Low autonomic arousal as vulnerability to externalising behaviour in infants with hostile mothers

Maternal psychopathology and the child's autonomic nervous system functioning are risk factors for aggressive behaviour later in life. While research has shown that maternal psychopathology already affects young children, less is known about the association between autonomic functioning and aggressive behaviour in young children. In addition, maternal psychopathology and autonomic nervous system functioning may interact to determine the risk of aggressive behaviour.In a sample of 375 infants and their mothers, maternal psychiatric symptoms were assessed with the Brief Symptom Inventory and toddler aggressive behaviour with the Child Behaviour Checklist. Infant heart rate was recorded at 14 months.Maternal psychiatric problems, including hostility and depression, were associated with toddler aggressive behaviour. Maternal psychiatric problems interacted with mean heart rate (P = 0.01) and HF variability (P = 0.03) in their effect on toddler aggressive behaviour.Mothers with high psychiatric problems, in particular, high hostility, were more likely to have toddlers with high aggressive behaviour. Moreover, in the presence of maternal risk factors, low autonomic arousal renders children particularly susceptible to aggressive behaviour.     

Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

Acute otitis media is the most frequent diagnosis in children visiting physicians?? offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n?=?7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14?months in the focus cohort (n?=?1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6?months of life and between 6 and 12?months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24?C2.71 and aOR 2.72, 95% CI 2.18?C3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13?C1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life.     

Natural antibodies against several pneumococcal virulence proteins in children during the pre-pneumococcal-vaccine era: the generation R study

The currently available pneumococcal vaccines do not protect against all serotypes of Streptococcus pneumoniae. A shift toward nonvaccine serotypes causing colonization and invasive disease has occurred, and studies on protein-based vaccines have been undertaken. We assessed the association between specific antibodies against pneumococcal virulence proteins and colonization and respiratory tract infections (RTIs). Additionally, we assessed the extent to which colonization induces a humoral immune response. Nasopharyngeal swabs collected from children at 1.5, 6, 14, and 24 months of age were cultured for pneumococcus. Serum samples were obtained at birth and at 6, 14, and 24 months (n = 57 children providing 177 serum samples). Data were collected prior to the pneumococcal vaccine era. IgG, IgA, and IgM levels against 17 pneumococcal protein vaccine candidates were measured using a bead-based flow cytometry technique (xMAP; Luminex Corporation). Information regarding RTIs was questionnaire derived. Levels of IgG against all proteins were high in cord blood, decreased in the first 6 months and increased again thereafter, in contrast to the course of IgA and IgM levels. Specific antibodies were induced upon colonization. Increased levels of IgG against BVH-3, NanA, and SP1003 at 6 months, NanA, PpmA, PsaA, SlrA, SP0189, and SP1003 at 14 months, and SlrA at 24 months were associated with a decreased number of RTIs in the third year of life but not with colonization. Maternal antipneumococcal antibodies did not protect against pneumococcal colonization and infection. Certain antibodies against pneumococcal virulence proteins, some of which are induced by colonization, are associated with a decreased number of RTIs in children. This should be taken into account in future pneumococcal vaccine studies.     

Attachment,depression, and cortisol: Deviant patterns in insecure‐resistant and disorganized infants

Both attachment insecurity and maternal depression are thought to affect infants' emotional and physiological regulation. In the current study, Strange Situation Procedure (SSP) attachment classifications, and cortisol stress reactivity and diurnal rhythm were assessed at 14 months in a prospective cohort study of 369 mother–infant dyads. Maternal lifetime depression was diagnosed prenatally using the Composite International Diagnostic Interview (CIDI). Insecure‐resistant infants showed the largest increase in cortisol levels from pre‐ to post‐SSP; the effect was even stronger when they had depressive mothers. Disorganized children showed a more flattened diurnal cortisol pattern compared to nondisorganized children. Findings are discussed from the perspective of a cumulative risk model. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 441–452, 2010.     

Maternal Sensitivity and Internalizing Problems: Evidence from Two Longitudinal Studies in Early Childhood

The goal of this study is to clarify the relation between maternal sensitivity and internalizing problems during the preschool period. For this purpose, a longitudinal, bidirectional model was tested in two large prospective, population-based cohorts, the Generation R Study and the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD), including over 1,800 mother–child dyads in total. Maternal sensitivity was repeatedly observed in mother–child interaction tasks and information on child internalizing problems was obtained from maternal reports. Modest but consistent associations between maternal sensitivity and internalizing problems were found in both cohorts, confirming the importance of sensitive parenting for positive development in the preschool years. Pathways from maternal sensitivity to child internalizing problems were consistently observed but child-to-mother pathways were only found in the NICHD SECCYD sample.     

Role of dietary patterns,sedentary behaviour and overweight on the longitudinal development of childhood constipation: the Generation R study

The influence of childhood nutrition on the development of constipation beyond the period of weaning and breastfeeding is relatively understudied. In addition, eating patterns in childhood can be highly correlated with overweight and sedentary behaviour, which may also have an influence on constipation. The aim of this study was to assess whether common dietary patterns, sedentary behaviour and childhood overweight are associated with constipation in childhood. The study was embedded in a population‐based prospective birth cohort. Information on dietary intake was obtained by a food frequency questionnaire at the child's age of 14 months (n = 2420). The adherence scores on a ‘Health conscious’ and ‘Western‐like’ diet were extracted from principal component analysis. At the age of 24, 36 and 48 months, information on constipation and sedentary behaviour, and weight and height was obtained by parental‐derived questionnaires and from the child health centres, respectively. Adherence to a ‘Western‐like’ dietary pattern was associated with a higher prevalence of constipation up to 48 months [adjusted odds ratio (aOR); 95% confidence interval (CI): 1.39; 1.02–1.87], which was not mediated by overweight or sedentary behaviour. Adherence to a ‘Health Conscious’ dietary pattern was only associated at short term, with a lower prevalence of constipation at 24 months (aOR; 95%CI: 0.65; 0.44–0.96). No association was found between overweight, sedentary behaviour and constipation. Our results suggest that specific dietary patterns in early childhood could be associated with higher or lower risks for constipation, but these effects are time‐dependent. Overweight and sedentary behaviour seem to not have a major role on constipation in childhood.     

Differences in Quality of Antenatal Care Provided by Midwives to Low‐Risk Pregnant Dutch Women in Different Ethnic Groups

Introduction: The objective of this study was to evaluate whether differences existed in the adherence to the Dutch national guidelines regarding basic antenatal care by Dutch midwives for low‐risk women of different ethnic groups. Methods: This was an observational study using data from electronic antenatal charts of 7 midwife practices (23 midwives), participating in the Generation R Study. The Generation R Study is a multiethnic, population‐based, prospective, cohort study that is investigating the growth, development, and health of urban children from fetal life until young adulthood. The study is conducted in Rotterdam, The Netherlands. The antenatal charts of 2093 low‐risk pregnant women with an expected birthing date in 2002 through 2004 were used to determine the mean quality of antenatal care scores for 7 ethnic groups. These scores reflected the degree of adherence to the guidelines regarding 10 tests and examinations. Results: Few differences between ethnic groups were found in adherence to the guidelines that addressed the obstetric‐technical quality of antenatal care. This finding applied more to nulliparous than to multiparous women. Adherence to guidelines was not always better in the antenatal care provided to native Dutch multiparous women when compared to other ethnic groups. Midwives adhered well to the guidelines regarding most tests. For all women, irrespective of ethnic background, hemoglobin was not measured as often as recommended, and this was especially the case for Moroccan, Surinamese‐Creole, and Dutch‐Antillean multiparous women. Discussion: The poorer adherence regarding screening for hemoglobin needs further investigation, as women with African or Mediterranean heritage are more at risk for hemoglobinopathies. However, in general, midwives adhered well to the clinical guidelines regarding most tests irrespective of the ethnic background of the pregnant women. When differences were present, these were not systematically less favorable for non‐Dutch pregnant women.