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Background: Autism spectrum disorder (ASD) evolves from an interplay between genetic and environmental factors during prenatal development. Since identifying maternal biomarkers associated with ASD risk in offspring during early pregnancy might result in new strategies for intervention, we investigated maternal metabolic biomarkers in relation to occurrence of ASD in offspring using both univariate logistic regression and multivariate network analysis.

Methods: Serum samples from 100 women with an offspring diagnosed with ASD and 100 matched control women with typically developing offspring were collected at week 14 of pregnancy. Concentrations of 62 metabolic biomarkers were determined, including amino acids, vitamins (A, B, D, E, and K), and biomarkers related to folate (vitamin B9) metabolism, lifestyle factors, as well as C-reactive protein (CRP), the kynurenine-tryptophan ratio (KTR), and neopterin as markers of inflammation and immune activation.

Results: We found weak evidence for a positive association between higher maternal serum concentrations of folate and increased occurrence of ASD (OR per 1 SD increase: 1.70, 95% CI 1.22–2.37, FDR adjusted P = 0.07). Multivariate network analysis confirmed expected internal biochemical relations between the biomarkers. Neither inflammation markers nor vitamin D3 levels, all hypothesized to be involved in ASD etiology, displayed associations with ASD occurrence in the offspring.

Conclusions: Our findings suggest that high maternal serum folate status during early pregnancy may be associated with the occurrence of ASD in offspring. No inference about physiological mechanisms behind this observation can be made at the present time because blood folate levels may have complex relations with nutritional intake, the cellular folate status and status of other B-vitamins. Therefore, further investigations, which may clarify the potential role and mechanisms of maternal blood folate status in ASD risk and the interplay with other potential risk factors, in larger materials are warranted.

Aim: Few studies have examined the parents of moderately preterm children. The aim of this study was to investigate the experiences of parents of both extremely and moderately preterm children. 

Methods: Qualitative telephone interviews were conducted in 2013-2014 with 13 mothers and 10 fathers of extremely preterm children and with 11 mothers and seven fathers of moderately preterm children. The children were born between 2000 and 2003. Data were analysed with a narrative approach. 

Results: Parents of extremely preterm children recounted dramatic birth stories that, for most, ended positively. Parents of moderately preterm children presented more neutral birth stories, and most recounted that their children did not receive attention for prematurity from medical staff. Parents from both groups described staff mem-bers’ treatment in terms of long-lasting impressions, and they were deeply affected by the hospital environment and the other parents and children admitted. Parents whose children died or were disabled recounted dramatic stories and endless fights for support. 

Conclusion: Parents from both groups reported long-lasting impressions of the medi-cal staff and the hospital environment, which they found important to talk about, even a decade after the birth of their child/children.

Background: Previous studies suggest an overall increase of adolescent mental health symptoms globally since the 1980s until today, especially an increase of internalizing symptoms in girls. Due to methodological limitations of these studies, further studies are warranted to obtain a more solid knowledgebase.

Methods: This study was cross-sectional and compared two separate but geographically identical groups of adolescents in a middle-sized industrial municipality in Northern Sweden at two time-points [(i) 1981, n = 1083, (505 girls, 577 boys), response rate 99.7%; (ii) 2014, n = 682, (338 girls, 344 boys), response rate 98.3%]. All students in their last year of compulsory school were included. The same self-report questionnaire, consisting of four sub-scales (functional somatic-, anxiety-, depressive symptoms and conduct problems), was used at both occasions. Data were analyzed with descriptive statistics, two-way ANOVA and general linear model.

Results: Symptoms of anxiety and depression and functional somatic symptoms, increased among both boys and girls from 1981 until 2014 (P < 0.001 for all subscales), and the increase of these symptoms was higher in girls. Conduct problems were significantly higher in boys in 1981 and decreased over time so that in 2014 there was no longer a significant difference between boys and girls regarding conduct problems (P = 0.286).

Conclusion: In this population-based study spanning over 30 years, both girls and boys showed increasing internalizing problems, while conduct problems decreased. To halt this trend, we need a deeper understanding of the impact of the major societal changes that have occurred during the last three decades.

Aims and objectives: To explore how parents of preterm infants express the constructive aspects of their experiences. Using the notion of post‐traumatic growth as a back‐drop, this study supplements the research on parents' difficulties by providing a more nuanced understanding of what it is like to have a preterm child.

Background: Researchers have reported that parents feel afraid, worried, helpless, powerless, guilty and stressed, as well as that preterm birth can be associated with physical and psychological ill health among parents; however, a few researchers have found indications of post‐traumatic growth among parents.

Design: This study includes qualitative interviews and relates to COREQ guidelines for reporting qualitative research.

Methods: A total of 13 mothers and 10 fathers of extremely preterm children, as well as 11 mothers and 7 fathers of moderately preterm children, were interviewed. The data analysis was based on thematic analysis.

Results: The analysis resulted in six themes that describe various constructive aspects of having a preterm child: acceptance of the fact that events do not always occur as planned; gratitude and reconsideration of the situation; reappraisal of close relationships; reliance on one's own ability to deal with events; thankfulness for what one has; and openness to being exposed to various kinds of people and their experiences.

Conclusions: The parents recounted constructive aspects of their experiences such as an altered understanding of themselves, others and life itself. These themes provide a more nuanced way of understanding how parents can relate to having preterm children.

Relevance to clinical practice: This knowledge can help professionals to enable parents to activate their social network and to acknowledge their care for each other, as well as to help parents see beyond cultural ideals regarding childbirth and family life and to find their own solutions to everyday life.

Background Low-birth-weight infants (LBW) are at an increased risk of iron deficiency that has been associated with impaired neurodevelopment. We hypothesized that iron supplementation of LBW infants improves cognitive scores and reduces behavioral problems until school age.

Methods We randomized 285 marginally LBW (2,000-2,500 g) infants to receive 0, 1, or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age. At 7 years of age, 205 participants were assessed regarding cognition using Wechsler Intelligence Scale for Children (WISC-IV) and behavior using the parental questionnaires Child Behavior Checklist (CBCL) and Five to Fifteen (FTF).

Results There were no significant differences between the intervention groups in WISC-IV or FTF. However, the CBCL scores for externalizing problems were significantly different, in favor of supplemented children (P=0.045). When combining the supplemented groups, they had significantly lower scores for externalizing behavior compared with placebo (median (interquartile range): 44 [34;51] vs. 48.5 [41;56] P=0.013), and their risk ratio (95% confidence interval) for a total behavioral score above the cutoff for clinical problems was 0.31 (0.09-1.0), P=0.054.

Conclusion Lower scores of externalizing behavior in supplemented children support our previous findings at 3 years, and suggest that iron supplementation may have long-lasting effects on behavioral functions.

This is a descriptive case study of a 6-years old girl diagnosed with ADHD, whose family received the playful attachment-based intervention – Theraplay. Before therapy the parents felt exhausted, they could not regulate the girl, who developed symptoms of relational trauma. The article includes a theoretical background based on attachment- and polyvagal theory. Assessment before and after treatment are included and there is a description of the parents and the psychotherapists’ experiences during treatment based on interviews in the final phase of the therapy. The results were analysed theoretically and showed how the child’s relational trauma behaviour decreased and how the attachment behaviour improved. Through feelings of safety, physio-emotional meetings, social engagement, guidance and playfulness the stress levels of the mother were reduced and the parents mentalizing ability became stronger. The study shows the importance of working therapeutically with parents, to give parents and child new emotional experiences of being together and to help parents to develop a deeper understanding of their child. Theraplay has previously been successful in treating internalized problems but this case illustrates that attachment-based therapeutic work can be successful in treating children with ADHD.

BACKGROUND: This study examined mental health outcomes in extremely preterm children (EPT) born at 23 to 25 weeks of gestation between 1992 and 1998 at 2 Swedish tertiary care centers that offered regional and active perinatal care to all live-born EPT infants. METHODS; We assessed 132 (98%) of the 134 EPT survivors at 10 to 15 years of age alongside term-born controls. Behavioral and emotional problems were evaluated by using Achenbach's Child Behavior Checklist and Teacher Report Form and Conners' Parent and Teacher scales for attention-deficit/hyperactivity disorder. RESULTS: Parents and teachers reported significantly more problems with internalizing behaviors as well as attention, social, and thought problems in EPT children than in controls, even when those with major neurodevelopmental disabilities (NDDs) were excluded. Multivariate analysis of covariance of the behavioral problems reported by parents and teachers revealed no interactions, hut significant main effects emerged for group status (EPT versus control) and sex, with all effect sizes being medium to large and accounting for 8% to 14% of the variance. Compared with the controls, EPT children without NDDs had significantly increased rates of >= 90th percentile for total Conners' attention-deficit/hyperactivity disorder problem scores (parents: 40% vs 15%, odds ratio: 3.7, P <.001) (teachers: 24% vs 9%, odds ratio: 3.3, P =.005). The corresponding rates were higher in the total population. CONCLUSIONS: EPT children with or without NDDs had behavioral problems characterized by a higher risk for anxiety and attention, social, and thought problems. These findings further strengthen the proposition that a preterm behavioral phenotype is recognizable in adolescents born EPT.

OBJECTIVE: We examined chronic conditions, functional limitations, and special health care needs in extremely preterm children (EPT; 23-25 weeks' gestation) born between 1992 and 1998 at 2 Swedish tertiary care centers that offered regional and active perinatal care to all live-born EPT infants. METHODS: Of 134 surviving EPT children, 132 (98%) were assessed at 10 to 15 years of age alongside 103 term-born controls. Identification of children with functional limitations and special health care needs was based on a questionnaire administered to parents. Categorization of medical diagnoses and developmental disabilities was based on child examinations, medical record reviews, and parent questionnaires. RESULTS: In logistic regression analyses adjusting for social risk factors and sex, the EPT children had significantly more chronic conditions than the term-born controls, including functional limitations (64% vs 6%; odds ratio [OR], 15; 95% confidence interval [CI], 6.1-37.2; P < .001), compensatory dependency needs (60% vs 29%; OR, 3.8; 95% CI, 2.2-6.6; P < .001), and services above those routinely required by children (64% vs 25%; OR, 5.4; 95% CI, 3.0-9.6; P < .001). Specific diagnoses and disabilities for the EPT group versus controls included cerebral palsy (9.1% vs 0%; P < .001), asthma (21.2% vs 6.8%; P = 001), IQ < -2 SD (31.1% vs 4.9%; P < .001), poor motor skills without neurosensory impairment (21.9% vs 1.9%; P < .001), and psychiatric conditions (15.2% vs 1.9%; P < .001). CONCLUSIONS: Adolescents born EPT have considerable long-term health and educational needs. Few had severe impairments that curtailed major activities of daily life.

INTRODUCTION: This longitudinal case-controlled study examined the effects of universal parent-focused interventions on parents’ perceived competence in terms of parental efficacy and satisfaction.

METHOD: The study sample consisted of parents from northern Sweden in the general population who participated in parent training programmes from 2010 to 2013, and a matched-comparison group. All parents had children aged 0–17. Sense of competence was measured by the Parenting Sense of Competence Scale at pre- and post-intervention and six months after the intervention.

RESULTS: The intervention group showed a statistically significant improvement in parental competence compared to the comparison group over time. The intervention itself had a significant effect on parental satisfaction, but the efficacy effect was not sustained when taking into account potential confounders.

CONCLUSIONS: Earlier studies indicate that parent training programmes enhance perceived parental competence amongst referred parents. The present study shows that parent training programmes applied in the general population may also enhance perceived parental satisfaction, suggesting that parent training programmes can be an important preventive strategy to enhance parental feelings of satisfaction in the wider population. The results suggest that parents who participate in parent training programmes might have a need to increase parental competence, based on lower scores than the comparison group, both before and after the intervention.