Psychopathology Symptoms are Associated with Prenatal Health Practices in Pregnant Women with Heavy Smoking Levels

Purpose

Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy.

Methods

Birth mothers from an adoption study (N?=?912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum.

Results

One-quarter of participants (N?=?222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β?=????.14, p?=?.03) and depressive symptoms (β?=????.17, p?=?.03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β?=?.12, p?=?.01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers.

Conclusions for Practice

Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.

     

Gene × Environment Interactions in the Development of Preschool Effortful Control,and Its Implications for Childhood Externalizing Behavior

This study examined the role of gene × environment interaction (G × E) in the development of effortful control (EC) and externalizing symptoms (EXT). Participants included 361 adopted children, and their Adoptive Parents (APs) and Birth Mothers (BMs), drawn from the Early Growth and Development Study. The primary adoptive caregivers’ (AP1) laxness and overreactivity were assessed when children were 27-months-old, and used as indices of environmental influences on EC. Heritable influences on child EC were assessed by the BMs’ personality characteristics (emotion dysregulation, agreeableness). Secondary adoptive caregivers (AP2) reported on children’s EC at 54 months, and EXT at 7 years. Interactions between BM characteristics and AP1 laxness were related to EC and indirectly predicted EXT via EC. Parental laxness and EC were positively associated if children had high heritable risk for poor EC (BM high emotion dysregulation or low agreeableness), but negatively associated if children had low heritable risk for poor EC (BM low emotion dysregulation or high agreeableness). BM agreeableness also moderated associations between AP1 overreactivity and effortful control, and yielded a similar pattern of results. Our findings suggest that G × E is an important first step in the development of EXT via its effect on EC. Consistent with “goodness of fit” models, heritable tendencies can affect which parenting practices best support EC development.

     

Gastric mucosal damage induced by combination of ethanol and lysophosphatidylcholine

The purpose of this study was to determine the effect of lysophosphatidylcholine on the guinea pig stomach after dosing the animal with 20% ethanol by orogastric intubation. We studied four groups of animals; one control group received saline orogastrically followed by buffer and one test group received saline followed by buffer plus 1 mM lysophosphatidylcholine. Two other groups were challenged with 20% ethanol (5 ml) orogastrically followed by buffer or buffer plus 1 mM lysophosphatidylcholine. Compared to other groups, the stomachs of animals given ethanol followed by lysophosphatidylcholine displayed statistically significant increases in the number of gross hemorrhagic lesions, in back-diffusion of hydrogen ion, in net secretion of sodium ion and in morphologic damage. Transmucosal potential differences in this group were also decreased. We conclude that 90 min after dosing with ethanol, the guinea pig stomach is more susceptible to damage by lysophosphatidylcholine. Our data further suggest that these agents cause mucosal damage by different mechanisms and that the combination acts synergistically.This work was supported by funds from the Research Service of the Veterans Administration.These results were presented in part at the Annual Meeting of the Research Society on Alcoholism, Isle of Palms, South Corolina, May 29–June 1, 1985, and were published in abstract form (Alcoholism. Clin Exp Res 9:201, 1985).     

Pancreatitis with arthropathy and subcutaneous fat necrosis

The occurrence of peripheral fat necrosis in exceptional cases of pancreatic disease is not well understood. We report studies on such a patient with arthropathy and subcutaneous nodules. Examination of serial serum samples demonstrated striking elevations of the pancreatic enzymes phospholipase A, 3–3.4 units/ml (normal 0.17–0.41); lipase, 7–39 Sigma-Tietz units/ml (normal < 1); immunoreactive trypsin, 912–3,207 ng/ml (normal 12–41). The distinguishing characteristic of the patient's synovial fluid was a marked elevation of hydrolized fatty acids (680 mg/dl versus 19 ± 19 in control inflammatory joint fluids). Synovial fluid fatty acid distribution was identical to values for tissue fat. In contrast, serum fatty acid levels and distribution were normal. No associated proteinase inhibitor or significant immunologic abnormality was detected. Certain properties of adipose cells and lipolytic enzymes may help explain the characteristically selective necrosis of fat cells observed in this syndrome.     

Structured Parenting of Toddlers at High Versus Low Genetic Risk: Two Pathways to Child Problems

ObjectiveLittle is known about how parenting might offset genetic risk to prevent the onset of child problems during toddlerhood. We used a prospective adoption design to separate genetic and environmental influences and test whether associations between structured parenting and toddler behavior problems were conditioned by genetic risk for psychopathology.MethodThe sample included 290 linked sets of adoptive families and birth mothers and 95 linked birth fathers. Genetic risk was assessed via birth mother and birth father psychopathology (anxiety, depression, antisociality, and drug use). Structured parenting was assessed via microsocial coding of adoptive mothers' behavior during a cleanup task. Toddler behavior problems were assessed with the Child Behavior Checklist.ResultsControlling for tempera mental risk at 9 months, there was an interaction between birth mother psychopathology and adoptive mothers' par enting on toddler behavior problems at 18 months. The interaction indicated two pathways to child problems: structured parenting was beneficial for toddlers at high genetic risk but was related to behavior problems for toddlers at low genetic risk. This crossover interaction pattern was replicated with birth father psychopathology as the index of genetic risk.ConclusionsThe effects of structured parenting on toddler behavior problems varied as a function of genetic risk. Children at genetic risk might benefit from parenting interventions during toddlerhood that enhance structured par enting. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(11):1102–1109.     

The Metabolic Fate of Double-Labeled Disulfiram

The metabolic fate of disulfiram labeled with both 14C and 35S was studied in the rat. After administration of 50 mg of 14C, 35S-disulfiram dissolved in corn oil to rats by stomach tube, 95% of the radioactivity was recovered in urine, feces, and expired air at 144 hr. The major portion of the excreted radioactivity was in urine (75 +/- 6%). Feces and expired air contained 13 +/- 2% and 6 +/- 5% of the body organs or carcass. Pretreatment of rats with unlabeled disulfiram for 20 days prior to administration of 14C, 35S-disulfiram led to more rapid catabolism of the drug and more rapid excretion of radioactivity in the urine during the first 12 hr after dosing.