Stress-related eating in pregnancy? An RCT examining links between prenatal stress and food choices.

BACKGROUND: Diet quality during pregnancy is important for maternal health and offspring development. However, national dietary recommendations are not always met. A potential barrier for healthy food choices might be the experience of stress. Previous literature in non-pregnant populations suggests a negative effect of acute stress on diet quality. This preregistered study is the first to test whether an acute stressor leads to unhealthy food choices in pregnancy and examine the moderating role of stress, depressive and anxiety complaints in daily life. METHOD: Pregnant women (N = 110, 3rd trimester) completed online self-reported surveys measuring stress, depressive and anxiety complaints in daily life. Hereafter, participants were invited for a laboratory visit, in which they were exposed to the Trier Social Stress Test or a control task. After this manipulation, self-reported and actual food choices and food intake were assessed. At the end of the visit, a hair sample was collected. Throughout the visit, visual analogue scales on negative affect were completed and saliva samples were collected. RESULTS: The stress group experienced significantly more psychological stress than the control group during the experimental manipulation. Main regression analyses showed that the acute laboratory stressor did not cause unhealthy food choices in the third trimester of pregnancy. In fact, the stress group chose fewer unhealthy foods and consumed fewer kilocalories compared to the control group. Additionally, the findings point at a moderating role of depressive and stress complaints in daily life on food choices within the control group: higher scores were related to more unhealthy food choices and more kilocalories consumed. DISCUSSION: As this was the first study to test the effect of an acute stressor on food choices in pregnant women, more research is needed to obtain a better understanding of stress-related eating in pregnancy. This knowledge may inform future interventions to support pregnant women in improving their diet quality.

Urbanicity, hypothalamic-pituitary-adrenal axis functioning, and behavioral and emotional problems in children: a path analysis.

BACKGROUND: Urbanization is steadily increasing worldwide. Previous research indicated a higher incidence of mental health problems in more urban areas, however, very little is known regarding potential mechanisms underlying this association. We examined whether urbanicity was associated with mental health problems in children directly, and indirectly via hypothalamic-pituitary-adrenal (HPA)-axis functioning. METHODS: Utilizing data from two independent samples of children we examined the effects of current urbanicity (n = 306, ages seven to 12 years) and early childhood urbanicity (n = 141, followed from birth through age 7 years). Children's mothers reported on their mental health problems and their family's socioeconomic status. Salivary cortisol samples were collected during a psychosocial stress procedure to assess HPA axis reactivity to stress, and at home to assess basal HPA axis functioning. Neighborhood-level urbanicity and socioeconomic conditions were extracted from Statistics Netherlands. Path models were estimated using a bootstrapping procedure to detect indirect effects. RESULTS: We found no evidence for a direct effect of urbanicity on mental health problems, nor were there indirect effects of urbanicity through HPA axis functioning. Furthermore, we did not find evidence for an effect of urbanicity on HPA axis functioning or effects of HPA axis functioning on mental health problems. CONCLUSIONS: Possibly, the effects of urbanicity on HPA axis functioning and mental health do not manifest until adolescence. An alternative explanation is a buffering effect of high family socioeconomic status as the majority of children were from families with an average or high socioeconomic status. Further studies remain necessary to conclude that urbanicity does not affect children's mental health via HPA axis functioning.

Association between Psychosocial Stress and Fecal Microbiota in Pregnant Women.

Maternal prenatal psychosocial stress is associated with altered child emotional and behavioral development. One potential underlying mechanism is that prenatal psychosocial stress affects child outcomes via the mother's, and in turn the child's, intestinal microbiota. This study investigates the first step of this mechanism: the relation between psychosocial stress and fecal microbiota in pregnant mothers. Mothers (N = 70) provided a late pregnancy stool sample and filled in questionnaires on general and pregnancy-specific stress and anxiety. Bacterial DNA was extracted and analysed by Illumina HiSeq sequencing of PCR-amplified 16 S ribosomal RNA gene fragments. Associations between maternal general anxiety and microbial composition were found. No associations between the other measured psychosocial stress variables and the relative abundance of microbial groups were detected. This study shows associations between maternal pregnancy general anxiety and microbial composition, providing first evidence of a mechanism through which psychological symptoms in pregnancy may affect the offspring.

Childhood urbanicity and hair steroid hormone levels in ten-year-old children.

BACKGROUND: Research suggests that it may be more stressful for children to grow up in an urban area than in a rural area. Urbanicity may affect physiological stress system functioning as well as the timing of sexual maturation. The purpose of the current study was to investigate whether moderate urbanicity (current and childhood, ranging from rural areas to small cities) was associated with indices of long-term hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axis functioning (cortisol, cortisone, dehydroepiandrosterone and progesterone levels) and whether sex moderated any associations. METHOD: Children (N = 92) were all 10 years old and from the Dutch general population. Hair samples were collected and single segments (the three cm most proximal to the scalp) were assayed for concentrations of steroid hormones (LCMS/MS method). Neighborhood-level urbanicity and socioeconomic status were measured from birth through age ten years. Analyses were controlled for neighborhood- and family socioeconomic status, body mass index and season of sampling. RESULTS: The results from multivariate analyses of variance showed no associations between current or childhood moderate urbanicity and hair steroid hormone concentrations. Interaction terms between moderate urbanicity and sex were not statistically significant. CONCLUSIONS: Associations between urbanicity and steroid hormone levels may only be detectable in highly urban areas and/or during later stages of adolescence. Alternatively, our findings may have been due to most children being from families with a higher socioeconomic status.

Childhood BMI in relation to microbiota in infancy and lifetime antibiotic use.

BACKGROUND: Children with high body mass index (BMI) at preschool age are at risk of developing obesity. Early identification of factors that increase the risk of excessive weight gain could help direct preventive actions. The intestinal microbiota and antibiotic use have been identified as potential modulators of early metabolic programming and weight development. To test if the early microbiota composition is associated with later BMI, and if antibiotic use modifies this association, we analysed the faecal microbiota composition at 3 months and the BMI at 5-6 years in two cohorts of healthy children born vaginally at term in the Netherlands (N = 87) and Finland (N = 75). We obtained lifetime antibiotic use records and measured weight and height of all children. RESULTS: The relative abundance of streptococci was positively and the relative abundance of bifidobacteria negatively associated with the BMI outcome. The association was especially strong among children with a history of antibiotic use. Bacteroides relative abundance was associated with BMI only in the children with minimal lifetime antibiotic exposure. CONCLUSIONS: The intestinal microbiota of infants are predictive of later BMI and may serve as an early indicator of obesity risk. Bifidobacteria and streptococci, which are indicators of microbiota maturation in infants, are likely candidates for metabolic programming of infants, and their influence on BMI appears to depend on later antibiotic use.

Young adults' reactions to infant crying.

An infant's optimal development is determined to a great extent by the adequate and sensitive responses of the caregiver. The adequacy and sensitivity of a reaction to an infant in distress (i.e. crying) will partly depend on the causal attributions of the crying and on the individual's sympathy for the infant. Being female, prior caring experiences, and multiparity have shown to be linked to more sympathetic, tolerant and less hostile emotional responses to crying. However, little is known about other factors explaining inexperienced future caregivers' reactions to infant crying. The present paper's goal is to shed more light on the subject by looking at how personality factors, caregiving interest, sex, promptness of the reaction, and gender identity are related to emotional reactions and causal attributions to crying in a population of young adults without children. One hundred and ninety-one childless university students participated (126 females; ages 18-35 years). The participants completed questionnaires on personality, gender identity and caregiving interest, and listened to an audio sample of an infant crying, reporting their emotions and their causal attributions to the crying. The results showed that experiencing anger was associated with more child-blaming attributions to the crying, while quickness of response and feelings of sympathy predicted more child-oriented attributions. The latter was stronger in males. Explicit care interest decreased child-blaming causal attributions more for men than for the women. Interestingly, solely in the females' personality factors neuroticism and conscientiousness played a role in child blaming attributions together with anger. These findings suggest that the motives that young adults attribute to a crying infant depend in males on the emotions triggered by the crying, responsiveness and care interest. While in females, emotions, responsiveness and personality affect the causal attribution to the crying. Future research is needed in order to determine whether these attributions are also linked to young adults' actual behaviour towards a crying infant.

Cortisol reactions to a social evaluative paradigm in 5- and 6-year-old children.

The goal of the present study was to develop a stress paradigm to elicit cortisol secretory responses in a group of 5- and 6-year-old children as a whole. To this end, we tested a paradigm containing elements of social evaluative threat, unpredictability and uncontrollability, and with a duration of 20 min. The Children's Reactions to Evaluation Stress Test is composed of three short tasks that children have to perform in front of a judge. The tasks are rigged so as to provoke (partial) failure in the child's performance. Participants were 42 children (M = 68.0 months, SD = 4.3). Six saliva samples were taken during the testing session to obtain cortisol measurements of baseline concentrations, stress reactivity, and recovery. Our findings showed that this paradigm was effective in provoking a significant increase in salivary cortisol concentration in the group as a whole, with no effects of possible confounders (child's sex, age or school, parental educational level, time of testing, sex of experimenter, and sex of judge). The mean cortisol concentration increase for the group was 127.5% (SD = 190.9); 61% of the children could be classified as reactors (mean increase of 214%, SD = 201.5), and 39% as non-reactors (mean decrease of 7.8%, SD = 16.8). To our knowledge, this is the first study in this age group that shows a significant cortisol response for the group as a whole to a standardized laboratory paradigm. As such, this paradigm is a promising tool to be used in future research on early life interactions between physiology and psychology.

Solitary sleeping in young infants is associated with heightened cortisol reactivity to a bathing session but not to a vaccination.

BACKGROUND: In this prospective longitudinal study, we investigated the relation between sleeping arrangements and infant cortisol reactivity to stressors in the first two post-natal months. Co-sleeping, as compared to solitary sleeping, is hypothesized to provide more parental external stress regulation by night, thus reducing general stress sensitivity. We therefore expected lower cortisol reactivity to stress in infants who co-slept more regularly. METHODS: Participants were 163 mothers and infants from uncomplicated, singleton pregnancies. Mothers completed daily diaries on sleeping arrangements in the first 7 weeks of life. Co-sleeping was defined as sleeping in the parents' bedroom (i.e. own or parents' bed). Cortisol reactivity was measured twice: to a mild physical stressor (bathing session) at 5 weeks of age and to a mild pain stressor (vaccination) at 2 months of age. RESULTS: Infants with a solitary sleeping arrangement in their first month of life showed a heightened cortisol response to the bathing session at 5 weeks compared to infants that co-slept regularly. This effect was not explained by breastfeeding practices, maternal caregiving behavior, or infants' night waking and sleep duration. No effects were found of co-sleeping on the cortisol response to the vaccination at 2 months. CONCLUSIONS: The results suggest that solitary sleeping in the first month of life is associated with heightened sensitivity of the HPA-axis to a mild stressor, possibly due to less nocturnal parental availability as external stress regulator. Whether this effect continues in later life, remains to be investigated.

Maternal prenatal stress and cortisol reactivity to stressors in human infants.

Early life factors can shape the development of hypothalamic pituitary adrenal (HPA) axis. Maternal prenatal stress might constitute such an early environmental factor. As little is known about the relation between maternal prenatal stress and cortisol reactivity in human offspring, we performed a longitudinal study including four assessments of infant cortisol reactivity to stressful events in a non-clinical population. General and pregnancy-related feelings of stress and anxiety, as well as circadian cortisol levels, were measured in 173 mothers in the last trimester of pregnancy. Infant cortisol reactivity was measured at 5 weeks to a bathing session, at 8 weeks to a vaccination, at 5 months to a stressful mother-infant interaction (still face procedure), and at 12 months to a maternal separation (strange situation procedure). Maternal prenatal fear of bearing a handicapped child was a consistent predictor of infant cortisol reactivity. Although the effects were mild, higher fear was significantly related to higher salivary cortisol reactivity to the bathing session and to decreased cortisol reactivity to vaccination and maternal separation. Thus, pregnancy-specific anxieties predict infant cortisol reactivity in the first year of life, but the direction of the effect depends on infant age and/or the nature of the stressor. While this specific anxiety was a better predictor than stress experience or maternal cortisol concentrations, the underlying mechanisms of these associations remain unclear. Future studies should try to incorporate multiple measures of HPA-axis reactivity during development when studying the long-term consequences of maternal prenatal stress.

Five-year-olds' cortisol reactions to an attachment story completion task.

An earlier study showed that negative parent-child interactions elicit cortisol increases in 5-year-old children (Smeekens et al., 2007a). In the present study, we examined whether an "imaginary" parent-child interaction situation, in which the child used a parent and child doll to complete a set of more or less stressful story beginnings, also elicited cortisol increases in the children. In a sample of 89 five-year-old children (47 boys), an attachment story completion task (Verschueren and Marcoen, 1994) was administered during a school visit. Saliva samples to assess children's cortisol levels were collected right after arrival of the experimenter at the school (T0, baseline), immediately prior (T1, pretest) and 20min after (T2, posttest) the completion of the task. Hierarchical regression analysis indicated that children who displayed more insecure stories (i.e., stories depicting the parent as unavailable, unsupportive, or hostile) showed larger relative cortisol increases, but only if they had highly negative parent-child interactions 1 week earlier. Children who did not have negative interactions with the parent showed no cortisol increases when playing insecure stories. The results suggest that it is not the playing of insecure stories itself but perhaps the emotional memories of negative parent-child interactions triggered while playing insecure stories that elicit cortisol increases in children. This underscores the profound impact that negative interactions with parents may have on children's functioning and development, not only at the behavioural and emotional level, but also at the level of physiological arousal and regulation. Results also suggest that a secure attachment to one parent may act as a buffer against negative effects of low-quality interactions with the other parent, but more research is needed to more thoroughly test this assumption.

Intraindividual variability in infant behavior.

Longitudinal observational data of infant crying, fretting/fussing, and smiling and the time spent in physical contact with the mother were used in a study on behavioral variability. The infants were followed weekly for a 15-month period. Evidence was found of an important intraindividual variability in the studied behaviors, specifically between the ages of 0 and 5 months, 5 and 10 months, but not between 10 and 15 months. Results are discussed and analyzed in the light of earlier literature. The possible functions and the factors underlying variability in development as well as its methodological implications are discussed.

Empirische indicatoren voor regressies en sprangen bij baby's.

Het is al lang bekend dat het optreden van ontwikke-lingsmijlpalen sterk van baby tot baby kan verschillen. Theorieën of modellen die daarentegen een strakke timing, gepaard gaande met geringe individuele verschillen, voor ontwikkelingsverschijnselen postuleren, hebben dan ook een zware bewijslast te torsen. Het model van Van de Rijt-Plooij en Plooij van tien strak getimede regressieperioden tijdens de eerste achttien levensmaanden is een voorbeeld van een dergelijk model. In het licht van het feit dat het model mede ten grondslag ligt aan een wijd verspreid praktisch adviezenboek voor ouders, mag worden verwacht dat de empirische ondersteuning er-voor uitgebreid en hecht is. In deze bijdrage zullen we de empirische evidentie voor en tegen het model bespreken en ingaan op de methodologische problemen die bij het verifiëren dan wel falsifiëren van dit model kornen kijken.