Control Mothers Research Articles

Influenza vaccination during pregnancy and risk of selected major structural congenital heart defects, National Birth Defects Prevention Study 2006-2011.

Although results from studies of first-trimester influenza vaccination and congenital heart defects (CHDs) have been reassuring, data are limited for specific CHDs. We assessed associations between reported maternal influenza vaccination, 1 month before pregnancy (B1) through end of third pregnancy month (P3), and specific CHDs using data from a multisite, population-based case-control study. Analysis included 2,982 case children diagnosed with a simple CHD (no other cardiac involvement with or without extracardiac defects) and 4,937 control children without a birth defect with estimated delivery dates during 2006-2011. For defects with ≥5 exposed case children, we used logistic regression to estimate propensity score-adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusting for estimated delivery year and season; plurality; and maternal age at delivery, race/ethnicity, low folate intake, and smoking and alcohol use during B1P3. Overall, 124 (4.2%) simple CHD case mothers and 197 (4.0%) control mothers reported influenza vaccination from 1 month before through the third pregnancy month. The aOR for any simple CHD was 0.97 (95% CI: 0.76-1.23). Adjusted ORs for specific simple CHDs ranged from 0.62 for hypoplastic left heart syndrome to 2.34 for total anomalous pulmonary venous return (TAPVR). All adjusted CIs included the null except for TAPVR. Although we cannot fully exclude that exposure misclassification may have masked risks for some CHDs, findings add to existing evidence supporting the safety of inactivated influenza vaccination during pregnancy. The TAPVR result may be due to chance, but it may help inform future studies.

Nonpregnant and pregnant adult female rats affected by maternal diabetes environment

Maternal diabetes-mediated fetal programming is widely discussed, however, it is important to define the extent to which intrauterine hyperglycemia interferes with the health of female pups, along with determining whether these changes can be perpetuated across generations. This study aimed to evaluate the effects of maternal diabetes on fetal programming and the repercussions on the metabolism of pregnant and nonpregnant female pups. Diabetes status was induced (diabetic group—D) using streptozotocin (a beta cell cytotoxic drug) on the fifth postnatal day of female rats, while controls received a citrate buffer (Control—C). In adulthood, the rats were mated to obtain their female pups. At 90 days of age, half of the female pups were mated (preg) and the other half continued virgin (Npreg). Furthermore, they were distributed into four groups: OC/Npreg and OC/preg—female pups from control mothers; OD/Npreg and OD/preg—female pups from diabetic mothers. At 115 days of life and/or 17 days of pregnancy, the oral glucose tolerance test (OGTT) was performed with blood collection for insulin measurement. At 120 days of life and/or 21 days of pregnancy, the rats were anesthetized and euthanized to determine their blood oxidative stress status. The OD/Npreg group showed glucose intolerance during OGTT (p < 0.0001), while the OD/preg group showed increased insulin secretion during OGTT (p < 0.0001) and insulin resistance (IR; p = 0.0027). An increase in homeostatic model assessment β was shown in the pregnant groups, regardless of maternal diabetes (p < 0.0001). The OD/preg group presented increased thiobarbituric acid reactive substances (p < 0.0001) and –SH levels (p = 0.0005) and decreased superoxide dismutase activity (p = 0.0063). Additionally, small fetuses for gestational age (p < 0.0001) were found in these rats. In conclusion, exposure to maternal hyperglycemia compromises the glycemic metabolism of female pups before and during pregnancy and causes oxidative stress, IR, and impaired fetal growth during pregnancy.

Small Moments, Big Impact: Pilot Trial of a Relational Health App for Primary Care.

To conduct a pilot trial of Small Moments, Big Impact: a relational health app. Low-income mothers with 1 or no prior children, a full-term birth, above 18 years old, and without substance abuse were recruited. The control group was recruited prior to the intervention group to avoid contamination. Of the 117 mothers enrolled, 29 intervention and 29 control mothers completed the study. Five questionnaires were administered at baseline and 6-months to measure maternal depression, empathy, beliefs about children's emotions, intelligence mindsets, and app use. At 6 months, questionnaires assessing parenting stress, reflective functioning, and perceived value of app were also administered. Mothers in the final sample were similar to those who did not complete the study, except more mothers who dropped out were recruited during COVID-19 and had a lower empathetic subscale score. No differences were found between groups at pre- or post-test. However, because of skewed outcome variables which violated normality principles and the small sample size, quantile regression analyses were performed comparing the 25th, 50th, and 75th percentiles for each outcome. Controlling for pretest and potential confounders, subsets of SMBI mothers reported lower parental stress, more growth mindset and increased effort to understand their child's feelings. Ninety percent of mothers reported using SMBI at least once per week. Eighty percent of mothers would recommend the SMBI app to new mothers. Most mothers used SMBI weekly, rated it highly and reported less stress, more growth mindset, and more positive child rearing beliefs.

Intergenerational effects of overfeeding on aversive learning in zebrafish (Danio rerio).

The obesity epidemic is concerning as obesity appears to negatively impact cognition and behavior. Furthermore, some studies suggest that this negative effect could be carried across generations from both mothers and fathers although evidence is not consistent. Here, we attempt to address how obesogenic diets in the parental generation (F0) can impact offspring's cognition and anxiety intergenerationally (F1) in a zebrafish model. We compare both mean trait values and their variances. Using a multifactorial design, we created a total of four groups: F1T (treatment mothers × treatment fathers); F1M (treatment mothers × control fathers); F1P (treatment fathers × control mothers); and F1C (control mothers × control fathers, F1C); and subjected them to anxiety tank tests and aversive learning assays. When both parents were exposed, offspring (F1T) displayed the poorest aversive learning, while offspring that only had one parent exposed (F1P and F1M) learnt the aversive learning task the best. Zebrafish in all groups displayed no statistically significant differences in anxiety‐associated behaviors. Males and females also performed similarly in both anxiety and aversive learning assays. While all F1 groups had similar levels of fasting blood glucose, variance in glucose levels were reduced in F1P and F1T indicating the importance of investigating heteroskedasticity between groups. Furthermore, anxiety behaviors of these two groups appeared to be less repeatable. To our knowledge, this is the first study to test the intergenerational effects of an obesogenic diet on zebrafish cognition. Our multifactorial design as well as repeated tests also allowed us to disentangle maternal and paternal effects (as well as combined effects) and accurately detect subtle information such as between‐individual variation.

Sleep SAAF responsive parenting intervention improves mothers’ feeding practices: a randomized controlled trial among African American mother-infant dyads

Background/ObjectiveParents shape children’s early experiences with food, influencing what is served, children’s food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers’ infant feeding practices.MethodsPrimiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not).ResultsRP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2–0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe.ConclusionsResponsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls.Trial registrationSleep SAAF: A Strong African American Families Study. www.clinicaltrials.gov NCT03505203. Registered 3 April 2018.

Intrauterine malnutrition disrupts leptin and ghrelin milk hormones, programming rats.

Herein, we assessed milk hormones, the biochemical composition of milk, and its association with neonatal body weight gain and metabolic homeostasis in weaned rats whose mothers were undernourished in the last third of pregnancy. From the 14th day of pregnancy until delivery, undernourished mothers had their food restricted by 50% (FR50), whereas control mothers were fed ad libitum. The litter size was adjusted to eight pups, and rats were weaned at 22 days old. Milk and blood from mothers, as well as blood and tissues from pups, were collected for further analyses. At birth, FR50 pups were smaller than control pups, and they exhibited hyperphagia and rapid catch-up growth during the suckling period. On day 12, the milk from FR50 mothers had higher energy content, glucose, total cholesterol, triglycerides, and acylated ghrelin but lower leptin and corticosterone levels. Interestingly, FR50 mothers were hypoglycemic and hyperleptinemic at the end of the nursing period. Weaned FR50 pups had an obese phenotype and exhibited insulin resistance, which was associated with hyperglycemia and hypertriglyceridemia; they also had high blood levels of total cholesterol, leptin, and acylated ghrelin. In addition, the protein expression of growth hormone secretagogue receptor (GHSR) in the hypothalamus was increased by almost 4-fold in FR50 pups. In summary, maternal calorie restriction during the last third of pregnancy disrupts energy and metabolic hormones in milk, induces pup hyperleptinemia and hyperghrelinemia, and upregulates their hypothalamic GHSR, thus suggesting that the hypothalamic neuroendocrine circuitry may be working to address the early onset of obesity.

Assessment of Impact of Regional Analgesia on Labor and Neonates in Hilla City

Background: Epidural is the most effective form of pain relief in labor with around 30% of laboring women in the UK and 60% in the USA receiving epidural analgesia. Objectives: To assess effect of regional analgesia on labor pain, duration, outcome of delivery and neonates. Materials and Methods: Case control study included 400 pregnant woman 200 of them delivered by painless labour and other 200 whose delivered without analgesia who attended to the babylon maternity and pediatric hospital, Al sadiq hospital and private hospitals in al hilla city which included private Teiba, Al Fayhaa hospitals from first of february 2022 to June 2022. Results: The duration of first stage of labor was significantly prolonged at control mothers 26%(52) in compare to 10%(20) of mothers with epidural anesthesia had prolonged labor. While second stage shown no significant association with epidural anesthesia (P = 0.47). Fetal heart rate abnormalities shown no significant association with epidural analgesia (P = 0.96). While back pain and headache was significantly higher in mothers with epidural analgesia (P &lt; 0.001). Conclusions: EA was not associated with a higher instrumental delivery rate and higher rate of c/s, EA not cause significant maternal or neonatal complications in primi- and multiparas. Importantly, EA associated with short first stage of labor and not higher rate effect on duration of second stage of labour.

Increases in Language Input are Sustained among Mothers of Low SES: Evidence from a Randomized Controlled Trial

SYNOPSIS Objective. This randomized controlled trial examined whether the quantity and quality of maternal language input were increased through the 3Ts Home Visiting (3Ts-HV) intervention early in toddlerhood and whether increases in maternal language input were sustained over time among families of low SES, controlling for maternal education level, language skill, depressive symptoms, family adversity, child age, child language skills, and the length of recording. Design. 149 mother-toddler dyads of low SES were randomized to receive either the 3Ts-HV intervention (n = 76) or Healthy Lifestyle control (n = 73) curriculum from 14 to 20 months. Both quantity (tokens) and quality (lexical diversity, syntactic complexity, and use of complex sentences and wh-questions) of maternal language input were assessed at 14, 20, 26, 32, and 38 months. Hierarchical linear models were estimated to compare maternal language input between groups over time. Growth trajectories were modeled during the post-curriculum period alone, controlling for baseline maternal language input. Results. Intervention mothers had significantly larger increases in both quantity and quality of language input than Control mothers at 20 months. Intervention mothers’ increases in both quantity and quality of language input were sustained at 26, 32, and 38 months. Conclusions. Language input can be promoted early in toddlerhood and sustained over time among families facing socioeconomic disadvantages. Fostering sustainable increases in maternal language behaviors with very young children among families of low SES is a critical first step in addressing early language input disparities.

Why do mothers never stop grieving for their deceased children? Enduring alterations of brain connectivity and function.

A child’s death is a profound loss for mothers and affects hundreds of thousands of women. Mothers report inconsolable and progressive grief that is distinct from depression and impacts daily emotions and functions. The brain mechanisms responsible for this relatively common and profound mental health problem are unclear, hampering its clinical recognition and care. In an initial exploration of this condition, we used resting state functional MRI (fMRI) scans to examine functional connectivity in key circuits, and task-based fMRI to examine brain network activity in grieving mothers in response to pictures of their deceased child and as well as recognizable deceased celebrities and unfamiliar individuals. We compared nine mothers who had lost an adult child and aged-matched control mothers with a living child of a similar age. Additionally, we collected diffusion imaging scans to probe structural connectivity and complemented the imaging studies with neuropsychological assessments. Increased functional activation in Ventral Attention/Salience Networks accompanied by a reduced activation in the medial prefrontal cortex in response to the deceased child’s picture robustly distinguished the grieving mothers from controls. Heightened resting-state functional connectivity between the paraventricular thalamic nucleus (PVT) and the amygdala distinguished the grieving mothers from the controls and correlated with subjective grief severity. Structurally, maternal grief and its severity were associated with alterations in corticolimbic white matter tracts. Finally, grieving mothers performed worse than controls on neuropsychological tests of learning, memory, and executive function, linked with grief severity. Reduced activation in cortical regions inhibiting emotions and changes in the PVT circuitry—a region involved in long-term emotional memories and decision making under conflict—distinguish grieving mothers from controls. Notably, the magnitude of neurobiological changes correlates with the subjective severity of grief. Together, these new discoveries delineate a prevalent and under-recognized mental health syndrome and chart a path for its appreciation and care.

Determinants of Meconium-Stained Amniotic Fluid at Hadiya Zone Hospitals, Southern Ethiopia; Unmatched Case-Control Study.

BackgroundMeconium-stained amniotic fluid (MSAF) refers to an amniotic fluid that is green in color or mixed with meconium. MSAF leads to a serious maternal complication that increases the likelihood of operative delivery and poses a hazard to the fetus or the neonate. This in turn enhances the chances of maternal and neonatal mortality and morbidity. So, the identification of determinants helps to breach this vicious cycle. The current study aimed to assess the determinants of MSAF.MethodsAn institution-based, unmatched case-control study with a sample size of 363 participants (121 cases and 242 controls) was conducted on mothers who gave birth at Hadiya zone public hospitals between March and April 2020. A proportionate distribution was made to each facility depending on the volume of patients, and cases and control mothers were chosen sequentially. The data was gathered through in-person interviews and secondary data extraction. In multivariable logistic regression, variables with (p < 0.25) in bivariate analysis were included. After multivariable logistic regression was finished, statistical significance was declared at (p < 0.05).ResultsA total of 121 cases and 242 controls were included in this study Multivariable logistic regression analysis showed that gestational age ≥ 41 week (AOR = 3.44, 95% CI: 1.02–11.63), premature rupture of membrane (AOR = 3.71, 95% CI: 1.98–6.93) obstructed labor (AOR = 2.90, 95% CI: 1.15–7.33) preeclampsia (AOR = 4.16, 95% CI: 1.29–13.35) and non-reassuring fetal heart rate (AOR = 6.75, 95% CI: 3.45–13.19) were significantly associated with MSAF.ConclusionAdvanced gestational age, an early membrane rupture, an obstructed labor, preeclampsia, and non-reassuring fetal heart rate all increase the incidence of meconium-stained amniotic fluid in laboring mothers. Making every effort to prevent, identify, and treat those obstetric determinants as early as feasible should be taken into consideration throughout follow-up of pregnancy, labor, and delivery could assist to lower the incidence of MSAF.

Severity of Depression in Mothers of children suffering from Cerebral Palsy

Background: Cerebral palsy (CP) is the most common cause of motor disability in children with worldwide having incidence of 2 per 1000 live births. Children with CP have motor disability, decreased ability to walk, poor feeding and limited exposure to sunlight. Malnutrition, behavior challenges and motor deficits in CP children are common causes of depression in their mothers. Aim: The present study focused to estimate the severity of depression in mothers, looking after the children suffering from severe CP and to compare their depression scoring with the scores of mothers having healthy children. Methods: The cross-sectional comparative study included 21 mothers having children suffering from severe CP and 21 controls (Mothers of normal children). Depression was calculated by the Beck Depression Inventory (BDI). Results: A statistically significant difference was observed between the mean scores of BDI II between the two groups Conclusion: Results revealed that mothers having CP children are more depressed than mothers having healthy children. It imitates the importance of psychiatric, social and family support to mother along with the treatment of the child. Keywords: CP, depression, BDI II.

Association between Maternal Choline, Fetal Brain Development, and Child Neurocognition: Systematic Review and Meta-Analysis of Human Studies.

We studied associations between prenatal and early postnatal choline intake, brain development, and neurocognitive function of children. We conducted a systematic review followed by a meta-analysis and critical appraisal of human studies published from 1997 to 2021. Thirty publications were identified. The meta-analysis included 5 of 7 case-control studies studying neural tube defects (NTDs) in relation to maternal choline intakes/circulating concentrations. Low maternal choline intake/circulating concentrations were associated with a higher OR for NTDs among 1131 mothers of newborns with NTDs and 4439 control mothers (pooled estimate = 1.36; 95% CI: 1.11, 1.67). The 95% prediction intervals were 0.78, 2.36. Findings and critical evaluation of 10 publications with interventional designs showed that higher maternal choline intakes during the second half of pregnancy and early postnatal period (550mg up to 1g/d on top of the diet) or a child intake of 513 to 625mg/d from supplements were safe and likely to demonstrate favorable effects on several domains of child neurocognition, such as memory, attention, and visuospatial learning versus the comparators. Findings from observational studies (n=13) partly supported the association between maternal choline intake/serum concentrations and child neurocognition, but there was low confidence in the use of plasma choline concentrations as a choline intake marker. In conclusion, low maternal choline intakes were associated with a higher OR for NTDs. The risk could be up to 2.36-fold in some populations. Despite limitations of available trials and observational studies, higher maternal choline intake was likely to be associated with better child neurocognition/neurodevelopment. The results should be used to guide choline intake recommendations in pregnancy and lactation, especially because most young women are not achieving the reference intake of choline. This meta-analysis is registered at PROSPERO as CRD42021233790.

Maternal exposure to heparin products and risk of birth defects in the National Birth Defects Prevention Study.

Heparin and low-molecular-weight heparin are the preferred anticoagulants during pregnancy as they do not cross the placenta. Although research on the safety of heparin products has been reassuring, previous studies have considered birth defects as a single outcome or by larger organ system and have not examined associations with specific birth defects. We analyzed data from the National Birth Defects Prevention Study, a multisite, population-based case-control study from 1997 to 2011. We used unconditional logistic regression with Firth's penalized likelihood to calculate adjusted odds ratios (ORs) and profile likelihood 95% confidence intervals (CIs) for defects with at least five exposed cases. For defects with 3-4 exposed cases, we estimated crude ORs and exact 95% CIs. Of the 42,743 women in our analysis, 117 (0.4%) case and 44 (0.4%) control mothers reported using a heparin product in early pregnancy. The adjusted ORs ranged from 0.9 to 3.9 and were elevated for anorectal atresia (OR=2.0, 95% CI=0.8-4.3), longitudinal limb deficiency (3.5, 1.3-7.8), transverse limb deficiency (1.8, 0.6-4.3), atrioventricular septal defect (3.9, 1.4-9.0), and secundum atrial septal defect (2.2, 1.2-3.8). We observed elevated associations for some birth defects, although heparin is a rare exposure, which limited our ability to evaluate many associations. Future studies that can explore specific birth defects and adequately control for confounding by indication are needed. Given that women with an indication for heparin products during pregnancy often need to take medication, one must remain mindful of the underlying risk of a birth defect that exists regardless of medication use.

Association and Interaction Effect of BHMT Gene Polymorphisms and Maternal Dietary Habits with Ventricular Septal Defect in Offspring.

This study attempted to learn the association between maternal betaine-homocysteine methyltransferase (BHMT) gene polymorphisms, maternal dietary habits, and their interactions with the risk of ventricular septal defects (VSD) in offspring. A total of 426 mothers of VSD children and 740 control mothers were included in the study. Logistic regression was used to evaluate the level of associations and interaction effects. Our study suggested that mothers reporting excessive intake of smoked foods (aOR = 2.44, 95%CI: 1.89–3.13), barbecued foods (aOR = 1.86, 95%CI: 1.39–2.48), fried foods (aOR = 1.93, 95%CI: 1.51–2.46), and pickled vegetables (aOR = 2.50, 95%CI: 1.92–3.25) were at a significantly higher risk of VSD in offspring, instead, mothers reporting regular intake of fresh fruits (aOR = 0.47, 95%CI: 0.36–0.62), fish and shrimp (aOR = 0.35, 95%CI: 0.28–0.44), fresh eggs, (aOR = 0.56, 95%CI: 0.45–0.71), beans (aOR = 0.68, 95%CI: 0.56–0.83), and milk products (aOR = 0.67, 95%CI: 0.56–0.80) were at a lower risk of VSD in offspring. In addition, maternal BHMT gene polymorphisms at rs1316753 (CG vs. CC: aOR = 2.01, 95%CI: 1.43–2.83) and rs1915706 (CT vs. TT: (aOR = 1.81, 95%CI: 1.33–2.46) were significantly associated with increased risk of VSD in offspring. Furthermore, a significant interaction between BHMT polymorphisms and maternal bean intake was identified in the study. In conclusion, Maternal BHMT polymorphisms at rs1316753 and rs1915706, dietary habits as well as their interaction were observed to be significantly associated with the risk of VSD in offspring.

Different effects of maternal homocysteine concentration, MTHFR and MTRR genetic polymorphisms on the occurrence of fetal aneuploidy

Research questionDo maternal homocysteine (Hcy) concentrations, MTHFR and MTRR genes have effects on the occurrence of fetal aneuploidy? DesignA total of 619 aneuploidy mothers and 192 control mothers were recruited in this study. Differences in distributions of maternal MTHFR 677C>T, MTHFR 1298A>C and MTRR 66A>G genetic polymorphisms and maternal Hcy concentrations between aneuploidy mothers and control mothers were analysed. ResultsThe maternal MTHFR 677C>T polymorphism was found to be a risk factor for the occurrence of many fetal non-mosaic aneuploidies studied here, including trisomies 13, 15, 16, 18, 21, 22, TRA and TS. The maternal MTHFR 1298A>C polymorphism was found to be a risk factor specifically associated with the occurrence of fetal trisomy 15 and fetal TS. The maternal MTRR 66A>G polymorphism was found to be a risk factor only specifically associated with the occurrence of fetal trisomy 21. The Hcy concentrations of mothers of trisomies 22, 21, 18, 16, 15 and TS fetuses were significantly higher than the Hcy concentrations of control mothers. ConclusionsOverall, data suggested an association between these maternal polymorphisms and the susceptibility of fetal non-mosaic trisomy and Turner syndrome. However, these three maternal polymorphisms had different associations with the susceptibility of different fetal aneuploidies, and the elevated maternal Hcy concentration appeared to be a likely risk factor for fetal Turner syndrome and fetal trisomies.

Determinants of birth asphyxia at public hospitals in Ilu Aba Bor zone southwest, Ethiopia: a case control study

Birth asphyxia is a leading cause of neonatal deaths, which accounts for about 31.6% of all neonatal deaths in Ethiopia. Despite its being one of the important causes of morbidity and mortality in newborns, its determinants were not investigated according to local context. So, this study was aimed at investigating the determinants of asphyxia at Illu Aba Bor zone public health facilities. An institution-based case–control study was employed. A pre-tested, structured and adapted interviewer administered questionnaire for mothers of newborn interviews and a data extraction tool for chart review were used. The collected data were entered into Epi-data version 3.1 and exported to SPSS version 24 for further analysis. A binary logistic regression was employed, and variables with a p-value < 0.25 were taken to a multi-variable logistic regression. Finally, a Bonferroni correction was used and variables with a p-value < 0.0038 at 95% CI were declared statistically significant. A total of 308 (103 cases vs 205 controls) mothers of newborns were interviewed, yielding a response rate of 100%. The mean age (SD) of mothers for the cases and the controls were (25.97 ± 4.47) and (25.52 ± 4.17) respectively. Prolonged duration of labor [AOR 4.12; 95% CI 1.78, 9.50], non-cephalic fetal presentation [AOR 4.35; 95% CI 1.77, 10.67], being preterm [AOR 5.77; l95% CI 2.62, 12.69] and low birth weight [AOR 4.43; (95% CI 1.94, 10.13) were found to be the determinants of birth asphyxia. Prolonged duration of labor, non-cephalic presentation, prim parous, preterm, and low birth weight were the independent determinants of birth asphyxia. Hence, improving the utilization of parthograph during labor and interventions focusing on this area should give priority to reducing the risk of morbidity and mortality.

Maternal and Offspring Sugar Consumption Increases Perigonadal Adipose Tissue Hypertrophy and Negatively Affects the Testis Histological Organization in Adult Rats.

Sugar intake has been associated with the development of male reproductive pathologies because of the increase and dysfunction in different adipose tissue depots. The establishment of these dysfunctions in the early stages of development is unknown. We evaluated the effect of maternal (pregnancy and lactation) and male offspring (from weaning to adulthood) consumption of 5% sucrose on perigonadal adipose tissue (PAT) and testis in adulthood. Moreover, two rat groups were compared, both including pregnant and lactating females: Control (C—drinking tap water) and sugar (S—consuming 5% sucrose solution). From weaning to adulthood with male offspring, four subgroups were formed: Control Mother → Control and Sugar offspring (CC, CS) and Sugar Mother → Control and Sugar offspring (SC, SS). At 120 postnatal days, the testes and PAT were collected and morphologically described. Furthermore, we quantified the number and cross-sectional area of perigonadal adipocytes and their distribution. We found that the males from SC and SS groups showed high PAT weight (p < 0.005), a high number (p < 0.05), and a relative frequency of large adipocytes (p < 0.05), establishing these results during gestational and lactation stages, and enhancing in adulthood since postnatal diet and its interaction. More macrophages, mast cells, and Leydig cells were observed in the interstitial space of the testis for the CS, SC, and SS groups, concluding that consumption of a high-carbohydrate maternal diet, program hypertrophy processes in adult PAT, developing and enhancing with sugar consumption during postnatal life. Furthermore, they are associated with inflammatory processes within the interstitial space of the testis.

Maternal High-Fat Diet Aggravates Allergic Asthma in Offspring via Modulating CD4+ T-Cell Differentiation.

Maternal improper nutrition has been reported to trigger respiratory disorders in offspring. Here, we characterized the effects of high-fat environment in the fetal period on mice and human cord blood CD4+ T-lymphocytes, and investigated their roles in susceptibility to asthma. Mice born to mothers that consumed a high-fat diet (HFD) throughout the gestation period were sensitized by ovalbumin to establish an experimental asthma model. To further extrapolate to humans, we collected cord blood from neonates of hypercholesterolemic (HC) mothers (n = 18) and control mothers (n = 20). In mice, aggravated airway hyperresponsiveness and inflammation revealed that maternal high-fat diet could lead to exacerbated allergic asthma in adult offspring. It was partially due to augmented activation and proliferation of CD4+ T-cells, where upregulated klf2 mRNA levels may be potentially involved. Notably, naïve HFD CD4+ T-cells had enhanced TH2-based immune response both in vivo and in vitro, resulting from DNA hypomethylation of the Il-4 promoter region. Moreover, in human, TH2 cytokines transcripts were enhanced in CD4+ T-cells of the HC group, which was associated with an increased risk of developing allergic diseases at 3 years old. Together, our study indicated that early life improper nutrition-triggered epigenetic changes in T-cells may contribute to long-lasting alterations in allergic diseases.

Effect of the INSIGHT Firstborn Parenting Intervention on Secondborn Sleep.

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention for first-time mothers improved firstborn infant sleep compared with controls. The goals of this analysis were to test intervention spillover effects on secondborn siblings and examine birth order differences in infant sleep. Secondborns (n = 117) of INSIGHT mothers were enrolled in an observational cohort, SIBSIGHT. The Brief Infant Sleep Questionnaire was collected at 3, 16, and 52 weeks. Generalized linear mixed models assessed differences among secondborns by firstborn randomization, as well as birth order differences at 16 and 52 weeks. The RP group secondborns slept 42 minutes longer at night (95% confidence interval [95% CI]: 19-64) and 53 minutes longer total (95% CI: 17-90) than control secondborns. RP secondborns were more likely to self-soothe to sleep (odds ratio [OR] = 2.0, 95% CI: 1.1-3.7) and less likely to be fed back to sleep after waking (OR = 0.5, 95% CI: 0.3-0.9) than secondborns of control mothers. RP secondborns were more likely to have a bedtime ≤8 pm at 3 (OR = 2.9, 95% CI: 1.1-7.7) and 16 weeks (OR = 4.7, 95% CI: 2.0-11.0). Few differences in sleep parenting practices were observed when comparing siblings within families. Secondborns slept 37 minutes longer than firstborns at 16 weeks (CI: 7-67, P = .03). The INSIGHT RP intervention for first-time mothers had a spillover effect to secondborns, positively impacting sleep duration and behaviors. Intervening with first-time mothers benefits both firstborns and subsequent children.

Child type 1 diabetes associated with mother vaginal bacteriome and mycobiome

Mother vaginal microbes contribute to microbiome of vaginally delivered neonates. Child microbiome can be associated with autoimmune diseases, such as type 1 diabetes (T1D). We collected vaginal DNA samples from 25 mothers with a vaginally delivered child diagnosed with T1D and samples from 24 control mothers who had vaginally delivered a healthy child and analyzed bacteriome and mycobiome of the samples. The total DNA of the samples was extracted, and ribosomal DNA regions (16S for bacteria, ITS2 for fungi) were amplified, followed by next-generation sequencing and machine learning. We found that alpha-diversity of bacteriome was increased (P < 0.002), whereas alpha-diversity of mycobiome was decreased (P < 0.001) in mothers with a diabetic child compared to the control mothers. Beta-diversity analysis suggested differences in mycobiomes between the mother groups (P = 0.001). Random forest models were able to effectively predict diabetes and control status of unknown samples (bacteria: 0.86 AUC, fungi: 0.96 AUC). Our data indicate several fungal genera and bacterial metabolic pathways of mother vaginal microbiome to be associated with child T1D. We suggest that early onset of T1D in a child has a relationship with altered mother vaginal microbiome and that both bacteriome and mycobiome contribute to this shift.