In Utero Exposure to Diethylstilbestrol and Blood DNA Methylation in Women Ages 40–59 Years from the Sister Study

In utero exposure to diethylstilbestrol (DES) has been associated with increased risk of adverse health outcomes such as fertility problems and vaginal as well as breast cancer. Animal studies have linked prenatal DES exposure to lasting DNA methylation changes. We investigated genome-wide DNA methylation and in utero DES exposure in a sample of non-Hispanic white women aged 40–59 years from the Sister Study, a large United States cohort study of women with a family history of breast cancer. Using questionnaire information from women and their mothers, we selected 100 women whose mothers reported taking DES while pregnant and 100 control women whose mothers had not taken DES. DNA methylation in blood was measured at 485,577 CpG sites using the Illumina HumanMethylation450 BeadChip. Associations between CpG methylation and DES exposure status were analyzed using robust linear regression with adjustment for blood cell composition and multiple comparisons. Although four CpGs had p<10⁵, after accounting for multiple comparisons using the false discovery rate (FDR), none reached genome-wide significance. In conclusion, adult women exposed to DES in utero had no evidence of large persistent changes in blood DNA methylation.     

Gender Difference in Associations between Chronic Temporomandibular Disorders and General Quality of Life in Koreans: A Cross-Sectional Study

Background

Chronic temporomandibular disorder (TMD) is known to have strong correlations with psychological factors and to display gender disparity. However, while chronic TMD is known to affect quality of life, large-scale studies investigating the influence on quality of life by gender are scarce.

Methods

This cross-sectional study assessed the data of 17,198 participants aged ≥19 years who completed chronic TMD and EuroQol-5 Dimension sections in the 4^th Korean National Health and Nutrition Examination Survey (2007–2009). We adjusted for covariates (health behavior, sociodemographic factors) in regression analysis for complex sampling design to calculate regression coefficients and 95% CIs for gender difference in the association between chronic TMD and quality of life. We also evaluated which covariates of somatic health, mental health, health behavior, and sociodemographic factors weakened the relationship between TMD and EQ-5D.

Results

Prevalence of chronic TMD was 1.6% (men 1.3%, women 1.8%), and chronic TMD persisted to negatively impact quality of life even after adjusting for confounding variables. Low sociodemographic factors and health behavior had a negative effect on quality of life. Somatic health and mental health were most affected by chronic TMD. As for quality of life, women were affected to a greater extent than men by TMD. Women were more affected by osteoarthritis and general mental health (stress, depressive symptoms, and thoughts of suicide), and men by employment.

Conclusions

These results imply that chronic diseases and psychological factors are important in chronic TMD, and that there may be physiological and pathological gender differences in TMD.     

Limb reduction defects in the first generation and deafness in the second generation of intrauterine exposed fetuses to diethylstilbestrol

Maternal treatment with diethylstilbestrol (DES) during pregnancy can produce vaginal adenocarcinoma and other abnormalities of the vagina in her daughters when they reach adolescence or adulthood, miscarriages and absence of full term infants. Concerning malformations in newborns whose mothers were treated with DES, clitoromegaly and malformations of the uterus were reported in females and genital lesions in males. However, the frequencies of major congenital anomalies were not greater than expected. We report three cases of limb reduction defects (LRD) in the first generation of children whose mothers were treated with DES during pregnancy, and two children (one male, one female) with deafness in the second generation after intrauterine exposure to DES. The LRD were not associated with other congenital anomalies. The malformed children with LRD were born between 1965 and 1973. The deafness was also isolated. The two mothers who have no hearing problems and who are healthy were exposed in utero to DES in 1963 and 1965, respectively. Their children were born in 1989 and 1994, respectively. In conclusion, the association of LRD and hearing loss with intrauterine exposure to DES could be coincidental. However, some hypothesis may explain these associations. Congenital hearing loss in the second generation may suggest a transgenerational effect.     

Psychological health and religious coping of Ghanaian women with infertility

Background

Infertility has been shown to have considerable psychological effects on the well-being of couples, especially women. Religion has been found as a resource used by infertile women to cope with their distress. Little research has examined the influence of religious coping on psychological distress among infertile women in Ghana. This study examines the relationship between positive and negative religious coping and psychological health for women with infertility problems in Ghana.

Methods

One hundred and fifty married women who were receiving assisted reproduction care in two specialized clinics were recruited for this study. Participants were administered with the Brief Symptom Inventory and Brief Religious Coping Scale to assess psychological health associated with infertility and religious coping respectively. A hierarchical regression was performed to examine the relative contribution of the domains of psychological health (i.e. somatization, anxiety and depression) in predicting negative religious coping and positive religious.

Results

The results showed that negative religious coping was significant and positively correlated with somatization, depression and anxiety. Furthermore, a positive relationship also existed between positive religious coping and somatization and anxiety but not depression. After controlling for age and duration of infertility, somatization and anxiety predicted positive religious coping whilst all the domains of psychological health (somatization, anxiety and depression) precited negative religious coping.

Conclusions

This study expanded on the existing literature by examining positive and negative religious coping with psychological distress associated with infertility for women. These results underscore the need for health professionals providing therapies for women with infertility to acknowledge and consider their religious beliefs as this influences their mental health.

     

The development of gender-related behavior in females following prenatal exposure to diethylstilbestrol (DES)

Animal research has shown that diethylstilbestrol (DES) present during the sensitive developmental periods of the hypothalamus and adjacent areas of the brain affects the development of sex-dimorphic brain structures and subsequent behavior. To test for corresponding behavioral effects in humans, 30 women with a history of prenatal DES exposure were contrasted with 30 unexposed women who had been referred to the same clinic for a colposcopic examination because of an abnormal Pap smear. Gender-role behavior of childhood, adolescence, and adulthood was assessed by means of a semistructured interview, the Gender Role Assessment Schedule-Adult, and the Bem Sex Role Inventory. The mothers of these women were interviewed about their daughters with the "mother form" of the same interview schedule. The results suggest that DES women show less orientation toward parenting than the controls. There were no consistent group differences in other domains of gender-role behavior.     

Factors relating to the mental health of women who were pregnant at the time of the Great East Japan earthquake: analysis from month 10 to month 48 after the earthquake

Background

The Great East Japan Earthquake occurred at 2:46 p.m. on March 11, 2011. The epicenter was off the coast of Miyagi prefecture, and the magnitude of the earthquake was 9.0 with a maximum seismic intensity of 7.0. Although it has already been four years, victims continue to have complex problems. In the stricken areas of Miyagi prefecture, almost ten percent of the residents continue to live in temporary housing. Life altering events that force relocation and a change of living environment are known to adversely affect mental health. The purpose of this study was to examine the mental health of mothers of infants who experienced this disaster in Miyagi prefecture.

Methods

We conducted a survey using The Edinburgh Postnatal Depression Scale (10 months) and The General Health Questionnaire-28, an efficient screening tool for psychiatric distress. Eight hundred eighty-six mothers of children born from February to October, 2011 in Miyagi prefecture were surveyed 10, 16, 24, 36 and 48 months after the disaster. Data were analyzed with the use of SPSS 21.0 J for Windows. The study was approval by the review board of ethics at Tohoku University.

Results

The questionnaire was answered by the following number of mothers at the specified months after the disaster: 677 at 10 months, 384 at 16 months, 351 at 24 months, 250 at 36 months and 193 at 48 months. Results at all time periods indicated a high prevalence of psychiatric distress among the mothers surveyed. The percentage of Japanese adults with high-risk GHQ-28 scores is 14 %, thus psychological distress among the subjects in the present study is considerably more widespread. General Health Questionnaire-28 scores were significantly higher for those mothers experiencing dissatisfaction in their marital relationships. We found that mothers have experienced severe mental distress since the disaster, which we think is a possible cause of depression that is leading to poor mental health.

Conclusion

The results indicate that the upheaval caused by the tsunami affected the mental health of the mothers. Psychological distress continued to be prevalent up to four years after the disaster. Different factors were found to be associated with their distress. The most common issues were economic problems, dissatisfaction in the marital relationship, and no support with childcare.

     

Comparing Indigenous and public health infant feeding recommendations in Peru: opportunities for optimizing intercultural health policies

Background

The problem of childhood undernutrition in low-income countries persists despite long-standing efforts by local governmental and international development agencies. In order to address this problem, the Peruvian Ministry of Health has focused on improving access to primary healthcare and providing maternal and child health monitoring and education. Current maternal-child health policies in Peru introduce recommendations that are in some respect distinct from those of Indigenous highland communities. This paper analyses the similarities and differences between public health and mothers’ infant feeding recommendations. Furthermore, it analyses persistence and change in those recommendations among women who were mothers before and after the introduction of current public health policies.

Methods

Semi-structured interviews were conducted with 18 older mothers, 15 currently breastfeeding mothers, and 15 public health staff in highland rural communities of Peru. During data analysis, thematic codes and text passages were used in an iterative analytic process to document emerging themes.

Results

The results highlight the existence of a traditional corpus of beliefs surrounding infant feeding and care that is consistent with Andean ethnomedical beliefs. This is illustrated by mother’s accounts referring to the importance of maintaining a dietary balance of fluids and semi-fluids and of maintaining harmony with the elements in the natural environment. Mothers also incorporate aspects of public health recommendations that they find useful including initiating breastfeeding immediately after birth and exclusive breastfeeding up until 6 months. There are also tensions between the two systems including differences in the conceptualization of breastfeeding and infant food, the imposition of public health care services by coercive means, and negative stereotyping of rural Andean diets and mothers.

Conclusions

Identifying similarities and differences between distinct systems may provide useful input for effective intercultural health policies. Sources of tension should be carefully assessed with the aim of improving public health policies. Such efforts should apply a process of cultural humility engaging health care professionals in exchange and conversations with patients and communities acknowledging the assumptions and beliefs that are embedded in their own understanding. This process should also recognize and value the knowledge and practices of Andean mothers and their role as primary caretakers.

     

High-protein diet in lactation leads to a sudden infant death-like syndrome in mice

Background

It is well accepted that reduced foetal growth and development resulting from maternal malnutrition are associated with a number of chronic conditions in later life. On the other hand such generation-transcending effects of over-nutrition and of high-protein consumption in pregnancy and lactation, a proven fact in all developed societies, are widely unknown. Thus, we intended to describe the generation-transcending effects of a high-protein diet, covering most relevant topics of human life like embryonic mortality, infant death, and physical health in later life.

Methods

Female mice received control food (21% protein) or were fed a high protein diet (42% protein) during mating. After fertilisation, females stayed on their respective diet until weaning. At birth, pups were put to foster mothers who were fed with standard food or with HP diet. After weaning, control diet was fed to all mice. All offspring were monitored up to 360 days after birth. We determined glucose-tolerance and measured cardiovascular parameters using a tip-catheter. Finally, abdominal fat amount was measured.

Results and Conclusions

We identified a worried impact of high-protein diet during pregnancy on dams'' body weight gain, body weight of newborns, number of offspring, and also survival in later life. Even more important is the discovery that high-protein diet during lactation caused a more than eight-fold increase in offspring mortality. The observed higher newborn mortality during lactation is a hitherto non-described, unique link to the still incompletely understood human sudden infant death syndrome (SIDS). Thus, although offspring of lactating mothers on high-protein diet might have the advantage of lower abdominal fat within the second half of life, this benefit seems not to compensate the immense risk of an early sudden death during lactation. Our data may implicate that both pregnant women and lactating mothers should not follow classical high-protein diets.     

Breastfeeding and its impact on daily life in women with type 1 diabetes during the first six months after childbirth: a prospective cohort study

Background

For mothers with diabetes, breastfeeding is a great challenge due to their struggle with potentially unstable blood glucose levels. This paper explores breastfeeding attitudes and impact of breastfeeding on the daily life of mothers with type 1 diabetes compared with non-diabetic mothers.

Methods

We performed a prospective cohort study of 108 mothers with type 1 diabetes and a reference group of 104 mothers in the west of Sweden. Data were collected through medical records and structured telephone interviews at 2 and 6 months after childbirth.

Results

Women in both the diabetes group and the reference group had high levels of confidence (84% and 93% respectively) in their breastfeeding capacity before childbirth, and 90% assessed breastfeeding as a positive and an important experience during the six months of follow-up. About 80% assessed breastfeeding as influencing daily life ‘very much’ or ‘quite a lot’ at 2 months as did 60% at 6 months, with no difference between the groups. In mothers with diabetes, the impact of breastfeeding on the priority of other duties decreased over time, as did feelings of time pressure and negative effects on patterns of sleep. Compared to the reference group, mothers with diabetes at 6 months remained more affected by disruptions in daily life and they felt more worried about their health both at 2 and 6 months after childbirth. For the reference group mothers’ sensitivity to unexpected disruptions in daily routines decreased between 2 and 6 months after childbirth, and they expressed a greater need to organize their time than mothers with diabetes.

Conclusion

Mothers with diabetes type 1 express more worry for own health and are more sensitive to distruptions. To balance their everyday life and to reduce the risk of stress and illhealth they are therefor, compared to other mothers, likely to need additional professional and peer support.

     

Investigating the Relationship between Socially-Assigned Ethnicity,Racial Discrimination and Health Advantage in New Zealand

Background

While evidence of the contribution of racial discrimination to ethnic health disparities has increased significantly, there has been less research examining relationships between ascribed racial/ethnic categories and health. It has been hypothesized that in racially-stratified societies being assigned as belonging to the dominant racial/ethnic group may be associated with health advantage. This study aimed to investigate associations between socially-assigned ethnicity, self-identified ethnicity, and health, and to consider the role of self-reported experience of racial discrimination in any relationships between socially-assigned ethnicity and health.

Methods

The study used data from the 2006/07 New Zealand Health Survey (n = 12,488), a nationally representative cross-sectional survey of adults 15 years and over. Racial discrimination was measured as reported individual-level experiences across five domains. Health outcome measures examined were self-reported general health and psychological distress.

Results

The study identified varying levels of agreement between participants'' self-identified and socially-assigned ethnicities. Individuals who reported both self-identifying and being socially-assigned as always belonging to the dominant European grouping tended to have more socioeconomic advantage and experience less racial discrimination. This group also had the highest odds of reporting optimal self-rated health and lower mean levels of psychological distress. These differences were attenuated in models adjusting for socioeconomic measures and individual-level racial discrimination.

Conclusions

The results suggest health advantage accrues to individuals who self-identify and are socially-assigned as belonging to the dominant European ethnic grouping in New Zealand, operating in part through socioeconomic advantage and lower exposure to individual-level racial discrimination. This is consistent with the broader evidence of the negative impacts of racism on health and ethnic inequalities that result from the inequitable distribution of health determinants, the harm and chronic stress linked to experiences of racial discrimination, and via the processes and consequences of racialization at a societal level.     

Impact of a Participatory Intervention with Women’s Groups on Psychological Distress among Mothers in Rural Bangladesh: Secondary Analysis of a Cluster-Randomised Controlled Trial

Background

Perinatal common mental disorders (PCMDs) are a major cause of disability among women and disproportionately affect lower income countries. Interventions to address PCMDs are urgently needed in these settings, and group-based and peer-led approaches are potential strategies to increase access to mental health interventions. Participatory women’s health groups led by local women previously reduced postpartum psychological distress in eastern India. We assessed the effect of a similar intervention on postpartum psychological distress in rural Bangladesh.

Method

We conducted a secondary analysis of data from a cluster-randomised controlled trial with 18 clusters and an estimated population of 532,996. Nine clusters received an intervention comprising monthly meetings during which women’s groups worked through a participatory learning and action cycle to develop strategies for improving women’s and children’s health. There was one group for every 309 individuals in the population, 810 groups in total. Mothers in nine control clusters had access to usual perinatal care. Postpartum psychological distress was measured with the 20-item Self Reporting Questionnaire (SRQ-20) between six and 52 weeks after delivery, during the months of January to April, in 2010 and 2011.

Results

We analysed outcomes for 6275 mothers. Although the cluster mean SRQ-20 score was lower in the intervention arm (mean 5.2, standard deviation 1.8) compared to control (5.3, 1.2), the difference was not significant (β 1.44, 95% CI 0.28, 3.08).

Conclusions

Despite promising results in India, participatory women’s groups focused on women’s and children’s health had no significant effect on postpartum psychological distress in rural Bangladesh.     

Effects of a chronic stress treatment on vaccinal response in lambs

Farming systems can expose animals to chronic mild stress which is known to induce negative affective state. Affective state in animals, as in humans, can be assessed through behavioral cues. This study aimed to describe the effect of a chronic mild stress, known to induce a negative affective state, on sheep health through their response to vaccination. The study used 15 lambs subjected to a model of chronic mild stress for 15 weeks and 15 lambs reared under conventional farming as a control group. After 7 weeks of stressful treatment, the lambs were individually exposed to a judgment bias test to assess a putative stress-induced ‘pessimism.’ After 15 weeks of stressful treatment, antibody immune response was measured after an injection of a live vaccine challenge (Chlamydia abortus attenuated vaccine strain 1B). Stressed lambs displayed a pessimistic-like perception in the judgment bias test, revealing a negative affective state. Stressed and control animals showed different immunological reactions to vaccine challenge: stressed sheep had lower hemoglobin concentrations and higher platelet, granulocyte and acute-phase protein concentrations. Antibody response induced by the vaccine strain was not different between stressed and control sheep. Our results suggest that negative affective state induced by chronic stress treatment may induce a stronger inflammatory response to vaccine challenge in sheep. Improvement of animal health may be achieved through consideration of stressors that may affect the emotional and immunological state of sheep.     

Working status and stress of middle class women of Calcutta

In India an increase in female employment outside the home has occurred during the last few decades, especially in urban areas. A working woman may face difficulties in attempting to fulfil the demands of both worlds, at home and outside, while a housewife may feel tired and irritated with her household chores and financial dependence. All these may cause stress for these groups of women. The present study compares a group of working mothers with their non-working counterparts with respect to: (a) stress level, measured in terms of their anxiety score; and (b) certain general indicators of health including a broad measure of stress. The results show that anxiety and health scores of the two groups of women are similar. Further, the health score and anxiety score seem to be correlated, more clearly among the working mothers.     

Women's physical and psychological condition independently predict their preference for apparent health in faces

Physical condition (e.g., health, fertility) influences female mate preferences in many species, with females in good condition preferring "higher quality" (e.g., healthier) mates. In humans, condition may comprise both physical (e.g., health and fertility) and psychological factors (e.g., stress, anxiety, and depression). We found that women with low waist-to-hip ratios (indicating health and fertility) or who scored low on anxiety, depression, and stress measures expressed greater attraction to composite male (but not female) faces with color and texture cues associated with apparent health than did women with relatively high waist-to-hip ratios or who scored relatively high on the anxiety, depression, and stress measures. These effects of physical and psychological condition were independent and were not mediated by women's perceptions of their own attractiveness. Our findings indicate that women's physical and psychological conditions both contribute to individual differences in face preferences.     

Low blood pressure,low mood?

OBJECTIVE--To determine whether a set of physical symptoms is associated with low blood pressure and to investigate the possible role of psychological factors in their occurrence. DESIGN--Analysis of data collected by questionnaire and physical screening from the first phase of the Whitehall II study, a cohort study of an employed population. SETTING--23 civil service departments in London. SUBJECTS--10,314 male and female London based civil servants aged between 35 and 55. MAIN OUTCOME MEASURES--Symptoms of dizziness-giddiness and unexplained tiredness; psychological functioning as measured by the 30 item general health questionnaire in which the response "no more than usual" to an item about disease was scored as indicating chronic illness. RESULTS--Dizziness-giddiness in men and unexplained tiredness in both men and women were significantly related to low systolic blood pressure. There was a highly significant inverse relation between general health questionnaire score and systolic blood pressure for both men and women, which persisted after controlling for potentially confounding variables, including age, body mass index, drug treatment, physical illness, and exercise. This association of low blood pressure with physical symptoms was no longer significant when general health questionnaire score was controlled for. CONCLUSIONS--There seems a strong relation between low systolic blood pressure and minor psychological dysfunction. Associated physical symptoms seem to be secondary to the primary disturbance in mental state.     

Labor and delivery complications among teenage mothers

A broad set of academic literatures shows that childbearing is associated with a variety of negative health outcomes for teenage mothers. Many researchers question whether teenage childbearing is the causal explanation for the negative outcomes (i.e., whether there is a biological effect of teenage childbearing or whether the relationship is due to other factors correlated with health and teenage childbearing). This study investigates the relationship between teenage childbearing and labor and delivery complications using a panel of confidential birth certificate data over the period from 1994 to 2003 from the state of Texas. Findings show that compared to mothers aged 25 to 29 having their first child, teenager mothers appear to have superior health in most--but not all--labor and delivery outcomes.     

Gender Differences in Associations of Eating Pathology between Mothers and Their Adolescent Offspring

Objective: To study the association of eating pathology between mothers and their adolescent offspring in a population sample. Research Methods and Procedures: The participants were 481 women (mean age, 47 ± SD 5 years; BMI, 25 ± 4 kg/m²) and their 481 adolescent children 16 to 17 years old (BMI, 21 ± 3 kg/m²) of the Stockholm Weight Development Study. Assessment methods were the Three‐Factor Eating Questionnaire Revised 18 and the Eating Disorder Inventory 2. Results: A higher body weight was most related to cognitive restraint for adolescents and to emotional eating for adult women. A mother‐daughter link could be identified for eating pathology, with the strongest link found for emotional eating. No mother‐son link could be identified. Age subgroup analyses revealed a stronger mother‐daughter link for body attitudes in younger mothers and for cognitive restraint in older mothers. Discussion: Gender differences revealed that eating pathology was shared by mothers and daughters but not by mothers and sons. A psychological strategy such as eating as a response to negative emotions was most interrelated between mothers and daughters. Younger mothers shared more attitudes toward the body with their daughters, whereas older mothers shared more restrictive eating behaviors with their daughters. The mother‐daughter links found may be due to gender‐specific genetic and psychological family transmission and gender‐specific environmental influences. The sons’ eating behaviors seem to be more independent and would be formed by other factors than for the girls.     

乙型肝炎病毒的水平传播和围产期传播

在上海、河北、黑龙江和四川四省市调查了4 500名子女及其母亲的HBsAg阳性率。结果表明,HBsAg阳性母亲的子女,受水平和围产期传播的共同作用,其HBsAg阳性危险性显著高于单纯受水平传播作用的HBsAg阴性母亲的子女。HBsAg阴性母亲的74名HBsAg阳性子女,二年后11人转阴,年龄越大,阴转率呈越高的趋势,而HBsAg阳性母亲的31名阳性子女仅1例转阴,即后者的携带率(96.77％)高于前者(85.13％)。但就人群中HBsAg阳性和携带者的构成而言,仅32.25％的HBsAg的携带者,来源于受双重传播作用的HBsAg阳性母亲。换言之,水平传播的权重明显大于围产期传播,故阻断围产期传播的同时还应预防水平传播。     

Brain-Derived Neurotrophic Factor in Post-Partum Depressive Mothers

Postpartum depression (PPD) is the most common psychiatric complication observed in women after they give birth. Some women are particularly sensitive to hormonal changes, starting in early menarche, thus increasing their vulnerability to psychological stressing agents that are triggered by environmental and physiological factors throughout their lives. Decreased serum brain-derived neurotrophic factor (BDNF) levels have been associated to different neuropsychiatric conditions and BDNF has been considered as a candidate marker for such dysfunctions. The goal of this study was to compare the levels of BDNF between mothers who suffer from PPD and healthy control mothers as well as to searching for associations between BDNF levels and the severity of PPD. This is a case-control study including 36 mothers with PPD and 36 healthy control mothers. PPD was defined according to the Beck Depression Inventory (BDI). Serum BDNF was assayed with the sandwich ELISA method. Results: Serum levels of BDNF were significantly lower in women with PPD than in control mothers (P?≤?0.03). A significant negative correlation between BDI score and serum BDNF levels was observed (P?≤?0.02 and r?=?-0.29). Our study demonstrated that low BDNF levels are associated with PPD. This result point out to the potential usage of BDNF in the screening of PPD, which could promote early treatment and, therefore, reduce the burden to the PPD women and to the health system.