Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study

Pini, Nicolò; Shuffrey, Lauren C.; Lucchini, Maristella; Sania, Ayesha; Nelson, Morgan E.; Nugent, J. David; Ochoa, Timothy N.; Odendaal, Hein J.; Fifer, William P.; Myers, Michael; Elliott, Amy J.

doi:10.1109/embc.2019.8857428

Cited by 10 publications

(11 citation statements)

References 9 publications

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“…Measures to collect prenatal alcohol, tobacco and recreational drug exposure have been previously described 31 32. Prenatal maternal alcohol and tobacco use behaviours were previously characterised using cluster analysis 33 34. Through study specific case report forms, participants indicated demographic and socioeconomic information including race, maternal educational attainment, household crowding (persons per room in household), access to running water inside the house, prenatal care during pregnancy and marital status.…”

Section: Methodsmentioning

confidence: 99%

Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study

et al. 2022

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ObjectiveA robust literature has identified associations between prenatal maternal depression and adverse child social-emotional and cognitive outcomes. The majority of prior research is from high-income countries despite increased reporting of perinatal depression in low/middle-income countries (LMICs). Additionally, despite the comorbidity between depression and anxiety, few prior studies have examined their joint impact on child neurodevelopment. The objective of the current analysis was to examine associations between prenatal maternal depression and anxiety with child social-emotional and cognitive development in a cohort from the Western Cape Province of South Africa.DesignPrenatal maternal depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory Scale at 20–24 weeks’ gestation. Child neurobehaviour was assessed at age 3 using the Brief Infant-Toddler Social Emotional Assessment and the Bayley Scales of Infant Development III Screening Test (BSID-III ST). We used linear regression models to examine the independent and joint association between prenatal maternal depression, anxiety and child developmental outcomes.ResultsParticipants consisted of 600 maternal-infant dyads (274 females; gestational age at birth: 38.89 weeks±2.03). Children born to mothers with both prenatal depression and trait anxiety had higher social-emotional problems (mean difference: 4.66; 95% CI 3.43 to 5.90) compared with children born to mothers with no prenatal depression or trait anxiety, each condition alone, or compared with mothers with depression and state anxiety. Additionally, children born to mothers with prenatal maternal depression and trait anxiety had the greatest reduction in mean cognitive scores on the BSID-III ST (mean difference: −1.04; 95% CI −1.99 to –0.08).ConclusionsThe observed association between comorbid prenatal maternal depression and chronic anxiety with subsequent child social-emotional and cognitive development underscores the need for targeting mental health support among perinatal women in LMICs to improve long-term child neurobehavioural outcomes.

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Section: Methodsmentioning

confidence: 99%

Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study

et al. 2022

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“…We then used clustering techniques to characterize multiple patterns of maternal drinking and smoking behaviors ( Pini et al, 2019 ). Further information on alcohol and smoking exposure clustering can be found in the Supplementary Material 2 .…”

Section: Methodsmentioning

confidence: 99%

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Lucchini¹,

Shuffrey²,

Nugent³

et al. 2021

Front. Physiol.

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Negative associations of prenatal tobacco and alcohol exposure (PTE and PAE) on birth outcomes and childhood development have been well documented, but less is known about underlying mechanisms. A possible pathway for the adverse fetal outcomes associated with PTE and PAE is the alteration of fetal autonomic nervous system development. This study assessed PTE and PAE effects on measures of fetal autonomic regulation, as quantified by heart rate (HR), heart rate variability (SD-HR), movement, and HR-movement coupling in a population of fetuses at ≥ 34 weeks gestational age. Participants are a subset of the Safe Passage Study, a prospective cohort study that enrolled pregnant women from clinical sites in Cape Town, South Africa, and the Northern Plains region, United States. PAE was defined by six levels: no alcohol, low quit early, high quit early, low continuous, moderate continuous, and high continuous; while PTE by 4 levels: no smoking, quit early, low continuous, and moderate/high continuous. Linear regression analyses of autonomic measures were employed controlling for fetal sex, gestational age at assessment, site, maternal education, household crowding, and depression. Analyses were also stratified by sleep state (1F and 2F) and site (South Africa, N = 4025, Northern Plains, N = 2466). The final sample included 6491 maternal-fetal-dyad assessed in the third trimester [35.21 ± 1.26 (mean ± SD) weeks gestation]. PTE was associated with a decrease in mean HR in state 2F, in a dose dependent fashion, only for fetuses of mothers who continued smoking after the first trimester. In state 1F, there was a significant increase in mean HR in fetuses whose mother quit during the first trimester. This effect was driven by the Norther Plains cohort. PTE was also associated with a significant reduction in fetal movement in the most highly exposed group. In South Africa a significant increase in mean HR both for the high quit early and the high continuous group was observed. In conclusion, this investigation addresses a critical knowledge gap regarding the relationship between PTE and PAE and fetal autonomic regulation. We believe these results can contribute to elucidating mechanisms underlying risk for adverse outcomes.

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“…To discern associations between different patterns of PAE and PTE during pregnancy on newborn brain activity, we implemented cluster analysis to characterize multiple patterns of maternal drinking and smoking behaviors (eMethods in the Supplement). 38 In the present analysis, we collapsed the PASS alcohol and smoking cluster groups 38…”

Section: Alcohol and Smoking Cluster Analysismentioning

confidence: 99%

Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity

et al. 2020

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IMPORTANCE Research to date has not determined a safe level of alcohol or tobacco use during pregnancy. Electroencephalography (EEG) is a noninvasive measure of cortical function that has previously been used to examine effects of in utero exposures and associations with neurodevelopment. OBJECTIVE To examine the association of prenatal exposure to alcohol (PAE) and tobacco smoking (PTE) with brain activity in newborns.

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Cluster Analysis of Alcohol Consumption during Pregnancy in the Safe Passage Study

Cited by 10 publications

References 9 publications

Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study

Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation

Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity

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