Maternal milk tied to better school-age outcomes for children born preterm

July 13, 2022

Science Daily/Brigham and Women's Hospital

Children who were born preterm are at heightened risk of lower academic achievement in math, reading and other skills and are also at greater risk for attention-deficit/hyperactivity disorder (ADHD). But a new study suggests that an intervention in the first weeks and months of a preterm infant's life may lead to better neurodevelopmental outcomes in later years. In a study that followed preterm infants for seven years, investigators from Brigham and Women's Hospital together with collaborators at the South Australian Health and Medical Research Institute found that children who received greater quantities of maternal milk both during and after time in the neonatal intensive care unit (NICU) had greater academic achievement, higher IQs and reduced ADHD symptoms. Results are published in JAMA Network Open.

"Our study finds that there may be long-term neurodevelopmental benefits to providing maternal milk to preterm infants," said corresponding author Mandy Brown Belfort, MD, MPH, of the Department of Pediatric Newborn Medicine. "A lot of families are dedicated to the idea of providing maternal milk but may face steep challenges. Our findings emphasize the importance of providing support for initiating and sustaining lactation because maternal milk at this early age can provide benefits years later."

Belfort and colleagues looked at neurodevelopmental outcomes for 586 infants born at less than 33 weeks' gestation at one of five Australian perinatal centers. Children were evaluated at age 7 (corrected for prematurity). The team looked at data on maternal milk dose (volume of maternal milk infants received each day) and maternal milk duration (how long parents continued breastfeeding) predicted several neurodevelopmental outcomes. These outcomes included academic achievement, Verbal and Performance IQ, symptoms of ADHD, executive function, and behavior.

Overall, the team found that higher maternal milk intake was associated with higher Performance IQ and higher reading and math scores. Parents also reported fewer ADHD symptoms for children who consumed more maternal milk during infancy. Duration of maternal milk intake (up to 18 months corrected age) was also associated with higher reading, spelling and math scores. The researchers controlled for confounders, including clinical and social factors. These beneficial associations were stronger for infants born at the lowest gestational ages, particularly those born below 30 weeks of gestation.

The authors note that their study is observational -- they cannot determine causality as there may be other, unaccounted factors that influence both the ability to provide maternal milk and academic achievement. The study's strengths include its large size, the range of outcomes examined, and that the researchers could assess school-age outcomes. Other studies have only followed children through preschool age, making it difficult to assess the full range of neurodevelopmental outcomes.

Overall, Belfort sees the team's findings as an affirmation of guidance from the American Academy of Pediatrics and World Health Organization, both of which recommend maternal milk for infants.

"Our study confirms recommended strategies for supporting parents to provide maternal milk for preterm infants," said Belfort. "And it strengthens the call for health policies and parental leave policies that support rather than work against parents. As a society, we need to invest in families -- it's an investment that will continue to benefit children when they reach school age."

https://www.sciencedaily.com/releases/2022/07/220713114545.htm

Study finds women have more brain changes after menopause

June 29, 2022

Science Daily/American Academy of Neurology

Women who have gone through menopause may have more of a brain biomarker called white matter hyperintensities than premenopausal women or men of the same age, according to a new study published in the June 29, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology.

White matter hyperintensities are tiny lesions visible on brain scans that become more common with age or with uncontrolled high blood pressure. These brain biomarkers have been linked in some studies to an increased risk of stroke, Alzheimer's disease and cognitive decline.

"White matter hyperintensities increase as the brain ages, and while having them does not mean that a person will develop dementia or have a stroke, larger amounts may increase a person's risk," said study author Monique M. B. Breteler, MD, PhD, of the German Center of Neurodegenerative Diseases (DZNE), in Bonn, Germany, and a member of the American Academy of Neurology. "Our study examined what role menopause may have on amounts of these brain biomarkers. Our results imply that white matter hyperintensities evolve differently for men and women, where menopause or factors that determine when menopause starts, such as variations in the aging process, are defining factors."

The study involved 3,410 people with an average age of 54. Of those, 58% were women, and of the women, 59% were postmenopausal. Also, 35% of all participants had high blood pressure and of those, half had uncontrolled high blood pressure.

All participants had MRI brain scans. Researchers looked at the scans and calculated the amount of white matter hyperintensities for each participant. Average total volume for these brain biomarkers was 0.5 milliliters (ml). Average total brain volume was 1,180 ml for men and 1,053 ml for women. Average total white matter volume, the area of the brain where white matter hyperintensities can be found, was 490 ml for men and 430 ml for women.

After adjusting for age and vascular risk factors such as high blood pressure and diabetes, researchers found that postmenopausal women had more of these brain biomarkers when compared to men of similar age. In people 45 and older, postmenopausal women had an average total white matter hyperintensities volume of 0.94 ml compared to 0.72 ml for men. Researchers also found that the increase in brain biomarkers accelerated with age and at a faster rate in women than in men.

Premenopausal women and men of a similar age did not have a difference in the average amount of white matter hyperintensities.

Researchers also found that postmenopausal women had more white matter hyperintensities than premenopausal women of similar age. In a group of participants ages 45 to 59, postmenopausal women had an average total volume of white matter hyperintensities of 0.51 ml compared to 0.33 ml for premenopausal women.

There was no difference between postmenopausal and premenopausal women using hormone therapy. Breteler said this finding suggests that hormone therapy after menopause may not have a protective effect on the brain.

Unrelated to menopausal status, women with uncontrolled high blood pressure had higher amounts of this brain biomarker compared to men.

"It has been known that high blood pressure, which affects the small blood vessels in the brain, can lead to an increase in white matter hyperintensities," said Breteler. "The results of our study not only show more research is needed to investigate how menopause may be related to the vascular health of the brain. They also demonstrate the necessity to account for different health trajectories for men and women, and menopausal status. Our research underscores the importance of sex-specific medicine and more attentive therapy for older women, especially those with vascular risk factors."

A limitation of the study was that researchers did not know the exact age of menopause onset or whether some participants were perimenopausal.

https://www.sciencedaily.com/releases/2022/06/220629160922.htm

Helping babies to sleep more

June 29, 2022

Science Daily/Penn State

Over the last decade, researchers and staff working on Penn State's INSIGHT study have trained new mothers in skills that -- among other things -- help newborns sleep more during the night. New research from Penn State's Center for Childhood Obesity Research (CCOR) shows that second children in these families also slept longer.

New parents often want infants to sleep because the parents are tired, but sleep is critical to health and development. The researchers in CCOR study sleep because it affects whether children develop obesity. Sleep also affects a child's capacity for emotional regulation and cognitive development. What is more, research shows that sleep deprived parents are more likely to develop depression and be involved in traffic accidents. Infant sleep can be important for the whole family's health and well-being.

Responsive parenting

The INSIGHT study -- an acronym for intervention nurses start infants growing on healthy trajectories -- began in 2012 with CCOR researchers training 279 mothers of first-born infants in responsive parenting practices. Responsive parenting involves responding to children in a timely, sensitive, and age-appropriate manner, based on the child's presenting needs.

In INSIGHT, the mothers were taught how to respond to infant behavior states like fussiness, alertness (feeding and interactive play), drowsiness, and sleeping. The training included several specific recommendations about bedtime routines and responding to nighttime waking.

Children in the INSIGHT intervention group slept longer each night and were more likely to soothe themselves to sleep than children in the control group. Significantly, these children also had lower body mass indices (BMIs) for the first three years of their lives.

Understanding 'spillover' effects

As the INSIGHT study progressed, it led the investigators to explore whether the training also affected children who were later born into INSIGHT families.

"Many parents say things like, 'Oh, I did everything right with my first child, and then I had no time for the others,'" explained Emily Hohman, assistant research professor in CCOR. "So, in order to understand whether the effects of INSIGHT spill over to other siblings, we launched a new study where we do not provide any training or intervention for parents or children. We just track information about second-born children in families where mothers received the INSIGHT training for their first-born."

Hohman led a team of researchers who examined data from 117 mothers from the original INSIGHT study who were having a second child, about half of whom had received the responsive parenting training with their firstborn child. The team used a brief questionnaire to assess second-born children's sleep behavior and duration when the children were three, 16, and 52 weeks old.

In a recent publication in the journal Pediatrics, the researchers demonstrated that second-born children in INSIGHT families slept an average of 40 minutes longer per night than second-born children in the control group. The second-born INSIGHT children also slept more than 50 minutes longer per 24-hour period, had earlier bedtimes in early life, and were more likely to fall asleep in under 15 minutes.

This is not the first study that has shown that the effects of INSIGHT spilled over to second-born children. Other studies have demonstrated that second-born children in INSIGHT families have lower body-mass indices (BMIs) as infants than children in the control group. Additionally, parental feeding practices and infants' dietary intake were healthier than those of children from control group families.

How parents can promote better sleep for their infants (and themselves)

The INSIGHT study trained mothers, but responsive parenting skills are useful for anyone who provides care to children. At bedtime, responsive parenting involves establishing healthy routines, responding to children according to their development and needs, and teaching children to soothe themselves as much as possible.

For parents who do not know anything about responsive parenting, Hohman recommends starting by establishing a bedtime. "People sometimes think that if they keep their babies awake with them later at night, then the baby will sleep later. But the research shows that early establishment of a bedtime between seven and eight o'clock will help babies sleep longer," said Hohman.

Once a regular bedtime is established, research indicates that consistent bedtime routines also promote longer sleep. The routine should be soothing and include things like baths and reading, while avoiding overly stimulating activities like rowdy play. The routine will help the child prepare for sleep. Additionally, infants who are not yet rolling over can be swaddled to increase their sense of calm.

To help children learn to soothe themselves to sleep, parents are encouraged to put their children to bed while they are drowsy but still awake. Self-soothing is a valuable skill, and the sooner children learn it, the better they and their parents will sleep.

Nighttime waking is inevitable; newborns and infants wake throughout the night for many reasons, including hunger. This does not mean that feeding should always be a parent's first response when their baby wakes. Hohman and her colleagues encourage parents to use "lighter touch" soothing methods like offering the baby a pacifier, words of reassurance, and gentle touches. More engaged soothing, like holding, rocking and feeding, should only be used if the baby remains distressed or shows signs of hunger.

"No one likes to hear their baby cry, and everyone wants to get back to sleep as soon as possible," said Hohman. "But a baby can only learn to soothe themselves when they are not being soothed by someone else. During the daytime, parents should feel free to use more active soothing strategies like holding or rocking, but these should be used more judiciously at nighttime in order to promote better sleep."

Helping families everywhere

The study results indicate that intervening with first-time parents could be an efficient way to help multiple children in a family.

"Our outcomes suggest that pediatricians may have a new tool to help promote better infant sleeping and prevent unhealthy infant weight gain," Hohman said. "Pediatricians typically have a lot of visits with new families. If those clinicians help new parents build responsive parenting skills, the benefits could extend to the parents, their newborns, and any potential future children in those families."

https://www.sciencedaily.com/releases/2022/06/220629150317.htm

Words matter: How to reduce gender bias with word choice

June 10, 2022

Science Daily/Cell Press

In the workplace, even subtle differences in language choice can influence the perception of gender, for better or worse. These choices fall into two main categories: minimizing the role of gender by using gender-neutral terms or emphasizing an individual's gender through "gender marking." In a commentary in the journal Trends in Cognitive Sciences, behavioral scientist Stav Atir argues that by using these two approaches thoughtfully, one can promote gender equality.

"If anyone suggested saying 'female politician' or 'lady scientist,' I think many would say 'No, thank you,'" says Atir, an assistant professor at the University of Wisconsin Madison who studies how gender bias can affect perceptions of professionals.

The gender-neutral approach involves using words like "businessperson," instead of "businessman" or "businesswoman," or using gender-neutral pronouns like "they" instead of "he" or "she." Using this language can erase the conception that men and women are wildly different beings, and it fights back against our natural tendency to rely on stereotypes in our thinking, studies show.

"But wholesale gender neutrality in language is no panacea," says Atir. This approach suffers from the fact that gender-neutral terms tend to be considered masculine by default.

"Even when gender isn't explicitly specified, stereotypes often fill in the gender blank," says Atir. "Occupation words such as 'businessperson' or 'surgeon,' though technically gender neutral, likely conjure up an image of a man; likewise, 'nurse' (also technically gender neutral) conjures up an image of a woman."

The alternative -- using a gender-marking approach -- can be used to highlight the success of women in male-dominated fields. "In order to spotlight the breakers of glass ceilings and those following in their footsteps, we must mention their gender," says Atir.

This approach comes with its own drawbacks, like reinforcing negative stereotypes. "Gender marking, then, should not be used thoughtlessly," says Atir. "Though it can draw attention to professionals whose gender is underrepresented, it can also have ironic consequences, prompting stereotypical thinking and bolstering the perception of women as exotic exceptions to the male rule."

"We might be tempted to throw up our hands and give up the endeavor of using language to express and promote our beliefs. That would be a mistake," says Atir. "Language remains one tool in our toolbox for social change, and, unlike some of our other tools, it's one that we can all use. The key to using this tool effectively is to tailor our language to the context, taking into account our situation-specific goals."

https://www.sciencedaily.com/releases/2022/06/220610120216.htm

COVID-19 vaccination in pregnancy helps protect infants from needing hospital care for COVID-19

CDC study results reinforce importance of COVID-19 vaccination during pregnancy

June 24, 2022

Science Daily/Ann & Robert H. Lurie Children's Hospital of Chicago

In a new study sponsored by the Centers for Disease Control and Prevention and published in the New England Journal of Medicine, researchers provide additional evidence that COVID-19 vaccination during pregnancy helps protect babies younger than 6 months from being hospitalized due to COVID-19. The risk of COVID-19 hospitalization among babies was reduced by about 80 percent during the Delta wave (July 1-December 18, 2021) and 40 percent during the Omicron wave (December 19-March 8, 2022).

"Our results reinforce the importance of COVID-19 vaccination during pregnancy to protect both the women and their babies from COVID-19," said co-author Bria Coates, MD, Critical Care physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "Although protection was lower during the Omicron period, compared to the Delta period, even a moderate reduction in risk is important, because COVID-19 vaccines are not likely to be available for babies younger than 6 months old in the foreseeable future."

The study included infants younger than 6 months of age who were admitted to 30 pediatric hospitals in 22 states from July 1, 2021, to March 8, 2022.

Dr. Coates and colleagues found that most infants (90 percent) who needed intensive care due to COVID-19 infection were born to mothers who were not vaccinated during pregnancy.

Infants aged younger than 6 months old are at high risk for complications of COVID-19, including severe respiratory failure or death and account for a disproportionately high percentage of hospitalizations among those aged 0-4 years. This study included data on 537 babies who were hospitalized with COVID-19. Of those, 21 percent were admitted to the intensive care unit and 12 percent required mechanical ventilation, or extra help getting enough oxygen to the body, or vasoactive infusions. Two babies died because of COVID-19 and two required advanced life support that helps the body get enough oxygen; mothers of these babies were not vaccinated.

Researchers also found that effectiveness of maternal COVID-19 vaccination against COVID-19 hospitalization for babies was higher among women vaccinated after 20 weeks of pregnancy, versus early in pregnancy.

"While protection for the baby is important, it is critical to remember that COVID-19 vaccines protect women against severe illness during pregnancy and reduce complications from COVID-19," said Dr. Coates, who also is the Crown Family Research Scholar in Developmental Biology.

When considering the timing of COVID-19 vaccination during pregnancy, the CDC and professional medical organizations, like the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, recommend COVID-19 vaccination as soon as eligible and at any point in pregnancy. The CDC recommends that women who are pregnant, breastfeeding, trying to get pregnant, or might become pregnant in the future get vaccinated and stay up to date with their COVID-19 vaccines.

https://www.sciencedaily.com/releases/2022/06/220624115417.htm

Preadolescents exposed to high levels of air pollution in their first years of life display changes in brain connectivity

June 15, 2022

Science Daily/Barcelona Institute for Global Health (ISGlobal)

Higher exposure to air pollution is associated with higher functional brain connectivity among several brain regions in preadolescents, while exposure to traffic noise was not, according to a study led by ISGlobal, an institution supported by "la Caixa" Foundation. The findings also identify the first years of life as the most sensitive period of exposure to air pollution.

Traffic-related air pollution and noise are affecting an increasing number of people worldwide. "We already know that children are particularly vulnerable to the effect of these exposures, because of their immature metabolism and developing brain," says ISGlobal researcher and senior author Mónica Guxens. In fact, several studies by Guxens and others have found an association between exposure to traffic-related air pollution during early childhood and alterations in the brain structure.

In this study, the research team used magnetic resonance imaging (MRI) to explore whether higher exposure to air pollution or noise could also be associated with possible alterations in brain connectivity (i.e. the way in which different brain regions interact). "The use of MRI has opened up new possibilities in epidemiological research for investigating the structure and the functioning of the brain," says Guxens.

The researchers used data of 2,197 children from the Generation R Study, born between April 2002 and Jan 2006 and living in Rotterdam, the Netherlands. Using land use models, they estimated levels of nitrogen oxides (NOx and NO2) and particulate matter (PM) at the participants' homes at different time periods: during pregnancy, from birth to 3 years, from 3 to 6 years, and from 6 years of age to the age at which the MRI scan was performed. Noise levels due to traffic road were estimated using existing noise maps. Between 9 and 12 years of age, the participants were invited to undergo an MRI scan in the resting state (i.e. with no external stimuli).

The findings show that higher exposures to NO2 and PM2.5 absorbance (an indicator of black carbon particles) from birth to 3 years, and to NOx from 3 to 6 years of age were associated with higher functional brain connectivity among several brain regions in the preadolescents. The associations were identified in brain areas predominantly involved in two networks that have strongly opposing functions: the task negative (or "default-mode") network tends to be activated in resting conditions and the task positive network tends to be activated during tasks that demand attention. "We still have to understand the consequences of this increased activity of both networks in resting conditions, but for now we can say that the brain connectivity in children exposed to higher levels of air pollution is different from what we would expect," says Laura Pérez-Crespo, first author of the study.

The period from birth to 3 years was the one with the highest susceptibility to air pollution, and black carbon was the pollutant most associated with brain connectivity changes. As the authors note, the main source of black carbon and nitrogen oxide gases in European cities are diesel vehicles. Noise exposure at home was not associated with differences in brain connectivity, even though several studies show that noise affects cognitive development in children.

https://www.sciencedaily.com/releases/2022/06/220615113249.htm

Nicotine-sired male offspring at risk of addiction behavior and memory impairments

June 8, 2022

Science Daily/University of Pennsylvania School of Nursing

Parental smoking is a significant risk factor for developing smoking behavior and nicotine dependence in offspring. These findings suggest that parental nicotine exposure may promote addiction-like behaviors in subsequent generations. Given the significance of cigarette smoking for public health, preventing nicotine use among adolescents is critical to ending tobacco use disorder and decreasing e-cigarette use.

In a novel study, researchers from the University of Pennsylvania School of Nursing (Penn Nursing) have discovered that paternal nicotine taking is associated with addiction-like behaviors, cognitive deficits, and anxiety-like behaviors in male offspring. These heritable effects were associated with reduced expression of Satb2, a transcription factor, in the hippocampus of male offspring. Increasing Satb2 expression in the hippocampus rescued the memory deficits associated with paternal nicotine taking in male offspring.

"Understanding how voluntary nicotine-taking changes germ cells and/or seminal fluid and how these modifications translate into neuroadaptations and behavioral phenotypes in subsequent generations is necessary for understanding the heritability of parental drug taking," says Heath D. Schmidt, PhD, Associate Professor and lead author of the article. "Findings from these studies highlight vulnerable populations at risk for developing nicotine dependence, cognitive impairments, and/or mental health disorders."

https://www.sciencedaily.com/releases/2022/06/220608161405.htm

High optimism linked with longer life and living past 90 in women across racial, ethnic groups

June 8, 2022

Science Daily/Harvard T.H. Chan School of Public Health

Higher levels of optimism were associated with longer lifespan and living beyond age 90 in women across racial and ethnic groups in a study led by researchers at Harvard T.H. Chan School of Public Health.

"Although optimism itself may be affected by social structural factors, such as race and ethnicity, our research suggests that the benefits of optimism may hold across diverse groups," said Hayami Koga, a PhD candidate in the Department of Social and Behavioral Sciences at Harvard Chan School and lead author of the study. "A lot of previous work has focused on deficits or risk factors that increase the risks for diseases and premature death. Our findings suggest that there's value to focusing on positive psychological factors, like optimism, as possible new ways of promoting longevity and healthy aging across diverse groups."

The study will be published online on June 8, 2022, in the Journal of the American Geriatrics Society.

In a previous study, the research group determined that optimism was linked to a longer lifespan and exceptional longevity, which was defined as living beyond 85 years of age. Because they had looked at mostly white populations in that previous study, Koga and her colleagues broadened the participant pool in the current study to include women from across racial and ethnic groups. According to Koga, including diverse populations in research is important to public health because these groups have higher mortality rates than white populations, and there is limited research about them to help inform health policy decisions.

For this study, the researchers analyzed data and survey responses from 159,255 participants in the Women's Health Initiative, which included postmenopausal women in the U.S. The women enrolled at ages 50-79 from 1993 to 1998 and were followed for up to 26 years.

Of the participants, the 25% who were the most optimistic were likely to have a 5.4% longer lifespan and a 10% greater likelihood of living beyond 90 years than the 25% who were the least optimistic. The researchers also found no interaction between optimism and any categories of race and ethnicity, and these trends held true after taking into account demographics, chronic conditions, and depression. Lifestyle factors, such as regular exercise and healthy eating, accounted for less than a quarter of the optimism-lifespan association, indicating that other factors may be at play.

Koga said that the study's results could reframe how people view the decisions that affect their health.

"We tend to focus on the negative risk factors that affect our health," said Koga. "It is also important to think about the positive resources such as optimism that may be beneficial to our health, especially if we see that these benefits are seen across racial and ethnic groups."

https://www.sciencedaily.com/releases/2022/06/220608161431.htm

Pregnant women's drinking correlates with their partner's drinking

June 8, 2022

University of Eastern Finland

Pregnant women's use of alcohol correlates with that of their partner, a new study from the University of Eastern Finland and Kuopio University Hospital shows. Paying attention to both parents' use of alcohol may help to prevent drinking during pregnancy, as well as fetal exposure to the adverse effects of alcohol.

Exposure to alcohol is detrimental to fetal development, and there is no known safe limit of exposure. The harmful effects of alcohol may manifest during the child's development and growth in many ways. The risk of alcohol use during pregnancy has previously been assessed mainly on the basis of the expectant mother's previous use of alcohol, but not on the basis of their partner's drinking habits.

The new study looked at the alcohol consumption of 14,822 Finnish women and their partners before and during pregnancy. The study covered a total of 21,472 pregnancies between 2009 and 2018.

In 86% of the pregnancies, the expectant mother reported having used alcohol before pregnancy, and 4.5% also during pregnancy. In 25% of the pregnancies, women reported that they had stopped drinking only after learning about their pregnancy, which means that the fetus may have been exposed to alcohol in the early stages of pregnancy. However, partners generally did not reduce their alcohol consumption before or during pregnancy.

Before pregnancy, partners' alcohol use was strongly linked to the frequency and quantity of alcohol consumed by women, how often they binge drank, and whether their drinking met the criteria for risk use. A weaker, yet significant association was observed also during pregnancy. In women who consumed alcohol during pregnancy, the quantity of alcohol used, for example, was affected by their partner's use of alcohol.

Women who reported having used alcohol during pregnancy were usually heavy drinkers before pregnancy. Younger women had higher alcohol use risk scores before pregnancy, but during pregnancy their alcohol consumption did not differ from other age groups.

According to the researchers, the results show that, in order to protect the fetus from exposure to alcohol, both parents should reduce their alcohol consumption already when planning pregnancy. Both parents need information on the harmful effects of alcohol on the fetus, and when assessing the risk of alcohol consumption during pregnancy, the use of alcohol should be taken into account not only for the expectant mother, but also for the partner. The partner's support may help to avoid alcohol consumption during pregnancy.

"Our findings are well in line with those from other European and American studies. There can, of course, be great local variation in maternal drinking between different sub-populations. When it comes to partners, we noticed that Finns seem to reduce their alcohol use less than what has been observed in other Nordic studies, but otherwise that, too, is in line with other Western countries," Senior Researcher Olli Kärkkäinen from the University of Eastern Finland says.

https://www.sciencedaily.com/releases/2022/06/220608112622.htm

Whole-body learning can boost children's letter sound recognition -- the first step toward reading

Children who move while learning sounds of letters significantly improve their ability to recognize individual letter sounds

June 8, 2022

Science Daily/University of Copenhagen - Faculty of Science

Children who move while learning sounds of letters significantly improve their ability to recognize individual letter sounds. This is the conclusion of a new study conducted by the University of Copenhagen's Department of Nutrition, Exercise and Sports and Denmark's National Centre for Reading, in collaboration with 10 Copenhagen area school classes.

Reading is a complex and crucial skill that impacts the ability of youth to perform as students, across social contexts and in their eventual working lives. Therefore, it is important to develop reading skills during childhood.

Children get twice as good with difficult letter sounds

Now, a team of researchers from the University of Copenhagen and Denmark's National Centre for Reading has focused on whether whole-body learning in instruction, known as embodied learning, has a positive impact on children's ability to learn letter sounds.

"Our research demonstrated that children who used their whole body to shape the sounds of letters became twice as proficient at letter sounds that are more difficult to learn compared to those who received traditional instruction," says PhD student Linn Damsgaard of UCPH's Department of Nutrition, Exercise and Sports.

With regards to difficult letter sounds, she adds, "There are many difficult letter sounds in Danish and these sounds are particularly important, because once children become proficient at them, it has already been shown that they will be better readers."

The project included 149 children, 5 -- 6 years old, who had just started school. They were divided into three groups: one that stood up and used their whole body to shape letter sounds; a seated group that shaped letter sounds with their hands and arms; and a control group that received traditional, seated instruction during which they wrote letters out by hand.

The study also demonstrated that students who shaped difficult letter sounds with hand movements while seated also had a greater increase in proficiency than the control group.

Giving beginner readers the best start possible 

Associate Professor Jacob Wienecke of UCPH's Department of Nutrition, Exercise and Sports led the study and explains the project's background:

"The overarching goal is to learn more about which methods can be used to give beginner readers a good start. The idea is that if, through play and movement, we can reach children where they are and where their strengths truly lie -- and we can create a form of learning that combines reading with play -- then that's truly positive."

Previously, the researchers demonstrated that the children felt more motivated by teaching methods which incorporated physical movement. Associate Professor Jacob Wienecke hopes this will provide an opportunity to inspire teachers and school managers to prioritise movement across subjects.

The study also investigated whether a direct effect of embodied learning could be found through children's reading of individual words. This was not possible, which may be due, among other things, to the fact that the children were at such an early stage of their literacy development that they could not yet transfer their knowledge of letter sounds to reading words. Or, as PhD student Linn Damsgaard describes it: "Just because you learn the notes and sounds of a flute, doesn't make you a master."

The study is the first in the world to examine the effect of linking whole-body movement to the learning of letters and their sounds. It is published in Educational Psychology Review as: Effects of Eight Weeks with Embodied Learning on 5-6 Years Old Danish Children's Pre-reading Skills and Word Reading Skills: The PLAYMORE Project, DK.

https://www.sciencedaily.com/releases/2022/06/220608091403.htm

New insights on infant word learning

June 7, 2022

Science Daily/Indiana University

A lot is unknown about how infants begin to connect names with objects, a critical skill for later language development. A new study by Indiana University researchers offers a fresh perspective on how infants reach this milestone in human development.

The work, recently published in the Proceedings of the National Academy of Sciences, is led by Linda Smith, Distinguished Professor in the College of Arts and Sciences' Department of Psychological and Brain Sciences at IU Bloomington, and Elizabeth Clerkin, a postdoctoral researcher in the department.

Before they can speak, infants between the ages of 7 and 11 months begin to pair the words they hear with the everyday objects in their surroundings. To explain this phenomenon, the field of developmental psychology has focused on "naming moments," when the names and objects are presented to the infant at the same time.

However, the names of objects are rarely spoken in tandem with the objects, and the brain's hippocampal memory system, which can form strong memories from singular events, may not be mature enough in infants for them to form durable memories of those rare direct co-occurrences between objects and names.

"Our study shows that a different perspective is potentially needed to explain how infants are making these links by looking at the time outside naming moments," Clerkin said. "We focus on understanding how infants are developing their memories for the objects and categories more generally."

In other words, early language learning may be tied to memory representations that build up over time, rather than to repeated connections between words and objects.

To conduct their study, Smith and Clerkin looked at infants' daily encounters with the objects in their surroundings, during which infants build up "a deep and robust familiarity" with their environment. The researchers compiled a catalog of objects and the heard names of objects as they occurred in infants' daily lives. They then considered how these experiences align with infant memory systems in a way that would make it possible to link objects and names at those scarce moments of co-occurrence.

Specifically, the researchers drew upon 67 hours of audiovisual mealtime recordings of 14 infants, ranging from 7 to 11 months old, sampling statistical regularities of the infants' everyday interactions with people and objects. These data are part of a much larger dataset called the Home View Project, for which Smith's lab outfitted infants with head cameras so that parents or caretakers could record several hours of daily activity in their homes.

"When scientists think about how it is that infants managed to learn words, they've traditionally focused on internal cognitive mechanisms," Smith said. "This assumption about co-occurring names and objects is not wrong, but if you look at the infants' learning environment more broadly, you see their learning task -- and the mechanisms by which this learning may occur -- differently. We need to study the structure of these learning environments, not just the internal cognitive mechanism, because that will tell us more about what needs to be in place for children to learn language."

A full understanding of the learning environment could enable researchers and clinicians to develop interventions for children who are considered "late talkers," revealing ways in which the environment could be augmented to help children who are learning language more slowly than their peers.

This broader view of object name learning ultimately aligns with a memory system operating in the brain's neocortex that is known to be functional in infancy and builds up memory representations over long stretches of time, Smith said.

She added that when well-established memories are re-activated by new information, the new information is rapidly integrated into the existing memory. A single instance of hearing the word "table," for example, will make sense when it is heard in the context of visual memories of a table.

It's across these two "timescales of experience" -- and the workings of the neocortical memory system -- that the researchers assert infants make their first links between words and objects.

"The idea is that over long periods of time, traces of memory for visual objects are being built up slowly in the neocortex," Clerkin said. "When a word is spoken at a specific moment and the memory trace is also reactivated close in time to the name, this mechanism allows the infants to make a connection rapidly."

The researchers said their work also has significant implications for machine learning researchers who are designing and building artificial intelligence to recognize object categories. That work, which focuses on how names teach categories, requires massive amounts of training for machine learning systems to even approach human object recognition.

The implication of the infant pathway in this study suggests a new approach to machine learning, in which training is structured more like the natural environment, and object categories are learned first without labels, after which they are linked to labels.

https://www.sciencedaily.com/releases/2022/06/220607182305.htm

Healthy development thanks to older siblings

If expectant mothers are exposed to stress their child can develop behavioral problems -- but this is less often the case for children with siblings

May 31, 2022

Science Daily/Max Planck Institute for Evolutionary Anthropology

During the first years of their lives, children develop the cognitive, social and emotional skills that will provide the foundations for their lifelong health and achievements. However, exposure to environmental stressors during critical periods of life can have negative long-term consequences for their development. One of the most critical stressors for children is maternal stress, which is known to have a detrimental effect on children's health and well-being, already in utero.

In a new study, a Leipzig-based team of researchers including scientists from the Helmholtz Centre for Environmental Research (UFZ), Leipzig University (UL), the MPI for Evolutionary Anthropology (MPI EVA) and the German Centre for Integrative Biodiversity Research (iDiv) used longitudinal data from the LINA (Lifestyle and environmental factors and their Influence on the Newborn Allergy risk) cohort to test 373 German mother-child pairs, from pregnancy until 10 years of age.

Mothers were asked to fill in three validated questionnaires, to assess their stress levels and their child's behavioural problems. First, the researchers assessed which social and environmental factors were linked to an increase in maternal stress levels during pregnancy, and the long-term consequences of maternal stress on the occurrence of child behavioural problems. Second, the researchers assessed whether the presence of siblings had a positive effect on the occurrence of child behavioural problems, by directly reducing stress levels and increasing children's psychological well-being, or by indirectly buffering the negative consequences of maternal stress.

Prenatal stress can cause behavioural problems in the child

The results of the study demonstrated that socio-environmental stressors, like the lack of sufficient social areas in the neighbourhood, were clearly linked to an increase in maternal stress levels during pregnancy. Moreover, mothers who had experienced high stress levels, like worries, loss of joy or tension, during pregnancy were also more likely to report the occurrence of behavioural problems when their children were 7, 8 or 10 years old. "These results confirm previous findings about the negative impact that even mild forms of prenatal stress might have on child behaviour, even after several years, and highlight the importance of early intervention policies that increase maternal wellbeing and reduce the risks of maternal stress already during pregnancy," explains Federica Amici (UL, MPI-EVA), one of the researchers involved in the project.

On a more positive note, the study also found a lower occurrence of behavioural problems in children with older siblings. "Children who have older brothers or sisters in their households are less likely to develop problems, which suggests that siblings are crucial to promote a healthy child development," explains Gunda Herberth (UFZ), coordinator of the LINA study.

Higher social competence thanks to older siblings?

This study further suggests that the presence of older siblings directly reduced the likelihood of developing behavioral problems, but did not modulate the negative effects of maternal stress on child behaviour. How could older siblings reduce the occurrence of behavioural problems in children? By interacting with their older siblings, children may develop better emotional, perspective taking and problem solving skills, which are linked to higher social competence and emotional understanding. Moreover, the presence of older siblings may provide learning opportunities for parents, who might thus develop different expectations and better parental skills.

"We were especially impressed by the important role that siblings appear to play for a healthy child development," concludes Anja Widdig (UL, MPI-EVA, iDiv). "We hope that our findings will draw attention to the importance of public health policies that directly target children and their siblings, and promote a healthy environment for their well-being and the development of high-quality sibling relationships."

https://www.sciencedaily.com/releases/2022/05/220531102708.htm

Pregnant moms and depression: Study links rising symptoms to kids' behavioral issues

May 31, 2022

Science Daily/University of California - Los Angeles

Children whose mothers experience rising levels of depression from the period before pregnancy until the months just after giving birth are at greater risk of developing emotional, social and academic problems during their youth, UCLA psychology researchers and colleagues report.

Their recently published seven-year study, which tracked mothers and their offspring from preconception until the children were 5 years old, is the first to demonstrate how changes in mothers' level of depression over time may impact early childhood behavior and emotional well-being, the authors said.

"Our findings suggest that increases in mother's symptoms of depression from preconception to postpartum contribute to children's lower attention and behavioral control, which can raise the risk of problems across the life span," said lead author Gabrielle Rinne, a UCLA psychology graduate student. "Parents should know, however, that this can be addressed through early childhood intervention."

For the two-part study, the researchers first analyzed data on 362 women -- most of whom were Black or Hispanic and from low-income backgrounds -- collected as part of a study by the Community Child Health Network, a collaboration among health scientists from UCLA and other institutions, along with community partners, that investigated disparities in maternal and child health among poor and minority families.

The women, all of whom already had a young child, were followed through a subsequent pregnancy and were interviewed on four occasions about their symptoms of depression -- once before becoming pregnant, twice during pregnancy and again approximately three months after their baby's birth -- with researchers tracking how these symptoms changed over time.

Just under 75% of the women reported low symptoms of depression that didn't change over the study period, while 12% had low symptoms that significantly increased and 7% had persistently high symptoms.

For the second part of the study, the researchers followed 125 of these women several years later. When their children were 4, or preschool age, the mothers were asked to describe in detail their child's temperament and behavior -- particularly their experiences of emotional distress and their ability to regulate their emotions.

Then, at age 5, the children performed a task requiring focused attention. Looking at an iPad screen showing a series of fish, they were asked to identify the direction the fish in the middle was facing while ignoring the direction of all the other fish. Higher scores on this task reflect a greater ability to concentrate and inhibit attention to surrounding stimuli, Rinne said.

Children of mothers whose depression had increased from preconception through the postpartum period performed significantly worse on the computer task than those whose mothers had reported consistently low symptoms of depression. Interestingly, there were no differences in performance between kids whose mothers had experienced consistently high depression and those whose mothers had consistently low depression.

The findings are published in the Journal of Affective Disorders(free access through June 15).

"This study suggests that a pattern of increasing depression may adversely affect children," said senior author Christine Dunkel Schetter, a distinguished professor of psychology and psychiatry at UCLA who had a lead role in study design and in interview development. She noted that not all of these kids are destined to experience problems but emphasized that "they are at higher risk of socio-emotional and behavioral issues and problems at school."

Children whose mothers consistently reported low symptoms of depression, she said, are not at risk.

"Moms who experience depression or stress at multiple times should know the effects this can have on young children," Dunkel Schetter added. "They can seek evaluation and treatment from a doctor or mental health professional for their children and themselves."

The importance of getting treatment for maternal depression

"The addition of a child to the family is a significant emotional and psychological adjustment that can involve both joy and distress," Rinne said. "Maternal depression is one of the most common complications of pregnancy and postpartum."

In Los Angeles County, she pointed out, estimates of depression during pregnancy and in new mothers range as high as 25%.

The study's findings, Rinne said, support "the importance of comprehensive mental health care at multiple periods of the reproductive life course," beginning even before pregnancy and continuing afterward -- especially for mothers who are feeling elevated level of distress at any point.

Los Angeles County resources for maternal mental health care in pregnancy are available here. If a mother is depressed but too busy to see a doctor or therapist, she may be able to find help through evidence-based apps online. Newer forms of digital mental health treatment can also be effective, Dunkel Schetter said.

https://www.sciencedaily.com/releases/2022/05/220531151954.htm

New research challenges established ideas about infant crying

May 20, 2022

Science Daily/Aarhus University

When will my infant child stop crying so much?

If you are a new parent who, in a more or less sleep-deprived state, googles this question, then the answer could reassure you.

Many top google hits will refer you to an old study which concludes that infant crying normally peaks at around the age of six weeks, after which it decreases markedly and stabilises at a low level after three months.

Typically referred to as the 'cry curve', parents might expect their infants to cry radically less after the initial peak. However, a new study from Denmark, challenges this "cry curve" pattern, by pooling data from parents in 17 different countries.

"We've created two mathematical models that reasonably represent the available data. Neither of them show that the duration of crying falls so markedly after five weeks, which is what is otherwise seen in the graphs that are presented to parents. The available data shows that crying is still a significant part of many infants' repertoire after six months," says Christine Parsons, who is an associate professor at the Department of Clinical Medicine at Aarhus University.

Widely used cry curve

The researchers behind the study have compiled data from 57 research articles from all over the world, in which parents have registered how much their infants cry every day.

The normal pattern of crying, the "cry curve" which parents are presently often referred to, is based on an American study from 1962, which only focuses on the first twelve weeks of a child's life.

"It's a graph that new parents are often presented with. If you google 'infant crying' you'll see lots of images of this particular graph. Therefore, we thought it would be interesting to model all the available data to see what type of pattern best represents the data, and test if this is consistent with the original 'cry curve'," says Arnault-Quentin Vermillet, the first author of the article.

Important tool for clinicians

Crying is one of the first forms of communication used by infants to get their parents' attention. The infant's cognitive and emotional development is stimulated when parents react to the child's signals appropriately.

New parents often seek help from the healthcare system if they are worried that their child is crying too much.

According to Christine Parsons, it is therefore important that both healthcare professionals and parents have a correct and precise understanding of normal patterns of crying for infants.

"For clinicians in particular, it's important because their job is to help, support and reconcile the expectations of any worried parents. It's important that clinicians have up-to-date data on what is normal for infant crying, so that they can best support new parents. When parents consider their child to cry excessively, this can be associated with negative consequences for both parent and child," she explains.

Cry patterns vary a lot

A widely-used definition for excessive crying, or colic, is when a baby cries for more than 3 hours per day, more than 3 days over a week. In the first 6 weeks after birth, colic has been estimated as affecting between 17 and 25% of infants.

The researchers at Aarhus University have drawn up two new models for the infant cry pattern. One of them shows infant crying peaks after four weeks. The other shows that infants cry a lot and at a stable level during the first weeks, after which the level falls.

However, neither model indicates a steep decline, as otherwise appears to be the case from the "original cry pattern."

According to Christine Parsons, another noteworthy finding in the study is how different crying patterns are among babies- both within and across national borders.

https://www.sciencedaily.com/releases/2022/05/220520132846.htm

How mother-youth emotional climate helps adolescents cope with stress

June 10, 2022

Science Daily/University of Illinois College of Agricultural, Consumer and Environmental Sciences

Transition to middle school can be a stressful time for adolescents. They must adjust to a new peer group and social environment while going through the developmental changes of puberty. A recent University of Illinois study looks at how emotional aspects of parenting can help youth better cope with peer stressors during this transitional period.

The researchers evaluated emotional closeness between fifth-graders and their mothers, gauging how it predicted the youths' ability to deal with social challenges when they started middle school the following year. They combined observations of mother-youth interactions with measures of the youths' biological stress response capacity.

The study is part of a larger, ongoing project in the research lab of Kelly Tu, examining the mental health and wellbeing of adolescents and the role of parental involvement. Tu is an associate professor in the Department of Human Development and Family Studies (HDFS) at U of I, and co-author on the paper.

"Adolescents often turn to their mothers to discuss peer problems. As mothers give advice, it's not just what they tell adolescents that matter, but also how they are conveying those messages. Therefore, moving beyond mothers' specific suggestions for coping, here we focus on the emotional climate of these conversations," explains Xiaomei Li, doctoral candidate in HDFS and the paper's lead author.

The researchers invited mothers and adolescents in the last semester of fifth grade to the research lab, asking them to spend five minutes talking about a peer problem the youth was facing. The youth also filled out questionnaires reporting on how they typically cope with peer stress, once during fifth grade and again after they started sixth grade the following school year. Being able to engage in active forms of coping -- attempting to resolve the problem and managing one's reactions -- is typically considered more beneficial for youths' successful adaptation to new environments, the researchers say.

During the five-minute conversation, trained observers rated maternal affect (such as smiles, physical and verbal affection, frustration or tension) and dyadic connection or cohesiveness (such as taking turns and communicating smoothly). The researchers also measured youths' biological response in the form of their respiratory sinus arrhythmia (RSA), gauging the baseline RSA at rest while they watched a slide show of nature images. RSA measures the variations in heart rate, and higher baseline RSA indicates greater capacity to respond to stressful situations by regulating the heart rate.

"Stress response is a multi-level mechanism which includes behavioral strategies and biological reactions. We wanted to observe how some common biological markers of the stress response system might inform how youth engage in behavioral strategies to cope with stress, in addition to how their mothers may support them," Li says.

Youth who experienced more positive affect and greater cohesiveness during their conversations with mothers reported more active coping and advice seeking from parents in middle school. In comparison, youth whose mothers displayed less positive affect (or more criticism and lack of interest) and who were less cohesive with their children during the conversation were less able to actively cope with social stress when starting middle school. This was particularly noticeable for kids with lower baseline RSA.

"For some youth who may be biologically dispositioned to be vulnerable to stress, such as displaying lower baseline RSA, the mother's positive, warm affect and a cohesive, collaborative conversation atmosphere appear to be especially important for the development and use of active coping," Li says.

One takeaway from these findings is for parents to think about how to create a positive and supportive space to talk with their children about their problems, Tu explains.

"As a parent, you could be giving great advice. But what our study shows is that how parents talk with their children matters for how adolescents cope with stress. Conversations that are less warm and supportive could undermine parents' efforts to help. And youth are less likely to seek parents' advice in the future," she adds.

Tu and Li say there may also be cultural differences in parental emotional closeness and how much it matters to youth. Study participants included a diverse sample of 57% White, 10% Black, 13% Hispanic/Latino, 6% Asian, and 14% other/mixed race. While the ethnic groups were too small to analyze separately, the researchers recognize the need to better understand cultural factors in future studies.

https://www.sciencedaily.com/releases/2022/06/220610120205.htm

Women who embraced their partner subsequently had lower stress-induced cortisol response

Romantic partner embrace did not buffer the response to stress for men

May 18, 2022

Science Daily/PLOS

Women instructed to embrace their romantic partner prior to undergoing a stressful experience had a lower biological stress response -- as indicated by levels of the stress hormone cortisol in saliva -- compared to women who did not embrace their partner. This effect was not seen for men. Gesa Berretz of Ruhr University Bochum, Germany, and colleagues present these findings in the open-access journal PLOS ONE on May 18.

In some settings, social touch may buffer against stress. Previous research has shown that massages, embraces combined with hand-holding, and embraces combined with affectionate communication can all reduce signs of stress in women. However, few studies have investigated these effects in men, nor have they explored the effects of brief embraces on their own.

To explore potential stress-reducing effects of embracing, Berretz and colleagues conducted an analysis of 76 people in romantic relationships. All participants underwent a stress-inducing test in which they were asked to keep one hand in an ice-water bath for three minutes while being observed and maintaining eye contact with a camera. Prior to this test, half of the couples were instructed to embrace, and the others did not embrace. The researchers measured various indicators of stress, including participants' salivary cortisol levels, before and after the experiment.

Statistical analysis revealed that women who embraced their partner had a lower cortisol response to the stress test than women who did not embrace their partner. However, for men, no associations were observed between embrace and stress-induced cortisol response. Other measures of stress including changes in blood pressure and emotional state did not show any associations with partner embrace.

These results suggest that a brief embrace with a romantic partner might subsequently reduce the cortisol response for women facing stressful social situations, such as school exams, job interviews, or presentations. Further research could investigate whether this benefit extends to embraces with platonic friends.

The authors also call for research into related effects of the COVID-19 pandemic. Such investigations could explore whether social restrictions that reduced social touch may be associated with observed increases in stress and depression during the pandemic.

The authors add: "As a woman, hugging your romantic partner can prevent the acute stress response of your body."

https://www.sciencedaily.com/releases/2022/05/220518140723.htm

Hypertensive pregnancy disorders linked to future cardiac events

May 9, 2022

Science Daily/NIH/National Heart, Lung and Blood Institute

Women who experienced complications related to developing high blood pressure, or hypertension, during pregnancy had a 63% increased risk for developing cardiovascular disease later in life, according to research funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

While hypertensive pregnancy complications previously have been linked to increased cardiovascular risks, the current study controlled for pre-pregnancy shared risk factors for these types of complications and cardiovascular disease. Researchers also found that high blood pressure, high cholesterol, type 2 diabetes, or being overweight or obese after pregnancy accounted for most of the increased risk between pregnancy complications and future cardiovascular events.

The findings, published in the Journal of the American College of Cardiology, could support healthcare providers in developing personalized heart disease prevention and monitoring strategies for women who had hypertension during pregnancy. The information could also help bridge the gap that often occurs after a woman ends obstetric care and resumes or starts care with another provider.

Using health data shared by more than 60,000 participants in the Nurses' Health Study II, the research represents one of the most comprehensive reviews evaluating links between future cardiovascular events in women who have had preeclampsia or gestational hypertension. Gestational hypertension is characterized by an increase in blood pressure during pregnancy. Preeclampsia is a more severe complication marked by a sudden rise in blood pressure that can affect the organs and be dangerous for both mother and baby. Both conditions are often diagnosed after 20 weeks of pregnancy.

"Women with a history of gestational hypertension or preeclampsia should be informed that they have an increased risk for cardiovascular disease," said Jennifer J. Stuart, Sc.D., a study author and associate epidemiologist in the Division of Women's Health at Brigham and Women's Hospital and Harvard Medical School, Boston. "While the American Heart Association and American College of Cardiology recognize these conditions as cardiovascular risk factors, women and their providers have lacked clear direction on what to do in the intervening years between delivery of a hypertensive pregnancy and the onset of cardiovascular disease."

The researchers' analysis showed that early screening and monitoring in four targeted areas -- blood pressure, cholesterol and glucose levels, and body mass index -- could provide even more personalized targets to help delay or possibly prevent future cardiovascular events among these women.

In this study, almost 10% of women developed hypertension during their first pregnancy. Among these women, 3,834 (6.4%) developed preeclampsia and 1,789 (3%) developed gestational hypertension. Women who were obese before pregnancy were three times more likely to experience a hypertensive pregnancy disorder, and those with a family history of heart disease or stroke also shared increased risks. In their analysis, the researchers controlled for these and other important pre-pregnancy factors that could increase the risk of developing hypertension during pregnancy and having a heart attack or stroke later in life.

After about 30 years, when the average age of women in the study was 61 years, approximately 1,074 (1.8%) of study participants had experienced a cardiovascular event, such as a heart attack or stroke. The type of event women had -- and when they had it -- often overlapped with specific pregnancy complications.

For example, compared to women with normal blood pressure in pregnancy, women with gestational hypertension, which was associated with a 41% increased risk for cardiovascular disease, were more likely to have a stroke about 30 years after their first pregnancy. Women with preeclampsia, which was associated with a 72% increased cardiovascular risk, were more likely to have a coronary artery event, such as a heart attack, as early as 10 years after their first pregnancy.

Post-pregnancy cardiometabolic risk factors, such as obesity, type 2 diabetes, and chronic hypertension, explained most of the increased cardiovascular risk observed among women with gestational hypertension or preeclampsia. Chronic hypertension was the largest contributor of all, accounting for 81% of increased cardiovascular disease risks among women who had gestational hypertension and for 48% of increased risks among women who had preeclampsia. Most women who experienced a hypertensive pregnancy disorder developed chronic hypertension in the years or decades after they gave birth.

"This study reinforces how important it is for women and their healthcare providers to address known cardiovascular disease risk factors, such as obesity or having high blood pressure, while thinking about starting a family and then during and after during pregnancy," said Victoria Pemberton, R.N.C., a program officer at NHLBI.

For future research, Stuart said diversity is key. Most women in the Nurses' Health Study II were white, which means the percentage of women affected by different risk factors may vary. The study also provides a foundation to expand on emerging associations, such as studying links between gestational hypertension and stroke and between preeclampsia and coronary artery disease.

Additionally, while over 80% of the increased risk for cardiovascular disease among women with a history of gestational hypertension appears to be jointly accounted for by established cardiovascular risk factors, nearly 40% of the risk for cardiovascular disease following preeclampsia remains unexplained.

Investigating these pathways may help clarify why some women who experienced preeclampsia are more likely to develop heart disease. By better understanding these connections, researchers may be able to contribute insight to help healthcare providers provide even more personalized recommendations and strategies for women at greatest risk.

https://www.sciencedaily.com/releases/2022/05/220509150748.htm 

Complex human childbirth and cognitive abilities a result of walking upright

May 10, 2022

Science Daily/University of Zurich

Childbirth in humans is much more complex and painful than in great apes. It was long believed that this was a result of humans' larger brains and the narrow dimensions of the mother's pelvis. Researchers have now used 3D simulations to show that childbirth was also a highly complex process in early hominins that gave birth to relatively small-brained newborns -- with important implications for their cognitive development.

During human birth, the fetus typically navigates a tight, convoluted birth canal by flexing and rotating its head at various stages. This complex process comes with a high risk of birth complications, from prolonged labor to stillbirth or maternal death. These complications were long believed to be the result of a conflict between humans adapting to walking upright and our larger brains.

Dilemma between walking upright and larger brains

Bipedalism developed around seven million years ago and dramatically reshaped the hominin pelvis into a real birth canal. Larger brains, however, didn't start to develop until two million years ago, when the earliest species of the genus Homo emerged. The evolutionary solution to the dilemma brought about by these two conflicting evolutionary forces was to give birth to neurologically immature and helpless newborns with relatively small brains -- a condition known as secondary altriciality.

A research group led by Martin Häusler from the Institute of Evolutionary Medicine at the University of Zurich (UZH) and a team headed up by Pierre Frémondière from Aix-Marseille University have now found that australopithecines, who lived about four to two million years ago, had a complex birth pattern compared to great apes. "Because australopithecines such as Lucy had relatively small brain sizes but already displayed morphological adaptations to bipedalism, they are ideal to investigate the effects of these two conflicting evolutionary forces," Häusler says.

Typical ratio of fetal and adult head size

The researchers used three-dimensional computer simulations to develop their findings. Since no fossils of newborn australopithecines are known to exist, they simulated the birth process using different fetal head sizes to take into account the possible range of estimates. Every species has a typical ratio between the brain sizes of its newborns and adults. Based on the ratio of non-human primates and the average brain size of an adult Australopithecus, the researchers calculated a mean neonatal brain size of 180 g. This would correspond to a size of 110 g in humans.

For their 3D simulations, the researchers also took into account the increased pelvic joint mobility during pregnancy and determined a realistic soft tissue thickness. They found that only the 110 g fetal head sizes passed through the pelvic inlet and midplane without difficulty, unlike the 180 g and 145 g sizes. "This means that Australopithecus newborns were neurologically immature and dependent on help, similar to human babies today," Häusler explains.

Prolonged learning key for cognitive and cultural abilities

The findings indicate that australopithecines are likely to have practiced a form of cooperative breeding, even before the genus Homo appeared. Compared to great apes, the brains developed for longer outside the uterus, enabling infants to learn from other members of the group. "This prolonged period of learning is generally considered crucial for the cognitive and cultural development of humans," Häusler says. This conclusion is also supported by the earliest documented stone tools, which date back to 3.3 million years ago -- long before the genus Homo appeared.

https://www.sciencedaily.com/releases/2022/05/220510102920.htm

Stress may be associated with fertility issues in women

Animal study links scream sound exposure to lower egg count in female rats

May 10, 2022

Science Daily/The Endocrine Society

Female rats exposed to a scream sound may have diminished ovarian reserve and reduced fertility, according to a small animal study published in the Endocrine Society's journal, Endocrinology.

Ovarian reserve is the reproductive potential left within a woman's two ovaries based on the number and quality of eggs. A woman is born with a finite number of eggs and her body cannot create any more. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs.

"We examined the effect of stress on ovarian reserve using a scream sound model in rats," said Wenyan Xi, Ph.D., of the Second Affiliation Hospital of Xi'an Jiao Tong University in Xian, China. "We found that female rats exposed to the scream sound had diminished ovarian reserve and decreased fertility."

The researchers used a scream sound model to investigate the effect of stress on ovarian reserve in female rats. They exposed female rats to a scream sound for 3 weeks and analyzed the effect on their sex hormones, the number and quality of their eggs and their ability to get pregnant and have babies after mating.

They found the scream sound decreased the rats' estrogen and Anti-Mullerian hormone levels. Estrogen is a group of hormones that play an important role in growth and reproductive development, and Anti-Mullerian hormone is a hormone made by the ovaries which helps form reproductive organs. The scream sound also lowered the number and quality of the women's eggs and resulted in smaller litters.

"Based on these findings, we suggest stress may be associated with diminished ovarian reserve," Xi said. "It is important to determine an association between chronic stress and ovarian reserve because doing so may expand our appreciation of the limitations of current clinical interventions and provide valuable insight into the cause of diminished ovarian reserve."

Other authors of this study include: Hui Mao, Haoyan Yao and Ruiting Shi of the Second Affiliation Hospital of Xi'an Jiao Tong University; and Zhiwei Cui of the First Affiliation Hospital of Xi'an Jiao Tong University in Xian, China.

The study received funding from the Natural Science Foundation of Shaanxi Provincial Department of Education.

https://www.sciencedaily.com/releases/2022/05/220510102841.htm

Surprising risk factors may predict heart attacks in young women

May 4, 2022

Science Daily/Yale University

A new Yale-led study has for the first time identified which risk factors are more likely to trigger a heart attack or acute myocardial infarction (AMI) for men and women 55 years and younger.

Researchers discovered significant sex differences in risk factors associated with AMI and in the strength of associations among young adults, suggesting the need for a sex-specific preventive strategy. For example, hypertension, diabetes, depression, and poverty had stronger associations with AMI in women compared with men, they found.

The study was published May 3 in JAMA Network Open.

While heart attacks are often associated with older adults, this population-based case-control study examined the relationship between a wide range of AMI-related risk factors among younger adults. The researchers used data from 2,264 AMI patients from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) study and 2,264 population-based controls matched for age, sex, and race from the National Health and Nutrition Examination Survey (NHANES).

The key finding is that young men and women often have different risk factors. Seven risk factors -- including diabetes, depression, hypertension or high blood pressure, current smoking, family history of AMI, low household income, and high cholesterol -- were associated with a greater risk of AMI in women. The highest association was diabetes, followed by current smoking, depression, hypertension, low household income, and family history of AMI. Among men, current smoking and family history of AMI were the leading risk factors.

Rates of AMI in younger women have increased in recent years said Yuan Lu, an assistant professor at Yale School of Medicine and the study's lead author.

"Young women with AMI are an unusual or extreme phenotype on account of their age," she said. "In the past, we found that young women, but not older women, have a twice higher risk of dying after an AMI than similarly aged men. In this new study, we now identified significant differences in risk factor profiles and risk factor associations with AMI by sex."

Analysis of population attributable risk was used to measure the impact different risk factors at the population level. The study found that seven risk factors, many potentially modifiable, collectively accounted for majority of the total risk of AMI in young women (83.9%) and young men (85.1%). Some of these factors -- including hypertension, diabetes, depression, and poverty -- have a larger impact on young woman than they do among young men, Lu and her colleagues found.

"This study speaks to the importance of specifically studying young women suffering heart attacks, a group that has largely been neglected in many studies and yet is about as large as the number of young women diagnosed with breast cancer," said Dr. Harlan M. Krumholz, the Harold H. Hines Jr. Professor of Medicine at Yale, director of the Center for Outcomes Research and Evaluation (CORE), and senior author of the paper.

Raising awareness among physicians and young patients is a first step, researchers said. National initiatives, such as the American Heart Association's "Go Red for Women" campaign, should be expanded to increase awareness about cardiovascular disease risk in young women, they said. Health care providers also need to identify effective strategies to improve optimal delivery of evidence-based guidelines on preventing AMI. For example, risk prediction tool for individual patients could help physicians identify which individuals are most at risk and develop treatment strategies.

Accounting for AMI subtypes may also be effective. The researchers found that many traditional risk factors including hypertension, diabetes, and high cholesterol, are more prevalent in type-1 AMI, whereas different AMI subtypes -- including type-2 AMI (a subtype associated with higher mortality) -- are less common.

"We are moving more towards a precision medicine approach, where we are not treating each patient the same, but recognizing that there are many different subtypes of AMI," Lu said. "Individual-level interventions are needed to maximize health benefits and prevent AMI."

The study is among the first and the largest in the United States to comprehensively evaluate the associations between a wide range of predisposing risk factors and incident AMI in young women and a comparable sample of young men. The study design also included a comparable population-based control group from the National Health and Nutrition Examination Survey, a program to assess demographic, socioeconomic, dietary, and health-related information.

A longitudinal study is traditionally used to assess AMI risk in younger populations. Because the incidence rate is low in young people, however, it takes a long time for the disease to manifest. So researchers often don't have enough AMI events to make inferences about risk factors and their relative importance in young women and men, said Lu.

"Here we used a novel study design with a large cohort of patients with AMI and then we identified age-sex-race matched population control from a national population survey to compare this with, and we used a case-control design to evaluate the association of these risk factors with AMI," said Lu. "This is one of the first and largest studies to address this issue comprehensively."

In the United States, hospitalization rates for heart attacks have been decreasing with time, according to research in the journal JAMA Cardiology.

"However, if you analyze the proportion of these patients by age, you will find that the proportion of younger people who are hospitalized for heart attack is increasing," said Lu. "So it seems there's a general trend for AMI to happen earlier in life, so that makes prevention of heart attack in younger people, especially important."

Younger women represent about 5% of all heart attacks that occur in the U.S. each year. "This small percentage effects a large number of people because so many AMIs occur in the US each year," she said. "There about 40,000 AMI hospitalizations in young women each year, and heart disease is the leading cause of death in this age group."

Lu emphasized the importance of education. "When we talk about heart attack in young women, people are often not aware of it," she said. "If we can prevent women from having heart attacks that will improve outcomes."

Raising awareness about the incidence of heart attacks in younger women is a key part of the strategy, she said. The next frontier of cardiovascular disease prevention in young women could be better understanding the role of women-related factors.

Previous studies have shown that women-related factors may be associated with risk of heart attack, but there is limited data on women under the age of 55. "We hope to explore women-related factors including menopausal history, pregnancy, menstrual cycle, and other factors that are specifically related women and analyze whether that's contributing to the risk of heart attack," she said.

https://www.sciencedaily.com/releases/2022/05/220504130820.htm