Higher alcohol consumption in early pregnancy or low-to-moderate drinking during pregnancy may affect children's behaviour and development at one year and six months.

AIM: It is unclear whether low-to-moderate alcohol consumption during pregnancy affects child development. This study examined the effects that a mother's self-reported alcohol consumption had on her pregnancy and her child's birth, behaviour and development. METHODS: We asked 291 Swedish women to report their alcohol consumption before and during pregnancy using the Alcohol Use Disorders Identification Test (AUDIT); provide data on their pregnancy, labour and neonatal period; and complete a child behaviour and development questionnaire when their child was one year and six months of age. The mothers were separated into four subgroups based on their AUDIT scores. RESULTS: There were no group differences in gestational length, but children were shorter at birth if their mother drank during pregnancy. Mothers with the highest alcohol consumption before pregnancy were generally younger and more likely to smoke, have unplanned pregnancies and have children who displayed behavioural problems than controls who reported abstinence before and during pregnancy. Mothers who drank more during pregnancy than before were more likely to have had abortions and unplanned pregnancies and less likely to breastfeed for more than six months. CONCLUSION: Our results suggested that low-to-moderate alcohol consumption during pregnancy may negatively influence a child's development and behaviour in several ways.

Neurobehavioural development of preschool-age children born to addicted mothers given opiate maintenance treatment with buprenorphine during pregnancy.

AIM: To study the neurobehavioural development and somatic growth of children at preschool-age born to opioid-addicted mothers given opiate maintenance treatment (OMT) with buprenorphine during pregnancy. METHODS: Twenty-eight children, whose 21 opiate-addicted mothers were treated with OMT during pregnancy and accepted participation to the study, went through a battery of neurobehavioural tests (WPPSI-R, McCarthy, BROWN and SDQ). Twenty-five children fulfilled the tests at an age of 5-6 years. RESULTS: The children showed evidence of serious visual motor and attention problems in the field of performance (WPPSI-R scales) and major problems in the field of motor skills and memory abilities (McCarthy Scales). The results of behavioural tests also showed significantly elevated levels of hyperactivity, impulsivity and attention problems on the attention deficit hyperactivity disorder (ADHD) scale in BROWN and in SDQ tests estimated by the teachers, while the parents estimated no problems for their children. Regarding the outcomes, there were no significant differences in terms of neonatal abstinence syndrome, gender or socio-economic factors. The somatic growth of the children corresponded to the mean values of the normal population in weight, length and head circumference at birth and at preschool-age, respectively. CONCLUSION: Children to opiate-addicted mothers with buprenorphine maintenance treatment during pregnancy constitute a risk population, which should be recognized before start of the school. Whether the effects are associated with buprenorphine exposition during foetal life or not are discussed and need further investigation.

Alcohol consumption among pregnant women in a Swedish sample and its effects on the newborn outcomes.

BACKGROUND: Little is known about the effects of low levels of maternal alcohol intake on the neuropsychological development of the child. This study is part of an ongoing investigation on maternal drinking and presents data on demographic variables, maternal alcohol use, and birth outcomes from that study. METHODS: The sample comprised 2,264 women from a Swedish antenatal clinic. Retrospective self-report data were collected on alcohol consumption before and during pregnancy, using the Alcohol Use Disorders Identification Test (AUDIT), and on nicotine use. Specific alcohol biomarkers for excessive drinking, carbohydrate-deficient transferrin (CDT) in serum and phosphatidylethanol (PEth) in whole blood, were determined during mid-pregnancy in a subsample of the women. Data on labor and early characteristics of the child were also assessed. RESULTS: Before pregnancy, 89% of the women regularly consumed alcohol and 49% reported occasional or frequent binge drinking. Nicotine was used by 15% before and by 5% during pregnancy. During pregnancy, 12% continued using alcohol and 5% also admitted binge drinking. However, all alcohol biomarker values were below the reporting limits (CDT ≤ 1.7% disialotransferrin; total PEth < 0.1 µmol/L). Self-reported drinking during pregnancy was associated with a higher AUDIT score before pregnancy, nicotine use at the time of the first prenatal visit, older age, and previous legal abortions. CONCLUSIONS: The AUDIT questionnaire and 2 specific alcohol biomarkers were used in routine maternity care to collect information about drinking during pregnancy and thereby to identify children at risk for alcohol-related complications. While the AUDIT results suggested that a significant number of women continued using alcohol during pregnancy, implying a risk for fetal disorders, the biomarkers showed negative test values thus indicating only modest drinking levels.

Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: an epidemiological approach.

The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.

Applying EMDR on children with PTSD.

OBJECTIVE: To find out child-adjusted protocol for eye movement desensitization and reprocessing (EMDR). METHOD: Child-adjusted modification were made in the original adult-based protocol, and within-session measurements, when EMDR was used in a randomized controlled trial (RCT) on thirty-three 6-16-year-old children with post-traumatic stress disorder (PTSD). RESULTS: EMDR was applicable after certain modifications adjusted to the age and developmental level of the child. The average treatment effect size was largest on re-experiencing, and smallest on hyperarousal scale. The age of the child yielded no significant effects on the dependent variables in the study. CONCLUSIONS: A child-adjusted protocol for EMDR is suggested after being applied in a RCT for PTSD among traumatized and psychosocially exposed children.

Traumatic Experiences and Post-traumatic Stress Symptoms in Kurdish Children in their Native Country and in Exile.

BACKGROUND: Traumatic experiences and post-traumatic stress symptoms were assessed in Kurdish children in their native country and in exile. METHOD: 312 randomly selected school-age children at two sites completed assessments of traumatic experiences and post-traumatic symptoms. RESULTS: Although traumatic experiences showed more similarities than differences between the two samples, the PTSD frequencies and post-traumatic stress symptom scores were higher in Kurdistan than in exile. Living in exile showed negative correlation with PTSD frequencies and post-traumatic stress symptom scores. CONCLUSIONS: Living in exile seems to have trauma healing effect on children of Kurdistan.

EMDR treatment for children with PTSD: results of a randomized controlled trial.

The objective of the study was to examine the efficacy of EMDR treatment for children with post-traumatic stress disorder (PTSD) compared with untreated children in a waiting list control group (WLC) participating in a randomized controlled superiority trial (RCT). Thirty-three 6-16-year-old children with a DSM-IV diagnosis of PTSD were randomly assigned to eight weekly EMDR sessions or the WLC group. The Posttraumatic Stress Symptom Scale for Children (PTSS-C scale) was used in interviews with children to evaluate their symptoms and outcome. Post-treatment scores of the EMDR group were significantly lower than the WLC indicating improvement in total PTSS-C scores, PTSD-related symptom scale, and the subscales re-experiencing and avoidance among subjects in the EMDR group, while untreated children improved in PTSD-non-related symptom scale. The improvement in re-experiencing symptoms proved to be the most significant between-group difference over time. The results of the present exploratory study including a limited number of children with PTSD are encouraging and warrant further controlled studies of larger samples of children suffering from PTSD.