Physical punishment in childhood increased odds for CVD, obesity in adulthood.


Children who were punished with pushing or hitting, independent of severe child abuse, may have increased odds for developing adult CVD, arthritis and obesity, according to researchers.

In a recent study conducted by Tracie Afifi, PhD, of the departments of community health sciences, psychiatry and family social sciences at the University of Manitoba in Winnipeg, Canada, potential associations between harsh physical punishment (i.e., pushing, grabbing, shoving, slapping and hitting) independent of severe child maltreatment (i.e., physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and exposure to intimate partner violence) and various health conditions were examined.

 “The findings from the current study are novel and support the hypothesis that harsh physical punishment in the absence of child maltreatment is associated with higher odds of several adult physical health conditions,” researchers wrote.

They extracted 2004 and 2005 data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,226) which represented US adults aged 20 years or older.

According to data, harsh physical punishment was associated with greater probability of developing CVD with borderline significance, arthritis andobesity. These associations were consistent after adjustments for sociodemographic variables, family history of dysfunction and Axis I and II mental disorders, with odds ratios ranging from 1.20 to 1.30.

“Child maltreatment compared with no harsh physical punishment or child maltreatment was associated with high odds of all physical health outcomes,” researchers wrote. “Notably, when harsh physical punishment and child maltreatment categories were compared, no statistically significant differences were found for any of the eight physical conditions.”

According to researchers, these findings are consistent with the current literature. Afifi and colleagues recommend positive parenting approaches and nonphysical disciplinary methods to promote healthy child development.

 

Source: Endocrine Today

Ondansetron in pregnancy and risk of adverse fetal outcomes.


Ondansetron is frequently used to treat nausea and vomiting during pregnancy, but the safety of this drug for the fetus has not been well studied.

METHODS: We investigated the risk of adverse fetal outcomes associated with ondansetron administered during pregnancy. From a historical cohort of 608,385 pregnancies in Denmark, women who were exposed to ondansetron and those who were not exposed were included, in a 1:4 ratio, in propensity-score-matched analyses of spontaneous abortion (1849 exposed women vs. 7396 unexposed women), stillbirth (1915 vs. 7660), any major birth defect (1233 vs. 4932), preterm delivery (1792 vs. 7168), and birth of infants at low birth weight and small for gestational age (1784 vs. 7136). In addition, estimates were adjusted for hospitalization for nausea and vomiting during pregnancy (as a proxy for severity) and the use of other antiemetics.
RESULTS: Receipt of ondansetron was not associated with a significantly increased risk of spontaneous abortion, which occurred in 1.1% of exposed women and 3.7% of unexposed women during gestational weeks 7 to 12 (hazard ratio, 0.49; 95% confidence interval [CI], 0.27 to 0.91) and in 1.0% and 2.1%, respectively, during weeks 13 to 22 (hazard ratio, 0.60; 95% CI, 0.29 to 1.21). Ondansetron also conferred no significantly increased risk of stillbirth (0.3% for exposed women and 0.4% for unexposed women; hazard ratio, 0.42; 95% CI, 0.10 to 1.73), any major birth defect (2.9% and 2.9%, respectively; prevalence odds ratio, 1.12; 95% CI, 0.69 to 1.82), preterm delivery (6.2% and 5.2%; prevalence odds ratio, 0.90; 95% CI, 0.66 to 1.25), delivery of a low-birth-weight infant (4.1% and 3.7%; prevalence odds ratio, 0.76; 95% CI, 0.51 to 1.13), or delivery of a small-for-gestational-age infant (10.4% and 9.2%; prevalence odds ratio, 1.13; 95% CI, 0.89 to 1.44).
CONCLUSIONS: Ondansetron taken during pregnancy was not associated with a significantly increased risk of adverse fetal outcomes.

Source: NEJM