ABSTRACT
Childhood stress leads to adverse developmental and health outcomes in adulthood, and childhood poverty is perhaps the most significant source of stress that exists today for Canadian children. Previously, three key factors were identified that are important in improving developmental outcomes in children: reducing the stress of poverty; connecting the mother to the child's education; and connecting the mother to social support. The Mom2Mom Child Poverty Initiative was established as a model to improve developmental outcomes for vulnerable children. Mom2Mom combines current evidence regarding the social and biological determinants of child health with direct advocacy. It provides mentorship, and financial and practical support to families, with the goal of improving outcomes for children living in poverty.
Le stress vécu pendant l'enfance s'associe à des problèmes de développement et de santé à l'âge adulte. À l'heure actuelle, la pauvreté est peutêtre la plus grande source de stress pour les enfants canadiens. Trois facteurs clés déjà établis sont essentiels pour améliorer l'issue des enfants sur le plan du développement : réduire le stress causé par la pauvreté, engager la mère dans l'éducation de l'enfant et orienter la mère vers un soutien social. La Mom2Mom Child Poverty Initiative Society a été créée comme modèle pour améliorer l'issue des enfants vulnérables sur le plan du développement. Mom2Mom combine des données probantes à jour sur les déterminants sociaux et biologiques de la santé des enfants avec de la défense d'intérêts directe. Elle offre du mentorat et un soutien financier et pratique aux familles, afin d'améliorer le sort des enfants qui vivent dans la pauvreté.
ABSTRACT
Second-generation antipsychotics (SGAs) are increasingly being used to treat children with a variety of psychiatric illnesses. Metabolic syndrome (MetS), a risk factor for cardiovascular disease, is a side-effect of SGA-treatment. We conducted a cross-sectional study and assessed the association of the methylenetetrahydrofolate reductase (MTHFR) C677T variant with features of MetS in SGA-treated (n=105) and SGA-naïve (n=112) children. We targeted the MTHFR C677T variant, because it is associated with risk for cardiovascular disease, and features of MetS in adults without psychiatric illness. MetS in children is based on the presence of any three of the following: waist circumference ≥ 90th percentile for age and sex; plasma triglyceride ≥ 1.24 mmol l(-1); plasma high-density lipoprotein-cholesterol ≤ 1.03 mmol l(-1); systolic or diastolic blood pressure ≥ 90th percentile for age, sex, and height; and fasting glucose ≥ 5.6 mmol l(-1). We found that 15% of SGA-treated children had MetS compared with 2% of SGA-naïve children (OR 8.113, P<0.05). No effect of the MTHFR C677T variant on psychiatric diagnosis was observed. The MTHFR 677T allele was associated (P<0.05) with MetS (OR 5.75, 95% CI= 1.18-28.12) in SGA-treated children. Models adjusted for duration of SGA treatment, ethnicity, sex, age and use of other medications revealed a positive relationship between the MTHFR 677T allele and diastolic blood pressure Z-scores (P=0.001) and fasting plasma glucose (P<0.05) in SGA-treated children. These findings illustrate the high prevalence of MetS in SGA-treated children and suggest metabolic alterations associated with the MTHFR C677T variant may have a role in the development of MetS features in SGA-treated children.
