Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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Author: search.filters.author.Eisner, M.Has files: Yes

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    Associations between ADHD symptoms and maternal and birth outcomes: An exploratory analysis in a multi-country cohort of expectant mothers
    (SAGE Publications, 2022) Murray, A.L.; Taut, D; Baban, A.; Hemady, C.L.; Walker, S.; Osafo, J.; Sikander, S.; Tomlinson, M.; Toit, S.D.; Marlow, M.; Ward, C.L.; Fernando, A.; Madrid, B.; Van, T.V.; Tuyen, H.D.; Dunne, M.; Hughes, C.; Fearon, P.; Valdebenito, S.; Eisner, M.
    OBJECTIVE: ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. METHOD: We used data (n = 1,204) from a longitudinal birth cohort study spanning eight countries to address this gap. RESULTS: ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b = -0.16, p = .031), friends (b = -0.16, p = .024), and significant others (b = -0.09, p = .001); higher stress (b = 0.34, p < .001) and depressive symptoms (b = 0.31, p < .001), and increased likelihood of an unwanted pregnancy (b = 0.30, p = .009). Significant associations with tobacco use (b = 0.36, p = .023) and premature birth (b = 0.35, p = .007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. CONCLUSION: Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.
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    Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: a latent class analysis
    (BioMed Central,London, 2022) Hemady, C.L.; Speyer, L.G.; Murray, A.L.; Brown, R.H.; Meinck, F.; Fry, D.; Do, H.; Sikander, S.; Madrid, B.; Fernando, A.; Walker, S.; Dunne, M.; Foley, S.; Hughes, C.; Osafo, J.; Baban, A.; Taut, D.; Ward, C.L.; Thang, V.V.; Fearon, P.; Tomlinson, M.; Valdebenito, S.; Eisner, M.
    Background: This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). Methods: A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. Results: Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes.Conclusion: Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.
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    Correction to: Prenatal attachment: Using measurement invariance to test the validity of comparisons across eight culturally diverse countries
    (Springer, 2021) Foley, S.; Hughes, C.; Murray, A.L.; Baban, A.; Fernando, A.D.; Madrid, B.; Osafo, J.; Sikander, S.; Abbasi, F.; Walker, S.; Van, T.V.; Luong-Thanh, B.Y.; Tomlinson, M.; Fearon, P.; Ward, C.L.; Valdebenito, S.; Eisner, M.
    [This corrects the article Archives of Women's Mental Health.2021; 24(4): 619-625] Erratum for Prenatal attachment: using measurement invariance to test the validity of comparisons across eight culturally diverse countries
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    Prenatal attachment: using measurement invariance to test the validity of comparisons across eight culturally diverse countries
    (Springer, 2021) Foley, S.; Hughes, C.; Murray, A.L.; Baban, A.; Fernando, A.D.; Madrid, B.; Osafo, J.; Sikander, S.; Abbasi, F.; Walker, S.; Luong-Thanh, B.Y.; Bảo, Y.L.T.; Tomlinson, M.; Fearon, P.; Ward, C.L.; Valdebenito, S.; Eisner, M.
    ABSTRACT: Studies in high-income countries (HICs) have shown that variability in maternal-fetal attachment (MFA) predict important maternal health and child outcomes. However, the validity of MFA ratings in low- and middle-income countries (LMICs) remains unknown. Addressing this gap, we assessed measurement invariance to test the conceptual equivalence of the Prenatal Attachment Inventory (PAI: Muller, 1993) across eight LMICs. Our aim was to determine whether the PAI yields similar information from pregnant women across different cultural contexts. We administered the 18-item PAI to 1181 mothers in the third trimester (Mean age = 28.27 years old, SD = 5.81 years, range = 18-48 years) expecting their first infant (n = 359) or a later-born infant (n = 820) as part of a prospective birth cohort study involving eight middle-income countries: Ghana, Jamaica, Pakistan, Philippines, Romania, South Africa, Sri Lanka and Vietnam. We used Multiple Group Confirmatory Factor Analyses to assess across-site measurement invariance. A single latent factor with partial measurement invariance was found across all sites except Pakistan. Group comparisons showed that mean levels of MFA were lowest for expectant mothers in Vietnam and highest for expectant mothers in Sri Lanka. MFA was higher in first-time mothers than in mothers expecting a later-born child. The PAI yields similar information about MFA across culturally distinct middle-income countries. These findings strengthen confidence in the use of the tool across different settings; future studies should explore the use of the PAI as a screen for maternal behaviour that place children at risk. KEYWORDS: Cross-cultural; Lower-middle income; Maternal-fetal attachment; Measurement invariance; Parity; Pregnancy.
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    Evidence for Better Lives Study: a comparative birth-cohort study on child exposure to violence and other adversities in eight low- and middle-income countries - foundational research (study protocol)
    (BMJ Publishing Group Ltd, 2020) Valdebenito, S.; Murray, A.; Hughes, C.; Băban, A.; Fernando, A.D.; Madrid, B.J.; Ward, C.; Osafo, J.; Dunne, M.; Sikander, S.; Walker, S.P.; Thang, V.V.; Tomlinson, M.; Fearon, P.; Shenderovich, Y.; Marlow, M.; Chathurika, D.; Taut, D.; Eisner, M.
    Introduction: Violence against children is a health, human rights and social problem affecting approximately half of the world's children. Its effects begin at prenatal stages with long-lasting impacts on later health and well-being. The Evidence for Better Lives Study (EBLS) aims to produce high-quality longitudinal data from cities in eight low- and middle-income countries-Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam-to support effective intervention to reduce violence against children. EBLS-Foundational Research (EBLS-FR) tests critical aspects of the planned EBLS, including participant recruitment and retention, data collection and analysis. Alongside epidemiological estimates of levels and predictors of exposure to violence and adversity during pregnancy, we plan to explore mechanisms that may link exposure to violence to mothers' biological stress markers and subjective well-being. Methods and analyses: EBLS-FR is a short longitudinal study with a sample of 1200 pregnant women. Data are collected during the last trimester of pregnancy and 2 to 6 months after birth. The questionnaire for participating women has been translated into nine languages. Measures obtained from mothers will include, among others, mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence, substance use and social/community support. Hair and dry blood spot samples are collected from the pregnant women to measure stress markers. To explore research participation among fathers, EBLS-FR is recruiting 300 fathers in the Philippines and Sri Lanka. Ethics and dissemination: The study received ethical approvals at all recruiting sites and universities in the project. Results will be disseminated through journal publications, conferences and seminar presentations involving local communities, health services and other stakeholders. Findings from this work will help to adjust the subsequent stages of the EBLS project. Keywords: Child protection; Community child health; EPIDEMIOLOGY; MENTAL HEALTH; Prenatal diagnosis.
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