Both pre-pregnancy maternal body mass index (BMI) and higher BMI of children themselves are reported to be associated with children’s lower cognitive functions. The current study aimed to explore whether pre-pregnancy maternal BMI is directly related to children’s cognitive functions or whether this relationship is mediated by children’s BMI. Of the 1258 participants in the Hamamatsu Birth Cohort Study for Mothers and Children (HBC Study), 857 children who completed measurements at age 6 years were included. Cognitive functions were measured at age 9 using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC–IV); full-scale IQ (FSIQ), and scores of the four subscales (verbal comprehension, perceptual reasoning, working memory, and processing speed) were obtained. The results of counterfactual-based mediation analysis showed a significant natural direct effect between maternal BMI and children’s FSIQ and a natural indirect effect via children’s BMI. The proportion of mediation was estimated to explain 49.8%. Similar direct and indirect effects were observed in the perceptual reasoning and working memory subscales. The association between higher maternal BMI and lower cognitive functions in children was partially mediated by higher BMI in children. On the other hand, higher maternal BMI had a direct negative effect on children’s cognitive functions.

This study explored the effect of treatment stigma on the intervention effects of cognitive behavioral therapy (CBT) on adolescents with autism spectrum disorder (ASD) and their guardians. Secondary analyses were conducted using data from a randomized controlled trial, and only the intervention group (adolescents with ASD [n=23; 16 boys and 7 girls; mean age=12.8±2.2 years] and their guardians [n=23; 22 women and 1 man; mean age=44.8±6.1 years]) was used. We used the Japanese version of the Barriers to Access to Care Evaluation scale version 3 (BACEv3) to assess treatment stigma. Correlations between the BACEv3 scores at pre-intervention and the difference scores for pre-to-post-intervention in each measure were analyzed using Spearman’s rank correlation coefficient. Adolescents’ BACEv3 scores at pre-intervention were not correlated with difference scores in any measure. However, guardians’ BACEv3 scores at pre-intervention demonstrated a significant positive correlation with adolescents’ knowledge of ASD and a significant negative correlation with the communication of adaptive behaviors. Interventions through CBT are expected to be somewhat effective, regardless of adolescents’ or their guardians’ pre-treatment stigma. Further research is required to clarify whether treatment stigma in adolescents with ASD and their guardians affects CBT intervention effectiveness.