Neighborhood Opportunity and Obesity in Early Adolescence: Differential Associations by Sex.

PURPOSE: Though research indicates that certain aspects of adverse neighborhood conditions may influence weight development in childhood and adolescence, it is unknown if the Child Opportunity Index (COI), a composite measure of 29 indicators of neighborhood conditions, is associated with weight outcomes in adolescence. We hypothesized that lower COI would be associated with higher overweight and obesity in cross-sectional and longitudinal modeling in a national sample of 9 year olds and 10 year olds and that this association would be different by sex. METHODS: Using data from the Adolescent Brain Cognitive Development study (n = 11,857), we examined the cross-sectional association between COI quintile and overweight and obesity in 9 year olds and 10 year olds. Additionally, we used hazard ratios to examine incident overweight and obesity across three waves of data collection. RESULTS: Due to the interaction between sex and COI (p < .05), we present sex-specific models. There was a stepwise bivariate association, in which higher COI was associated with lower obesity prevalence. This pattern held in multilevel models, with a stronger association in females. In models adjusted for individual and household characteristics, female adolescents in the lowest quintile COI neighborhoods had 1.81 (95% confidence interval: 1.32, 2.48) times the odds of obesity compared to those in the highest quintile. In longitudinal models, the COI was associated with incident obesity in females only: adjusted hazard ratio = 4.27 (95% confidence interval: 1.50, 12.13) for lowest compared to highest COI. DISCUSSION: Neighborhood opportunity is associated with risk of obesity in pre-adolescence into mid-adolescence. Females may be particularly influenced by neighborhood conditions.

Comparing two measures of neighborhood quality and internalizing and externalizing behaviors in the adolescent brain cognitive development study.

PURPOSE: There is widespread recognition of the importance and complexity of measuring neighborhood contexts within research on child psychopathology. In this study, we assessed the cross-sectional associations between two measures of neighborhood quality and internalizing and externalizing behaviors in preadolescence. METHODS: Drawing on baseline data from the Adolescent Brain Cognitive Development Study (n = 10,577 preadolescents), we examined two multi-component assessments of neighborhood quality in relation to children's internalizing and externalizing symptoms: the Area Deprivation Index (ADI), which measures socioeconomic adversity, and the Child Opportunity Index 2.0 (COI), which measures economic, educational, and environmental opportunity. Both measures were categorized into quintiles. We then used mixed-effects linear regression models to examine bivariate and adjusted associations. RESULTS: The bivariate associations displayed strong inverse associations between the COI and ADI and externalizing symptoms, with a graded pattern of fewer externalizing behaviors with increasing neighborhood quality. Only the ADI was associated with externalizing behaviors in models adjusted for child and family characteristics. We did not observe a clear association between either measure of neighborhood quality and internalizing behaviors in bivariate or adjusted models. CONCLUSIONS: Neighborhood quality, as measured by the COI and ADI, was associated with externalizing behaviors in preadolescent children. The association using the ADI persisted after adjustment for family-level characteristics, including financial strain. Our results indicate that different assessments of neighborhood quality display distinct associations with preadolescent behavioral health. Future research is needed to assess the association between neighborhood quality and behavior trajectories and to identify place-based intervention strategies.

Parent-child separation and cardiometabolic outcomes and risk factors in adulthood: A systematic review.

BACKGROUND: Parent-child separation has been associated with negative mental health across childhood and adulthood, yet little is known about the long-term impacts for cardiovascular health. This systematic review synthesized and evaluated the quality of the literature examining the association between exposures to parent-child separation and cardiometabolic outcomes in adulthood. METHODS: Following a registered protocol, online databases (Pubmed, PsycInfo, and Web of Science) were searched for relevant studies. Studies were included if they (a) defined the exposure before age 18 as institutionalization, foster care placement, parental incarceration, separation due to parents migrating for economic reasons, or asylum and war; and (b) quantified the association between parent-child separation and cardiometabolic events and diagnoses (e.g., coronary heart disease, diabetes) and risk factors (e.g., body mass index, fat distribution, serum-based metabolic markers, inflammatory markers in adulthood (≥ age 18). Studies lacking an unexposed comparison group were excluded. The risk for bias in each study was assessed with a modified Newcastle-Ottawa Scale. RESULTS: Of the 1938 studies identified, 13 met our inclusion criteria. Two of the four studies examining associations between parent-child separation and cardiometabolic events and diagnoses found positive associations with coronary heart disease and diabetes. Amongst the 13 studies examining associations with any type of adult cardiometabolic risk factors, eight studies reported at least one positive association. Sub-analyses considering separate reasons for parent-child separation provided clearer insights: War evacuation was associated with hypertension and high blood pressure across four studies from the same cohort; out-of home care experiences largely evidenced null results across five different studies, and two studies on parental incarceration suggested positive associations with elevated inflammation, BMI and blood pressure. CONCLUSIONS: The connections between parent-child separation and adult cardiometabolic outcomes and risk factors are currently inconsistent. The results may depend on the reason for separation, age of assessment, analytic differences and other psychosocial variables that are often unmeasured in this literature.

Stress and Anxiety are Associated with Lower Gestational Weight Gain in Hispanic Women.

OBJECTIVE: Prior studies indicate that inadequate and excessive gestational weight gain (GWG) are associated with poor maternal and infant outcomes, and that stress and anxiety may contribute to GWG. However, these studies often failed to use validated measures of stress and anxiety, measured only total GWG, and were limited to largely non-Hispanic White populations. We explored the association between stress and anxiety and GWG. METHODS: We used data from 1,308 participants in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women 18-40 years of age (2006-2012). We measured stress with the Perceived Stress Scale and anxiety with the State-Trait Anxiety Scale, and abstracted GWG from medical records. RESULTS: The average GWG was 31.0 ± 16.1 pounds. More than one-half of participants (51.8%) exceeded Institute of Medicine guidelines for GWG. After adjusting for age and pre-pregnancy body mass index, women in the highest quartiles of stress and anxiety in early pregnancy had approximately 4 lbs lower GWG (ß = -3.89; SE = 1.54; p = .012 and ß = -4.37; SE = 1.54; p = .005, respectively) as compared with those in the lowest quartiles. Similarly, women in the highest quartiles of mid/late pregnancy stress and anxiety had lower GWG (ß = -3.84 lbs; SE = 1.39; p = .006, and ß = -3.51 lbs; SE = 1.38; p = .011, respectively) and a lower rate of GWG in the second and third trimesters (ß = -0.117 lbs/week; SE = 0.044; p = .008 and ß = -0.116 lbs/week; SE = 0.043; p = .007, respectively), compared with those in the lowest quartiles. CONCLUSIONS: High stress and anxiety were associated with lower GWG. Interventions to decrease stress and anxiety during pregnancy should include counseling on maintaining healthy GWG.

Prepregnancy Body Mass Index, Gestational Weight Gain, and Odds of Cesarean Delivery in Hispanic Women.

OBJECTIVE: This study aimed to evaluate the association between prepregnancy body mass index (BMI), gestational weight gain (GWG), and cesarean delivery in Hispanics. METHODS: We examined these associations among 1,215 participants in Proyecto Buena Salud, a prospective cohort of Hispanic women studied from 2006 to 2011. Prepregnancy BMI, GWG, and the mode of delivery were abstracted from medical records. RESULTS: A quarter of the participants entered pregnancy with obesity, 23% delivered via cesarean, and 52% exceeded the Institute of Medicine guidelines for GWG. After adjusting for age, women with obesity had 2.03 times the odds of cesarean delivery compared with women with normal BMI (95% confidence interval [CI]: 1.46-2.82); findings remained significant after adjusting for GWG. Women with excessive total GWG had 1.49 times the odds of cesarean delivery (95% CI: 1.06-2.10) compared with women who gained within guidelines. An excessive rate of third trimester GWG (standard deviation [SD] change in GWG per week) increased the odds of cesarean delivery (odds ratio = 1.66; 95% CI: 1.05-2.62), while an excessive rate of first and third trimester GWG was not associated with increased odds. CONCLUSIONS: Obesity prior to pregnancy was associated with increased odds of cesarean delivery among Hispanics. Excessive GWG across pregnancy and an excessive rate of third trimester GWG were also associated with increased odds.

Perinatal weight and risk of prenatal and postpartum depressive symptoms.

PURPOSE: Prepregnancy obesity and weight changes accompanying pregnancy (gestational weight gain and postpartum weight retention) may be associated with risk of maternal depressive symptoms during pregnancy and in the postpartum. The few studies that have examined these relationships report conflicting findings. METHODS: We studied pregnant (n = 2112) and postpartum (n = 1686) women enrolled in Project Viva. We used self-reported prepregnancy and postpartum weight and measured prenatal weight to calculate prepregnancy body mass index (BMI), gestational weight gain (GWG), and postpartum weight retention at 6 months after birth. We assessed elevated depressive symptoms (EDS) with the Edinburgh Postnatal Depression Scale (≥13 on 0-30 scale) at midpregnancy and 6 months postpartum. We used logistic regression to estimate the odds of prenatal and postpartum EDS in relation to prepregnancy BMI, GWG, and postpartum weight retention. RESULTS: A total of 214 (10%) participants experienced prenatal EDS and 151 (9%) postpartum EDS. Neither prepregnancy BMI nor GWG was associated with prenatal EDS. Prepregnancy obesity (BMI ≥ 30 kg per m2) was associated with higher odds of postpartum EDS (odds ratio = 1.69, 95% confidence interval, 1.01-2.83) compared to normal prepregnancy weight in a model adjusted for age, race/ethnicity, nativity, education, marital status, household income, parity, pregnancy intention, and smoking. CONCLUSIONS: Prepregnancy obesity is associated with elevated depressive symptoms in the postpartum period. Given the current obesity epidemic in the US and the consequences of perinatal depression, additional prevention and screening efforts in this population may be warranted.

Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms.

BACKGROUND: Glucose dysregulation in pregnancy may affect maternal depressive symptoms during the prenatal and postpartum periods via both physiologic and psychological pathways. METHODS: During mid-pregnancy, a combination of 50-g 1-h non-fasting glucose challenge test (GCT) and 100-g 3-h fasting oral glucose tolerance test was used to determine pregnancy glycaemic status among women participating in Project Viva: normal glucose tolerance (NGT), isolated hyperglycaemia (IHG), impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). Using the Edinburgh Postnatal Depression Scale (EPDS), we assessed depressive symptoms at mid-pregnancy and again at 6 months postpartum. We used logistic regression, adjusted for sociodemographic, anthropometric and lifestyle factors, to estimate the odds of elevated prenatal and postpartum depressive symptoms (EPDS ≥ 13 on 0-30 scale) in relation to GCT glucose levels and GDM status in separate models. RESULTS: A total of 9.6% of women showed prenatal and 8.4% postpartum depressive symptoms. Women with higher GCT glucose levels were at greater odds of elevated prenatal depressive symptoms [multivariable-adjusted odds ratio (OR) per standard deviation (SD) increase in glucose levels (27 mg/dL): 1.25; 95%: 1.07, 1.48]. Compared with NGT women, the association appeared stronger among women with IHG [OR: 1.80; 95% confidence interval (CI): 1.08, 3.00] than among those with GDM (OR: 1.45; 95% CI: 0.72, 2.91) or IGT (OR: 1.43; 95% CI: 0.59, 3.46). Neither glucose levels assessed from the GCT nor pregnancy glycaemic status were significantly associated with elevated postpartum depressive symptoms. CONCLUSION: Pregnancy hyperglycaemia was cross-sectionally associated with higher risk of prenatal depressive symptoms, but not with postpartum depressive symptoms.

The role of body image in prenatal and postpartum depression: a critical review of the literature.

Maternal depression increases risk of adverse perinatal outcomes, and recent evidence suggests that body image may play an important role in depression. This systematic review identifies studies of body image and perinatal depression with the goal of elucidating the complex role that body image plays in prenatal and postpartum depression, improving measurement, and informing next steps in research. We conducted a literature search of the PubMed database (1996-2014) for English language studies of (1) depression, (2) body image, and (3) pregnancy or postpartum. In total, 19 studies matched these criteria. Cross-sectional studies consistently found a positive association between body image dissatisfaction and perinatal depression. Prospective cohort studies found that body image dissatisfaction predicted incident prenatal and postpartum depression; findings were consistent across different aspects of body image and various pregnancy and postpartum time periods. Prospective studies that examined the reverse association found that depression influenced the onset of some aspects of body image dissatisfaction during pregnancy, but few evaluated the postpartum onset of body image dissatisfaction. The majority of studies found that body image dissatisfaction is consistently but weakly associated with the onset of prenatal and postpartum depression. Findings were less consistent for the association between perinatal depression and subsequent body image dissatisfaction. While published studies provide a foundation for understanding these issues, methodologically rigorous studies that capture the perinatal variation in depression and body image via instruments validated in pregnant women, consistently adjust for important confounders, and include ethnically diverse populations will further elucidate this association.

Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVE: Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with an increased incidence of pregnancy complications, adverse pregnancy outcomes, and maternal and fetal risks of chronic health conditions later in life. Physical activity has been proposed to reduce the risk of GDM and is supported by observational studies, but experimental research assessing its effectiveness is limited and conflicting. We aimed to use meta-analysis to synthesize existing randomized controlled studies of physical activity and GDM. DATA SOURCES: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for eligible studies. METHODS OF STUDY SELECTION: The following combination of keywords was used: (pregnant or pregnancy or gestation or gestate or gestational or maternity or maternal or prenatal) AND (exercise or locomotion or activity or training or sports) AND (diabetes or insulin sensitivity or glucose tolerance) AND (random* or trial). Eligibility was restricted to studies that randomized participants to an exercise-only-based intervention (ie, separate from dietary interventions) and presented data regarding GDM risk. Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies, and a third resolved any discrepancies. A total of 469 studies was retrieved, of which 10 met inclusion criteria and could be used for analysis (3,401 participants). TABULATION, INTEGRATION, AND RESULTS: Fixed-effects models were used to estimate summary relative risk (RR) and 95% confidence interval (CI) and I to assess heterogeneity. There was a 28% reduced risk (95% CI 9-42%) in the intervention group compared with the control group (RR 0.72, P=.005). Heterogeneity was low (I=12%) and nonsignificant (P=.33). CONCLUSION: The results from this meta-analysis suggest that physical activity in pregnancy provides a slight protective effect against the development of GDM. Studies evaluating type, timing, duration, and compliance of physical activity regimens are warranted to best inform obstetric guidelines.

Prepregnancy body mass index, gestational weight gain, and elevated depressive symptoms in a Hispanic cohort.

OBJECTIVES: Our objective was to assess the associations among prepregnancy Body Mass Index (BMI), gestational weight gain (GWG), and elevated depressive symptoms across pregnancy. METHODS: We evaluated these associations among 1,090 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. BMI and GWG were self-reported; GWG was classified according to the 2009 Institute of Medicine guidelines. Depressive symptoms were assessed in early, mid-, and late pregnancy using the 10-item Edinburgh Postnatal Depression Scale (EPDS). We defined elevated depressive symptoms as EPDS scores ≥13 and ≥15. RESULTS: In multivariable, longitudinal modeling, overweight (25.0 to <30 kg/m2) women had an odds ratio of 0.53 (95% CI [0.31, 0.90]) for EPDS scores ≥13 and 0.51 (95% CI [0.28, 0.91]) for EPDS scores ≥15 compared to normal weight women. We did not observe an association between GWG or an interaction between BMI and GWG, in predicting elevated depressive symptoms. CONCLUSIONS: Our findings provide preliminary support for an association of prepregnancy overweight status and lower depressive symptoms across pregnancy in Hispanic women. Future research should focus on potential social and cultural differences in perceptions of weight and weight gain in the perinatal period and how these influence psychological health.

Prenatal depressive symptoms and abnormalities of glucose tolerance during pregnancy among Hispanic women.

The aim of this study is to prospectively examine the association between maternal depressive symptoms in early pregnancy and risk of abnormal glucose tolerance (AGT) and impaired glucose tolerance (IGT) in mid-pregnancy. We evaluated this association among 934 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. Depressive symptoms were assessed in early pregnancy using the 10-item Edinburgh Postnatal Depression Scale. Scores ≥13 indicated at least probable minor depression and scores ≥15 indicated probable major depression. AGT and IGT were diagnosed using American Diabetes Association criteria. In early pregnancy, 247 (26.5 %) participants experienced at least minor depression and 163 (17.4 %) experienced major depression. A total of 123 (13.2 %) were classified with AGT and 56 (6.0 %) were classified with IGT. In fully-adjusted models, the odds ratio for AGT associated with minor depression was 1.20 (95 % CI 0.77-1.89) and for major depression was 1.34 (95 % CI 0.81-2.23). The odds ratio for IGT associated with minor depression was 1.22 (95 % CI 0.62-2.40) and for major depression was 1.53 (95 % CI 0.73-3.22). We did not observe an association with continuous screening glucose measures. Findings in this prospective cohort of Hispanic women did not indicate a statistically significant association between minor or major depression in early pregnancy and AGT or screening glucose values in mid-pregnancy. Due to the small number of cases of IGT, our ability to evaluate the association between depression and IGT risk was constrained.

Racial discrimination, response to unfair treatment, and depressive symptoms among pregnant black and African American women in the United States.

PURPOSE: To assess the association between self-reported racial discrimination and prenatal depressive symptoms among black women. METHODS: Our study population consisted of two cohorts of pregnant women: the Asthma Coalition on Community, Environment, and Social Stress project (ACCESS) and Project Viva. We measured self-reported racial discrimination among black women using a modified Experiences of Discrimination scale (score 0-8). We assessed elevated depressive symptoms (EDS) with the Edinburgh Postnatal Depression Scale (≥13 on a 0-30 scale). RESULTS: Fifty-four percent of ACCESS and 78% of Viva participants reported experiencing racial discrimination. After adjusting for age, marital status, income, education, and nativity, a 1-U increment in Experiences of Discrimination score was associated with 48% increased odds of EDS (odds ratio, 1.48; 95% confidence interval, 1.24-1.76) for ACCESS participants but was not significantly associated among Viva participants (odds ratio, 1.12; 95% confidence interval, 0.92-1.37). In both cohorts, responding to unfair treatment by talking to others was associated with the lowest odds of EDS. CONCLUSIONS: Our findings suggest that higher levels of perceived racial discrimination may increase depressive symptoms during pregnancy among U.S. black women. Interventions involving talking to others may aid in reducing the risk of depressive symptoms among black women experiencing higher levels of racial discrimination.

Maternal perinatal depression is not independently associated with child body mass index in the Generation R Study: methods and missing data matter.

OBJECTIVES: To advance the understanding of the relationship between maternal perinatal depression and child overweight, we used appropriate methodology to account for missing data; incorporated three exposure time points; and included adequate covariate adjustment in a large, sociodemographically diverse sample. STUDY DESIGN AND SETTING: We used data from 6,782 mother-child pairs in a prospective population-based study. Maternal depression was assessed with the Brief Symptom Inventory at midpregnancy and 2 and 6 months postpartum. Child height and weight were measured at 36 months of age and converted to body mass index (BMI) z-scores. We compared the complete-case and multiple imputation (MI) analyses. RESULTS: Fully adjusted complete-case models showed a positive association between depression at 2 months postpartum and child BMI z-score (ß=0.19 [95% confidence interval (CI)=0.03, 0.36]; n=1,732), and no association between prenatal depression or 6-month postpartum depression and child BMI. Using MI (n=6,782), there was no association between perinatal depression and child BMI at any time point. CONCLUSIONS: Our study adds evidence that postpartum depression is not associated with child growth across the population in high-income countries. Our results highlight the importance of appropriate handling of missing data, adequate covariate control, and the value of studying the conditions that have produced conflicting evidence regarding perinatal depression and child weight.

Depressive symptoms in extended-care employees: children, social support, and work-family conditions.

To examine the relation between having a child aged 18 years and under in the home and employee depressive symptoms, we analyzed cross-sectional data from four extended care facilities in Boston, MA (n = 376 employees). Results show that having a child is associated with slightly higher depressive symptoms. The strength of this relationship in our models is attenuated with the inclusion of social support at home (ß = 1.08 and ß = 0.85, with and without support, respectively) and may differ by gender. We recommend that future research examine the role of parenting and social support in predicting employee mental health.

Maternal depression in the United States: nationally representative rates and risks.

OBJECTIVES: To examine the public health burden of major depressive disorder (MDD) among mothers: its prevalence and sociodemographic patterns; associated functioning, comorbidities, and adversities; and racial/ethnic disparities. METHODS: This was a cross-sectional analysis of 8916 mothers in the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of the civilian U.S. population in 2001?2002. Past-year MDD was assessed with a structured interview protocol. RESULTS: Ten percent of mothers experienced depression in the past year. White and Native American women, those with low education or income, and those not married had high rates of depression. Depression was not strongly patterned by number of or age of children. Depressed mothers experienced more adversities (poverty, separation or divorce, unemployment, financial difficulties) and had worse functioning. Half of depressed mothers received services for their depression. Black and Hispanic depressed mothers were more likely to experience multiple adversities and less likely to receive services than white depressed mothers. CONCLUSIONS: Maternal depression is a major public health problem in the United States, with an estimated 1 in 10 children experiencing a depressed mother in any given year. Professionals who work with mothers and children should be aware of its prevalence and its detrimental effects.

Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immigrants and US White health care workers.

STUDY OBJECTIVES: o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant-white difference in sleep duration. DESIGN: Cross sectional SETTING: Four extended care facilities in Massachusetts, United States PARTICIPANTS: 340 employees in extended care facilities MEASUREMENTS AND RESULTS: Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: -81.0, -47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (-69.2, -32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (-57.8, -17.6). CONCLUSIONS: his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant-white difference in sleep duration in the United States, especially among health care workers.

Maternal depressive symptoms not associated with reduced height in young children in a US prospective cohort study.

BACKGROUND: Shorter stature is associated with greater all cause and heart disease mortality, but taller stature with increased risk of cancer mortality. Though childhood environment is important in determining height, limited data address how maternal depression affects linear growth in children. We examined the relationships between antenatal and postpartum depressive symptoms and child height and linear growth from birth to age 3 years in a U.S. sample. METHODS: Subjects were 872 mother-child pairs in Project Viva, a prospective pre-birth cohort study. The study population is relatively advantaged with high levels of income and education and low risk of food insecurity. We assessed maternal depression at mid-pregnancy (mean 28 weeks' gestation) and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score > = 13 on 0-30 scale indicating probable depression). Child outcomes at age 3 were height-for-age z-score (HAZ) and leg length. HAZ was also available at birth and ages 6 months, 1, 2, and 3 years. FINDINGS: Seventy (8.0%) women experienced antenatal depression and 64 (7.3%) experienced postpartum depression. The mean (SD) height for children age 3 was 97.2 cm (4.2), with leg length of 41.6 cm (2.6). In multivariable linear regression models, exposure to postpartum depression was associated with greater HAZ (0.37 [95% confidence interval: 0.16, 0.58]) and longer leg length (0.88 cm [0.35, 1.41]). The relationship between postpartum depression and greater HAZ was evident starting at 6 months and continued to age 3. We found minimal relationships between antenatal depression and child height outcomes. CONCLUSION: Our findings do not support the hypothesis that maternal depression is associated with reduced height in children in this relatively advantaged sample in a high-income country.

Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity.

Antenatal depression is associated with small-for-gestational age, but few studies have examined associations with weight during childhood. Similarly, few studies address whether antenatal and postpartum depression differentially affect child weight. Among 838 mother-child dyads in Project Viva, a prospective cohort study, we examined relationships of antenatal and postpartum depression with child weight and adiposity. We assessed maternal depression at mid-pregnancy and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score > or =13 indicating probable depression). We assessed child outcomes at age 3 years: body mass index (BMI) z-score, weight-for-height z-score, sum of subscapular (SS) and triceps (TR) skinfold thickness (SS + TR) for overall adiposity, and SS : TR ratio for central adiposity. Sixty-nine (8.2%) women experienced antenatal depression and 59 (7.0%) postpartum depression. Mean (SD) outcomes at age 3 were: BMI z-score, 0.45 (1.01); SS + TR, 16.72 (4.03) mm; SS : TR, 0.64 (0.15). In multivariable models, antenatal depression was associated with lower child BMI z-score (-0.24 [95% confidence interval: -0.49, 0.00]), but higher SS : TR (0.05 [0.01, 0.09]). There was no evidence of a dose-response relationship between antenatal depression and these outcomes. Postpartum depression was associated with higher SS + TR (1.14 [0.11, 2.18]). In conclusion, whereas antenatal depression was associated with smaller size and central adiposity at age 3 years, postpartum depression was associated with higher overall adiposity.

Incorporating home demands into models of job strain: findings from the work, family, and health network.

OBJECTIVE: The purpose of this article was to integrate home demands with the demand-control-support model to test if home demands interact with job strain to increase depressive symptoms. METHODS: Data were from 431 employees in four extended care facilities. Presence of a child younger than 18 years in the household signified home demands. The outcome was depressive symptoms based on a shortened version of the Center for Epidemiologic Studies Depression Scale. RESULTS: The association between job strain and depressive symptoms was moderated by social support (SS) and presence of a child in the household (child). There was no association among participants with high SS and no child, but a positive one among participants with low SS and a child. CONCLUSIONS: Job strain may be a particularly important determinant of depressive symptoms among employees with family demands. Models of job strain should expand to incorporate family demands.

Effects of social integration on preserving memory function in a nationally representative US elderly population.

OBJECTIVES: We tested whether social integration protects against memory loss and other cognitive disorders in late life in a nationally representative US sample of elderly adults, whether effects were stronger among disadvantaged individuals, and whether earlier cognitive losses explained the association (reverse causation). METHODS: Using data from the Health and Retirement Study (N = 16,638), we examined whether social integration predicted memory change over 6 years. Memory was measured by immediate and delayed recall of a 10-word list. Social integration was assessed by marital status, volunteer activity, and frequency of contact with children, parents, and neighbors. We examined growth-curve models for the whole sample and within subgroups. RESULTS: The mean memory score declined from 11.0 in 1998 to 10.0 in 2004. Higher baseline social integration predicted slower memory decline in fully adjusted models (P<.01). Memory among the least integrated declined at twice the rate as among the most integrated. This association was largest for respondents with fewer than 12 years of education. There was no evidence of reverse causation. CONCLUSIONS: Our study provides evidence that social integration delays memory loss among elderly Americans. Future research should focus on identifying the specific aspects of social integration most important for preserving memory.