Suzanne M. Bouffard

Birth outcomes following prenatal exposure to fluoxetine

BACKGROUND Although pregnancy has frequently been described as a time of emotional well-being, some women experience significant antenatal depression that may require treatment with antidepressants. The purpose of this investigation was to examine the relative effects of early and late trimester exposure to fluoxetine and perinatal outcome. METHODS Obstetric and neonatal records were reviewed for 64 mother-infant pairs where there was documented use of fluoxetine at some point during pregnancy. Differences in several measures of obstetrical outcome and neonatal well-being were examined in early trimester- and late trimester-exposed infants. RESULTS No differences in birth weight and acute neonatal outcome were evident across the two groups, though there was a higher frequency of special care nursery admissions for infants with exposure to fluoxetine late in pregnancy. Special care nursery admissions could not be attributed to any specific factor. CONCLUSIONS Given the growing numbers of women who are treated with antidepressants, including fluoxetine, during pregnancy, and the strong association between depression during pregnancy and risk for postpartum depression, patients may be best advised to continue treatment with antidepressants through labor and delivery versus making any change in intensity of treatment during the acute peripartum period.

Do neighborhood and home contexts help explain why low-income children miss opportunities to participate in activities outside of school?

In this study, childrens participation (N = 1,420) in activities outside of elementary school was examined as a function of disparities in family income using data from the Panel Study of Income Dynamics, Child Development Supplement. Childrens neighborhood and home environments were investigated as mechanisms linking income disparities and participation rates. Family income was positively associated with childrens participation in activities, with the largest effect sizes evident for children at the lowest end of the income distribution. Affluence in the neighborhood and cognitive stimulation in the home were both important mediators of the association between income and participation, explaining from approximately one tenth to one half of the estimated associations between income and participation.

Predicting youth out-of-school time participation: Multiple risks and developmental differences.

Youth out-of-school time (OST) programs and activities can provide developmental benefits for participating youth. Yet little research has examined the contextual predictors of youth OST participation. To address this issue, we examined a collection of child-, family-, school-, and neighborhood-level characteristics as predictors of OST participation using data from the Panel Study of Income Dynamics—Child Development Supplement. In summary, child and family characteristics were most useful in predicting participation such that children least likely to participate were those characterized by high levels of developmental (e.g., low achievement, behavior problems, poor health) and family (e.g., parent psychological distress and low emotional support) problems. These relations, however, emerged only during middle school and high school. For certain types of activities, namely athletics and lessons, problems measured across various contexts were more strongly associated with OST participation for higher-income families than for lower-income families. These findings point to the importance of considering multiple developmental domains and developmental periods in understanding predictors of youth OST participation.

Strengthen What Happens outside School to Improve What Happens inside.

F ederal education legislation has long assumed that K-12 schools could operate alone to level the learning field for poor children. But 40 years of steadily accumulating research has shown that this assumption is incorrect. We now know that opportunities for after-school learning, summer learning, and support for families are major predictors of children’s development, educational achievement, and school success. Research also suggests that economically and otherwise disadvantaged children are less likely than their more-advantaged peers to have access to these out-of-school or complementary learning opportunities and that this inequity substantially undermines their development and chances for school success. This research confirms that America will not achieve its national goals of equal educational opportunity, leaving no child behind, or preparing its workforce and citizenry for 21st-century challenges without addressing the importance of and inequities in out-of-school learning opportu-