5th Postnatal Day Research Articles

MICROBIOME: The trials and errors of developing an experimental model to study the impact of maternal gut microbiome disruption on perinatal asphyxia.

Maternal gut microbiome impairment has garnered attention for its potential role in influencing neurodevelopmental outcomes in offspring, especially in situations that increase brain vulnerability such as perinatal asphyxia (PA). Maternal microbiome and fetal brain interplay emerge as a critical link between maternal health and offspring neurodevelopment. This study aims to generate a model to assess the impact of maternal dysbiosis triggered by gestational antibiotic administration and PA on offspring neurodevelopment. Wistar rats were subjected to antibiotics in drinking water from the 11th gestational day until birth. On the 6th postnatal day, pups were subjected to PA/normoxia, resulting in four experimental groups: control-normoxia, antibiotics-normoxia, control-asphyxia, and antibiotics-asphyxia. Early-life behavioral tests were conducted between postnatal days 7 and 9. The initial antimicrobial cocktail (ampicillin, vancomycin, neomycin, clindamycin, amphotericin-B) led to an increased number of miscarriages, poor weight gain during pregnancy, reduced offspring weight, and changes in the maternal gut microbiome compared to control. Offspring presented impaired neurodevelopmental reflexes in both PA and antibiotic groups and increased hippocampal neuroinflammation. Due to these detrimental effects, a more pregnancy-safe antibiotic cocktail was used for a second experiment (ampicillin, vancomycin, neomycin, meropenem). This resulted in no miscarriages or pregnancy-weight loss but was still linked to gut microbiome disruption. PA impaired neurodevelopmental reflexes and increased neuroinflammation, effects amplified by antibiotic administration. These preliminary findings reveal the cumulative potential of maternal dysbiosis and PA on neurodevelopment impairment, emphasizing caution in gestational antimicrobial use. Further investigations should include offspring long-term follow-up and maternal behavior and integrate probiotics to counteract antibiotic effects. This study investigates the impact of maternal gut microbiome disruptions caused by gestational antibiotic treatment and low oxygen exposure shortly after birth on the development of the rats' babies. We found that both antibiotic exposure and reduced oxygen levels led to changes in early behavior and increased inflammation of the nervous tissue in the baby rats. Although using a different, potentially safer antibiotic combination reduced pregnancy complications, it still changed the bacteria in the mother's gut and worsened early behavior. These findings show that antibiotics during pregnancy can affect the developing brain of baby rats and careful consideration should be used before prescribing them. Future research will explore longer-term effects and potential medicines.

Effects of Antipsychotics on the Hypothalamus-Pituitary-Adrenal Axis in a Phencyclidine Animal Model of Schizophrenia.

Schizophrenia (SCH) is a mental disorder that requires long-term antipsychotic treatment. SCH patients are thought to have an increased sensitivity to stress. The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, observed in SCH, could include altered levels of glucocorticoids, glucocorticoid receptors (GRs), and associated proteins. The perinatal administration of phencyclidine (PCP) to rodents represents an animal model of SCH. This study investigated the effects of perinatal PCP exposure and subsequent haloperidol/clozapine treatment on corticosterone levels measured by ELISA and the expression of GR-related proteins (GR, pGR, HSP70, HSP90, FKBP51, and 11β-Hydroxysteroid dehydrogenase-11β-HSD) determined by Western blot, in different brain regions of adult rats. Six groups of male rats were treated on the 2nd, 6th, 9th, and 12th postnatal days (PN), with either PCP or saline. Subsequently, one saline and one PCP group received haloperidol/clozapine from PN day 35 to PN day 100. The results showed altered GR sensitivity in the rat brain after PCP exposure, which decreased after haloperidol/clozapine treatment. These findings highlight disturbances in the HPA axis in a PCP-induced model of SCH and the potential protective effects of antipsychotics. To the best of our knowledge, this is the first study to investigate the effects of antipsychotic drugs on the HPA axis in a PCP animal model of SCH.

Dynamics of Urine Electrolytes in Term Neonates during the 1st Week of Life

Background: Urine electrolyte assessment is vital for diagnosing and managing neonatal conditions. However, the challenge of urine collection in neonates has resulted in a lack of standardized urine electrolyte reference values. Aim: This study seeks to explore the reference levels and potential trends in serum and urine electrolytes to better understand how the kidneys handle these substances. Methods: Healthy neonates were prospectively enrolled following normal births. Using biochemical methods, blood and urine samples were collected and analyzed on the 1st and 5th postnatal days. Statistical analysis was performed using descriptive statistics and the Wilcoxon matched-pairs signed-rank test. Results: This prospective study enrolled 55 healthy neonates. Significant changes in serum electrolyte concentrations were observed between the 1st and 5th days after birth. Notably, sodium, creatinine, urea nitrogen, and uric acid levels decreased, whereas potassium, calcium, and phosphate levels increased. Urine analysis revealed significant increases in the tubular maximum phosphate reabsorption per glomerular filtration rate and decreases in the fractional excretion of potassium and uric acid by Day 5. Conclusion: This study challenges prevailing assumptions about the stability of neonatal urine electrolytes and highlights dynamic changes in the first postnatal week. These insights lay the groundwork for further research into electrolyte disorders in newborns and have potential implications for improving neonatal care practices.

Біофізичні властивості шкіри щурів із метаболічним синдромом

It is known that metabolic syndrome (MS) prolongs the healing time of the wound surface of various genesis. We hypothesized that this may be related to changes in the biophysical properties of the skin. The aim of the work was to investigate the biophysical properties of skin (content of moisture, collagen, fused gelatin in the skin, and skin thermal fusion temperature) in rats with MS. Materials and methods. Research was conducted on 40 white non-linear rats (20 – males, 20 – females). After birth, males and females were divided into 2 groups. The first group served as a control for the second groups, in which MS was simulated by administering monosodium glutamate at a dose of 4.0 mg/kg on the 2nd, 4th, 6th, 8th, and 10th postnatal days. At the age of 4 months, the animals were decapitated under ether anesthesia. Biochemical studies were conducted to confirm the development of MS. The percentage of moisture, collagen content, destructive changes in collagen fibers and resistance of skin collagen to thermal factors were determined in native skin. The results. 4-month-old rats injected with monosodium glutamate in the early neonatal period developed MS as evidenced by abdominal obesity, insulin resistance, and dyslipidemia. In comparison with animals of the control group, in the skin of male and female rats with MS, the moisture content decreased, and the collagen content did not change. At the same time, the percentage of melted gelatin doubled, which indicates the depth of destructive changes in collagen fibers. Thermal welding of skin samples of male and female rats with signs of MS occurred at rather low temperatures compared to rats of the control group. Conclusion. Changes in the biophysical properties of the skin, which are registered in rats with MS, may be the reason for the later closure of the wound surface.

Evaluation of education and counseling using social media tools after discharge in women who underwent episiotomy

In this study, it was aimed to evaluate the effects of post-discharge education and counseling using social media tools on wound healing, pain status, and care and practices for women with episiotomy. The study was conducted experimentally with 60 women (30 experimental, 30 control) who had vaginal delivery with episiotomy in a public hospital in Istanbul. Data were collected using a data entry form and evaluations on the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, VAS (Visual Analogue Scale), and Diagnostic Form for Episiotomy Care and challenges. In our study, training and counseling were given to the experimental group by making video calls via social media on the 3rd, 5th, 7th, and 14th postnatal days (PP), and the results were evaluated without any training to the control group. SPSS program was used for data analysis. There was no difference between the experimental and control groups in terms of demographic and obstetric data. It was determined that the total scores of the experimental group on the REEDA scale on the 7th postnatal day (x¯ =2.167 ± 0.747) were statistically significantly lower than the total scores of the control group on the REEDA scale on 7th postnatal day (x¯ =3.100 ± 0.923) (p = 0.000 > 0.05). It was determined that the total scores of the experimental group on REEDA scale on the 14th postnatal day (x¯ =0.200 ± 0.407) were also statistically significantly lower than the total scores of the control group on REEDA scale on the 14th postnatal day. (x¯ =1.333 ± 0.844) (p = 0.000 > 0.05). The VAS DS scores of the experimental group on 3rd (x¯ =4.733 ± 0.907) and the 5th (x¯ =3.267 ± 0.691) postnatal day were statistically significantly lower than the VAS DS scores of the control group on 3rd (x¯ =5.267 ± 0.944) and 5th (x¯ =3.933 ± 0.944) (p = 0.003 > 0.05) postnatal day. In the light of this information, it was found that scores on REEDA scale were lower and pain experiences were significantly less in the group that received education and counseling with social media tools after discharge in women who underwent episiotomy.

P-343 The role of Yes-Associated protein (YAP) activity in uterus adenogenesis process

Abstract Study question Could Yes-Associated protein(YAP) be effective in the adenogenesis process that occurs in the mouse uterus in the postnatal period? Summary answer It was observed that the YAP and phospho-YAP levels decreased in mice with inhibited gland development during adenogenesis process when compared to the control groups. What is known already The mouse uterus is composed of undifferentiated mesenchyme surrounded by a single layer of epithelium at birth. On the 5th Postnatal Day (PD), the luminal epithelium begins to bud, and the process called adenogenesis, which is termed as gland development in the uterus, begins. The gland development is evident on the PD 10th day. The uterus shows adult tissue characteristics by PD 15th-20th days. Although it has been stated that various signaling pathways are active in this process, Hippo signaling pathway role in the adenogenesis process have not been clarified yet. Study design, size, duration The uterus with normal gland development and gland development inhibited by Progesterone were evaluated for YAP and phospho-YAP, which is one of the main components of Hippo signaling pathway, by immunohistochemistry, western blotting, and q-RT-PCR methods. For experimental groups, 50 µg/g Progesterone was dissolved in 0.1 mL Sesame oil and for control groups, only 0.1 mL of Sesame oil given subcutaneously on PN 2nd-10th days. Animals were sacrificed on the PN 5th-10th and 15th days. Participants/materials, setting, methods In total of 30 newborn Balb/c female mice were used. They were divided as control (n = 15) and experimental(n = 15) groups. After the injections were finished, mice from both groups at PN5th(n = 5), PN10th(n = 5), and PN15th(n = 5) days were cervical dissociated, and uteri were collected. For immunohistochemical analyses, tissues were taken into buffered formalin, paraffin blocks were made, and the sections were taken. Protein and RNA isolations were performed from uteri for western blotting and q-RT-PCR analyses, respectively. Main results and the role of chance When YAP expression was evaluated by immunohistochemistry, western blotting and q-RT-PCR methods, there was no difference between the groups on the PN 5th day. But there was an active signaling was observed in the control groups on the PN10th day, which is very important for gland formation, and on the PN 15th day, that is effective in the maturation process. On the PN10th and 15th days, it was determined that YAP and phospho-YAP signal expression were decreased significantly in the experimental groups when compared with the control groups in immunohistochemically and protein levels. In addition, these findings were supported by mRNA analysis with YAP. Limitations, reasons for caution The study was performed in vivo mouse model. Further studies can be done with a transgenic animal model. Wider implications of the findings Considering the contribution of uterine gland development to the implantation process, errors in the development of these glands may cause infertility. This study can bring a new perspective to researching the uterus adenogenesis period and causes of infertility and treatment approaches. Trial registration number not applicable

Creatine supplementation increases postnatal growth and strength and prevents overexpression of pro-inflammatory interleukin 6 in the hippocampus in an experimental model of cerebral palsy

ABSTRACT Objectives: The aim of this study was thus to evaluate the effect of Cr supplementation on morphological changes and expression of pro-inflammatory cytokines in the hippocampus and on developmental parameters. Methods: Male Wistar rat pups were submitted to an experimental model of CP. Cr was administered via gavage from the 21st to the 28th postnatal day, and in water after the 28th, until the end of the experiment. Body weight (BW), food consumption (FC), muscle strength, and locomotion were evaluated. Expression of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were assessed in the hippocampus by quantitative real-time polymerase chain reaction. Iba1 immunoreactivity was assessed by immunocytochemistry in the hippocampal hilus. Results: Experimental CP caused increased density and activation of microglial cells, and overexpression of IL-6. The rats with CP also presented abnormal BW development and impairment of strength and locomotion. Cr supplementation was able to reverse the overexpression of IL-6 in the hippocampus and mitigate the impairments observed in BW, strength, and locomotion. Discussion: Future studies should evaluate other neurobiological characteristics, including changes in neural precursor cells and other cytokines, both pro- and anti-inflammatory.

A New Perspective on the Pathogenesis of Infantile Colic: Is Infantile Colic a Biorhythm Disorder?

In this study, we investigated the relationship between infantile colic, migraine, and biorhythm regulation, by evaluating biochemical and molecular parameters. Healthy infants with and without infantile colic were eligible for this prospective cohort study. A questionnaire was applied. Between the 6th and 8th postnatal weeks, day and night circadian histone gene H3f3b mRNA expression and spot urine excretion of serotonin, cortisol, and 6-sulphatoxymelatonin were analyzed. Among the 95 infants included, 49 were diagnosed with infantile colic. In the colic group, defecation difficulty, sensitivity to light/sound, and maternal migraine frequency increased and sleep disruption was typical. In the melatonin analysis, the difference between day and night levels was significant in the control group, indicating an established circadian rhythm ( P = 0.014). In the colic group, there was no day-night difference ( P = 0.216) in melatonin, but serotonin levels were higher at night. In the cortisol analysis, day-night values were similar in both groups. Day-night variability of H3f3b mRNA levels between the groups was significant, indicating circadian rhythm disturbance in the colic group compared to the control group ( P = 0.003). Fluctuations in circadian genes and hormones expected in healthy rhythm were revealed in the control group, but were missing in the colic group. Due to the gaps in the etipathogenesis in infantile colic, a unique effective agent has not been discovered so far. This study, which demonstrated for the first time that infantile colic is a biorhythm disorder using molecular methods, fills the gap in this regard and points to a completely different perspective in terms of treatment.

The Impact of Early Life Experiences and Gut Microbiota on Neurobehavioral Development in Preterm Infants: A Longitudinal Cohort Study.

The objective of this study is to investigate the impact of early life experiences and gut microbiota on neurobehavioral development in preterm infants during neonatal intensive care unit (NICU) hospitalization. Preterm infants were followed from NICU admission until their 28th postnatal day or until discharge. Daily stool samples, painful/stressful experiences, feeding patterns, and other clinical and demographic data were collected. Gut microbiota was profiled using 16S rRNA sequencing, and operational taxonomic units (OTUs) were selected to predict the neurobehaviors. The neurobehavioral development was assessed by the Neonatal Neurobehavioral Scale (NNNS) at 36 to 38 weeks of post-menstrual age (PMA). Fifty-five infants who had NNNS measurements were included in the sparse log-contrast regression analysis. Preterm infants who experienced a high level of pain/stress during the NICU hospitalization had higher NNNS stress/abstinence scores. Eight operational taxonomic units (OTUs) were identified to be associated with NNNS subscales after controlling demographic and clinical features, feeding patterns, and painful/stressful experiences. These OTUs and taxa belonging to seven genera, i.e., Enterobacteriaceae_unclassified, Escherichia-Shigella, Incertae_Sedis, Veillonella, Enterococcus, Clostridium_sensu_stricto_1, and Streptococcus with five belonging to Firmicutes and two belonging to Proteobacteria phylum. The enriched abundance of Enterobacteriaceae_unclassified (OTU17) and Streptococcus (OTU28) were consistently associated with less optimal neurobehavioral outcomes. The other six OTUs were also associated with infant neurobehavioral responses depending on days at NICU stay. This study explored the dynamic impact of specific OTUs on neurobehavioral development in preterm infants after controlling for early life experiences, i.e., acute and chronic pain/stress and feeding in the NICU. The gut microbiota and acute pain/stressful experiences dynamically impact the neurobehavioral development in preterm infants during their NICU hospitalization.

Maternal treadmill exercise ameliorates impairment of neurological outcome, caspase-1 and NLRP3 gene expression alteration in neonatal hypoxia-ischemia rats.

Neonatal hypoxia-ischemia (HI) is one of the most important causes of neurological disorders in children. Various studies suggest that maternal exercise during pregnancy has a beneficial impact on the health status of offspring infants. In this study, the effect of maternal treadmill exercise during pregnancy on neurological and molecular changes induced by HI in newborn rats was investigated. In this experiment, 24 pregnant female rats were divided into two groups; the first group was subjected to treadmill exercise for six weeks. The treadmill exercise program was initiated by running for 17 min at 5-10 m/min at 0 inclination in the first week, followed by running for 21 min at 5-25 m/min at 5° inclination in the second week, running for 25 min at 5-30 m/min at 10° inclination in the third and fourth weeks, running for 25 min at 5-15 m/min at 10° inclination in the fifth and sixth weeks. The second group was left untreated and did not perform the exercise. Newborn rats were assigned to four groups; (1) control, (2) control+exercise, (3) HI, and (4) HI+exercise. HI was developed in the offspring on the 8th postnatal day. One week following the induction of HI, the Garcia test was carried out. The histological morphology of neonates was assessed, and the expression levels of caspase-1 and NLRP3 were evaluated. The data showed that maternal exercise during pregnancy significantly improved neural cell death (P<0.001) and the Garcia score (P<0.05), while it attenuated the expression levels of caspase-1 (P<0.001) and NLRP3 (P<0.05) genes in newborn rats induced by HI. These results demonstrated that maternal treadmill exercise during pregnancy could reverse the neurological deficits, as well as the expression levels of caspase-1 and NLRP3 genes, which occur in neonatal hypoxia-ischemia.

Measuring locomotor strategies of freely moving previsual rat pups

Blind walks of previsual rat pups in the open field test were analyzed for random components and/or strategies of locomotion. Wistar infants (n = 51) on their 13th postnatal day was tracked in the open field test for 2 minutes. At this age, immature rats should rely only on non-visual modalities in their navigation. Three distinct patterns were observed. A large portion of the pups (n = 22) performed sub-diffusive localized walks in the center. A smaller cohort (n = 9) undertook almost immediate quasi-linear raids in a random direction, thus succeeded in reaching a shelter (i.e., walls’ vicinity). The rest (n = 20) demonstrated a mixed strategy: localized walks interspersed with quasi-linear raids. We applied a method of space potentials for an automated segmentation of the tracks into the localized walks and quasi-linear fragments. We found that the localized walks were random only for the time scale below 2–3 seconds, but essentially non-random (sub-diffusive) for longer scales. The sub-diffusion was caused by the trajectories’ re-attraction, as seen from the averaged velocity autocorrelation function. Self-odor traces can be a physical cue ensuring the trajectorial returns. Oppositely, the quasi-linear raids can be considered a primary form of an active escape response.

Monitoring of lamotrigine concentrations in mothers, colostrum, and breastfed newborns during the early postpartum period

ObjectiveTo analyse the concentrations of lamotrigine in maternal serum, colostrum, and serum of breastfed newborns, and to evaluate the effect of comedication with enzyme-inducing antiseizure medication and valproic acid. MethodsThis cohort study collected data from 158 women and 143 breastfed newborns. Maternal serum, milk (i.e., colostrum), and newborn serum samples were collected between the 2nd and 5th postnatal days, and lamotrigine concentrations were measured by high-performance liquid chromatography. ResultsThe median lamotrigine concentrations were 2.7 mg/L in maternal serum, 1.4 mg/L in milk, and 1.7 mg/L in newborn serum. The median milk/maternal serum concentration ratio was 0.60, the median newborn/maternal serum concentration ratio was also 0.60, and the median newborn serum/milk concentration ratio was 1.00. A significant correlation was observed between milk and maternal serum concentrations and between newborn serum and milk concentrations, maternal serum concentrations, maternal daily dose, and dose related to maternal body weight. ConclusionsExposure to lamotrigine in breastfed newborns is lower than exposure during pregnancy. However, by the same dose by the same mother, lamotrigine concentrations in both maternal serum and milk increase significantly after delivery. This finding, together with the immature function of eliminating enzymes in newborns, may be the reason for reaching concentrations in the reference range used for the general epileptic population in breastfed newborns. Therapeutic monitoring of breastfed newborns serum concentrations of lamotrigine is not mandatory; however, if signs of possible adverse events are noted, newborn serum concentrations should be analysed.

Valproic Acid Concentrations in Mothers, Colostrum and Breastfed Infants during the Early Postpartum Period: Comparison with Concentrations Determined during Delivery and in the Mature Milk Period.

To obtain information on the transport of valproic acid from mothers to colostrum and breastfed infants, in this cohort study, valproic acid concentrations in maternal serum (90 subjects), colostrum and the serum of breastfed infants were analyzed in years 1993–2018, between the 2nd and 5th postnatal days. Valproic acid concentrations ranged from 4.3 to 66.5 mg/L (mean 31.2 ± 13.6 mg/L) in maternal serum, from 0.5 to 5.9 mg/L (mean 1.1 ± 1.2 mg/L) in milk, and from 0.5 to 42.9 mg/L (mean 15.4 ± 9.4 mg/L) in infant serum. The milk/maternal serum concentration ratio ranged from 0.01 to 0.22 (mean 0.04 ± 0.04), and the infant/maternal serum concentration ratio ranged from 0.01 to 1.61 (mean 0.51 ± 0.28). A significant correlation was found between serum concentrations of breastfed infants and milk concentrations, maternal serum concentrations, maternal daily dose, and dose related to maternal body weight. Valproic acid concentrations in milk and infant serum did not reach the lower limit of the reference range used for the general epileptic population, and three-quarters of the concentrations in milk were lower than the lower limit of quantification. Routine monitoring of serum concentrations of breastfed infants is not necessary. If signs of potential adverse reactions are noted, serum concentrations of the infants should be measured.

Outcome of Intermittent Kangaroo Mother Care in Neonatal Intensive Care Unit

Objective: To find out the outcome of intermittent Kangaroo Mother Care KMC) in terms of weight-gain among low birth weight (LBW) neonates in Neonatal Intensive Care Unit (NICU). Study Design: A randomized controlled trial. Place and Duration of the Study: This study was conducted at Department of Pediatrics Gulab Devi Hospital, Lahore from March 2020 to February 2021. Methodology: A total of 226 (113 KMC Group and 113 controls) neonates of both genders with birth weight between 1500 grams to 2499 grams admitted to NICU with their mothers available for KMC application were enrolled. KMC Groups received KMC whereas controls were given conventional care. KMC was started from 8th post-natal day and a separate block of NICU was dedicated for the implementation of KMC. Body weight of all the neonates was measured from day-zero (8th post-natal day) up to day-7 (15th post-natal day). Results: Out of a total of 226 neonates, 121 (53.5%) were boys and 105 (46.5%) girls, Overall, mean gestational age was calculated to be 34.8±2.6 weeks. Most frequent main diagnosis at the time of admission was pneumonia, 64 (28.3%) neonates. Mean body weight was significantly increased among neonates of KMC Group in comparison to control at day-4, day-6 and day-7 (p&lt;0.05). Total weight gain from day-0 to day-7 was found to be 0.24±0.1 kg in KMC groups and 0.15±0.1 kg among controls (p&lt;0.0001). Mean duration of hospital stay was noted to be 17.5±2.9 days in KMC Group versus 20.7±3.4 days among controls (p&lt;0.0001). Conclusion: In comparison to conventional care, intermittent KMC was found to significantly more effective in terms of improvement in weight gain and reduction in duration of hospitalization. Keywords: Exclusive breast-feeding, Kangaroo mother care, neonatal intensive care unit, pneumonia.

B.3 The incidence of perinatal stroke is 1:1200 births in Southern Alberta: Population-based incidence of disease-specific perinatal stroke

Background: Perinatal stroke encompasses six cerebrovascular syndromes which occur between the 20th week of gestation and the 28th post-natal day. Subtypes are neonatal arterial ischemic stroke (NAIS), neonatal cerebral sinovenous thrombosis (CSVT), neonatal hemorrhagic stroke (NHS), arterial presumed perinatal ischemic stroke (APPIS), periventricular venous infarction (PVI), and presumed perinatal hemorrhagic stroke (PPHS). Inconsistent terminology and lack of population-based case series has limited accurate measurement of disease-specific perinatal stroke incidence. Our objective was to define the incidence of the subtypes of perinatal stroke using a population-based cohort. Methods: The Alberta Perinatal Stroke Project is a research cohort established in 2008 in Southern Alberta. Case acquisition included retrospective hospital and ICD code searches (1990-2008) and prospective enrollment from all NICU and neurology/stroke clinics (2008-2017). Results: The overall incidence of perinatal stroke in Southern Alberta was 9.0 cases per 10,000 births, or 1:1200 births. Per 10,000 births, the incidence of each subtype was: NAIS = 3.2 (~1:3000), APPIS =1.2 (~1:8500), PVI = 1.5 (~1:6500), CSVT = 1.0 (~1:9900), NHS = 1.4 (~1/7300), PPHS = 0.1 (1/82,000). Conclusions: The overall incidence of perinatal stroke in Southern Alberta is 1:1200 live births. Population-based sampling of disease-specific states may explain why this rate is much higher than previous estimates

Higher viral RNA detection in placenta biopsies than maternal serum in a term infant born to a mother with confirmed SARS-CoV-2 infection

The SARS-CoV-2 outbreak was declared a pandemic by the WHO in March 2020. The neonatal population is thought to have a low incidence and severity of the disease, but maternal-to-fetus transmission has not been well studied. We present a term infant born to a mother with mild symptoms of laboratory confirmed SARS-CoV-2 infection seven days prior to cesarean delivery. Four placental biopsies tested by RT-PCR for SARS-CoV-2 were positive, while a nasopharyngeal swab and rectal swab were negative. The infant was not symptomatic. No anti-SARS-CoV-2 maternal antibodies were detected in the infant’s sera through the 28th postnatal day.

IgG modulation in male mice with reproductive failure after prenatal inflammation.

Sexual performance in adult male rats is highly sensitive to prenatal stress which can affect the functionality of the reproductive system and various brain structures involved in modulating sexual behavior. The immunomodulatory effect of mouse IgG on reproductive maturity in male offspring after LPS exposure in vivo and in vitro was studied. Prenatal IgG injection (20 µg/mouse) had a positive impact on the puberty of male mice whose mothers were exposed to LPS (100 µg/kg) on the 12th day of pregnancy. The numbers of Sertoli cells were increased, whereas the body weight and the number of symplastic spermatids were decreased in offspring as compared to LPS-treated animals. Besides, IgG had a positive effect on altered hormone levels: reduced estradiol level on the 5th and 14th postnatal days and increased testosterone level on the 30th postnatal day in blood that led to an increased number of mounting attempts in sexually mature males. The cAMP-dependent pathway may be involved in the regulation of the LPS-induced inflammation. IgG reduced the increased level of cAMP in mouse peritoneal macrophages activated by LPS in vitro. IgG is able to modulate inflammation processes but its exposure time is important.

Gamma aminobutyric acid signaling disturbances and altered astrocytic morphology associated with Bisphenol A induced cognitive impairments in rat offspring.

Bisphenol A (BPA) is a well-recognized endocrine disruptor and is globally used in the manufacture of many plastic items. Multiple studies suggest links between prenatal BPA exposure and alterations in neurodevelopment and behaviors in children, even at lower levels. This study was conducted to reveal the role of astrocyte morphology and Gamma aminobutyric acid (GABA) signaling in BPA induced cognitive defects in the offspring of Wistar albino rats when exposed during the prenatal and postnatal periods. Dams of Wistar albino rats were exposed to a dose of 5mg/kg body weight of BPA throughout the pregnancy and lactation period until the third postnatal day (PND). After delivery of pups, cognitive tests were carried out on the 21st, 24th, and 28th PNDs. Blood samples were collected for measurement of serum GABA levels. On the same day as the blood collections, pups were sacrificed and their right frontal cortices were dissected out. Immunohistochemical analysis for glial fibrillar acidic protein + astrocytes was conducted. Pre and postnatal BPA exposure led to anxiety like behavior in pups. This exposure also resulted in reduced serum GABA concentrations. Immunohistochemical analysis revealed reduced astrocyte numbers as well as decreased numbers of dendritic spines in the BPA exposed pups. BPA exposure during critical periods of development leads to cognitive impairments that correlate with the defects in the GABA signaling pathways and deteriorated morphology of the astrocytes in the offspring of the Wistar rats.

Therapeutic monitoring of carbamazepine and its active metabolite during the 1st postnatal month: Influence of drug interactions

ObjectiveTo receive information about carbamazepine and its active metabolite 10,11-epoxide transport into mature milk and suckling infants. MethodsIn this cohort study, maternal serum, mature milk, and infant serum carbamazepine and epoxide levels were measured between the 6th and 29th postnatal day (carbamazepine in 1990–2017, epoxide in 1997–2017). Paired maternal serum, infant serum and milk levels were used for the assessment of ratios of this levels. The influence of combined treatment with enzyme-inducing antiepileptic drugs and valproic acid was assessed. Relationship between maternal serum, infant serum, and milk levels was also evaluated. ResultsMaternal carbamazepine levels were 1.4–10.4 mg/L, milk 0.5–6.7 mg/L and infant 0.5–2.6 mg/L. Maternal 10,11-epoxide levels were 0.3–5.4 mg/L, milk 0.3–3.7 mg/L and infant 0.3–0.6 mg/L. Highly significant correlations were observed exclusively between milk and maternal serum levels of both carbamazepine and 10,11-epoxide. Concomitant administration of enzyme-inducing antiepileptic drugs significantly increased the maternal apparent oral clearance of carbamazepine by approximately 130%. Carbamazepine combined with valproic acid significantly increased epoxide levels in milk and maternal serum but not in breastfed infants. ConclusionsIn breastfed infants, carbamazepine levels did not reach the lower limit of the therapeutic range used for the general epileptic population, and the majority of epoxide levels were less than the lower limit of quantification. Routine monitoring of carbamazepine in these infants is not compulsory. However, observation of breastfed infants is desirable. If signs of potential adverse reactions are evident, infant serum concentrations should be monitor.

Efficacy of Oxytocin Massage on Involution of Uterus Among Postnatal Mothers

After a lady has cautiously accommodated the physiologic adversities of pregnancy and three phases of work, the consideration of essentially everybody regularly goes to the baby. Absence of sufficient uterine withdrawals during the puerperium can repress the cycle of uterine involution leading to many complications. The study aim is to assess the efficacy of oxytocin massage on involution of the uterus in the experimental and control group among postnatal mothers. A quasi-experimental research design was conducted among 60 postnatal mothers who were selected by Convenience sampling technique. Semi-structured interview method was used to collect the demographical data and by measuring the length between the fundus of the uterus and Symphysis Pubis with a measuring tape. Oxytocin massage was given for 15 minutes from 1st- 5th postnatal day. Among 60 samples in the experimental group the level of involution among postnatal mothers in the experimental group, 6 had good involution, 14 had average involution and 10 had poor involution. In the present study, there was a statistically significant association in Postnatal vaginal bleeding and breastfeeding frequency which had shown statistically significant association with post-test level of involution of the uterus among postnatal mothers in the experimental group at p&lt;0.05 level and the other variables had not shown statistical significance. This reveals that oxytocin massage is highly significant in the experimental group because oxytocin hormone which is secreted by the neurons of the hypothalamus during massage stimulates the contraction of uterine smooth muscle by increasing the sodium permeability of uterine myofibrils.