Perceived racial/ethnic discrimination and psychological outcomes among adult international adoptees in Finland: Moderating effects of social support and sense of coherence.

Quantitative literature on international adoptees and racial/ethnic discrimination is lacking despite results in qualitative studies from Europe and the United States that have consistently indicated how racism constantly complicates adoptees' everyday lives. To advance the literature, the present study examined the prevalence of perceived racial/ethnic discrimination among 213 adult international adoptees in Finland (59.6% women and 40.4% men, mean age 24.1 years), and the association between perceived racial/ethnic discrimination and psychological well-being indicators, including psychological distress and sleeping problems. In addition, we examined social support and sense of coherence as moderators of the association between perceived racial/ethnic discrimination and psychological well-being. Our results showed that, on average, adult international adoptees perceived racial/ethnic discrimination occasionally. Hierarchical linear regression analyses indicated a significant association between perceived racial/ethnic discrimination and psychological distress and sleeping problems. Additionally, a significant 2-way interaction of perceived racial/ethnic discrimination and social support indicated that the availability of social support may moderate the association between perceived racial/ethnic discrimination and psychological distress such that adoptees with high levels of social support may be protected from the harmful effects of discrimination. These results highlight the potential significance of social support in reducing the harmful effects of racial/ethnic discrimination on international adoptees. (PsycINFO Database Record

High lipoprotein(a) concentrations are associated with impaired endothelial function in children.

OBJECTIVE: To examine the association between familial high lipoprotein(a), or Lp(a), concentrations and endothelial function in children participating in the Special Turku Coronary Risk Factor Intervention Project study. STUDY DESIGN: Seven-month-old children (n = 1062) with their families were randomized to a risk intervention group or to a control group. The intervention group received individualized dietary counseling to reduce the total cholesterol concentration. Children's Lp(a) and lipid values were measured repeatedly. At age 11 years, children were recruited to an ultrasound study of the flow-mediated dilation (FMD) of the brachial artery. The association between relative peak FMD and Lp(a) concentration was examined in 198 control and 193 intervention group children by linear regression analyses adjusted for sex, total cholesterol concentration, and basal artery diameter. The analyses were made in both the control and intervention groups and in the familial risk children who had a parent with Lp(a) concentration greater than 250 mg/l. RESULTS: Lp(a) concentrations were similar at age 11 years in the intervention and control groups. In all control children, FMD (%) associated inversely with Lp(a) concentration: (ß [%/1000 mg/L] = -3.74, 95% CI [-6.43, -1.45]; P = .007) and in 68 familial risk children (ß = -4.92, 95% CI [-8.18, -1.66]; P = .0037). In the intervention group the associations were lacking (P > .5), and FMD in the children with high Lp(a) concentrations (>500 mg/L, n = 12) had no attenuation (P = .027). CONCLUSIONS: Familial high Lp(a) concentration is associated with attenuated endothelial function. This association may be mitigated by an early lifestyle intervention. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00223600.

Maternal smoking during pregnancy and regional brain volumes in preterm infants.

OBJECTIVE: To evaluate the association between maternal smoking during pregnancy and both brain volumes and head circumference in very-low-birth-weight/very-low-gestational-age infants. STUDY DESIGN: The PIPARI Study is a prospective follow-up study of infants with a birth weight < or =1500 g or a gestational age <32 weeks born in 2001 to 2006 (n = 232) at Turku University Hospital. The brain was imaged by serial brain ultrasound examinations until discharge and magnetic resonance imaging at term age. The head circumference was measured at birth, term, and 2 years corrected age. These measures were correlated to maternal smoking during pregnancy as reported by the mothers. RESULTS: The prevalence of maternal smoking was 18%. The frontal lobe (P = .01) and the cerebellar (P = .03) volumes were significantly smaller in the exposed than in the unexposed infants. The volumes of the other parts of the brain did not differ. There was no association between prenatal smoking exposure and head growth or structural brain disease. CONCLUSIONS: Prenatal smoking exposure was associated with significantly smaller frontal lobe and cerebellar volumes in the brains of preterm infants. This is consistent with reports showing an association between prenatal smoking exposure and impairments in frontal lobe and cerebellar functions such as emotion, impulse control, and attention.

Interleukin-6 polymorphism is associated with chorioamnionitis and neonatal infections in preterm infants.

OBJECTIVES: To evaluate whether genotypes of interleukin (IL)-6 gene promoter positions -174 and -572 are associated with histologic chorioamnionitis and neonatal inflammatory disease in preterm infants. STUDY DESIGN: DNA from very low birth weight or very preterm infants (n = 107) was genotyped for IL-6-174 and -572 polymorphisms (GG/GC/CC). The placentas were analyzed for histological inflammatory findings. Data on neonatal inflammatory diseases, including chronic lung disease (CLD), necrotizing enterocolitis (NEC), and septicemia, were collected using the definitions of the Vermont Oxford Network database. RESULTS: In univariate analyses, the IL-6-174 GG genotype was associated with a higher incidence of histologic chorioamnionitis. In multivariate analyses, the -174 GG and -572 GC genotypes were correlated with histologic chorioamnionitis (P = .039 and .009, respectively). Gestational age was not associated with genotype polymorphisms. IL-6-174 genotypes were not associated with CLD and/or NEC, but the CC genotype was correlated with septicemia in both univariate and multivariate analyses (P = .027). IL-6-572 genotypes were not associated with neonatal inflammatory disease. CONCLUSIONS: The IL-6-174 GG and -572 GC genotypes were associated with a higher incidence of histologic chorioamnionitis, and the IL-6-174 CC genotype was associated with septicemia in preterm infants. These findings suggest that the genetic composition of the IL-6 promoter area plays a significant role in the pathogenesis of chorioamnionitis and neonatal infections.

Does placental inflammation relate to brain lesions and volume in preterm infants?

OBJECTIVES: To evaluate the association between histologic inflammation of placenta and brain findings in ultrasound examinations and regional brain volumes in magnetic resonance imaging in very-low-birth-weight (VLBW) or in very preterm infants. STUDY DESIGN: VLBW or very preterm infants (n = 121) were categorized into 3 groups according to the most pathologic brain finding on ultrasound examinations until term. The brain magnetic resonance imaging performed at term was analyzed for regional brain volumes. The placentas were analyzed for histologic inflammatory findings. RESULTS: Histologic chorioamnionitis on the fetal side correlated to brain lesions in univariate but not in multivariate analyses. Low gestational age was the only significant risk factor for brain lesions in multivariate analysis (P < .0001). Histologic chorioamnionitis was not associated with brain volumes in multivariate analyses. Female sex, low gestational age, and low birth weight z score correlated to smaller volumes in total brain tissue (P = .001, P = .0002, P < .0001, respectively) and cerebellum (P = .047, P = .003, P = .001, respectively). In addition, low gestational age and low-birth-weight z score correlated to a smaller combined volume of basal ganglia and thalami (P = .0002). CONCLUSIONS: Placental inflammation does not appear to correlate to brain lesions or smaller regional brain volumes in VLBW or in very preterm infants at term age.

Antenatal Doppler measurements and early brain injury in very low birth weight infants.

OBJECTIVE: To determine the correlation between fetoplacental blood flow and brain injury and volumes in very low birth weight (VLBW) infants. STUDY DESIGN: Antenatal blood flow from the umbilical artery (UA), middle cerebral artery (MCA), and descending aorta was determined in 70 VLBW infants. The directions of the total diastolic flow of the aortic isthmus and the end-diastolic flow of ductus venosus also were measured. Serial brain ultrasound examinations and MRI at term were performed to assess brain abnormalities. On the basis of brain imaging findings, the newborn infants were classified as normal (n = 14), intermediate brain pathology (n = 31), and major pathology (n = 25) groups. RESULTS: Abnormalities in fetoplacental blood flow were not related to anatomic brain lesions. However, an abnormal UA/MCA pulsatility index ratio was associated with reduced total brain volume (mean, 360 mL; SD, 32.5 mL) and reduced cerebral volume (344 mL; SD, 28.4 mL) compared with infants with normal UA/MCA pulsatility index ratio (mean, 405 mL; SD, 51.3 mL, P = .01, and mean, 368 mL; SD, 52.3 mL, P = .012), respectively. CONCLUSIONS: Redistribution of fetal blood flow in VLBW infants is associated with reduced brain volume at term age. Neurodevelopmental follow-up of this cohort will clarify the significance of these blood flow changes on development.

Growth, energy intake, and meal pattern in five-year-old children considered as poor eaters.

OBJECTIVE: To investigate whether 5-year-old children considered poor eaters differ from their peers regarding growth, intake of energy and nutrients, or meal pattern. Study design Parental evaluations of children's (n=494) eating at age 5 years were collected using questionnaires, and energy and nutrient intakes and meal pattern of the children were assessed using 4-day food records. Weight and height were measured at birth and at ages 7 and 13 months, and 2, 3, 4, and 5 years. Of the children 30.2% (149) were poor eaters according to the parents. The rest of the sample (n=345) formed the comparison group. RESULTS: Poor eaters were on average lighter and shorter at birth (P=.026 and P=.020, respectively), and at age 5 years (P<.001 for both weight and height) than the comparison children. At age 5 years the poor eaters on average received less of their daily total energy from warm meals (P=.044) and more from snacks (P=.013) than the comparison group, but the mean daily weight-adjusted intake of energy showed no difference between the groups (P=.153). CONCLUSIONS: There appears not to be reason for serious concern about growth and diet of preschool-aged children considered as poor eaters by parents.