Multiple Risk in Pregnancy- Prenatal Risk Constellations and Mother-Infant Interactions, Parenting Stress, and Child Externalizing and Internalizing Behaviors: A Prospective Longitudinal Cohort Study from Pregnancy to 18 Months Postpartum.

Multiple risk is associated with adverse developmental outcomes across domains. However, as risk factors tend to cluster, it is important to investigate formation of risk constellations, and how they relate to child and parental outcomes. By means of latent class analysis patterns of prenatal risk factors were identified, and relations to interactional quality, parenting stress, and child internalizing and externalizing behaviors were investigated. An array of prenatal risk factors was assessed in 1036 Norwegian pregnant women participating in a prospective longitudinal community-based study, Little in Norway. Mother-infant interactions were videotaped and scored with the Early Relational Health Screen (ERHS) at 12 months. The Parenting Stress Index (PSI) and Infant-Toddler Social and Emotional Assessment (ITSEA) were administered at 18 months. First, we analyzed response patterns to prenatal risks to identify number and characteristics of latent classes. Second, we investigated whether latent class membership could predict mother-child interactional quality, parenting stress, and child internalizing and externalizing behavior after the child was born. Results revealed three prenatal risk constellations: broad risk (7.52%), mental health risk (21.62%) and low-risk (70.86%). Membership in the broad risk group predicted lower scores on interactional quality, while membership in the mental health risk group predicted less favorable scores on all outcome measures. Prenatal risks clustered together in specific risk constellations that differentially related to parent, child and interactional outcomes.

Becoming Dad: Expectant Fathers' Attachment Style and Prenatal Representations of the Unborn Child.

How expectant fathers think and feel about the unborn child (prenatal representations), has shown associations with fathers' postnatal parenting behaviors, observed father-infant interactional quality and child cognitive development. There is limited knowledge about fathers' prenatal representations. The present study examined if fathers' partner-related attachment styles were related to their prenatal representations of the unborn child. In the "Little in Norway Study", an ongoing prospective, longitudinal population-based study, 396 expectant fathers completed the Experiences in Close Relationships Scale at enrollment (mean gestational week = 23.76, SD = 4.93), and in gestational weeks 27-35 completed three questions assessing prenatal representations. Correlations of attachment style and prenatal representations were reported using logistic regression analyses. We found that an avoidant attachment style by fathers were predicted to have absent or negative representations on all three items (1) "strongest feeling about the unborn child" (Cl = 1.19-2.73), (2) "thoughts about child personality" (Cl = 1.16-1.87), and (3) "experiences of relationship with the child" (Cl = 1.14-1.75). Father anxious attachment style was not significantly associated with absent or negative prenatal representations. Results suggest that expectant fathers with a partner related avoidant attachment style have an increased risk of having absent or negative prenatal representations of the unborn child.

Dyadic parent-infant interaction patterns at 12 months: Exploring dyadic parent-infant gender compositions.

This study investigates differences in dyadic mother-infant and father-infant interaction patterns at infant age 12 months, and the relation between different parent-infant gender compositions and the dyadic interaction. Data were drawn from a large-scale, population-based Norwegian community sample comprising 671 mother-infant and 337 father-infant interactions. The Early Relational Health Screen (ERHS), a screening method for observing dyadic parent-infant interactions, was used to assess the parent-infant interactions. Scores on the ERHS were employed to investigate dyadic differences in the overall interaction scores, and dyadic interaction on seven sub-dimensions between mother-infant and father-infant pairs. The relation between different parent-infant gender compositions and the dyadic interaction scores was also examined. As expected in a normative sample, most parent-infant interactions received scores in the upper rating levels. Differences between mother-infant and father-infant patterns were generally small, but mother-infant dyads tended to obtain slightly higher scores. The mother-infant dyads received higher scores on the dimensions of engagement and enjoyment, but no other significant differences between the parent-infant pairs were found for the remaining dimensions. We did not find evidence for a moderation effect of child gender. However, parent-daughter dyads received somewhat higher scores than the parent-son dyads.

Este estudio investiga las diferencias en los patrones de interacción de las díadas madre-infante y padre-infante a los 12 meses de edad del infante, y la relación entre las diferentes composiciones de género de progenitor-infante y la interacción diádica. Los datos se obtuvieron de un grupo muestra a gran escala con base en la población en una comunidad noruega y el mismo comprendía 671 interacciones madre-infante y 337 padre-infante. La Temprana Detección de Salud de la Relación (ERHS), un método de examinación para observar las interacciones progenitor-infante, se usó para evaluar las interacciones progenitor-infante. Los puntajes de ERHS se emplearon para investigar las diferencias diádicas dentro de los puntajes de interacción generales, y las interacciones diádicas acerca de siete sub-dimensiones entre los pares de madre-infante y padre-infante. También se examinó la relación entre las diferentes composiciones de género progenitor-infante y la interacción diádica. Como se esperaba en un grupo muestra normativo, la mayoría de las interacciones progenitor-infante recibió puntajes en los niveles superiores de la evaluación. Las diferencias entre los patrones madre-infante y padre-infante fueron generalmente pequeñas, pero las díadas madre-infante tendieron a recibir puntajes un poquito más altos. Las díadas madre-infante recibieron más altos puntajes en las dimensiones de participación y disfrute, pero no se encontraron otras diferencias significativas entre los pares progenitor-infante en el resto de las dimensiones. No encontramos evidencia de un efecto de moderación del género del infante. Sin embargo, las díadas padre-hija recibieron hasta cierto punto puntaje más altos que las díadas padre-hijo.

Cette étude porte sur les différences dans les patterns d'interaction dyadique mère-nourrisson et père-nourrisson à l'âge de 12 mois pour le bébé, et la relation entre les différentes compositions de genre parent-bébés et l'interaction dyadique. Les données ont été extraites d'un échantillon communautaire norvégien de grande taille, basé sur la population, comprenant 671 interactions mère-nourrisson et 337 interactions père-nourrisson. Le Dépistage Précoce de Santé Relationnelle (ERHS), une méthode de dépistage pour l'observation des interactions dyadiques parent-bébé, a été utilisé afin d'évaluer les interactions parent-bébé. Les scores au ERHS ont été employés pour rechercher les différences entre les scores d'interaction généraux et l'interaction dyadique concernant sept sous-dimensions entre les paires mère-bébé et père-bébé. La relation entre les différentes compositions de genre parent-bébé et les scores d'interaction dyadique a également été examinée. Comme prévu dans un échantillon normatif la plupart des interactions parent-bébé ont reçu des scores dans les niveaux les plus hauts. Les différences entre les patterns mère-bébé et père-bébé étaient généralement petites mais les dyades mère-bébé ont eu tendance à obtenir des scores un peu plus élevés. Les dyades mère-bébé ont reçu de meilleurs scores quant aux dimensions d'engagement et de plaisir, mais aucune autre différence importante n'a été trouvée entre les paires parent-bébé pour les autres dimensions. Nous n'avons pas trouvé de preuves d'un effet de modération pour le genre de l'enfant. Cependant les dyades parent-fille ont reçu des scores un peu plus élevés que les dyades parent-fils.

The context and development of the early relational health screen.

Early relational experiences are key drivers for developing social emotional capacities, educational achievement, mental health, physical health, and overall wellbeing. The child health sectors are committed to promotion, prevention, and early intervention that optimize children's health and development, often employing evidence-based screening as foundational practices. Despite a variety of validated parent-infant observational assessment tools, few are practical within busy practice settings, acceptable with all racial and ethnic groups and ready for universal adoption. In response to this need, a team of clinicians, early childhood educators, researchers and infant mental health specialists collaborated to develop and test a novel video-based, dyadic relational screening and monitoring tool, the Early Relational Health Screen (ERHS). This tool uniquely focuses on the early parent-child relationship (6-24 months), within the construct of early relational health (ERH). Initial testing demonstrated that the ERHS is a valid, reliable, feasible, and useful screening and monitoring tool for clinical applications. The ERHS was further developed within a population-based, prospective research study and adapted with brief video feedback for parents in the home visiting and child health sectors. The ERHS and its adaptations appear to advance ERH and equity within the transforming child health and public health care systems of today.

Las tempranas experiencias de relaciones afectivas son clave para desarrollar las capacidades socioemocionales, para los logros educativos, la salud mental, la salud física y el bienestar en general. Los sectores de salud infantil están comprometidos a promover, prevenir e intervenir a tiempo para que la salud de los niños y su desarrollo sean óptimos, a menudo empleando examinaciones basadas en la evidencia como prácticas fundamentales. A pesar de la variedad de válidas herramientas para la evaluación con base en la observación progenitor-infante, pocas son prácticas dentro del ocupado campo de la práctica, aceptables con todos los grupos raciales y étnicos, y pocas están listas para ser adoptadas en forma generalizada. Como respuesta a esta necesidad, un equipo formado por clínicos profesionales, educadores de la temprana niñez, investigadores y especialistas de la salud mental infantil colaboraron para desarrollar y probar una herramienta novedosa basada en videos, con el fin de examinar y darle seguimiento a la relación de la díada, el Examen del Bienestar de la Temprana Relación (ERHS). Esta herramienta de manera única se enfoca en la temprana relación progenitor-niño (6-24 meses), dentro del marco del temprano bienestar de la relación. La examinación inicial demostró que ERHS es una herramienta de examinación y seguimiento válida, confiable, posible y útil para la aplicación clínica. Entonces ERHS se desarrolló dentro de un estudio de investigación de probabilidades, con base en la población, y se adaptó con breves respuestas en video para progenitores en los sectores de visitas a casa y salud infantil. ERHS y sus adaptaciones parecen avanzar el temprano bienestar de la relación (ERH) y la equidad dentro de los sistemas de salud infantil y cuidado de salud pública en transformación hoy día.

Les expériences relationnelles sont des moteurs essentiels pour le développement des capacités socio-émotionnelles, la réussite scolaire, la santé mentale, la santé physique et le bien-être général. Les secteurs de la santé de l'enfant sont dédiés à la promotion, à la prévention et à l'intervention précoce qui optimisent la santé des enfants et leur développement, en employant souvent des dépistages fondés sur des données probantes en tant que pratiques fondamentales. En dépit d'une variété d'outils d'évaluation observationnelle parent-bébé validés, peu de ces outils sont pratique au sein d'un cabinet de pratique très occupé et peu sont acceptables pour tous groupes raciaux et éthiques ainsi que prêts pour une adoption universelle. Pour répondre à ce besoin une équipe de cliniciens, d'éducateurs de la petite enfance, de chercheurs et de spécialistes de la santé mentale du nourrisson ont collaboré afin de développer et de tester un outil innovateur et basé sur la vidéo de dépistage relationnel dyadique et de suivi, le Dépistage de Santé Relationnelle Précoce (en anglais Early Relational Health Screen dont nous gardons l'abréviation ici, ERHS). Cet outil se concentre uniquement sur la relation précoce parent-enfant (6-24 mois), dans le cadre de la construction de la santé relationnelle précoce. Les essais ont montré que l'ERHS est un outil de dépistage et de suivi valide, fiable, réalisable et utile pour les applications cliniques. L'ERHS a été plus profondément développé au sein d'une étude de recherches de prospection, basées sur certaines populations, et adapté avec de brefs commentaires vidéo pour les parents dans les secteurs des visites à domicile et de la santé de l'enfant. L'ERHS et ses adaptations semblent faire progresser la Santé Relationnelle Précoce et l'équité au sein des transformation de la santé de l'enfant et des systèmes de santé publique d'aujourd'hui.

From Generative Models to Generative Passages: A Computational Approach to (Neuro) Phenomenology.

This paper presents a version of neurophenomenology based on generative modelling techniques developed in computational neuroscience and biology. Our approach can be described as computational phenomenology because it applies methods originally developed in computational modelling to provide a formal model of the descriptions of lived experience in the phenomenological tradition of philosophy (e.g., the work of Edmund Husserl, Maurice Merleau-Ponty, etc.). The first section presents a brief review of the overall project to naturalize phenomenology. The second section presents and evaluates philosophical objections to that project and situates our version of computational phenomenology with respect to these projects. The third section reviews the generative modelling framework. The final section presents our approach in detail. We conclude by discussing how our approach differs from previous attempts to use generative modelling to help understand consciousness. In summary, we describe a version of computational phenomenology which uses generative modelling to construct a computational model of the inferential or interpretive processes that best explain this or that kind of lived experience.

Towards a computational phenomenology of mental action: modelling meta-awareness and attentional control with deep parametric active inference.

Meta-awareness refers to the capacity to explicitly notice the current content of consciousness and has been identified as a key component for the successful control of cognitive states, such as the deliberate direction of attention. This paper proposes a formal model of meta-awareness and attentional control using hierarchical active inference. To do so, we cast mental action as policy selection over higher-level cognitive states and add a further hierarchical level to model meta-awareness states that modulate the expected confidence (precision) in the mapping between observations and hidden cognitive states. We simulate the example of mind-wandering and its regulation during a task involving sustained selective attention on a perceptual object. This provides a computational case study for an inferential architecture that is apt to enable the emergence of these central components of human phenomenology, namely, the ability to access and control cognitive states. We propose that this approach can be generalized to other cognitive states, and hence, this paper provides the first steps towards the development of a computational phenomenology of mental action and more broadly of our ability to monitor and control our own cognitive states. Future steps of this work will focus on fitting the model with qualitative, behavioural, and neural data.

Iodine status during pregnancy and at 6 weeks, 6, 12 and 18 months post-partum.

Iodine deficiency during pregnancy and in the post-partum period may lead to impaired child development. Our aim is to describe iodine status longitudinally in women from pregnancy until 18 months post-partum. Furthermore, we explore whether iodine status is associated with dietary intake, iodine-containing supplement use and breastfeeding status from pregnancy until 18 months post-partum. We also assess the correlation between maternal iodine status 18 months post-partum and child iodine status at 18 months of age. Iodine status was measured by urinary iodine concentration (UIC) during pregnancy (n = 1,004), 6 weeks post-partum (n = 915), 6 months post-partum (n = 849), 12 months post-partum (n = 733) and 18 months post-partum (n = 714). The toddlers' UIC was assessed at 18 months of age (n = 416). Demographic variables and dietary data (food frequency questionnaire) were collected during pregnancy, and dietary data and breastfeeding practices were collected at all time points post-partum. We found that iodine status was insufficient in both pregnant and post-partum women. The UIC was at its lowermost 6 weeks post-partum and gradually improved with increasing time post-partum. Intake of milk and use of iodine-containing supplements significantly increased the odds of having a UIC above 100 µg/L. Neither the mothers' UIC, vegetarian practice, nor exclusion of milk and dairy products were associated with the toddlers UIC 18 months post-partum. Women who exclude milk and dairy products from their diets and/or do not use iodine-containing supplements may be at risk of iodine deficiency. The women possibly also have an increased risk of thyroid dysfunction and for conceiving children with nonoptimal developmental status.

Fatty Acid Reference Intervals in Red Blood Cells among Pregnant Women in Norway-Cross Sectional Data from the 'Little in Norway' Cohort.

There is a growing interest in determining fatty acid reference intervals from pregnancy cohort, especially considering the lack of reference values for pregnant women in the literature and the generalized misconception of equating reference intervals for nonpregnant women as equivalent to pregnant women. Seafood and supplements are important dietary sources for the omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA), such as eicosapentaenoic acid (EPA, 20:5ω-3), docosapentaenoic acid (DPA, 22:55ω-3), and docosahexaenoic acid (DHA, 22:6ω-3). Sufficient intake of EPA and DHA is vital during pregnancy for the development of the fetus, as well as for maintaining adequate levels for the mother. This study describes the fatty acid status and suggests reference values and cut-offs for fatty acids in red blood cells (RBC) from pregnant women (n = 247). An electronic food frequency questionnaire (e-FFQ) mapped the dietary habits of the participants, and gas chromatography was used to determine the fatty acid levels in RBC. The association between e-FFQ variables and fatty acid concentrations was established using a principal component analysis (PCA). Twenty-nine-point-one percent (29.1%) of the participants reported eating seafood as dinner according to the Norwegian recommendations, and they added in their diet as well a high percentage (76.9%) intake of ω-3 supplements. The concentration levels of fatty acids in RBC were in agreement with those reported in similar populations from different countries. The reference interval 2.5/97.5 percentiles for EPA, DPA, DHA were 0.23/2.12, 0.56/2.80, 3.76/10.12 in relative concentration units (%), and 5.99/51.25, 11.08/61.97, 64.25/218.08 in absolute concentration units (µg/g), respectively. The number of participants and their selection from all over Norway vouch for the representativeness of the study and the validity of the proposed reference values, and therefore, the study may be a useful tool when studying associations between fatty acid status and health outcome in future studies. To the best of our knowledge, this is the first PCA study reporting a direct association between ω-3 LCPUFA and intake of seafood and ω-3 supplements in a pregnancy cohort.

Antecedents of fathers' perception of child behavior at child age 12 months.

This study investigates whether fathers' adverse childhood experiences (ACE) and attachment style reported during pregnancy predict fathers' perception of child behavior assessed 12 months postpartum, expressed by the Parenting Stress Index (PSI), Child Domain. Prospective fathers (N = 835) were recruited to "The Little in Norway (LiN) study" (Moe & Smith) at nine well-baby clinics in Norway, with data collection composed of five time points during pregnancy and two time points postpartum (6 and 12 months). The main analyses included linear regression, path-analysis modeling, and intraclass correlation based on mixed effects modeling. First, linear regression analyses showed that neither fathers' ACE nor attachment style significantly predicted perceived child behavior postpartum directly. Furthermore, path analyses showed that ACE and less secure attachment style (especially avoidant attachment) measured early in pregnancy strongly predicted negatively perceived child behavior, mediated by fathers' mental health symptoms during pregnancy and partner disharmony postpartum. Second, intraclass correlation analyses showed that fathers' perceived child behavior showed substantial stability between 6 and 12 months postpartum. Family interventions beginning in pregnancy may be most beneficial given that fathers' early experiences and perceptions of attachment in pregnancy were associated with later partner disharmony and stress.

Este estudio investiga si las experiencias adversas de los papás en su niñez y el estilo de afectividad reportado durante el embarazo predicen las percepciones de los papás sobre el comportamiento del niño según evaluación a los 12 meses después del parto, expresada por el Índice de Estrés de Crianza (PSI), Ámbito del Niño. Los papás con la posibilidad de participar (N = 835) fueron reclutados para el "estudio El Pequeño en Noruega (LiN)" (Moe y Smith, 2010) en nueve clínicas de revisión pediátrica en Noruega, con un proceso de recoger información compuesto de cinco momentos temporales durante el embarazo y dos momentos después del parto (6 y 12 meses). Los análisis principales incluyeron regresión lineal, diseños de análisis de trayectoria y correlación intraclase basados en diseños de efectos mixtos. Primero, los análisis de regresión lineal mostraron que ni las experiencias adversas de los papás en su niñez ni el estilo de afectividad predijeron significativamente la percepción del comportamiento del niño posterior al parto directamente. Es más, los análisis de trayectoria mostraron que las experiencias adversas en la niñez y un menos seguro estilo de afectividad (especialmente la afectividad esquiva) tal como fueron medidos a principios del embarazo predijeron fuertemente la percepción negativa del comportamiento del niño, todo lo cual fue mediado por los síntomas de salud mental de los papás durante el embarazo y la desarmonía de la pareja después del parto. Segundo, los análisis de correlación intraclase mostraron que la percepción que tenían los papás acerca del comportamiento del niño mostraba una estabilidad sustancial entre los 6 y 12 meses después del parto. Las intervenciones familiares que comienzan durante el embarazo pudieran ser más beneficiosas dado que las tempranas experiencias de los papás y sus percepciones de la afectividad durante el embarazo se asociaron con la posterior desarmonía y estrés de la pareja.

Cette étude s'est interrogée si les expériences adverses de l'enfance des pères et le style d'attachement rapporté durant la grossesse prédisait la perception des pères du comportement de l'enfant évalué 12 mois après la naissance, exprimé par l'Index de Stress de Parentage (en anglais PSI), le Domaine de l'Enfant. Des pères potentiels (N = 835) ont été recruté pour l'étude norvégienne "The Little in Norway (LiN) study" (Moe & Smith, 2010) dans neuf cliniques de bien-être du bébé en Norvège, avec un recueil de données comprenant cinq points de recueil durant la grossesse et deux après la grossesse (6 et 12 mois). Les analyses principales ont inclus une régression linéaire, une modélisation de l'analyse des trajectoires et une corrélation intraclasse basée sur une modélisation des effets mixtes. Tout d'abord, les analyses de régression linéaires ont montré que ni les expériences adverses vécues par les pères durant leur enfance ni le style d'attachement ne prédisait directement de façon importante le comportement de l'enfant perçu après la naissance. De plus les analyses de parcours ont montré que les expériences adverses vécues pendant l'enfance et le style d'attachement moins sécure (particulièrement l'attachement évitant) mesurés tôt dans la grossesse prédisaient fortement le comportement de l'enfant perçu négativement, médié par les symptômes de santé mentale des pères durant la grossesse et la discorde entre partenaires après la naissance. Deuxièmement les analyses de corrélation intraclasse ont montré que le comportement de l'enfant perçu des pères faisait preuve de stabilité substantielle entre 6 et 12 mois après la naissance. Des interventions sur la famille commençant durant la grossesse peuvent être plus bénéfiques au vu des expériences vécues des pères et les perceptions de l'attachement durant la grossesse étaient liées à la discorde ultérieure entre les partenaires et au stress.

DNA methylation changes in infants between 6 and 52 weeks.

Infants undergo extensive developments during their first year of life. Although the biological mechanisms involved are not yet fully understood, changes in the DNA methylation in mammals are believed to play a key role. This study was designed to investigate changes in infant DNA methylation that occurs between 6 and 52 weeks. A total of 214 infant saliva samples from 6 or 52 weeks were assessed using principal component analyses and t-distributed stochastic neighbor-embedding algorithms. Between the two time points, there were clear differences in DNA methylation. To further investigate these findings, paired two-sided student's t-tests were performed. Differently methylated regions were defined as at least two consecutive probes that showed significant differences, with a q-value < 0.01 and a mean difference > 0.2. After correcting for false discovery rates, changes in the DNA methylation levels were found in 42 genes. Of these, 36 genes showed increased and six decreased DNA methylation. The overall DNA methylation changes indicated decreased gene expression. This was surprising because infants undergo such profound developments during their first year of life. The results were evaluated by taking into consideration the extensive development that occurs during pregnancy. During the first year of life, infants have an overall three-fold increase in weight, while the fetus develops from a single cell into a viable infant in 9 months, with an 875-million-fold increase in weight. It is possible that the findings represent a biological slowing mechanism in response to extensive fetal development. In conclusion, our study provides evidence of DNA methylation changes during the first year of life, representing a possible biological slowing mechanism. We encourage future studies of DNA methylation changes in infants to replicate the findings by using a repeated measures model and less stringent criteria to see if the same genes can be found, as well as investigating whether other genes are involved in development during this period.

Prenatal maternal depressive symptoms and infant DNA methylation: a longitudinal epigenome-wide study.

Background: Prenatal maternal stress increases the risk of offspring developmental and psychological difficulties. The biological mechanisms behind these associations are mostly unknown. One explanation suggests that exposure of the fetus to maternal stress may influence DNA methylation. However, this hypothesis is largely based on animal studies, and human studies of candidate genes from single timepoints. Aim: The aim of this study was to investigate if prenatal maternal stress, in the form of maternal depressive symptoms, was associated with variation in genome-wide DNA methylation at two timepoints. Methods: One-hundred and eighty-four mother-child dyads were selected from a population of pregnant women in the Little-in-Norway study. The Edinburgh Postnatal Depression Scale (EPDS) measured maternal depressive symptoms. It was completed by the pregnant mothers between weeks 17 and 32 of gestation. DNA was obtained from infant saliva cells at two timepoints (age 6 weeks and 12 months). DNA methylation was measured in 274 samples from 6 weeks (n = 146) and 12 months (n = 128) using the Illumina Infinium HumanMethylation 450 BeadChip. Linear regression analyses of prenatal maternal depressive symptoms and infant methylation were performed at 6 weeks and 12 months separately, and for both timepoints together using a mixed model. Results: The analyses revealed no significant genome-wide association between maternal depressive symptoms and infant DNA methylation in the separate analyses and for both timepoints together. Conclusions: This sample of pregnant women and their infants living in Norway did not reveal associations between maternal depressive symptoms and infant DNA methylation.

Depressive symptom contagion in the transition to parenthood: Interparental processes and the role of partner-related attachment.

How depressive symptoms unfold within a couple during the perinatal events of pregnancy, childbirth, and early parenthood is poorly understood. In this prospective study, we aim to investigate the reciprocal relation between maternal and paternal depressive symptomatology, specifically how symptoms in 1 partner relate to subsequent symptom level changes in the other partner throughout the perinatal period. Further, we aim to identify parents who are particularly vulnerable to the development of disruptive processes of negative mood states. Data were collected from 1,036 mothers and 878 fathers participating in the Little in Norway study from midpregnancy until 12 months postpartum. Depressive symptoms were assessed at 7 time points (4 prenatally) in both parents. Partner-related attachment was measured early in pregnancy. By using an autoregressive latent trajectory modeling approach, accounting for time invariant confounding, we found mothers' depressive symptoms late in pregnancy to predict elevated symptom levels in fathers 6 weeks after birth, with a small effect size. No other time-adjacent effects were observed among partners at other time points or with the opposite directionality. However, moderation analyses revealed that among parents characterized by insecure partner-attachment styles, additional cross-lagged pathways were evident during pregnancy and throughout the first year of parenthood. Clinicians need to be aware of fathers' vulnerability to symptom development in instances of maternal perinatal depressive states at the time around childbirth, and tailor preventive and treatment efforts to address both parents' needs. Further, particular attention should be directed to parents with heightened susceptibility to prolonged depression contagion processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Parenting Stress Plays a Mediating Role in the Prediction of Early Child Development from Both Parents' Perinatal Depressive Symptoms.

Maternal postnatal depression has been associated with a broad range of developmental risk among children. However, there has been less focus on disentangling the effects of pre- and postnatal depressive symptoms, as well as examining the symptoms of both parents. This study aims to investigate the separate effects of pre- and postnatal depressive symptoms in mothers and fathers, and parents' differential effects on child social-emotional, cognitive, and language development at 18 months of age. Further, we investigate whether effects of depressive symptomatology on child outcomes are particularly strong when both parents evinced high symptom loads and whether parenting stress mediates associations between perinatal depressive symptoms and child developmental outcomes. The study used data from 1036 families participating in a community-based study from mid-pregnancy until 18 months postpartum. Depressive symptoms were assessed at seven time points (four prenatally). Within a structural equation framework, we found that parental perinatal depressive symptoms predicted child social-emotional functioning, specifically externalizing, internalizing, and dysregulation problems, as well as language developmental delay at 18 months. Controlling for postnatal symptoms we found no independent effect of prenatal depressive symptoms on any child outcomes. A differential effect was evident, linking maternal symptoms to social-emotional outcomes, and paternal symptoms to language outcomes. There was no evidence of stronger associations between depressive symptoms and child outcomes when both parents showed high symptom loads. However, parenting stress mediated most relations between parental depressive symptoms and child outcomes. Findings demonstrate the importance of including paternal depressive symptoms in both clinical and research contexts.

Quality of social interaction in foster dyads at child age 2 and 3 years.

The main aim of this study was to investigate the quality of social interaction between 60 foster parents and their foster children compared to a group of 55 non-foster families at 2 (T1) and again at 3 (T2) years of age. Video observations were used to investigate child-parent interaction at both time-points. "This is My Baby" interview was administered to investigate foster parents' commitment at T1. The main results revealed significant group differences at T1 on all child-parent social interaction measures, although not at T2. Further, a significant group by time interaction was identified for parental sensitivity, revealing a positive development over time in the foster group. Finally, a significant positive relation was found between commitment at T1 and parental sensitivity. The results convey an optimistic view of the possibilities for foster dyads to develop positive patterns of social interaction over time.

Early postpartum discharge: maternal depression, breastfeeding habits and different follow-up strategies.

BACKGROUND: In most maternity wards in Norway, early discharge (<48 hour) is the norm. To monitor newborns' and women's health during the first week after delivery, most maternity wards offer early check-ups, where families return to the hospital (standard care). However, a few municipalities offer home visits by midwives (domiciliary care) to ensure seamless services for the family. AIM: The primary aim of this study was to explore whether different follow-up strategies were differently associated with maternal depression and breastfeeding habits, 6 weeks and 6 months postpartum. The secondary aim was to investigate whether families at risk of postpartum depression were included in the home visiting programme in the municipality that offered both follow-up strategies. METHOD: This study draws on data from the 'Little in Norway' (LIN) study, which followed families from pregnancy until the child was 18 months. This study used data from two different well-baby clinics in two municipalities, where one offered standard care (n = 95) and the other domiciliary (n = 64) and standard care (n = 17). The Edinburg Postnatal Depression Scale (EPDS) was used to measure maternal depression. Breastfeeding habits were measured using a self-report questionnaire. The Life Stress subscale of the Parenting Stress Index (PSI) was used to identify women at risk of postpartum depression. RESULTS: There were no differences in maternal depressive symptoms or breastfeeding habits at neither 6 weeks nor 6 months postpartum between women who received standard or domiciliary care in the two municipalities. Within the municipality that offered both follow-up strategies, a higher number of women scoring high on prenatal life stress were included in domiciliary - compared to standard care. CONCLUSION: Differential follow-up strategies in the first week after birth did not impact on maternal depression or breastfeeding habits. However, domiciliary care seems to be regarded as supportive and nonstigmatising for women at risk of postpartum depression.

Little in Norway: a prospective longitudinal community-based cohort from pregnancy to child age 18 months.

PURPOSE: The Little in Norway (LiN) project is a cross-disciplinary prospective longitudinal study starting in pregnancy. It was set up to investigate maternal and paternal mental health functioning in the transition to parenthood, detect pathways to healthy and aberrant child development and generate new knowledge about mechanisms underlying differential child mental health susceptibility. PARTICIPANTS: The LiN cohort is a community-based sample comprising 1036 families (1036 mothers, 884 partners, 1017 children). All pregnant women and their partners receiving routine prenatal care at well-baby clinics at nine geographically selected sites across Norway were invited to participate. Enrolment took place from September 2011 to October 2012. This cohort profile comprises 10 data collection waves spanning from enrolment in pregnancy until child age 18 months. FINDINGS TO DATE: Four types of information have been collected: multi-informant questionnaire reports, direct observation of interaction, test data and biological samples. The most significant findings so far relate to three domains of results. First, when examining risk factors for parental mental health problems, results showed that the parents' own adverse childhood experiences and attachment style were related to anxiety, depression and stress in the perinatal period. The perception of difficult child temperament was also found to contribute to parenting stress in the first year after birth. Second, we studied how parental mental health risk factors were related to later child development and social emotional functioning, for example, linking maternal symptoms to social-emotional outcomes and paternal symptoms to language outcomes. Third, we investigated the relation between maternal nutrition during pregnancy and aspects of early child development. Results showed that mild to moderate maternal iodine deficiency in pregnancy was associated with poorer language skills up to 18 months, but not with reduced cognitive or fine and gross motor skills. FUTURE PLANS: A data collection point at 36 months is completed and currently being analysed. A new data collection wave is planned when the children are 8 years of age. TRIAL REGISTRATION NUMBER: ISRCTN66710572.

Sufficient iodine status among Norwegian toddlers 18 months of age - cross-sectional data from the Little in Norway study.

BACKGROUND: Inadequate iodine intake has been identified in several population groups in the Nordic countries over the past years; however, studies of iodine status in infants and toddlers are scarce. OBJECTIVE: The aim of this study is to evaluate the iodine status and dietary iodine sources among 18-month-old toddlers from Norway. METHODS: Cross-sectional and country representative data from the Little in Norway study were used. All children who had given a spot urine sample at 18 months age were included (n = 416). Urinary iodine concentration (UIC) was determined by inductively coupled plasma mass-spectrometry. Dietary habits and supplement use were measured by a food frequency questionnaire. RESULTS: Median (25th-75th percentiles [p25-p75]) UIC was 129 (81-190) µg/L while estimated median (p25-p75) habitual iodine intake was 109 (101-117) µg/day. None of the children were below the estimated average requirement (EAR) of 65 µg/day or above the upper intake level of 180 µg/day. There were no differences in either UIC or estimated habitual iodine intake between different geographic areas in Norway. Milk was the most important iodine source, contributing an estimated 70% to the total iodine intake, while other foods rich in iodine such as seafood and enriched baby porridge contributed about 30%. CONCLUSIONS: The iodine status among 18-month-old toddlers from different geographic areas in Norway was sufficient, indicated by a median UIC above the WHO cutoff of 100 µg/L. This was further supported by the estimated habitual iodine intake, where none of the participants were below the EAR. Milk was an important iodine source in this age group; thus children with a low intake might be at risk of insufficient iodine intake.

The Multiple Determinants of Maternal Parenting Stress 12 Months After Birth: The Contribution of Antenatal Attachment Style, Adverse Childhood Experiences, and Infant Temperament.

Parenting stress can influence caregiving behavior negatively, which in turn may harm children's development. Identifying precursors of parenting stress, preferably beginning during pregnancy and throughout the first year of life, is therefore important. The present study aims to provide novel knowledge on this issue through a detailed examination of the association between maternal attachment style and later parenting stress. Moreover, we examine the role of several additional risk factors, specificially the mothers' own adverse childhood experiences (ACE), as well as infants' temperamental characteristics. Data from a community based longitudinal study of 1,036 Norwegian mothers, collected during pregnancy and 12 months after childbirth, were used. Results showed that attachment style in pregnancy predicted parenting stress 1 year after birth. In addition, it was demonstrated that the mothers' own ACEs predicted postnatal parenting stress, and that attachment style operated as a mediator of this association. A significant association between perceived infant temperament and parenting stress was also found. The study illustrates the importance of understanding the multifactorial antecedents of parenting stress. The results may inform early intervention efforts aimed at supporting mothers and their partners in the potentially difficult transition period around childbirth.