Background: Adolescent female depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood. However, the long-term effects of pre-pregnancy depressive symptoms on birth outcomes in adulthood have not been given adequate empirical assessments. Method: In this study, we assessed the relationship between the life time duration of depressive symptoms over a 14-year period and birth outcomes (LBW and PTB) among a sample of 6023 female respondents who took part in the National Longitudinal Study of Adolescent to Adult Health (Add Health). We used the generalized estimating equation (GEE) models to assess these relationships. Results: Exposure to elevated depressive symptoms in late adolescence, but not in adulthood, was associated with increased odds of LBW by more than 2-fold in early and young adulthoods (adjusted odds ratio [aOR] = 2.19; 95% confidence interval, CI: 1.56, 3.08). Depressive symptoms in early adulthood were independently associated with increased odds of PTB and were higher for black mothers. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and LBW or PTB in adulthood. Conclusion: This study provides compelling evidence that effects of elevated depressive symptomatology on LBW or PTB appear to be linked to a specific development period in adolescence. National policies to address social inequalities and stratification particularly in health at all stages of human development, will provide an important step in reducing depressive symptoms prior to early adulthood and in pregnancy and childbirth.

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La prématurité est un problème de santé publique mondial qui affecte aujourd'hui 1 sur 10 enfants chaque année. En France, ce phénomène a régulièrement augmenté, les prématurés représentant 7,3% des nouveaux nés français en 2014, contre 5,9% en 1995. Des recherches scientifiques ont établi que les enfants nés prématurément sont plus susceptibles de rencontrer des difficultés dans le développement langagier ainsi que dans d'autres domaines cognitifs que les enfants nés à terme. Cependant, nos connaissances sur les habilités langagières précoces des enfants prématurés restent actuellement limitées. Le premier objectif de cette thèse était donc de spécifier différentes capacités de perception de la parole pendant les deux premières années, en référence à celles d'enfants nés à terme de même âge postnatal. Son second objectif était d'étudier si le degré de prématurité module les performances langagières des enfants prématurés. Cette thèse est organisée en trois parties expérimentales. La première a exploré la segmentation, c'est-à-dire la capacité à découper la parole en mots, qui est liée à l'acquisition du vocabulaire. Nos résultats ont établi qu'à 6 mois d'âge postnatal, les enfants prématurés ont des capacités de segmentation basiques (segmentation de mots monosyllabiques, Exp. 1), comme les enfants nés à terme de même âge postnatal (6 mois ; Nishibayashi, Goyet, & Nazzi, 2015) et corrigé (4 mois ; Exp. 2). Toutefois, nous avons aussi trouvé des différences avec les nés à terme. Si les enfants prématurés de 6 mois segmentent des syllabes intégrées dans des mots, comme précédemment trouvé pour les enfants nés à terme, l'effet de segmentation à des directions opposées chez les deux populations, suggérant différents mécanismes de traitement (Exp. 3). En outre, à 8 mois d'âge postnatal, nos résultats ne font pas apparaître de biais consonantique dans la reconnaissance des mots segmentés, comme chez les enfants nés à terme (Exp. 4). Néanmoins, des enfants bilingues prématurés et nés à terme qui ont le français comme langue dominante sont capables de segmenter des mots monosyllabiques à l'âge de 6 mois (Exp. 5). La deuxième partie a mesuré le comportement visuel d'enfants prématurés et nés à terme face à un visage parlant dans la langue maternelle (le français) et une langue étrangère (l'anglais). Nos résultats révèlent qu'à 8 mois, les enfants prématurés ont un comportement visuel différent de celui d'enfants nés à terme au même âge postnatal et corrigé. Alors que les enfants nés à terme ont un comportement visuel différent dans les deux langues, ce n'est pas le cas chez les enfants prématurés (Exp. 6). Ces comportements visuels différentiels sont les premiers éléments de caractérisation de la trajectoire développementale de la perception audiovisuelle des enfants prématurés. La troisième partie a porté sur le développement lexical. Nos résultats montrent que les enfants prématurés reconnaissent la forme des mots familiers à 11 mois d'âge postnatal (Exp.7), comme les enfants nés à terme (Hallé & de Boysson-Bardies, 1994). Concernant la production lexicale autour de l'âge de 24 mois postnatal (Exp. 8), nos résultats révèlent que les enfants prématurés ont un vocabulaire réduit par rapport aux enfants nés à terme de même âge postnatal, mais des niveaux similaires à ceux de même âge corrigé. Cependant, un pourcentage élevé des enfants prématurés étaient en dessous du centile 10 selon les normes de la population typique, ce qui pourrait constituer un indice d'identification de risque de délais langagiers. Pris ensemble, nos résultats offrent une vision plus détaillée et nuancée de l'acquisition langagière précoce des enfants nés à terme, et aident à mieux comprendre la contribution relative de l'input environnemental (i.e. exposition à input visuel et auditif non filtré) et la maturation neuronale à cette trajectoire développementale. / Prematurity is currently an important public health problem in the world that affects 1 in 10 babies worldwide every year. In France, preterm birth has steadily increased from 5.9% in 1995 to 7.3% in 2014. Research has demonstrated that prematurely born children are more susceptible to encounter some difficulties in language development and other cognitive domains than children born fullterm. To date, knowledge on early language abilities in preterm infants remains limited. The first goal of this doctoral research was to specify different speech perception abilities in the first two years of life in preterm infants, comparing their abilities to those of fullterm infants of the same postnatal age. The second goal was to investigate whether degree of prematurity modulates linguistic performance across preterm infants. This thesis is organized in three experimental parts. First, we explored word segmentation (the ability to extract word forms) from fluent speech, an ability that is related to lexical acquisition. Our findings showed that basic segmentation abilities are in place in monolingual preterm infants at 6 months of postnatal age (Exp. 1), since they segment monosyllabic words just like their postnatal (Nishibayashi, Goyet, & Nazzi, 2015) and corrected age (4-month-olds; Exp.2) fullterm peers. However, we also found differences with fullterms. While 6-month-old preterms segment embedded syllables as fullterms do (Nishibayashi et al., 2015), the direction of the effect is reversed, suggesting differential processing mechanisms (Exp. 3). Moreover, at 8 months postnatal age, we failed to find evidence for a consonant bias in recognition of segmented word forms (Exp. 4) as found for fullterms of the same age (Nishibayashi & Nazzi, 2016). Nevertheless, French-dominant bilingual populations were found to segment monosyllabic words in French at 6 months, whether being born pre- or full-term (Exp. 5). In the second part, using eye-tracking techniques, we measured preterm and fullterm infants scanning patterns of a talking face in the native (French) and a non-native (English) language. We found that preterm infants at 8 months postnatal age show different looking behavior than their fullterm counterparts matched on postnatal and maturational age. Compared to fullterm infants who showed different scanning pattern of a face speaking in the two languages, preterm infants showed similar scanning patterns for both languages (Exp. 6). These differential gaze patterns provide a first step to characterize the developmental course of audiovisual speech perception in preterm infants. The third part focused on lexical development. Our results show that preterm infants recognize familiar word forms at 11 months postnatal age (Exp. 7), hence at the same postnatal age as fullterm infants (Hallé & de Boysson-Bardies, 1994). With respect to word production at around 24 months of postnatal age (Exp. 8), we found that preterm infants have smaller vocabularies than fullterms of the same postnatal age, but as a group have similar levels as their fullterm, corrected age peers. However, more preterm infants were below the 10th percentile than expected based on (fullterm) norms, which might constitute an index for early identification of (preterm) infants at risk for linguistic delays. Taken together, our results help us build a more detailed and nuanced picture of early language acquisition in preterm infants, and better understand the relative contribution of environmental input (i.e. exposure to unfiltered auditory and visual input after preterm birth) and brain maturation on this developmental trajectory.

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京都大学 / 新制・課程博士 / 博士(医学) / 甲第24488号 / 医博第4930号 / 新制||医||1063(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 花川 隆, 教授 渡邉 大, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Type 2 diabetes (T2D) is increasing in the United States, currently affecting 11.3% of the nation. The Developmental Origins of Health and Disease Hypothesis suggests that environmental stresses in utero and in early stages of life, such as preterm birth (age), can lead to development of adulthood diseases, including T2D. However, research on the association between preterm birth and T2D is sparse and predominantly based on European ancestry populations. We examined this association in postmenopausal women (N = 85,356) from the Women’s Health Initiative, a nationwide prospective cohort. Logistic regression models were used to examine the association between self-reported preterm birth and T2D status, adjusting for demographic and lifestyle covariates. Preterm birth was significantly and positively associated with odds of T2D at baseline (unadjusted: OR=1.51, 95% CI 1.24, 1.83; P

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13514号 / 論医博第2264号 / 新制||医||1061(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 萩原 正敏, 教授 湊谷 謙司, 教授 中島 貴子 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

The present study systematically reviewed and statistically summarized the current body of literature on the relationship between maternal health literacy and maternal sensitivity, and the effect of these two variables on mothers' care and decision making on distal attachment outcomes. In so doing, a systematic review of the extant peer-reviewed, published literature examining the effectiveness of interventions in effort to improve health literacy and maternal sensitivity, with a focus on increasing the quality of mother-preterm infant attachment outcomes, was undergone. This was followed by four multilevel random effects meta-analyses. Results indicated that mothers who participated in health literacy (maternal sensitivity) interventions had, on average, higher attachment quality, in comparison to those who did not participate. Additionally, maternal age was found to be a statistically significant predictor of the overall average effect size. This suggests that maternal health literacy may be a yet unexplored correlate of mother-preterm infant attachment outcomes.

No description available.