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2. Maternal education and offspring birthweight for gestational age: the mediating effect of smoking during pregnancy

Author

Nakamura, Aurelie, Pryor, Laura, Ballon, Morgane, Lioret, Sandrine, Heude, Barbara, Charles, Marie-Aline, Melchior, Maria, and Lesueur, El-Khoury

Subjects
Quantitative Biology - Quantitative Methods
Abstract

Background Small for gestational age (SGA) birthweight, a risk factor of infant mortality and delayed child development, is associated with maternal educational attainment. Maternal tobacco smoking during pregnancy could contribute to this association. We aimed to quantify the contribution of maternal smoking during pregnancy to social inequalities in child birthweight for gestational age (GA). Methods Data come from the French nation-wide ELFE cohort study, which included 17,155 singletons. Birthweights for GA were calculated using z-scores. Associations between maternal educational attainment, tobacco smoking during pregnancy and child birthweight for GA were ascertained using mediation analysis. Mediation analyses were also stratified by maternal pre-pregnancy body mass index.Results Low maternal educational attainment was associated with an increased odd of tobacco smoking during pregnancy (adjusted OR (ORa)=2.58 [95% CI 2.34, 2.84]) as well as a decrease in child birthweight for GA (RRa=0.94 [95% 0.91, 0.98]). Tobacco smoking during pregnancy was associated with a decrease in offspring birthweight for GA (RRa=0.73 [95% CI 0.70, 0.76]). Mediation analysis suggests that 39% of the effect of low maternal educational attainment on offspring birthweight for GA was mediated by smoking during pregnancy. A more important direct effect of maternal educational attainment on child birthweight for GA was observed among underweight women (RRa=0.82 [95%CI 0.72, 0.93]).Conclusions The relationship between maternal educational attainment and child birthweight for GA is strongly mediated by smoking during pregnancy. Reducing maternal smoking could lessen the occurrence of infant SGA and decrease socioeconomic inequalities in birthweight for GA.Keywords Birthweight, educational attainment, tobacco smoking, pregnancy, mediation analysis, health inequalities

Published
2020

3. Partner support during pregnancy mediates social inequalities in maternal postpartum depression for non-migrant and first generation migrant women

Author

Nakamura, Aurelie, El-Khoury, Fabienne, Sutter-Dallay, Anne-Laure, Franck, Jeanna-Eve, Thierry, Xavier, Melchior, Maria, and van der Waerden, Judith

Subjects
Quantitative Biology - Quantitative Methods
Abstract

Background An advantaged socioeconomic position (SEP) and satisfying social support during pregnancy (SSP) have been found to be protective factors of maternal postpartum depression (PDD). An advantaged SEP is also associated with satisfying SSP, making SSP a potential mediator of social inequalities in PPD. SEP, SSP and PPD are associated with migrant status. The aim of this study was to quantify the mediating role of SSP in social inequalities in PPD regarding mother's migrant status. Methods A sub-sample of 15,000 mothers from the French nationally-representative ELFE cohort study was used for the present analyses. SEP was constructed as a latent variable measured with educational attainment, occupational grade, employment, financial difficulties and household income. SSP was characterized as perceived support from partner (good relation, satisfying support and paternal leave) and actual support from midwives (psychosocial risk factors assessment and antenatal education). Mediation analyses with multiple mediators, stratified by migrant status were conducted. Results Study population included 76% of non-migrant women, 12% of second and 12% of first generation migrant. SEP was positively associated with support from partner, regardless of migrant status. Satisfying partner support was associated with a 8 (non-migrant women) to 11% (first generation migrant women) reduction in PPD score. Limitations History of depression was not reported.Conclusions Partner support could reduce social inequalities in PPD. This work supports the need of interventions, longitudinal and qualitative studies including fathers and adapted to women at risk of PPD to better understand the role of SSP in social inequalities in PPD. Keywords social support, postpartum depression, epidemiology, social inequalities, pregnancy, mediation analysis

Published
2020

4. Intergenerational transmission of tobacco smoking:The role of the child's behavioral difficulties. Data from the Danish National Birth cohort (DNBC)

Author

Fekom, Mathilde, Nguyen, Tri-Long, Lepeule, Johanna, Nakamura, Aurélie, Keyes, Katherine, Martins, Silvia, Strandberg-Larsen, Katrine, Melchior, Maria, Fekom, Mathilde, Nguyen, Tri-Long, Lepeule, Johanna, Nakamura, Aurélie, Keyes, Katherine, Martins, Silvia, Strandberg-Larsen, Katrine, and Melchior, Maria

Abstract

Aims This study explores the role of offspring behavioral difficulties in the intergeneration transmission of tobacco smoking. Methods This longitudinal cohort study is based on children born in Denmark in 1996–2003 participating in the Danish National Birth Cohort (DNBC), followed-up until 18 years of age. We included mother-child pairs with complete data regarding the exposure (4 trajectories of maternal daily smoking quantity during pregnancy: low, intermediate/stable, intermediate/decreasing and high), outcome (offspring daily smoking status at 18 years) and mediator (offspring symptoms of hyperactivity-inattention at 11 years), that is 24,588 mother-child pairs. Results In our study population, during pregnancy respectively 86.2%, 6.80%, 4.08% and 2.97% mothers belonged to the low, intermediate/stable, intermediate/decreasing and high smoking trajectory groups. After controlling for covariates using propensity scores, the direct effect of maternal smoking in pregnancy on offspring smoking in adolescence was statistically significant, especially when the mother belonged to the intermediate/stable smoking trajectory group (ORIPW = 2.09, 95% CI: 1.70 – 2.61) or to the high smoking trajectory group (ORIPW = 2.08, 95% CI: 1.52 – 3.11) compared to the low smoking trajectory group. None of the indirect effects of maternal smoking in pregnancy were statistically significant, and neither were the proportions mediated. Conclusion Maternal pregnancy smoking seems to have an influence on offspring smoking in early adulthood, which does not appear to be mediated by offspring behavioral difficulties. Women should be strongly encouraged to quit smoking in pregnancy to reduce both short and long-term health risks among their offspring., AIMS: This study explores the role of offspring behavioral difficulties in the intergeneration transmission of tobacco smoking.METHODS: This longitudinal cohort study is based on children born in Denmark in 1996-2003 participating in the Danish National Birth Cohort (DNBC), followed-up until 18years of age. We included mother-child pairs with complete data regarding the exposure (4 trajectories of maternal daily smoking quantity during pregnancy: low, intermediate/stable, intermediate/decreasing and high), outcome (offspring daily smoking status at 18 years) and mediator (offspring symptoms of hyperactivity-inattention at 11 years), that is 24,588 mother-child pairs.RESULTS: In our study population, during pregnancy respectively 86.2%, 6.80%, 4.08% and 2.97% mothers belonged to the low, intermediate/stable, intermediate/decreasing and high smoking trajectory groups. After controlling for covariates using propensity scores, the direct effect of maternal smoking in pregnancy on offspring smoking in adolescence was statistically significant, especially when the mother belonged to the intermediate/stable smoking trajectory group (ORIPW = 2.09, 95% CI: 1.70 - 2.61) or to the high smoking trajectory group (ORIPW = 2.08, 95% CI: 1.52 - 3.11) compared to the low smoking trajectory group. None of the indirect effects of maternal smoking in pregnancy were statistically significant, and neither were the proportions mediated.CONCLUSION: Maternal pregnancy smoking seems to have an influence on offspring smoking in early adulthood, which does not appear to be mediated by offspring behavioral difficulties. Women should be strongly encouraged to quit smoking in pregnancy to reduce both short and long-term health risks among their offspring.

Published
2024

8. Epigenome-Wide Associations of Placental DNA Methylation and Behavioral and Emotional Difficulties in Children at 3 Years of Age

Author

Nakamura, Aurélie, primary, Broséus, Lucile, additional, Tost, Jörg, additional, Vaiman, Daniel, additional, Martins, Silvia, additional, Keyes, Katherine, additional, Bonello, Kim, additional, Fekom, Mathilde, additional, Strandberg-Larsen, Katrine, additional, Sutter-Dallay, Anne-Laure, additional, Heude, Barbara, additional, Melchior, Maria, additional, and Lepeule, Johanna, additional

Published
2023
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9. Epigenome-Wide Associations of Placental DNA Methylation and Behavioral and Emotional Difficulties in Children at 3 Years of Age

Author

Nakamura, Aurélie, Broséus, Lucile, Tost, Jörg, Vaiman, Daniel, Martins, Silvia, Keyes, Katherine, Bonello, Kim, Fekom, Mathilde, Strandberg-Larsen, Katrine, Sutter-Dallay, Anne Laure, Heude, Barbara, Melchior, Maria, Lepeule, Johanna, Nakamura, Aurélie, Broséus, Lucile, Tost, Jörg, Vaiman, Daniel, Martins, Silvia, Keyes, Katherine, Bonello, Kim, Fekom, Mathilde, Strandberg-Larsen, Katrine, Sutter-Dallay, Anne Laure, Heude, Barbara, Melchior, Maria, and Lepeule, Johanna

Abstract

The placenta is a key organ for fetal and brain development. Its epigenome can be regarded as a biochemical record of the prenatal environment and a potential mechanism of its association with the future health of the fetus. We investigated associations between placental DNA methylation levels and child behavioral and emotional difficulties, assessed at 3 years of age using the Strengths and Difficulties Questionnaire (SDQ) in 441 mother–child dyads from the EDEN cohort. Hypothesis-driven and exploratory analyses (on differentially methylated probes (EWAS) and regions (DMR)) were adjusted for confounders, technical factors, and cell composition estimates, corrected for multiple comparisons, and stratified by child sex. Hypothesis-driven analyses showed an association of cg26703534 (AHRR) with emotional symptoms, and exploratory analyses identified two probes, cg09126090 (intergenic region) and cg10305789 (PPP1R16B), as negatively associated with peer relationship problems, as well as 33 DMRs, mostly positively associated with at least one of the SDQ subscales. Among girls, most associations were seen with emotional difficulties, whereas in boys, DMRs were as much associated with emotional than behavioral difficulties. This study provides the first evidence of associations between placental DNA methylation and child behavioral and emotional difficulties. Our results suggest sex-specific associations and might provide new insights into the mechanisms of neurodevelopment. Keywords: EWAS; DNA methylation; DOHAD; placenta; child behavior; pregnancy; epidemiology, The placenta is a key organ for fetal and brain development. Its epigenome can be regarded as a biochemical record of the prenatal environment and a potential mechanism of its association with the future health of the fetus. We investigated associations between placental DNA methylation levels and child behavioral and emotional difficulties, assessed at 3 years of age using the Strengths and Difficulties Questionnaire (SDQ) in 441 mother–child dyads from the EDEN cohort. Hypothesis-driven and exploratory analyses (on differentially methylated probes (EWAS) and regions (DMR)) were adjusted for confounders, technical factors, and cell composition estimates, corrected for multiple comparisons, and stratified by child sex. Hypothesis-driven analyses showed an association of cg26703534 (AHRR) with emotional symptoms, and exploratory analyses identified two probes, cg09126090 (intergenic region) and cg10305789 (PPP1R16B), as negatively associated with peer relationship problems, as well as 33 DMRs, mostly positively associated with at least one of the SDQ subscales. Among girls, most associations were seen with emotional difficulties, whereas in boys, DMRs were as much associated with emotional than behavioral difficulties. This study provides the first evidence of associations between placental DNA methylation and child behavioral and emotional difficulties. Our results suggest sex-specific associations and might provide new insights into the mechanisms of neurodevelopment.

Published
2023

10. Maternal tobacco smoking during pregnancy and children’s emotional and behavioural trajectories : The EDEN mother-child birth cohort study

Author

Bonello, Kim, primary, Gomajee, Ramchandar, additional, Ibanez, Gladys, additional, Martins, Silvia, additional, Keyes, Katherine, additional, Nakamura, Aurélie, additional, Lepeule, Johanna, additional, Strandberg-Larsen, Katrine, additional, Fekom, Mathilde, additional, and Melchior, Maria, additional

Published
2023
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14. Does Liberalisation of Cannabis Policy Influence Levels of Use in Adolescents and Young Adults? A Systematic Review and Meta-Analysis

Author

Melchior, Maria, Nakamura, Aurélie, Bolze, Camille, Hausfater, Félix, El Khoury, Fabienne, Mary-Krause, Murielle, Azevedo Da Silva, Marine, Equipe de Recherche en Epidémiologie Sociale [iPLesp] (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Columbia University [New York], and Gestionnaire, Hal Sorbonne Université

Subjects
cannabis, Adolescent, Research, [SDV]Life Sciences [q-bio], Legislation, Drug, [SDV] Life Sciences [q-bio], Young Adult, Criminal Law, Public Opinion, Drug and Narcotic Control, Humans, Public Health, adolescents, marijuana, policy
Abstract

International audience; Objectives To examine the effect of cannabis policy liberalisation (decriminalisation and legalisation) levels of use in adolescents and young adults. Design Systematic review and meta-analysis. Inclusion criteria Included studies were conducted among individuals younger than 25 years and quantitatively assessing consequences of cannabis policy change. We excluded articles: (A) exclusively based on participants older than 25 years; (B) only reporting changes in perceptions of cannabis use; (C) not including at least two measures of cannabis use; (D) not including quantitative data; and (E) reviews, letters, opinions and policy papers. PubMed, PsycINFO, Embase and Web of Science were searched through 1 March 2018. Data extraction and synthesis Two independent readers reviewed the eligibility of titles and abstracts and read eligible articles, and four authors assessed the risk of bias (Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies). Extracted data were meta-analysed. The protocol was registered with PROSPERO. Results 3438 records were identified via search terms and four via citation lists; 2312 were retained after removal of duplicates, 99 were assessed for eligibility and 41 were included in our systematic review. 13 articles examined cannabis decriminalisation, 20 examined legalisation for medical purposes and 8 examined legalisation for recreational purposes. Findings regarding the consequences of cannabis decriminalisation or legalisation for medical purposes were too heterogeneous to be meta-analysed. Our systematic review and meta-analysis suggest a small increase in cannabis use among adolescents and young adults following legalisation of cannabis for recreational purposes (standardised mean difference of 0.03, 95%\,CI -0.01 to \textendash 0.07). Nevertheless, studies characterised by a very low/low risk of bias showed no evidence of changes in cannabis use following policy modifications. Conclusions Cannabis policy liberalisation does not appear to result in significant changes in youths' use, with the possible exception of legalisation for recreational purposes that requires monitoring. Trial registration number CRD42018083950.

Published
2019

20. Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study

Author

Merritt, Melissa A., Riboli, Elio, Murphy, Neil, Kadi, Mai, Tjønneland, Anne, Olsen, Anja, Overvad, Kim, Dossus, Laure, Dartois, Laureen, Clavel-Chapelon, Françoise, Fortner, Renée T., Katzke, Verena A., Boeing, Heiner, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrios, Palli, Domenico, Sieri, Sabina, Tumino, Rosario, Sacerdote, Carlotta, Panico, Salvatore, Bueno-de-Mesquita, H. Bas, Peeters, Petra H., Lund, Eiliv, Nakamura, Aurelie, Weiderpass, Elisabete, Quirós, J. Ramón, Agudo, Antonio, Molina-Montes, Esther, Larrañaga, Nerea, Dorronsoro, Miren, Cirera, Lluís, Barricarte, Aurelio, Olsson, Åsa, Butt, Salma, Idahl, Annika, Lundin, Eva, Wareham, Nicholas J., Key, Timothy J., Brennan, Paul, Ferrari, Pietro, Wark, Petra A., Norat, Teresa, Cross, Amanda J., and Gunter, Marc J.

Subjects
Age at menarche, Age at menopause, Breastfeeding, Mortality, Oral contraceptives, Parity
Abstract

Background: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. Methods: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled >500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25–70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. Results: During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76–0.84), in women who had ever versus never breastfed (0.92; 0.87–0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86–0.95), and in women reporting a later age at menarche (≥15 years versus <12; 0.90; 0.85–0.96; P for trend = 0.038). Conclusions: Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women. Electronic supplementary material The online version of this article (doi:10.1186/s12916-015-0484-3) contains supplementary material, which is available to authorized users.

Published
2015
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21. IJSP_Manuscript_Nakamura_SocialSupport_PPD_Supp_Files – Supplemental material for Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study

Author

Nakamura, Aurélie, Anne-Laure Sutter-Dallay, Lesueur, Fabienne El-Khoury, Thierry, Xavier, Gressier, Florence, Melchior, Maria, and Waerden, Judith Van Der

Subjects
FOS: Psychology, FOS: Clinical medicine, 170199 Psychology not elsewhere classified, 110319 Psychiatry (incl. Psychotherapy), 16. Peace & justice, 3. Good health
Abstract

Supplemental material, IJSP_Manuscript_Nakamura_SocialSupport_PPD_Supp_Files for Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study by Aurélie Nakamura, Anne-Laure Sutter-Dallay, Fabienne El-Khoury Lesueur, Xavier Thierry, Florence Gressier, Maria Melchior and Judith van der Waerden in International Journal of Social Psychiatry

22. IJSP_Manuscript_Nakamura_SocialSupport_PPD_Supp_Files – Supplemental material for Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study

Author

Nakamura, Aurélie, Anne-Laure Sutter-Dallay, Lesueur, Fabienne El-Khoury, Thierry, Xavier, Gressier, Florence, Melchior, Maria, and Waerden, Judith Van Der

Subjects
FOS: Psychology, FOS: Clinical medicine, 170199 Psychology not elsewhere classified, 110319 Psychiatry (incl. Psychotherapy), 16. Peace & justice, 3. Good health
Abstract

Supplemental material, IJSP_Manuscript_Nakamura_SocialSupport_PPD_Supp_Files for Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study by Aurélie Nakamura, Anne-Laure Sutter-Dallay, Fabienne El-Khoury Lesueur, Xavier Thierry, Florence Gressier, Maria Melchior and Judith van der Waerden in International Journal of Social Psychiatry

23. Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study

Author

Aurélie Nakamura, Anne-Laure Sutter-Dallay, Fabienne El-Khoury Lesueur, Xavier Thierry, Florence Gressier, Maria Melchior, Judith van der Waerden, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Réseau doctoral de l'Ecole des hautes études en santé publique, Rennes, Department of Adult Psychiatry, Université de Bordeaux (UB)-Hôpital Charles Perrens, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Etude longitudinale française depuis l'enfance (UMS : Ined-Inserm-EFS) (ELFE), EFS-Institut national d'études démographiques (INED)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Team Depression and Antidepressants (INSERM UMR 1178), Santé mentale et santé publique (SMSP - U1178), Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université de Bordeaux (UB)-Centre hospitalier Charles Perrens [Bordeaux], Institut national d'études démographiques (INED)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, and Nakamura, Aurélie

Subjects
Adult, Male, Postpartum depression, Epidemiology, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Mothers, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Cohort Studies, Depression, Postpartum, Social support, Fathers, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Pregnancy, medicine, Humans, 030212 general & internal medicine, Parent-Child Relations, Risk factor, PharmacoEpi-Drugs, Psychiatric Status Rating Scales, Depression, business.industry, MENTAL_HEALTH, medicine.disease, Mental health, 030227 psychiatry, Pregnancy Complications, Mother-child cohort study, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Psychiatry and Mental health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Multivariate Analysis, Regression Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Risk assessment, business, Psychosocial, Demography, Cohort study
Abstract

Background: Insufficient social support has been intensively studied as a risk factor of postpartum depression (PPD) among mothers. However, to date, no study has examined the role of informal and formal dimensions of social support during pregnancy with regard to joint maternal and paternal depression after birth. Aim: Study associations between insufficient informal and formal support during pregnancy and joint parental PPD. Methods: Using data from the nationally representative French ELFE ( Etude Longitudinale Française depuis l’Enfance) cohort study ( N = 12,350), we estimated associations between insufficient informal and formal support received by the mother during pregnancy and joint parental PPD in multi-imputed multivariate multinomial regression models. Results: In 166 couples (1.3%), both parents were depressed. The likelihood of joint parental PPD was increased in case of insufficient informal support (insufficient partner support: odds ratio (OR) = 1.68 (95% confidence interval (CI): 1.57–1.80); frequent quarrels: OR = 1.38 (95% CI: 1.19–1.60)). We also observed associations between formal support during pregnancy and joint parental PPD (early prenatal psychosocial risk assessment: OR = 1.13 (95% CI: 1.05–1.22); antenatal education: OR = 1.13 (95% CI: 1.05–1.23)), which disappeared when analyses were restricted to women with no psychological difficulties during pregnancy. Conclusion: Insufficient informal social support during pregnancy appears to predict risk of joint PPD in mothers and fathers and should be identified early on to limit complications and the impact on children.

Published
2020

24. Subclinical psychosis in adult migrants and ethnic minorities: systematic review and meta-analysis

Author

Andrea Tortelli, Aurélie Nakamura, Federico Suprani, Franck Schürhoff, Judith Van der Waerden, Andrei Szöke, Ilaria Tarricone, Baptiste Pignon, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), University of Bologna/Università di Bologna, Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Fondation FondaMental [Créteil], Université Pierre et Marie Curie - Paris 6 (UPMC), Service de psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Tortelli, Andrea, Nakamura, Aurélie, Suprani, Federico, Schürhoff, Franck, Van der Waerden, Judith, Szöke, Andrei, Tarricone, Ilaria, and Pignon, Baptiste

Subjects
Psychosis, Ethnic group, Review, ethnic minorities, ethnic minoritie, subclinical psychosis, Migrants, 03 medical and health sciences, 0302 clinical medicine, medicine, psychotic-like experience, Association (psychology), psychosis continuum, Subclinical infection, psychotic-like experiences, Migrant, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Systematic review, Meta-analysis, [SCCO.PSYC]Cognitive science/Psychology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Psychology, Psychosocial, 030217 neurology & neurosurgery, Cohort study, Clinical psychology
Abstract

BackgroundIt is well established that migration and ethnic minority status are risk factors for psychotic disorders. Recent studies have aimed to determine if they are also associated with subclinical psychosis (psychotic-like experiences and schizotypal traits).AimsWe aimed to determine to what extent migrant and ethnic minority groups are associated with higher risk of subclinical psychosis.MethodWe conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and examined findings by ethnicity, migrant status, outcomes of subclinical psychosis and host country. A meta-analysis was carried out with robust variance estimation where possible, to handle statistically dependent effect size estimates.ResultsWe included 28 studies (19 studies on psychotic-like experiences and 9 studies on schizotypal traits) and found that ethnicity, but not migrant status, was associated with current and lifetime psychotic-like experiences. In the narrative analysis, we observed the effect of psychosocial risk factors on this association: Black ethnicity groups showed consistent increased prevalence of current and lifetime psychotic-like experiences compared with the reference population across countries.ConclusionsMore generalisable and standardised cohort studies of psychotic-like experiences and schizotypal traits in relation to migration/ethnicity are necessary to examine the effects of exposures and outcomes in different contexts, and to understand the underlying mechanisms of the association between subclinical psychosis and migrant and ethnic minority status.Declaration of interestNone.

Published
2018

25. Does liberalisation of cannabis policy influence levels of use in adolescents and young adults? A systematic review and meta-analysis.

Author

Melchior M, Nakamura A, Bolze C, Hausfater F, El Khoury F, Mary-Krause M, and Azevedo Da Silva M

Subjects
Adolescent, Humans, Young Adult, Cannabis, Criminal Law trends, Drug and Narcotic Control legislation & jurisprudence, Legislation, Drug trends, Public Opinion
Abstract

Objectives: To examine the effect of cannabis policy liberalisation (decriminalisation and legalisation) levels of use in adolescents and young adults., Design: Systematic review and meta-analysis., Inclusion Criteria: Included studies were conducted among individuals younger than 25 years and quantitatively assessing consequences of cannabis policy change. We excluded articles: (A) exclusively based on participants older than 25 years; (B) only reporting changes in perceptions of cannabis use; (C) not including at least two measures of cannabis use; (D) not including quantitative data; and (E) reviews, letters, opinions and policy papers. PubMed, PsycINFO, Embase and Web of Science were searched through 1 March 2018., Data Extraction and Synthesis: Two independent readers reviewed the eligibility of titles and abstracts and read eligible articles, and four authors assessed the risk of bias (Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies). Extracted data were meta-analysed. The protocol was registered with PROSPERO., Results: 3438 records were identified via search terms and four via citation lists; 2312 were retained after removal of duplicates, 99 were assessed for eligibility and 41 were included in our systematic review. 13 articles examined cannabis decriminalisation, 20 examined legalisation for medical purposes and 8 examined legalisation for recreational purposes. Findings regarding the consequences of cannabis decriminalisation or legalisation for medical purposes were too heterogeneous to be meta-analysed. Our systematic review and meta-analysis suggest a small increase in cannabis use among adolescents and young adults following legalisation of cannabis for recreational purposes (standardised mean difference of 0.03, 95% CI -0.01 to -0.07). Nevertheless, studies characterised by a very low/low risk of bias showed no evidence of changes in cannabis use following policy modifications., Conclusions: Cannabis policy liberalisation does not appear to result in significant changes in youths' use, with the possible exception of legalisation for recreational purposes that requires monitoring., Trial Registration Number: CRD42018083950., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2019
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