The associations between nighttime sleep duration, bedtime and preschool children's obesity / 中华预防医学杂志

Objective@#To examine the relationship of nighttime sleep duration and bedtime with preschool children's obesity, and to explore possible early life risk factors for childhood obesity.@*Methods@#A total of 14 946 valid children from 16 439 pre-school children aged 3-6 years in 91 kindergartens in Ma'anshan city participated in the study. The body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years was used as the criterion for judging overweight and obesity, and pathological and secondary causes of obesity were excluded. The associations of nighttime sleep duration and bedtime with preschool children's obesity was analyzed by using non-conditional multivariate binary logistic regression model.@*Results@#Among the preschool children, 22.4% (n=3 345) had shorter sleep duration. 9.5% (n=1 415) had bedtimes after 22:00 on weekdays and 21.8% (n=3 260) had bedtimes after 22:00 on weekends. The prevalence of overweight and obesity were 16.5% (n=2 466) and 10.5% (n=1 562), respectively. After the adjustent of age, gender, whether or not only child, residence in the last six months, parents' body mass index parents' educational level, diet preference, outdoor activities, TV viewing duration, sleep duration, bedtime on weekdays and weekends, only the shorter sleep duration (OR=1.25, 95%CI: 1.03-1.51) was still positively associated with the prevalence of obesity in preschool children.@*Conclusion@#Shorter sleep duration was positively associated with the prevalence of obesity among preschool children.

Potential interaction effect on attention-deficit/hyperactivity disorder between mother's educational level and preschoolers' dietary pattern / 中华流行病学杂志

Objective To explore the interaction effect between mother's educational level and preschoolers' dietary pattern on attention-deficit/hyperactivity disorder (ADHD).Methods In 2014,there were 16 439 children aged 3-6 years old from 91 kindergartens in Ma'anshan municipality of China.A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' Abbreviated Symptom Questionnaire (C-ASQ) were administered to assess the usual dietary intake and symptoms on ADHD.Social-demographic information was collected through questionnaires.Unconditional logistic regression was used to analyze the multiplication interaction effect between mother's educational level and preschoolers' dietary pattern on ADHD.Excel software was used to analyze the additive interaction effect of mother's educational level and preschoolers' dietary pattern on ADHD.Results Results showed that factors as:mother's low educational level [aOR=1.31 (1.13-1.52)],scores related to preschoolers in the top quintile of "food processing" [aOR=l.31 (1.16-1.48)] and "snack" [aOR=l.45 (1.29-1.63)]patterns showed greater odds while preschoolers in the top quintile of "vegetarian" [aOR=0.80 (0.71-0.90)] showed less odds for having ADHD symptoms.Both multiplication and additive interactions were observed between mothers with less education.The processed dietary patterns (OR=1.17,95％CI:1.11-1.25),relative excess risk of interaction (RERI),attributable proportion (AP) and the interaction index (SI)appeared as 0.21,0.13 and 1.47,respectively.Multiplication interaction was observed between levels of mother's low education and the snack dietary pattern (OR=1.21,95％CI:1.14-1.29),with RERI,AP and SI as 0.49,0.26 and 2.36,respectively.However,neither multiplication interaction or additive interaction was noticed between levels of mother's low education and the vegetarian dietary pattern (OR=0.97,95％CI:0.92-1.03),with RERI,AP and SI as 0.09,0.05 and 1.15,respectively.Conclusions Levels of mother's low education presented a risk factor for ADHD symptoms in preschool children.Both multiplication interaction and additive interaction were observed between mother's low education levels and the processed dietary pattern.Multiplication interaction was noticed between mother's education levels and the snack dietary pattern but not with the vegetarian dietary pattern.

Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children / 中华流行病学杂志

Objective To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children.Methods The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS).A unified questionnaire was used to collect basic information on both pregnant women and their children.Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS).The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children.A total of 1 713 pairs of mothers and children were included in this study.Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model.Results Prevalence rates in 1 713 preschool children appeared as:6.48％ of emotional problems,8.11％ for conduct problems,8.35％ for hyperactivity/ inattention,2.86％ for peer problems,11.38％ for prosocial behaviors and 7.94％ for total difficulties.Subjects were divided according to the degrees of exposure and the results showed as:low exposure group (≤0.120 ng/ml),medium exposure group (0.120＜BPA＜0.400 ng/ ml) and high exposure group (≥0.400 ng/ml) according to the serum BPA concentration in tertile.Results from the multivariate logistic regression analysis showed that high level of maternal BPA exposure appeared a risk factor on children's abnormal conducts (OR=1.876,95％CI:1.161-3.029),more obvious in boys (OR=2.291,95％CI:1.126-4.661).Conclusion Maternal exposure to high level of BPA during pregnancy might increase the detrimental effects of abnormal conducts in their preschool children,more obviously seen in boys.

Potential interaction effect on attention-deficit/hyperactivity disorder between mother's educational level and preschoolers' dietary pattern / 中华流行病学杂志

Objective To explore the interaction effect between mother's educational level and preschoolers' dietary pattern on attention-deficit/hyperactivity disorder (ADHD).Methods In 2014,there were 16 439 children aged 3-6 years old from 91 kindergartens in Ma'anshan municipality of China.A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' Abbreviated Symptom Questionnaire (C-ASQ) were administered to assess the usual dietary intake and symptoms on ADHD.Social-demographic information was collected through questionnaires.Unconditional logistic regression was used to analyze the multiplication interaction effect between mother's educational level and preschoolers' dietary pattern on ADHD.Excel software was used to analyze the additive interaction effect of mother's educational level and preschoolers' dietary pattern on ADHD.Results Results showed that factors as:mother's low educational level [aOR=1.31 (1.13-1.52)],scores related to preschoolers in the top quintile of "food processing" [aOR=l.31 (1.16-1.48)] and "snack" [aOR=l.45 (1.29-1.63)]patterns showed greater odds while preschoolers in the top quintile of "vegetarian" [aOR=0.80 (0.71-0.90)] showed less odds for having ADHD symptoms.Both multiplication and additive interactions were observed between mothers with less education.The processed dietary patterns (OR=1.17,95％CI:1.11-1.25),relative excess risk of interaction (RERI),attributable proportion (AP) and the interaction index (SI)appeared as 0.21,0.13 and 1.47,respectively.Multiplication interaction was observed between levels of mother's low education and the snack dietary pattern (OR=1.21,95％CI:1.14-1.29),with RERI,AP and SI as 0.49,0.26 and 2.36,respectively.However,neither multiplication interaction or additive interaction was noticed between levels of mother's low education and the vegetarian dietary pattern (OR=0.97,95％CI:0.92-1.03),with RERI,AP and SI as 0.09,0.05 and 1.15,respectively.Conclusions Levels of mother's low education presented a risk factor for ADHD symptoms in preschool children.Both multiplication interaction and additive interaction were observed between mother's low education levels and the processed dietary pattern.Multiplication interaction was noticed between mother's education levels and the snack dietary pattern but not with the vegetarian dietary pattern.

Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children / 中华流行病学杂志

Objective To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children.Methods The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS).A unified questionnaire was used to collect basic information on both pregnant women and their children.Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS).The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children.A total of 1 713 pairs of mothers and children were included in this study.Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model.Results Prevalence rates in 1 713 preschool children appeared as:6.48％ of emotional problems,8.11％ for conduct problems,8.35％ for hyperactivity/ inattention,2.86％ for peer problems,11.38％ for prosocial behaviors and 7.94％ for total difficulties.Subjects were divided according to the degrees of exposure and the results showed as:low exposure group (≤0.120 ng/ml),medium exposure group (0.120＜BPA＜0.400 ng/ ml) and high exposure group (≥0.400 ng/ml) according to the serum BPA concentration in tertile.Results from the multivariate logistic regression analysis showed that high level of maternal BPA exposure appeared a risk factor on children's abnormal conducts (OR=1.876,95％CI:1.161-3.029),more obvious in boys (OR=2.291,95％CI:1.126-4.661).Conclusion Maternal exposure to high level of BPA during pregnancy might increase the detrimental effects of abnormal conducts in their preschool children,more obviously seen in boys.

Association between early pregnancy bisphenol A exposure and sleep problems among preschool children / 中华预防医学杂志

Objective@#To analyze the association between maternal bisphenol A exposure during early pregnancy and sleep problems among preschool children.@*Methods@#Research subjects were from one of the sub-cohorts(Ma'anshan Cohort) of the China-Anhui Birth Cohort Study (C-ABCS) in Ma'anshan city. The basic situation of pregnant women and sleep information of preschool children were investigated. We selected preschool children whose mother's maternal serum bisphenol A concentrations of the first trimester had been already detected between December 2012 to Januray 2014. 1 259 pairs of mothers and children were included. The concentrations of bisphenol A exposure during early pregnancy were divided into low, medium and high exposure groups according to 25th percentile (P25) and 75th percentile (P75) levels. Multivariate multinomial logistic regression model was used to analyze the association between maternal bisphenol A exposure during early pregnancy and sleep-related problems in preschool children.@*Results@#The P50 (P25-P75) of serum bisphenol A exposure level during early pregnancy was 0.231 (0.106-0.512) ng/ml. The sleep-related problems scores of 1 259 preschool children were (16.43±3.82) points. The occasional sleep-related problems were detected about 47.8% (602 cases) and frequent sleep-related problems were detected about 18.3% (230 cases). After the adjustment of the confounding factors such as children's gender, age, BMI, sleep position (lying down, sleeping on one's back), the length of time to sleep and the length of sleep at night, in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool children with occasional sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 1.44 (1.01-2.06). After the gender stratification, the results showed that in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool girls with occasional sleep-related problems in maternal bisphenol A medium and high exposure group during early pregnancy were 1.61 (1.05-2.46) and 2.40 (1.42-4.04), respectively. The OR (95%CI) value of preschool girls with frequent sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 2.64 (1.34-5.17). However, in boys, there was no statistically significant association between maternal bisphenol A exposure during early pregnancy and sleep-related problems (P>0.05).@*Conclusion@#Maternal bisphenol A exposure during early pregnancy might be related to sleep-related problems in preschool children.

Association between the internal exposure levels of phthalates and executive function of preschool children / 中华预防医学杂志

Objective@#To investigate the association between the internal exposure levels of phthalic acid esters (PAEs) and executive function (EF) of preschool children.@*Methods@#Between October 2008 and October 2010, pregnant women who accepted pregnancy health care services in four municipal medical and health institutions in Ma'anshan city, Anhui Province, were recruited as study objects. A total of 5 084 pregnant women and 4 669 singleton live births were enrolled in this cohort. The follow-up study was conducted from April 2014 to April 2015. A total of 3 725 data-completed preschool children aged 3 to 6 years older entered in this study. The method of analysis seven metabolites of phthalates in urine was high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and divided objects into low (P0-P24), medium (P25-P74) and high (P75-P100) groups according to their exposure concentrations. To investigate the executive function of preschool children, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the etiology association between the phthalate metabolites levels and preschool children's executive function.@*Results@#In this study, 53.6% (1 997/3 725) of preschoolers were boys, children's age was (51.5±5.6) months. The detection rates of seven phthalate esters were: mono-n-methyl phthalate (MMP) was 99.89% (3 721/3 725); mono-ethyl phthalate (MEP) was 99.97% (3 724/3 725); mono-benzyl phthalate (MBzP) was 69.10% (2 574/3 725); mono-butyl phthalate (MBP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono- (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) were 100.00% and mono-ethylhexyl phthalate (MEHP) was 99.95% (3 723/3 725). The median concentrations of the seven phthalate metabolites were: 17.71, 15.36, 0.07, 155.24, 10.73, 14.67, 3.59 µg/L, respectively. The median concentrations corrected by urinary creatinine were 29.65, 26.65, 0.12, 257.73, 17.94, 24.80, 6.27 µg/g Cr, respectively. The P25 and P75 concentration of the total PAEs metabolites corrected by urinary creatinine were 1.20 µmol/g Cr and 3.04 µmol/g Cr. After adjusted the relevant demographic information: children sex, children age in month, maternal age, parental education levels, household exposure to secondhand smoke and whether the child is the only child as confounds, multivariate logistic regression model showed that the risk of inhibitory self-control index (ISCI) dysplasia in MEHHP high concentration group and MEOHP high concentration group were 1.71 and 1.54 times (OR=1.71, 95% CI: 1.11-2.62; OR=1.54, 95% CI: 1.01-2.34) than in low concentration group. The risk of ISCI dysplasia in total PAEs metabolites high concentration group was 1.55 times (OR=1.55, 95% CI: 1.00-2.38) than in low concentration group.@*Conclusion@#Phthalates exposure may damage the executive function of preschool children.

Dietary patterns among preschoolers and its association with education level of the parents / 中华流行病学杂志

Objective To identify the dietary patterns among preschoolers in Ma'anshan,and to investigate its association with the education levels of the parents.Methods A total of 16 439 children aged 3-6 were recruited from 91 kindergartens in Ma'anshan city to participate in the study.Food frequency and socio-demographic information were collected through questionnaire survey.Dietary data was collected using a food frequency questionnaire (FFQ),and principal-components analysis was used to derive the dietary patterns.Ordinal multinomial logistic regression was employed to explore the association between the education level of parents and the dietary patterns.Results Five dietary patterns-"processed","beverage","snack","protein" and "vegetarian" were identified.Data showed that the total variance was 48.02％ and the cumulative proportion of processed reached 24.78％.Low educational level of the father was positively associated with both "beverage"(OR=1.36,95％CI:1.15-1.63) and "snack" dietary pattern (OR=1.21,95％CI:1.01-1.43).Low educational level of mother was positively associated with the "processed" (OR =1.31,95％CI:1.09-1.57) and "beverage"dietary pattern (OR=1.48,95％CI:1.23-1.77),and showed a negative correlation with "protein" (OR=0.62,95％ CI:0.52-0.74) and "vegetarian" dietary pattern (OR=0.72,95％ CI:0.60-0.86).Conclusion Findings from this study showed that preschoolers in Ma'anshan tend to choose unhealthy dietary pattern.Dietary pattern was directly influenced by the parents,and especially the education level of the mothers.

Dietary patterns among preschoolers and its association with education level of the parents / 中华流行病学杂志

Objective To identify the dietary patterns among preschoolers in Ma'anshan,and to investigate its association with the education levels of the parents.Methods A total of 16 439 children aged 3-6 were recruited from 91 kindergartens in Ma'anshan city to participate in the study.Food frequency and socio-demographic information were collected through questionnaire survey.Dietary data was collected using a food frequency questionnaire (FFQ),and principal-components analysis was used to derive the dietary patterns.Ordinal multinomial logistic regression was employed to explore the association between the education level of parents and the dietary patterns.Results Five dietary patterns-"processed","beverage","snack","protein" and "vegetarian" were identified.Data showed that the total variance was 48.02％ and the cumulative proportion of processed reached 24.78％.Low educational level of the father was positively associated with both "beverage"(OR=1.36,95％CI:1.15-1.63) and "snack" dietary pattern (OR=1.21,95％CI:1.01-1.43).Low educational level of mother was positively associated with the "processed" (OR =1.31,95％CI:1.09-1.57) and "beverage"dietary pattern (OR=1.48,95％CI:1.23-1.77),and showed a negative correlation with "protein" (OR=0.62,95％ CI:0.52-0.74) and "vegetarian" dietary pattern (OR=0.72,95％ CI:0.60-0.86).Conclusion Findings from this study showed that preschoolers in Ma'anshan tend to choose unhealthy dietary pattern.Dietary pattern was directly influenced by the parents,and especially the education level of the mothers.

Epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic diseases in preschool children / 中华预防医学杂志

Objective@#To understand the epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city.@*Methods@#During April 2014 to April 2015, 91 kindergartens over 3 years old were investigated. In the investigation, 16 439 questionnaires were distributed to parents, and 15 291 valid questionnaires were collected. Conners abbreviated symptom questionnaire (brief symptom questionnaire) was filled out by parents to assess the children's hyperactive behaviors. Information of allergic disease history was reported by parents, including allergic dermatitis/eczema, food/drug allergy, allergic rhinitis and asthma. Multivariate unconditional logistic regression was used to analyze the relevant factors of comorbidity of hyperactivity behavior and allergy diseases.@*Results@#The average age of the 15 291 children were (4.5±1.0) years old, among which 53.7% (8 218/15 291) were boys. The prevalence of hyperactive behaviors was 8.6%(1 317/15 291), and the comorbidity rate of hyperactivity and allergic deseases was 1.7% (258/15 291). After confounding factors including gender, age, delivery mode, father's age and pregnancy complications adjusted, poor sleep quality (OR=4.45, 95%CI: 2.85-6.94), long duration of watching TV at weekend (OR=1.39, 95%CI: 1.00-1.94) and poor eating behavior (OR=1.78, 95%CI: 1.07-2.98) were relevant factors of the comorbidity of hyperactivity and allergic diseases.@*Conclusion@#The prevalence of comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city was not high. Poor night sleep quality, long duration of watching TV and frequently picky eating were relevant factors of the comorbidity of hyperactive behaviors and allergic diseases.

Pregnancy-related anxiety and subthreshold autism trait in preschool children based a birth cohort study / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children.</p><p><b>METHODS</b>Baseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children.</p><p><b>RESULTS</b>During the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal pregnancy-specific anxiety in the third trimester and SAT in preschool children (OR=1.36, 95% CI: 0.82-2.22). Compared with the single function of maternal pregnancy-specific anxiety in trimester or the third trimester for SAT in preschool children, maternal pregnancy-specific anxiety in both periods presented a joint action that increasing the risk for SAT (OR=2.02, 95% CI: 1.36-2.98).</p><p><b>CONCLUSION</b>Maternal pregnancy-related anxiety was a risk factor for subthreshold autism trait in preschooler children. Pregnant women should try to keep a good mental state to create a good environment for fetal growth.</p>

Maternal pre-pregnancy body mass index and gestational weight gain with preschool children's overweight and obesity / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity, and to explore possible early life risk factors for obesity in preschool children.</p><p><b>METHODS</b>Basic information of pregnant women and gestation period came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). Pregnant women in routine health care from four municipal medical and health institutions were enrolled voluntarily during October 2008 and October 2010 in Ma'anshan City. A total of 5 084 pregnant women and 4 669 singleton live births were included in this study. Between April 2014 and April 2015, 3 797 children were followed up. Children whose BMI were >85th percentiles for age and genders of World Health Organization (WHO) reference were considered as overweight, and >95th percentiles for age and genders cut-off values were considered as obesity (pathological and secondary causes of obesity were excluded). Gestational weight gain was defined according to the Institute of Medicine (IOM) guidelines. Univariate and binary regression model analysis was used to examine the effect of pre-pregnancy BMI and GWG with childhood overweight and adiposity.</p><p><b>RESULTS</b>Of the 3 797 pregnant women, the prevalence of underweight, normal weight, overweight and obesity were respectively 22.6% (n=858), 70.3% (n=2 671), 6.2% (n=234) and 0.9% (n=34). There were 3 563 pregnant women who were obtained gestational weight gain data, the prevalence of inadequate GWG, appropriate GWG, excessive GWG were respectively 12.4% (n=443), 25.9% (n=922) and 61.7% (n=2 198). The prevalence of overweight and obesity were 11.5% (n=437) and 10.8% (n= 411) in preschool children, respectively. After adjusting confounding factors including age at delivery, genders of children, children age, birth weight, breastfeeding and household economic status, binary logistic regression analysis showed that pre-pregnancy overweight and obesity(OR=2.01, 95% CI: 1.53-2.65), excessive GWG(OR=1.65, 95% CI: 1.35-2.03) were risk factors for overweight and obesity, and pre-pregnancy underweight was protective factor for childhood overweight and obesity (OR=0.49, 95% CI: 0.39-0.62). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study: compared to only pre-pregnancy higher BMI or excessive GWG or indequate GWG, combination of high pre-pregnancy BMI and excessive GWG or high pre-pregnancy BMI and inadequate GWG, adverse effects on childhood overweight and obesity were much higher,OR (95%CI) values were 2.90(1.97-4.28), 3.17(1.44-6.97) respectively.</p><p><b>CONCLUSION</b>Both high pre-pregnancy BMI and inappropriate GWG are associated with greater offspring BMI. Pregnant women should achieve appropriate weight gain and help prevent obesity in their children.</p>

The relationship between maternal emotional symptoms during pregnancy and emotional and behavioral problems in preschool children: a birth cohort study / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the related influencing factors of preschool children's emotional and behavioral problems in early life and explore the associations between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.</p><p><b>METHODS</b>Based on the Ma'anshan Birth Cohort Study of the China-Anhui Birth Cohort Study (C-ABCS), women were recruited at their first clinical visit between October 2008 and October 2010 in four municipal medical and health institutions of Ma'anshan City, a total of 5 084 pregnant women and 4 669 singletons live births were included in the birth cohort. Women completed measures of depressive (Self-Rating Anxiety scale) and anxious (Center for Epidemiologic Studies Depression) symptoms in pregnancy. By the age of 3-6 follow-up, 3 653 children were followed with completed information between April 2014 and April 2015, strengths and difficulties questionnaires were used to assessed offspring emotional and behavioral problems. Logistics regression was used to investigate the relationship between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.</p><p><b>RESULTS</b>The detected rates of emotional symptoms, conduct problems, hyperactivity and peer problems in preschool children were 6.3% (229/3 653), 7.5% (274/3 653), 7.6% (278/3 653) and 2.8% (103/3 653), while 7.6% (277/3 653) for total difficulties, 10.9%(398/3 653) for prosocial behavior and 27.4%(981/3 557) for impact respectively. Prevalence of anxiety and depression in the first trimester was 2.7%(100/3 653) and 4.7%(171/3 653) respectively, and in the second trimester was 2.0%(66/3 375) and 3.6%(122/3 375) respectively. After we controlled the confoundings of gestation age, place of residence, family income, maternal education, paternal education, premature birth and folic acid supplement before pregnancy, multinomial logistic regression analysis showed that the risk of children's emotional symptoms in maternal anxiety in both first-trimester and second-trimester group was higher than the group of no depression and anxiety symptoms, and OR(95%CI) was 5.90(2.00-17.48). Compared with whose mother no depression in both first-trimester and second-trimester, the risk of children's emotional symptoms in maternal depression in both first-trimester and second-trimester group was higher, and OR(95% CI) was 3.07 (1.30-7.28). And the risk of children's total difficulties of maternal anxiety in second-trimester was 2.27 (95%CI: 1.10-4.71) times of no anxiety in second-trimester. While the risk of children's total difficulties of maternal depression in second-trimester was 2.20 (95%CI: 1.24-3.93) times of no depression in second-trimester. Maternal emotional symptoms were not significant associations with conduct problems, hyperactivity, peer problems and prosocial behaviors (P> 0.05).</p><p><b>CONCLUSION</b>There was a negative impact of maternal anxiety and depression symptoms during pregnancy on emotional and behavioral problems in preschool children. These findings highlight the need for additional clinical and research attention to both maternal depression and anxiety in pregnancy, which may be helpful to reduce the incidence of children's emotional and behavioral problems and act as an important measure in prevention.</p>

Effect of parents' occupational and life environment exposure during six months before pregnancy on executive function of preschool children / 中华预防医学杂志

<p><b>OBJECTIVE</b>To examine the effect of parents' occupational and life exposure during six months before pregnancy on executive function of preschool children.</p><p><b>METHODS</b>Pregnant women involved in the study came from the Ma'anshan Birth Cohort Study,a part of the China-Anhui Birth Cohort Study. Between October 2008 and October 2010, pregnant women who accepted pregnancy care in four municipal medical and health institutions in Ma'anshan city were recruited as study objects. A total of 5,084 pregnant women and 4,669 singleton live births entered in this cohort. Between April 2014 and April 2015, a total of 3,803 pre-school children were followed up. Finally, except 32 preschool children did not have EF evaluation result, there were 3,771 children included in this study. By using self-designed " Maternal health handbook", we researched parents' general demographic characteristics, and life and occupational exposure during six months before pregnancy. To research preschool children's executive function, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the association of parents' life and occupational exposure during six months before pregnancy and preschool children's EF.</p><p><b>RESULTS</b>3,771 preschool children's detected rate of inhibitory self-control index (ISCI), flexibility index (FI), emergent metacognition index (EMI) and global executive composite (GEC) dysplasia were 4.8% (182), 2.3% (88), 16.5% (623) and 8.6% (324) respectively. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.86, 95% CI: 1.36-2.54), whose maternal were exposed to pesticides were the risk of ISCI dysplasia(OR=3.60, 95% CI: 1.45-8.95). During six months before pregnancy, children whose maternal were exposed to pesticides (OR=6.72, 95% CI: 2.50-18.07) and whose father were exposed to occupational lead (OR=2.10, 95% CI: 1.25-3.54) were the risk of FI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.42, 95%CI: 1.18-1.71) and whose father were exposed to occupational lead (OR=1.30, 95%CI: 1.02-1.65) were the risk of EMI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.58, 95% CI: 1.24-2.01) and whose maternal were exposed to pesticides (OR=2.39, 95% CI: 1.02-5.58) were the risk of GEC dysplasia.</p><p><b>CONCLUSION</b>The development of executive function is worse among preschool children whose parents live in noise environment, mother exposed to pesticides, and father exposed to occupational lead during six months before pregnancy.</p>