Infant-related Factors Research Articles

Study on the levels of microRNA-146b, microRNA-155 and microRNA-30b in human milk and their correlation with maternal and infant health

Objective To explore the expression levels of immune-related microRNA-146b(miR-146b), microRNA-155(miR-155) and microRNA-30b(miR-30b) in human breast milk and its relationship with maternal and infant's health. Methods One hundred and thirty-four mothers and their infants from obstetrical department were recruited in the study after delivery.The subjects were divided into 2 groups, breast feeding group(n=86) and formula-fee-ding group(n=48), and were followed up 3 months after delivery.Breast milk samples were collected at 2-5 days after delivery(colostrum) and 3 months after delivery(mature milk). The expression levels of microRNAs in milk samples were detected by real-time PCR.The relationship between levels of microRNAs and maternal and infant-related factors was analyzed. Results 1.MiR-146b, miR-155 and miR-30b expressions were abundant both in human colostrums(5.950±0.823, 3.899±0.920, 4.057±0.604) and mature milk(4.840±0.805, 2.128±0.969, 4.929±0.566). The levels of miR-146b and miR-155 were higher in colostrum than that of mature milk(t=7.716, 10.215, all P<0.01), while the level of miR-30b was higher in mature milk than that of colostrums(t=-8.626, P<0.01).2.Additionally, the level of miR-30b was negatively correlated with maternal pre-pregnancy body mass index(r=-0.298, P<0.01).3.The levels of miR-146b and miR-30b were higher in mothers giving birth by vaginal delivery than those who underwent cesarean section(t=2.356, 3.108, all P<0.05).4.The levels of miR-146b and miR-155 were higher in colostrum-fed girls than boys(t=-2.204, -2.985, all P<0.05).5.The level of miR-146b in mature milk was negatively correlated with 3-month-old infant's Z score of body weight(r=-0.425, P<0.05) and body length(r=-0.569, P<0.01).6.During follow-up, the incidence of baby eczema in breast feeding group(8.82%, 3/34 cases) was lower than that in formula milk feeding group(29.17%, 14/48 cases) (χ2 = 5.012, P=0.025). Conclusions The levels of immunocompetent microRNAs in human milk are influenced by the lactation period, maternal pre-pregnancy body mass index, mode of delivery and infant sex.The immune-related microRNAs in human milk could be involved in the regulation of infant's immunity and growth. Key words: Human milk; Immunity; MicroRNA-146b; MicroRNA-155; MicroRNA-30b; Maternal and infant health

What explains violated expectations of parent–child relationship in transition to parenthood?

Parent-child relationship is created already in prenatal fantasies and expectations of the child-to-be. Negative violation of these expectations after the child is born is known to be harmful for the parent-child relationship. Yet, research is scarce about the medical and psychological factors contributing to violated expectations (VE). This study models the role of parent-, delivery- and infant-related underlying mechanisms for VE. It further compares parents with assisted reproductive treatment (ART) and spontaneous conception (SC), and primi- and multiparous couples. The couples (n = 743) separately filled in questionnaires concerning their prenatal expectations (T1) and 2 months postnatal representations (T2) of intimacy and autonomy in the relationship with their child, measured with Subjective Family Picture Test. A negative or positive discrepancy indicated violated expectations. The parent-related (mental health and marital quality), delivery-related (maternal and paternal birth experience, unplanned Caesarean, and amount of analgesia) and infant-related (infant health problems, difficult infant characteristics, and parental worry) factors were assessed at T2. Results show that among mothers, the associations were mostly indirect and mediated via mental health problems. Among fathers, the associations were direct, marital problems most crucially predicting VE. ART fathers were less susceptible to VE resulting from infant-related problems than SC fathers, but more susceptible to VE resulting from delivery problems. Delivery- and infant-related factors also predicted VE differently among primi- and multiparous mothers. Considering factors that contribute to VE is important when working with couples in transition to parenthood.

Primiparous and multiparous mothers' perceptions of social support from nursing professionals in postnatal wards

Objectivethe study aimed at evaluating primiparous or multiparous mothers' perceptions of social support from nursing professionals (SSNP) in postnatal wards and factors associated with SSNP. Designa cross-sectional and correlational design was used. Methodsdata was collected in 2007–2008 in two maternity hospitals with a convenience sample of Finnish-comprehending primiparous and multiparous mothers (N=1300). Multiple-birth and early discharge mothers were excluded. The amount of SSNP including affection, affirmation and concrete aid was measured. Questionnaires were returned from 754 mothers (58%). Fisher's exact test, t-test, Pearson's correlation coefficients, ordinal regression and multiple regression were used in the analyses. Findingsmothers perceived the amount of SSNP as moderate. The amount of affirmational support was perceived as the highest compared with concrete and affectional support. Multiparas received statistically significantly less concrete aid compared with primiparas. The number of mother- and infant-related factors was substantial and their association was stronger among primiparas. Depressive symptoms were a significant factor among multiparas. Advice from nursing professionals, parenting self-efficacy, mother's age and infant age explained 54.0% of the variation in SSNP for primiparas. Correspondingly, advice from nursing professionals, state of mind on hospital discharge and family functioning explained 49.3% of the variation in SSNP for multiparas. Key conclusion and implications for practiceprimiparas that are vulnerable for a scarce amount of SSNP were easier to recognise on the basis of their background information, infant characteristics, childbirth-related factors, and sense of efficacy. Challenges lie in taking into account the whole family, especially among multiparas, and in developing professionals' guidance skills. Among primiparas the model of postpartum care may matter. Our results give professionals a better understanding of the resources and challenges faced by mothers in order to develop postnatal SSNP.

The early prediction of neonatal morbidity and mortality in singleton small for gestational age infants with a birthweight &lt; 1,500 g

Identify factors for discrimination of "high" and "low risk" small for gestational age infants. Singleton infants born small for gestational age with a birthweight <1,500g between 1999 and 2007 were included. Maternal, placental, and infant related factors were analyzed with regard to mortality and morbidity. Patients who died or suffered from complications were defined "high risk" as opposed to "low risk". Parameters associated with "high risk" were identified and an equation established to predict the minimal expected probability to die or suffer from neonatal morbidity. Around 231 patients showed a mortality rate of 12.6%, respiratory distress syndrome in 35.5%, necrotizing enterocolitis in 8.2% and neurological morbidities in 6.5%. Of these, 58.9% survived without complications. The factors for discrimination of "high" and "low risk" were Z-score of birth weight, gestational age, and pH. We facilitate prognostication by classifying small for gestational age preterms into "low" and "high risk".

Measuring the risk factors for postpartum depression: development of the Japanese version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R-J)

BackgroundPostpartum depression (PPD) is a global phenomenon. Depression in the first month following delivery is experienced by 20% of mothers in Japan. Therefore, a screening instrument that identifies the risk for depression during pregnancy and in the early postpartum period is required for primary prevention. The aims of this study were to develop the Japanese version of the Postpartum Depression Predictors Inventory-Revised (PDPI-R-J) and determine its predictive validity during pregnancy and one month after delivery.MethodsIn order to develop the inventory, two bilingual translators translated the PDPI-R into Japanese. Then, back translation was done and a thorough discussion with the original developer was conducted in order to establish semantic equivalence. After the PDPI-R-J was developed, the study used a prospective cohort design. A total of 84 women in their eighth month of pregnancy participated in the study. Seventy-six mothers completed the PDPI-R-J at the first month after childbirth. Women were diagnosed using Mini-International Neuropsychiatric Interview (M.I.N.I.) to determine the presence of minor or major depression at the first month after childbirth and the receiver operating characteristic curve was plotted to evaluate the predictive capacity of PDPI-R-J.ResultsOf the 76 mothers who completed the PDPI-R-J during the first-month assessment, 16 mothers (21%) met the PPD criteria. The prenatal version of the PDPI-R-J administered during pregnancy accurately predicted 62.8% of PPD (95% CI 0.48–0.77) and the postpartum version administered at the first month after delivery predicted 82.0% of PPD (95% CI 0.71–0.93). The cutoffs identified were 5.5 for the prenatal version and 7.5 for the postpartum version. The PDPI-R-J postpartum version, which includes items relating to the infant, increased the predictive validity of PPD (0.67 to 0.82). Comments from the participants included that the use of the PDPI-R-J enhanced the chance to openly communicate about their history and risks for depression with the researchers, if any existed.ConclusionsThe PDPI-R-J was found to be a useful and valid screening tool for predicting PPD. Both the prenatal and postpartum versions should be continuously administered to mothers because delivery and infant-related factors affect the potential for PPD.

1079 Sleep-Wake Cycling in Healthy Term Newborn Infants in The Immediate Postnatal Period

Background and AimsAs sleep-wake cycling (SWCing) of healthy infants within hours of birth has not been quantified with conventional EEG monitoring, in this study we examine the SWC composition of...

Factors Associated with Maternal-infant Attachment One Month Postnatally

Background: maternal-infant attachment (MIA) or bonding is a vital process which has tremendous implications for both mother and infant and is affected by many factors. Identifying such factors enable healthcare staff to detect those mothers with bonding difficulties and in need of individualized attention during their postpartum period.Objectives: To identify factors associated with MIA one month after child birth.Methods: We executed a cross-sectional descriptive study that included a convenience sample of 150 postnatal women attending El Shatby Maternity University hospital in Alexandria, free of any medical condition and willing to participate in the study. A structured validated interview questionnaire was used to collect socio-demographic characteristics, reproductive history and the MIA Scale. Results: A month after delivery, 48(32%), 31(20.7%) and 71(47.3%)of mothers respectively had negative, unclear and positive MIA. Positive MIA was significantly more among educated(50.8%), employed(52.7%), socially supported(61.1%),primigravidous(60.7%) and primiparous(58%) mothers having urban residency(53%), full-term(54.2%) breast fed(61.3%) boy (63.5%), planned pregnancy(58.4%)andno history of abortion(52.7%) (p<0.05). Conclusion: Bonding is significantly associated with maternal and infant factors. Maternal factors include women education, occupation, residence, social support, gravidity, parity, abortion and pregnancy planning status, whereas infant related factors included infant gender, feeding pattern, maturity and type of care received. Key words: Mother-infant attachment, bonding, postnatal period.

Sero-epidemiology of measles-specific IgG antibodies and predictive factors for low or missing titres in a German population-based cross-sectional study in children and adolescents (KiGGS)

In the European Region, measles elimination is now targeted to 2015. To measure progress towards elimination age-group specific susceptibility targets have been defined. Age-specific measles susceptibility in children and adolescents was evaluated in Germany. Taking into account a broad range of socio-demographic, health- and vaccination status related variables, populations for vaccination campaigns were identified. We analysed data from children aged 1-17 years in the representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Measles immunoglobulin G antibodies were measured in 13,977 participants by enzyme immunoassay (ELISA). Bivariate and multivariate logistic regression analyses were used to determine parental and infant related factors associated with measles susceptibility. The overall prevalence of seronegativity in children tested for measles IgG aged 1-17 years was 10.0% (95% CI 9.4-10.7). The prevalence of seronegativity in the German population was below the WHO targets for measles elimination in children aged 2-9 year-olds but exceeded the target for 10-17 year-olds. Age differences in the level of seronegativity were found to be mainly due to differences in vaccination coverage. A higher level of susceptibility was observed if parents did not comply with the request to present the child's vaccination card. In vaccinated children, immigration, male gender, very young age at first vaccination and a longer time period since last vaccination were associated with a higher level of susceptibility. Further increase of the two-dose vaccination coverage is necessary in order to achieve the WHO targets. Catch up vaccination campaigns should focus on adolescents and immigrants.

Effects of Postpartum Depression and Temperament of Infant on Child-care Stress among Mothers of Newborn Infants

Purpose: This study was designed to identify mother and infant related factors that influence child-care stress among the moth er of newborn infants. Methods: Data were collected through self-administered questionnaires and descriptive statistics, correlation and multiple regression were used to analyze the data. The data survey was conducted with 957 conveniently selected mothers of infants when they visited a public health center in Seoul to have their children immunized. Results: The average item score for the Childcare Stress Inventory was 38.03, for the Edinburgh Postnatal Depression Scale, 9.31 and for the Degree of Bother Inventory, 23.42. The CSI was positively correlated to EPDS (r=.44, p<.001) and DBI (r=.40, p<.001). Also these two variables explained 30.0% of CSI in infants’ mothers. Conclusion: These findings are expected to expand the understanding about postpartum mothers’ child-care stress and can contribute to the development of comprehensive interventions based on community health nursing.

Psychological correlates of depression in fathers and mothers in the first postnatal year

This study investigated psychological correlates of depression in fathers and mothers in the first postnatal year, using a mixed, mainly clinically referred sample and a cross-sectional design. The Edinburgh Postnatal Depression Scale (EPDS) was used for depression screening for mothers, and the EPDS, Beck Depression Inventory (BDI) and General Health Questionnaire (GHQ) for fathers. A total of 75 mothers (47.5%) had EPDS scores > 12, and 45 fathers (48.9%) exceeded the threshold on one or more of the three screening instruments. Most of the variance in paternal and maternal depression was accounted for by neuroticism. However, while mothers appeared primarily influenced by their own personality, perinatal and infant-related factors, fathers appeared more influenced by mothers' personality difficulties and unresolved past events, and mothers' current mental health and infant-related problems, as well as the state of the marital/ de facto relationship. The BDI and EPDS seemed to measure more severe pervasive forms of paternal depression than the GHQ, and the EPDS appeared to tap some items more specifically associated with perinatal psychological risk than the BDI. Depression in one partner was moderately correlated with depression in the other. High rates of paternal depression and anxiety in mothercraft settings suggest the need to routinely assess the mental state of both parents in these settings, and to include fathers in postnatal depression intervention programmes. The mother's negative perceptions of her infant's temperament are significantly associated with maternal and paternal depression, suggesting an important focus for intervention.

Predicting Postpartum Depressive Symptoms: A Structural Modelling Analysis

In this prospective, longitudinal study, 42 first-time mothers, recruited through prenatal classes, were assessed on variables predictive of postpartum depressive symptoms. Using a causal modelling structural analysis, it was found that prenatal depression, partners' support, and infant-related factors all contributed to the development of depression following childbirth.

PREDICTING POSTPARTUM DEPRESSIVE SYMPTOMS - A STRUCTURAL MODELING ANALYSIS

In this prospective, longitudinal study, 42 first-time mothers, recruited through prenatal classes, were assessed on variables predictive of postpartum depressive symptoms. Using a causal modelling structural analysis, it was found that prenatal depression, partners' support, and infant-related factors all contributed to the development of depression following childbirth.