Breastfeeding boosts metabolites important for brain growth

April 27, 2019

Science Daily/Children's National Health System

Micro-preemies who primarily consume breast milk have significantly higher levels of metabolites important for brain growth and development, according to sophisticated imaging conducted by an interdisciplinary research team at Children's National.

"Our previous research established that vulnerable preterm infants who are fed breast milk early in life have improved brain growth and neurodevelopmental outcomes. It was unclear what makes breastfeeding so beneficial for newborns' developing brains," says Catherine Limperopoulos, Ph.D., director of MRI Research of the Developing Brain at Children's National. "Proton magnetic resonance spectroscopy, a non-invasive imaging technique that describes the chemical composition of specific brain structures, enables us to measure metabolites essential for growth and answer that lingering question."

According to the Centers for Disease Control and Prevention, about 1 in 10 U.S. infants is born preterm. The Children's research team presented their findings during the Pediatric Academic Societies 2019 Annual Meeting.

The research-clinicians enrolled babies who were very low birthweight (less than 1,500 grams) and 32 weeks gestational age or younger at birth when they were admitted to Children's neonatal intensive care unit in the first week of life. The team gathered data from the right frontal white matter and the cerebellum -- a brain region that enables people to maintain balance and proper muscle coordination and that supports high-order cognitive functions.

Each chemical has its own a unique spectral fingerprint. The team generated light signatures for key metabolites and calculated the quantity of each metabolite. Of note:

·     Cerebral white matter spectra showed significantly greater levels of inositol (a molecule similar to glucose) for babies fed breast milk, compared with babies fed formula.

·     Cerebellar spectra had significantly greater creatine levels for breastfed babies compared with infants fed formula.

·     And the percentage of days infants were fed breast milk was associated with significantly greater levels of both creatine and choline, a water soluble nutrient.

"Key metabolite levels ramp up during the times babies' brains experience exponential growth," says Katherine M. Ottolini, the study's lead author. "Creatine facilitates recycling of ATP, the cell's energy currency. Seeing greater quantities of this metabolite denotes more rapid changes and higher cellular maturation. Choline is a marker of cell membrane turnover; when new cells are generated, we see choline levels rise."

Already, Children's National leverages an array of imaging options that describe normal brain growth, which makes it easier to spot when fetal or neonatal brain development goes awry, enabling earlier intervention and more effective treatment. "Proton magnetic resonance spectroscopy may serve as an important additional tool to advance our understanding of how breastfeeding boosts neurodevelopment for preterm infants," Limperopoulos adds.

https://www.sciencedaily.com/releases/2019/04/190427104808.htm

No safe amount of alcohol during pregnancy

Brain connectivity issues found in children who have experienced prenatal alcohol exposure

April 26, 2019

Science Daily/American Institute of Physics

An international group of researchers has taken one of the first major steps in finding the biological changes in the brain that drive fetal alcohol spectrum disorder (FASD). New work using chaos theory to analyze brain signals, discussed this month in the journal Chaos, from AIP Publishing, shows the long-term effects.

Researchers found that teenagers who were exposed to alcohol while in the womb showed altered brain connections that were consistent with impaired cognitive performance. Their findings were reached by measuring the responses from a brain imaging technique called magnetoencephalography (MEG) and then analyzing them with tools developed using chaos theory.

FASD is one of the leading causes of intellectual disability worldwide and is linked to a wide array of neurological issues, including ADHD. While the prevailing theory links expectant mothers' alcohol consumption to cognitive impairments for children, questions about the extent of this effect remain. Despite the known link, researchers are uncertain about the precise mechanism by which alcohol alters the developing brain.

The group's efforts mark one of the first times researchers have been able to quantify the effects of alcohol exposure on the developing brain.

"The paper provides important integrative results for the field of FASD," said Julia Stephen, an author on the paper. "These results may then indicate that simple sensory measures may provide sensitivity for brain deficits that affect the broader cognitive domain."

Previous attempts to study the brain circuitry in affected individuals have been hampered by the difficulty of drawing conclusions from complicated MEG data.

To get to the heart of the problem, members of the team developed a sophisticated computer technique called Cortical Start Spatio-Temporal multidipole analysis that could identify which areas of the brain were active when research subjects were in the MEG machine.

After data from 19 FASD patients and 21 subjects without FASD was collected, the computational approach revealed several areas of the brain that showed impaired connectivity among the FASD group.

Subjects who were exposed to alcohol in the womb were more likely to have issues with connections through their corpus callosum, the band of brain tissue that connects the left and right halves of the brain. Deficits in this area have been reported in people with schizophrenia, multiple sclerosis, autism, depression and abnormalities in sensation.

"This work presents major evidence that children exposed to alcohol prenatally are at risk of suffering from impaired cognitive abilities and other secondary factors," said Lin Gao, an author on the paper. "Our study ... shows that there is no safe amount or safe stages during pregnancy for alcohol consumption."

The authors hope their work inspires other groups to conduct similarly collaborative research on diseases like FASD that benefit from drawing together medical and computational fields.

https://www.sciencedaily.com/releases/2019/04/190426150639.htm

Antibiotic use linked to greater risk of heart attack and stroke in women

April 24, 2019

Science Daily/European Society of Cardiology

Women who take antibiotics over a long period of time are at increased risk of heart attack or stroke, according to research carried out in nearly 36,500 women.

The study, published in the European Heart Journal [1] today (Thursday), found that women aged 60 or older who took antibiotics for two months or more had the greatest risk of cardiovascular disease, but long duration of antibiotic use was also associated with an increased risk if taken during middle age (aged 40-59). The researchers could find no increased risk from antibiotic use by younger adults aged between 20-39.

Professor Lu Qi, director of the Tulane University Obesity Research Centre, Tulane University, New Orleans, and adjunct professor of nutrition at Harvard T.C. Chan School of Public Health, Boston, USA, who led the research, says that a possible reason why antibiotic use is linked to an increased risk of cardiovascular disease is because antibiotics alter the balance of the micro-environment in the gut, destroying "good" probiotic bacteria and increasing the prevalence of viruses, bacteria or other micro-organisms that can cause disease.

"Antibiotic use is the most critical factor in altering the balance of microorganisms in the gut. Previous studies have shown a link between alterations in the microbiotic environment of the gut and inflammation and narrowing of the blood vessels, stroke and heart disease," he said.

The researchers studied 36,429 women who took part in the Nurses' Health Study, which has been running in the USA since 1976. The current study looked at data from 2004 to June 2012. In 2004 the women were aged 60 or older, and they were asked about their use of antibiotics when they were young (20-39), middle-aged (40-59) or older (60 and older). The researchers categorised them into four groups: those who had never taken antibiotics, those who had taken them for time periods of less than 15 days, 15 days to two months, or for two months or longer.

During an average follow-up period of nearly eight years, during which time the women continued to complete questionnaires every two years, 1056 participants developed cardiovascular disease.

After adjustments to take account of factors that could affect their results, such as age, race, sex, diet and lifestyle, reasons for antibiotic use, overweight or obesity, other diseases and medication use, the researchers found that women who used antibiotics for periods of two months or longer in late adulthood were 32% more likely to develop cardiovascular disease than women who did not use antibiotics. Women who took antibiotics for longer than two months in middle age had a 28% increased risk compared to women who did not.

These findings mean that among women who take antibiotics for two months or more in late adulthood, six women per 1,000 would develop a cardiovascular disease, compared to three per 1,000 among women who had not taken antibiotics.

The first author of the study is Dr Yoriko Heianza. a research fellow at Tulane University. She said: "By investigating the duration of antibiotic use in various stages of adulthood we have found an association between long-term use in middle age and later life and an increased risk of stroke and heart disease during the following eight years. As these women grew older they were more likely to need more antibiotics, and sometimes for longer periods of time, which suggests a cumulative effect may be the reason for the stronger link in older age between antibiotic use and cardiovascular disease."

The most common reasons for antibiotic use were respiratory infections, urinary tract infections and dental problems.

The study is the largest prospective study to investigate the link between antibiotic use and risk of heart disease and stroke, and this is one of the strengths of the study, as well as the long follow-up and comprehensive information on factors that could affect the results such as life style, diet, age, other diseases and medication use.

Limitations include the fact that the participants reported their use of antibiotics and so this could be mis-remembered. However, as they were all health professionals, they were able to provide more accurate information on medication use than the general population. The researchers did not have information on the different classes of antibiotics used, but believe that the most common type of prescription tends to depend on the infections it is treating, and information on these was included in their analysis. As the study only looked at middle-aged and elderly women, the results cannot necessarily be extrapolated to younger ages and to men.

Prof Qi concluded: "This is an observational study and so it cannot show that antibiotics cause heart disease and stroke, only that there is a link between them. It's possible that women who reported more antibiotic use might be sicker in other ways that we were unable to measure, or there may be other factors that could affect the results that we have not been able take account of.

"Our study suggests that antibiotics should be used only when they are absolutely needed. Considering the potentially cumulative adverse effects, the shorter time of antibiotic use the better."

https://www.sciencedaily.com/releases/2019/04/190424202539.htm

Short period of parental sexual contact prior to pregnancy increases offspring risk of schizophrenia

Study may help explain some of the excess risks for inflammatory diseases in first born children

April 23, 2019

Science Daily/The Mount Sinai Hospital / Mount Sinai School of Medicine

Children may be at a slightly increased risk of schizophrenia when their parents were in sexual contact for less than three years before conceiving them, according to research conducted at the Icahn School of Medicine at Mount Sinai and published April 23 in the journal Schizophrenia Research.

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem to have lost touch with reality and may suffer from hallucinations, delusions, disordered thinking, negative mood, and cognitive impairments. Research has shown that many different genes may increase the risk of schizophrenia and also that interactions between genes and aspects of the individual's environment, including exposure to viruses, malnutrition before birth, problems during birth, and/or psychosocial factors, are necessary for schizophrenia to develop.

Previous research has shown that preeclampsia, the most common pregnancy complication involving placental inflammation, is associated with developmental abnormalities in offspring that predispose them to a two- to four-fold increase in the risk for schizophrenia. Research has also shown that a lengthy period of prepregnancy vaginal exposure to the sperm of the offspring's father can overcome the maternal intolerance to paternal antigens that is a risk factor for preeclampsia.

"We hypothesized that if maternal immune intolerance to the father's sperm is a component pathway of risk for schizophrenia, then the couples' duration of prepregnancy sexual contact could be related to the offspring's risk for schizophrenia," said Dolores Malaspina, MD, MS, MPH, Professor of Psychiatry, Genetics and Genomic Sciences, and Neuroscience at the Icahn School of Medicine at Mount Sinai and first author of the paper. "Our results conclude that offspring born to couples married for less than three years, across all paternal ages, harbor a small increased risk for schizophrenia, which was independent of parental psychiatric disorders and paternal age. We anticipate that this work will inspire many follow-up studies to examine this disease pathway."

A prior study conducted by Dr. Malaspina demonstrated an association between short durations of marriage and increased offspring risk for schizophrenia, with preeclampsia considered as the explanation. That study did not account for parental psychiatric illness or the father's age at marriage, both of which may be relevant to an inherited vulnerability for the disease.

In this new study, researchers analyzed offspring risk for schizophrenia and separated the inter-related measures of paternal age, father's age at marriage, parental psychiatric diagnoses, and duration of marriage. Specifically, the research team conducted analyses of more than 90,000 offspring from the prospective, population-based Jerusalem Perinatal Cohort Schizophrenia Study (JPSS), a birth cohort study that recorded all births in a defined area of Jerusalem from 1964 to 1976. They found that offspring born to parents married less than two years, equivalent to about one year of prepregnancy sexual contact, had a 50 percent increase in risk for schizophrenia, and those of marriages lasting two to four years had a 30 percent increase in risk. Conversely, there were protective effects of longer marriage duration against risk, with each five years predicting a 14 percent reduction in risk for schizophrenia.

While duration of marriage is an insufficient proxy for the total length of sexual cohabitation by a couple in almost all developed countries, 97 percent of the offspring in the 1964-1976 JPSS group were born to married couples. Then, as now, Israel had among the lowest out-of-wedlock births of any country and so duration of marriage at the time of each research subject's birth is reasonably considered to be the lower limit on the length of time that the mother was vaginally exposed to the sperm of the offspring's father.

"Our findings, which coincide with obstetric literature that shows a shorter duration of parental sexual contact before conception increases the pregnancy risk for preeclampsia, is timely in light of recent discovery that some genes implicated in schizophrenia are placental genes with differential expression from prenatal adversity like preeclampsia and hypertension," says Dr. Malaspina. "The data suggests that prenatal immune activation from preeclampsia could produce lasting inflammatory vulnerability for the mother and fetus, increasing the susceptibility for psychiatric and metabolic conditions."

Dr. Malaspina's research team is currently being examining duration of marriage as a risk factor for other psychiatric disorders and for metabolic disorders.

https://www.sciencedaily.com/releases/2019/04/190423133653.htm

Integrating infant mental health into the neonatal intensive care unit

April 3, 2019

Science Daily/Children's Hospital Los Angeles

Psychotherapists attend to mental health needs of NICU families, specifically focusing on the developing relationship between babies and parents.

Bringing a baby into the world involves many firsts -- mothers and fathers are discovering their new roles, babies are learning what it means to live outside the womb, and the family is forging a relationship and bonding. What happens when this time of uncertainty is complicated by medical issues?

Many infants born premature or with other complications often forego their first weeks or months at home for a stay in the neonatal intensive care unit. The NICU is designed to deliver critical medical care to babies in need but can be traumatic for infants and their families, alike. In the Early Childhood Mental Health Program at Children's Hospital Los Angeles, clinical psychologists Marian Williams, PhD, Patricia Lakatos, PhD, and a team of infant-family mental health specialists work towards greater mental health awareness in the NICU.

Infants may not be the first age group called to mind in discussions of mental health. Yet, for babies in critical medical condition, Dr. Lakatos says an "infant mental health-informed perspective" could reduce stress and improve bonding with parents. This means not only focusing on the physical needs of the child but also the emotional and mental needs, not an easy task for newborn infants who cannot make their voices heard.

In an article published in Journal of Clinical Psychology in Medical Settings, Dr. Lakatos, Dr. Williams, and co-authors Tamara Matic, MD, and Melissa Carson, MD, advocate for a third component of the NICU family -- the relationship between baby and parents. "A lot of mental health work in NICUs currently focus on either the mental health of parents or on the baby's development," says Dr. Williams, who is also the Director of the Stein Tikun Olam Infant-Family Mental Health Initiative at CHLA. "We also want to focus on the relationship between babies and their parents."

Many parents of children in intensive care units experience symptoms of post-traumatic stress, which can threaten bonding with a newborn baby. In order to support the developing relationship between parents and their new baby, the CHLA infant mental health team turned to a model of intervention that has demonstrated success in families who have undergone trauma. Child-Parent Psychotherapy -- or CPP -- addresses the parent-child relationship directly, nurturing and advocating for it in its own right.

With funding from the Stein Tikun Olam Infant-Family Health Initiative, Drs. Williams and Lakatos, and the team were able to adapt CPP to the NICU setting at Children's Hospital Los Angeles. Their publication describes how the established, evidence-based CPP model can be used to nurture developing infant-parent relationships in the NICU. While it has been implemented in other settings, CPP is not commonly integrated into NICU patient care.

CPP is a flexible model that has multiple levels of intervention, depending upon individual family needs. Sessions with trained CPP providers can vary in number or duration, with the aim of restoring a developmental trajectory for parent and child. CPP providers advocate for mental health needs of parents and babies, working alongside their medical and social work colleagues. "When babies are in the hospital, we need to think about them, their parents, and their relationships," says Dr. Lakatos.

Appropriately, NICU medical staff focus on the acute physical needs of the child. Dr. Williams sees clinical psychologists in a necessary, complementary role. "These babies are eventually going home," she says. "They are missing out on their bonding time, but there is great potential for resilience. Being mindful of the stressors these families are facing helps them feel understood and can set them on a positive trajectory."

https://www.sciencedaily.com/releases/2019/04/190403135019.htm

For some people, attractive wives and high status husbands enhance marital quality

March 28, 2019

Science Daily/Society for Personality and Social Psychology

Researchers found that maximizing men -- those who seek to make the 'best' choice -- who had attractive wives were more satisfied at the start of their marriages than maximizing men who had less attractive wives, and maximizing women who had high status husbands experienced less steep declines in satisfaction over time than maximizing women who had low status husbands.

Your decision-making style -- whether you make a "good enough" choice or seek to make the "best" possible choice among all possible options -- influences your satisfaction with your partner, according to a 3-year study of newlyweds. Researchers from Florida State University found that maximizing men -- those who seek to make the "best" choice -- who had attractive wives were more satisfied at the start of their marriages than maximizing men who had less attractive wives, and maximizing women who had high status husbands experienced less steep declines in satisfaction over time than maximizing women who had low status husbands.

The research appears in Personality and Social Psychology Bulletin.

"Maximizing people are constantly trying to obtain the very best outcomes in life," says lead author Juliana French (Florida State University). "For example, which is the best ice cream flavor? Which is the best song on the radio right now?"

"In the context of romantic relationships, maximizers are those who seek the best possible partner and who, over the course of their relationships, continue to compare their partners to other potential partners," says French. This could lead to overall lower satisfaction in maximizers' long-term relationships if their partners do not compare favorably to those alternatives on qualities that are important to them.

To test how maximizers might find happiness in their long-term relationships, the researchers studied 113 heterosexual newlywed couples in north Texas and 120 newlywed couples in north Florida. In both studies, people completed questionnaires assessing their marital satisfaction, tendencies to maximize when making decisions, and social status; additionally, the researchers obtained photographs of each spouse that they objectively coded for physical attractiveness.

They found that maximizers were more satisfied with their marriages if their partners possessed traits that were desirable to them -- maximizing men were more satisfied if they had attractive wives, and maximizing women were more satisfied if they had high-status husbands. In contrast, satisficing men and women were similarly satisfied regardless of their partners' traits.

Making decisions about romance -- for example, who to date and who to marry -- are central to our lives and well-being.

What other aspects of relationship functioning are impacted by maximizing tendencies?

"We might find that maximizers take relationships slower than satisficers," speculates French. "For example, maximizers might take longer to decide to be exclusive with someone, to move in together, to get married, to have children together, and so on."

https://www.sciencedaily.com/releases/2019/03/190328102655.htm

Maternal diet during pregnancy may modulate the risk of ADHD symptoms in children

Association found between omega-6:omega-3 ratio in the umbilical cord and the appearance of ADHD symptoms

March 28, 2019

Science Daily/Barcelona Institute for Global Health (ISGlobal)

The results of a study led by a team from the Barcelona Institute for Global Health (ISGlobal), a centre supported by "la Caixa," suggest that the risk of a child developing symptoms of attention deficit hyperactivity disorder (ADHD) may be modulated by the mother's diet during pregnancy. The study, published in the Journal of Pediatrics, analysed samples of umbilical cord plasma to quantify the levels of omega-6 and omega-3 that reach the fetus. The statistical analysis showed a higher omega-6:omega-3 ratio to be associated with a higher risk of ADHD symptoms at seven years of age.

Omega-6 and omega-3 are long-chain polyunsaturated fatty acids that play a crucial role in the function and architecture of the central nervous system, particularly during the later stages of gestation. These two fatty acids compete for incorporation into cell membranes and are primarily obtained through diet. Since omega-6 and omega-3 have opposing physiological functions -- the former promotes systemic pro-inflammatory states, while the latter promotes anti-inflammatory states -- a balanced intake of these two fatty acids is important. Previous research had shown that children with ADHD symptoms have a higher omega-6:omega-3 ratio.

The authors studied data from 600 children living in four Spanish regions (Asturias, Basque Country, Catalonia and Valencia) who are participating in the INMA Project. They analysed umbilical cord plasma samples and data from questionnaires completed by the children's mothers. ADHD symptoms were assessed using two standard questionnaires: the first completed by the children's teachers at age four years, and the second by their parents at age seven years.

The results showed that, at age seven years, the number of ADHD symptoms increased by 13% per each unit increase in the omega-6:omega-3 ratio in umbilical cord plasma. The study analysed the number of symptoms in the children who met the diagnostic criteria for ADHD (minimum six symptoms) and also in the children with a smaller number of ADHD symptoms. The ratio of the two fatty acids was associated with the number of ADHD symptoms present but not with diagnosis of the disorder, and only in the assessment carried out at seven years of age. The authors suggest that the assessment carried out at four years of age may have been affected by a measurement error because ADHD symptoms reported at early ages may be caused by a neurodevelopmental delay falling within the normal range.

"Our findings are in line with previous studies that established a relationship between the omega-6:omega-3 ratio in mothers and various early neurodevelopmental outcomes," commented Mónica López-Vicente, ISGlobal researcher and lead author of the study.

"Although the association was not clinically significant, our findings are important at the level of the population as a whole," noted López-Vicente. "If a large proportion of the population is exposed to a high omega-6:omega-3 ratio, the distribution for ADHD symptom scores would likely move to the right and the prevalence of extreme values would increase, leading to a negative impact on the community's health costs and productivity."

"This study adds more evidence to the growing body of research on the importance of maternal diet during pregnancy," commented ISGlobal researcher Jordi Júlvez, a co-author of the study. "The nutrient supply during the earliest stages of life is essential in that it programs the structure and function of the organs, and this programming, in turn, has an impact on health at every stage of life. As the brain takes a long time to develop, it is particularly vulnerable to misprogramming. Alterations of this sort could therefore lead to neurodevelopmental disorders."

https://www.sciencedaily.com/releases/2019/03/190328080410.htm

Fewer reproductive years in women linked to an increased risk of dementia

March 27, 2019

Science Daily/American Academy of Neurology

Women who start their period later, go through menopause earlier or have a hysterectomy may have a greater risk of developing dementia, according to a new study published in the March 27, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study found a link between increased risk of dementia and fewer total reproductive years when women are exposed to higher levels of estrogen hormones.

"Since women are 50 percent more likely to develop dementia over their lifetimes than men, it's important to study any risk factors that are specific to women that could eventually lead us to potential points of intervention," said study author Paola Gilsanz, ScD, of Kaiser Permanente Division of Research in Oakland, Calif.

The study involved 6,137 women who were members of Kaiser Permanente Northern California. Participants completed health surveys and had medical exams. They were asked when they had their first menstrual cycle, when they went through menopause and if they had a hysterectomy. Researchers then calculated the number of reproductive years for each participant. Researchers also used medical records to determine which participants received a diagnosis of dementia later in life.

Participants' average age of first period was 13, average age of menopause was 45 and average total number of reproductive years was 32, and 34 percent reported a hysterectomy. When looking at only women who did not have hysterectomy, average age of menopause was 47 and average total number of reproductive years was 34.

Of all participants, 42 percent later developed dementia.

Researchers found that women who had their first menstrual cycle at age 16 or older had a 23 percent greater risk of dementia than women who had their first menstrual cycle at age 13. Of the 258 women who had their first menstrual cycle at age 16 or older, 120 later developed dementia, compared to 511 of the 1,188 women who had their first menstrual cycle at age 13.

They also found that women who went through natural menopause before age 47 had a 19 percent greater risk of dementia than women who went through menopause at age 47 or older. Of the 1,645 women who entered menopause at 47 or younger, 700 later developed dementia, compared to 1052 of the 2,402 women who entered menopause at age 47 or older.

When looking at total reproductive years, from the age of first period to the age of menopause, women who had fewer than 34 years had a 20 percent greater risk of dementia than women who had 34 or more reproductive years. Of the 1,702 women who had fewer than 34 total reproductive years, 728 later developed dementia, compared to 1024 of the 2,345 women who entered menopause at age 47 or older.

Women who had hysterectomies had an 8 percent greater risk of dementia than those who did not.

The results were all after researchers adjusted for other factors that could affect the women's risk of dementia, such as smoking, diabetes and high blood pressure.

"Estrogen levels can go up and down throughout a woman's lifetime," said Gilsanz. "Our results show that less exposure to estrogen over the course of a lifetime is linked to an increased risk of dementia. However, while our study was large, we did not have enough data to account for other factors that could affect estrogen levels, like pregnancies, hormone replacement therapy or birth control, so more research is needed."

https://www.sciencedaily.com/releases/2019/03/190327161245.htm

Advanced paternal age increases risk of early-onset schizophrenia in offspring

March 26, 2019

Science Daily/Elsevier

Advanced paternal age increases the risk in offspring of early-onset schizophrenia, a severe form of the disorder, according to a study in Biological Psychiatry, published by Elsevier. The association between paternal age and risk in children remained after accounting for the contributions of the fathers' and mothers' genetic predispositions for schizophrenia, indicating that advanced paternal age itself contributes to risk.

Advanced paternal age has been associated with increased schizophrenia risk in offspring before, but it has been difficult to disentangle the effects of age versus factors related to age. "The paternal age association could be spurious if it was explained by selection into late fatherhood, which reflects fathers' own predisposition to schizophrenia," said senior author Wei J. Chen, MD, National Taiwan University in Taipei.

Maternal predisposition could also lead to late parenthood and increased risk in offspring. Recent advances in technology have allowed for schizophrenia predisposition to be estimated through genotyping -- combining the individual contribution of genetic variations associated with schizophrenia across the entire genome provides a polygenic risk score, which helps predict the risk of developing the disorder.

Dr. Chen and colleagues determined the polygenic risk scores for the parents of over 1,600 people with schizophrenia to estimate the maternal and paternal predispositions to the disorder. Men who had their first child later in life tended to have increased polygenic risk for schizophrenia.

"After controlling for parental polygenic risk scores, every 10-year delay in paternal age increased the risk of early-onset schizophrenia in offspring by about 30 percent," said lead author Shi-Heng Wang, PhD, China Medical University in Taichung. Maternal age was not associated with risk of early onset in offspring. This finding supports that paternal age itself plays an independent role in the increased psychiatric risk in offspring, rather than being associated with increased risk through other factors related to late parenthood.

The authors defined early-onset schizophrenia as occurring before 18-years old, which tends to be a more severe form of the disorder and associated with more genetic abnormalities. Patients included in the study had healthy parents and no apparent family history of schizophrenia. These cases, referred to as sporadic, are thought to arise mainly from increased genetic mutations.

"Presumably, advanced paternal age increases risk for early-onset schizophrenia because advancing age is associated with an accumulation of mutations. These age-related mutations appear to be distinct from those more commonly associated with the risk for schizophrenia. It would be important to understand the distinct neural mechanisms through which advanced paternal age influenced the age of onset," said John Krystal, MD, Editor of Biological Psychiatry.

Identifying these mechanisms is of particular concern with the increasing age of fathers. The findings that the association with risk of early-onset schizophrenia exists after accounting for paternal and maternal polygenic risk provides an important advance in understanding the advanced paternal age effect on schizophrenia.

https://www.sciencedaily.com/releases/2019/03/190326132710.htm

Mind melding: Understanding the connected, social brain

March 26, 2019

Science Daily/Cognitive Neuroscience Society

Parents may often feel like they are not "on the same wavelength" as their kids. But it turns out that, at least for babies, their brainwaves literally sync with their moms when they are learning from them about their social environment. In a new study being presented at the Cognitive Neuroscience Society's (CNS) annual meeting in San Francisco this week, researchers found that how well babies' neural activity syncs with their moms' predicts how well they learn social cues about new toys.

"Despite the fact that this is such a powerful learning mechanism, surprisingly little is known about how the human brain performs social learning," says Victoria Leong, of the University of Cambridge. "When we connect neurally with others, we are opening ourselves to receiving information and influence from others."

In a body of new work being presented at the CNS meeting, cognitive neuroscientists are starting to shed light on the social brain and new ways to study it. "We're this massively social species and yet the field of neuroscience has focused on the brain in isolation," says Thalia Wheatley of Dartmouth College, who is chairing a symposium on the topic at CNS. "There's this huge gap in knowledge about how our brains work in concert with other minds."

Dissatisfied by the classical neuroimaging studies that put people in dark, loud, and isolated brain scanning machines to understand the human mind, Wheatley is working to come up with new methods to understand how brains behave in a social context. Social brains interact like a dance, Wheatley and Leong say, where partners take their own steps but move in concert, continuously adjusting and adapting.

At the CNS meeting, scientists presented work on the mother-infant and other social connections, as well as how even fruit flies have vivid social lives that require a new neural understanding.

The mother-baby connection

"There is no substitute for being physically present and in the moment to connect with an infant." That's the key message to come out of the new work by Leong and colleagues.

In the study, her team looked at how mothers' emotional responses toward novel toys affected their infants' decisions to interact with the toys. Infants wearing wireless EEG technology would watch their mothers, who were also wearing wireless EEG, show either a positive emotion -- e.g. smiling and saying "I like this" -- or a negative emotion toward an object -- e.g. frowning and saying "I don't like this." The babies would then choose which object to play with.

The researchers analyzed whether the level of "neural synchrony" between the mother and infant predicted how the infant would respond to a toy. "We found that stronger neural synchrony predicted a higher likelihood of social learning by the infant," Leong says. Neural synchrony is when brainwaves from two people follow predictable patterns with respect to each other. The researchers found that social signals like eye contact were associated with increased synchrony and improved social learning, though Leong says that there is still much work to be done in teasing apart exactly what leads to the neural synchrony.

Conducting EEG work with infants is challenging, Leong says, but rewarding. If they are ready and interested in the task, that resulting data is "like pure nectar. You feel like you've been granted exclusive backstage access to one of the most exciting reality shows on the planet," Leong says. "But on the other hand, if they are having a tummy ache, or are teething, or would just rather be left alone, this sentiment is expressed loudly, firmly, and with escalating urgency until the nice lady who is trying to put on a funny hat with wires retreats into a corner."

For Leong, the work has wide significance for classroom learning, social bonding, and developmental disorders. "I am interested in understanding what happens when parents or children fail to synchronize with each other, which may occur in certain mental health difficulties and developmental disorders, and the impact that this might have on learning and development in the longer term," she explains.

Common bonds

"The overarching goal of the symposium is to show that we and other species are social and there's something really important about looking at a brain in its social context," says Thalia Wheatley of Dartmouth. "We can't fully understand the human mind or any other social mind without understanding what happens in interaction."

While humans are an undisputedly social species, a growing amount of research is also showing sociality in unexpected species. "Most people don't think of fruit flies, for example, as being social at all," Wheatley says.

But, as Giovanni Bosco, also of Dartmouth College, will present at CNS, fruit flies communicate with each other with their wing patterns, and understanding their communication is key to understanding them. "Many fruit fly behavioral paradigms need to be revisited given our new appreciation of how social these animals are," Bosco says, because fruit flies used in research are raised in isolation and then do not behave as they would in nature. Simple strategies like co-housing them quickly changes their communication and behavior.

New methods are needed to better understand the social mind across species, Wheatley says. Indeed, says Leong, understanding interpersonal neural signals is "a new frontier that is ripe for exploration." Wheatley is currently working on a new method that allows people in fMRI scanners to talk to each other at the same time across different sites. "We are excited about creating new tools that will open up new ways to study the brain in interaction."

The symposium "An Emerging Neuroscience of Social Connectedness" is taking place at the CNS annual meeting in San Francisco.

https://www.sciencedaily.com/releases/2019/03/190326132708.htm

Mothers of fussy babies at higher risk of depressive symptoms

March 25, 2019

Science Daily/Michigan Medicine - University of Michigan

As FDA approval of the first postpartum depression drug hits the news, study looks at how infant fussiness and a baby's level of prematurity may influence the severity of maternal depressive symptoms.

It's no secret that fussy newborns can be especially challenging for parents already facing physical and mental exhaustion from caring for a new baby.

But now science backs up the impact on parents: The less soothable the infant, the more distressed the mother.

Mothers of highly irritable infants experience greater depressive symptoms, according to new University of Michigan-led research. The nationally representative study, which included data from more than 8,200 children and their parents, appears in Academic Pediatrics.

The study is also believed to be the first to explore whether the degree of a baby's prematurity in combination with infant fussiness may influence the severity of maternal depressive symptoms.

Researchers found that mothers of very preterm, fussy infants (born at 24-31 weeks) had about twice the odds of experiencing mild depressive symptoms compared to moms of very preterm infants without fussiness.

However, mothers of fussy babies born moderate-late preterm (32-36 weeks gestation) as well as mothers of full-term infants were about twice as likely to report moderate to severe depressive symptoms as moms of less irritable babies born at the same gestational age.

"We found that maternal depression risk varied by gestational age and infant fussiness," says senior author Prachi Shah, M.D., a developmental and behavioral pediatrician at U-M C.S. Mott Children's Hospital and an associate research scientist at U-M's Center for Human Growth and Development. "Mothers of fussy infants born late preterm and full term are more likely to experience more severe levels of maternal depression, than mothers of fussy infants who were born more preterm."

"These findings reinforce that all mothers caring for babies with more difficult temperaments may need extra help managing the emotional toll," she adds. "Early screening for infant fussiness may help identify mothers with depressive symptoms in need of support, but may be especially important for mothers of infants born mildly preterm, in whom the symptoms of depression are more severe."

Shah notes that while very preterm infants have higher morbidity than babies born later, the perinatal care of infants born very preterm may actually help buffer against more severe maternal depression.

Very preterm infants are often cared for in a neonatal ICU setting where part of the specialized care includes guidance focused on the vulnerabilities associated with preterm birth. As parents transition home they often receive an enhanced level of postnatal support and developmental follow up, including referrals to early intervention programs, home visiting and subsequent care in neonatal clinics.

"The additional support and services provided to families of very premature children help prepare parents for the potential challenges associated with caring for a preterm infant and may help mitigate the risk for maternal depressive symptoms," Shah says.

However, she notes that mild depressive symptoms may progress into more severe depressive symptoms, and should also be addressed as early as possible.

Additionally, researchers found that maternal characteristics associated with prenatal stress and socioeconomic disadvantages -- such as lower income, unmarried status and smoking -were associated with greater odds of both mild and moderate-severe maternal depressive symptoms.

Asian and black race were also associated with greater odds of moderate-severe depressive symptoms whereas Hispanic ethnicity was associated with lower odds of maternal depression. Authors say this raises questions regarding the role of culture as a potential risk or protective factor in the development of maternal depression.

The study included data from the Early Childhood Longitudinal Study, Birth Cohort. Maternal depressive symptoms were assessed through self-reported questionnaires at the baby's nine-month visit.

The study adds to previous research suggesting that mothers of more irritable infants report significantly less confidence and more stress than mothers of less fussy infants.

"Pediatricians and providers should pay close attention to mothers who describe difficulty soothing their babies," Shah says. "Early interventions may help reduce the risk of maternal depression that negatively impacts a child-parent relationship and that may be harmful to both the health of a mother and child."

https://www.sciencedaily.com/releases/2019/03/190325110321.htm

Some pregnant women don't believe cannabis is harmful to their fetus

January 21, 2019

Science Daily/University of British Columbia

Up to one-third of pregnant women do not believe cannabis is harmful to their fetus, according to a new review by UBC researchers.

In some cases, women perceived a lack of communication from their health care providers about the risks of cannabis as an indication that the drug is safe to use during pregnancy.

The findings are outlined in a new review, published in the journal Preventive Medicine, in which UBC researchers sought to identify the latest evidence on women's perspectives on the health aspects of cannabis use during pregnancy and post-partum and whether their perceptions influence decision-making about using the drug.

"Our research suggests that, over the past decade, more women seem to be using cannabis during pregnancy than ever before, even though evidence of its safety is limited and conflicting," said lead author Hamideh Bayrampour, assistant professor in the UBC department of family practice and affiliate investigator at BC Children's Hospital Research Institute. "As many jurisdictions around the world, including Canada, legalize cannabis, it's becoming increasingly important for public health officials to understand perceptions of cannabis use and to increase awareness of the health concerns around its use, especially for pregnant women."

For the review, researchers identified six studies, all conducted in the United States, which looked at women's perceptions about cannabis use during pregnancy.

Across the studies, the rate of cannabis use among pregnant women varied considerably. In a large U.S. population-based study, nearly four per cent of women self-reported using cannabis within the past month, while seven per cent self-reported using cannabis within the past year. However, in another study that saw researchers also test hair and urine samples, the rate of cannabis use increased to 28 per cent.

Pregnant cannabis users were more likely to be under the age of 25, unemployed, single or uninsured, African American, and to have low income and education, or use other substances such as tobacco and alcohol. A diagnosis of anxiety or depression was also associated with cannabis use during pregnancy.

As for patterns of use, the researchers found that cannabis use rates were highest during the first trimester (7.4 per cent) and lowest during the third trimester (1.8 per cent). Most pregnant users reported using cannabis to treat nausea early in their pregnancy.

In one study involving 306 pregnant women, 35 per cent reported being cannabis users when they realized they were pregnant. Two-thirds of those women quit after finding out they were pregnant, but among those who continued to use cannabis, half reported using almost daily or twice a week.

When women were asked about their perception of general harm associated with cannabis use, 70 per cent of both pregnant and non-pregnant cannabis users responded that they perceived slight or no risk of harm. In another study, when asked if they believed cannabis is harmful to a baby during pregnancy, 30 per cent of pregnant women responded "no." When women were asked to identify substances most likely to harm the baby during pregnancy, 70 per cent chose alcohol and 16 per cent chose tobacco, while only two per cent chose cannabis.

While research on the health effects of cannabis is limited, some studies have shown an increased risk of problems for pregnant women, including anemia, low birth weight, stillbirth and newborn admission to the neonatal intensive care unit. Due to the risk of potential problems, many professional organizations, including the Society of Obstetricians and Gynaecologists of Canada, recommend women not use cannabis when trying to conceive, during pregnancy and while breastfeeding.

Still, some women reported that not having specific counselling provided about the risks of cannabis use suggest that the drug is safe.

"One of our review findings revealed that some people don't consider cannabis to be a drug," said Bayrampour. "With this in mind, it's especially important for health care providers to ask specific questions about cannabis use during pregnancy and breastfeeding to help spark a productive conversation about the potential health impacts and to help support women in their decision to reduce use and quit."

https://www.sciencedaily.com/releases/2019/01/190121103421.htm

Prenatal exposure to cannabis impacts sociability of male offspring only

September 11, 2018

Science Daily/eLife

Taking cannabinoids during pregnancy can cause behavioural and neuronal deficits in adult male offspring, while females remain unaffected, says new research published in eLife.

The study in rats, from the Inserm and Aix-Marseille University Mediterranean Institute of Neurobiology, France, and Roma Tre University, Italy, in collaboration with Indiana University, US, suggests that prenatal cannabinoid use can lead to less sociability and increased neuronal excitability in males only. The findings also point towards a potential pharmacological strategy to help reverse these effects in humans.

Senior author Olivier Manzoni, Inserm Research Director at the Mediterranean Institute of Neurobiology, and Director of the CannaLab at the institute, says: "As cannabinoids can cross the placenta, they may interfere with fetal endocannabinoid signaling during neurodevelopment, which is involved in regulating a variety of processes such as pregnancy, appetite, pain sensation, and mediating the pharmacological effects of cannabis. This could in turn lead to some serious long-term deficits. But despite increasing reports of cannabis consumption during pregnancy, the long-term consequences of prenatal cannabinoid exposure remain incompletely understood."

To fill this knowledge gap, the international collaborators examined how prenatal cannabinoid exposure influences the synaptic and behavioral functions of the medial prefrontal cortex -- a brain region often implicated in neuropsychiatric disorders -- in adult male and female rats.

Their results revealed that males exposed to cannabinoids while in the uterus were less sociable than normal animals, and spent less time interacting with others. Their sniffing and playing behaviors were impaired, while the number of attacks among males remained unchanged. Additionally, the researchers saw that the exposed males had a heightened excitability of pyramidal neurons in the prefrontal cortex. None of these effects were seen in females.

"The deleterious effects of prenatal exposure to cannabinoids on social behavior were specific to male offspring only," explains co-first author Anissa Bara, who was a PhD candidate in Manzoni's lab at the time the study was carried out. "But while social interaction was specifically impaired in males, locomotion, anxiety and cognition remained unaffected in both sexes, suggesting discrete and sex-specific behavioral consequences of cannabinoid exposure during adulthood."

The results also revealed that the mGlu5 gene -- an effector of endocannabinoid signaling in the prefrontal cortex -- was reduced in the exposed males' prefrontal cortex. The team discovered that amplifying mGlu5 signaling could normalise the synaptic and behavioral deficits induced by prenatal exposure to cannabinoids partly by activating the cannabinoid type 1 receptor (CB1R). Similarly, later tests also revealed that enhancing levels of anandamide (a type of endocannabinoid) in exposed males helped to restore their social deficits via CB1R.

"Altogether, these results provide compelling evidence for sex-specific effects of prenatal cannabinoid exposure," concludes co-first author Antonia Manduca, Inserm Postdoctoral Researcher at the Mediterranean Institute of Neurobiology. "The fact that increasing mGlu5 signaling and enhancing anandamide levels helped to reverse the negative effects of early exposure in rats also hints at a new pharmacological strategy that could one day be trialled in humans."

https://www.sciencedaily.com/releases/2018/09/180911132101.htm

Marijuana found in breast milk up to six days after use

Researchers report 63 percent of breast milk samples from mothers using marijuana contained traces of the drug

August 27, 2018

Science Daily/University of California - San Diego

To better understand how much marijuana or constituent compounds actually get into breast milk and how long it remains, researchers conducted a study.

With the legalization of marijuana in several states, increased use for both medicinal and recreational purposes has been documented in pregnant and breastfeeding women. Although national organizations like the American Academy of Pediatrics recommend that breastfeeding mothers do not use marijuana, there has been a lack of specific data to support health or neurodevelopmental concerns in infants as a result of exposure to tetrahydrocannabinol (THC) or other components of marijuana via breast milk.

To better understand how much marijuana or constituent compounds actually get into breast milk and how long it remains, researchers at University of California San Diego School of Medicine conducted a study, publishing online August 27 in Pediatrics.

Fifty-four samples from 50 women who used marijuana either daily, weekly or sporadically -- with inhalation being the primary method of intake -- were examined. Researchers detected THC, the primary psychoactive component of marijuana, in 63 percent of the breast milk samples for up to six days after the mother's last reported use.

"Pediatricians are often put into a challenging situation when a breastfeeding mother asks about the safety of marijuana use. We don't have strong, published data to support advising against use of marijuana while breastfeeding, and if women feel they have to choose, we run the risk of them deciding to stop breastfeeding -- something we know is hugely beneficial for both mom and baby," said Christina Chambers, PhD, MPH, principal investigator of the study, professor in the Department of Pediatrics at UC San Diego School of Medicine and director of clinical research at Rady Children's Hospital-San Diego.

The World Health Organization recommends exclusive breastfeeding for up to six months. Early breastfeeding is associated with a reduced risk of obesity, asthma and sudden infant death syndrome and with improved immune health and performance on intelligence tests. In mothers, breastfeeding has been associated with lower risks for breast and uterine cancer and type 2 diabetes.

Cannabinoids -- marijuana's active compounds, such as THC -- like to bind to fat molecules, which are abundant in breast milk. This stickiness has suggested that, in women who use marijuana, these compounds can end up in breast milk, raising concerns about their potential effects on nursing babies.

"We found that the amount of THC that the infant could potentially ingest from breast milk was relatively low, but we still don't know enough about the drug to say whether or not there is a concern for the infant at any dose, or if there is a safe dosing level," said Chambers, co-director of the Center for Better Beginnings at UC San Diego. "The ingredients in marijuana products that are available today are thought to be much more potent than products available 20 or 30 years ago."

The samples of breast milk used for the study were obtained from mothers who joined the Mommy's Milk Human Milk Research Biorepository at UC San Diego, a program that focuses on looking at the numerous benefits of breast milk at the molecular level. Chambers and her research team collaborated with Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego to measure the levels of marijuana in the samples.

Chambers said the results are a stepping stone for future research. More studies need to be done, not only to determine the long-term impact of marijuana in breast milk for children, but more specifically: "Are there any differences in effects of marijuana in breast milk for a two-month-old versus a 12-month-old, and is it different if the mother smokes versus eats the cannabis? These are critical areas where we need answers as we continue to promote breast milk as the premium in nutrition for infants."

https://www.sciencedaily.com/releases/2018/08/180827080911.htm

Prenatal marijuana use can affect infant size, behavior

May 10, 2018

Science Daily/University at Buffalo

Smoking during pregnancy has well-documented negative effects on birth weight in infants and is linked to several childhood health problems. Now, researchers at the University at Buffalo Research Institute on Addictions have found that prenatal marijuana use also can have consequences on infants' weight and can influence behavior problems, especially when combined with tobacco use.

"Nearly 30 percent of women who smoke cigarettes during pregnancy also report using marijuana," says Rina Das Eiden, PhD, RIA senior research scientist. "That number is likely to increase with many states moving toward marijuana legalization, so it's imperative we know what effects prenatal marijuana use may have on infants."

Through a grant from the National Institute on Drug Abuse, Eiden studied nearly 250 infants and their mothers. Of these, 173 of the infants had been exposed to tobacco and/or marijuana during their mothers' pregnancies. None were exposed to significant amounts of alcohol.

Eiden found that infants who had been exposed to both tobacco and marijuana, especially into the third trimester, were smaller in length, weight and head size, and were more likely to be born earlier, compared to babies who were not exposed to anything. They also were more likely to be smaller in length and weight compared to babies exposed only to tobacco in the third trimester. The results were stronger for boys compared to girls.

"We also found that lower birth weight and size predicted a baby's behavior in later infancy," Eiden says. "Babies who were smaller were reported by their mothers to be more irritable, more easily frustrated and had greater difficulty calming themselves when frustrated. Thus, there was an indirect association between co-exposure to tobacco and marijuana and infant behavior via poor growth at delivery."

Furthermore, women who showed symptoms of anger, hostility and aggression reported more stress in pregnancy and were more likely to continue using tobacco and marijuana throughout pregnancy. Therefore, due to the co-exposure, they were more likely to give birth to infants smaller in size and who were more irritable and easily frustrated. The infants' irritability and frustration is also linked to mothers who experienced higher levels of stress while pregnant.

"Our results suggest that interventions with women who smoke cigarettes or use marijuana while pregnant should also focus on reducing stress and helping them cope with negative emotions," Eiden says. "This may help reduce prenatal substance exposure and subsequent behavior problems in infants."

The study appeared in the March/April issue of Child Development and was authored by Pamela Schuetze, PhD, Department of Psychology, Buffalo State College, with co-authors Eiden; Craig R. Colder, PhD, UB Department of Psychology; Marilyn A. Huestis, PhD, Institute of Emerging Health Professions, Thomas Jefferson University, Philadelphia; and Kenneth E. Leonard, PhD, RIA director.

https://www.sciencedaily.com/releases/2018/05/180510145924.htm

Hemp shows potential for treating ovarian cancer

Researchers demonstrate hemp's ability to slow cancer growth and uncover mechanism for its cancer-fighting ability

https://www.sciencedaily.com/images/2018/04/180423155046_1_540x360.jpg

April 23, 2018

Science Daily/Experimental Biology 2018

Results from some of the first studies to examine hemp's ability to fight cancer show that it might one day be useful as plant-based treatment for ovarian cancer. Hemp is part of the same cannabis family as marijuana but doesn't have any psychoactive properties or cause addiction.

Sara Biela and Chase Turner, graduate students in the lab of Wasana Sumanasekera at Sullivan University College of Pharmacy in Kentucky, will present new findings tied to hemp's anti-cancer properties at the American Society for Biochemistry and Molecular Biology annual meeting during the 2018 Experimental Biology meeting to be held April 21-25 in San Diego.

"Hemp, like marijuana, contains therapeutically valuable components such as cannabidiol, cannabinol, and tetrahydrocannabinol," explained Biela. "However, unlike marijuana, hemp's therapeutic ability has not been studied in detail."

Two new studies examined the therapeutic potential of an extract known as KY-hemp, which is produced from hemp grown in Kentucky. The plant strain, growing conditions and processing techniques were all optimized to produce an extract containing substances with potential therapeutic benefit and to eliminate any residue that could contaminate the product.

In one study, the researchers found that adding various doses of KY-hemp extract to cultured ovarian cells led to significant dose-dependent slowing of cell migration. This finding indicated that the extract might be useful for stopping or slowing down metastasis -- the spreading of cancer to other parts of the body.

In a second study, the researchers explored the biology of KY-hemp's protective effects against ovarian cancer, which they had observed in previous studies. Experiments with cultured ovarian cancer cells showed that KY-hemp slowed the secretion of the interleukin IL-1 beta. Interleukins produce inflammation that can be damaging and has been linked to cancer progression. The hemp-induced slowing of IL-1 β secretion represents a possible biological mechanism responsible for KY-hemp's anti-cancer effects.

"Our findings from this research as well as prior research show that KY hemp slows ovarian cancer comparable to or even better than the current ovarian cancer drug Cisplatin," said Turner. "Since Cisplatin exhibits high toxicity, we anticipate that hemp would carry less side effects. However, that needed to be tested in the future."

The researchers plan to test the extract in mice after they complete additional studies in cultured cancer cells to learn more about how it leads to cancer cell death.

https://www.sciencedaily.com/releases/2018/04/180423155046.htm

Prenatal cannabis use associated with low birth weights

The study, led by Colorado School of Public Health, shows a 50 percent increase in low birth weights among women who use cannabis during pregnancy

April 23, 2018

Science Daily/University of Colorado Anschutz Medical Campus

With marijuana use during pregnancy on the rise, a new study led by the Colorado School of Public Health shows that prenatal cannabis use was associated with a 50 percent increased likelihood of low birth weight, setting the stage for serious future health problems including infection and time spent in Neonatal Intensive Care Units.

"Our findings underscore the importance of screening for cannabis use during prenatal care and the need for provider counselling about the adverse health consequences of continued use during pregnancy," said the study's lead author Tessa Crume, PhD, MSPH, assistant professor of epidemiology at the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus.

The study was published last month in The Journal of Pediatrics.

Crume and her colleagues utilized survey data from 3,207 women who participated in the Colorado Pregnancy Risk Assessment Monitoring System in 2014 and 15. They found the prevalence of marijuana use in the state of Colorado was 5.7 percent during pregnancy and 5 percent among women who were breastfeeding.

They also discovered that prenatal marijuana use was associated with a 50 percent increased chance of low birth weight regardless of tobacco use during pregnancy. Prenatal marijuana use was three to four times higher among women who were younger, less educated, received Medicaid or WIC, were white, unmarried and lived in poverty.

Crume said the numbers are surprising but also reflect changing attitudes toward marijuana, especially in a state like Colorado where it is legal.

"There is increased availability, increased potency and a vocal pro-cannabis advocacy movement that may be creating a perception that marijuana is safe to use during pregnancy," Crume said.

The National Survey on Drug Use and Health suggests that cannabis use among pregnant women has increased as much as 62 percent between 2002 and 2014. At the same time, the potency of the drug has increased six or seven fold since the 1970s along with the ways it is consumed -- eating, vaping, lotions etc.

"Growing evidence suggests prenatal cannabis exposure has a detrimental impact on offspring brain function starting in the toddler years, specifically issues related to attention deficit disorder," Crume said. "But much of the research on the effects of prenatal cannabis on neonatal outcomes was based on marijuana exposures in the 1980s and 1990s which may not reflect the potency of today's cannabis or the many ways it is used."

The study found that 88.6 percent of women who used cannabis during pregnancy also breastfed. The risk of cannabis to the infant through breastmilk remains unknown. Various studies have found that cannabinoids are passed to the baby in this way. One of the study's co-authors, Dr. Erica Wymore, MD, MPH, from Children's Hospital Colorado and the CU School of Medicine, is currently conducting a study to evaluate this issue.

The researchers recommend that health care providers ask pregnant women about their cannabis use and advise them to stop during pregnancy and lactation.

"Obstetric providers should refrain from prescribing or recommending cannabis for medical purposes during preconception, pregnancy and lactation," Crume said. "Guidance and messaging about this should be incorporated into prenatal care. And screening of pregnant women at risk for cannabis dependency should be linked to treatment options."

https://www.sciencedaily.com/releases/2018/04/180423125052.htm

Testing breast milk for cannabinoids

January 11, 2017

Science Daily/American Chemical Society

With the legalization of medical and recreational marijuana spreading across the country, the drug's use is reportedly increasing among pregnant women. It stands to reason that many of these women will continue to use marijuana after they give birth. Now researchers have developed a new method to help determine what this means for infants' potential exposure to the active compounds in marijuana in breast milk. Their report appears in the journal ACS Omega.

Cannabinoids, marijuana's active compounds such as tetrahydrocannabinol (THC) and cannabinol, like to stick to fat, which is abundant in breast milk. This stickiness suggests that in women who use marijuana, these compounds can end up in breast milk, raising concerns about their potential effects on nursing babies. But the health risks to these infants largely remain undetermined. This is partly due to researchers' limited ability to precisely measure marijuana's active compounds in milk. Current analytical methods can detect THC at levels of 1.5 nanograms per milliliter or higher, but no current method can measure cannabinol or cannabidiol in milk.

Researchers at the Centers for Disease Control and Prevention developed a method that begins with saponification -- a process often associated with soap-making -- to separate cannabinoids from fat in milk. With this approach, the team can detect trace levels (picograms per milliliter) of active marijuana compounds, including cannabinol and cannabidiol, that they say could be present in milk due to second-hand exposure. The test is 100 times better at detecting THC in milk than previous techniques. The researchers say that their approach could contribute to future studies designed to determine potential health risks of a mother's marijuana exposure to her breastfeeding infant.

https://www.sciencedaily.com/releases/2017/01/170111102842.htm

Forgotten fathers: New dads also at risk for postpartum depression

Study provides an in-depth look at new fathers' experiences with PPD

March 7, 2019

Science Daily/University of Nevada, Las Vegas

A new study offers an in-depth view of new fathers' experiences with postpartum depression (PPD). The study explores issues they encounter and how they can move beyond barriers they face in receiving diagnoses and treatment of the little-known phenomenon.

It's increasingly common to hear about new moms suffering from the baby blues. But what about new dads?

A new UNLV study, published last week in the Journal of Family Issues, offers an in-depth view of new fathers' experiences with postpartum depression (PPD). The study explores issues they encounter and how they can move beyond barriers they face in receiving diagnoses and treatment of the little-known phenomenon.

Between 5 and 10 percent of new fathers in the United States suffer from PPD, according to U.S. Centers for Disease Control and Prevention data. One study shows that the risk goes up to 24 to 50 percent for men whose partners suffer from PPD.

A team of researchers, led by UNLV Couple and Family Therapy professor Brandon Eddy, scoured blogs, websites, forums, and chat rooms for first-hand accounts from new dads. Six themes emerged:

·     Needing education.Fathers didn't know men could suffer from PPD and were surprised to learn others experienced it. Women who saw PPD in men were unsure of what to call it. Men complained about pushback or not receiving information from doctors or therapists, or frustration that the PPD resources they did manage to find focused solely on how to help their wives.

·     Adhering to gender expectations. Many dads felt pressured to espouse traditional "tough guy" stereotypes. In fact, one man who told another father to "suck it up" said he knew it was bad advice but explained that it's what's expected of men.

·     Repressing feelings.Men were reluctant to share their feelings for fear of sounding ridiculous or looking weak to their wives, who were the primary caregivers.

·     Overwhelmed.Many of the new dads found it difficult to express their emotions of confusion, exhaustion, helplessness, loneliness, and feeling trapped. Parents often suffer from lack of sleep after birth, which can exacerbate stress and depressive symptoms -- making them more irritable to their children's crying.

·     Resentment of baby.While many fathers expressed joy and excitement for the arrival of their children, others resented their baby's constant needs and attention. A few talked about suppressing urges to hurt the baby or themselves.

·     Experience of neglect.The dads felt lost, forgotten, and neglected -- by their wives, the health care system, and society. One father described "uncomfortably laughing" while reading PPD screening questions typically asked of women during routine checkups: "I began to feel like someone should be asking me the same questions." Another said men, who must simply wait while women do the hard work of pregnancy and labor and lack an umbilical cord connection to their children, had often shared with him similar stories of struggling with PPD: "There's no truly acceptable place or context for men to publicly reveal being challenged -- much less rocked to the core -- by what I call 'sudden parenthood'."

Overall, the findings complement previous studies on barriers for fathers suffering from PPD. UNLV researchers said encountering a lack of information and stigma often causes dads to distance themselves from their child and has been associated with marital difficulties.

Previous research elsewhere has found that paternal involvement has many positive outcomes for children, such as boys displaying less hostile behavior then children with absent dads, reduced delinquency for both sexes, considerably higher IQ scores for children in their early development years, and lower levels of emotional distress. That's on top of studies showing fathers who suffer from PPD report lower levels of communication with their partners, as well as increased rates of substance abuse and domestic violence.

"The expectations society gives to men of what they are supposed to be, what they are supposed to do, and how they do it was a significant factor on how many of these men chose to cope with life stressors," the UNLV researchers wrote.

"Because men are already less likely than women to seek professional help for depression, it is vital that the stigma of PPD decreases," they added. "Because paternal involvement is a significant factor in the healthy development of children, it would seem wise to make information about paternal PPD more available in order to combat its negative impact on families."

The U.S. Preventative Services Task Force -- an independent coalition of national experts -- recently recommended that all women be screened for depression before and after giving birth. There is no current assessment designed to specifically screen men for PPD.

"With the vast amount of research conducted on the importance of paternal involvement and the rising rates of PPD in fathers," researchers wrote, "it seems logical that fathers should also be included in this recommendation."

https://www.sciencedaily.com/releases/2019/03/190307091448.htm

Child's elevated mental ill-health risk if mother treated for infection during pregnancy

March 7, 2019

Science Daily/University of Gothenburg

Risks for autism and depression are higher if one's mother was in hospital with an infection during pregnancy. This is shown by a major Swedish observational study of nearly 1.8 million children.

"The results indicate that safeguarding against and preventing infection during pregnancy as far as possible by, for instance, following flu vaccination recommendations, may be called for," says Verena Sengpiel, Associate Professor of Obstetrics and Gynecology at Sahlgrenska Academy, University of Gothenburg, and last author of the study, published in the journal JAMA Psychiatry.

Maternal infection with certain infectious agents, such as cytomegalovirus (CMV) or the herpes virus, are already known to be capable of harming fetal brain development and boosting the risk of certain psychiatric disorders.

The findings of the current study, however, also show that infection in general during pregnancy, too -- including when the actual infectious agent does not reach the fetal brain -- is related to elevated risk of the child developing autism or depression later in life.

More autism and depression

The study is based on data on all children, totaling almost 1.8 million, born in Sweden during the years 1973-2014. The particulars from the Swedish Medical Birth Register were linked to the national inpatient register, which records whether the mother was treated in hospital with an infection diagnosis during the pregnancy concerned.

Using the inpatient register, the researchers also monitored these children's mental health until 2014, when the oldest were aged 41.

It was found that if, during pregnancy, a mother with an infection diagnosis received hospital treatment, there was a marked rise in the risk of her child needing hospital care later in life, with a diagnosis of either autism or depression. The increase in risk was 79 percent for autism and 24 percent for depression.

In contrast, there was no association between the mothers being in hospital with an infection diagnosis during pregnancy and two other psychiatric diagnoses studied in their children: bipolar disorder and psychosis, including schizophrenia.

Increased risk even after mild infection

The pregnant women in the study may have been hospitalized with diagnoses other than infections, but then had infections diagnosed during their stay as well. The elevated risk of mental ill-health in the child was also evident after infections in the pregnant women that are usually considered mild, such as a common urinary tract infection.

The study, which was observational, provides no answer on how maternal infection during pregnancy affects fetal brain development. However, other studies have shown that an infection in the mother leads to an inflammatory reaction, and that some inflammatory proteins can affect gene expression in fetal brain cells.

Other research shows that inflammation in the mother boosts production of the neurotransmitter serotonin in the placenta, which may conceivably affect the unborn child's brain development.

https://www.sciencedaily.com/releases/2019/03/190307103212.htm