Early Life Environments and Cognitive-Behavioral Outcomes of Children: A Life Course Approach

With ever increasing prevalence of obesity among reproductive aged women, more attention has been paid to prevention of adverse pregnancy and birth outcomes. In addition, the relationships of maternal prepregnancy obesity with the offspring’s future obesity and metabolic syndrome have been well established. However, its effects on the fetal brain are unclear. Obesity-related metabolic alterations may create suboptimal intrauterine environment for rapidly growing brain. Fetal period is a critical period of brain development. Any insult during this period may have lasting effects on cognitive and behavior outcomes. Therefore, it is important to examine the relationship. The current study uses a life course approach to examine the association between maternal prepregnancy obesity and the offspring’s cognitive-behavioral development. A child’s health develops over time as his or her biological systems interact with surrounding environments. It is no longer adequate to examine current health status by only looking at contextual factors in present time. Better understanding of current health conditions requires examination of the child’s past experiences beginning from prenatal period. The first chapter introduces a life course model used throughout this dissertation study. This is followed by a review in chapter 2 of risk factors that are associated with the development of type 2 diabetes during childhood. This chapter ascertains the fact that risk factors for shaping one’s health are present throughout one’s life course and that early life adverse environment may play an important role setting up one’s health trajectory. In the subsequent two chapters, the association between maternal prepregnancy obesity and the offspring’s cognitive and behavioral outcomes are examined using data from the National Longitudinal Survey of Youth. Maternal prepregnancy obesity was associated with reductions in reading and mathematical test scores among term birth children 5 and 6 years old. The association was statistically significant after adjustment for birth weight, maternal prenatal cigarette smoking, home environment, household income, child’s factors, and maternal socioeconomic factors including cognitive trainability. In contrast, no consistent association was present between maternal prepregnancy obesity and children’s behavior problem scores across two racial groups of children, whites and African Americans at ages 8 and 9 years. In both racial groups, the strong influence of postnatal family and social environments on children’s behavior problems was present. Socially disadvantaged characteristics emerged only among white women who were obese prior to pregnancy compared to among those who were non-obese. This study demonstrated usefulness of a life course approach. Results of the first study suggest maternal prepregnancy obesity adversely affect the offspring’s cognitive development through biological pathways. However, inconsistency across the two racial groups in the second study results suggests little evidence for maternal metabolic alterations influencing the offspring’s behavior problems. Replications of the study results are recommended using cohorts with diverse racial/ethnic groups of children. Future research should be directed to examine mechanisms associated with maternal prepregnancy obesity and the offspring’s cognitive development, to test effects of weight reduction before conceptions, and to examine timing and methods to support cognitive stimulation of individuals who are exposed to maternal metabolic alterations.

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

doctoral

Discipline thesis:degree_discipline

Nursing

Grantor dc:publisher

The Ohio State University

Year dc:date

2013

Author dc:creator

• Tanda, Rika

Contributors dc:contributor

• Reagan, Patricia
• Salsberry, Pamela

• Health
• Epidemiology
• Nursing

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=osu1363090981

OAI identifier oai:identifier

oai:etd.ohiolink.edu:osu1363090981