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Some evidence, but not enough to be conclusive, suggests that physical activity in pregnancy reduces the risk of perinatal complications. Our objective was to examine if physical activity in the year before pregnancy and in the first half of pregnancy is associated with maternal and neonatal outcomes. Associations between physical activity and maternal and neonatal outcomes were examined in a prospective cohort (n = 1,749) in Halifax, Canada. The Kaiser Physical Activity Survey, completed at approximately 20 weeks' gestation, requested information regarding physical activity during the year before the pregnancy and the first 20 weeks of pregnancy. Outcomes were assessed by medical chart review. Multiple logistic regression was used to estimate odds ratios (OR) with 95 % confidence intervals (CI). Women with prepregnancy physical activity levels in the middle and highest tertiles were more likely to have high gestational weight gain relative to women in the lowest tertile [OR (CI): 1.40 (1.06-1.85) and 1.57 (1.18-2.09), respectively]. Higher physical activity in the first half of pregnancy decreased the odds of delivering a macrosomic infant (p trend = 0.005). Associations were not observed between total physical activity and gestational diabetes, gestational hypertension, pre-eclampsia, preterm birth, and low birth weight. Physical activity before, but not in the first half of pregnancy, is associated with high gestational weight gain. Physical activity in the first half of pregnancy may reduce the occurrence of macrosomia without affecting preterm birth or low birth weight. Keywords Exercise * Gestational diabetes * Pre-eclampsia * Gestational weight gain * Birth weight, Introduction Physical activity is an essential component of healthful living across the lifespan. Guidelines in Canada, the United Kingdom, the United States, and elsewhere recommend that physical activity be incorporated [...]

Abstract: Antisocial behaviour disorders (ABDs) are among the most costly and treatment resistant of all psychiatric syndromes. Select neurodevelopmental abnormalities have been labelled a risk factor for ABDs, but it is unknown if maternal ABDs are associated with early neurodevelopmental abnormalities. This study tested whether infants of ABD mothers had more neurodevelopmental abnormalities than mothers with no psychiatric disorder (ND). Thirty‐nine pregnant women (49% with ABDs; 51% no psychiatric disorder) were recruited from the community. Infant neurodevelopment was assessed at ≤1 and 8 weeks using the Neonatal Behavioural Assessment Scale and at 16 weeks of age using the Bayley Scales of Infant and Toddler Development‐III. There was no significant group difference at ≤8 weeks. At 16 weeks, ABD mothers rated their infants higher on the Adapted Behaviours subscale, specifically on the leisure and self‐directed scales, when corrected for substance use and socio‐economic status. This pilot study found higher maternal ratings of Adapted Behaviours at 16 weeks, which may be due to unrealistic expectations about infant development. Highlights: Maternal Antisocial behaviour disorders (ABDs) do not impact early infant neurodevelopment at ≤ 8 weeks old as measured by standardized assessment. Mothers with ABDs view their infants at 16 weeks as better adapted than women without any psychiatric disorder. Specifically, mothers with ABDs reported their infants as better adapted on the leisure and self‐direction subscales of the Bayley Scales of Infant and Toddler Development‐III. This finding may be due to less knowledge about normal infant adaptive behavior. [ABSTRACT FROM AUTHOR]

Background: Self-harm is increasing among adolescents, and because of changing behaviours, current data are needed on the consequences of self-harm. We sought to investigate the trends related to hospital presentation, readmission, patient outcome and medical costs in adolescents who presented with self-harm to the emergency department., Methods: We used administrative data on 403 805 adolescents aged 13-17 years presenting to Ontario emergency departments in 2011-2013. Adolescents with self-harm visits were 1:2 propensity matched to controls with visits without self-harm, using demographic, mental health and other clinical variables. Five years after the index presentation, hospital or emergency department admission rates for self-harm, overall mortality, suicides and conservative cost estimates were compared between the 2 groups., Results: Of 5832 adolescents who visited Ontario emergency departments in 2011-2013 after self-harm (1.4% of visits), 5661 were matched to 10 731 adolescents who presented for reasons other than self-harm. Adolescents who presented with self-harm had a shorter time to a repeat emergency department or hospital admission for self-harm (hazard ratio [HR] 4.84, 95% confidence interval [CI] 4.44-5.27), more suicides (HR 7.96, 95% CI 4.00-15.86), and higher overall mortality (HR 3.23, 95% CI 2.12-4.93; p < 0.001). The positive predictive value of self-harm-related emergency department visits for suicide was 0.7%. Adolescents with self-harm visits had mean 5-year estimates of health care costs of $30 388 compared with $19 055 for controls ( p < 0.001)., Interpretation: Adolescents with emergency department visits for self-harm have higher rates of mortality, suicide and recurrent self-harm, as well as higher health care costs, than matched controls. Development of algorithms and interventions that can identify and help adolescents at highest risk of recurrent self-harm is warranted., Competing Interests: Competing interests: William Gardner reports receiving grants from the Canadian Institutes of Health Research and research contracts from the Public Health Agency of Canada and the US Centers for Disease Control. Dr. Gardner is also the CHEO and University of Ottawa Senior Research Chair in Child and Adolescent Psychiatry. Ian Colman is a Canada Research Chair in mental health epidemiology. Roger Zemek reports receiving competitively funded research grants from the Canadian Institutes of Health Research, Ontario Neurotrauma Foundation, Physician Services Incorporated Foundation, CHEO Foundation, Ontario Brain Institute, the Ontario SPOR Support Unit and the National Football League. Dr. Zemek is also the Clinical Research Chair in Pediatric Concussion at University of Ottawa. No other competing interests were declared., (© 2019 Joule Inc. or its licensors.)