Australian and New Zealand Journal of Psychiatry, 2008
The purpose of the present study was to examine the longitudinal association between early childh... more The purpose of the present study was to examine the longitudinal association between early childhood factors and early initiation of use of substances and substance use disorders in a large prospective study. Data were from the Mater Hospital University of Queensland Study of Pregnancy, a prospective birth cohort study in Brisbane, Australia. Use of nicotine, alcohol and cannabis and age of initiation of such use were reported at the 21 year follow up. DSM-IV diagnosis of nicotine, alcohol and cannabis use disorders was assessed at 21 years using a computerized version of the Composite International Diagnostic Interview (CIDI-Auto). Early childhood factors were measured between mother's pregnancy and child age 5 years. Of the 3647 respondents with complete data, 15.4% had started to smoke cigarettes before 15 years. Another 17.4% and 12.2% reported having started to consume alcohol or use cannabis in early adolescence, respectively. Some 16.2%, 27.8% and 21.9% had ever had nicotine, alcohol or cannabis abuse or dependence (disorder) by 21 years, respectively. In multivariate models early initiation of use of substances, and substance use disorders were associated with disrupted families or drug-using parents, childhood problem behaviours, and poor parental monitoring and supervision in childhood. There are four independent factors in early or middle childhood that predict early initiation of use of substances and subsequent substance use disorders by early adulthood. There is a need to consider whether what is known about the risk factors that predict young age of substance use, and substance use disorders, may be incorporated into treatment and/or prevention initiatives.
Few studies have explored early predictors of problem drinking in youth, and fewer still have sim... more Few studies have explored early predictors of problem drinking in youth, and fewer still have simultaneously considered the role of biologic, familial, and intrapersonal factors. The present study explored early life course and later life course predictors of alcohol abuse and dependence in young adulthood. Data were taken from a cohort of 2,551 mothers and their children recruited as part of the longitudinal Mater University Study of Pregnancy and its outcomes (MUSP) carried out in Brisbane, Australia, from 1981 to 1984. Data were collected prenatally and then postnatally at 6 months and at 5, 14, and 21 years. A range of biologic, familial, and intrapersonal factors was considered. A series of logistic regression models with inverse probability weighting was used to explore pathways to problem drinking from adolescence to early adulthood. For males and females, no association was found between either birth factors or childhood factors and a lifetime diagnosis of alcohol disorders at age 21 years. Externalizing symptoms and maternal factors at age 14 years were significantly associated with alcohol problems. For youth aged 14 years, maternal moderate alcohol consumption accounted for the highest percentage of attributable risk among those exposed. Results show that exposure to maternal drinking in adolescence is a strong risk factor for the development of alcohol problems in early adulthood. adolescent; alcohol drinking; cohort studies; mothers; risk factors Abbreviations: CIDI-Auto, Composite International Diagnostic Interview-computerized version; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; MUSP, Mater University Study of Pregnancy and its outcomes.
Aims To examine whether there is evidence of an independent association between childhood sexual... more Aims To examine whether there is evidence of an independent association between childhood sexual abuse (CSA) and nicotine disorder in youth and to explore the mechanisms underlying this association in a prospective cohort study.Design Birth cohort study followed-up to 21 years.Setting One of two major obstetric hospitals in Brisbane, Australia.Participants The Mater-University of Queensland Study of Pregnancy involves a prospective birth cohort from a population-based sample involving 7223 singletons whose mothers were enrolled between 1981 and 1984 at the first antenatal visit. The present cohort consisted of a subgroup of 2571 youth who completed the life-time version of the Composite International Diagnostic Interview—computerized version (CIDI-Auto) at the 21-year follow-up.Measurements Nicotine disorder was measured based on Diagnostic and Statistical Manual version IV (DSM-IV) diagnostic criteria and measures of CSA, including retrospective self-reports of rape, were obtained at 21 years.Results Of 2571 young adults, 16.6% met the criteria for either dependence (12.8%) or withdrawal (8.5%). Non-penetrative sexual abuse was reported by 15.5% of respondents and 8.0% reported penetrative sexual abuse. For any types of sexual abuse including non-penetrative, penetrative and self-reported rape before age 16 years, young adults had significantly higher rates of nicotine disorder than young adults who did not experience CSA. This relationship was independent and appeared direct after adjustment for a range of potential confounding and mediating factors.Conclusions This study shows that CSA is associated with young adult nicotine disorder. The results extend the public health significance of findings in this area and highlight the importance of not only intensifying public health efforts to address substance use problems among those who have experienced CSA, but of early intervention, so that emerging risky behaviours may be targeted in the earliest stages.
Journal of The American Academy of Child and Adolescent Psychiatry, 2007
Objective: To examine whether age of first use or frequency of use of cannabis is associated with... more Objective: To examine whether age of first use or frequency of use of cannabis is associated with anxiety and depression (AD) in young adults, independent of known potential confounders, including the use of other illicit drugs. Method: A cohort of 3,239 Australian young adults was followed from birth to the age of 21 when data on AD were obtained from sample members along with information on their use of cannabis at 21 years. Potential confounding factors were prospectively measured when the child was born and at 14 years. Results: After controlling for confounding factors, those who started using cannabis before age 15 years and used it frequently at 21 years were more likely to report symptoms of AD in early adulthood (odds ratio 3.4; 95% CI 1.9Y6.1). This association was of similar magnitude for those who had only used cannabis and those who reported having used cannabis and other illicit drugs. Conclusion: The relationship between early-onset and frequent use of cannabis and symptoms of AD is independent of individual and family backgrounds.
MAMUN, ABDULLAH A., DEBBIE A. LAWLOR, MICHAEL J. O'CALLAGHAN, WILLIAM BOR, GAIL M. WILLIAMS, AND ... more MAMUN, ABDULLAH A., DEBBIE A. LAWLOR, MICHAEL J. O'CALLAGHAN, WILLIAM BOR, GAIL M. WILLIAMS, AND JAKE M. NAJMAN. Does childhood sexual abuse predict young adult's BMI? A birth cohort study. Obesity. 2007;15:2103-2110. Objective: The objective was to identify the extent to which childhood sexual abuse (CSA) is associated with BMI and overweight status in young adulthood and to examine whether any associations differ by gender.
To determine whether parental marital status and marital quality in adolescence are associated wi... more To determine whether parental marital status and marital quality in adolescence are associated with cannabis use disorders in young adults. Design Prospective birth cohort study. Setting A 21 year follow-up of 4815 mothers and their children who participated at 14 years after the child's birth in Queensland, Australia. Participants Cohort of 2303 young adults who completed the life-time version of the Composite International Diagnostic Interview-computerized version (CIDI-Auto) at the 21-year follow-up. Measurements Young adults' cannabis use disorders were assessed using the CIDI-Auto. Marital status and quality (marital circumstances) and potential confounding factors such as socio-economic status (SES), maternal mental health and maternal substance use were measured when the child was 14 years of age. Findings Marital circumstances of the mother when child was 14 years predicted risk of cannabis use disorders in their offspring. After adjustment for potential confounding factors, adolescents who grew up in step-father families were more likely to have cannabis use disorders in early adulthood and a moderate association was found for those children who experienced maternal marital disagreement (OR = 1.7; 95% CI: 1.0, 2.9). There was no significant increase in subsequent risk of cannabis use disorders for children whose mothers were un-partnered at 14 years. Conclusions Maternal marital status and marital quality are associated with young adults' subsequent cannabis use disorders. This association is independent of suspected confounding factors measured at 14 years. However, at least part of the association is explained by changes in marital status before 14 years.
Asthma in early childhood has been associated with maternal smoking during pregnancy and parental... more Asthma in early childhood has been associated with maternal smoking during pregnancy and parental smoking soon after birth. However, less is known about these exposures and the development of asthma symptoms in adolescence. Data were taken from the Mater University Study of Pregnancy, a large birth cohort study of mothers and children enrolled in Brisbane, Australia, beginning in 1981. Smoking was assessed at 2 stages during pregnancy and at the 6-month and 5-year follow-up visits. Asthma was assessed from maternal reports that were provided when the child was age 14 years. We conducted multivariable multinomial logistic regression analyses to assess the effect of maternal smoking on asthma symptoms. There was a strong sex interaction such that girls whose mothers had smoked heavily (20 or more cigarettes per day) in pregnancy and at the 6-month follow up had increased odds of experiencing asthma symptoms at age 14 (odds ratio = 1.96; 95% confidence interval = 1.25-3.08). The contribution of heavy smoking during pregnancy appeared to be stronger than heavy smoking after the birth. No similar associations were seen for boys. Female adolescents whose mothers smoked heavily during the fetal period and the early months of life have increased risk of asthma symptoms in adolescence. In utero exposure to heavy smoking was found to have a stronger effect than postnatal environmental tobacco exposure.
The fetal overnutrition hypothesis proposes that greater maternal adiposity results in increased ... more The fetal overnutrition hypothesis proposes that greater maternal adiposity results in increased obesity throughout life in the offspring. The authors examined the associations between parental prepregnancy body mass index (BMI; weight (kg)/height (m) 2 ), based on height and weight reported by the mother at her first antenatal clinic visit, and offspring BMI (height and weight measured at age 14 years) in 3,340 parent-offspring trios from a birth cohort based in Brisbane, Australia (mothers were recruited in 1981-1984). The maternal-offspring BMI association was stronger than the paternal-offspring BMI association. In the fully adjusted model, the increase in standardized offspring BMI at age 14 for a one-standard-deviation (SD) increase in maternal BMI was 0.362 SD (95% confidence interval: 0.323, 0.402), and the corresponding result for a one-SD increase in paternal BMI was 0.239 SD (95% confidence interval: 0.197, 0.282). There was statistical support for a difference in the magnitude of the association between maternal-offspring BMI and paternal-offspring BMI in all confounder-adjusted models tested (all p's < 0.0001). In sensitivity analyses taking account of different plausible levels of nonpaternity (up to 15%), the greater maternal effect remained. These findings provide some support for the fetal overnutrition hypothesis. body mass index; fetal development; fetal nutrition disorders Abbreviations: BMI, body mass index; CI, confidence interval. Correspondence to Prof. Evidence for the Fetal Overnutrition Hypothesis 419 Am J Epidemiol 2007;165:418-424 * Coefficients were calculated using the formula presented in the Appendix. y Weight (kg)/height (m) 2 . z BMI, body mass index. 422 Lawlor et al. Am J Epidemiol 2007;165:418-424
The objectives of this study were to examine the extent of clustering of smoking, high levels of ... more The objectives of this study were to examine the extent of clustering of smoking, high levels of television watching, overweight, and high blood pressure among adolescents and whether this clustering varies by socioeconomic position and cognitive function. Methods: This study was a cross-sectional analysis of 3613 (1742 females) participants of an Australian birth cohort who were examined at age 14. Results: Three hundred fifty-three (9.8%) of the participants had co-occurrence of three or four risk factors. Risk factors clustered in these adolescents with a greater number of participants than would be predicted by assumptions of independence having no risk factors and three or four risk factors. The extent of clustering tended to be greater in those from lower-income families and among those with lower cognitive function. The age-adjusted ratio of observed to expected cooccurrence of three or four risk factors was 2.70 (95% confidence interval [CI], 1.80 -4.06) among those from low-income families and 1.70 (95% CI, 1.34 -2.16) among those from more affluent families. The ratio among those with low Raven's scores (nonverbal reasoning) was 2.36 (95% CI, 1.69 -3.30) and among those with higher scores was 1.51 (95% CI, 1.19 -1.92); similar results for the WRAT 3 score (reading ability) were 2.69 (95% CI, 1.85-3.94) and 1.68 (95% CI, 1.34 -2.11). Clustering did not differ by sex. Conclusion: Among adolescents, coronary heart disease risk factors cluster, and there is some evidence that this clustering is greater among those from families with low income and those who have lower cognitive function.
It has been suggested that sleeping problems are causally associated with obesity in early life, ... more It has been suggested that sleeping problems are causally associated with obesity in early life, but most studies examining this association have been cross-sectional. The authors used a population-based birth cohort of 2,494 children who were born between 1981 and 1983 in Brisbane, Australia, to examine the prospective association between early-life sleeping problems (at ages 6 months and 2-4 years) and obesity at age 21 years. The authors compared mean body mass indices (BMIs; weight (kg)/height (m) 2 ) and persons in the categories of overweight (BMI 25.0-29.9) and obesity (BMI 30) among offspring at age 21 years according to maternally reported childhood sleeping problems. They found that young adult BMI and the prevalence of obesity were greater in offspring who had had sleeping problems at ages 2-4 years than in with those who had not had sleeping problems. These associations were robust to adjustment for a variety of potential confounders, including offspring sex, maternal mental health, and BMI, and several mediators, including adolescent dietary patterns and television-watching. These findings provide some evidence for a long-term impact of childhood sleeping problems on the later development of obesity.
Objective: To examine the association between maternal smoking during pregnancy and the developme... more Objective: To examine the association between maternal smoking during pregnancy and the development of smoking behaviour patterns among young adult offspring. Method: Data were from the Mater-University of Queensland Study of Pregnancy (MUSP), a birth cohort of 7223 mothers and children enrolled in Brisbane, Australia, in 1981. The development of smoking behaviours (early or late onset, or combination of onset and prevalence patterns) among offspring at age 21 years with different patterns of maternal smoking (never smoked, smoked before or after pregnancy but not during pregnancy, or smoked during pregnancy) were compared. Maternal smoking information was derived from the prospectively collected data from the beginning of pregnancy until the child was 14 years of age. Analyses were restricted to the 3058 mothers and children whose smoking status was reported.
It is unclear whether there is a fetal origin of adult depression. In particular, previous studie... more It is unclear whether there is a fetal origin of adult depression. In particular, previous studies have been unable to adjust for the potential effect of maternal depression during pregnancy on any association. The association of birth weight with adult symptoms of depression was examined in an Australian prospective birth cohort, the Mater University Study of Pregnancy and its outcomes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale among 3,719 participants at the 21-year follow-up in 2002-2005. In multivariable analyses, there were a weak inverse association between birth weight and symptoms of depression in the whole cohort and some evidence of sex differences in this association. Among females, there was a graded inverse association: In the fully adjusted model, the odds ratio for a high level of depressive symptoms for a 1-standard deviation increase in birth weight (gestational age-standardized z score) was 0.82 (95% confidence interval: 0.73, 0.92). Among males, there was no association (with sex in all models: p interaction < 0.004). Study results provide some support for a fetal origin of adult depression and suggest that the association is not explained by maternal mental health characteristics during pregnancy. Further research is needed to better understand the mechanisms underlying the association.
The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, ... more The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, Australia, between 1981 and 1984 to prospectively examine whether maternal smoking during pregnancy was associated with offspring overweight and obesity. The authors compared mean body mass indexes (weight (kg)/height (m) 2 ) and levels of overweight and obesity at age 14 years among offspring by patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy). Adolescent body mass index and prevalences of overweight and obesity were greater in offspring whose mothers had smoked during pregnancy than in those whose mothers had never smoked. Body mass index and levels of overweight and obesity among adolescent offspring whose mothers stopped smoking during pregnancy but smoked at other times in the child's life were similar to those among offspring whose mothers had never smoked. These results were independent of a range of potentially confounding factors and suggest a direct effect of maternal smoking during pregnancy on adolescent overweight and obesity. They provide yet another incentive for pregnant women to be persuaded not to smoke and for young women to be encouraged to never take up smoking. body mass index; obesity; overweight; pregnancy; smoking Abbreviation: BMI, body mass index.
Australian and New Zealand Journal of Psychiatry, 2008
The purpose of the present study was to examine the longitudinal association between early childh... more The purpose of the present study was to examine the longitudinal association between early childhood factors and early initiation of use of substances and substance use disorders in a large prospective study. Data were from the Mater Hospital University of Queensland Study of Pregnancy, a prospective birth cohort study in Brisbane, Australia. Use of nicotine, alcohol and cannabis and age of initiation of such use were reported at the 21 year follow up. DSM-IV diagnosis of nicotine, alcohol and cannabis use disorders was assessed at 21 years using a computerized version of the Composite International Diagnostic Interview (CIDI-Auto). Early childhood factors were measured between mother&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s pregnancy and child age 5 years. Of the 3647 respondents with complete data, 15.4% had started to smoke cigarettes before 15 years. Another 17.4% and 12.2% reported having started to consume alcohol or use cannabis in early adolescence, respectively. Some 16.2%, 27.8% and 21.9% had ever had nicotine, alcohol or cannabis abuse or dependence (disorder) by 21 years, respectively. In multivariate models early initiation of use of substances, and substance use disorders were associated with disrupted families or drug-using parents, childhood problem behaviours, and poor parental monitoring and supervision in childhood. There are four independent factors in early or middle childhood that predict early initiation of use of substances and subsequent substance use disorders by early adulthood. There is a need to consider whether what is known about the risk factors that predict young age of substance use, and substance use disorders, may be incorporated into treatment and/or prevention initiatives.
Few studies have explored early predictors of problem drinking in youth, and fewer still have sim... more Few studies have explored early predictors of problem drinking in youth, and fewer still have simultaneously considered the role of biologic, familial, and intrapersonal factors. The present study explored early life course and later life course predictors of alcohol abuse and dependence in young adulthood. Data were taken from a cohort of 2,551 mothers and their children recruited as part of the longitudinal Mater University Study of Pregnancy and its outcomes (MUSP) carried out in Brisbane, Australia, from 1981 to 1984. Data were collected prenatally and then postnatally at 6 months and at 5, 14, and 21 years. A range of biologic, familial, and intrapersonal factors was considered. A series of logistic regression models with inverse probability weighting was used to explore pathways to problem drinking from adolescence to early adulthood. For males and females, no association was found between either birth factors or childhood factors and a lifetime diagnosis of alcohol disorders at age 21 years. Externalizing symptoms and maternal factors at age 14 years were significantly associated with alcohol problems. For youth aged 14 years, maternal moderate alcohol consumption accounted for the highest percentage of attributable risk among those exposed. Results show that exposure to maternal drinking in adolescence is a strong risk factor for the development of alcohol problems in early adulthood. adolescent; alcohol drinking; cohort studies; mothers; risk factors Abbreviations: CIDI-Auto, Composite International Diagnostic Interview-computerized version; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; MUSP, Mater University Study of Pregnancy and its outcomes.
Aims To examine whether there is evidence of an independent association between childhood sexual... more Aims To examine whether there is evidence of an independent association between childhood sexual abuse (CSA) and nicotine disorder in youth and to explore the mechanisms underlying this association in a prospective cohort study.Design Birth cohort study followed-up to 21 years.Setting One of two major obstetric hospitals in Brisbane, Australia.Participants The Mater-University of Queensland Study of Pregnancy involves a prospective birth cohort from a population-based sample involving 7223 singletons whose mothers were enrolled between 1981 and 1984 at the first antenatal visit. The present cohort consisted of a subgroup of 2571 youth who completed the life-time version of the Composite International Diagnostic Interview—computerized version (CIDI-Auto) at the 21-year follow-up.Measurements Nicotine disorder was measured based on Diagnostic and Statistical Manual version IV (DSM-IV) diagnostic criteria and measures of CSA, including retrospective self-reports of rape, were obtained at 21 years.Results Of 2571 young adults, 16.6% met the criteria for either dependence (12.8%) or withdrawal (8.5%). Non-penetrative sexual abuse was reported by 15.5% of respondents and 8.0% reported penetrative sexual abuse. For any types of sexual abuse including non-penetrative, penetrative and self-reported rape before age 16 years, young adults had significantly higher rates of nicotine disorder than young adults who did not experience CSA. This relationship was independent and appeared direct after adjustment for a range of potential confounding and mediating factors.Conclusions This study shows that CSA is associated with young adult nicotine disorder. The results extend the public health significance of findings in this area and highlight the importance of not only intensifying public health efforts to address substance use problems among those who have experienced CSA, but of early intervention, so that emerging risky behaviours may be targeted in the earliest stages.
Journal of The American Academy of Child and Adolescent Psychiatry, 2007
Objective: To examine whether age of first use or frequency of use of cannabis is associated with... more Objective: To examine whether age of first use or frequency of use of cannabis is associated with anxiety and depression (AD) in young adults, independent of known potential confounders, including the use of other illicit drugs. Method: A cohort of 3,239 Australian young adults was followed from birth to the age of 21 when data on AD were obtained from sample members along with information on their use of cannabis at 21 years. Potential confounding factors were prospectively measured when the child was born and at 14 years. Results: After controlling for confounding factors, those who started using cannabis before age 15 years and used it frequently at 21 years were more likely to report symptoms of AD in early adulthood (odds ratio 3.4; 95% CI 1.9Y6.1). This association was of similar magnitude for those who had only used cannabis and those who reported having used cannabis and other illicit drugs. Conclusion: The relationship between early-onset and frequent use of cannabis and symptoms of AD is independent of individual and family backgrounds.
MAMUN, ABDULLAH A., DEBBIE A. LAWLOR, MICHAEL J. O'CALLAGHAN, WILLIAM BOR, GAIL M. WILLIAMS, AND ... more MAMUN, ABDULLAH A., DEBBIE A. LAWLOR, MICHAEL J. O'CALLAGHAN, WILLIAM BOR, GAIL M. WILLIAMS, AND JAKE M. NAJMAN. Does childhood sexual abuse predict young adult's BMI? A birth cohort study. Obesity. 2007;15:2103-2110. Objective: The objective was to identify the extent to which childhood sexual abuse (CSA) is associated with BMI and overweight status in young adulthood and to examine whether any associations differ by gender.
To determine whether parental marital status and marital quality in adolescence are associated wi... more To determine whether parental marital status and marital quality in adolescence are associated with cannabis use disorders in young adults. Design Prospective birth cohort study. Setting A 21 year follow-up of 4815 mothers and their children who participated at 14 years after the child's birth in Queensland, Australia. Participants Cohort of 2303 young adults who completed the life-time version of the Composite International Diagnostic Interview-computerized version (CIDI-Auto) at the 21-year follow-up. Measurements Young adults' cannabis use disorders were assessed using the CIDI-Auto. Marital status and quality (marital circumstances) and potential confounding factors such as socio-economic status (SES), maternal mental health and maternal substance use were measured when the child was 14 years of age. Findings Marital circumstances of the mother when child was 14 years predicted risk of cannabis use disorders in their offspring. After adjustment for potential confounding factors, adolescents who grew up in step-father families were more likely to have cannabis use disorders in early adulthood and a moderate association was found for those children who experienced maternal marital disagreement (OR = 1.7; 95% CI: 1.0, 2.9). There was no significant increase in subsequent risk of cannabis use disorders for children whose mothers were un-partnered at 14 years. Conclusions Maternal marital status and marital quality are associated with young adults' subsequent cannabis use disorders. This association is independent of suspected confounding factors measured at 14 years. However, at least part of the association is explained by changes in marital status before 14 years.
Asthma in early childhood has been associated with maternal smoking during pregnancy and parental... more Asthma in early childhood has been associated with maternal smoking during pregnancy and parental smoking soon after birth. However, less is known about these exposures and the development of asthma symptoms in adolescence. Data were taken from the Mater University Study of Pregnancy, a large birth cohort study of mothers and children enrolled in Brisbane, Australia, beginning in 1981. Smoking was assessed at 2 stages during pregnancy and at the 6-month and 5-year follow-up visits. Asthma was assessed from maternal reports that were provided when the child was age 14 years. We conducted multivariable multinomial logistic regression analyses to assess the effect of maternal smoking on asthma symptoms. There was a strong sex interaction such that girls whose mothers had smoked heavily (20 or more cigarettes per day) in pregnancy and at the 6-month follow up had increased odds of experiencing asthma symptoms at age 14 (odds ratio = 1.96; 95% confidence interval = 1.25-3.08). The contribution of heavy smoking during pregnancy appeared to be stronger than heavy smoking after the birth. No similar associations were seen for boys. Female adolescents whose mothers smoked heavily during the fetal period and the early months of life have increased risk of asthma symptoms in adolescence. In utero exposure to heavy smoking was found to have a stronger effect than postnatal environmental tobacco exposure.
The fetal overnutrition hypothesis proposes that greater maternal adiposity results in increased ... more The fetal overnutrition hypothesis proposes that greater maternal adiposity results in increased obesity throughout life in the offspring. The authors examined the associations between parental prepregnancy body mass index (BMI; weight (kg)/height (m) 2 ), based on height and weight reported by the mother at her first antenatal clinic visit, and offspring BMI (height and weight measured at age 14 years) in 3,340 parent-offspring trios from a birth cohort based in Brisbane, Australia (mothers were recruited in 1981-1984). The maternal-offspring BMI association was stronger than the paternal-offspring BMI association. In the fully adjusted model, the increase in standardized offspring BMI at age 14 for a one-standard-deviation (SD) increase in maternal BMI was 0.362 SD (95% confidence interval: 0.323, 0.402), and the corresponding result for a one-SD increase in paternal BMI was 0.239 SD (95% confidence interval: 0.197, 0.282). There was statistical support for a difference in the magnitude of the association between maternal-offspring BMI and paternal-offspring BMI in all confounder-adjusted models tested (all p's < 0.0001). In sensitivity analyses taking account of different plausible levels of nonpaternity (up to 15%), the greater maternal effect remained. These findings provide some support for the fetal overnutrition hypothesis. body mass index; fetal development; fetal nutrition disorders Abbreviations: BMI, body mass index; CI, confidence interval. Correspondence to Prof. Evidence for the Fetal Overnutrition Hypothesis 419 Am J Epidemiol 2007;165:418-424 * Coefficients were calculated using the formula presented in the Appendix. y Weight (kg)/height (m) 2 . z BMI, body mass index. 422 Lawlor et al. Am J Epidemiol 2007;165:418-424
The objectives of this study were to examine the extent of clustering of smoking, high levels of ... more The objectives of this study were to examine the extent of clustering of smoking, high levels of television watching, overweight, and high blood pressure among adolescents and whether this clustering varies by socioeconomic position and cognitive function. Methods: This study was a cross-sectional analysis of 3613 (1742 females) participants of an Australian birth cohort who were examined at age 14. Results: Three hundred fifty-three (9.8%) of the participants had co-occurrence of three or four risk factors. Risk factors clustered in these adolescents with a greater number of participants than would be predicted by assumptions of independence having no risk factors and three or four risk factors. The extent of clustering tended to be greater in those from lower-income families and among those with lower cognitive function. The age-adjusted ratio of observed to expected cooccurrence of three or four risk factors was 2.70 (95% confidence interval [CI], 1.80 -4.06) among those from low-income families and 1.70 (95% CI, 1.34 -2.16) among those from more affluent families. The ratio among those with low Raven's scores (nonverbal reasoning) was 2.36 (95% CI, 1.69 -3.30) and among those with higher scores was 1.51 (95% CI, 1.19 -1.92); similar results for the WRAT 3 score (reading ability) were 2.69 (95% CI, 1.85-3.94) and 1.68 (95% CI, 1.34 -2.11). Clustering did not differ by sex. Conclusion: Among adolescents, coronary heart disease risk factors cluster, and there is some evidence that this clustering is greater among those from families with low income and those who have lower cognitive function.
It has been suggested that sleeping problems are causally associated with obesity in early life, ... more It has been suggested that sleeping problems are causally associated with obesity in early life, but most studies examining this association have been cross-sectional. The authors used a population-based birth cohort of 2,494 children who were born between 1981 and 1983 in Brisbane, Australia, to examine the prospective association between early-life sleeping problems (at ages 6 months and 2-4 years) and obesity at age 21 years. The authors compared mean body mass indices (BMIs; weight (kg)/height (m) 2 ) and persons in the categories of overweight (BMI 25.0-29.9) and obesity (BMI 30) among offspring at age 21 years according to maternally reported childhood sleeping problems. They found that young adult BMI and the prevalence of obesity were greater in offspring who had had sleeping problems at ages 2-4 years than in with those who had not had sleeping problems. These associations were robust to adjustment for a variety of potential confounders, including offspring sex, maternal mental health, and BMI, and several mediators, including adolescent dietary patterns and television-watching. These findings provide some evidence for a long-term impact of childhood sleeping problems on the later development of obesity.
Objective: To examine the association between maternal smoking during pregnancy and the developme... more Objective: To examine the association between maternal smoking during pregnancy and the development of smoking behaviour patterns among young adult offspring. Method: Data were from the Mater-University of Queensland Study of Pregnancy (MUSP), a birth cohort of 7223 mothers and children enrolled in Brisbane, Australia, in 1981. The development of smoking behaviours (early or late onset, or combination of onset and prevalence patterns) among offspring at age 21 years with different patterns of maternal smoking (never smoked, smoked before or after pregnancy but not during pregnancy, or smoked during pregnancy) were compared. Maternal smoking information was derived from the prospectively collected data from the beginning of pregnancy until the child was 14 years of age. Analyses were restricted to the 3058 mothers and children whose smoking status was reported.
It is unclear whether there is a fetal origin of adult depression. In particular, previous studie... more It is unclear whether there is a fetal origin of adult depression. In particular, previous studies have been unable to adjust for the potential effect of maternal depression during pregnancy on any association. The association of birth weight with adult symptoms of depression was examined in an Australian prospective birth cohort, the Mater University Study of Pregnancy and its outcomes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale among 3,719 participants at the 21-year follow-up in 2002-2005. In multivariable analyses, there were a weak inverse association between birth weight and symptoms of depression in the whole cohort and some evidence of sex differences in this association. Among females, there was a graded inverse association: In the fully adjusted model, the odds ratio for a high level of depressive symptoms for a 1-standard deviation increase in birth weight (gestational age-standardized z score) was 0.82 (95% confidence interval: 0.73, 0.92). Among males, there was no association (with sex in all models: p interaction < 0.004). Study results provide some support for a fetal origin of adult depression and suggest that the association is not explained by maternal mental health characteristics during pregnancy. Further research is needed to better understand the mechanisms underlying the association.
The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, ... more The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, Australia, between 1981 and 1984 to prospectively examine whether maternal smoking during pregnancy was associated with offspring overweight and obesity. The authors compared mean body mass indexes (weight (kg)/height (m) 2 ) and levels of overweight and obesity at age 14 years among offspring by patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy). Adolescent body mass index and prevalences of overweight and obesity were greater in offspring whose mothers had smoked during pregnancy than in those whose mothers had never smoked. Body mass index and levels of overweight and obesity among adolescent offspring whose mothers stopped smoking during pregnancy but smoked at other times in the child's life were similar to those among offspring whose mothers had never smoked. These results were independent of a range of potentially confounding factors and suggest a direct effect of maternal smoking during pregnancy on adolescent overweight and obesity. They provide yet another incentive for pregnant women to be persuaded not to smoke and for young women to be encouraged to never take up smoking. body mass index; obesity; overweight; pregnancy; smoking Abbreviation: BMI, body mass index.
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