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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2009;163(10):878.
Pregnancy Outcomes in Female Childhood and Adolescent Cancer Survivors: A Linked Cancer-Birth Registry Analysis
One concern of female childhood and adolescent cancer survivors is the possibility of adverse outcomes among their offspring. Using data from 4 US regions, Mueller and colleagues conducted a population-based study to compare the occurrence of infancy outcomes among offspring of female cancer survivors with a comparison group identified from birth records. The proportion of childhood cancer patients identified with live births ranged from 13% to 17% across the 4 regions, with an overall mean time from diagnosis to delivery of 8.5 years. Infants of childhood cancer survivors were more likely to be born preterm and to weigh less than 2500 g. There was no increased risk of birth malformations or infant death.
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Selective Serotonin Reuptake Inhibitor Exposure In Utero and Pregnancy Outcomes
This study sought to investigate the association between selective serotonin reuptake inhibitor (SSRI) intake, a history of psychiatric disease, and pregnancy outcomes in a Danish cohort of 57 001 pregnancies. There was no association of SSRI exposure during pregnancy with birth weight or head circumference. However, infants exposed to SSRIs were more likely to have a 5-minute Apgar score of less than 8 and were more likely to be admitted to the neonatal intensive care unit. The results corroborate earlier studies with less control for the potential effects of the underlying disease. However, treatment of depression during pregnancy may be warranted and future studies need to distinguish between individual SSRIs to find the safest medication.
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A Longitudinal Study of Maternal Depression and Child Maltreatment in a National Sample of Families Investigated by Child Protective Services
Maternal depression is common and it is associated with a 2- to 3-fold increased risk of perpetrating physical child abuse, psychological aggression, and medical neglect. This study used longitudinal data collected from a nationally representative sample of more than 2000 families investigated for maltreatment to examine whether change in depression status predicts change in maltreatment. More than one-third of mothers experienced the onset or remission of depression during the 3-year follow-up. Change in a mother's depression status was associated with a change in the number of psychologically aggressive acts toward her child, but it was not associated with a change in physical assault or neglect. These findings suggest that reducing maternal depression may reduce children's exposure to psychological aggression. Effective programs to treat maternal depression must be developed and implemented.
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Characteristics and Concordance of Autism Spectrum Disorders Among 277 Twin Pairs
While only 10% of autism spectrum disorder (ASD) cases can be directly attributed to an underlying medical condition, the etiologies of idiopathic autism are likely a combination of genetic and environmental contributions. This study examined 277 twin pairs in which at least 1 twin was affected by ASD. Concordance for ASD was significantly higher among monozygotic than dizygotic twins (88.1% vs 30.5%). Autism syndrome and pervasive developmental delay may be inherited differently, since concordant monozygotic twins were much less likely to have the same severity of ASD. This cross-sectional study represents the largest collection of twins with at least 1 ASD-affected sibling, culled from a US online autism registry.
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Lag in autism spectrum disorder (ASD) diagnosis among concordant twin pairs, dizygotic (DZ) (n = 32) vs monozygotic (MZ) (n = 29).
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