Mothers Of Age Research Articles

Investigating diverse sources of variation in the amount of time Weddell seal (Leptonychotes weddellii) pups spend in the water during the lactation period

AbstractField observations suggest that time spent in the water by Weddell seal pups during lactation varies among individuals, which could yield important developmental tradeoffs. We analyzed data from 713 pups born to 419 different mothers over 9 years to evaluate total time in the water, age at first entry, and potential sources of variation using temperature loggers attached to the rear flipper of pups. Pups first entered the water at 11–29 days of age (M = 14.9) and spent 4–204 hr (M = 69.3) in the water by 30 days of age. Age at first entry was earlier for pups with higher birth mass and mothers of above average reproductive experience. Total time in the water was related to maternal identity and greater for female pups and for pups that had higher birth mass, mothers of intermediate age, mothers that skipped reproduction in the previous year, and for pups that first entered the water at younger ages. Phenotypic traits explain observed variation in the development of a key life history behavior in the Weddell seal. Strong individual variation in time spent in metabolically costly swimming and diving might lead to variation in growth, energy stores, and survival and fitness outcomes.

Adverse Maternal and Perinatal Outcome of Women Aged 40 Years or Over: A Retrospective Study

BACKGROUNDAdvanced maternal age is traditionally described to be 35 years of age or over. In recent years, new trends have suggested that it may be 40 years of age or over; this occurs in Hungary.AIMThe aim of this study was to determine the association between advanced maternal age and various adverse maternal and neonatal outcomes.METHODSA retrospective analysis was performed among women who delivered between 2015 and 2017. All women aged 40 years or over (cases) were involved into the analysis (n = 374). The controls (n = 378) were randomly selected from women aged 25 to 29 years who delivered during the same period considering the number of previous gestations and previous deliveries. The data collected from the medical records comprised the mothers’ demographic and obstetric characteristics and neonatal data. To assess the contribution of maternal age to various maternal and neonatal outcomes, multiple logistic regression analyses were used.RESULTSThe logistic regression analyses showed higher odds of gestational diabetes (AOR, adjusted odds ratio: 2.81), preeclampsia (AOR: 13.05), threatened preterm delivery (AOR: 3.62), and cesarean section (AOR: 3.31) in mothers of higher age. The odds of low birth weight (AOR: 2.56) and intensive care (AOR: 2.03) were significantly higher in older vs. younger mothers, while no significant associations were between maternal age and fetal macrosomia and congenital malformations.CONCLUSIONSConsidering our results, it is important to educate women about the consequences of delayed childbearing and the need of continuous observation within prenatal care.

Impact of maternal age on neonatal outcomes among very preterm infants admitted to Chinese neonatal intensive care units: a multi-center cohort study.

BackgroundThe percentage of advanced maternal age (aged over 35 years) mothers has been rising across the world, the evidence of maternal age on neonatal outcomes from low- and middle-income countries is scarce. Our objective was to evaluate the effect of maternal age on mortality and major morbidity among very preterm infants admitted to Chinese neonatal intensive care units.MethodsData from a retrospective multi-center cohort of all complete care very preterm infants admitted to 57 neonatal intensive care units that participated in the Chinese Neonatal Network from January 1st to December 31st, 2019 were analyzed. Neonatal outcomes including mortality or any major morbidity, defined as necrotizing enterocolitis stage 2 or 3, moderate & severe bronchopulmonary dysplasia, severe intraventricular hemorrhage, cystic periventricular leukomalacia, severe retinopathy of prematurity, or sepsis. A multiple logistic regression model was constructed to analyze the independent association between maternal age and neonatal outcome.ResultsAmong 7,698 eligible newborns, 80.5% of very preterm infants were born to mothers between the ages of 21 and 35 years, with 18.0% born to mothers >35 years and 1.5% born to mothers <21 years. Higher rates of maternal hypertension, maternal diabetes, cesarean deliveries, antenatal steroid usage were noted as maternal age increased. The proportion of prenatal care, cesarean section, antenatal steroid usage and inborn for very preterm infants born to mothers <21 years was lower than those of mothers of other ages. Compared to the ages of 21–35 years group, the odds of severe intraventricular hemorrhage (adjusted odd ratio: 2.00, 95% CI: 1.08–3.71) was significantly higher in the ages of 15–20 years group. Increasing maternal age was associated with higher rates of small for gestational age and lower birth weight of very preterm infants, but no correlation between advanced maternal age and very preterm infants mortality or major morbidity.ConclusionsAmong very preterm infants, increasing maternal age was associated with higher rates of small for gestational age but not neonatal mortality or major morbidity. Young maternal age may increase the risk of severe intraventricular hemorrhage of very preterm infants.

EFFECT OF INJECTED DIFFERENT CONCENTRATIONS OF ALCOHOLIC EXTRACT OF Moringa oleifera LEAVES POWDER IN HATCHING EGGS OF ADVANCED AGE OF BROILER BREEDERS ON PRODUCTIVE PERFORMANCE AND CARCASSES OF BROILER CHICKENS

This experiment was conducted to study the effect of injecting hatching eggs into a flock of broiler aged mothers with different concentrations of the alcoholic extract of Moringa oleifera powder on productive performance of broilers during the period of rearing of 35 days. The study included two experiments for a period at 2/10/2021 to 28/11/2021, where eggs were injected into the Mustafa Poultry Hatchery/ Wasit Governorate- Aziziyah District. A 400 hatching eggs of 308 Ross mothers of modern broilers used at age of 48 week, eggs of average weight 66 ± 1 g/egg were collected in same day then stored for two days. A quarter of treatments were randomly distributed with 100 eggs for each treatment. The first treatment T1 without injection as control treatment, and T4, T3, and T2 (while injected into the space air) on day 12 of, in an amount of 0.2 mL for each egg, with concentration of 450, 300, 150 µg/mL, respectively. The hatched chicks were bred in the same fields, where 180 chicks of the chicks were distributed into four treatments, 45 chicks for each treated and three replicates (15 chicks) for each T1, T2, T3 and T4 were placed in a cage for 35 days. The results Showed A significant (p&lt;0.05) increase for T4 compared to the control in body weight, body weight gain and relative weight of the gizzard, will all injection treatment recorded a highly significant decrease in the total feed consumption and feed conversion ratio compared to control treatment. While there were no significant differences between treatments in the percentage of total Mortality, relative weights of the heart, liver, breast and thighs and dressing ratio.

Mothers’ School Readiness Beliefs and Literacy Involvement and Children’s Academic Outcomes in Ethnic Minority Families

ABSTRACT This research tested a mediation model, examining whether individual differences in mothers’ school readiness beliefs influenced home literacy practices and children’s later academic achievement among African American (n = 114) and primarily Mexican origin Latina mothers (n = 164) and their children. Mothers of children ages 3–4 years reported school readiness beliefs and home literacy practices. Later (ages 6–7 years), reading and math achievement scores were measured using the Woodcock-Johnson Revised (WJR) or the Batería Woodcock-Muñoz, as appropriate, depending upon the child’s primary language. Research Findings: Results showed that African American and Latina mothers differed in their beliefs about school readiness skills, with African American mothers more likely to emphasize general pre-academic knowledge and Latina mothers more likely to emphasize social-focused readiness skills. Academic-focused readiness beliefs predicted mothers’ engagement in home literacy practices, social-focused readiness beliefs predicted math achievement, and home literacy practices mediated the association between academic-focused readiness beliefs and math achievement. Policy or Practice: Findings suggest that interventions to enhance school readiness should consider ethnic minority parents’ expectations and at-home practices, particularly during children’s early childhood.

THE REPRODUCTIVE PATHOLOGIES OF MALE OFFSPRING BORN TO MOTHERS WITH FETOPLACENTAL INSUFFICIENCY: HORMONE DEPENDENT MECHANISMS OF DEVELOPING AND PROFYLAXIS

Introduction. Fetoplacental insufficiency (FPI) is the symptom complex that substantially results not only in pregnancy development and childbirth, but in the health condition of offspring at different times. It has been shown that offspring born to mothers with FPI have morphological and functional disturbances of different systems of organs. The aims of this research were to determine hormone depended mechanisms of reproductive pathologies developing in the ontogenesis of male offspring born to different aged mothers with FPI and experimental grounding of potential preventive activity of developed pharmaceutical composition suitable for animals of this phenotype. Materials and methods. Mature Wistar rat females of young (3-4 months) and mature (8-10 months) reproductive age have been used in the experiment. Eights groups for 7 pregnant females in each group have been formed. Modeling of FPI has been carried out by daily subcutaneous administration of the 50 % tetrachloromethane oil solution at dose of 2 ml/kg of body weight from 12th to 18th day of pregnancy. The reproductive system of male offspring has been estimated. Results. FPI influences the sex differentiation of brain in male offspring that reflects in delaying of sexual maturity in the form of postponed testicles moving to the scrotum. FPI leads to relative estrogenization, inhibition of sperm cells differentiation and causes significant changes in antioxidant defense system in male offspring at puberty. FPI causes changes of testosterone, estradiol levels and shifts sex hormones ratio to the hyperestrogenemia in the all of mature male offspring that influence the activity of male sexual behavior, worsens spermogram and fertility. Conclusion. Fetoplacental insufficiency in females in third trimester of pregnancy leads to marked changes in reproductive system of their male offspring born to mothers of reproductively young and reproductively mature age. Data obtained indicate the opportunity and ways to develop the medicines for prophylaxis of reproductive pathologies in children born to mothers with fetoplacental insufficiency.

Mothers’ Willingness to Use Breastfeeding Supports: Evidence From Formally Employed Mothers in Central Kenya

ObjectivesWe aimed to understand mothers’ willingness to use currently available breastfeeding supports at their workplaces and expected use if new supports were made available. MethodsWe conducted a cross-sectional survey with closed and open-ended questions among 300 formally employed mothers of children ages 12 months and younger at two public healthcare facilities in Naivasha, Kenya, and community transportation sites for commercials farms and hotels. We surveyed maternal demographics, healthcare access and utilization, employment history, mother’s awareness of current breastfeeding supports at her workplace, and self-reported willingness to use additional breastfeeding supports. ResultsThe most available reported current workplace supports were schedule flexibility to arrive late or leave early (87.8%), opportunity to return home during lunch (24.7%), and company-funded daycare in the community (7.6%). Few mothers reported availability of lactation rooms (3.6%), on-site daycare (3.3%), transportation to breastfeed during lunch (2.3%), a refrigerator for expressed milk (1.6%), a manual breastmilk pump (1.0%), or an electric breastmilk pump (0.7%). When asked about willingness to use if made available, mothers were most willing (>80% agreement) to use flexible work schedules to arrive late, leave early, break during lunch, and use transportation to return home to breastfeed. A moderate proportion were willing to use on-site daycare (63.8%), company-funded community daycare (56.9%), on-site lactation rooms (60.5%), refrigeration for expressed milk (49.3%), manual (40.5%) and electric pumps (27.6%). ConclusionsThe currently available workplace breastfeeding supports do not align well with mothers’ demand for or willingness to use certain supports. Current resources – such as on-site daycare – are rare at workplaces but are among the most demanded supports by mothers. Lactation rooms are also rare, but demanded less by mothers than on-site daycare or flexible work schedules. Funding SourcesSupported by the National Institutes of Health Fogarty International Center.

Inconsistent Media Mediation and Problematic Smartphone Use in Preschoolers: Maternal Conflict Resolution Styles as Moderators.

Previous studies suggest that inconsistent parenting leads to undesired consequences, such as a child’s defiant reactance or parent–child conflicts. In light of this, we examined whether mothers’ inconsistent smartphone mediation strategies would influence their children’s problematic smartphone use during early childhood. Furthermore, given that harsh parenting often escalates a child’s behavioral problems, we focused on parent–child conflict resolution tactics as moderators. One hundred fifty-four mothers (ages 25–48 years; M = 35.58 years) of preschoolers (ages 42–77 months) reported their media mediation and parent–child conflict resolution tactics and their child’s problematic smartphone use. We found that the positive association between the mother’s inconsistent mediation and their child’s problematic smartphone use was more pronounced when mothers relied on negative parent–child resolution tactics—i.e., psychological aggression and physical assault. Our findings provide vital theoretical and empirical insights into mother–child relational characteristics for the child’s problematic smartphone use.

Knowledge and Attitude of Mothers about Children Immunization and Barriers to Adherence the Program, in Erbil City

Background and objective: Immunization programs are one of the most important methods to prevent infections and sickness among children. We can overcome many obstacles if mothers have the necessary knowledge and attitude regarding vaccines. The study aims to assess mothers’ knowledge, attitudes, and barriers related to immunization programs and associations related to socio-demographic characteristics. Methods: A cross-sectional study design was carried out in Erbil city across six primary health care centers (Hawkari, Azadi, Runaki, Shadi, Mala Afandi, and Nazdar Bamarni) during the period of January 5, 2021, to April 8, 2021. Non-probability convenience sampling methods were used. The sample consisted of 410 mothers ages 18 and older. A questionnaire with four parts (socio-demographic characteristics, knowledge, attitude, and barriers to adherence immunization programs) was used to collect data. Statistical package for Social Science (version 23) was used for data analysis. Chi-square and Fisher exact tests were used to determine the association between socio-demographic characteristics and knowledge and attitudes. Frequency and percentage were used to identify barriers. Results: The study findings showed a statistically significant association between the knowledge of mothers and their age, educational level, occupation, and socioeconomic status. Mothers have a high attitude regarding immunizations. The majority (69.3%) of mothers have not had any missed opportunities for not given immunizations. The most common reasons for not giving immunizations were mothers being busy and child sickness at the time of immunizations. Conclusions: There was statistically significant association between mother’s knowledge and age, education, occupations, and socioeconomic status. A high level of attitude was recorded among mothers regarding immunizations. Mothers reported being busy on the day of the immunizations and child sickness as the most common barriers to receiving immunizations.

Neonatal Mortality Rate and Its Determinants: A Community-Based Panel Study in Ethiopia.

BackgroundThe Sustainable Development Goals specifically target a reduction in neonatal mortality rates. However, the highest neonatal mortality rates occur in sub-Saharan Africa, including Ethiopia. Although several factors contributing to these high rates have been explored, there continues to be a general dearth of studies and inconsistencies of factors to understand the problem. Therefore, this study aimed to identify the prevalence and factors associated with neonatal mortality in Ethiopia.MethodsA panel study was conducted among 2,855 pregnant or recently postpartum women selected using the multistage cluster sampling technique from October 2019 to September 2020. Data were collected by experienced and trained female resident enumerators and coded, cleaned, and analyzed using STATA version 16.1 software. We used the Kaplan–Meier survival curve to show the pattern of neonatal deaths during the first 28 days of life. Frequencies and rates were reported along with the percentages and using a 95% confidence interval, respectively. The Cox proportional hazard regression model was used to explore the association of explanatory and outcome variables. Finally, an adjusted hazard ratio with a 95% confidence interval was used to report the results, with a p < 0.05 to declare statistical significance.ResultsThe neonatal mortality rate was 26.84 (95% CI: 19.43, 36.96) per 1,000 live births. Neonates born to rural resident mothers (AHR = 2.18, 95% CI: 1.05, 4.54), mothers of advanced age (AHR = 2.49, 95% CI: 1.19, 5.21), and primipara mothers (AHR = 3.16, 95% CI: 1.52, 6.60) had a higher hazard of neonatal mortality. However, neonates born to women who attended technical and vocational level education (AHR = 0.08, 95% CI: 0.01, 0.62) had a lower hazard of neonatal mortality.ConclusionsThe neonatal mortality rate in Ethiopia is high, with increased risk among specific subsets of the population. The findings highlight that neonatal survival can be improved through tailored interventions for rural residents, emerging regions, and primipara women by improving female education and avoiding pregnancy at an advanced maternal age to achieve Sustainable Development Goal target 3.2.

Book Review: Migrant mothers in the digital age: Emotion and belonging in migrant maternal online communities by Leah Williams Veazey

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Mothering in the Streets: The Familial Adaptation Strategies of Street-Identified Black American Mothers.

Using components of the Family Adjustment and Adaptation Response Model, Critical Race Feminism, and Sites of Resilience this study explored how street-identified Black American mothers engage in street life, while juggling the pressures of childrearing, family, and home life within a distressed, urban Black community. Street-identified Black American mothers are vilified for their intersecting identities of being Black women who are experiencing poverty, and who may also be involved in illegal activity. Black mothers are disproportionately represented in the criminal legal system, but existing research has inadequately examined how street-identified Black mothers "do" family in the confines of structural violence. We addressed this gap by analyzing interview data with 39 street-identified Black American mothers ages 18 to 54. Data were collected using street participatory action research. We identified a typology of three adaptive mothering strategies employed by street-identified Black women as they respond to and cope with violent structural conditions shaping their mothering: constrained mothering, racialized mothering, and aspirational mothering. Findings suggested that these strategies were developed in response to an overarching carceral apparatus, of which these mothers were tasked with avoiding when possible and confronting when necessary. Their mothering strategies were shaped by a collective, Black American cultural identity and worldview, and the mothers possessed a unique way of perceiving the world as criminalized subjects with disproportionate proximity to the punitive State.

Cross-Cultural Adaptation and Psychometric Evaluation of the Neonatal Eating Assessment Tool–Breastfeeding Into Tamil

ObjectiveTo adapt the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT-Breastfeeding) into Tamil, a language spoken in several South Asian countries, to identify the tool’s factor structure, and to assess its psychometric properties. DesignCross-sectional. SettingTertiary care hospital in South India. ParticipantsA cohort of 323 mothers of infants ages 1 week to 7 months, including infants with and without feeding difficulties. MethodTo adapt the English tool to Tamil, we followed standard procedures specified by the tool developers and international guidelines for tool translation and adaptation, including pilot testing and personal interviews with participants who had infants younger than 7 months. Participants completed the NeoEAT-Breastfeeding (Tamil) after assessment of breastfeeding by professionals. The 62-item tool involves rating each item on a 6-point scale, and higher scores indicate increased feeding difficulties. ResultsAfter exploratory factor analysis, we divided the tool into five subscales in the Tamil version compared to the seven subscales in the original English version. The Tamil version demonstrated high internal consistency reliability (Cronbach’s α = 0.97) and test–retest reliability (intraclass correlation = 0.99) for the total scores. Infants with feeding concerns demonstrated significantly higher total and subscale scores on the NeoEAT-Breastfeeding (Tamil) than infants without feeding concerns (p = .000; construct validity). ConclusionThe NeoEAT-Breastfeeding (Tamil) holds promise as a culturally appropriate, clinically useful parent-report tool with evidence for initial reliability and validity for identifying feeding-related concerns among infants younger than 7 months in the Tamil-speaking population.

Pregnancy outcomes at advanced maternal age in a tertiary Hospital, Jeddah, Saudi Arabia.

Objectives:To evaluate obstetrical and fetal outcomes among advanced maternal age (AMA) women.Methods:Retrospective cohort study carried out at a teaching hospital, Jeddah, Saudi Arabia, during 18 years period (from January 2003 until December 2020). A total of 79095 women gave birth, and randomized block was used to include 4318 singleton pregnancy women (>28 gestational weeks), of them 2162 age ≥40 years. Associations between AMA and obstetrical and fetal parameters were assessed.Results:Advanced maternal age independently associated with non-Saudi national, mother’s weights 80-99 kg, diabetes mellitus, and hypertension. Advanced maternal age mothers were more liable to premature rupture of membranes (PROM), caesarean (CS) deliveries, and postpartum hemorrhage. Newborn of AMA women were at high risk of birth weight <2500 g, birth weight 3600-4500 g, decline Apgar score at 5 minutes, and neonatal intensive care unit (NICU) admissions.Conclusion:Advanced maternal age is an independent risk factor for adverse obstetric hazards as CS, antepartum haemorrhage, diabetes mellitus, hypertension, PROM, postpartum hemmorage, and fetal complications as low birth weight, macrosomia, NICU admission, congenital anomalies, and low Apgar score. These results must be carefully considered by maternal care providers to effectively improve clinical surveillance.

Supplemental Material for A Cluster Analysis of Mothers of Reproductive Age Based on Their Attitude and Risk of Alcohol Use

Supplemental Material for A Cluster Analysis of Mothers of Reproductive Age Based on Their Attitude and Risk of Alcohol Use

Factors Associated with (Exclusive) Breastfeeding Duration-Results of the SUKIE-Study.

The WHO European Region has the lowest exclusive breastfeeding (EBF) rates at 6 months in the world. In Austria, 55.5% of infants are EBF at the age of one week, although breastfeeding initiation is 97.5%. The study was conducted in 2019/2020 and considered 1214 mothers of legal age, who received four online questionnaires during their child’s first year of life. The influence of different variables on total/exclusive breastfeeding duration were analysed by using a Cox model (Extension of the Cox Proportional Hazards Model) with time-dependent covariates. Multivariate analyses showed a significant influence of maternal BMI, lifestyle factors, such as smoking, and breastfeeding support on total breastfeeding duration. Remarkable differences in the median duration of any breastfeeding were found for breastfeeding support, where mothers breastfed twice as long. Support came primarily from hospital staff, the midwife and the partner. A higher monthly household net income, delivery in a baby-friendly certified hospital (BFH) and breastfeeding support were associated with a longer EBF duration. Obese mothers started feeding infant formula earlier and had a higher risk of early weaning. The results offer valuable insights into the importance of breastfeeding-friendly structures such as BFHs, a focus on breastfeeding aftercare and support of the mother to promote and protect breastfeeding.

Preterm birth ---- A novel risk factor of Ischemic Heart Disease and Stroke

Madam, preterm birth (PTB) is classified as having a gestational age of fewer than 37 weeks; annually, approximately 15 million infants are born preterm worldwide(1). Major risk factors of PTB include placenta previa, fetal distress, maternal thyroid disease, and maternal asthma(2). Both teenage (&lt;20 years) and advanced age (&gt;35 years) mothers carry an increased risk of giving birth prematurely(2). Previous studies have shown a positive correlation between PTB and numerous disorders, including hypertension, diabetes mellitus, and hyperlipidemia(3). Mounting evidence suggests PTB is a significant risk factor for ischemic heart disease (IHD) and stroke. However, due to prior discrepant findings, there is a possibility that these associations might be spurious. However, recent literature surfaced two cohorts by Crump et al. in 2019(4) and 2021(3). In 2019, compiled data from 2,141,709 participants over 43 years, and preterm babies were found to have a significantly higher risk of developing IHD in the future (aHR: 1.44 [1.19-1.73](4). Moreover, the incidence of IHD was more prevalent among preterm-born men than preterm-born women(4). The 2021 cohort evaluated the frequency of stroke with PTB. It concluded that PTB was associated with higher risks of both hemorrhagic stroke (aHR: 1.15 [0.97–1.35]) and ischemic stroke (aHR: 1.31 [1.07–1.60]), compared with full-term birth(3). These results are worrisome for Pakistan since it has a high tally of PTB cases, as highlighted by a 2017 study by Hanif et al., which showed a 21.64% prevalence of PTB among 1691 females(2). These preterm infants have an increased likelihood of acquiring IHD and Stroke coupled with the already established diseases including hypertension, diabetes, and hyperlipidemia later in life, which exacerbates the already high disease burden in Pakistan. Moreover, unaware of the medicines’ cost-effectiveness, medical practitioners commonly prescribe expensive popular generics for treating IHD(5), which inflicts a substantial financial burden on these patients. Hence, paediatricians should be advised to follow up with preterm babies regularly assess their progress, educate mothers about the risk factors of PTB and minimize the chances of them showing up down the line by emphasizing proper diet, regular exercise, and abstinence from smoking. Nationwide campaigns and awareness drives are a few ways the general population could be made aware of PTB and its threat to the health of these children in the future. Continue...

Learning to Live With Ambiguity: Rethinking Ambiguous Loss for Mothers of Children With Disabilities

The purpose of this study was to explore the mothering experiences of children with disabilities. The theory of ambiguous loss was applied to interpret the meanings that mothers give to the process of caregiving and the ways they stay proactive in the midst of challenges. Eleven mothers of children ages 6 to 35 with various disabilities participated in in-depth interviews to talk about their child’s educational history, their family’s routine, and the rewards and challenges of raising a child with disabilities. Findings illustrate that the mothers faced different experiences of ambiguity depending on the visible or invisible nature of their child’s disabilities. However, regardless of the nature of the disabilities, the mothers had learned to live with ambiguity in the face of new and continuous challenges. They did this by redefining their lives through maintaining valued identities as mothers and redefining the meaning of family. Findings also imply that the scope of ambiguous loss needs to be expanded.

Perceptions of Pregnant Women on Traditional Health Practices in a Rural Setting in South Africa.

Though there are prenatal and perinatal protocols across the African continent, traditional practices are commonly used. Improving maternal health requires an understanding of local cultural approaches and traditional health systems. The purpose of this study was to determine the perceptions of pregnant mothers of various ages and gravidities towards traditional maternal health practices during pregnancy. A descriptive phenomenological study was carried out with 27 purposively selected pregnant women from the King Sabatha Dalindyebo health sub-district. Discussion from three focus groups yielded three major themes and eight sub-themes. Content analysis revealed strong opinions and support for traditional practices. Although specialist practitioners were mentioned, family members were the primary source of information on traditional perinatal health practices. African mahogany bark, herbal decoctions, and holy water were allegedly used to treat labor pains, postnatal care, and the warding off of evil spirits. During pregnancy, these were thought to be beneficial and necessary. Nonetheless, the protection of some traditional practices’ know-how prevents integration of the traditional health system into the national health system. Consequently, there is a need for dialogue to facilitate the exchange of ideas on maternal health between the two health systems in order to facilitate more efficient policy formulation and implementation.

Low placental angiotensin-converting enzyme expression is related to fetal small for gestational age but not to metabolic control in type 1 diabetic pregnancies.

The maternal renin-angiotensin system is involved in blood pressure control and plays a crucial role in fetoplacental nutrition. Pre-gestational type 1 diabetes (PGDM) leads to serious pregnancy complications. We thus performed a longitudinal study to analyse the association of maternal angiotensin-converting enzyme (ACE) serum levels and placental mRNA expression with fetal newborns gestational weight in type 1 diabetes mellitus (T1DM) women. We recruited 65 singleton pregnant women with T1DM. Placental mRNA ACE gene expression was examined using quantitative real-time PCR. Serum ACE levels were measured in the first, second and third trimesters of pregnancy by ELISA commercial kits. Placental expression of ACE mRNA was significantly lower in small for gestational age (SGA) than appropriate for gestational age (AGA) and large for gestational age (LGA) mothers (0.55±0.06 vs 0.78±0.06 and 0.85±0.07 respectively, p=0.003). In the SGA group, the mRNA expression of ACE positively correlated with maternal body mass index (BMI) in the third trimester (r=0.49; p=0.04). In all study groups maternal ACE level was significantly higher in the third trimester (mean 139.91±SD 69.64) compared to the first and second trimesters of pregnancy (13.57±4.32 and 15.69±15.92 respectively). Our data suggest that lower placental ACE gene mRNA expression may have a vital role in the etiology of SGA babies.