Infants Of Mothers Research Articles

Early postpartum pumping behaviors, pumped milk volume, and achievement of secretory activation in breast pump-dependent mothers of preterm infants.

Pumping studies in mothers of preterm infants are limited by self-reported pumping behaviors and non-objective measures of pumped milk volume and secretory activation (SA). Non-randomized observational study of first 14 days postpartum in 29 mothers of preterm infants. Smart pumps measured and stored pumping behaviors and pumped milk volume. Selective ion electrodes measured sodium and sodium:potassium ratio to determine SA. Generalized estimating equations, cluster analyses and multivariate regression were used. SA was delayed (median 5.8 days) and impermanent. Each additional daily pumping increased odds of SA within 2 days by 48% (p = 0.01). High-intensity pumping mothers (N = 17) had greater daily and cumulative pumped milk volume than low-intensity pumping mothers (N = 12). Pumping variables showed daily changes in the first week, then plateaued. The first week postpartum is critical for optimizing pumping behaviors. Accurate, objective measures of pumping behaviors, pumped milk volume and SA are a research priority.

Post-partum depression: Its association with IYCF practices and effect on child growth indicators in urban slums of Mumbai, India

BackgroundThe nexus of postpartum depression (PPD) does not limit itself to maternal health but has a profound impact on child health through compromised caregiving and nursing practices of the mother. This impairs child's cognitive, emotional, and physical health during crucial stages of growth. ObjectiveThe paper aims to identify the association between PPD and Infant and Young Child Feeding practices and the effect of PPD on child growth during the first 1000 days of life in urban slum settings of Mumbai. ResultsFor infants below six months of age, bottle-feeding practices, initiation of breastfeeding within 1 hour of birth, and exclusive breastfeeding for the first 2 days were associated with PPD (p < 0.05). For children, 6–24 months, minimum meal frequency, minimum dietary diversity, zero consumption of fruits and green vegetables, and initiation of semisolid and soft food were associated with the postpartum depression status of the mother (p < 0.05). The infants of the depressed mothers were 10 %, 16 % and 20 % more likely to be underweight, wasted and stunted as compared to infants of the mothers who do not show symptoms of PPD. ConclusionMeasurement of prevalence of PPD is essential to manage it. It is essential to build mental health inclusive policies/programmes for mother and child health, engage in capacity building of grassroot workers to spread awareness about PPD, and be skilled to identify and refer the early signs of PPD.

Cohort profile: longitudinal and population comparison of children who are HIV-exposed uninfected and children who are HIV unexposed in Kenya (HOPE study)

PurposeGlobally, the number of children/adolescents exposed to HIV but uninfected (HIV-exposed uninfected, HEU) is growing. The HEU outcomes: population-evaluation and screening strategies study was designed to provide population-level evidence of...

The importance of group factors in the delivery of group-based parenting programmes: a process evaluation of Mellow Babies

IntroductionThe role of the group has been largely overlooked within evaluations of group-based parenting programmes. Group contextual factors, including size and level of homogeneity, may impact on essential group processes, such as group identification and cohesion, that are necessary to activate interpersonal change mechanisms and attain programme outcomes. This process evaluation of Mellow Babies, a 14-week attachment-based group parenting programme for mothers of infants aged under 18 months, explores how group context affected mother and practitioner experiences of the programme.MethodsIn-depth interviews were conducted with fourteen mothers and three practitioners from three different Mellow Babies groups. Framework Analysis was employed to analyse data, using groups as cases within the framework matrix while preserving individual participants within each case. This allowed comparisons to be made within and between groups.ResultsFour group contextual factors impacted on the quality of programme delivery: (1) group size; (2) level of group homogeneity; (3) pre-existing relationships; and (4) personalities within the group. These contextual factors affected the hypothesised intervention mechanisms: (1) fluid progression through the stages of group development; (2) a safe, non-judgemental, contained space; (3) social identification with group; (4) group cohesion; and (5) a culture of openness, support and empowerment.DiscussionFindings have implications for future delivery and implementation of group-based parenting programmes, for example, the importance of considering group composition during programme recruitment. Practitioners may also benefit from a stronger focus on group processes and enabling group dynamics within training, supervision, and the programme manual.

Maternal History of Adverse Childhood Experiences and Subsequent Infant Paternal Involvement

Background and Objective Adverse childhood experiences (ACEs) are associated with unfavorable pregnancy outcomes. Fathers’ involvement during pregnancy positively impacts maternal behaviors and birth outcomes. Lack of voluntary paternity acknowledgment (PA) at birth implies potential limited paternal involvement. This study explores the association between mothers with a history of ACEs and PA status for their infants. Methods Using secondary data from the Monroe County Mothers and Babies Health Survey and logistic regression modeling, we assessed the odds of court-mandated paternity affidavit (CM-PA) associated with maternal ACEs. Univariate analyses were conducted first, with additional variables included subsequently. Results Of the 1,556 mothers with legal paternity established for their infants, 279 (18%) had a CM-PA for their infants, and 1,277 (82%) had a PA established voluntarily (vPA). Mothers of infants with CM-PA were more likely to be Black or Hispanic, had lower income and education, had higher substance use and traumatic stress, and had lower social support. A one-point increase in maternal ACE total score was associated with 14% higher odds of CM-PA (OR = 1.14; 95% CI, 1.03–1.27). Maternal experience of household dysfunction was linked to 83% higher odds of CM-PA (OR = 1.83; 95% CI, 1.23–2.71) while living with a problem drinker or drug user during childhood was associated with 70% higher odds of CM-PA (OR = 1.70; 95% CI, 1.09–2.65). Conclusion and Implications for Translation This study suggests a potential link between maternal ACEs and CM-PA, implying possible lower father involvement for the infants whose mothers experienced adverse events in childhood. To address this, future research is warranted to confirm this association and explore interventions like prenatal ACE screening in pregnancy, providing psychological support and resources for mothers to promote infant paternal involvement.

Prenatal Maternal Psychological Distress During the COVID-19 Pandemic and Newborn Brain Development

Elevated maternal psychological distress during pregnancy is associated with altered fetal brain development. During the COVID-19 pandemic, prenatal maternal psychological distress more than doubled. To examine the association of the pandemic and rising maternal psychological distress with brain growth in newborns using quantitative 3-dimensional volumetric magnetic resonance imaging (MRI). This prospective cross-sectional study recruited mother-infant dyads at Children's National Hospital, Washington, DC, during the COVID-19 pandemic (June 1, 2020, to June 30, 2022) into a longitudinal infant brain development study and compared them with an existing normative healthy cohort (recruited March 1, 2014, to December 31, 2019). Exclusion criteria included multiple gestation pregnancy, known or suspected congenital infection, documented chromosomal abnormalities, or any maternal contraindication to MRI, as well as prenatal COVID-19 exposure. Infants with structural brain abnormalities or a postnatal confirmation of a genetic syndrome were excluded. Psychological distress during COVID-19 pandemic. Prenatal maternal mental health was evaluated using the Spielberger State-Trait Anxiety Inventory and the Perceived Stress Scale. Neonates underwent nonsedated brain MRI. An ordinary least squares linear regression model was used to measure the differences in regional brain volumes of neonates born before vs during the pandemic with and without exposure to elevated prenatal maternal psychological distress after adjustment for neonatal sex and gestational age at MRI and maternal age and educational level. A total of 159 mother-infant dyads were included in the analysis: 103 before and 56 during the pandemic (median gestational age of infants, 39.6 [IQR, 38.4-40.4] weeks; median maternal age, 34.5 [IQR, 31.0-37.0] years). Eighty-three infants (52.2%) were female. Among the mothers, 130 (81.8%) had a college degree and 87 (54.7%) had a graduate degree. Forty-four mothers (27.7%) identified as Asian, Hispanic, or multiracial; 27 (17.0%), as Black; and 88 (55.3%), as White. Scores on anxiety and stress measures were significantly increased in the pandemic cohort. Infants of mothers with elevated maternal distress showed median reductions in white matter (-0.36 [95% CI, -0.61 to -0.11] cm3; Q < .001), right hippocampal (-0.35 [95% CI, -0.65 to -0.06] cm3; Q = .04), and left amygdala (-0.49 [95% CI, -0.84 to -0.13] cm3; Q = .03) volumes compared with infants of mothers with low distress levels. After adjusting for the cohort effect of the pandemic, elevated trait anxiety remained significantly associated with decreased left amygdalar volumes (-0.71 [95% CI, -1.12 to -0.29]; Q < .001). In this cross-sectional study of maternal-infant dyads prior to and during the COVID-19 pandemic, regional neonatal brain volumes were associated with elevated maternal psychological distress.

Neonatal morbidity in the 2011 JAKIDS Jamaican birth cohort

ABSTRACT This study reports the spectrum of discharge diagnoses in a national cohort of newborns admitted during a 3-month period to hospitals across Jamaica. The data were analyzed using measures of central tendency and risk assessed using odds ratio. Data on 1607 admissions were used to describe the spectrum of morbidity in hospitalized infants. Eight hundred and seven (50%) male and 754 (48%) female neonates were admitted. There was a 15% (240) readmission rate during the neonatal period. Infants of diabetic mothers were almost three times as likely to be admitted as infants whose mothers were not diabetic OR 2.89 (CI 1.96 − 4.13). Infants of women who were hypertensive were 1.5 times more likely to be admitted than infants of non-hypertensive women OR 1.56 (CI 1.56–1.9). The odds ratio for admission of an infant born to a woman delivered by caesarean section was 2.1 (CI: 1.67–2.38). Premature infants constituted 50% of admissions. The most prevalent discharge diagnosis included presumed sepsis, respiratory distress and neonatal jaundice in both preterm and term neonates. In the extreme preterm infant respiratory distress syndrome was the most predominant discharge diagnosis. Multiple gestation was a significant risk for admission OR 2.7 (CI 1.8 to 3.9). Prematurity, multiple gestation, macrosomia, maternal diabetes, maternal hypertension and low 5 minute Apgar score < 7 were all found to be independent predictors of neonatal admission in a logistic regression model (p < 0.001). The recognition of the discharge morbidity is useful for future health planning for the most vulnerable in our population.

ECD - Pregnancy outcomes of a birth cohort. Are adolescent mothers really at more risk?

ABSTRACT This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16–19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother–infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample – 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers.

Prevalence of postnatal anxiety disorders in mothers of preterm infants: a systematic review protocol.

The objective of this systematic review is to evaluate and synthesize the available evidence on the prevalence of postnatal anxiety disorders in mothers of preterm infants within 12 months of delivery. Mothers of preterm infants report more postpartum psychological problems than other mothers. Anxiety disorders are among the most frequently reported manifestations, and affect the quality of maternal care and the baby's development. However, data on the prevalence of postnatal anxiety disorders in mothers of preterm infants are inconsistent and imprecise. It is, therefore, necessary to estimate the prevalence of anxiety disorders among mothers of premature infants in order to develop appropriate interventions for screening, support, and treatment. This review will consider studies conducted in any setting and any geographical location that report on the prevalence of any anxiety disorders in mothers of preterm infants within 12 months of delivery. Any analytical or descriptive observational studies and experimental or quasi-experimental studies will be included. MEDLINE (Ovid), PsycINFO (Ovid), Embase (Elsevier), CINAHL (EBSCOhost), Google Scholar, MedNar, and the World Health Organization website will be searched for studies written in English or French. Screening, critical appraisal, and data extraction will be performed by 2 independent reviewers using the relevant JBI systematic review tools. The findings will be presented in narrative format, including tables and figures to aid in data presentation. PROSPERO CRD42023428202.

A preliminary study of the effectiveness of video visitation on depression and stress in mothers with preterm infants during the pandemic

Background and purposeParents of preterm infants experience anxiety and stress in the neonatal intensive care unit (NICU). Visitation restrictions due to COVID-19 have increased maternal pressure and limited bonding opportunities. Little research exists in Taiwan on using video conferencing as a solution. This study investigates depression and stress levels in mothers of preterm infants and evaluates the effectiveness of video visitation during NICU restrictions. MethodsThis study adopts a cross-sectional design and a qualitative survey. Mothers of premature infants were recruited and they participated in the study. Interventions for video visits were scheduled on the third day of admission to the NICU (T1) and during the second week of the study (T2). After each video visit, participants completed an online survey. The study's online survey used structured questionnaires including demographics, the Edinburgh Postnatal Depression Scale (EPDS) and the Parental Stress Scale (PSS): Infant Hospitalization (IH). ResultsA total of 51 mothers of preterm infants participated in the study. During the T1 and T2 periods, single mothers with lower educational levels and those aged below 30 experienced depression and high levels of stress. Lower birth weight and gestational age were associated with maternal depression. Video visitation intervention led to a significant decrease in depression scores (EPDS, T1: 11.3 ± 5.5 vs. T2: 10.1 ± 5.2, p = 0.039). Positive correlations were observed between EPDS and PSS: IH scores (p < 0 .005). ConclusionVideo visitation intervention can reduce maternal depression in mothers with preterm infants. Since it is practical, video visitation may be applied even after the pandemic.

Relationship Between Frequency of Remote Visitation and Postpartum Depression in Mothers of Hospitalized Neonates During the COVID-19 Pandemic

ObjectiveTo explore the relationship between symptoms of postpartum depression and the number of remote visitations among mothers of infants in the NICU. DesignRetrospective cohort study. SettingNICU in a medical university in Iwate, Japan. ParticipantsA total of 89 mothers of infants who spent more than 1 month in the NICU from June 2021 to December 2022. MethodsParticipants completed the Edinburgh Postnatal Depression Scale (EPDS) at 4 days and 1 month after birth. We used a one-way analysis of variance with Tukey–Kramer or Games–Howell post hoc tests to examine differences in postpartum depression among three groups based on the frequency of remote visitation: frequent visitation, rare visitation, or no visitation. ResultsOf the 89 mothers, 41 scored 9 points or higher on the EPDS conducted 4 days after birth; among them, 14 did not visit, 13 rarely visited, and 14 frequently visited the NICU remotely through a web camera. The rare visitation group had significantly higher EPDS scores 1 month after birth (M = 9.7, SD = 5.2) than the frequent (M = 5.3, SD = 3.7) and no visitation (M = 5.1, SD = 4.2) groups (p < .05). The rare visitation group demonstrated lower improvement on the EPDS than the frequent and no visitation groups (nonsignificant). ConclusionIt is unclear whether remote visitation reduces symptoms of postpartum depression; however, the frequency of remote visitation could be assessed to identify at-risk mothers in need of social support.

FRI-424 Effectiveness of immunoprophylaxis for preterm infants of mothers having chronic hepatitis B virus infection: a retrospective study

FRI-424 Effectiveness of immunoprophylaxis for preterm infants of mothers having chronic hepatitis B virus infection: a retrospective study

Face-to-face vs. online delivery of the Lullaby Project: A therapeutic community music group for mothers of infants

Online delivery of community music groups has become more widely accepted following the COVID-19 pandemic, and may reduce barriers to attendance for certain demographics, including mothers with caring responsibilities. However, different interaction patterns may affect group processes, altering a programme’s underlying mechanisms of change when adapted for online delivery. This research compares in-person and videoconference delivery of the Lullaby Project, a therapeutic community music group for mothers with infants aged under 3. It explores engagement, participation and group processes, and elucidates the mechanisms of change for both modes of implementation. Semi-structured interviews were conducted with nine mothers and seven musicians who had experienced one of three delivery methods: (1) face-to-face; (2) face-to-face and online combination and (3) online. Interviews were analysed inductively using thematic analysis and eleven sub-themes were identified within three overarching themes: (1) engagement; (2) group processes and (3) change mechanisms. Mothers perceived benefits and formed meaningful relationships in-person and online, although the distinct group processes and change mechanisms suggest the delivery methods constitute distinct interventions. Specifically, relationships were formed on an individual level during in-person delivery, whereas group-based connections were more likely with online delivery. Further research is needed to explore a diversity of experiences, and to evaluate the efficacy of online delivery of community music groups.

Food intake of breastfeeding mothers versus protein content of breastmilk in the coastal area of Bengkulu, Indonesia.

Maternal intake has a role in the composition of nutritional content, especially breast milk protein, but is rarely studied in fish producing areas (coastal). This study aimed to assess protein concentrations in human milk and evaluate their changes according to diet. The type of study was analytical observation, cross-sectional research design with a total sample of 50 from 313 breastfeeding mothers of infants 0-6 months domiciled at the Padang Serai Health Center. Dietary intake is collected using the food recall form 2 x 24 hours. Breast milk is collected in the morning as much as 30 ml using an electric breast pump. T-Test Independent analyzed the data. The results showed that as many as 10% of mothers had breast milk protein content above 0.9 g/100mL, and there was a relationship between maternal age, energy, and protein with breast milk protein content. Maternal diet, especially energy and protein, affects the protein content of breast milk. It is recommended that mothers improve their daily intake through nutritionally balanced and varied foods.

Determinants of Exclusive Breastfeeding Practices among Mothers of 6-24 Months-Old Infants in Padang City, Indonesia

The practice of exclusive breastfeeding (EBF) can reduce mortality and morbidity rates in children and supports optimal growth and development in children. The practice of EBF influenced by various predisposing factors, supporting factors and reinforcing factors. This study aimed to evaluate the determinants of exclusive breastfeeding practices among mothers of infants 6-24 months old infants in Padang. This case control study conducted at Padang with 200 mothers, consisting of 100 mothers of case groups and 100 mothers of control groups. Maternal and infant characteristics, family characteristics, predisposing factors, supporting factors and reinforcing factors, and exclusive breastfeeding were collected for this study. Chi square and binary logistic regression were used to the data analysis. Results showed that mother's occupation, exclusive breastfeeding knowledge and parent’s support were the most influencing determinants for exclusive breastfeeding.

Cetaceans are the next frontier for vocal rhythm research

While rhythm can facilitate and enhance many aspects of behavior, its evolutionary trajectory in vocal communication systems remains enigmatic. We can trace evolutionary processes by investigating rhythmic abilities in different species, but research to date has largely focused on songbirds and primates. We present evidence that cetaceans—whales, dolphins, and porpoises—are a missing piece of the puzzle for understanding why rhythm evolved in vocal communication systems. Cetaceans not only produce rhythmic vocalizations but also exhibit behaviors known or thought to play a role in the evolution of different features of rhythm. These behaviors include vocal learning abilities, advanced breathing control, sexually selected vocal displays, prolonged mother–infant bonds, and behavioral synchronization. The untapped comparative potential of cetaceans is further enhanced by high interspecific diversity, which generates natural ranges of vocal and social complexity for investigating various evolutionary hypotheses. We show that rhythm (particularly isochronous rhythm, when sounds are equally spaced in time) is prevalent in cetacean vocalizations but is used in different contexts by baleen and toothed whales. We also highlight key questions and research areas that will enhance understanding of vocal rhythms across taxa. By coupling an infraorder-level taxonomic assessment of vocal rhythm production with comparisons to other species, we illustrate how broadly comparative research can contribute to a more nuanced understanding of the prevalence, evolution, and possible functions of rhythm in animal communication.

Infant Care: Predictors of Outdoor Walking, Infant Carrying and Infant Outdoor Sleeping.

Although spending time outdoors is beneficial for development, little is known about outdoor time during infancy. The aim of this study was to assess frequencies and durations of (1a) outdoor walking and carrying in mother-infant dyads and (1b) infant outdoor sleeping in a stationary cot or pram. We furthermore aimed to identify associations of (2a) outdoor walking and carrying and (2b) infant outdoor sleeping, with infant, maternal and environmental sample characteristics. An online survey was distributed among mothers of 0- to 12-month-old infants. Initially, 1453 mothers were recruited, of which 1275 were included in the analyses. With respect to (1a) the outcomes of interest were: mother-infant dyads' total weekly duration of walking in minutes, frequency of walking on weekdays, as well as weekends, and the frequency of using an infant carrier during walks, as well as the daily duration of carrying in hours (indoors and outdoors together). With respect to (1b) the outcome variables were: placing the infant outdoors to sleep (yes/no), the total weekly duration of outdoor sleeping and the weekly frequency of outdoor sleeping. For aim 2, associations of the outcome variables with infant (i.e., age), maternal (i.e., working status) and environmental (i.e., house type) sample characteristics were assessed. Mother-infant dyads engaged in walks for a total weekly duration of 201 min, for approximately one to three walks over weekdays (Monday through Friday), as well as one to three walks on the weekend. The infant carrier was used by 22% of mothers at least half of the time during outdoor walks, and 18% reported a daily duration of infant carrying of one hour or more. Among other associations, infant and maternal enjoyment of outdoor walking correlated positively with the duration as well as the frequency of walking during weekdays and during the weekend. Furthermore, employed mothers walked for a shorter duration and less frequently on weekdays as compared to mothers on maternity leave or mothers without a paid job. The availability of nearby recreational areas correlated positively with the weekly duration and frequency of walks. The infant carrier was used more frequently during outdoor walks if more than one child lived in the household. Infant carrying during outdoor walks was also related to infant behavior at night. Roughly a third of the mothers (29%) regularly had their infant sleep outdoors for a weekly duration of four hours and a weekly frequency of approximately one to two times. Younger infants, infants of mothers with higher education and infants living in detached houses were more likely to be placed outdoors to sleep. We identified associations of infant, maternal and environmental characteristics with outdoor time spent during infancy. These results lay the foundation for future research on the effects of the outdoors on child development as well as on facilitators and barriers for caregivers.

Neonatal outcomes in women with diabetes mellitus — analysis of DAPSY data

BACKGROUND: Hyperglycemia in pregnancy is associated with short- and long-term implications for children. Nevertheless, the effects of different types of diabetes mellitus and treatment methods on the neonatal outcomes are to be investigated. AIM: The aim of this study was to evaluate the contribution of different types of maternal diabetes mellitus to the risk of adverse neonatal outcomes. MATERIALS AND METHODS: This retrospective cohort study included women (n = 3261) who delivered at the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott, Saint Petersburg, Russia in 2008–2017. The following comparison groups were used: type 1 diabetes mellitus (n = 506; 1a, continuous subcutaneous insulin injections; 1b, multiple daily insulin injections), type 2 diabetes mellitus (n = 229; 2a, diet; 2b, insulin therapy), gestational diabetes mellitus (n = 2387; 3a, diet; 3b, insulin therapy), and control (n = 139). The main birth outcomes assessed included weight and length of newborns, Apgar score at birth and at 5 minutes after birth, and pathological conditions such as fetal macrosomia, syndrome of infant of mother with gestational diabetes mellitus or diabetic mother (P70.0–P70.1), light (P05.0) or small for gestational age (P05.1), intrauterine growth restriction, prematurity (P07), neonatal hypoglycemia (P70.4), and neonatal respiratory distress syndrome (P22). The secondary birth outcomes assessed included birth trauma (P10–P15), stillbirth (P95), disturbances of cerebral status of newborn (P91), and congenital malformations, deformations and chromosomal abnormalities (Q00–Q99). RESULTS: Pregestational diabetes mellitus is strongly associated with adverse neonatal outcomes. Type 1 diabetes mellitus women had the highest risks for fetal macrosomia and diabetic fetopathy, neonatal hypoglycemia, prematurity, and congenital malformations (odds ratio 3.54, 20.2, 5.59, 4.24 and 3.92 respectively). In type 2 diabetes mellitus patients, the risks of low birth weight, intrauterine growth restriction and birth trauma (odds 9.14, 5.42 and 6.3 respectively) were higher. For women with gestational diabetes mellitus, these risks were lower. CONCLUSIONS: This study provides a comprehensive analysis of the major neonatal pathology in patients with different types of diabetes mellitus, taking into account the treatment method. Preconception care and optimal glycemic control are necessary to reduce the risk of obstetric and perinatal complications in women with pregestational types of diabetes mellitus. Further research into the health status of this cohort of children at a later age is required.

Risk of Neonatal Hypoglycemia in Infants of Mothers With Gestational Glucose Intolerance.

To examine the relationship between gestational glucose intolerance (GGI) and neonatal hypoglycemia. This was a secondary analysis of 8,262 mother-infant dyads, with delivery at two hospitals between 2014 and 2023. We categorized maternal glycemic status as normal glucose tolerance (NGT), GGI, or gestational diabetes mellitus (GDM). We defined NGT according to a normal glucose load test result, GGI according to an abnormal glucose load test result with zero (GGI-0) or one (GGI-1) abnormal value on the 100-g oral glucose tolerance test, and GDM according to an abnormal glucose load test result with two or more abnormal values on the glucose tolerance test. Neonatal hypoglycemia was defined according to blood glucose <45 mg/dL or ICD-9 or ICD-10 diagnosis of neonatal hypoglycemia. We used logistic regression analysis to determine associations between maternal glucose tolerance category and neonatal hypoglycemia and conducted a sensitivity analysis using Δ-adjusted multiple imputation, assuming for unscreened infants a rate of neonatal hypoglycemia as high as 33%. Of infants, 12% had neonatal hypoglycemia. In adjusted models, infants born to mothers with GGI-0 had 1.28 (95% 1.12, 1.65), GGI-1 1.58 (95% CI 1.11, 2.25), and GDM 4.90 (95% CI 3.81, 6.29) times higher odds of neonatal hypoglycemia in comparison with infants born to mothers with NGT. Associations in sensitivity analyses were consistent with the primary analysis. GGI is associated with increased risk of neonatal hypoglycemia. Future research should include examination of these associations in a cohort with more complete neonatal blood glucose ascertainment and determination of the clinical significance of these findings on long-term child health.

Construct validity of the Coding Interactive Behaviour instrument for fathers of infants

ABSTRACT Observational instruments are proposed as the best method to assess the quality of parent–child interaction. However, the psychometric properties and theoretical foundations of these observational tools have been questioned. Further, very few studies have focussed on the construct validity of these instruments for father–child interaction quality. In this study, we examined the construct validity of the Coding Interactive Behavior (CIB) measure in a sample of 320 father-infant dyads. A four-factor model, previously found to fit mother–infant interactions, failed to demonstrate an acceptable model fit for our father-infant sample. Instead, a data-driven three-factor model was indicated to be a better fit. This model consists of the composites, ‘Paternal Sensitivity’, ‘Paternal Positive Affect’, and ‘Child Engagement’. Interestingly, while these factors bear similarities to those found in maternal interactions, they manifest distinct characteristics for fathers. Our results emphasize the necessity of refining and validating observational tools specifically for diverse parent–child contexts.