Nearly half (44

Nearly half (44.4%) of the women with MDD/no SRI were obese compared to 26.8% of the SRI and 19.4% of the unexposed groups. with the Bayley Scales of Infant Development, Second Edition, including the psychomotor (Psychomotor Development Index; PDI), cognitive (Mental Development Index; MDI), and behavioral (Behavioral Rating Scale; BRS) components. Study assessments occurred between 2003 and 2009. Results: Neither prenatal exposure to MDD/SRI nor MDD/no SRI significantly impacted overall PDI, MDI, or BRS scores. However, we observed a significant SRI exposure by time conversation for the PDI ((SCID).21 To be included in the MDD/no SRI group, the woman had to have depression that met criteria for MDD. If she had a history of MDD or depressive symptoms but did not meet criteria for MDD at some point during pregnancy, she was LXS196 not included in the MDD/no SRI group. Maternal symptoms were measured at each assessment point using the Structured Interview Guideline for the Hamilton Depressive disorder Rating Scale, Atypical Depressive disorder Symptoms version (SIGH-ADS).22 The Longitudinal Interval Follow-up Evaluation23 was used in conjunction with the SCID to assess for MDD diagnostic status change. Exposures to alcohol or tobacco also were recorded at each assessment, and urine screens for drugs of abuse were obtained for all those subjects at enrollment. Infant Assessments At 12, 26, 52, and 78 weeks of age (corrected for prematurity), infants were evaluated with the BSID-II.24 The BSID-II has both good reliability and concurrent validity for infants from LXS196 1 to 42 months.24 The BSID-II consists of 3 primary scales: the Mental Development Index (MDI), the PDI, and the BRS. The MDI and PDI assess the infants cognitive, language, personal-social, and fine and gross motor development. The BRS assesses the infants behavior during testing. The MDI and PDI scales are age-adjusted and converted to a standardized value (index scores), with a mean of 100 and a standard deviation of 15. The standardized scores Rabbit Polyclonal to Smad1 for the MDI and PDI were outcome variables in our analyses. The BRS total score is converted to a percentile score ranging from 1 LXS196 to 100. Given the mixture of dimensions in the BRS percentage, the 4 factor scales (attention/arousal, orientation/engagement, emotional regulation, and motor quality) were also considered as primary outcomes. Duration of gestation, type of birth, neonatal intensive care unit admission (present or absent), infant sex, birth weight, and length were collected from hospital records by impartial evaluators blind to the study hypotheses and design. Analyses Descriptive statistics for continuous steps are presented as means and standard deviations and for categorical steps as frequencies and proportions. Assessments of association included analysis of variance when continuous steps were normally distributed and Kruskal-Wallis when they were not. Assessments of independence included 2 when expected cell frequencies were of adequate size and Fisher exact otherwise. Probability values for all those post hoc pairwise comparisons were adjusted using the Bonferroni correction. The effect of exposure around the mental and physical indices was tested using repeated-measures mixed models with a random intercept and an unstructured covariance matrix. Percentile scores for the behavioral subscales were dichotomized at 75% because their distributions LXS196 were heavily left skewed. The effect of exposure around the dichotomized subscales was tested using repeated-measures mixed logistic models also with a random intercept and an unstructured covariance matrix. Due to the curvilinear relationship between BSID-II scores and time, a quadratic term (age2) was added to each model. Interactions between exposure and time and exposure and time squared were also added to each model to test for differential exposure effects across the postpartum period. The attention/arousal factor was not modeled by age since this assessment is made only at 12 weeks. An approach to confounder selection, which estimates effect sizes for each potential variable on both exposure and each BSID-II index (MDI, PDI, BRS) and BRS subscale, was used. Potential confounders were maternal age, race, education, current employment, relationship status, prepregnancy body mass index (BMI), parity, LXS196 stress (lifetime), and use of alcohol or tobacco during pregnancy. An a priori rule was to retain a measure as a potential confounder if it had at least a medium effect on both exposure and BSID-II score (ie, Cohen 0.5).25 No potential confounders met these criteria. Therefore, no adjusted models of BSID-II scores were estimated. RESULTS Participants Of 238 mother-infant pairs included at delivery, 166 (70%) provided infant BSID-II data (Physique 1). Compared with mother-infant pairs from the parent study20 whose infants did not complete BSID-II assessments, the mothers whose infants contributed BSID-II examinations were more likely to complete university or postuniversity education (79% vs 21%, respectively, = .026). Open.