Out-of-Home Care and Subsequent Preterm Delivery: An Intergenerational Cohort Study

Liu, Can; Vinnerljung, Bo; Östberg, Viveca; Gauffin, Karl; Juárez, Sol; Cnattingius, Sven; Hjern, Anders

doi:10.1542/peds.2017-2729

Cited by 7 publications

(6 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparably, in a report sampling around half of the present population of women where body mass index (BMI) was computed from the direct measurement of height and weight, around 15% of women had a BMI of ≥30kg/m 2 . 29 This clear differential may be at least partially explained by the ascertainment of obesity in our study being based on a health professionals’ observation resulting in a diagnosis, rather than actual measurement. Importantly, in that study, 29 as in the present one, the prevalence of gestational obesity, diabetes, and hypertension were the same in the out-of-home care group and the general population controls.…”

Section: Discussionmentioning

confidence: 86%

“…29 This clear differential may be at least partially explained by the ascertainment of obesity in our study being based on a health professionals’ observation resulting in a diagnosis, rather than actual measurement. Importantly, in that study, 29 as in the present one, the prevalence of gestational obesity, diabetes, and hypertension were the same in the out-of-home care group and the general population controls. Relatedly, in being related to elevated CVD risk in the expected directions (table 3), the metabolic indices of gestational obesity, diabetes, and hypertension have predictive validity.…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Hjern

Brännström

Vinnerljung

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Individuals with a history of out-of-home care in childhood experience elevated rates of mortality from all-causes and suicide in adulthood but the relationship with chronic disease is unknown. We examined the association between out-of-home care and cardiovascular disease (CVD) in a large cohort study and, in the women, explored how care is embodied to give rise to CVD. Methods: This is a cohort study generated from linkage of a range of Swedish national registers. Born 1972-1981, 447,516 men (12711 with a care background) and 415,910 women (11926 with a care background) were followed between care graduation at age 18 and up to age 48 years for hospitalisations and death. A subgroup of 377,500 women (87% of the birth cohort) were linked to a maternity database which yielded data on adult cigarette smoking and metabolic risk factors. Results: A maximum of 30 years of health surveillance gave rise to 5519 CVD events (2049 in women). After adjusting for the confounding factors of year of birth and maternal education, men (hazard ratio 1.95 [95% CI 1.68-2.25]) and women (1.80 [1.48-2.18]) with a history of out-of-home care in childhood had around a doubling of CVD risk in adulthood compared with general population controls. Separate presentations of CVD, such as myocardial infarction and stroke, revealed similar magnitudes of association with care. In women who had given birth, adjustment for the mediating variables of adult smoking status (1.41 [1.12-1.78]) and educational performance (1.57 [1.25-1.98]), but not metabolic risk factors (1.98 [1.24-3.15]), led to marked attenuation in CVD risk. Conclusion: In the present study, men and women separated from their family of origin in early life experienced an increased burden of CVD as adults. Results for women suggest that targeting health behaviours, teenage pregnancy, and educational performance in these groups may potentially mitigate risk. These findings add to the array of adverse adult health outcomes seemingly experienced following care graduation.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 86%

Cardiovascular disease in individuals with a history of out-of-home care: a Swedish national cohort study

Hjern

Brännström

Vinnerljung

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Abuse is also strongly associated with mental health issues, which raise the risk for several poor outcomes, both directly and via health behaviors, substance use, and partner violence during the pregnancy [ 27 ]. Experiencing out-of-home care (foster or residential care) as a child is associated with increased risk of PTB [ 28 ]. More generally, adverse childhood experiences (ACEs), such as abuse, parental substance use, or neglect, are linked to adverse birth outcomes [ 29 , 30 ], unintended pregnancy [ 31 ], and risky reproductive health behaviors, including early sexual debut and prenatal substance use [ 32 – 34 ].…”

Section: Early-life Influences On Women’s Reproductive Healthmentioning

confidence: 99%

The Impact of Early-Life Exposures on Women’s Reproductive Health in Adulthood

2021

View full text Add to dashboard Cite

Purpose of Review To review the effects of early-life, preconception, and prior-generation exposures on reproductive health in women. Recent Findings Women’s early-life factors can affect reproductive health by contributing to health status or exposure level on entering pregnancy. Alternately, they can have permanent effects, regardless of later-life experience. Nutrition, social class, parental smoking, other adverse childhood experiences, environmental pollutants, infectious agents, and racism and discrimination all affect reproductive health, even if experienced in childhood or in utero. Possible transgenerational effects are now being investigated through three- or more-generation studies. These effects occur with mechanisms that may include direct exposure, behavioral, endocrine, inflammatory, and epigenetic pathways. Summary Pregnancy is increasingly understood in a life course perspective, but rigorously testing hypotheses on early-life effects is still difficult. In order to improve the health outcomes of all women, we need to expand our toolkit of methods and theory. Supplementary Information The online version contains supplementary material available at 10.1007/s40471-021-00279-0.

show abstract

“…In Liu et al's study, 1 the accumulation of adversities over the life span in generation 1 fits another concept in life-course science: that of developmental cascades. In this concept, risk often begets risk, leading to an ever-increasing burden of adversities that erode resilience over time.…”

mentioning

confidence: 98%

“…In an intriguing article by Liu et al, 1 "Out-of-Home Care and Subsequent Preterm Delivery: An Intergenerational Cohort Study, " in the current issue of Pediatrics, the authors report on the elevated rates of preterm delivery among women with a history of out-of-home care (OHC) before and after the age of 10 years. The authors framed their study using the science of toxic stress and its known impact on health outcomes as the theoretical construct and using OHC as a proxy for early life adversity.…”

mentioning

confidence: 99%