TY - GEN A1 - Wandschneider, Lisa A1 - Batram-Zantvoort, Stephanie A1 - Alaze, Anita A1 - Niehues, Vera A1 - Spallek, Jacob A1 - Razum, Oliver A1 - Miani, Céline T1 - Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study T2 - Women’s Health N2 - Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April–May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews’ data to further understand the determinants of the women’s mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it. KW - COVID-19 KW - mental health KW - mixed-methods analysis KW - motherhood KW - ccupational status KW - psychosocial determinants KW - well-being Y1 - 2022 UR - https://journals.sagepub.com/doi/10.1177/17455057221114274 U6 - https://doi.org/10.1177/17455057221114274 SN - 1617-8041 VL - 18 SP - 1 EP - 17 ER - TY - GEN A1 - Herr, Raphael A1 - De Bock, Freia A1 - Diehl, Katharina A1 - Wiedemann, Eva A1 - Sterdt, Elena A1 - Blume, Miriam A1 - Hoffmann, Stephanie A1 - Herke, Max A1 - Reuter, Marvin A1 - Iashchenko, Iryna A1 - Schneider, Sven T1 - Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers’ BMI in Germany T2 - BMC Public Health N2 - Background The number of obese children is rising worldwide. Many studies have investigated single determinants of children’s body mass index (BMI), yet studies measuring determinants at different potential levels of influence are sparse. The aim of this study is to investigate the independent role of parental socioeconomic position (SEP), additional family factors at the micro level, as well as early childhood education and care (ECEC) centre characteristics at the meso level regarding BMI. Methods Analyses used the baseline data of the PReschool INtervention Study (PRINS) including up to 1,151 children from 53 ECEC centres. Multi-level models first estimated the associations of parental SEP indicators (parental school education, vocational training, and household income) with the children’s standard deviation scores for BMI (SDS BMI, standardised for age and gender). Second, structural (number of siblings), psychosocial (strained family relationships), and nutrition behavioural (soft-drink consumption, frequency of fast-food restaurant visits) family factors at the micro level were included. Third, characteristics of the ECEC centre at the meso level in terms of average group size, the ratio of overweight children in the group, ECEC centre type (all-day care), and the location of the ECEC centre (rural vs urban) were included. All analyses were stratified by gender and adjusted for age, migration background, and parental employment status. Results Estimates for boys and girls appeared to differ. In the full model, for boys the parental SEP indicators were not related to SDS BMI. Factors related to SDS BMI in boys were: two or more siblings; B = -.55; p = 0.045 [ref.: no sibling]), the characteristics of the ECEC centre in terms of average group size (20 – 25 children; B = -.54; p = 0.022 [ref.: < 20 children]), and the ratio of overweight children (more overweight children B = -1.39; p < 0.001 [ref.: few overweight children]). For girls the number of siblings (two and more siblings; B = .67; p = 0.027 [ref.: no sibling]) and average group size (> 25 children; B = -.52; p = 0.037 [ref.: < 20 children]) were related to SDS BMI. Conclusions The BMI of preschool children appears to be associated with determinants at the micro and meso level, however with some gender differences. The identified factors at the micro and meso level appear largely modifiable and can inform about possible interventions to reduce obesity in preschool children. KW - BMI KW - Obesity KW - Preschool children KW - ECEC centres KW - Kindergarten KW - Meso level KW - Socioeconomic position Y1 - 2022 UR - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13814-5 U6 - https://doi.org/10.1186/s12889-022-13814-5 SN - 1471-2458 VL - 22 SP - 1 EP - 13 ER - TY - GEN A1 - Spallek, Jacob A1 - Kaatsch, Peter A1 - Spix, Claudia A1 - Ulusoy, Nazan A1 - Zeeb, Hajo A1 - Razum, Oliver T1 - Namensbasierte Identifizierung von Fällen mit türkischer Herkunft im Kinderkrebsregister Mainz T2 - Gesundheitswesen Y1 - 2006 U6 - https://doi.org/10.1055/s-2006-927166 SN - 1439-4421 SN - 0941-3790 VL - 68 IS - 10 SP - 643 EP - 649 ER - TY - GEN A1 - Hintermeier, Maren A1 - Gencer, Hande A1 - Kajikhina, Katja A1 - Rohleder, Sven A1 - Santos-Hövener, Claudia A1 - Tallarek, Marie A1 - Spallek, Jacob A1 - Bozorgmehr, Kayvan T1 - SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review T2 - Journal of Migration and Health N2 - The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesise the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12% to 2•08% in non-outbreak settings and from 5•64% to 21•15% in outbreak settings. Migrants showed a lower hospitalisation rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs. KW - migrants KW - forcibly displaced KW - SARS-CoV-2 KW - COVID-19 KW - refugees KW - asylum seekers Y1 - 2021 UR - https://www.sciencedirect.com/science/article/pii/S2666623521000234 U6 - https://doi.org/10.1016/j.jmh.2021.100056 SN - 2666-6235 VL - 4 ER - TY - CHAP A1 - Okken, Petra-Karin A1 - Spallek, Jacob A1 - Razum, Oliver ED - Bauer, Ullrich ED - Büchel, Andreas T1 - Pflege türkischer Migranten T2 - Soziale Ungleichheit und Pflege N2 - Obwohl die Bevölkerungsgruppe mit türkischem Migrationshintergrund in Deutschland zur Zeit noch ein vergleichsweise niedriges Durchschnittsalter aufweist, wächst der Anteil älterer Menschen unter den türkischen Migrantinnen und Migranten. Vor diesem Hintergrund gewinnen Fragen zur Pflegeversorgung dieser Bevölkerungsgruppe stark an Bedeutung, über die bisher in Deutschland kaum wissenschaftlich abgesicherte Erkenntnisse existieren. Das folgende Kapitel beschreibt die besondere Situation von Menschen mit türkischem Migrationshintergrund, die in Deutschland leben, und gibt so erste Einblicke in dieses noch junge aber wichtige Forschungsfeld und stellt einen Einstieg in die weitere Forschung zu diesem Thema dar. KW - Migration KW - Pflege KW - Situation türkischer Migranten Y1 - 2008 SN - 978-3-531-15621-7 SP - 396 EP - 422 PB - VS Verlag für Sozialwissenschaften CY - Wiesbaden ER - TY - CHAP A1 - Spallek, Jacob A1 - Razum, Oliver ED - Kolip, Petra ED - Hurrelmann, Klaus T1 - Migration und Gesundheit aus Geschlechterperspektive T2 - Handbuch Geschlecht und Gesundheit KW - Migration KW - Gesundheit KW - Geschlechterperspektive Y1 - 2016 SN - 978-3-456-85466-3 SP - 125 EP - 133 PB - Hogrefe CY - Bern ER - TY - CHAP A1 - Voigtländer, Sven A1 - Brzoska, Patrick A1 - Spallek, Jacob A1 - Exner, Anne-Kathrin A1 - Razum, Oliver ED - Schott, Thomas ED - Razum, Oliver T1 - Die Inanspruchnahme medizinischer Rehabilitation bei Menschen mit Migrationshintergrund T2 - Migration und medizinische Rehabilitation KW - Medizinische Rehabilitation KW - Migrationshintergrund Y1 - 2013 SN - 978-3-7799-1987-2 SP - 92 EP - 104 PB - Beltz Juventa CY - Weinheim ; Basel ER - TY - CHAP A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Spallek, Jacob A1 - Razum, Oliver ED - Schott, Thomas ED - Razum, Oliver T1 - Reha-Erfolg bei Migrant(inn)en: Herkunftsländer im Vergleich T2 - Migration und medizinische Rehabilitation KW - Reha-Erfolg KW - Migrant(inn)en KW - Herkunftsländer KW - Vergleich Y1 - 2013 SN - 978-3-7799-1987-2 SP - 105 EP - 110 PB - Beltz Juventa CY - Weinheim ; Basel ER - TY - CHAP A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Spallek, Jacob A1 - Razum, Oliver ED - Schott, Thomas ED - Razum, Oliver T1 - Arbeitsunfälle, Berufskrankheiten und Erwerbsminderung bei Menschen mit Migrationshintergrund T2 - Migration und medizinische Rehabilitation KW - Arbeitsunfälle KW - Berufskrankheiten KW - Erwerbsminderung KW - Migrationshintergrund Y1 - 2013 SN - 978-3-7799-1987-2 SP - 49 EP - 61 PB - Beltz Juventa CY - Weinheim ; Basel ER - TY - CHAP A1 - Spallek, Jacob A1 - Razum, Oliver ED - Richter, Matthias ED - Hurrelmann, Klaus T1 - Migration und Gesundheit T2 - Soziologie von Gesundheit und Krankheit N2 - Deutschland ist ein Zuwanderungsland. Hier lebende Menschen mit Migrationshintergrund sollten den gleichen Zugang zu gesundheitsbezogenen Leistungen haben wie die gesamte Bevölkerung. Es bestehen jedoch noch Zugangshindernisse sowie Unterschiede im Nutzungsverhalten und bei den gesundheitlichen Ergebnissen. Diversity Management wird als eine Strategie diskutiert, um unterschiedliche Bedarfe und Bedürfnisse zu berücksichtigen und gesundheitliche Chancengleichheit zu erreichen. KW - Migration KW - Gesundheit Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:1111-20160205276 UR - http://www.springerlink.com/content/978-3-658-11010-9 SN - 978-3-658-11009-3 SP - 153 EP - 166 PB - Springer VS CY - Wiesbaden ER - TY - CHAP A1 - Brause, Michaela A1 - Brzoska, Patrick A1 - Razum, Oliver A1 - Reutin, Barbara A1 - Schott, Thomas A1 - Spallek, Jacob A1 - Voigtländer, Sven A1 - Yilmaz-Aslan, Yüce ED - Schott, Thomas ED - Razum, Oliver T1 - Abschließende Handlungsempfehlungen und Schlussfolgerungen für die Praxis T2 - Migration und medizinische Rehabilitation KW - Handlungsempfehlungen KW - Schlussfolgerungen Y1 - 2013 SN - 978-3-7799-1987-2 SP - 211 EP - 216 PB - Beltz Juventa CY - Weinheim ; Basel ER - TY - CHAP A1 - Spallek, Jacob A1 - Yilmaz-Aslan, Yüce A1 - Spallek, Lena A1 - Gök, Yesim A1 - Razum, Oliver ED - Mehnert, Anja ED - Koch, Uwe T1 - Interkulturelle Aspekte und Migration T2 - Handbuch Psychoonkologie KW - interkulturell KW - Aspekte KW - Migration Y1 - 2016 SN - 978-3-8017-2474-0 SP - 444 EP - 453 PB - Hogrefe CY - Göttingen ER - TY - GEN A1 - Tallarek, Marie A1 - Spallek, Jacob T1 - Factors promoting or limiting self-determined childbirth: midwives’ perspectives in Germany T2 - European Journal of Public Health N2 - Background Claims for self-determined childbirth (SDC) have gained increasing scientific, political and societal attention. However, research on SDC is limited. This study analyzes and compares midwives’ experiences and perspectives on factors that promote or limit SDC in hospitals, birthing centers and during home births in Germany. We argue that these insights are essential in order to foster self-determination and to avoid its violation. Methods A qualitative case study was conducted based on semi-structured face-to-face interviews with midwives working in hospitals, birthing centers, and offering home births in Germany. In total, nine interviews were conducted in 2021 and have been audiotaped, transcribed, anonymized and analyzed by use of Thematic Analysis. Results The results indicate eight inter-related categories, each of which imply promoting and limiting factors: 1) Structural/ legal conditions; 2) Perception of birth (e. g. as natural or medical process; required competence and control); 3) Trust and atmosphere; 4) Getting acquainted/relationship building; 5) Birthing person’s socioeconomic position; 6) Birthing person’s preparation/ education; 7) Birthing person’s capability of decision making and expression; and 8) Behavior of accompanying persons. Moreover, we identified midwives’ strategies to extend possibilities of choice. Several factors clearly differ depending on the birth setting. Conclusions The opportunities for SDC seem to differ according to the setting (e.g. institutional routines), inter-personal relations (e.g. getting acquainted, trust), and individual factors (e.g. socioeconomic position, capabilities). Hence, political, institutional and individual strategies may support SDC in consideration of the above factors. Measures may, among others, include the improvement of information processes, the reduction of economic barriers, relationship building before and during birth as well as respective structural adjustments. KW - self-determined childbirth KW - interview study KW - obstetric care KW - hospitals KW - birthing centers KW - home birth Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac131.423/6765637?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac131.423 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Do regional characteristics predict developmental delay? Analyses of German school entry examination T2 - European Journal of Public Health N2 - Background Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP. Methods The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP. Results Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP. Conclusions In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP. KW - regional characteristics KW - developmental delay KW - school entry examination KW - Germany Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.342/6766047?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.342 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Scholaske, Laura A1 - Entringer, Sonja A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Elevated stress during pregnancy in women of Turkish origin: Results from a prospective cohort study T2 - European Journal of Public Health N2 - Background Ethnic health disparities exist in the context of pregnancy and childbirth, suggesting that women of Turkish origin (i.e., they or their parents born in Turkey) in Germany have higher risks for some adverse maternal health and child developmental outcomes. Stress is believed to be a relevant pathway by which migration may be associated with these risks. In this study, we tested associations of Turkish origin with stress biology and psychological stress experiences during pregnancy. Methods 140 pregnant women (33 of Turkish/26 of other origin) participated in a prospective cohort study that was carried out in Bielefeld and Berlin (Spallek et al., 2020). Inflammatory markers CRP and IL-6 from venous blood samples and diurnal cortisol profiles from salivary cortisol samples were derived and participants completed the Perceived Stress Scale (PSS) and Center for Epidemiologic Studies Depression Scale (CESD) at two study visits during pregnancy (T1: 20-25 weeks of gestation, T2: 30-35 weeks of gestation). Multilevel models were conducted to account for the nested data structure due to repeated measurements. Results Compared to non-migrant women, women of Turkish origin had significantly higher inflammatory levels (b = 0.28, SE = 0.14, p=.052) (Spallek et al., 2021), a blunted cortisol awakening response (b=-0.21, CI=-0.38–0.03, p<.05), a flatter diurnal cortisol slope (b = 0.02, CI = 0.00-0.04, p<.05), and higher PSS (b = 0.46, SE = 0.13, p< .001) and CESD scores (b = 0.29, SE = 0.08, p<.001) during pregnancy after adjusting for socioeconomic factors. Conclusions The results of our study suggest higher stress at the biological and psychological level in pregnant women of Turkish origin. Stress is a risk factor for pregnancy complications and poor birth and child developmental outcomes. To reduce such unequally distributed risks, interventions for stress reduction are needed that are tailored to women of Turkish origin. KW - stress KW - pregnancy KW - Turkish origin KW - prospective cohort study Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.608/6765682?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.608 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Rattay, Petra A1 - Blume, Miriam A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Herr, Raphael A1 - Herke, Max A1 - Reuter, Marvin A1 - Novelli, Anna A1 - Hövener, Claudia T1 - Socioeconomic position and self-rated health among adolescents: the mediating role of the family T2 - European Journal of Public Health N2 - Background Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining adolescents’ health inequalities. The study aimed to explore whether the association between socioeconomic position and self-rated health (SRH) was mediated by familial determinants. Methods Using data from wave 2 of the KiGGS study (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of parents’ education, occupation, income, socioeconomic position index, and adolescents’ subjective social status on SRH into direct effects and indirect effects through familial determinants (family cohesion, parenting styles, parental well-being, stress, obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on SRH was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations of parental education, the socioeconomic position index and subjective social status with SRH were also mediated by familial determinants (family cohesion, parental smoking and obesity). However, a significant direct effect of subjective social status remained. Conclusions The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions, community-based strategies, as well as programs to improve parenting and family functioning. KW - Socioeconomic position KW - self-rated health KW - adolescents KW - family Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.580/6765541?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.580 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Ulrich, Hanna-Sophie A1 - Kohler, Emma A1 - Spallek, Jacob A1 - Richter, Matthias A1 - Clauß, Daniel A1 - Mlinarić, Martin T1 - Explaining psychosocial care among unaccompanied minor refugees: a realist review T2 - European child & adolescent psychiatry N2 - Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations. KW - Migration KW - Psychosocial care KW - Realist review KW - Unaccompanied minor refugees KW - mental health Y1 - 2021 U6 - https://doi.org/10.1007/s00787-021-01762-1 SN - 1435-165X VL - 31(2022) IS - 12 SP - 1857 EP - 1870 ER - TY - GEN A1 - Schmidt, Juliana J. A1 - Schmidt, Guilherme J. A1 - Tolentino, Julio C. A1 - Simoes, Eunice N. A1 - Obongo, Angela A1 - Tolentino, Yolanda A1 - Coelho, Francisco A. A1 - Landesmann, Maria C. P. P. A1 - Fonseca, Lea M. B. A1 - Lacerda, Glenda C. B. A1 - Schmidt, Sergio L. T1 - A serial SPECT-CT study in a celiac disease patient with cerebellar ataxia and psychiatric symptoms T2 - Neurological sciences N2 - Celiac disease (CD) is an immune-mediated systemic disorder triggered by gluten and related prolamins in genetically predisposed individuals. Here, we described a case of a 31-year-old Caucasian woman who exhibited cerebellar and psychiatric dysfunctions. The patient underwent single-photon emission computed tomography (SPECT-CT) before and after a gluten-free diet (GFD). There was an improvement in cerebellar perfusion accompanied by a remission of cerebellar manifestations. The maintenance of the psychiatric manifestations was related to the persistence of the hypoperfusion in the frontal lobes. The patient's psychiatric symptoms did not change after 4 months under a GFD in the hospital. To our knowledge, this is the first case that shows the relationship between improvement in cerebellar perfusion and remission of cerebellar clinical manifestations in a CD patient under a GFD. KW - Celiac disease KW - Cerebellar perfusion KW - Cerebellum KW - SPECT-CT Y1 - 2021 UR - https://pubmed.ncbi.nlm.nih.gov/33230758/ U6 - https://doi.org/10.1007/s10072-020-04908-2 SN - 1590-3478 VL - 42 SP - 1545 EP - 1548 ER - TY - GEN A1 - Tallarek, Marie A1 - Bozorgmehr, Kayvan A1 - Spallek, Jacob T1 - Towards inclusionary and diversity-sensitive public health: the consequences of exclusionary othering in public health using the example of COVID-19 management in German reception centres and asylum camps T2 - BMJ Global Health N2 - The German government’s response to the COVID-19 pandemic has been predominantly considered wellfounded. Still, the practice of mass quarantine in reception centres and asylum camps has been criticised for its discrimination of refugees and asylum seekers. Building on the concept of othering, this article argues that processes of othering are structurally anchored in German asylum regulations and they have further pervaded public health measures against COVID-19. The practice of mass quarantine made the negative consequences of exclusionary othering for public health particularly noticeable. In the light of recent data indicating this measure to be epidemiologically, legally and ethically insufficient, we apply the concept of othering to public health and discuss (1) exclusionary, (2) inclusionary and (3) diversity-sensitive approaches to public health. We finally conclude that a shift of perspective from exclusion to inclusion, from subordination to empowerment and from silencing to participation is urgently required. KW - inclusionary public health KW - exclusionary public health KW - diversity-sensitive public health KW - othering KW - COVID-19 KW - refugees KW - asylum seekers KW - mass quarantine Y1 - 2020 UR - https://gh.bmj.com/content/bmjgh/5/12/e003789.full.pdf U6 - https://doi.org/10.1136/bmjgh-2020-003789 SN - 2059-7908 VL - 5 IS - 12 ER - TY - GEN A1 - Mayer, Alena A1 - Herr, Raphael M. A1 - Klein, Thomas A1 - Wiedemann, Eva A1 - Diehl, Katharina A1 - Hoffmann, Stephanie A1 - Blume, Miriam A1 - Jepsen, Dennis A1 - Sundmacher, Leonie A1 - Andreas, Marike A1 - Schneider, Sven T1 - Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference? T2 - Frontiers in Public Health N2 - Background: Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI. Methods: We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents. Results: Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus. Conclusion: We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity. KW - BMI KW - children KW - meso-level KW - sport KW - early childhood education and care center KW - pre-school KW - health equalities Y1 - 2023 U6 - https://doi.org/10.3389/fpubh.2023.1079871 SN - 2296-2565 VL - Vol. 11 ER - TY - CHAP A1 - Schulz, Karl-Heinz A1 - Eckert, Sandra van ED - Mehnert, Anja ED - Koch, Uwe T1 - Körperliche Aktivität und Tumorerkrankungen T2 - Handbuch Psychoonkologie Y1 - 2016 SN - 978-3-8017-2474-0 SP - 554 EP - 566 PB - Hogrefe Verlag CY - Göttingen ET - 1. Auflage ER - TY - GEN A1 - Entringer, Sonja A1 - Scholaske, Laura A1 - Kurt, Medlin A1 - Duman, Elif Aysimi A1 - Adam, Emma K. A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Diurnal cortisol variation during pregnancy in Turkish origin and non-migrant women in a German birth cohort study T2 - Journal of Psychosomatic Research N2 - Background Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy. Methods 109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy. Results Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants. Discussion A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group. KW - cortisol variation KW - pregnancy KW - Turkish origin KW - birth cohort study KW - Germany Y1 - 2022 UR - https://www.sciencedirect.com/science/article/abs/pii/S0022399922003051 U6 - https://doi.org/10.1016/j.jpsychores.2022.111020 SN - 0022-3999 VL - 162 SP - 1 EP - 10 ER - TY - GEN A1 - Lampert, Thomas A1 - Richter, Matthias A1 - Schreiber, Sven A1 - Spallek, Jacob A1 - Dragano, Nico T1 - Soziale Ungleichheit und Gesundheit. Stand und Perspektiven der sozialepidemiologischen Forschung in Deutschland T2 - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Y1 - 2016 U6 - https://doi.org/10.1007/s00103-015-2275-6 SN - 1436-9990 SN - 1437-1588 VL - 59 IS - 2 SP - 153 EP - 165 ER - TY - GEN A1 - Razum, Oliver A1 - Karrasch, Laura A1 - Spallek, Jacob T1 - Migration : Eine vernachlässigte Dimension gesundheitlicher Ungleichheit? T2 - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Y1 - 2016 U6 - https://doi.org/10.1007/s00103-015-2286-3 SN - 1436-9990 SN - 1437-1588 VL - 59 IS - 2 SP - 259 EP - 265 ER - TY - GEN A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Die Nutzung von Routinedaten in der rehabilitationswissenschaftlichen Versorgungsforschung bei Menschen mit Migrationshintergrund: Möglichkeiten und Grenzen T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1280759 SN - 1439-442 SN - 0941-3790 VL - 74 IS - 6 SP - 371 EP - 378 ER - TY - GEN A1 - Reeske, Anna A1 - Spallek, Jacob T1 - Sozioökonomische Aspekte der Primärprävention von Adipositas bei Kindern und Jugendlichen - Ansatzpunkte vor dem Hintergrund eines lebenslaufbasierten Ansatzes der Adipositasentstehung T2 - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz Y1 - 2011 U6 - https://doi.org/10.1007/s00103-010-1221-x SN - 1436-9990 SN - 1437-1588 VL - 54 IS - 3 SP - 272 EP - 280 ER - TY - GEN A1 - Zeeb, Hajo A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Epidemiologische Perspektiven der Migrationsforschung am Beispiel von Krebserkrankungen T2 - Psychotherapie, Psychosomatik, Medizinische Psychologie Y1 - 2008 U6 - https://doi.org/10.1055/s-2008-1067347 SN - 1439-1058 SN - 0937-2032 VL - 58 IS - 3 SP - 130 EP - 135 ER - TY - GEN A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Gesundheit von Migranten: Defizite im Bereich der Prävention T2 - Medzinische Klinik Y1 - 2007 U6 - https://doi.org/10.1007/s00063-007-1058-8 SN - 2193-6218 SN - 2193-6226 VL - 102 IS - 6 SP - 451 EP - 456 ER - TY - GEN A1 - Reiss, Katharina A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Die Entwicklung des Rauchverhaltens im Kontext der Migration nach Deutschland T2 - Public Health Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0031 SN - 1876-4851 SN - 0944-5587 VL - 23 IS - 2 SP - 85 EP - 87 ER - TY - GEN A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Migration und Geschlecht T2 - Public Heatlth Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0027 SN - 1876-4851 SN - 0944-5587 VL - 23 IS - 2 SP - 73 EP - 75 ER - TY - GEN A1 - Spallek, Jacob A1 - Kuntz, Benjamin A1 - Schott, Thomas T1 - Sozialepidemiologie T2 - Public Health Forum Y1 - 2012 U6 - https://doi.org/10.1016/j.phf.2012.06.015 SN - 1876-4851 SN - 0944-5587 VL - 20 IS - 3 SP - 4 EP - 8 ER - TY - GEN A1 - Spallek, Jacob A1 - Zeeb, Hajo T1 - Gesundheit von Migranten. Erkenntnisse am Beispiel der Zuwanderer in Deutschland T2 - Ärzteblatt Rheinland-Pfalz Y1 - 2009 SN - 0001-9488 VL - 62 IS - 7 SP - 20 ER - TY - GEN A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Migration und Gesundheit T2 - Public Health Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0021 SN - 1876-4851 SN - 0944-5587 VL - 23 IS - 2 SP - 54 EP - 57 ER - TY - GEN A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Gesundheitschancen. Frühzeitige Weichenstellung. [BaBi-Studie] T2 - Deutsches Ärzteblatt Y1 - 2012 VL - 109 IS - 46 ER - TY - GEN A1 - Jahn, Ingeborg A1 - Bolte, Gabriele A1 - Spallek, Jacob T1 - Epidemiologische Fachgesellschaften für „Geschlechtersensible Planung und Durchführung der geplanten Nationalen Kohortenstudie“ Ein wichtiger Schritt für geschlechtersensible Gesundheitsforschung in Deutschland T2 - Gesundheitswesen Y1 - 2010 U6 - https://doi.org/10.1055/s-0030-1261917 VL - 72 IS - 7 SP - 383 EP - 386 ER - TY - CHAP A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Potenziale und Limitationen der Reha-Statistik-Datenbasis für die rehabilitationswissenschaftliche Migrationsforschung T2 - Gesundheit, Migration und Einkommensgleichheit Y1 - 2010 SN - 978-3-00-033860-1 SP - 121 EP - 130 PB - DRV Schriftenband CY - Berlin ER - TY - CHAP A1 - Brzoska, Patrick A1 - Spallek, Jacob A1 - Voigtländer, Sven A1 - Razum, Oliver ED - Biffl, Gudrun ED - Rössl, Lydia T1 - Sozioökonomischer Status, Gesundheit und Gesundheitsversorgung von Menschen mit Migrationshintergrund in Deutschland T2 - Migration & Integration, Band 3 Y1 - 2012 SN - 978-3-99031-011-3 SP - 85 EP - 94 PB - Omninum CY - Bad Vöslau ER - TY - GEN A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Wie gesund sind Migranten? Erkenntnisse und Zusammenhänge am Beispiel der Zuwanderer in Deutschland T2 - Focus Migration : Kurzdossier Y1 - 2009 SN - 1864-5704 IS - 12 SP - 1 EP - 9 ER - TY - CHAP A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Das deutsche Konzept „Staatsangehörigkeit“ T2 - Migrationssensible Studiendesigns zur Repräsentation des Migrationsstatus in der Gesundheitsforschung Y1 - 2006 SN - 978-3-89606-098-3 SN - 3-89606-098-8 SP - 23 EP - 29 PB - Robert Koch Institut CY - Berlin ER - TY - BOOK A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Reutin, Barbara A1 - Yilmaz-Aslan, Yüce A1 - Barz, Irina A1 - Starikow, Klara A1 - Reiss, Katharina A1 - Dröge, Angela A1 - Hinz, Julia A1 - Exner, Anne A1 - Striedelmeyer, Lena A1 - Krupa, Elzbieta A1 - Spallek, Jacob A1 - Berg-Beckhoff, Gabriele A1 - Schott, Thomas A1 - Razum, Oliver T1 - Rehabilitative Versorgung und gesundheitsbedingte Frühberentung von Personen mit Migrationshintergrund in Deutschland : Abschlussbericht Y1 - 2010 PB - Bundesministerium für Arbeit und Soziales CY - Bonn ER - TY - GEN A1 - Spallek, Jacob A1 - Berens, Eva-Maria A1 - Kolip, Petra T1 - Früherkennung – Herausforderung der „Informierten Entscheidung“ im Kontext des Mammografie-Screening-Programms T2 - Geburtshilfe und Frauenheilkunde Y1 - 2016 U6 - https://doi.org/10.1055/s-0042-112118 SN - 1438-8804 VL - 76 IS - 11 SP - 1117 EP - 1120 ER - TY - GEN A1 - Tallarek, Marie A1 - Jost, Annemarie A1 - Spallek, Jacob T1 - How do midwives deal with women’s preferences during childbirth in Germany? An action model T2 - European Journal of Public Health N2 - Background Midwifery care is increasingly discussed in terms of its ability to promote a self-determined childbirth. The degree of self-determination (SD) depends on the extent to which women's preferences are negotiated and implemented. From the perspective of midwives in different obstetric settings in Germany, this study answered the research question: “How do midwives deal with women's preferences during birth?”. Methods 11 semi-structured face-to-face interviews were conducted with active midwives. The sample showed a high variance in terms of obstetric settings (clinics, birth centers, home births), regions, and participants’ characteristics (e. g. experience, age). All interviews were recorded, transcribed, anonymized, and analyzed using the Grounded Theory Methodology (Strauss/Corbin, 1994). Results A model consisting of 7 steps was developed: 1) Interpret the situation; 2) Prioritize relevant parameters; 3) Determine a frame of possibilities; 4) Match the preference(s) to the frame of possibilities; 5) Negotiate preference(s); 6) Continuously monitor contextual/situational changes; 7) Adjust the frame of possibilities. The actions are related to contextual conditions (structural; interpersonal; personal; health situation; course of birth; understanding of birth). The model shows how midwives can promote SD even if prior preferences are discarded or modified at birth. Conclusions The model describes how midwives in Germany deal with women's preferences during birth, which factors they consider decisive in doing so, and how SD may be promoted despite of discarded or modified preferences. Further research should examine the role of relationship building, test the model with regard to its generalizability, and use it to analyze and support person-centered midwifery care. Key messages • The model describes how midwives in different obstetric settings in Germany deal with women’s preferences during birth and, thereby, influence self-determination. • Midwives can promote self-determination also if prior preferences are discarded, modified, or redeveloped at birth. KW - midwifery KW - self-determination KW - preferences KW - birthing centers KW - home birth KW - hospital KW - interview study KW - action model KW - obstetric care KW - self-determined birth Y1 - 2023 UR - https://academic.oup.com/eurpub/article/33/Supplement_2/ckad160.1512/7327229 U6 - https://doi.org/10.1093/eurpub/ckad160.1512 SN - 1788-7119 SN - 1788-4934 N1 - 16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8–11 November 2023 VL - 33 IS - Supplement 2 SP - S. ii603 ER - TY - GEN A1 - Höpker, T. A1 - Lampert, Thomas A1 - Spallek, Jacob T1 - Identifizierung und Charakterisierung von Gesundheitsverhaltenstypen bei 11- bis 17-jährigen Jungen und Mädchen. Eine Clusteranalyse auf Basis der Daten des Kinder- und Jugendgesundheitssurveys (KiGGS) T2 - Gesundheitswesen Y1 - 2014 U6 - https://doi.org/10.1055/s-0034-1372619 SN - 1439-4421 SN - 0941-3790 VL - 76 IS - 7 SP - 453 EP - 461 ER - TY - GEN A1 - Makarova, Nataliya A1 - Reiss, Katharina A1 - Zeeb, Hajo A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Verbesserte Möglichkeiten zur Identifikation von Menschen mit Migrationshintergrund für die Mortalitätsforschung am Beispiel Bremens T2 - Gesundheitswesen Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1321767 SN - 1439-4421 SN - 0941-3790 VL - 75 IS - 6 SP - 360 EP - 365 ER - TY - GEN A1 - Spallek, Jacob A1 - Reeske, Anna A1 - Grosser, Angelique A1 - Schwabe, Wolfgang A1 - Rieger, Michael A1 - Krahn, U. A1 - Razum, Oliver T1 - Pflegebedürftigkeit bei türkischstämmigen und nicht-türkischstämmigen Säuglingen. Eine Analyse der Pflegegutachten des MDK-Westfalen-Lippe von 2004 bis 2008 T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1286276 SN - 1439-4421 SN - 0941-3790 VL - 74 IS - 8-9 SP - 485 EP - 487 ER - TY - GEN A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Kraywinkel, Klaus A1 - Krieg, V. A1 - Schwabe, Wolfgang A1 - Greiner, Wolfgang A1 - Damm, Oliver A1 - Hense, H. W. A1 - Razum, Oliver T1 - Abgleich von Verwaltungsdaten des Medizinischen Dienstes der Krankenversicherung mit Krebsregisterdaten T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1286274 SN - 1439-4421 SN - 0941-3790 VL - 74 IS - 7 SP - e52 EP - e60 ER - TY - GEN A1 - Reiss, Katharina A1 - Makarova, Nataliya A1 - Spallek, Jacob A1 - Zeeb, Hajo A1 - Razum, Oliver T1 - Identifizierung und Rekrutierung von Menschen mit Migrationshintergrund für epidemiologische Studien in Deutschland T2 - Gesundheitswesen Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1321768 SN - 1439-4421 SN - 0941-3790 VL - 75 IS - 6 SP - e49 EP - e58 ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Digital technology use for physical activity promotion: Results of a nationwide survey in Germany T2 - 37th Annual Conference of the European Health Psychology Society N2 - Background. Digital technologies can contribute to healthy behaviour. We aimed to investigate a digital technology use for physical activity (PA) promotion using a nationwide survey. Methods. Our cross-sectional survey was conducted using a panel sample of 1020 adult internet users living in Germany (age: 18-92 years, 47% female). Computer-assisted telephone interviews were conducted using a self-developed questionnaire in November 2022. Survey data were analysed using relative frequencies and bivariate logistic regression. Findings. Among all participants, 626/1020 reported internet use in health context and 278/626 (44%) reported digital technology use for PA promotion. Most of the 278 users for PA promotion reported that such technologies are easy to use (92%) and use them at least once a week (91%). The reasons for using digital technologies were to measure own PA (74%) or to find exercise ideas (57%). Most participants reported using mobile devices (e.g., smartphones, 77%, or activity trackers, 58%) and rated device feedback as helpful (69%). Among sociodemographic factors (age, gender, education, household income), health status and eHealth literacy, younger age was the only significant predictor (OR=.98, 95% CI: .97-.99) of digital technology use for PA promotion. Discussion. Despite their availability, the prevalence of digital technology use for PA promotion is still low among adult internet users in Germany. Such technologies are likely to support PA behaviour change because users rate them as easy to use, their feedback as helpful and use them frequently. Health interventions are necessary to encourage digital technology use for PA promotion among adults in Germany. Y1 - 2023 U6 - https://doi.org/10.13140/RG.2.2.22062.48967 ER - TY - GEN A1 - Müllmann, Saskia A1 - De Santis, Karina Karolina A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Attitudes towards digital technology use in health context according to a nationwide survey in Germany T2 - 37th Annual Conference of the European Health Psychology Society N2 - Background Digitalization has led to a proliferation of digital health technologies and online health information. We aimed to assess the attitudes towards digital technology use in health context using a nationwide survey. Methods A cross-sectional nationwide survey of a panel sample of adult internet users living in Germany was conducted in November 2022. Participants completed computer-assisted telephone interviews using a self-developed, 30-item questionnaire. Survey data were analysed using frequencies and univariate multiple regression analysis. Findings Among 1,020 participants (18-92 years, 56±16 years, 47% female), 62% completed up to tertiary education and 42% reported the household income of up to 3500 Euro/month. The minority of participants reported that they trust health websites when recommended by friends and family (39%), that their social network relies on the internet for health information (35%), that they consider the internet as the immediate source of health information (39%) and that they are interested in digital health technologies (40%). Most participants (71%) reported that they prefer to receive health information in person or on paper. The preference for such sources of health information was associated with lower eHealth literacy (β= -.12, p<.001), worse health status (β= -.08, p=.026) and female gender (β= -.08, p=.033). Discussion The trust in the internet as the source of health information and the interest in digital health technologies were low among internet users in Germany. Interventions should strengthen eHealth literacy to empower adults to find, understand and assess reliable health information on the Internet. Y1 - 2023 U6 - https://doi.org/10.13140/RG.2.2.24579.07200 ER - TY - GEN A1 - Scholaske, Laura A1 - Adam, Emma K. A1 - Spallek, Jacob A1 - Entringer, Sonja T1 - Maternal BMI and inflammation during pregnancy: a bi- or unidirectional association? T2 - Brain, Behavior, and Immunity N2 - Methods: 140 pregnant women participated in a multi-site prospective cohort study in, Germany with two study visits during pregnancy (T1: 24.44 ± 2.34, T2: 32.92 ± 1.72 weeks of gestation). Maternal BMI was derived from body length and current weight and was residualized for gestational week at assessment. Pro-inflammatory markers CRP and IL-6 were analyzed from venous blood samples and combined into a repeatedly measured composite inflammation score. Results: In a path model, T1-BMI significantly predicted T2-inflammation (b=0.53, SE=0.02, p <.001), and T1-inflammation predicted T2-BMI (b=0.46, SE=0.42, p <.001), suggesting a bidirectional relationship between BMI and inflammation. However, further adjustment for pre-pregnancy BMI diminished the association between T1-inflammation and T2-BMI (b=0.004, SE=0.22, p =.922), whereas the relationship between T1-BMI and T2-inflammation remained significant (b=0.20, SE=0.01, p =.004). Thus, adjusting for pre-pregnancy BMI underlined a unidirectional relationship. Conclusions: Based on these results, reducing overweight may be a relevant target for interventions to reduce inflammation and the risk of subsequent adverse outcomes. KW - BMI KW - inflammation KW - pregnancy Y1 - 2022 UR - https://www.sciencedirect.com/science/article/pii/S0889159122002239?via%3Dihub U6 - https://doi.org/10.1016/j.bbi.2022.07.049 VL - 106 SP - 12 PB - Elsevier ER -