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Age-dependent burden of atopic dermatitis in primary care - a nationwide database study from Finland (2024)Abstract Background: The burden of atopic dermatitis (AD) is not limited to childhood or young adults and seems to be increasing in older patients. Methods: Based on the databank of the Finnish Institute for Health and Welfare, we analysed the amount of general practitioners’ visits due to AD in Finland during the year 2018. The database comprised the main diagnosis of all visits in the Finnish public primary health care sector. Results: The total amount of primary care patients was 2,094,673 (males 904,686; 43.19%, females 1,189,987; 56.81%). The amount of consultations due to AD was 24,178 (0.45% of all consultations) and amount of AD patients was 20,906 (1.00% of all patients). The highest amounts of AD patients were in the groups of 14 years and younger (9,922 patients, 47.46%) and 15-65 years of age (9,144 patients, 43.74%). There was a substantial amount of consultations in the groups 65 years and older (1,947 patients, 9.31%), but no statistically significant differences between age groups (p = 0.303), gender (p = 0,389) or comparison of patients and amount of consultations (p = 0.235). Conclusions: There is a substantial burden of AD in all age-related patient groups in Finnish primary care (childhood, early adulthood, late adulthood and elderly). Consultations were relatively frequent in older patients, indicating that the burden of AD is not limited to young age and may be shifting to older age. Abbreviations: AD: Atopic dermatitis
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(2019)Reniini-angiotensiinijärjestelmän (RAS) paikallisia toimintoja on kuvattu monissa kudoksissa. RAS:n fysiologinen kokonaisvaikutus on riippuvainen kahden vastavaikuttavan biokemiallisen akselin suhteellisesta aktiivisuudesta. Klassisen akselin muodostavat angiotensiinikonvertaasi (ACE), angiotensiini II (Ang II) ja tyypin 1 angiotensiini II -reseptori (AT1R). Vaihtoehtoiseen akseliin kuuluvat angiotensiinikonvertaasi 2 [ACE2], angiotensiini 1-7 [Ang (1-7)] sekä Mas-reseptori (MAS). Suoliston paikallinen RAS toimii parakriinisena säätelijänä ja osallistuu tulehduksen säätelyyn. Järjestelmän vaikutus paikalliseen kudokseen riippuu klassisen ja vaihtoehtoisen akselin aktiivisuuksien suhteesta. Klassinen akseli edistää ja vaihtoehtoinen akseli lievittää tulehdusta. Paikallisten reniini- angiotensiinijärjestelmien toiminnan ja akselien välisen suhteen tiedetään muuttuvan ikääntyessä. Asiaa ei kuitenkaan aiemmin ole tutkittu suoliston osalta. Tutkimukseni kartoitti paikallisen RAS:n ilmentymistä nuorten ja vanhojen rottien suolistossa. Tutkin jejunumia ja paksusuolta. Päälöydökseni oli, että vanhempien rottien suolistossa ACE:n ja ACE2:n suhde oli korkeampi, sekä entsyymiaktiivisuudella että proteiinikonsentraatiolla mitattuna. Näyttää siltä, että ikääntymisen myötä rottien suoliston paikallisen reniini-angiotensiinijärjestelmän toiminta painottuu klassiselle ACE-välitteiselle akselille. On mahdollista, että paikallisen RAS:n toiminnan painottuminen ACE-välitteiselle akselille liittyy siihen, että iän myötä suolistossa tapahtuu tulehduksen ja sidekudoksen muodostuksen lisääntymistä.
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(2015)Tutkielman tavoitteena oli selvittää, onko parodontiitin tunnettujen patogeenien Porphyromonas gingivaliksen ja Aggregatibacter actinomycetemcomitansin tai niiden immunoglobuliini A (IgA)- ja immunoglobuliini G (IgG)- luokan vasta-aineiden esiintymisellä raskautta suunnittelevien naisten syljessä ja seerumissa yhteyttä raskauden alkamiseen, keskenmenoihin tai ennenaikaisiin synnytyksiin. Tutkimusjoukko koostui 256 terveestä suomalaisnaisesta, joiden kuukautiset olivat säännölliset ja jotka eivät olleet raskaana mutta olivat lopettaneet ehkäisyn käytön ja halusivat tulla raskaaksi. Tutkimuksen alussa tutkittavien sairaushistoria selvitettiin, heille suoritettiin perusteellinen suututkimus ja heiltä kerättiin sylki- ja seeruminäytteet. Sylkinäytteistä eristettiin bakteriaalinen DNA, jonka jälkeen A. actinomycetemcomitans ja P. gingivalis detektoitiin näytteestä PCR-menetelmällä. Seerumin IgA- ja IgG-luokan vasta-aineet A. actinomycetemcomitansille ja P. gingivalikselle määritettiin seerumeista entsyymivälitteisellä immunosorbenttimäärityksellä (ELISA). Tutkimuksessa havaittiin, että P. gingivalis ja sen IgA- ja IgG-luokan vasta-aineiden korkea taso raskautta suunnittelevien naisten syljessä on yhteydessä raskaaksi tulemisen epäonnistumiseen. Tutkimuksemme on näin ollen ensimmäinen, joka osoittaa sekä mikrobiologisin että serologisin menetelmin parodontiitin pääpatogeenin Porphyromas gingivaliksen estävän nuoria naisia tulemasta raskaaksi.
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(2015)Parodontiitti on krooninen hampaan kiinnityskudossairaus, johon liitetyistä patogeeneistä yksi on Aggregatibacter actinomycetemcomitans. Tutkielman tarkoituksena oli tutkia ientaskuista semikvantitatiivisesti määritettyjen serotyyppiä a ja b edustavien kantojen yhteyttä syljen kvantitatiivisten PCR tulosten kanssa. Lisäksi tutkittiin edellä mainittujen bakteerimäärien yhteyttä IgA- ja IgG-luokan A. actinomycetemcomitans vasta-aineisiin seerumissa, sekä näiden kaikkien laboratoriotulosten yhdistymistä kliinisiin ja radiologisiin parodontiittia kuvaaviin merkkeihin. Tutkielmaa varten analysoitiin 506 potilaasta koostuva Corogene-tutkimuksen osatutkimuksesta muodostettu Parogene-aineisto tilastotieteellisesti IMB SPSS Statistics 22-ohjelman avulla. Analyysin lopputuloksena havaittiin, että syljen kvantitatiivinen A. actinomycetemcomitans ja ientaskujen semikvantitatiivinen bakteerimääritys yhdistyvät vain heikosti kliinisiin parodontiittiparametereihin ja vain osittain toisiinsa. Sylkinäytteestä havaittu A. actinomycetemcomitans ei korreloinut minkään kliinisen parametrin kanssa, mutta nosti veren immunoglobuliinipitoisuuksia, kuten on todettu myös aiemmissa tutkimuksissa. A. actinomycetemcomitansin rooli parodontiitissa on siis edelleen epäselvä, vaikka sillä on todettu olevan yhteys sydän- ja verisuonisairauksiin.
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(2021)Aggressiolla ja suuttumustaipumuksella voi olla yksilö- ja yhteiskunnallisella tasolla isoja kustannuksia, sekä rahallisesti mitattuna että mielenterveydellisenä taakkana. Näiden tekijöiden aiheuttamat taloudelliset menot voidaan huomata vahingonkorvauksissa ja terveydenhuollossa. Yksilön tasolla ongelmat ovat muun muassa työpaikkojen, parisuhteiden ja yhteiskuntaan sopeutumisen suhteen. Tässä tutkimuksessa pyritään selvittämään aggression ja suuttumuksen itsenäistä kuolleisuutta kohottavan riskin mahdollisuus huomioiden mahdollisia sekoittavia tekijöitä. Kirjallisuuskatsauksen avulla käydään läpi aggression merkityksiä sekä eri muotoja, katsotaan aiheesta aiempaa tutkimustietoa sekä löydöksiä ja verrataan näitä meidän tutkimuksemme tuloksiin. Tutkimusta varten käytettävä aineisto suuttumustaipumuksen tason selvitykseen on Suomen kaksoskohortin (the Finnish twin cohort study) avulla tehty kysely vuodelta 1990. Tähän kyselyyn vastanneiden kaksosten kuolleisuutta sitten seurattiin vuoteen 2018 asti ja näiden tietojen avulla luotiin kuolleisuusanalyysit noin 12 000 vastaajasta. Edellä mainitussa kirjallisuuskatsauksessa ilmenee muiden tuloksissa kohonneen suuttumustaipumuksen ja kuolleisuuden sekä tämän riskitekijöiden, kuten sydän- ja verisuonitautien, välisiä korrelaatioita, joka näyttäytyy myös meidän tuloksissamme. Tästä huomataan vähemmän tutkitun aggression ja suuttumustaipumuksen sekä kuolleisuuden välistä yhteyttä, joka oikein ajoitetulla preventiolla olisi mahdollinen terveydenhuoltoa ja yhteiskunnan varoja säästävä toimenpide. (163 sanaa)
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(2019)Aggressive natural killer-cell (NK-cell) leukemia (ANKL) is an extremely aggressive malig- nancy with dismal prognosis and lack of targeted therapies. Here, we elucidate the molecular pathogenesis of ANKL using a combination of genomic and drug sensitivity profiling. We study 14 ANKL patients using whole-exome sequencing (WES) and identify mutations in STAT3 (21%) and RAS-MAPK pathway genes (21%) as well as in DDX3X (29%) and epi- genetic modifiers (50%). Additional alterations include JAK-STAT copy gains and tyrosine phosphatase mutations, which we show recurrent also in extranodal NK/T-cell lymphoma, nasal type (NKTCL) through integration of public genomic data. Drug sensitivity profiling further demonstrates the role of the JAK-STAT pathway in the pathogenesis of NK-cell malignancies, identifying NK cells to be highly sensitive to JAK and BCL2 inhibition compared to other hematopoietic cell lineages. Our results provide insight into ANKL genetics and a framework for application of targeted therapies in NK-cell malignancies.
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(2023)Tavoitteet: COVID-19-tautiin voi liittyä heikentynyttä mielenterveyttä. Yli vuoden seuranta-ajan tutkimuksia COVID-taudista on vielä vähän, sillä pandemian alusta on kulunut vasta kolme vuotta. Näin ollen tietoa muun muassa ahdistusoireilun ja post-traumaattisen stressioireilun ilmenemisestä ja niiden jatkuvuudesta 24 kuukautta taudin akuuttivaiheen jälkeen ei juuri ole. Tämän tutkimuksen tavoitteena on tutkia, eroavatko COVID-19-potilaat verrokeista ahdistusoireilun ja post-traumaattisen oireilun määrässä, onko taudin vaikeusaste yhteydessä oireiluun ja onko oireilun määrässä tapahtunut muutosta potilasaineistossa 24 kuukauden seurannassa. Menetelmät: Tutkimus on osa Recovid-20-tutkimushanketta. Tämän osatutkimuksen aineistoon kuului 136 henkilöä; COVID-19-potilaita taudin eri vaikeusasteita edustavista ryhmistä (n=103) ja verrokit (n = 33) Ahdistusoireilua arvioitiin GAD-7-menetelmällä ja post-traumaattista stressioireilua IES-6-kyselyllä. Ryhmien välisiä eroja tutkittiin logistisen regressioanalyysin avulla ja mittauspisteiden välillä tapahtunutta muutosta tutkittiin toistettujen mittausten varianssianalyysilla. Muutosta tutkittaessa tutkittavia oli 92, joista kaikki olivat COVID-19-potilaita. Tulokset: 24 kuukauden seurannassa ahdistusoireilulla ja COVID-19-taudin sairastamisella ei havaittu yhteyttä, eikä eroa taudin eri vaikeusasteiden välillä ilmennyt. Ahdistusoireilu pysyi samalla matalalla tasolla 24 kuukauden seurannassa. Sen sijaan 24 kuukauden kohdalla havaittu post-traumaattinen stressioireilu oli yhteydessä sairastettuun COVID-19-tautiin ja sen eri vaikeusasteisiin. Post-traumaattinen stressioireilu väheni merkitsevästi verrattaessa kolmen ja 24 kuukauden mittauspisteitä toisiinsa. Johtopäätökset: Sairastetun COVID-19-taudin ja post-traumaattisen stressioireilun yhteys on tärkeää huomioida COVID-19-potilaita arvioitaessa silloinkin, kun taudin sairastamisesta on jo kulunut aikaa. Tutkimusta tarvitaan lisää esimerkiksi ahdistuksen ja post-traumaattisen oireilun mahdollisista yhdysvaikutuksista toisiinsa COVID-19-taudin yhteydessä.
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(2017)Objectives. Previous research has found associations between both cognitive ability and anxiety and school performance and anxiety. The nature of these associations is not yet clear however. On one hand, it has been speculated that the optimal development of emotion regulation requires cognitive skills and that performing well at school could protect one from anxiety e.g. through increased feelings of competence. On the other hand, anxiety may interfere with cognitive performance by directing attention to negative thoughts and impair school performance e.g. through absences from school. The objective of this study was to investigate the associations between anxiety, cognitive ability and school performance in 12- and 17-year-old youth. Of additional interest were the longitudinal changes in anxiety and cognitive ability in a 5-year follow-up. Methods. The data in this study consisted of the youth who participated in the 12- and 17-year follow-ups (N = 451) of the longitudinal study of Glycyrrhizin in Licorice (GLAKU). Anxiety was assessed using an Achenbach Child Behavior Checklist (CBCL) questionnaire completed by parents when the participants were 12. When participants were 17, they completed an Achenbach Youth Self Report (YSR) questionnaire. The cognitive ability of the participants was assessed using two subtests of verbal reasoning and two subtests of visual reasoning of Wechsler Intelligence Scale. Information about school performance was gained from parent evaluations. The associations between anxiety, cognitive ability and school performance were examined with negative binomial, logistic and linear regression models. Results and conclusions. In accordance with the diverse and partly controversial results of previous research this study also found the complexity of the associations between cognitive ability and anxiety: On one hand, lower anxiety was associated with better cognitive ability in cross-sectional designs. On the other hand, higher anxiety at the age of 12 was associated with improved performance IQ in a 5-year follow up. However, this association was found only among girls and for boys anxiety had an impairing effect on the development of performance IQ. These results suggest that early support should be targeted especially towards boys with anxiety in order to protect their cognitive development.
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(2020)Immunohistochemistry (IHC) is a widely used research tool for detecting antigens and can be used in medical and biochemical research. The co-localization of two separate proteins is sometimes crucial for analysis, requiring a double staining. This comes with a number of challenges since staining results depend on the pre-treatment of samples, host-species where the antibody was raised and spectral differentiation of the two proteins. In this study, the proteins GABAR-α2 and CAMKII were stained simultaneously to study the expression of the GABA receptor in hippocampal pyramidal cells. This was performed in PGC-1α transgenic mice, possibly expressing GABAR-α2 excessively compared to wildtype mice. Staining optimization was performed regarding primary and secondary antibody concentration, section thickness, antigen retrieval and detergent. Double staining was performed successfully and proteins of interest were visualized using a confocal microscope after which image analyses were performed using two different methods: 1) a traditional image analysis based on intensity and density of stained dots and 2) a novel convolutional neural network (CNN) machine learning approach. The traditional image analysis did not detect any differences in the stained brain slices, whereas the CNN model showed an accuracy of 72% in categorizing the images correctly as transgenic/wildtype brain slices. The results from the CNN model imply that GABAR-α2 is expressed differently in PGC-1α transgenic mice, which might impact other factors such as behaviour and learning. This protocol and the novel method of using CNN as an image analysis tool can be of future help when performing IHC analysis on brain neuronal studies.
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(2022)Tämän syventävän tutkielman tavoitteena on kirjallisuuskatsauksen ja kliinisen potilastapauksen avulla tarkastella hammaskaaren ahtauden hoitomenetelmiä vaihduntavaiheen hampaistossa. Ahtaus on yleisin oikomalla hoidettava purentavirhe ja yleisin oikomishoitoon hakeutumisen syy. Yli puolella 12-18 -vuotiaista suomalaisnuorista on ahtautta hammaskaarella. Suomessa käytössä olevan 10-portaisen purentavirheiden arviointiasteikon mukaan vain erittäin vaikea ahtaus voi täyttää kunnalliseen hoitoon pääsyn kriteerit. Kirjallisuuskatsauksessa keskitytään vaihduntavaiheen hampaiston hoitomenetelmiin ja hoidon ajoitukseen, mutta perehdytään lyhyesti myös ahtauden etiologiaan. Tutkimusaineistona käytettiin ortodontian oppikirjoja sekä tieteellisiä julkaisuja aiheesta. Julkaisuja haettiin Medline, Pubmed ja Google Scholar -tietokannoista käyttäen ensisijaisina hakutermeinä ”dental crowding” ja ”treatment of dental crowding”. Tutkielman kliininen osuus käsitteli 10-vuotiaan tytön oikomishoidon kulkua HUS Suusairauksien opetus- ja hoitoyksikössä. Hammaskaaren ahtautta voi vaihduntavaiheen hampaistossa hoitaa mahduttamalla hampaat kaarelle tai poistohoidolla. Menetelmiä hampaiden kaarelle mahduttamiselle ovat esimerkiksi maitohampaiden lähdöstä vapautuvan tilan säilyttäminen, kaarten sagittaalinen ja transversaalinen levitys sekä hampaiden selektiiviset hionnat. Hammaskaaren ahtaus esiintyy usein yhdessä jonkin toisen purentavirheen kanssa. Monissa tapauksissa pyritäänkin ensisijaisesti korjaamaan toiminnallisesti vakavampi purentavirhe, jonka kanssa ahtautta esiintyy. Potilaan purennan kokonaistilanne tulee huomioida hoidon suunnittelussa ja näin ollen on mahdotonta nimetä yksittäistä hoitomenetelmää ylitse muiden. Eniten ahtauden hoitolinjan ja -menetelmän valinnassa vaikuttavat ahtauden vaikeusaste ja potilaan ko-operaatiokyky. Ahtaus on vielä aiheena suhteellisen vähän tutkittu ja lisätutkimus aiheesta onkin suositeltavaa.
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(2020)Objectives. Anxiety causes significant suffering in different life domains, and its prevalence rates are high already in childhood and adolescence. Often symptoms develop into a disorder which is why identifying factors associated with anxiety is important. Anxiety disorders run in families but only few studies have examined the association between maternal and child anxiety on a symptom level. It’s possible that this association is mediated by parenting competence but, as far as is known, this has never been studied. The aim of this study was to examine the associations of maternal anxiety with child anxiety and fears both cross-sectionally and longitudinally. It was also examined whether this association is mediated by parenting competence. Methods. The sample of this study was part of the Finnish Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) cohort. The sample consisted of 992 mothers who evaluated their own anxiety symptoms (Beck Anxiety Inventory) first when children were 2–5 years old and again when they were 7–11 years old. In the latter follow-up mothers also evaluated their parenting competence (Parenting Sense of Competence) as well as children’s anxiety (Spence Children’s Anxiety Scale for Parents) and fears (The Short Form of the Fear Survey Schedule for Children – Revised). The association of maternal anxiety with child anxiety and fears was examined with linear regression analysis. The mediating effect of parenting competence was examined with mediation analysis. Results and conclusions. Child anxiety and fears were associated with both current and previous maternal anxiety. Children of more anxious mothers showed more anxiety and fear-related symptoms and the association with mother’s former symptoms was as strong as with mother’s current symptoms. The associations of maternal anxiety with children’s later anxiety and fears were partially mediated by parenting competence. These results support previous findings that even low maternal anxiety is associated with child development and elaborates them by showing that it is associated specifically with child anxiety and fear-related symptoms. The current findings also extend existing knowledge about this association by showing that it is partially mediated by parenting competence. These findings can be utilized in prevention and treatment of childhood anxiety.
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(2019)Abstract Aims. Family functioning plays an important role in the development, health and well-being of the child. Research literature has shown the connection between the characteristics and distress of family members and the family functioning. However, the understanding of the importance of individual strengths to family functioning is significantly more limited compared to the knowledge of connection between risk factors and family functioning. The trait of optimism is known to be associated with better social relationships, but optimism as the predictor of family functioning has not been studied yet at all. The aim of the study is to examine the relationship of mother's and child's optimism on family functioning. In addition, it is aimed to determine the stability of child’s optimism in transition from childhood to adolescence. Methods. The data consisted of mothers and children who participated in the Finnish Glycyrrhiz in Licorice (GLAKU) follow-up study. A total of 213 mother-child pairs were selected from the original GLAKU study to the sample. Of the children selected in the sample, 113 (53.1%) were girls. Mother's optimism was measured by a Life Orientation Test - Revised (LOT-R) questionnaire based on self-assessment at the child's age of 7-8 years and 11-13 years. Child's optimism at the age of 7-8 years was measured by the mother's assessment with the Parent-rated Life Orientation Test (PLOT) questionnaire. Child's optimism at 11-13 years of age was measured by the child's own assessment with the Youth Life Orientation Test (YLOT) questionnaire. The family functioning was measured according the McMaster model by the mother assessment of the Family Assessment Device (FAD) questionnaire at the child's age of 11-13. The study examined the link between optimism and McMaster model's dimensions of family functioning: general family functioning, problem-solving, communication, roles, affective responsiveness, affective involvement, and behavioral control. The connections between optimism and family functioning were studied by linear regression analysis. Results and Conclusions. The families of the more optimistic mothers were generally better functioning. Mothers' higher optimism was associated with better problem solving skills, better communication and emotional involvement. Families with higher child’s optimism at 7-8 years of age were also better functioning when the child was 11-13 years old. The child's higher optimism at the age of 7-8 was related to better problem solving skills, affective responsiveness, affective involvement and better behavior control. Child’s optimism decreased between 7-8 years and 11-13 years. The results of the connections between child's optimism and family functioning were contradictory as the child's optimism at the age of 11-13 was not connected to the dimensions of the family functioning and, on the other hand, the decrease in child's optimism was associated with better family responsiveness and emotional involvement. Because of the contradictory results, it is important to study the topic further in the future. The results provide more knowledge about the importance of optimism for social relations. Optimism seems to be a significant psychological resource especially for mothers, and it may promote the processes that support the family functioning. According to the study, the trait of optimism can be utilize as a resource when helping families with children to improve the functioning of the family and when promoting the well-being of children and parents.
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(2023)Objective: Parent–infant therapeutic work is an intensive intervention, individually tailored for families with an infant to support the parent–infant relationship. It is offered when support provided by maternity and child health clinics and other basic services is not enough. Maternal mentalization and emotion regulation are thought to be the underlying mechanisms of the intervention’s potential effectiveness. There are many similarities in the development of mentalization and emotion regulation as well as in their importance to parenting. Theoretically it has been thought that the association between them is bidirectional and mutually reinforcing. This study investigates whether maternal mentalization and emotion regulation change during parent–infant therapeutic work. In addition, the association between mentalization and emotion regulation is investigated with both cross-sectional and longitudinal research designs. Methods: The study sample was part of a larger effectiveness study of services offered to families with infants in finnish family centers. The sample consisted of 90 mothers receiving parent–infant therapeutic work. Emotion regulation was assessed using the Difficulties in Emotion Regulation Scale Short Form (DERS-SF) questionnaire. Maternal mentalizing was assessed in a subsample of 31 mothers, using either the Pregnancy Interview (PI) or the Parent Development Interview Revised (PDI-R), depending on whether the measurement was made during pregnancy or after childbirth. Changes in emotion regulation and mentalization during the intervention as well as the relationship between the changes were evaluated using linear mixed models. The association between mentalization and emotion regulation at baseline was evaluated using linear regression analysis. Results and conclusions: One of the DERS-SF subscales, access to emotion regulation strategies, improved during treatment. In addition, maternal mentalizing improved in mothers with low baseline mentalizing capacity. This result supports the previously observed phenomenon that it may be easier to increase low mentalization ability than high mentalization ability. It is possible that in order to improve emotion regulation and mentalizing more broadly, the intervention should include more systematic support of emotion regulation and mentalization. This study also confirmed previous, albeit conflicting evidence that maternal mentalizing and emotion regulation are not unequivocally associated. More research is needed on the effectiveness of parent–infant therapeutic work and the association between parental mentalizing and emotional regulation using different research methods and designs.
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(2020)Aims. Maternal perinatal depression has been shown to have multiform adverse effects on child development, such as cognitive ability. However, the prior studies are limited to early childhood cognitive ability, and the association in school-age is yet to be determined. The aim of this study was to examine the relationship between maternal perinatal depression and child cognitive ability at 7-11 years. It was hypothesized that both prenatal and postpartum depression, and also the continuity of perinatal depression from prenatal to postpartum period, would have a negative effect on child cognitive ability. Methods. The study sample, 423 mother-child-pairs, originates from Finnish PREDO-cohort. Perinatal depression was assessed with CES-D 14 times biweekly during pregnancy, beginning from gestational week 12+0, and two weeks and six months after delivery. Child cognitive ability was assessed with WISC-IV in terms of general cognitive, verbal and visual ability. The association between perinatal depression and general cognitive ability was analysed with multiple linear regression, and the association with verbal and visual ability with multivariate multiple linear regression. Results. Neither maternal prenatal nor postpartum depression was related to child general cognitive ability, verbal ability nor visual ability at 7-11 years. Continuity of depression from pregnancy to postpartum period was not related to child cognitive ability either. Conclusions. According to this study, there is no association between maternal perinatal depression and child cognitive ability at 7-11 years.
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Äidin perinataalimasennusoireilun yhteys kouluikäisen lapsen ADHD-oireisiin ja toiminnanohjaukseen (2021)Äidin perinataalimasennuksen eli raskaudenaikaisen ja synnytyksen jälkeisen masennuksen on todettu olevan yhteydessä moniin lapsen kasvun ja kehityksen ongelmiin. Aiemmissa tutkimuksissa on löydetty äidin perinataalimasennusoireilun yhteys lapsen ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Aihetta on kuitenkin tutkittu toistaiseksi melko vähän, ja ADHD-oireita käsitelleiden tutkimusten kohteina ovat olleet pääasiassa alle kouluikäiset lapset. Tämän tutkimuksen tavoitteena on selvittää, onko äidin perinataalimasennusoireilu yhteydessä kouluikäisen lapsen ADHD-oireisiin ja toiminnanohjaukseen. Tutkimuksessa selvitetään lisäksi, vaikuttaako sukupuoli äidin perinataalimasennusoireilun ja kouluikäisen lapsen ADHD-oireiden väliseen yhteyteen sekä äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen väliseen yhteyteen. Tutkimukseen osallistui 2 002 äiti-lapsiparia, jotka kuuluivat suomalaiseen The Prediction and Prevention of Pre‐eclampsia and Intrauterine Growth Restriction (PREDO) -kohorttitutkimukseen. Äidit vastasivat masennusoirekyselyyn 14 kertaa raskausaikana alkaen raskausviikolla 120/7–136/7 ja päättyen raskausviikolle 380/7–396/7 tai synnytykseen sekä kaksi viikkoa ja kuusi kuukautta synnytyksen jälkeen. Äidit arvioivat lastensa ADHD-oireita sekä ADHD Rating Scale että Conners’ 10-item Scale -kyselylomakkeilla ja toiminnanohjausta Behavior Rating Inventory of Executive Function (BRIEF) -kyselylomakkeella. Äidin perinataalimasennusoireilun yhteyttä lapsen ADHD-oireisiin ja toiminnanohjaukseen tutkittiin lineaarisella regressioanalyysillä, jossa huomioitiin useita äitiin ja lapseen liittyviä taustamuuttujia. Sukupuolen vaikutusta äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden sekä äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen välisiin yhteyksiin tutkittiin moderaatioanalyysillä. Lineaarisella regressioanalyysillä tutkittiin, onko sukupuolen ja äidin perinataalimasennuksen välillä yhdysvaikutusta ennustettaessa lapsen ADHD-oireita ja toiminnanohjausta. Tutkimuksen tuloksista ilmeni, että äidin masennusoireilu sekä raskausaikana että synnytyksen jälkeen oli yhteydessä lapsen voimakkaampiin ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Tulosten perusteella lapsen sukupuoli moderoi äidin ensimmäisen raskauskolmanneksen masennusoireilun ja kouluikäisen lapsen yliaktiivisuus-impulsiivisuusoireiden välistä yhteyttä. Sukupuoli ei kuitenkaan moderoinut muita äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden välillä löytyneitä yhteyksiä eikä vaikuttanut äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen väliseen yhteyteen. Tutkimus lisäsi tietoa siitä, kuinka äidin masennusoireilu jokaisena raskauskolmanneksena ja synnytyksen jälkeen on yhteydessä kouluikäisen lapsen voimakkaampiin ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Tässä tutkimuksessa sukupuoli moderoi äidin ensimmäisen raskauskolmanneksen masennusoireilun ja kouluikäisen lapsen yliaktiivisuus-impulsiivisuusoireiden välistä yhteyttä, mutta kyseessä saattaa olla satunnainen löydös. Sukupuolen mahdollisesta vaikutuksesta äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden väliseen yhteyteen tarvitaan lisää tutkimuksia.
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(2022)Objectives: Fetal exposure to excess cortisol may negatively affect the mental development of a child later in life. Consumption of licorice, containing glycyrrhizin (a potent inhibitor of placental 11β- hydroxysteroid dehydrogenase type 2, the “barrier” to maternal glucocorticoids), increases the cortisol level in fetal circulation. Therefore, since 2016, the national nutritional recommendations in Finland have recommended avoiding licorice consumption during pregnancy. The aim of this study is to assess the association between glycyrrhizin consumption in different stages of pregnancy and child neurocognitive development in early childhood. In earlier research, child neurodevelopment has not been studied before school age. Methods: The sample of the study is a part of the ITU (InTraUterine sampling in early pregnancy) cohort. Mothers reported their glycyrrhizin consumption from the preceding three months three times during pregnancy. The child’s neurocognitive development was assessed with Ages and Stages Questionnaires -3 (ASQ-3) at 1–2 years (mean age = 1.55 years, standard deviation (SD) = 1.44 months, n = 516, 47.50 % girls) and with Bayley Scales of Infant and Toddler Development III (BSID-III) at 3 years (mean = 2.96 years, SD = 2.69 months, n = 476, 50.40 % girls). The association between licorice consumption and neurocognitive development was assessed using linear, logistic, and Poisson regression models. Results and conclusions: Maternal glycyrrhizin consumption and child neurocognitive development were negatively associated at 1–2 and 3 years. The results varied between areas of development and the time of pregnancy: consumption during early pregnancy was associated with slower gross motor development at 3 years, mid-pregnancy consumption with slower cognitive and language development at 3 years, and late pregnancy with slower total neurodevelopment scores at 1–2 years. Thus, avoiding licorice consumption through pregnancy and following the national guidelines that followed the previous studies on this subject is recommended.
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(2021)The aim of the study. Maternal depression during pregnancy occurs in up to one in four women. It is a serious condition that can have long-term negative effects on the development of the foetus and the child through a harmful intrauterine environment. Maternal depression during pregnancy is for instance associated with internalizing mental health symptoms and temperament in children. However, there is little research evidence on the association of maternal depression during pregnancy with anxiety symptoms in school-aged children. Childhood anxiety symptoms can have serious and long-term consequences for an individual in terms of psychosocial, academic and professional functioning. This study examines whether maternal depressive symptoms during pregnancy increases the risk of anxiety symptoms in school-age children. I also investigate whether infant negative emotionality mediates the association between maternal depression symptoms during pregnancy and anxiety symptoms in school-age children. Methods. The sample of this study, which consists of 1625 mother-child pairs, was part of a larger PREDO (The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction) follow-up study. Data from 3-12 months infancy follow-up and follow-up at the age of 7 to 11 years were used in this study. Mothers rated depressive symptoms during pregnancy using a self-assessment questionnaire (Center for Epidemiologic Studies Depression Scale). Mothers assessed their children's negative emotionality (Revised Infant Behavior Questionnaire) in the infant follow-up and their children's anxiety symptoms (Spence Children's Anxiety Scale, parent report version & The Short Form of the Fear Survey Schedule for Children-Revised) in the school-age follow-up. The associations between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children were examined with linear regression analysis. Negative emotionality in infancy as a mediator of this relationship was examined with mediation analysis. Results and conclusions. According to this study, maternal depressive symptoms during pregnancy increased the risk of anxiety symptoms in school-age children. The observed associations between maternal depressive symptoms and anxiety symptoms in children were independent of all the covariates selected for this study, such as maternal depression symptoms during follow-up at the age of 7 to 11. Preliminary research findings were also obtained on negative emotionality in infancy as partly mediating the association between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children. This study helps to increase understanding of the early risk factors of anxiety symptoms in children and the importance of preventive measures during pregnancy. High negative emotionality in early childhood is also a justified target for interventions.
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(2019)Aims of the study. Mental disorders and their intergenerational nature are significant global health problems. Research shows that prenatal and postnatal exposure to maternal affective disorders increases the risk of mental disorders in children. A more precise understanding of the timing of maternal affective disorders in predicting the risk of child psychopathology is needed. This study examined whether maternal affective disorders before, during, and after pregnancy are associated with the risk of mental disorders in children up to the age of 7–11 years. Timing of maternal affective disorders, i.e. the sensitive periods, and additive effects of maternal affective disorders were also assessed. Methods. The study sample is a part of an ongoing prospective PREDO-study. The sample (N = 4692) comprised mother-child-pairs whose hospital records documenting mental disorders was available. The associations between maternal affective disorders and any mental disorder, disorders of psychological development, and behavioural and emotional disorders in the offspring were analyzed using Cox regression models, controlling for sociodemographic factors and maternal substance use disorders. Timing of maternal affective disorders was assessed by comparing the observed risks, i.e. hazard ratios, of the different time periods. Results and conclusions. Maternal affective disorders during every time period predicted increased risks of offspring mental disorders. Maternal affective disorders before and after pregnancy associated with the risk of any mental disorder, disorders of psychological development, and behavioural and emotional disorders. Maternal prenatal affective disorders were associated with increased risks of any mental disorders and disorders of psychological development. Timing of maternal affective disorders did not appear to be crucial, but maternal affective disorders at different timepoints had additive effects on child mental disorders. Findings suggest that maternal affective disorders predict mental disorders in young children. Preventive interventions for women planning for pregnancy, during pregnancy, and for families with young children may prevent mental disorders in both the mother and the child.
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(2021)Background and objectives. There is still little research about the screen time of parents, and it is also partly contradictory. Also, there aren’t any previous studies about the relationship between the screen time of the mother and the child’s performance in linguistic tests. Previ-ous studies have shown that the screen time of the mother decreases the interaction be-tween the mother and the child, which could also affect the language development of the child. The aim of this study was to examine the relationship between the quantity and quality of the screen time of the mother and the linguistic skills (receptive/expressive) of their 3- to 4-year-old child. This thesis was done as part of the LEINIKKI-study. Participants and methods. The participants were 49 (25 girls and 24 boys) 3- to 4-year-old, neurotypical, Finnish-speaking children, and their mothers. The language skills of the chil-dren were examined using the Finnish version of the Reynell Developmental Language Scales III and the LEINIKKI-method. The quantity and the quality of the mother’s screen time were assessed using the screen time questionnaire. The data was analyzed using the Spearman correlation coefficient and the Mann-Whitney U test. Results and conclusions. There was no statistically significant relationship between the quantity of the mother’s screen time and the linguistic skills of the child. However, a statisti-cally significant result concerning the quality of the screen time was found: The children whose mothers had four hours or more of work-related screen time on a weekday managed weaker in the LEINIKKI-method than those whose mothers had less than four hours of work-related screen time. The results of this master’s thesis give us precursory information about the negative relationship between heavy screen time of the mother and the development of the child’s linguistic skills. Future research would be important because of the lack of re-search in this subject matter.
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(2018)The aim of the study: In research literature depressive symptoms in mothers have been associated with lower parental sense of competence. The developmental mechanisms responsible for this relation are poorly understood and there is a need for longitudinal study especially. The study of this master’s thesis explores the association of both postnatal and later depressive symptoms with parental sense of competence when the child is 1–5 years. It also explores whether demographic factors have an impact to the relation and does later depressive symptomology in mothers mediate the relation between postnatal depressive symptomology and later parental competence. Method: Data is part of the Finnish cohort of The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) research. The sample includes 2255 mothers who gave birth between years 2006-2010. Mothers evaluated their depressive symptoms 2 weeks / 6 months after birth (Center for Epidemiologic Studies Depression Scale ) and at the follow-up when the child was between 1–5 years old (Beck´s Depression Inventory). Mothers also evaluated their parental sense of competence (Parenting Sense of Competence Scale) at the follow-up. Data was analysed using linear regression and mediation analysis. Results and Conclusion: Both postnatal and later depressive symptoms were associated to lower parental sense of competence when the child was 1–5 years and demographic background did not have any impact to the relations. A significant mediation model was found where later depressive symptomology in mothers partly mediated the relation between postnatal depressive symptomology and later parental competence. Therefore effective screening and early treatment of postnatal depressive symptoms are important. Evaluating parental competence could potentially be a valuable part of screening and treatment of depressive symptomology in mothers.
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