A new piece of research is the first to consider the impact of postnatal depression (PND) on the mother-child relationship in the longer-term, and on intergenerational relationships. (via Science Daily)
The researchers from the University of Kent surveyed over 300 women (predominantly from the UK and US) with an average age of 60 and who had given birth to an average of 2.2 children. Their children ranged in age from 8 to 48, with an average age of 29 and many of whom now had their own children. This wide-ranging data set allowed them to assess the impact of PND over a longer time frame than has been hitherto examined. They used their responses to this retrospective questionnaire study to assess the consequences of PND across two generations, the original mother-child relationship (generation 1) across the life of the child (generation 2) and the quality of the relationship they had with their child’s child/ren (generation 3).
They concluded that the average mother-child relationship quality was lower when the child’s birth was associated with PND. Their data showed that women who had PND reported lower relationship quality with their offspring, including those children who are now adults and that the worse the PND had been, the worse the quality of their relationship. (Peer J)
Postnatal depression (PND) is known to be associated with a range of detrimental child and adolescent outcomes, resulting from its disruptive impact on mother-child relationship quality. However, until now little has been known about the impact of PND on the longer-term relationships between mothers and their children, and any intergenerational effects this may have.
Mother-child relationship quality is of interest from an evolutionary perspective as it plays a role in the accrual of offspring embodied capital, thus affecting offspring quality and offspring’s capacity to subsequently invest in their own children. Relationships with offspring also mediate grandparent-grandchild relations; if PND negatively affects long-term mother–offspring relationship quality, it is also likely to negatively affect grandmaternal investment via reduced grandmother–grandchild relationship quality. Here, we use responses to a retrospective questionnaire study of postmenopausal women, to assess the impact of PND occurring in generation 1 on mother–child relationship quality across the life course of the child (generation 2) with whom it was associated, and also on the relationship quality with grandchildren (generation 3) from that child.
Average mother-child relationship quality was lower when the child’s birth was associated with PND. Additionally, intergenerational relationships appear to be affected, with PND negatively associated with grandmother-grandchild relations (individual grandmothers n = 125, relations with grandchildren from n = 197 grandmother-parent dyads). That PND has long-term detrimental consequences for mother-child relationships, well beyond adolescence, highlights the need for investment in strategies to prevent PND and its cascade of negative multigenerational effects.
Full reference: Myers S, Johns SE |(2018)| Postnatal depression is associated with detrimental life-long and multi-generational impacts on relationship quality. PeerJ6:e4305https://doi.org/10.7717/peerj.4305
NHS Improvement have published this guide to support maternity safety champions at every levels (fron line, trust board and regional). It outlines the role descriptions and responsibilities for maternity safety champions, suggests activities to promote best practice, and also signposts existing safety initiatives and improvements that can offer support. The full guide is available from NHS Improvement here .
Intrapartum care for a positive childbirth experience | The World Health Organization
This guideline brings together new and existing WHO recommendations that, when delivered as a package, will ensure good-quality and evidence-based care irrespective of the setting or level of health care.
It highlights the importance of woman-centred care to optimize the experience of labour and childbirth for women and their babies.
The Healthy Lifestyle Programme delivered to 9-10-year-old school children did not reduce their weight over the course of two years. Around a third remained overweight or obese, the same as in schools that followed the standard syllabus.
This trial, funded by the NIHR, assigned schools across Devon to follow a lifestyle programme in Year five. The comprehensive curriculum included drama and activity workshops, personal goal setting and parental involvement.
Children made better food choices, but this did not affect weight outcomes. It was almost certain the programme wouldn’t give value for money.
Programmes addressing the wider school environment or delivered at the community or population level may have greater scope for preventing obesity.
Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly ever eat them. Their diets were also higher in fat and lower in protein and calcium.
This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern.
Increasing numbers of people are eating takeaways in the UK. Local authorities and healthcare professionals are well placed to encourage parents and children to choose healthier foods, in line with current national guidance.
May, P. , A. et al. | Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities | JAMA| 2018| 319| Vol. 5| DOI: 10.1001/jama. 2017.21896
Researchers from University Of California, Sand Diego School of Medicine looked at 4 regions in the US between 2010 and 2016, examined the incidence of fetal alcohol spectrum disorders (FASD); found that a significant number had fetal alcohol spectrum disorders. The findings of this study, may represent more accurate prevelance rates of FASD than previous studies indicate.
Importance Fetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples.
Objective To estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States.
Design, Setting, and Participants Active case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled.
Exposures Alcohol consumption during pregnancy.
Main Outcomes and Measures Prevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation.
Results A total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children.
Conclusions and Relevance Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach.
The full article is available for Rotherham NHS staff from the hospital library or can be requested here