The current study examined the interaction between maternal depressive symptoms and child tempera... more The current study examined the interaction between maternal depressive symptoms and child temperament in predicting subsequent child language skills. Participants were 252 mother-child dyads recruited from the All Our Families longitudinal cohort, a primarily middle-class sample (62.9% completed postsecondary education) from Alberta, Canada (90.5% White, 6% Asian, 3.5% other). Maternal depressive symptoms at age 3, controlling for prenatal depressive symptoms, did not evidence a direct effect on child language skills at age 5 (49.6% males; mean [M] = 5.12 years old, standard deviation [SD] = .11). However, both child surgency and effortful control interacted with maternal depression at age 3 to predict later language skills. Low effortful control was a risk factor for poorer language abilities in contexts of high maternal depressive symptoms. High child surgency emerged as a differential susceptibility marker, predicting poorer language skills in contexts of high maternal depressive symptoms but better language skills in contexts of low depressive symptoms. Negative affect did not interact with maternal depressive symptoms in predicting language skills. These findings highlight the complex interaction between maternal and child characteristics in predicting language development during a developmental period in which language skills are a prime indicator of school readiness and a predictor of future academic achievement and socioemotional adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
The evidence regarding the effects of a Single Room Maternity Care (SRMC) model on women’s childb... more The evidence regarding the effects of a Single Room Maternity Care (SRMC) model on women’s childbirth experiences, healthcare providers’ workplace satisfaction, and cost outcomes remains equivocal. The research questions for this focused ethnographic study are: how is culture experienced by nurses and other healthcare providers on the SRMC unit, and how do the values, beliefs, and norms of nurses and other healthcare providers on the SRMC unit influence their day-to-day practices of caring for women and their families. The aim of this qualitative focused ethnography was to explore the culture and practices of the healthcare team in a SRMC unit. Twelve healthcare providers were recruited from a Single Room Maternity Care unit located in a Western Canadian hospital. Semi-structured interviews, participant observations, and examination of unit-related documents were conducted between October 2014 and January 2015. Data were analyzed using an approach by Roper and Shapira (2000). Two ma...
provide all levels of oncologic care. The aim of this study was to assess the need for palliative... more provide all levels of oncologic care. The aim of this study was to assess the need for palliative care in hospitalised cancer patients in Mato Grosso do Sul, one of the Brazilian states that has no public hospital offering this type of care. Methods A descriptive study of all hospitalisations due to "complications of clinical oncology (ICPO)" in hospitals of the Unified Health System (SUS) in the state of Mato Grosso do Sul, Brazil, was conducted from January 2008 to August 2010. Data were obtained from the Hospital Information System of the Unified Health System (SIH-SUS). Results There were 5165 hospitalisations for ICPO with cancer as the underlying cause in 94.7%. Average length of stay was 6.2 days and 1189 patients (23.0%) died. Individuals aged 65 years or older accounted for 44.3% of these deaths and for every 3.5 hospital admissions in this age group, one ended in death. Many patients died without the appropriate care. Conclusion The ageing of the population and the increased incidence of cancer brought new challenges to the Brazilian Unified Health System, including the need for palliative care. This need is not always met for instance as in Mato Grosso do Sul. In this sense, deaths of patients hospitalised for ICPO can be thought of as indicators of advanced disease and they could be useful to national and state policies for oncologic palliative care.
What is already known about the topic? Pregnancy-related anxiety (PrA) constitutes a distinct con... more What is already known about the topic? Pregnancy-related anxiety (PrA) constitutes a distinct concept from general anxiety and depression and is more strongly associated with maternal and child outcomes. Several recent reviews identified the need for a welldeveloped scale with a rigorous theoretical basis for the assessment of PrA. The assessment of PrA has been limited, mainly due to its poor conceptualization. What this paper adds Three critical attributes, three antecedents, four consequences, and nine dimensions for PrA were identified and a definition of the concept was proposed. Current tools are useful to determine whether the concept exists and to capture selected domains. A tool that includes all dimensions and examines the consequences and severity of PrA is needed. This knowledge provides nursing and midwifery professions with a conceptual basis to identify PrA and also constitutes a groundwork for further development of the concept.
Research on the effects of adversity has led to mounting interest in examining the differential i... more Research on the effects of adversity has led to mounting interest in examining the differential impact of adversity as a function of its timing and type. The current study examines whether the effects of different types (i.e., physical, sexual, and emotional abuse) and timing (i.e., early, middle childhood, adolescence, or adulthood) of adversity on maternal mental and physical health outcomes in pregnancy, are best accounted for by a cumulative model or independent effects model. Women from a prospective pregnancy cohort (N =3,362) reported retrospectively on their experiences of adversity (i.e., physical, sexual, and emotional abuse) in early childhood (0–5 years], middle childhood (6–12 years], adolescence (13–18 years], and adulthood (19+ years]. Measures of overall health, stress, anxiety, and depression were gathered in pregnancy. Results showed that a cumulative formative latent model was selected as more parsimonious than a direct effects model. Results also supported a mode...
Journal of Undergraduate Research in Alberta, 2015
Introduction Self-regulation (SR) is the ability to alter behavioral responses in response to int... more Introduction Self-regulation (SR) is the ability to alter behavioral responses in response to interactions with the environment. Children who develop skills associated with high SR early in life are more prepared for school than children who fail to develop these skills. Methods An environmental scan was used to collect data from 3 Albertan parenting magazines: Apple Magazine, Calgary Child’s Magazine, and Red Deer Child’s Magazine published within January 2010- January 2015. A textual analysis was conducted to identify the overall SR messages presented to the public. Inductive coding was used to organize similar themes into larger categories and thereafter to determine how these Albertan media resources suggest the development of SR in children. Results Three themes emerged from the scan: parental role in the development of SR, disciplining children in way that builds SR, and coping mechanisms for parents in response to tantrums. Discussion Albertan media resources describe SR in a...
BACKGROUND: In Canada, it is estimated that nearly one in three children are overweight or obese ... more BACKGROUND: In Canada, it is estimated that nearly one in three children are overweight or obese (Roberts et al., 2012). With a myriad of contributing factors and potential for serious long-term health consequences, overweight/obesity status constitutes an urgent and complex public health issue (Avis et al., 2014). Moreover, recent reports suggest that approximately 35-38% in American children with Autism Spectrum Disorder (ASD) are overweight or obese, higher than the general population (Sharp et al., 2014; Zuckerman et al., 2014). To date, no studies have looked at weight status among children with ASD in a Canadian population. OBJECTIVES: To determine the prevalence of overweight or obesity in a clinical sample of children with ASD at a tertiary care centre. DESIGN/METHODS: Participants were recruited within the first 12 months of receiving their diagnosis of ASD (as defined by the DSM-IV-TR) as part of an international registry. The primary health care provider (e.g. nurse practitioner, developmental pediatrician, etc.) completed several baseline measures, including age, gender, height, and weight. BMI was calculated for each participant using date of birth, date assessed, gender, height, and weight using the recommended BMI calculations by the Centre for Disease Control (2000) and terminology provided by Barlow et al. (2007). RESULTS: Complete information was available for 130 children with ASD (108 boys). Median age of participants was 5 years, 9 months (range: two years, two months-17 years, four months; standard deviation: 3 years, 5 months). In total, 2% of children had BMI under the 5th percentile (underweight), 55% of children had BMI within the 5th to 85th percentile (normal weight), 41% of children were at or above the 85th percentile (overweight or obese) and 21% of children were at or above the 95th percentile (obese). Using a one-sample binomial test, children and adolescents with ASD were found to be significantly different in the prevalence of overweight and obese rates compared to typically developing Canadian children and adolescents (p.05). CONCLUSION: These findings are in accordance with the prevalence of overweight and obese status in children with ASD in the USA but differ from typically developing Canadian children. Further monitoring is needed longitudinally to monitor the prevalence of overweight and obese children and adolescents with ASD and to provide appropriate weightmanagement intervention.
Objectives: To determine if there is a difference in exclusive breastfeeding rates between mother... more Objectives: To determine if there is a difference in exclusive breastfeeding rates between mothers who conceived spontaneously compared with those who conceived using Artificial Reproductive Technology (ART). Study methods: A prospective cohort study ("All Our Babies") of pregnant women was conducted in Calgary, Alberta, Canada from May 2008-May 2010. Participants completed three written questionnaires, two during pregnancy and one at four months postpartum. Data for this analysis included all participants who used ART to conceive the pregnancy, and a 2:1 random selection of women who conceived spontaneously. ART included use of fertility enhancing drugs and/or artificial insemination and/or in vitro fertilization +/-intra cytoplasmic sperm injection. Descriptive statistics were used to characterize the population. Chi square tests, Fisher exact tests and t-tests were used to assess differences between groups. Results: Seventy-six participants (5.9%) used some form of ART to conceive. Mothers in the group who used ART to conceive were older than the group who conceived spontaneously (p=0.001). At four months post-partum 54.1% of infants who were conceived via ART were exclusively breastfed compared to 59.7% of infants who were spontaneously conceived (p=0.99). No significant differences in terms of breastfeeding initiation (p=0.60), breastfeeding at 4 months postpartum (p=0.20) or breastfeeding difficulties (p=0.65) were found between women who conceived spontaneously and women who conceived through ART. Conclusion: This study suggests that mothers who conceive using ART do not differ from those who conceived spontaneously in breastfeeding initiation, duration or likelihood of difficulty. This suggests that specialized counseling for these mothers is not required in regards to breastfeeding and these mothers can be reassured that using ART to conceive will not impact their breastfeeding practices.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
The All Our Families cohort includes over 3,000 mothers and children who have been participants s... more The All Our Families cohort includes over 3,000 mothers and children who have been participants since the mothers were pregnant. This report is a summary of information collected when the children were 5 years of age. Recruitment into the All Our Families (formerly All Our Babies) cohort began in 2008 and concluded in 2011. Since then, we have collected information twice during pregnancy and at 4 months postpartum, as well as 1 year, 2 years, 3 years and 5 years post-birth. This report presents findings from All Our Families mothers and children at 5 years of age and integrates information from earlier time points. The history of this cohort is described and more details can be found at allourfamiliesstudy.com.
The All Our Families cohort includes over 3,000 mothers and children who have been participants s... more The All Our Families cohort includes over 3,000 mothers and children who have been participants since mothers were pregnant. This report is a summary of information collected when the children were 3 years of age. Recruitment into the All Our Families (formerly All Our Babies) cohort began in 2008 and concluded in 2011. Since then, we have collected information twice during pregnancy and at 4 months postpartum, as well as 1 year, 2 years, and 3 years post-birth. This report presents findings from All Our Families mothers and children at 3 years of age and integrates information from earlier time points. The history of this cohort is described briefly below, more details can be found on allourfamiliesstudy.com.
Language ability is strongly related to important child developmental outcomes. Family-level soci... more Language ability is strongly related to important child developmental outcomes. Family-level socioeconomic status influences child language ability; it is unclear if, and through which mechanisms, neighborhood-level factors impact child language. The current study investigated the association between neighborhood factors (deprivation and disorder) assessed before birth and child language outcomes at age 5, with sleep duration as a potential underlying pathway. Secondary analysis was conducted on data collected between 2008 and 2018 on a subsample of 2444 participants from the All Our Families cohort study (Calgary, Canada) for whom neighborhood information from pregnancy could be geocoded. Neighborhood deprivation was determined using the Vancouver Area Neighborhood Deprivation Index (VANDIX), and disorder was assessed using crime reports. Mothers reported on their children’s sleep duration and language ability. Multilevel modeling indicated that greater neighborhood deprivation and...
The authors have addressed all my comments satisfactorily with one exception The abstract still s... more The authors have addressed all my comments satisfactorily with one exception The abstract still suggests that the authors are reporting a prevalence of behaviour problems. The second clause of the first sentence of results should be changed to read '29.5% and 25.6% respectively of children were found to have internalising and externalising behaviour problem scores in the lowest quintile of the distribution on the NSCLY Child Behaviour Scales' or something similar. Statistical review:No, the manuscript does not need to be seen by a statistician.
Background Parents have faced substantial social and economic challenges during the COVID-19 pand... more Background Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. Methods In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. Findings Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35•21%, 95% CI 32•48-38•04) and anxiety symptoms (31•39%, 28•76-34•15) than at all previous data collection timepoints. The mean depression score (8•31, 95% CI 7•97-8•65) and anxiety score (11•90, 11•66-12•13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5•05, 4•85-5•25; mean anxiety score 9•51, 9•35-9•66), 5-year timepoint (mean depression score 5•43, 5•20-5•66; mean anxiety score 9•49, 9•33-9•65), and 8-year timepoint (mean depression score 5•79, 5•55-6•02; mean anxiety score 10•26, 10•10-10•42). For the within-person comparisons, depression scores were a mean of 2•30 points (95% CI 1•95-2•65) higher and anxiety scores were a mean of 1•04 points (0•65-1•43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and healthcare workers had smaller increases in depressive symptoms than non-health-care workers. Interpretation Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress.
Background: The negative effect of adverse childhood experiences (ACEs) on physical and mental he... more Background: The negative effect of adverse childhood experiences (ACEs) on physical and mental health has led to calls for routine screening for ACEs in primary care settings. We aimed to examine the association between maternal ACEs and children's behaviour problems (externalizing and internalizing) at age 5 in the context of other known predictors. Methods: We analyzed data from mother-and-child dyads participating in the All Our Families cohort in Calgary, Canada, between 2011 and 2017. Data were collected for factors related to the individual child (sex, age, temperament and behaviour), the mother (adverse childhood experiences, mental health, personality and parenting) and sociodemographic characteristics (family income, ethnicity and family structure) when the children were 3 and 5 years of age. We used logistic regression models to estimate crude and adjusted associations between maternal ACEs and children's externalizing (hyperactivity and aggression) and internalizing (anxiety, depression and somatization) behaviours. Results: Data were available for 1688 mother-and-child dyads. In the crude models, the presence of 4 or more maternal ACEs was associated with children's externalizing and internalizing behaviours at age 5. However, these associations were attenuated with adjustment. Persistent maternal mental health symptoms were associated with both externalizing and internalizing behaviours at age 5 (adjusted odds ratio [OR] 4.20, 95% confidence interval [CI] 2.50-7.05, and adjusted OR 2.52, 95% CI 1.66-3.81, respectively). High levels of ineffective parenting behaviours were also associated with both externalizing and internalizing behaviours at age 5 (adjusted OR 6.27, 95% CI 4.30-9.14, and adjusted OR 1.43, 95% CI 1.03-1.99, respectively). Interpretation: The association between maternal ACEs and children's behaviour at age 5 was weakened in the presence of other maternal and family-level factors. Assessments of maternal mental health and parenting behaviours may be better targets for identifying children at risk of behavioural problems.
Background: Maternal depression and anxiety have been associated with deleterious child outcomes.... more Background: Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5. Method: Participants were 1,992 mother-child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5. Results: Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., 3 or more timepoints) compared to mothers who had never experienced clinical-level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety. Conclusions: Increasing number of exposures to clinical-level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as "sensitive" periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood.
Ages and Stages Questionnaire NDD Neurodevelopmental disorder AIM This study examined children's ... more Ages and Stages Questionnaire NDD Neurodevelopmental disorder AIM This study examined children's health care service use, mothers' workforce participation, and mothers' community engagement based on children's risk of developmental delay.
The current study examined the interaction between maternal depressive symptoms and child tempera... more The current study examined the interaction between maternal depressive symptoms and child temperament in predicting subsequent child language skills. Participants were 252 mother-child dyads recruited from the All Our Families longitudinal cohort, a primarily middle-class sample (62.9% completed postsecondary education) from Alberta, Canada (90.5% White, 6% Asian, 3.5% other). Maternal depressive symptoms at age 3, controlling for prenatal depressive symptoms, did not evidence a direct effect on child language skills at age 5 (49.6% males; mean [M] = 5.12 years old, standard deviation [SD] = .11). However, both child surgency and effortful control interacted with maternal depression at age 3 to predict later language skills. Low effortful control was a risk factor for poorer language abilities in contexts of high maternal depressive symptoms. High child surgency emerged as a differential susceptibility marker, predicting poorer language skills in contexts of high maternal depressive symptoms but better language skills in contexts of low depressive symptoms. Negative affect did not interact with maternal depressive symptoms in predicting language skills. These findings highlight the complex interaction between maternal and child characteristics in predicting language development during a developmental period in which language skills are a prime indicator of school readiness and a predictor of future academic achievement and socioemotional adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
The evidence regarding the effects of a Single Room Maternity Care (SRMC) model on women’s childb... more The evidence regarding the effects of a Single Room Maternity Care (SRMC) model on women’s childbirth experiences, healthcare providers’ workplace satisfaction, and cost outcomes remains equivocal. The research questions for this focused ethnographic study are: how is culture experienced by nurses and other healthcare providers on the SRMC unit, and how do the values, beliefs, and norms of nurses and other healthcare providers on the SRMC unit influence their day-to-day practices of caring for women and their families. The aim of this qualitative focused ethnography was to explore the culture and practices of the healthcare team in a SRMC unit. Twelve healthcare providers were recruited from a Single Room Maternity Care unit located in a Western Canadian hospital. Semi-structured interviews, participant observations, and examination of unit-related documents were conducted between October 2014 and January 2015. Data were analyzed using an approach by Roper and Shapira (2000). Two ma...
provide all levels of oncologic care. The aim of this study was to assess the need for palliative... more provide all levels of oncologic care. The aim of this study was to assess the need for palliative care in hospitalised cancer patients in Mato Grosso do Sul, one of the Brazilian states that has no public hospital offering this type of care. Methods A descriptive study of all hospitalisations due to "complications of clinical oncology (ICPO)" in hospitals of the Unified Health System (SUS) in the state of Mato Grosso do Sul, Brazil, was conducted from January 2008 to August 2010. Data were obtained from the Hospital Information System of the Unified Health System (SIH-SUS). Results There were 5165 hospitalisations for ICPO with cancer as the underlying cause in 94.7%. Average length of stay was 6.2 days and 1189 patients (23.0%) died. Individuals aged 65 years or older accounted for 44.3% of these deaths and for every 3.5 hospital admissions in this age group, one ended in death. Many patients died without the appropriate care. Conclusion The ageing of the population and the increased incidence of cancer brought new challenges to the Brazilian Unified Health System, including the need for palliative care. This need is not always met for instance as in Mato Grosso do Sul. In this sense, deaths of patients hospitalised for ICPO can be thought of as indicators of advanced disease and they could be useful to national and state policies for oncologic palliative care.
What is already known about the topic? Pregnancy-related anxiety (PrA) constitutes a distinct con... more What is already known about the topic? Pregnancy-related anxiety (PrA) constitutes a distinct concept from general anxiety and depression and is more strongly associated with maternal and child outcomes. Several recent reviews identified the need for a welldeveloped scale with a rigorous theoretical basis for the assessment of PrA. The assessment of PrA has been limited, mainly due to its poor conceptualization. What this paper adds Three critical attributes, three antecedents, four consequences, and nine dimensions for PrA were identified and a definition of the concept was proposed. Current tools are useful to determine whether the concept exists and to capture selected domains. A tool that includes all dimensions and examines the consequences and severity of PrA is needed. This knowledge provides nursing and midwifery professions with a conceptual basis to identify PrA and also constitutes a groundwork for further development of the concept.
Research on the effects of adversity has led to mounting interest in examining the differential i... more Research on the effects of adversity has led to mounting interest in examining the differential impact of adversity as a function of its timing and type. The current study examines whether the effects of different types (i.e., physical, sexual, and emotional abuse) and timing (i.e., early, middle childhood, adolescence, or adulthood) of adversity on maternal mental and physical health outcomes in pregnancy, are best accounted for by a cumulative model or independent effects model. Women from a prospective pregnancy cohort (N =3,362) reported retrospectively on their experiences of adversity (i.e., physical, sexual, and emotional abuse) in early childhood (0–5 years], middle childhood (6–12 years], adolescence (13–18 years], and adulthood (19+ years]. Measures of overall health, stress, anxiety, and depression were gathered in pregnancy. Results showed that a cumulative formative latent model was selected as more parsimonious than a direct effects model. Results also supported a mode...
Journal of Undergraduate Research in Alberta, 2015
Introduction Self-regulation (SR) is the ability to alter behavioral responses in response to int... more Introduction Self-regulation (SR) is the ability to alter behavioral responses in response to interactions with the environment. Children who develop skills associated with high SR early in life are more prepared for school than children who fail to develop these skills. Methods An environmental scan was used to collect data from 3 Albertan parenting magazines: Apple Magazine, Calgary Child’s Magazine, and Red Deer Child’s Magazine published within January 2010- January 2015. A textual analysis was conducted to identify the overall SR messages presented to the public. Inductive coding was used to organize similar themes into larger categories and thereafter to determine how these Albertan media resources suggest the development of SR in children. Results Three themes emerged from the scan: parental role in the development of SR, disciplining children in way that builds SR, and coping mechanisms for parents in response to tantrums. Discussion Albertan media resources describe SR in a...
BACKGROUND: In Canada, it is estimated that nearly one in three children are overweight or obese ... more BACKGROUND: In Canada, it is estimated that nearly one in three children are overweight or obese (Roberts et al., 2012). With a myriad of contributing factors and potential for serious long-term health consequences, overweight/obesity status constitutes an urgent and complex public health issue (Avis et al., 2014). Moreover, recent reports suggest that approximately 35-38% in American children with Autism Spectrum Disorder (ASD) are overweight or obese, higher than the general population (Sharp et al., 2014; Zuckerman et al., 2014). To date, no studies have looked at weight status among children with ASD in a Canadian population. OBJECTIVES: To determine the prevalence of overweight or obesity in a clinical sample of children with ASD at a tertiary care centre. DESIGN/METHODS: Participants were recruited within the first 12 months of receiving their diagnosis of ASD (as defined by the DSM-IV-TR) as part of an international registry. The primary health care provider (e.g. nurse practitioner, developmental pediatrician, etc.) completed several baseline measures, including age, gender, height, and weight. BMI was calculated for each participant using date of birth, date assessed, gender, height, and weight using the recommended BMI calculations by the Centre for Disease Control (2000) and terminology provided by Barlow et al. (2007). RESULTS: Complete information was available for 130 children with ASD (108 boys). Median age of participants was 5 years, 9 months (range: two years, two months-17 years, four months; standard deviation: 3 years, 5 months). In total, 2% of children had BMI under the 5th percentile (underweight), 55% of children had BMI within the 5th to 85th percentile (normal weight), 41% of children were at or above the 85th percentile (overweight or obese) and 21% of children were at or above the 95th percentile (obese). Using a one-sample binomial test, children and adolescents with ASD were found to be significantly different in the prevalence of overweight and obese rates compared to typically developing Canadian children and adolescents (p.05). CONCLUSION: These findings are in accordance with the prevalence of overweight and obese status in children with ASD in the USA but differ from typically developing Canadian children. Further monitoring is needed longitudinally to monitor the prevalence of overweight and obese children and adolescents with ASD and to provide appropriate weightmanagement intervention.
Objectives: To determine if there is a difference in exclusive breastfeeding rates between mother... more Objectives: To determine if there is a difference in exclusive breastfeeding rates between mothers who conceived spontaneously compared with those who conceived using Artificial Reproductive Technology (ART). Study methods: A prospective cohort study ("All Our Babies") of pregnant women was conducted in Calgary, Alberta, Canada from May 2008-May 2010. Participants completed three written questionnaires, two during pregnancy and one at four months postpartum. Data for this analysis included all participants who used ART to conceive the pregnancy, and a 2:1 random selection of women who conceived spontaneously. ART included use of fertility enhancing drugs and/or artificial insemination and/or in vitro fertilization +/-intra cytoplasmic sperm injection. Descriptive statistics were used to characterize the population. Chi square tests, Fisher exact tests and t-tests were used to assess differences between groups. Results: Seventy-six participants (5.9%) used some form of ART to conceive. Mothers in the group who used ART to conceive were older than the group who conceived spontaneously (p=0.001). At four months post-partum 54.1% of infants who were conceived via ART were exclusively breastfed compared to 59.7% of infants who were spontaneously conceived (p=0.99). No significant differences in terms of breastfeeding initiation (p=0.60), breastfeeding at 4 months postpartum (p=0.20) or breastfeeding difficulties (p=0.65) were found between women who conceived spontaneously and women who conceived through ART. Conclusion: This study suggests that mothers who conceive using ART do not differ from those who conceived spontaneously in breastfeeding initiation, duration or likelihood of difficulty. This suggests that specialized counseling for these mothers is not required in regards to breastfeeding and these mothers can be reassured that using ART to conceive will not impact their breastfeeding practices.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
The All Our Families cohort includes over 3,000 mothers and children who have been participants s... more The All Our Families cohort includes over 3,000 mothers and children who have been participants since the mothers were pregnant. This report is a summary of information collected when the children were 5 years of age. Recruitment into the All Our Families (formerly All Our Babies) cohort began in 2008 and concluded in 2011. Since then, we have collected information twice during pregnancy and at 4 months postpartum, as well as 1 year, 2 years, 3 years and 5 years post-birth. This report presents findings from All Our Families mothers and children at 5 years of age and integrates information from earlier time points. The history of this cohort is described and more details can be found at allourfamiliesstudy.com.
The All Our Families cohort includes over 3,000 mothers and children who have been participants s... more The All Our Families cohort includes over 3,000 mothers and children who have been participants since mothers were pregnant. This report is a summary of information collected when the children were 3 years of age. Recruitment into the All Our Families (formerly All Our Babies) cohort began in 2008 and concluded in 2011. Since then, we have collected information twice during pregnancy and at 4 months postpartum, as well as 1 year, 2 years, and 3 years post-birth. This report presents findings from All Our Families mothers and children at 3 years of age and integrates information from earlier time points. The history of this cohort is described briefly below, more details can be found on allourfamiliesstudy.com.
Language ability is strongly related to important child developmental outcomes. Family-level soci... more Language ability is strongly related to important child developmental outcomes. Family-level socioeconomic status influences child language ability; it is unclear if, and through which mechanisms, neighborhood-level factors impact child language. The current study investigated the association between neighborhood factors (deprivation and disorder) assessed before birth and child language outcomes at age 5, with sleep duration as a potential underlying pathway. Secondary analysis was conducted on data collected between 2008 and 2018 on a subsample of 2444 participants from the All Our Families cohort study (Calgary, Canada) for whom neighborhood information from pregnancy could be geocoded. Neighborhood deprivation was determined using the Vancouver Area Neighborhood Deprivation Index (VANDIX), and disorder was assessed using crime reports. Mothers reported on their children’s sleep duration and language ability. Multilevel modeling indicated that greater neighborhood deprivation and...
The authors have addressed all my comments satisfactorily with one exception The abstract still s... more The authors have addressed all my comments satisfactorily with one exception The abstract still suggests that the authors are reporting a prevalence of behaviour problems. The second clause of the first sentence of results should be changed to read '29.5% and 25.6% respectively of children were found to have internalising and externalising behaviour problem scores in the lowest quintile of the distribution on the NSCLY Child Behaviour Scales' or something similar. Statistical review:No, the manuscript does not need to be seen by a statistician.
Background Parents have faced substantial social and economic challenges during the COVID-19 pand... more Background Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. Methods In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. Findings Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35•21%, 95% CI 32•48-38•04) and anxiety symptoms (31•39%, 28•76-34•15) than at all previous data collection timepoints. The mean depression score (8•31, 95% CI 7•97-8•65) and anxiety score (11•90, 11•66-12•13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5•05, 4•85-5•25; mean anxiety score 9•51, 9•35-9•66), 5-year timepoint (mean depression score 5•43, 5•20-5•66; mean anxiety score 9•49, 9•33-9•65), and 8-year timepoint (mean depression score 5•79, 5•55-6•02; mean anxiety score 10•26, 10•10-10•42). For the within-person comparisons, depression scores were a mean of 2•30 points (95% CI 1•95-2•65) higher and anxiety scores were a mean of 1•04 points (0•65-1•43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and healthcare workers had smaller increases in depressive symptoms than non-health-care workers. Interpretation Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress.
Background: The negative effect of adverse childhood experiences (ACEs) on physical and mental he... more Background: The negative effect of adverse childhood experiences (ACEs) on physical and mental health has led to calls for routine screening for ACEs in primary care settings. We aimed to examine the association between maternal ACEs and children's behaviour problems (externalizing and internalizing) at age 5 in the context of other known predictors. Methods: We analyzed data from mother-and-child dyads participating in the All Our Families cohort in Calgary, Canada, between 2011 and 2017. Data were collected for factors related to the individual child (sex, age, temperament and behaviour), the mother (adverse childhood experiences, mental health, personality and parenting) and sociodemographic characteristics (family income, ethnicity and family structure) when the children were 3 and 5 years of age. We used logistic regression models to estimate crude and adjusted associations between maternal ACEs and children's externalizing (hyperactivity and aggression) and internalizing (anxiety, depression and somatization) behaviours. Results: Data were available for 1688 mother-and-child dyads. In the crude models, the presence of 4 or more maternal ACEs was associated with children's externalizing and internalizing behaviours at age 5. However, these associations were attenuated with adjustment. Persistent maternal mental health symptoms were associated with both externalizing and internalizing behaviours at age 5 (adjusted odds ratio [OR] 4.20, 95% confidence interval [CI] 2.50-7.05, and adjusted OR 2.52, 95% CI 1.66-3.81, respectively). High levels of ineffective parenting behaviours were also associated with both externalizing and internalizing behaviours at age 5 (adjusted OR 6.27, 95% CI 4.30-9.14, and adjusted OR 1.43, 95% CI 1.03-1.99, respectively). Interpretation: The association between maternal ACEs and children's behaviour at age 5 was weakened in the presence of other maternal and family-level factors. Assessments of maternal mental health and parenting behaviours may be better targets for identifying children at risk of behavioural problems.
Background: Maternal depression and anxiety have been associated with deleterious child outcomes.... more Background: Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5. Method: Participants were 1,992 mother-child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5. Results: Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., 3 or more timepoints) compared to mothers who had never experienced clinical-level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety. Conclusions: Increasing number of exposures to clinical-level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as "sensitive" periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood.
Ages and Stages Questionnaire NDD Neurodevelopmental disorder AIM This study examined children's ... more Ages and Stages Questionnaire NDD Neurodevelopmental disorder AIM This study examined children's health care service use, mothers' workforce participation, and mothers' community engagement based on children's risk of developmental delay.
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Papers by Suzanne Tough