-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: Fetal growth is dependent on adequate development of the placenta. Impaired angiogenesis and vasculogenesis in early pregnancy compromises placental and embryonic development. The proteins soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and plasminogen activator inhibitor type 2 (PAI-2), and the B-vitamin folate are determinants of placental development. This study aims to identify associations between these maternal biomarkers and early fetal size. STUDY DESIGN: From a prospective birth cohort study in the Netherlands, 1,491 pregnant women were selected for this study. At a mean gestational age of 12.4 weeks (SD 0.8) maternal venous blood samples were obtained to determine the concentrations of sFlt-1, PlGF, PAI-2 and folate. Early fetal size was assessed with the measurement of the crown-to-rump length (CRL) at a mean of 12.4 weeks GA (SD 0.8). Analyses were performed using multivariable linear regression analyses with the biomarkers (continuous, quintiles) as regressors and CRL as main outcome measure. RESULTS: Linear trend analysis showed positive associations between maternal sFlt-1 (p<0.001), PlGF (p=0.042), PAI-2 (p<0.001) and folate (p=0.039) and CRL. These associations were independent of gestational age, maternal age, height, body mass index, ethnicity, fetal gender, parity, educational level, smoking and folic acid supplement use (folate not adjusted). CONCLUSION: sFlt-1, PlGF, PAI-2 and folate are positively associated with first trimester fetal size.
American journal of obstetrics and gynecology 04/2013; · 3.28 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Suboptimal maternal dietary intake during pregnancy might lead to fetal cardiovascular adaptations and higher blood pressure in the offspring. The aim of the present study was to investigate the associations of maternal first-trimester dietary intake with blood pressure in children at the age of 6 years. We assessed first-trimester maternal daily dietary intake by a FFQ and measured folate, homocysteine and vitamin B12 concentrations in the blood, in a population-based prospective cohort study among 2863 mothers and children. Childhood systolic and diastolic blood pressure was measured using a validated automatic sphygmomanometer. First-trimester maternal daily intake of energy, fat, protein and carbohydrate was not associated with childhood blood pressure. Furthermore, maternal intake of micronutrients was not associated with childhood blood pressure. Also, higher maternal vitamin B12 concentrations were associated with a higher diastolic blood pressure (0·31 mmHg per standard deviation increase in vitamin B12 (95 % CI 0·06, 0·56)). After taking into account multiple testing, none of the associations was statistically significant. Maternal first-trimester folate and homocysteine concentrations were not associated with childhood blood pressure. The results from the present study suggest that maternal Fe intake and vitamin B12 concentrations during the first trimester of pregnancy might affect childhood blood pressure, although the effect estimates were small and were not significant after correction for multiple testing. Further studies are needed to replicate these findings, to elucidate the underlying mechanisms and to assess whether these differences in blood pressure persist in later life.
The British journal of nutrition 03/2013; · 3.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: To describe and identify correlates of objectively measured physical activity and sedentary behavior in 2-year-old toddlers. STUDY DESIGN: A total of 347 children participating in a birth cohort study wore a unaxial ActiGraph accelerometer during 1 weekday and 1 weekend day. Information on potential correlates was assessed by parent-reported questionnaires, delivery reports, and regular visits to child health centers. Univariate and multivariable linear regression analyses were conducted to examine the associations between potential correlates and the following physical activity outcomes: percentage of time spent in sedentary behavior, percentage of time spent in moderate-to-vigorous physical activity, and mean counts per minute. RESULTS: A high percentage of monitored time was spent in sedentary behavior; 85.6% on weekdays and 84.5% on weekend days. Four correlates were significantly associated with at least 1 physical activity outcome in the multivariable regression models: child's sex, child's age, number of siblings, and season of measurement. The associations of gross motor development with moderate-to-vigorous physical activity and mean counts per minute approached significance. Associations of socioeconomic variables and child's body mass index z-score with physical activity outcomes were not significant. CONCLUSION: Two-year-old toddlers spend most of their time in sedentary behavior. No modifiable correlates were identified. Further research on physical activity and associated health benefits among very young children is warranted.
The Journal of pediatrics 03/2013; · 4.02 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND & AIMS: Maternal nutritional factors during pregnancy have been linked to foetal brain development and subsequent offspring behaviour. Less is known about associations between maternal dietary patterns and offspring behaviour. METHODS: Within a population-based cohort, we assessed maternal diet using a food frequency questionnaire. Three dietary patterns were derived by means of Principal Component Analysis. Child internalising (emotionally reactive, anxious/depressed or withdrawn, having somatic complaints) and externalising problems (inattention, aggression) were assessed with the Child Behaviour Checklist at 1.5, 3 and 6 years in 3104 children. We assessed the association of maternal Mediterranean, Traditionally Dutch and Confectionary dietary pattern during pregnancy with child internalising and externalising problems. RESULTS: After adjustment, the Mediterranean diet was negatively associated (ORper SD in Mediterranean score = 0.90, 95% CI: 0.83-0.97) and the Traditionally Dutch diet was positively associated with child externalising problems (ORper SD in Traditionally Dutch score = 1.11, 95% CI: 1.03-1.21). Neither diet was associated with internalising problems. CONCLUSIONS: Both low adherence to the Mediterranean diet and high adherence to the Traditionally Dutch diet during pregnancy are associated with an increased risk of child externalising problems. Further research is needed to unravel the effects of nutrient interplay during and after pregnancy on child behavioural development.
Clinical nutrition (Edinburgh, Scotland) 03/2013; · 3.27 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The objective of this study was to examine the validity of the diagnosis of "febrile seizure" as reported by parents. The study was embedded in a population-based prospective cohort study. Information on paroxysmal events was obtained by screening questions at ages 1, 2, and 3 years. One of these questions was the following: "Did your child have a febrile seizure?" If a screen-positive result was found, an additional questionnaire was sent and the medical record was consulted. Based on this information, paroxysmal events were classified by a pediatric neurologist as febrile seizure or other event. The validity of a positive reply to the screening question on febrile seizures was assessed, taking this classification as reference standard. Analyses were based on participants who reported at least one paroxysmal event (n = 610). The sensitivity of the positive reply to the question, "Did your child have a febrile seizure?", for the diagnosis of febrile seizures was 92%, the specificity 72%, the positive predictive value 41%, and the negative predictive value 98%. In conclusion, the sensitivity of the question, "Did your child have a febrile seizure?", is high. The positive predictive value is only 41%. Although this question may be appropriate as a screening instrument for febrile seizures, a second stage of evaluation is necessary to identify true cases.
Neuropediatrics 03/2013; · 0.94 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Characteristics of the uterine and umbilical artery blood flow patterns are indirect measures of uteroplacental circulation. We examined whether uterine and umbilical artery resistance indices are influenced by maternal demographic and lifestyle characteristics, track from the second trimester to the third, and are associated with the risk of pregnancy complications. This analysis was embedded among 7,660 pregnant women in the Generation R Study (Rotterdam, the Netherlands, 2001-2005). Placental resistance indices were assessed in the second and third trimesters. Information about pregnancy outcomes was obtained from medical records. Maternal characteristics affected second- and third-trimester placental resistance indices. Correlation coefficients for correlation between the second and third trimesters were 0.50 and 0.32 for uterine artery resistance index and umbilical artery pulsatility index, respectively. Higher placental resistance indices in the second and third trimesters and persistence in the highest tertile of uterine artery resistance index from the second trimester to the third were associated with the risks of preeclampsia, preterm birth, and small size for gestational age at birth (all P's < 0.05). Our study shows that placental resistance indices are influenced by maternal demographic and lifestyle characteristics and track moderately from the second trimester to the third. Increased placental resistance indices in the second and third trimesters are associated with increased risks of adverse pregnancy outcomes.
American journal of epidemiology 03/2013; · 5.59 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We studied the associations of maternal prepregnancy body mass index and gestational weight gain with risks of preschool wheezing in offspring and explored the role of growth, infectious and atopic mechanisms.This sub-study of 4,656 children was embedded in a population-based birth cohort. Information about maternal prepregnancy weight, gestational weight gain and wheezing at the ages 1 to 4 was obtained by physical measurements or questionnaires.Among mothers with a history of asthma or atopy, maternal prepregnancy obesity was associated with an overall increased risk of preschool wheezing (OR 1.47 (1.12, 1.95)). Also, each SD increase of gestational weight gain was associated with an increased overall risk of preschool wheezing (OR 1.09 (1.04, 1.14)), independent of prepregnancy body mass index and not different between mothers with and without a history of asthma or atopy. Child's growth, respiratory tract infections or eczema did not alter the results.Mothers with prepregnancy obesity and a history of asthma or atopy, and higher gestational weight gain showed higher risks of wheezing in their offspring. These associations could not be explained by growth, infectious or atopic mechanisms. Further research is needed to identify underlying mechanisms and long term consequences.
European Respiratory Journal 03/2013; · 5.89 Impact Factor
-
Diana L Cousminer,
Diane J Berry,
Nicholas J Timpson,
Wei Ang,
Elisabeth Thiering,
Enda Byrne,
H Rob Taal,
Ville Huikari,
Jonathan P Bradfield,
Marjan Kerkhof, [......],
Joachim Heinrich,
Craig E Pennell,
Olli Raitakari,
Johan G Eriksson,
George Davey Smith,
Elina Hyppönen,
Marjo-Riitta Järvelin,
Mark I McCarthy,
Samuli Ripatti,
Elisabeth Widén
[show abstract]
[hide abstract]
ABSTRACT: The pubertal height growth spurt is a distinctive feature of childhood growth reflecting both the central onset of puberty and local growth factors. While little is known about the underlying genetics, growth variability during puberty correlates with adult risks for hormone-dependent cancer and adverse cardiometabolic health. The only gene so far associated with pubertal height growth, LIN28B, pleiotropically influences childhood growth, puberty, and cancer progression, pointing to shared underlying mechanisms.To discover genetic loci influencing pubertal height and growth and place them in context of overall growth and maturation, we performed genome-wide association (GWA) meta-analyses in up to 18,737 European samples utilizing longitudinally collected height measurements. We found significant associations (P<1.67 x 10-8) at 10 loci, including LIN28B. Five loci associated with pubertal timing, all impacting multiple aspects of growth. In particular, a novel variant correlated with expression of MAPK3, and associated both with increased prepubertal growth and earlier menarche. Another variant near ADCY3-POMC associated with increased BMI, reduced pubertal growth, and earlier puberty.While epidemiological correlations suggest that early puberty marks a pathway from rapid prepubertal growth to reduced final height and adult obesity, our study shows that individual loci associating with pubertal growth have variable longitudinal growth patterns that may differ from epidemiological observations. Overall this study uncovers part of the complex genetic architecture linking pubertal height growth, the timing of puberty, and childhood obesity, and provides new information to pinpoint processes linking these traits.
Human Molecular Genetics 02/2013; · 7.64 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study separately assessed the associations of maternal and paternal psychological distress during pregnancy with early growth in preschool children. The study was based on data from a population-based cohort study involving 5,283 children and their parents (with data collected beginning in early pregnancy) in Rotterdam, the Netherlands, from 2002 to 2006. Information on parental psychological distress (symptoms of depression, anxiety, hostility, and family stress) was obtained by questionnaire in the second trimester of gestation by using the Brief Symptom Inventory and the "general functioning" subscale of the McMaster Family Assessment Device. Child height, weight, and body mass index (weight (kg)/height (m)(2)) were measured repeatedly from age 3 months to age 4 years. We observed no consistent associations between overall maternal psychological symptoms, depression, anxiety, or hostility and child height, weight, or body mass index after adjustment for confounders. All maternal psychological distress scores were positively associated with the risk of overweight in childhood; however, these associations attenuated toward the null and became nonsignificant after adjusting for potential confounders. We did not observe consistent associations between paternal psychological distress and growth in childhood. These results indicate that social, behavioral, or environmental factors that cluster with parental psychological distress may explain the previously suggested associations between maternal psychological distress and early childhood growth and risk of overweight.
American journal of epidemiology 02/2013; · 5.59 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The goal of this study is to clarify the relation between maternal sensitivity and internalizing problems during the preschool period. For this purpose, a longitudinal, bidirectional model was tested in two large prospective, population-based cohorts, the Generation R Study and the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD), including over 1,800 mother-child dyads in total. Maternal sensitivity was repeatedly observed in mother-child interaction tasks and information on child internalizing problems was obtained from maternal reports. Modest but consistent associations between maternal sensitivity and internalizing problems were found in both cohorts, confirming the importance of sensitive parenting for positive development in the preschool years. Pathways from maternal sensitivity to child internalizing problems were consistently observed but child-to-mother pathways were only found in the NICHD SECCYD sample.
Child Psychiatry and Human Development 02/2013; · 1.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Little is known about the relationship between diurnal cortisol secretion patterns and cognitive function early in life. This population-based study examined whether diurnal cortisol rhythms and cognitive functioning in toddlers are related. Within the Generation R Study, parents of 364 infants (median age: 14.2 months) collected saliva samples at five moments during one day. We assessed the diurnal cortisol rhythm by calculating the area under the curve (AUC), the cortisol awakening response (CAR), and the diurnal slope. Verbal cognitive functioning and fine motor development was determined at age 18 months. Nonverbal cognitive functioning was assessed at age 30 months. A more positive CAR was associated with a lower risk of delay in language comprehension (OR per 1-SD CAR: 0.62, 95%CI: 0.40-0.98, p = .04), a lower risk of nonoptimal fine motor development (OR per 1-SD slope: 0.74, 95%CI: 0.57-0.96, p = .03), and a lower risk of delay in nonverbal cognitive development (OR per 1-SD CAR: 0.58, 95%CI: 0.38-0.90, p = .02). Also, children with flatter slopes had a lower risk of delay in nonverbal cognitive development (OR per 1-SD slope: 0.51, 95%CI: 0.34-0.76, p = .001). Higher AUC levels were associated with a higher risk of delay in language production. These results show that variations in diurnal cortisol rhythms are already associated with variations in cognitive functioning at a young age. Infants with a diurnal cortisol pattern indicative of less stress and more cortisol reactivity, that is, lower AUC levels and a more positive CAR, show a lower risk of delay in cognitive functioning as toddlers.
Child Neuropsychology 02/2013; · 1.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Maternal psychological distress during pregnancy might lead to higher fetal cortisol exposure, which subsequently leads to fetal cardiovascular developmental adaptations and cardiovascular dysfunction in later life. AIMS: We examined whether maternal and paternal psychological distress was associated with the cardiovascular outcome measurements in school age children. STUDY DESIGN AND SUBJECTS: In a population-based prospective cohort study among 4831 children, we assessed maternal and paternal psychological distress during pregnancy by questionnaire, using the Brief Symptom Inventory (see Fig. 1). OUTCOME MEASURES: At the child age of six years, we performed blood pressure and carotid-femoral pulse wave velocity measurements, and M-mode measurements of left cardiac structures and fractional shortening. RESULTS: We did not observe associations of high maternal and paternal psychological symptom scores with childhood blood pressure and carotid-femoral pulse wave velocity after adjustment for potential confounders. Maternal overall psychological symptoms were associated with a lower childhood left ventricular mass (difference -1.10g (95% confidence interval -2.13 to -0.07) between mothers with high scores and normal scores), but not with other cardiac structures and fractional shortening. Paternal overall psychological symptoms showed a similar association with childhood left ventricular mass (difference -1.34 grams (95% confidence interval -3.69 to 1.02) between fathers with high scores and normal scores). CONCLUSIONS: Our results do not support the hypothesis that maternal psychological distress affects cardiovascular development in early life. Similar associations of maternal and paternal psychological distress with left ventricular mass suggest that these associations could be due to unmeasured social and environmental factors, rather than direct intra-uterine effects.
Early human development 02/2013; · 2.12 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE:: Children's television viewing has been associated with an increased risk of overweight and obesity. This study aims to assess the associations of ethnic background and acculturation characteristics with television viewing time in 4-year-old preschool children. METHOD:: The authors analyzed data from 3452 preschool children and their parents enrolled in the Generation R Study, a large, multiethnic, prospective birth cohort study in Rotterdam, the Netherlands. Multivariable logistic regression models were used to estimate odds ratios of watching television ≥2 hours/day and ≥1 hour/day for Turkish, Moroccan, and Surinamese children (reference group: native Dutch children), adjusted for family socioeconomic position. Effect modification by family socioeconomic position was also assessed. RESULTS:: After adjustment for family socioeconomic position, Turkish children (adjusted odds ratio [aOR], 2.27; 95% confidence interval [CI], 1.56-3.30), Moroccan children (aOR, 1.68; 95% CI, 1.03-2.76), and Surinamese children (aOR, 3.12; 95% CI, 2.16-4.50) were significantly more likely to watch television ≥2 hours/day compared with native Dutch children. Stratified analyses showed greater disparity between ethnic minority groups and native Dutch children at higher educational levels. There were no significant associations between acculturation characteristics (i.e., generational status, age at immigration, and Dutch language skills) and children's television viewing time. CONCLUSION:: Children from ethnic minority groups are at an increased risk for high levels of television viewing compared with native Dutch children, independent of family socioeconomic position. Interventions aimed to reduce television viewing time should target all children from ethnic minority groups.
Journal of developmental and behavioral pediatrics: JDBP 02/2013; 34(2):63-71. · 2.27 Impact Factor
-
Tonya White,
Hanan El Marroun,
Ilse Nijs,
Marcus Schmidt,
Aad van der Lugt,
Piotr A Wielopolki, Vincent W V Jaddoe,
Albert Hofman,
Gabriel P Krestin,
Henning Tiemeier,
Frank C Verhulst
[show abstract]
[hide abstract]
ABSTRACT: Neuroimaging studies of typically developing children and adolescents have provided valuable information on global and regional developmental trajectories of brain development. As these studies become larger and population-based, they are generating an intersection between the fields of developmental neuroscience and epidemiology. However, few of these studies have adequately probed the contribution of multiple environmental and genetic factors on brain development. Studies designed to optimally evaluate the role of multiple environmental and genetic factors on brain development require both large sample sizes and the prospective collection of multiple environmental factors. The Generation R Study is a large, prospective, prenatal-cohort study of nearly 10,000 children that began in 2002 in Rotterdam, the Netherlands. In September of 2009, 6-8 year old children from the Generation R Study were invited to participate in a magnetic resonance imaging component of the study. We provide an overview of the study design and experience for the first 801 children recruited for the neuroimaging component of the study. The protocol includes a 1-h neuropsychological assessment using the NEPSY-II, a mock scanning session, and a neuroimaging session that includes high-resolution structural, diffusion tensor, and resting-state functional MRI sequences. Image quality has been good to excellent in over 80 % of the children to date. The infusion of imaging into the Generation R Study will set the stage for evaluating the role of multiple environmental and genetic factors in both typical and atypical neurodevelopment.
European Journal of Epidemiology 01/2013; · 4.71 Impact Factor
-
-
Edith H van den Hooven,
Frank H Pierik,
Yvonne de Kluizenaar,
Sten P Willemsen,
Albert Hofman,
Sjoerd W van Ratingen,
Peter Y J Zandveld,
Johan P Mackenbach,
Eric A P Steegers,
Henk M E Miedema, Vincent W V Jaddoe
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND & AIMS: Celiac disease in pregnant women has been associated with poor growth of the fetus, but little is known about how the level of celiac disease affects fetal growth or birth outcomes. We assessed the associations between levels of antibodies against tissue transglutaminase (anti-tTG, a marker of celiac disease disease) and fetal growth and birth outcomes for pregnant women. METHODS: We performed a population-based prospective birth cohort study of 7046 pregnant women. Serum samples were collected during the second trimester of pregnancy and analyzed for levels of anti-tTG. Based on level, women were categorized into 3 groups: negative anti-tTG (≤0.79 U/ml, n=6702), intermediate anti-tTG (0.8 to ≤6 U/ml, n=308), or positive anti-TG (>6 U/ml, n=36). Data on fetal growth and birth outcomes were collected from ultrasound measurements and medical records. RESULTS: Fetuses of women in the positive anti-tTG group weighed 16 g less than those of women in the negative anti-tTG (95% confidence interval [CI], -32 to -1 g) during the second trimester and weighed 74 g less (95% CI, -140 to -8 g) during the third trimester. Infants of women in the intermediate and positive anti-tTG groups weighed 53 g (95% CI, -106 to -1 g) and 159 g (95% CI, -316 to -1 g) less at birth, respectively, than those of women in the negative anti-tTG group. The reduction in birth weight in offspring of mothers in the intermediate anti-tTG group was 2-fold greater among mothers that carried the human leukocyte antigens (HLA)-DQ2 or -DQ8 than among those without HLA-DQ2 or -DQ8. CONCLUSION: Levels of anti-tTGA in pregnant women are inversely associated with fetal growth. Frowth was reduced to the greatest extent in fetuses of women with the highest levels of anti-tTG (>6 U/ml). Birth weight was also reduced in women with intermediate levels of anti-tTG (0.8 to ≤6 U/ml), and further reduced in those with HLAs DQ2 and DQ8.
Gastroenterology 01/2013; · 11.68 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Fetal exposure to parental smoking may lead to developmental adaptations and promote various diseases in later life. This study evaluated the associations of parental smoking during pregnancy with the risk of hypertension in the daughter in adulthood, and assessed whether these associations are explained by birth weight or body weight throughout life. We used data on 33 086 participants of the Nurses' Health Study II and the Nurses' Mothers' Cohort. Cox proportional hazards models were used to examine the associations of maternal and paternal smoking during pregnancy with the nurse daughter, with self-reported physician-diagnosed hypertension from 1989 until 2007. Overall, 8575 (25.9%) mothers and 18 874 (57.0%) fathers smoked during pregnancy. During follow-up, 7825 incident cases of adult-onset hypertension were reported. Both maternal and paternal smoking of ≥15 cigarettes/d during pregnancy were associated with increased risks of hypertension (rate ratio, 1.19; 95% CI, 1.09-1.29; and rate ratio, 1.18; 95% CI, 1.12-1.25, respectively) in the age-adjusted models. Further adjustment for birth weight did not affect the effect estimates appreciably, whereas additional adjustment for body shape and weight until age 18, or current body mass index, attenuated the associations with both maternal and paternal smoking (rate ratio, 1.07; 95% CI, 0.98-1.16; and rate ratio, 1.06; 95% CI, 1.01-1.12, respectively). The associations of parental smoking during pregnancy with the risk of hypertension in the offspring were largely explained by body weight throughout life, suggesting that these associations may not reflect direct intrauterine mechanisms.
Hypertension 12/2012; · 6.21 Impact Factor
-
Anne Tharner,
Bram Dierckx,
Maartje P C M Luijk,
Marinus H van Ijzendoorn,
Marian J Bakermans-Kranenburg,
Joost R van Ginkel,
Henriette A Moll, Vincent W V Jaddoe,
Albert Hofman,
James J Hudziak,
Frank C Verhulst,
Henning Tiemeier
[show abstract]
[hide abstract]
ABSTRACT: We examined associations of disorganized attachment and maternal depressive symptoms with infant autonomic functioning in 450 infant-mother dyads enrolled in the Generation R study. Maternal depressive symptoms were measured 2 months postpartum with the Brief Symptom Inventory. At 14 months, we assessed infant attachment with a slightly shortened Strange Situation and measured infant resting heart rate. Respiratory sinus arrhythmia (RSA) was calculated using spectral analysis. Higher levels of maternal postnatal depressive symptoms predicted lower resting RSA in disorganized infants (B = -0.31, SE = 0.15, p = .04, R(2) = .05) but not in nondisorganized infants (B = 0.05, SE = 0.06, p = .36). This effect was buffered in disorganized infants with a secondary secure attachment classification. Disorganized infants were more vulnerable to the effect of maternal postnatal depressive symptoms on the physiological stress systems.
Psychophysiology 12/2012; · 3.29 Impact Factor
-
