Deborah Kurz

Background/Objectives: Although approximately 160 human milk oligosaccharides (HMOs) have been identified, current studies on HMO quantitation are limited to the 10–19 most abundant HMOs. We assessed the variations in the relative concentrations of 71 HMO structures over lactation in human milk samples by an advanced liquid chromatography–mass spectrometry approach. Methods: Samples were collected from 64 mothers at 6 weeks, 6 months, and 12 months of lactation in the Ulm SPATZ Health Study, a German birth cohort. In this longitudinal study, we fitted linear mixed-effect models to analyze changes in the log2-transformed and standardized HMO concentration over time. Based on the profile of 71 HMOs, we also fitted a group-based multi-trajectory (GBMT) model to cluster mothers secreting cluster type I milk, who account for the majority of lactating mothers. Results: We found that 52 HMOs had a decreasing trend (regression coefficients ranging from −1.41 to −0.17) and 9 had an increasing trend (regression coefficients ranging from 0.25 to 0.64) during lactation, and the findings were statistically significant after multiple testing corrections. Using human milk samples of 49 mothers with type I milk, we further identified two novel sub-clusters with distinct longitudinal trajectories of concentrations of 71 HMOs during lactation: Type I-a (N = 20) and I-b (N = 29). These sub-clusters were not associated with maternal non-genetic characteristics. Conclusions: Our findings extend existing knowledge about the structural diversity of HMOs and their variations over lactation. These may pave the way to investigate the potential nutritional benefits of various HMOs on infant health and early life development in the future.

Background: The evidence on maternal employment after childbirth and subsequent child mental health is controversial, and maternal employment is often assessed at only one point in time. Methods: In this prospective birth cohort study analyzing 536 families, we estimated trajectory classes of maternal employment 0-36 months postpartum. We used multivariable linear regression models to examine possible associations between (1) trajectory classes and (2) maternal employment status at 12 months postpartum with child mental health at 4, 5, and 6 years of age. Results: We identified five different trajectory classes and found substantial adverse associations with later mental health only among boys. For boys, trajectory classes 2 and 3 (characterized by relatively high maternal working hours/week) were associated with worse mental health at ages 5 and 6 compared to class 1 (relatively low or no working hours/week). For girls, in contrast, class 5 (increasing and subsequently decreasing working hours/week) was associated with better mental health compared to class 1. In addition, a positive association between part-time employment at 12 months postpartum and later mental health among boys was found. Conclusion: Maternal employment may be associated with children's mental health between the ages of 4 and 6, although an appropriate definition of exposure is needed as the time of assessment is important. Whether there are gender differences in the associations of maternal employment with child mental health, or whether this is an issue susceptible to parental perception requires further investigation.

Background: Many authors have described a significant mental health burden on children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores whether pre-pandemic family circumstances might be related to different aspects of child health during the pandemic. Methods: We analyzed trajectories of health-related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012–05/2013) conducted in the South of Germany. Outcomes were children’s mental health, quality of life, and lifestyle, such as screen time and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated with the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations. Results: We analyzed data from n = 588 children from whom at least one questionnaire was completed between T7 and T11. When not considering the pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in means (b): − 3.9 (95% confidence interval (CI): − 6.4, − 1.4). There were no substantial differences in mental health, screen time, or physical activity in boys or girls. When considering pre-pandemic family situations, boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life on the subscale of friends (b: − 10.5 (95% CI: − 19.7, − 1.4)). Among girls in this group, 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health-related quality of life (e.g., KINDL-physical well-being difference in means: − 12.2 (95% CI: − 18.9, − 5.4)). Furthermore, a substantial increase in screen time was found (+ 2.9 h (95% CI: 0.3, 5.6)). Conclusion: Our results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic, with adverse consequences differing by gender and very likely by the pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms, the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories, and it needs to be further assessed which factors exactly are behind the (socio-economic) factors, such as maternal working habits and limited living space, when analyzing the effect of the pandemic on children’s health.

Background: Many authors described a significant mental health burden of children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores if pre-pandemic family circumstances might be related to different aspects of child health during the pandemic. Methods: We analyzed trajectories of health related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012-05/2013) conducted in the South of Germany. Outcomes were children`s mental health, quality of life, and lifestyle, such as screen-time, and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated to the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations. Results: We analyzed data of n=588 children from whom at least one questionnaire was completed between T7 and T11. When not considering pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in mean (b): -3.9 (95% confidence interval (CI): -6.4, -1.4). There were no substantial differences in mental health, in screen-time, and in physical activity neither in boys nor in girls. When considering pre-pandemic family situation boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life in the subscale friends (b: -10.5 (95% CI: -19.7, -1.4). Among girls of this group 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health related quality of life (e.g. KINDL-physical well-being difference in means: -12.2 (95% CI: -18.9, -5.4)). Furthermore, a substantial increase in screen-time was found (+2.9 h (95% CI: 0.3, 5.6)). Conclusion: Our results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic with adverse consequences differing by gender and very likely by pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories and it needs to be further assessed which factors exactly are behind the (socioeconomic) factors such as maternal working habits and limited living space when analyzing the effect of the pandemic on children’s health.

Background: The measures against the COVID-19 pandemic are challenging for children and parents, and detrimental effects on child health are suggested especially from lock-down measures and school closings. Methods: We conducted a cross-sectional analysis using a population based longitudinal (birth-) cohort study (SPATZ study) conducted in the South of Germany. Data included all 6 or 7 year old children for whom a questionnaire was completed during first grade of school. Consequently, we were able to analyze children being in first grade before the first lockdown in Germany (≤ 15th March 2020), as well as children being in first grade during the pandemic (> 15th March 2020). We conducted descriptive statistics and estimated the associations between the two time periods, before and during the pandemic, and various outcomes of child health using multivariable adjusted linear or logistic regression modeling. The analysis was stratified by gender. Results: Results among n = 362 children aged six or seven years showed substantially lower mean scores of health-related quality of life (difference in means: − 5.5, 95% confidence interval (CI) − 9.0, − 2.0), and higher mean scores in total emotional and behavioral difficulties (difference in means: 2.0, 95% CI 0.2, 3.8) in girls during vs. before the COVID-19 pandemic using multivariable linear regression modeling. In addition, weekly screen-time was increased in boys by 3.5 h (95% CI 0.6, 6.4). We did not find substantial differences in sleep quality, physical activity, and time spent with books, neither in boys nor in girls, however, the limited sample size has to be considered. Conclusion: Child health (and behavior) of first grade school children is possibly impacted by the COVID-19 pandemic with adverse consequences possibly differing by gender.

Background: The measures against the COVID-19 pandemic are challenging for children and parents, and detrimental effects on child health are suggested especially from lock-down measures and school closings. Methods: We conducted a cross-sectional analysis using a population based longitudinal (birth-) cohort study (SPATZ study) conducted in the South of Germany. Data included all children of the 6- and 7-year follow-up for whom a questionnaire was completed during first grade of school. Consequently, we were able to analyze children being in first grade before the first lockdown in Germany (≤15^th March 2020), as well as children being in first grade during the pandemic (>15^th March 2020). We conducted descriptive statistics and estimated the associations between the two time periods, before and during the pandemic, and various outcomes of child health using multivariable adjusted linear or logistic regression modeling. The analysis was stratified by gender. Results: Results among n=362 children aged six or seven years showed substantially lower mean scores of health-related quality of life (b: -5.5, 95% confidence interval (CI): -9.0, -2.0), and higher mean scores in emotional and behavioral difficulties (b: 2.0, 95% CI: 0.2, 3.8) in girls during vs. before the COVID-19 pandemic using multivariable linear regression modeling. In addition, weekly screen-time was increased in boys by 3.5 hours (95% CI: 0.6, 6.4). We did not find substantial differences in sleep quality, physical activity, and time spent with books, neither in boys nor in girls, however, the limited sample size has to be considered.Conclusion: Child health (and behavior) of first grade school children is possibly impacted by the COVID-19 pandemic with adverse consequences possibly differing by gender.