symptoms on epigenetic regulation of placenta glucocorticoid signaling genes (NR3C1 and FKBP5). Lifetime trauma exposure and PTSD symptoms during pregnancy were assessed in a racially/ethnically diverse sample of pregnant women (N = 198). Participants were categorized into three groups: (1) No Trauma (-T); (2) Trauma, No Symptoms (T - S); and (3) Trauma and Symptoms (T + S). Placental tissue was analyzed via bisulfite pyrosequencing for degree of methylation at the NR3C1 promoter and FKBP5 regulatory regions. Analyses of covariance were used to test group differences in percentages of NR3C1 and FKBP5 methylation overall and at each CpG site. We found a significant impact of PTSD symptoms on placental NR3C1 methylation. Compared to the -T group, the T + S group had greater NR3C1 methylation overall and at CpG6, CpG8, CpG9, and CpG13, but lower methylation at CpG5. The T + S group had significantly higher NR3C1 methylation overall and at CpG8 compared to the T - S group. There were no differences between the T - S group and - T group. Additionally, no group differences emerged for FKBP5 methylation. Pregnant trauma survivors with PTSD symptoms exhibited differential patterns of placental NR3C1 methylation compared to trauma survivors without PTSD symptoms and pregnant women unexposed to trauma. Results highlight the critical importance of interventions to address the mental health of pregnant trauma survivors.
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Metilación de ADN , Receptores de Glucocorticoides , Trastornos por Estrés Postraumático , Proteínas de Unión a Tacrolimus , Adulto , Femenino , Humanos , Embarazo , Adulto Joven , Epigénesis Genética , Proyectos Piloto , Placenta/metabolismo , Complicaciones del Embarazo/psicología , Receptores de Glucocorticoides/genética , Trastornos por Estrés Postraumático/genética , Trastornos por Estrés Postraumático/psicología , Proteínas de Unión a Tacrolimus/genética , Efectos Tardíos de la Exposición Prenatal/genéticaRESUMEN
OBJECTIVE: Co-use of tobacco and cannabis may be prevalent in pregnancy, potentially leading to additional adverse health outcomes. Utilizing a national sample of women followed prospectively before, during, and after pregnancy, this study tested whether prepregnancy co-use of tobacco and cannabis (vs. tobacco-only use and cannabis-only use) was associated with greater likelihood of continuing to use tobacco and/or cannabis during pregnancy and postpartum. METHOD: Data were drawn from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study. Prepregnancy, pregnancy, and postpartum data were captured and stacked over three intervals (Waves 1-3, 2-4, and 3-5). Participants were N = 686 U.S. women (72% White, 46% age 25-34) who were currently pregnant during the middle wave of an interval. Rates of tobacco-only use, cannabis-only use, and tobacco and cannabis co-use at all three time points were examined. RESULTS: Generalized estimating equation models demonstrated that pregnant women who reported prepregnancy tobacco and cannabis co-use (vs. tobacco-only or cannabis-only use) were more likely to continue to use tobacco and/or cannabis during pregnancy and relapse in postpartum (p < .05). Among women who endorsed prepregnancy co-use and continued to use tobacco and/or cannabis in pregnancy, about half transitioned to tobacco-only use (45.16%). CONCLUSIONS: Findings underscore the need for further clinical and empirical focus on dynamic patterns of use/co-use of tobacco and cannabis across the perinatal period, including cessation interventions to reduce tobacco and cannabis use in pregnancy and protect against relapse in postpartum. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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INTRODUCTION: Early life stress is linked to childhood obesity. As children enter adolescence, early life stress may be associated with increased rejection sensitivity, resulting in activation of behavioral and physiological changes that contribute to higher body mass index (BMI). Understanding the potential influence of rejection sensitivity on the association between early life stress and BMI is important to examine in female adolescents. For this secondary data analysis, we hypothesized that female adolescents with greater early life stress and greater rejection sensitivity would exhibit higher BMI-for-age 12 months later. METHODS: Seventy-eight adolescents (Mage = 13.1 years; 100% female sex; MBMI = 23.2 kg/m2) in the United States completed study procedures from 2012 to 2016. Among these procedures, the Psychosocial Schedule was used to assess cumulative early life stress and the Children's Rejection Sensitivity Questionnaire was used to assess anger and anxiety in response to rejection. Twelve months later, height and weight were measured to derive BMI-for-age. RESULTS: Higher early life stress was associated with higher BMI-for-age among female adolescents with low rejection-provoked anger (1 SD below the mean). However, this association was not observed among female adolescents with high rejection-provoked anger (1 SD above the mean). Finally, there was no significant interaction between early life stress and rejection-provoked anxiety in predicting BMI-for-age. CONCLUSIONS: Experiencing early life stress may interact with rejection-provoked anger, but not anxiety, to predict BMI-for-age. Findings inform a developmental perspective of how rejection sensitivity may influence the association between early life stress and early cardiometabolic risk.
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Ira , Ansiedad , Índice de Masa Corporal , Estrés Psicológico , Humanos , Femenino , Adolescente , Ansiedad/psicología , Niño , Rechazo en Psicología , Estados Unidos , Encuestas y Cuestionarios , Obesidad Infantil/psicologíaRESUMEN
OBJECTIVE: Patients with depression during labor display dysregulated patterns of oxytocin release and this may impact second stage of labor. The objective of this study was to evaluate the association between maternal preconception and antenatal depressive disorders on the duration of second stage of labor and perinatal outcomes. STUDY DESIGN: Secondary analysis of patients enrolled in the Behavioral and Mood in Mothers, Behavior in Infants study who reached the second stage of labor. Participants were assigned to: pre-conception only major depressive disorder (MDD), prenatal major depressive disorder, and non-depressed controls. Primary outcome was prolonged second stage of labor. Secondary outcomes included perinatal morbidities. RESULTS: 172 patients were included. 24.4% (42/172) participants had preconception-only MDD, 42.4% (73/172) patients had prenatal MDD, and 33.1% (57/172) patients had as non-depressed controls. The adjusted pair-wise analysis between groups showed no significant difference in the duration of second stage. No statistically significant differences were noted between groups for adverse neonatal outcomes. CONCLUSION: Maternal depressive disorders did not impact length of second stage of labor or immediate perinatal outcomes.
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Trastorno Depresivo Mayor , Segundo Periodo del Trabajo de Parto , Recién Nacido , Embarazo , Femenino , Humanos , Madres , Estudios RetrospectivosRESUMEN
INTRODUCTION: Little is known about cigar use among women of reproductive age, especially potential differences relating to the use of premium versus non-premium cigars. AIMS AND METHODS: Using 2010-2019 data from the National Survey on Drug Use and Health, rates and trends in premium and non-premium cigar use were determined among women of reproductive age (18-49; n = 5651). Weighted sociodemographic characteristics, substance co-use, patterns of use, and health indicators were compared between women using premium versus non-premium cigars. RESULTS: Among reproductive-aged women who smoked cigars in the past 30 days, 4.9% reported use of premium cigar brands. The most commonly used premium brands were Romeo y Julieta, Cohiba, and Macanudos. Women who used premium versus non-premium cigars were less likely to identify as non-Hispanic black (16.5% vs. 35.5%), more likely to have household income >$50 000 (54.2% vs. 26.6%), and less likely to report past 30-day marijuana (28.7% vs. 55.7%) or blunt use (26.0% vs. 53.9%; ps < .001). Women who used premium cigars also reported later age of onset of cigar use (24.1 vs. 20.3 years; p < .001) and smoked fewer cigars in the last 30 days (9.8 vs. 2.3 days; p < .001). Trend analysis revealed that although rates of past 30-day premium cigar use remained consistent from 2010 (4.7%) to 2019 (4.9%), prevalence decreased from 6.6% in 2017 to 2.8% in 2018 before increasing to 4.9% in 2019. CONCLUSIONS: Understanding premium and non-premium cigar use among reproductive-age women, an understudied vulnerable population, will provide critical data to the Food and Drug Administration to inform policy and regulatory decisions. IMPLICATIONS: The current study revealed prevalence of ~5% premium cigar use among women of reproductive age who smoke cigars, and evidence for consistency in women's rates of premium cigar use across time. Women who used premium versus non-premium cigars were more likely to identify as non-Hispanic white, older, and of higher socioeconomic status were in better health and less likely to co-use cigarettes and marijuana, but more likely to co-use alcohol. Consideration of reproductive age and pregnant women as uniquely vulnerable populations is warranted in the development of regulations regarding premium and non-premium cigars. Comprehensive regulation of cigars (both premium and non-premium) may offer the potential to positively impact women's health.
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Fumar Puros , Trastornos Relacionados con Sustancias , Productos de Tabaco , Adulto , Femenino , Humanos , Embarazo , Cannabis , Prevalencia , Trastornos Relacionados con Sustancias/epidemiología , Salud de la Mujer , Fumar Puros/epidemiologíaRESUMEN
OBJECTIVE: Prior studies have established that childhood sexual abuse (CSA) survivors are at increased risk for anxiety during pregnancy. Less is known about the course of anxiety throughout pregnancy for CSA survivors as well as underlying mechanisms linking CSA and perinatal anxiety. We assessed change in anxiety over the course of pregnancy for CSA survivors and examined whether acceptance and awareness of pregnancy-related body changes mediated this change. METHODS: 299 pregnant participants from two larger longitudinal cohort studies were grouped into CSA (n = 67), "other Maltreatment" (OM; n = 111); and "no abuse" (NA; n = 121) based on responses to the Adverse Childhood Events scale. We used a general linear mixed model with repeated measures to examine change in anxiety (Hamilton Anxiety Scale) at two time points (MEGA = 26.2 weeks and 34.9) by abuse/maltreatment group and then examined whether group differences in anxiety were mediated by body awareness/acceptance (from Maternal Fetal Attachment Scale) using structural equation modeling. RESULTS: The CSA group demonstrated higher anxiety at both gestational time-points and significantly greater increase in anxiety over gestation compared to OM and NA groups (F(1, 280) p = .046). CSA and OM groups reported significantly lower body acceptance than those without abuse/maltreatment (F(2, 287) = 3.486, p = .032). A small proportion of the total effect of CSA on change in anxiety (0.5%) was attributable to body acceptance. CONCLUSION: Pregnant CSA survivors experienced a greater increase in anxiety over pregnancy compared to other groups. Both abuse/maltreatment groups exhibited lower body acceptance, yet this contributed little to the association between CSA and anxiety.
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Adultos Sobrevivientes del Maltrato a los Niños , Abuso Sexual Infantil , Maltrato a los Niños , Embarazo , Femenino , Humanos , Niño , Estudios Longitudinales , Ansiedad , Trastornos de Ansiedad , Estudios de CohortesRESUMEN
Neurobiological sensitivity to peer interactions is a proposed marker of risk for adolescent depression. We investigated neural response to peer rejection and acceptance in relation to concurrent and prospective depression risk in adolescent and pre-adolescent girls. Participants were 76 girls (Mage=13, 45% racial/ethnic minorities) varying in depression risk: 22 with current major depressive disorder (MDD), 30 at High Risk for MDD based on parental history, and 24 at Low Risk with no psychiatric history. Girls participated in the Chatroom-Interact task-involving rejection and acceptance feedback from fictitious peers-while undergoing functional magnetic resonance neuroimaging. Activation in response to peer rejection and acceptance was extracted from regions of interest. Depressive symptoms were assessed at 6- and 12-month follow-up. Girls with MDD showed blunted left subgenual anterior cingulate response to acceptance versus girls in High and Low Risk groups. Girls in the High Risk group showed greater right temporo-parietal junction (rTPJ) and right anterior insula (AI) activation to both acceptance and rejection versus girls in the MDD (rTPJ) and Low Risk (rTPJ, AI) groups. Greater rTPJ response to rejection was associated with fewer depressive symptoms at 12-months and mediated the association between High Risk group status and 12-month depressive symptoms; greater rTPJ response to acceptance mediated the association between High Risk and increased 12-month depressive symptoms. Our finding of associations between altered neural response to peer interactions and concurrent and prospective depression risk/resilience highlights the importance of neural underpinnings of social cognition as risk and compensatory adaptations along the pathway to depression.
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Trastorno Depresivo Mayor , Femenino , Humanos , Adolescente , Depresión/psicología , Estudios Prospectivos , Grupo Paritario , Giro del Cíngulo , Imagen por Resonancia MagnéticaRESUMEN
The intrauterine environment and early life stress regulation are widely recognized as an early foundation for lifelong physical and mental health. Methylation of CpG sites in the placenta represents an epigenetic modification that can potentially affect placental function, influence fetal development, and ultimately impact the health of offspring by programming the hypothalamic-pituitary-adrenal (HPA) axis stress response during prenatal development. Leptin, an adipokine produced by the placenta, is essential for energy homeostasis. It is also epigenetically regulated by promoter DNA methylation. Mounting evidence suggests that leptin also affects the stress response system. Though heterogeneity in the early stress response system may influence life-long mental and physical health, few studies explicitly examine the heterogeneity in the newborn stress response system. Less is known about leptin's association with the human hypothalamic-pituitary-adrenocortical (HPA) axis early in life. This study sought to serve as a proof of concept study investigating the relationship between newborn cortisol output trajectories and placental leptin DNA methylation in 117 healthy newborns from socioeconomically and racially- and ethnically-diverse families. We characterized heterogeneity in newborn cortisol output during the NICU Network Neurobehavioral Scales exam in the first week of life with latent growth mixture models. We then evaluated whether leptin promoter (LEP) methylation in placental samples was associated with newborn cortisol trajectories. Our findings suggest that increased placental LEP methylation, which corresponds to decreased leptin production, is associated with infant cortisol trajectories marked by increased cortisol output in the NNNS exam. These results provide important insights into the role of placental leptin DNA methylation in human newborn HPA axis development and subsequent developmental origins of health and disease processes.
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Metilación de ADN , Placenta , Femenino , Humanos , Recién Nacido , Embarazo , Metilación de ADN/genética , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisario/metabolismo , Leptina/genética , Leptina/metabolismo , Sistema Hipófiso-Suprarrenal/metabolismo , Placenta/metabolismo , Regiones Promotoras Genéticas/genética , Receptores de Leptina/genética , Receptores de Leptina/metabolismoRESUMEN
OBJECTIVE: Waterpipe tobacco (WPT) use is common among reproductive age patients and is often perceived as safer than cigarette use. Prior studies have shown a decrease in nausea and vomiting symptoms among pregnant women who use cigarettes, but no studies to date have examined these symptoms in pregnant women who use WPT. This study was aimed to investigate the extent of symptoms of nausea/vomiting of pregnancy among participants who self-reported WPT use during pregnancy. STUDY DESIGN: Secondary analysis of a prospective cohort study examining WPT use during pregnancy. Participants completed the Pregnancy-Unique Quantification of Emesis (PUQE) during first and third trimesters. Medical conditions were determined by medical record review. Participants were evaluated by sole WPT use versus dual/polysubstance WPT use and frequency of WPT use. RESULTS: Ninety-nine (100%) participants completed the PUQE questionnaire during first trimester and 82 (82.8%) completed the PUQE during third trimester. Almost all (91.9%) participants reported moderate nausea/vomiting symptoms at both assessments. There was no difference in frequency of WPT use in pregnancy or rates of dual/polysubstance WPT use in participants with all levels of the PUQE questionnaire. There was also no difference in rates of WPT use or PUQE scores between sole WPT users and dual/polysubstance users. When comparing low and high WPT use, those who were in the higher frequency use group had higher waterpipe dependence scale scores (7.2 vs. 5.3, p < 0.02). With regard to maternal medical comorbidities, the only difference between groups was that sole WPT users were more likely to have a diagnosis of asthma than dual/polysubstance users (36.8 vs. 14.9%, p < 0.02). CONCLUSION: There were no differences in symptoms of nausea and vomiting of pregnancy or medical conditions in pregnant women who use WPT with any frequency during pregnancy. However, sole WPT users had higher rates of asthma than dual/polysubstance WPT users. KEY POINTS: · Waterpipe tobacco use is one of the most common forms of tobacco use among reproductive age patients.. · Waterpipe tobacco use was not associated with any changes in nausea/vomiting of pregnancy symptoms.. · Future research on the use of waterpipe tobacco in pregnancy can aid in public health responses..
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Complicaciones del Embarazo , Pipas de Agua , Tabaco para Pipas de Agua , Humanos , Femenino , Embarazo , Estudios Prospectivos , Vómitos/epidemiología , Vómitos/etiología , Náusea/epidemiología , Náusea/etiología , Náusea/diagnóstico , Complicaciones del Embarazo/epidemiologíaRESUMEN
BACKGROUND: Flavors contribute to the appeal of tobacco products, but less is known about flavors in cigar products. The current study is the first to focus on characterizing the use and perceptions of flavors in cigar products among pregnant women. METHODS: Pregnant women (N = 124) reported their use, preferences (liking, attractiveness, smoothness, interest), perceptions of harm (general, pregnancy-specific, fetal), and postpartum intention to use eight flavor categories (menthol/mint, spices, fruit, chocolate, alcohol, other beverages, candy/sweet, tobacco). We utilized correspondence analysis of contingency tables to investigate clustering of preferences and perceptions of flavors across the sample, and examined how preferences and perceptions of flavors may differ based on history of cigar use (none vs. lifetime vs. prenatal). RESULTS: Overall, 37% reported never trying cigars, 51% reported lifetime use, and 12% reported prenatal use. Fruit (37%), tobacco (36%), and alcohol (14%) were the most common cigar flavors participants reported ever trying. Correspondence analysis revealed clustering in preferences for alcohol, fruit, and candy flavors compared to other flavors, and revealed lower intentions to use menthol/mint and tobacco flavors compared to other flavors. Participants who reported prenatal cigar use also reported more positive perceptions and greater intentions to use (1) spice and alcohol flavors compared to those who reported lifetime use (ps < .05); and (2) spice, alcohol, fruit, and tobacco cigar flavors compared to participants reporting never using cigars (ps < .04). CONCLUSIONS: Regulations to restrict the availability of flavors, especially fruit, spice, and alcohol, may reduce the appeal and use of cigar products in pregnant women.
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BACKGROUND: The current study examined reasons pregnant women in Rhode Island use non-cigarette nicotine/tobacco products during and prior to pregnancy. METHODS: Of the 124 pregnant women in Rhode Island enrolled in the study, 91% self-reported ever using e- cigarettes, hookah or cigars, and reasons for their use. We compared responses between participants who used these products during pregnancy (prenatal) and those who used prior to pregnancy (lifetime) for each product separately. RESULTS: Participants reported using e-cigarettes as a cessation aid, hookah for entertainment, and cigars as a vehicle for marijuana consumption as primary reasons for use. There were no significant differences in reasons for using hookah or cigars between prenatal and lifetime users, but prenatal e-cigarette users were more likely to report affordability as a reason for use compared to lifetime e-cigarette users. CONCLUSIONS: Differential reasons for use by tobacco product may have implications for targeted interventions in pregnant people in Rhode Island.
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Sistemas Electrónicos de Liberación de Nicotina , Pipas de Agua , Productos de Tabaco , Humanos , Femenino , Embarazo , Mujeres Embarazadas , Rhode Island/epidemiología , Uso de Tabaco/epidemiologíaRESUMEN
While extensive research has supported the developmental programming hypothesis regarding contributions of prenatal psychosocial or nutritional adversity to offspring stress physiology, fewer studies consider both exposures together with maternal stress physiology. This study examined newborn cortisol output during a stressor as a function of maternal pre-pregnancy health status and nutritional history (pre-pregnancy body mass index [PPBMI]), economic resources (household income), and maternal cortisol awakening response (mCAR) in late pregnancy. Participants were 102 mother-infant pairs from an economically and racial/ethnically diverse sample. Offspring salivary cortisol response to a neurobehavioral exam was assessed at 1 month. Income and maternal PPBMI were positively associated with mCAR in late pregnancy. mCAR was positively related to 1-month newborn cortisol response. The interaction of income and PPBMI was positively associated with newborn cortisol output during an exam at 1-month. Mothers with the highest PPBMI and lowest income had offspring with higher cortisol responses than offspring of mothers with higher income and lower PPBMI. There was no evidence of indirect mediation effects of predictors (PPBMI, income, and interaction) on infant cortisol via mCAR. The differential effects of the interaction of PPBMI and income suggest that these exposures influence infant cortisol output in the context of one another, independent of maternal pregnancy cortisol.
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Hidrocortisona , Efectos Tardíos de la Exposición Prenatal , Recién Nacido , Lactante , Femenino , Humanos , Embarazo , Índice de Masa Corporal , Madres/psicología , Pobreza , Estrés Psicológico/psicologíaRESUMEN
Detrimental effects of early life stress on cardiovascular health are evident in adolescence. Cardiovascular reactivity and recovery in response to interpersonal stress may be a mechanism. This study aimed to evaluate if adolescent girls with higher early life stress demonstrated greater cardiovascular reactivity and slower recovery to peer rejection. A sample of 92 adolescent girls (age: M = 13.24) self-reported early life stressors. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were continuously measured before, during, and after a laboratory peer rejection paradigm. Counter to hypotheses, adolescent girls with higher early life stress had lower, not higher, HR during the recovery period. Early life stress was not associated with SBP or DBP recovery. Additionally, early life stress was not associated with SBP, DBP, or HR reactivity. Future research is needed to assess if blunted cardiovascular reactivity to interpersonal rejection during adolescence is a mechanism linking early life stress and later cardiovascular disease risk in women.