Infant Health Research Articles

A cost analysis of upscaling access to continuity of midwifery carer: Population-based microsimulation in Queensland, Australia

ObjectiveTo quantify the economic impact of upscaling access to continuity of midwifery carer, compared with current standard maternity care, from the perspective of the public health care system. MethodsWe created a static microsimulation model based on a whole-of-population linked administrative data set containing all public hospital births in one Australian state (Queensland) between July 2017 to June 2018 (n = 37,701). This model was weighted to represent projected State-level births between July 2023 and June 2031. Woman and infant health service costs (inpatient, outpatient and emergency department) during pregnancy and birth were summed. The base model represented current standard maternity care and a counterfactual model represented two hypothetical scenarios where 50 % or 65 % of women giving birth would access continuity of midwifery carer. Costs were reported in 2021/22 AUD. ResultsThe estimated cost savings to Queensland public hospital funders per pregnancy were $336 in 2023/24 and $546 with 50 % access. With 65 % access, the cost savings were estimated to be $534 per pregnancy in 2023/24 and $839 in 2030/31. A total State-level annual cost saving of $12 million in 2023/24 and $19 million in 2030/31 was estimated with 50 % access. With 65 % access, total State-level annual cost savings were estimated to be $19 million in 2023/24 and $30 million in 2030/31. ConclusionEnabling most childbearing women in Australia to access continuity of midwifery carer would realise significant cost savings for the public health care system by reducing the rate of operative birth.

Beyond Birth Work: Addressing Social Determinants of Health With Community Perinatal Support Doulas.

Adverse maternal and infant health outcomes among African Americans are increasingly recognized as indicators of a critical public health crisis in the United States. Research has found that stress is related to structural racism and the social determinants of health (SDOH) that cause avoidable, unfair inequities in resources, education, power, and opportunities across ethnic groups. This paper describes the SDOH needs and experiences of pregnant Black women from the perspective of doulas and Birthing Beautiful Communities (BBC) clients. The design was a qualitative description, using data collected over time (2017-2018, 2020-2021, and 2023). This study took place in Cleveland and Akron, Ohio and the sample included 58 clients, 26 doulas, and 2 resource intake specialist assistants (RISAs). Qualitative data included individual client interviews, three doula focus groups, and one interview with two BBC RISAs. Three coders used content analysis to deductively identify SDOHs and calculate the number of interviews that contained information about specific SDOHs. Although the sample reported issues with all SDOH, particular ones caused a cascade of SDOH effects. Transportation issues, for example, impeded women from being able to make it to work, doctor's appointments, and to purchase essential baby items (e.g., food, infant supplies). An inability to work-whether because of transportation challenges or pregnancy-related health complications-led to unstable housing and an inability to deal with transportation challenges. Many clients mentioned that housing was a major issue, with many clients experiencing housing instability. Implications include ensuring SDOH information is collected from a trusted source who can advocate and ensure access to a wide range of local resources, ensuring policies protect pregnant women from experiencing a cascade of SDOH that may contribute to continuing health disparate infant and maternal health outcomes in African American women.

The Role of Lactobacillus Reuteri Probiotic for Preventing Functional Gastrointestinal Disorders in Toddlerhood

Probiotic<i> Lactobacillus </i>reuteri has been shown to be useful for a number of gastrointestinal disorders. Its ability to secrete antimicrobial compounds, prevent pathogenic microorganisms from colonizing the host, and alter the composition of the commensal microbiota in the host are all major contributors to its therapeutic advantages. Not only that, but L. reuteri treatment strengthens the host's defenses against infection and pro-inflammatory cytokine production while enhancing the growth and functionality of regulatory T cells. Numerous pediatric illnesses, particularly those pertaining to the intestinal health of infants, have been found to be well managed by L. reuteri, according to systematic reviews and meta-analyses. According to current research on L. reuteri, it may be useful in the management and avoidance of a number of common clinical disorders, including functional constipation, infantile colic, regurgitation, and diarrhea. Probiotic treatment for pediatric illnesses has had favorable benefits on bowel regularity in individuals with chronic constipation and has been found to successfully reduce screaming and/or fussing time in newborns with colic. Additionally, it quickens the emptying of the stomach and lessens distension. Several research have even come to the conclusion that this probiotic strain reduces the frequency of regurgitation. The potential of this probiotic strain for application in the treatment of several gastrointestinal disorders is evident from all of these findings. Therefore, this study aims to encapsulate and condense the advantages of this probiotic strain in clinical settings, with a particular emphasis on how it supports babies' and toddlers' immune systems and gut health.

DIGITAL HEALTH TOOLS FOR BREASTFEEDING MOTHERS: A COMPARATIVE REVIEW BETWEEN NIGERIA AND THE US

This comparative review evaluates and compares the impact and adoption of mobile apps and digital platforms, including Babyroo, in supporting breastfeeding mothers in Nigeria and the US. Breastfeeding is crucial for infant health and development, yet many mothers face challenges and require support. Digital health tools, such as mobile apps and online platforms, offer a promising solution to provide information, guidance, and support to breastfeeding mothers. Nigeria and the US were chosen for comparison due to their different healthcare systems, cultural norms, and levels of technological adoption. The review examines the features, accessibility, and effectiveness of digital health tools, particularly Babyroo, in supporting breastfeeding mothers in both countries. The findings reveal that digital health tools play a significant role in supporting breastfeeding mothers in both Nigeria and the US. Babyroo, in particular, offers a range of features such as breastfeeding tips, tracking tools, and online communities for mothers to connect and share experiences. However, the adoption of these tools varies between the two countries. In Nigeria, where access to healthcare services is limited, digital health tools like Babyroo can bridge the gap and provide essential support to breastfeeding mothers. In contrast, in the US, where healthcare services are more accessible, digital health tools serve as a supplement to traditional healthcare services, offering convenience and additional resources for breastfeeding mothers. Overall, the review highlights the potential of digital health tools, such as Babyroo, in supporting breastfeeding mothers globally. However, it also emphasizes the importance of context-specific approaches and the need for further research to understand the impact and effectiveness of these tools in different cultural and healthcare settings.
 Keywords: Digital Health, Tools, Breastfeeding, Mothers, Comparative.

SPOOC (Sensor for Periodic Observation of Choline): An Integrated Lab-on-a-Spoon Platform for At-Home Quantification of Choline in Infant Formula.

Choline is an essential micronutrient for infants' brain development and health. To ensure that infants receive the needed daily dose of choline, the U.S. Food and Drug Administration (FDA) has set requirements for choline levels in commercialized infant formulas. Unfortunately, not all families can access well-regulated formulas, leading to potential inadequacies in choline intake. Economic constraints or difficulties in obtaining formulas, exacerbated by situations like COVID-19, prompt families to stretch formulas. Accurate measurement of choline in infant formulas becomes imperative to guarantee that infants receive the necessary nutritional support. Yet, accessible tools for this purpose are lacking. An innovative integrated sensor for the periodic observation of choline (SPOOC) designed for at-home quantification of choline in infants' formulas and milk powders is reported. This system is composed of a choline potentiometric sensor and ionic-liquid reference electrode developed on laser-induced graphene (LIG) and integrated into a spoon-like device. SPOOC includes a micro-potentiometer that conducts the measurements and transmits results wirelessly to parents' mobile devices. SPOOC demonstrated rapid and accurate assessment of choline levels directly in pre-consuming infant formulas without any sample treatment. This work empowers parents with a user-friendly tool for choline monitoring promoting informed nutritional decision-making in the care of infants.

Racial and Ethnic Disparities in the Effects of Group Prenatal Care On Identification of Intimate Partner Violence: Findings from a Randomized Controlled Trial of CenteringPregnancy

Abstract Purpose Intimate Partner Violence (IPV) during pregnancy can have serious consequences for maternal, infant, and child health. Importantly, the risk and consequences of IPV are greater for Black and Hispanic pregnant individuals than for White pregnant individuals. Thus, identification of IPV and referral to services during pregnancy is important, particularly for Black and Hispanic patients. Continuity of care and patient-centered care are thought to be essential for the identification of IPV in healthcare settings. Thus, we proposed that group prenatal care, which involves prenatal care providers delivering health, education, and support services to patients in a group setting, would create an atmosphere that is conducive to the identification of IPV. We specifically expected to see this effect among Black and Hispanic patients because group prenatal care has been hypothesized to increase the quality of the provider-patient relationship and reduce clinical bias against patients of color. Methods We conducted a secondary analysis of data from a randomized controlled trial of CenteringPregnancy (N = 523). Results We found that group prenatal care does have a significant, positive effect on IPV identification among prenatal care patients, but only for White women. Members of other racial and ethnic groups, who are at increased risk of experiencing IPV and its harmful consequences, do not receive this benefit. Conclusions Moving forward, researchers and practitioners should establish whether group prenatal care could be improved by intentionally incorporating a curriculum that directly addresses racial and ethnic disparities in quality of healthcare. Trial Registration Number and Date NCT02640638 (Prospectively registered 12/29/2015).

Paid Family Leave Programs—Understanding the Consequences for Infant Health

Paid Family Leave Programs—Understanding the Consequences for Infant Health

Economic Growth and Gender Dynamics: Analyzing Socio-Economic Influences on Infant Mortality in China

This study explores the socio-economic determinants of infant mortality in China through two empirical models, employing linear regression analysis on data from 2010 to 2020. The first model examines the impact of female labor force participation, GDP per capita, health expenditure, and fertility rates on infant mortality. Findings indicate significant negative associations between infant mortality and both female labor force participation and GDP per capita, while health expenditure did not show a significant impact. The second model introduces an interaction term between female labor force participation and GDP, highlighting the nuanced relationship between economic growth and gender dynamics in influencing infant mortality. Results from this model suggest that the beneficial impact of female labor force participation on reducing infant mortality is more pronounced with higher GDP growth. Despite facing limitations such as small sample size and multicollinearity, this research underscores the importance of economic and gender factors in improving infant health outcomes in China, suggesting avenues for further study with more comprehensive models and variables.

The PRECISE-DYAD protocol: linking maternal and infant health trajectories in sub-Saharan Africa.

PRECISE-DYAD is an observational cohort study of mother-child dyads running in urban and rural communities in The Gambia and Kenya. The cohort is being followed for two years and includes uncomplicated pregnancies and those that suffered pregnancy hypertension, fetal growth restriction, preterm birth, and/or stillbirth. The PRECISE-DYAD study will follow up ~4200 women and their children recruited into the original PRECISE study. The study will add to the detailed pregnancy information and samples in PRECISE, collecting additional biological samples and clinical information on both the maternal and child health.Women will be asked about both their and their child's health, their diets as well as undertaking a basic cardiology assessment. Using a case-control approach, some mothers will be asked about their mental health, their experiences of care during labour in the healthcare facility. In a sub-group, data on financial expenditure during antenatal, intrapartum, and postnatal periods will also be collected. Child development will be assessed using a range of tools, including neurodevelopment assessments, and evaluating their home environment and quality of life. In the event developmental milestones are not met, additional assessments to assess vision and their risk of autism spectrum disorders will be conducted. Finally, a personal environmental exposure model for the full cohort will be created based on air and water quality data, combined with geographical, demographic, and behavioural variables. The PRECISE-DYAD study will provide a greater epidemiological and mechanistic understanding of health and disease pathways in two sub-Saharan African countries, following healthy and complicated pregnancies. We are seeking additional funding to maintain this cohort and to gain an understanding of the effects of pregnancies outcome on longer-term health trajectories in mothers and their children.

Barriers to Accessing Paid Parental Leave Among Birthing Parents With Perinatal Health Complications: A Multiple-Methods Study

IntroductionEven in the small number of U.S. states with paid parental leave (PPL) programs, studies have found awareness of PPL remains low and unevenly distributed among parents. Moreover, little is known about whether parents with perinatal health complications have unmet needs in obtaining information about and support for accessing parental leave during that time. This study aims to address this research gap. Given the strong evidence linking paid leave with improvements in maternal and infant health, it is critical to evaluate access among vulnerable populations. MethodsWe used a multiple methods approach, including a subset of the 2016–2017 Bay Area Parental Leave Survey of Mothers (analytic sample = 1,007) and interview data from mothers who stayed at a neonatal intensive care unit in 2019 (n = 7). All participants resided at that time in California, a state that offers PPL. The independent variable for the survey analysis was a composite measure of perinatal complications, quantified as binary with a value of 1 if respondents reported experiencing any of the four complications: poor maternal mental health during or after pregnancy, premature birth, or poor infant health. Dependent variables for the survey analysis measured lack of support or information for accessing PPL. We used linear probability models to assess the relationship between perinatal complications and PPL support. Thematic analysis was conducted with the interview data to understand how perinatal complications shape the process of accessing PPL. ResultsSurvey results revealed that parents with perinatal complications had a lower understanding of PPL benefits and low overall support for accessing leave, including from employers, compared with parents without perinatal complications. From interviews, we learned that perinatal complications present unique challenges to parents navigating PPL. There were multiple entities involved in managing leave and providing information, such as the benefits coordinator and employers. Supervisors were reported as providers of critical emotional and financial support. ConclusionsTaken together, the findings from surveys and interviews suggest that health care and human resources personnel should be better equipped to provide information and support, particularly to those who experience perinatal complications and might struggle to complete paperwork while facing health challenges.

Neurobiological and Behavioral Underpinnings of Perinatal Mood and Anxiety Disorders (PMADs): A Selective Narrative Review.

Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes.

Mental health in genocide: Balancing between posttraumatic distress and growth among displaced Yazidi mothers

Background The Islamic State of Iraq and Syria (ISIS) committed genocide of the Yazidis in Sinjar 2014, resulting in dispersion and enslavement. Research shows severe mental health problems, such as posttraumatic stress disorder (PTSD) among survivors, but less is known about their resources and strengths, conceptualized as posttraumatic growth (PTG). Aims are to examine the balance between symptoms and strengths among Yazidi women caring for their infants by identifying groups differing in PTSD and PTG, and analyze how demographic, obstetric, and infant-related factors associate with the groups. Method Participants were 283 Yazidi mothers with their 1-18-month-old infants displaced in Kurdish Region of North Iraq. PTSD symptoms were measured by Harvard Trauma Questionnaire and PTG by the Posttraumatic Growth Inventory. Results identified four groups: “Severe symptoms and low growth” (39%), “Low symptoms and moderate growth” (38%), “Moderate symptoms and very high growth” (13%), and “Moderate symptoms and low growth” (10%). Low education, economic difficulties and obstetric problems related to the “Severe symptoms and low growth” group, whereas newborn and infant health problems did not have an impact. Conclusion Effective help for genocide survivors should both alleviate suffering and encourage resources through tools of recreating a sense of cultural security and pride.

Analyzing Policy to Address Infant Mortality in High-Risk Populations

The United States faced a 3% increase in infant mortality rates in 2022, positioning it 33rd among OECD nations. Despite national efforts, racial and rural disparities persist, with Southern states exhibiting high rates. This paper analyzes policy criteria to reduce infant mortality, focusing on disparities, social determinants, existing initiatives, and necessary components for effective policy development. Research methods involved an extensive search for evidence-based articles and data related to infant mortality and related initiatives, focusing on systematic reviews, research studies, practice guidelines, and relevant articles Addressing this challenge requires targeted interventions, particularly in regions with heightened prevalence, necessitating further research to inform policies and improve maternal and infant health outcomes.

Arginine-NO metabolites are associated with morbidity in single ventricle infants undergoing stage 2 palliation.

Infants with single ventricle heart disease (SVHD) suffer morbidity from insufficient pulmonary blood flow, which may be related to impaired arginine metabolism. No prior study has reported quantitative mapping of arginine metabolites to evaluate the relationship between circulating metabolite levels and outcomes. Prospective cohort study of 75 SVHD cases peri-Stage 2 and 50 healthy controls. We targeted pre- and post-op absolute serum quantification of 9 key members of the arginine metabolism pathway by tandem mass spectrometry. Primary outcomes were length of stay (LOS) and post-Stage 2 hypoxemia. Pre-op cases showed alteration in 6 metabolites including decreased arginine and increased asymmetric dimethyl arginine (ADMA) levels compared to controls. Post-op cases demonstrated decreased arginine and citrulline levels persisting through 48 h. Adjusting for clinical variables, lower pre-op and 2 h post-op concentrations of multiple metabolites, including arginine and citrulline, were associated with longer post-op LOS (p < 0.01). Increased ADMA at 24 h was associated with greater post-op hypoxemia burden (p < 0.05). Arginine metabolism is impaired in interstage SVHD infants and is further deranged following Stage 2 palliation. Patients with greater metabolite alterations experience greater post-op morbidity. Decreased arginine metabolism may be an important driver of pathology in SVHD. Interstage infants with SVHD have significantly altered arginine-nitric oxide metabolism compared to healthy children with deficiency of multiple pathway intermediates persisting through 48 h post-Stage 2 palliation. After controlling for clinical covariates and classic catheterization-derived predictors of Stage 2 readiness, both lower pre-operation and lower post-operation circulating metabolite levels were associated with longer post-Stage 2 LOS while increased post-Stage 2 ADMA concentration was associated with greater post-op hypoxemia. Arginine metabolism mapping offers potential for development using personalized medicine strategies as a biomarker of Stage 2 readiness and therapeutic target to improve pulmonary vascular health in infants with SVHD.

Unlocking the Potential: A Systematic Literature Review on the Impact of Donor Human Milk on Infant Health Outcomes.

Human mother milk is considered the most healthy and best source of nutrition for both premature and full-term infants, as it possesses many health benefits and is associated with its consumption. Some of the mothers are not able to produce an adequate quantity of milk to meet the required needs of the infants, particularly in cases involving premature births or facing challenges in breastfeeding. Especially for the most vulnerable premature infants, donor human milk (DHM) provides a helpful bridge for effective breastfeeding. Even with the advancement in baby formulas, no other dietary source can match the bioactive matrix of benefits found in human breast milk. This literature review discusses the risks associated with prematurity and explores the use of DHM in the care of premature infants. It helps prevent substantial preterm complications, especially necrotizing enterocolitis, bronchopulmonary dysplasia, and late-onset sepsis, which are more commonly seen in infants who are given formulated milk made from cow's milk. It gives insights into the benefits of DHM, such as immunological and nutritional benefits, which is a basic infant's need. When medical distress prevents mothers from producing enough breast milk for their infants, pasteurized human donor breast milk should be made accessible as an alternative feeding option to ensure infants remain healthy and nourished. A systematic literature search was conducted using PubMed and Google Scholar databases and other sources. A total of 104 articles were searched, of which 35 were included after identification, filters were applied, eligibility was checked, and references out of scope were excluded. Human milk banking should be incorporated into programs encouraging breastfeeding, highlighting lactation in mothers and only using DHM when required.

Out-of-Home Care, Contact Orders and Infant Mental Health: Recognising a Unique Developmental Stage in Law, Policy and Practice

Child protection legislation in New South Wales (‘NSW’) has the advancement of the best interests of the child as a fundamental objective. This article argues that advancing the best interests of one group of children – infants (ie, children under 12 months of age) – involves recognising needs that are so distinct and important that infants should be treated as a discrete category of children under all legal instruments, including the Convention on the Rights of the Child and child protection legislation. The article examines how the status of ‘infancy’ influences contact orders for infants in out-of-home care (‘OOHC’) in the NSW jurisdiction and proposes law reform to recognise the unique developmental status and vulnerabilities of infants who are placed in OOHC. The lack of legal identification and regulation specific to infants as a sub-category in existing legal frameworks represents a deficit in the child protection regime; the best interests of infants require unique legal protection.

Non-Invasive Brain Stimulation for Perinatal Depressive Disorder: A Literature Review

IntroductionPeripartum Depressive Disorder (PPD) is a Peripartum Mental Disorder (PMD) characterized as a Major Depressive Disorder (MDD), wherein the manifestation of depressive symptoms initiates either during pregnancy or within the first 12 months following childbirth.PPD impacts both maternal well-being and infant health, resulting in unfavorable outcomes during pregnancy and the postpartum period.Non-Invasive Brain Stimulation (NIBS) is one of the rapidly expanding fields in medicine, using a range of techniques to modulate the brain.ObjectivesThis study aimed to summarize the latest evidence about the impact of NIBS (efficacy, tolerance, and safety) in PPD.MethodsA review was conducted, drawing on reputable (PubMed and Web of Science databases).Key brain stimulation modalities, such as Transcranial Magnetic Stimulation (TMS), Transcranial Electrical Stimulation (TES), and Electroconvulsive therapy (ECT) were analyzed in the context of PPD.ResultsPreliminary findings indicate promising positive effect of NIBS in reducing symptoms associated with PPD.In the postpartum, the favorable outlook on the effectiveness of NIBS implies that, when feasible, women diagnosed with mild to moderate PPD, especially those reluctant to initiate pharmacological interventions, should be presented with TMS or TES as an alternative therapeutic approach.However, some doubts persist about the safety of NIBS regarding fetus and preterm birth.ConclusionsNIBS constitutes a viable option for pharmacological and psychotherapeutic interventions, and it can also be integrated into comprehensive treatment regimens.Future research include large-scale clinical trials and longitudinal studies is needed to address the efficacy, security, and long-term effects of NIBS.Disclosure of InterestNone Declared

Comparison of Hemopoietic Biochemical Parameters in the First, Second, and Third Trimester of Pregnant Females Attending a Tertiary Care Hospital of Western Rajasthan.

Pregnant women constitute a high-risk group for nutrient deficiency anemia which may be associated with detrimental effects on maternal and infant health. This study aimed to assess and compare hematological and biochemical changes across trimesters in pregnant women, considering parameters such as hemoglobin, serum iron, unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), ferritin, vitamin B12, and folic acid. The research sought to identify mean value differences, correlations, and potential implications for maternal healthcare practices. A hospital-based prospective observational study was conducted, involving 60 primigravida women with singleton pregnancies. The subjects were assessed during the first, second, and third trimesters. Biochemical parameters were assessed using standard methods, and statistical analysis was performed to identify significance and correlations. The study revealed a significant decline in hemoglobin, serum iron, ferritin, vitamin B12, and folic acid as pregnancy advanced. Hemoglobin levels decreased from 11.40 g/dl (first trimester) to 10.43 g/dl (third trimester). Serum iron exhibited a decline from 109.73 µg/dl (first trimester) to 94.03 µg/dl (third trimester). Serum ferritin decreased from 24.93 ng/ml (first trimester) to 18.21 ng/ml (third trimester). Vitamin B12 levels dropped from 255.92 pg/ml (first trimester) to 92.13 pg/ml (third trimester). Folic acid levels decreased from 13.82 ng/ml (first trimester) to 11.77 ng/ml (third trimester). UIBC and TIBC concentrations increased progressively across trimesters. Statistical evaluations confirmed the significance of these trends. The coefficient of correlation indicated positive relationships between hemoglobinand serum iron, ferritin, folic acid, and vitamin B12.Positive correlation between serum iron and ferritin, vitamin B12, and negative with folic acid. Serum ferritin negatively correlated with vitamin B12 and folic acid. Serum folic acid and vitamin B12 are positively correlated. The findings emphasize the dynamic nature of hematological and biochemical changes during pregnancy. The observed trends have profound implications for maternal healthcare practices, urging targeted interventions, early monitoring, and supportive supplementation. Recognizing these variations contributes to the optimization of health outcomes for both mother and child.

Physical Intimate Partner Violence Against Pregnant Women in Türkiye: A Population Based Study

This study’s main objective was to determine the factors that led to Turkish women being physically abused by their husbands or partners during pregnancy. The National Research on Domestic Violence against Women in Turkey conducted in 2014 was utilized in our study. We analyzed the survey data using the binary logistic regression method. A pregnant woman who graduated from high school was less likely to encounter physical abuse than an illiterate woman. Those who made more money for the family than their husband or partner were more likely to experience physical abuse. Pregnant women with alcoholic husbands/partners were more likely to experience physical abuse. By supporting the prevention of other potential outcomes for maternal and infant health, implementing screening for partner violence and childbirth phobia in obstetrics and gynecology clinics, and offering comprehensive information about pregnancy labour, we can enhance family and social health.

Psychopharmacological management in patients with Di George syndrome

IntroductionIt is widely described in the scientific literature that patients who suffer from some type of congenital syndrome such as Di George Syndrome are more likely to present some type of psychopathological alteration during their development that may require intervention and treatment by infant and juvenile mental health teams in coordination with neuropediatrics (1). On this occasion, we will present the clinical case of a patient who regularly attends psychiatry consultations for management of anxious symptoms with impulse control deficits associated with intellectual disability, diagnosed since childhood with tetralogy of Fallot and later with Di George syndrome. In this type of case, treatment is usually considered taking into account possible comorbidities at the organic level (since there may be cardiological involvement, which can be an added difficulty when taking into account the adverse effects of some psychotropic drugs) (2).ObjectivesThis is followed by the presentation of the clinical case, which can serve to exemplify this type of case and clarify any doubts that may arise regarding treatment.MethodsPresentation of the clinical case and review of updated scientific literature on the subject.ResultsPatient who first came to the infantile-junior consultations at the age of 8 years due to delay in the acquisition of verbal language and impulsivity. The patient had a history of pediatric follow-up since birth for different physical symptoms that finally led to the diagnosis of Di George syndrome.Given the difficulties he presented both at home and at school, different psychometric tests were performed and it was determined that it could be beneficial to initiate treatment with extended-release methylphenidate. Prior to treatment, psychomotor restlessness (without aggressiveness) and difficulty in concentration prevailed, which improved significantly after upward adjustment of the dose to a guideline corresponding to his age and weight. It was not necessary in this case to administer other treatments (the possibility of starting Aripiprazole in case of episodes of agitation was considered, but it was not necessary). The patient has continued to be monitored by cardiology to assess the possible side effects of the treatment (since it can increase heart rate and blood pressure (3), but so far no complications have been detected).Thanks to psychotherapeutic and educational intervention, language acquisition was achieved, although to date he still requires support due to the difficulties he still presents.ConclusionsIt is important to take into account the possible side effects of psychopharmacological treatment in patients with an associated congenital syndrome. Intensive and comprehensive follow-up by psychiatry and pediatrics (and later by their primary care physician) should be performed.Disclosure of InterestNone Declared