Hannele Räihä

Cohort Profile: Steps to the Healthy Development and Well-being of Children (the STEPS Study)

The STEPS Study aims to search for the precursors and causes of problems in child health and well-being by using a multidisciplinary approach. The cohort consists of all mothers (Finnish or Swedish speaking) who had live deliveries in the Hospital District of Southwest Finland from January 2008 to April 2010 and their children (n=9811 mothers, n=9936 children). Of these, 1797 mothers and their 1827 children were recruited to an intensive follow-up group during the first trimester of pregnancy or soon after delivery. Information about the whole study cohort is based on pregnancy follow-up data from maternity clinics, National Longitudinal Census Files and child welfare clinics. Data from multiple sources are used to obtain a picture of the overall well-being of the child and the family. After birth, study visits include several clinical examinations. Collaboration is encouraged, and access to the data will be available when the data set is complete.

Family context of infantile colic

Psychological factors in families with a colicky baby were studied. A total of 59 families who had enrolled on the basis of information received at the postpartum wards in the city of Turku, Finland, were included in this study. In addition, 58 families with age-matched infants were selected as a control group. These families kept a diary of the infants crying. Thirty-six infants fulfilled the criteria for severe colic. Twenty-three families with a baby who cried excessively but did not fulfill the criteria were defined as the moderate colic group. A semistructured family interview was carried out to assess the structure, communcation patterns, functioning, and affective tone of the families. Mothers and fathers were younger in the moderate colic group compared with parents in the other groups. In the moderate colic families, the infant was more often the first child than in the control families. On the other hand, neither the infants gender nor the education of the parents was related to infants crying. Organized family structure and strong parental coalition were more often present in the severe colic and control groups than in the moderate colic group. Increased family chaos was noted in this group. The severe and moderate colic families had more enmeshed individual boundaries. Generational boundaries were enmeshed in the moderate colic families. Communication patterns did not differ between the groups. The families with a severely or moderately crying baby were less flexible, had decreased ability to cope with daily activities, and showed less energy and vitality than the control families. Both the severe and moderate colic families expressed more anxiety and conflict compared to the control families. In conclusion, an association between infantile colic and psychological characteristics of the family was found. Moreover, the families with a moderately colicky infant had specific psychological features that differed from both the control families and those with severely colicky infants.

Dental fear and sense of coherence among 18‐yr‐old adolescents in Finland

The aim was to investigate whether dental fear was associated with the sense of coherence (SOC) among 18-yr-old adolescents (n = 777). Cross-sectional data from a prospective cohort of a random sample of families from Finland and their first-born children were used. Dental fear was measured using the Modified Dental Anxiety Scale and categorized as high dental fear for scores of 19-25 and as no to moderate dental fear for scores of 5-18. Sense of coherence was measured using a 13-item version of Antonovskys Sense of Coherence Questionnaire, dichotomized as scores 13-63 for weak SOC and as scores of 64-91 for strong SOC. Gender and education were included as background factors in the logistic regression analyses. The prevalence of high dental fear was 8%. Those reporting high dental fear reported more often a weaker SOC than did those with no to moderate dental fear (69% vs. 31%, OR = 2.5, 95% CI = 1.4-4.4), also when adjusted for gender and education (OR = 2.2, 95% CI = 1.2-3.9). According to the theory of salutogenesis, as proposed by Antonovsky, SOC is a resource instrument especially in situations of tension or strain and hence a strong SOC might protect against high dental fear.

Psychological ill-being experienced by first-time mothers and their partners in pregnancy after abortion: a cohort study

Abstract The psychological effects of abortion have been much discussed lately, with recently published studies indicating that induced abortion (IA) may, contrary to the general consensus, be contributing to psychological symptoms post-abortion. Using a cohort of first-time mothers, we assessed the likelihood of them experiencing psychological ill-being at the midpoint of their pregnancy, depending on their IA history. We also examined the psychological symptoms of their partners, the hypothesis being that ill-being in IA-experienced mothers might reflect onto their partners. Altogether 680 future first-time mothers (9.8% of whom had an IA history) and their partners were selected. Most mothers attended their 16 check-ups at maternity health clinics (MHC), where the familys physical and emotional well-being were checked. Several internationally validated questionnaires, which gauged psychological ill-being, were filled in at the 20th week of pregnancy. There were no significant differences between the study and the control group in terms of psychological ill-being during the pregnancy. The contribution of prior IA to psychological ill-being during the next pregnancy seems to be minimal. The availability of IA procedures, intensive MHC services in Finland, as well as this societys neutral attitude towards IA, may be among the reasons why the results are so positive for mothers who have previously undergone one or more IAs.

Parents' depression and loneliness during pregnancy and respiratory infections in the offspring: A prospective birth cohort study

Background An association between maternal prenatal stress and increased rates of respiratory tract infections in the offspring has been described earlier. Data regarding the father’s role is lacking. In this study our aim was to evaluate, whether mothers’ and fathers’ depressive symptoms and loneliness during pregnancy predict higher rates of respiratory tract infections in the offspring. Methods In this longitudinal cohort study we gathered information on parental psychological risk during gestational week 20 using the BDI-II and UCLA loneliness scale questionnaires for the parents of 929 children. Loneliness was divided into social and emotional components, the former describing patterns of social isolation and the latter a perceived lack of intimate attachments. Episodes of acute otitis media, physician visits due to respiratory tract infections, and antibiotic consumption relating to respiratory tract infections were documented in the infants, excluding twins, from birth until 10 months of age using study diaries. Analyses were carried out by structural equation modeling, which provides dynamic estimates of covariances. Results Maternal depressive symptoms during pregnancy predicted higher rates of acute otitis media in the infant and maternal emotional loneliness predicted higher rates of physician visits. Acute otitis media, physician visits and antibiotic consumption in the infant were slightly less frequent for families who reported social loneliness in the father or mother. Associations remained when taking into account confounders. Conclusions Maternal prenatal depression and emotional loneliness predicted a higher burden of respiratory tract infections in the offspring. The protective influence of parental social loneliness on the burden of respiratory tract infections in infants was not in line with our study hypothesis, but could be explained by reduced use of healthcare services in these socially isolated families.