Infants Of Mothers Research Articles

Latent profiles of infant negative affect and respiratory sinus arrhythmia during the still‐face paradigm: The role of maternal sensitivity

AbstractWe examined if there were profiles of infants' behavioural and physiological responses during the still‐face and if these profiles were predicted by maternal sensitivity. Participants included 230 mothers (40.4% non‐white) and their 2‐month‐old infants (48.7% female). Three profiles were identified: continually increasing negative affect and decreasing respiratory sinus arrhythmia (RSA) (17.39%); modest, classic still‐face effect for negative affect and RSA (64.35%); high negative affect, late decreasing RSA (18.26%). Infants of highly sensitive mothers were more likely to be in the modest, classic still‐face effect for negative affect and RSA profile than in the continually increasing negative affect and decreasing RSA and the high negative affect, late decreasing RSA profiles. Additionally, infants of mothers who were high in maternal sensitivity were more likely to be in the continually increasing negative affect and decreasing RSA profile compared to the high negative affect, late decreasing RSA profile. The findings demonstrate heterogeneity in infant responses and that maternal sensitivity is an important predictor of children's behavioural and physiological responses to stressors.

Correlation of Maternal Vitamin D Status in Early Pregnancy and Vitamin D Supplementation during Pregnancy with Atopic Dermatitis in Infants: A Prospective Birth Cohort Study.

This study aimed to investigate the association of maternal first-trimester vitamin D levels and vitamin D supplementation during pregnancy with infant atopic dermatitis (AD) and to determine the effect of variables such as mode of conception on the association. This study was based on the Shanghai sub-cohort of the International Birth Cohort of China. A total of 4051 woman-infant pairs with singleton pregnancies were recruited. Vitamin D deficiency and insufficiency were defined as serum 25-hydroxyvitamin D concentrations of 25 and 50 nmol/L, respectively. AD in infants was assessed during the first six months using a standardized questionnaire based on the British Working Party criteria. Modified Poisson regression estimated the association between maternal vitamin D status and infant AD. The risk of AD in infants was higher in women with deficient 25-hydroxyvitamin D levels in the first trimester (RR: 1.77, 95% CI: 1.41-2.23). This increased risk was seen in naturally conceived pregnancies, but not in those conceived using assisted reproductive technology (ART). The incidence of AD decreased in infants of mothers who took multi-vitamin (RR: 0.79, 95% CI: 0.67-1.98) and vitamin D supplements (RR: 0.51, 95% CI: 0.37-0.71) compared to those whose mothers did not take any supplements. Maternal vitamin D deficiency had varying effects on AD risk based on passive smoking exposure and breastfeeding patterns. Our findings highlight the importance of monitoring and supplementing vitamin D during pregnancy, especially in specific maternal populations, to reduce the risk of AD in offspring.

A Study of the Complications in Infants of Diabetic Mothers

A Study of the Complications in Infants of Diabetic Mothers

Hypertrophic Cardiomyopathy Risk Factors in Infants of diabetic mothers

Abstract Background Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. Maternal DM significantly affects the fetal heart and fetal–placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs). Objective Assess the frequency of hypertrophic cardiomyopathy (HCM) among infants of diabetic mothers and its relationship to the maternal glycemic control and the birth weight for the gestational age. Patients and Methods This was a cross-sectional study conducted on (50) neonates with gestational age ≥ 35 weeks born to diabetic mothers recruited from the delivery room and Neonatal Observation Unit, Obstetrics and Gynecology Hospital, Ain shams university. Detailed history was taken for the duration of maternal diabetes, glycemic control and any associated complications and the level of hemoglobin A1C (HbA1C) was assessed for all the enrolled mothers. Neonates were subjected to full clinical examination and echocardiographic evaluation in the first week of life. Results Forty % of mothers had gestational diabetes mellitus (GDM), (20%) were pre-gestational diabetes type 1 and 40% were pre-GDM type 2. There were 18 infants (36%) had HCM. HCM was highly statistically significant (p-value < 0.001) more in cases with high maternal HbA1C (8.3 ± 0.9). The frequency of HCM among infants of pre-GDM mothers (15 patients, 50%) was significantly higher (p-value = 0.012) when compared to infants of GDM mothers (3 patients, 15%). But the frequency of HCM was equal in infants of pre-GDM type I mothers and those of pre-GDM type 2 mothers. HCM was more common with large for gestational age (LGA) infants (10 cases 55.6% of infants with HCM were LGA). Conclusion HCM is more frequent among infants of mothers with pre-GDM type 1 than infants of GDM. Poor maternal glycemic control and large for gestational age are associated with higher frequency of HCM among those infants.

Impact of Diabetes in Pregnancy on Stage II Lactogenesis among Postpartum Diabetic Women Compared to Non-Diabetics

Abstract Background Diabetes in pregnancy -whether preexisting or gestational can have negative impact on pregnancy, labor and lactation. Infants of diabetic mothers benefit most from early establishment of breastfeeding as it helps them regulate their blood glucose levels on the short term and decrease their risk of developing diabetes later on life. Aim of the Work This study aims to compare diabetic and non-diabetic pregnant women regarding the onset of stage II lactogenesis at 72 hours postpartum and to associate the degree of diabetes control in antepartum period with the delay in stage II of lactogenesis. Subjects and Methods This study is an observational prospective cohort study, carried out on 203 pregnant women aged from 18 to 40 years old during their routine antenatal care visits in the third trimester of pregnancy at Ain-Shams University Maternity hospital outpatient clinic from December 2020 to August 2021, Cairo, Egypt. Results We found that Diabetes in pregnancy can cause a delay in the onset of Lactogenesis stage II regardless of the degree of control. We can also say that diabetes can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother and delayed initiation of first breastfeed which was found to cause DOLII. And early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers. Conclusion Diabetes can cause series of unfortunate events in pregnancy, labor, and lactation. Many of diabetes implications on peripartum health can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother, delayed initiation of first breastfeed and other birth complications. All these can cause DOL II. Diabetes itself is a risk factor for delayed onset of lactogenesis II which can cause further neonatal hypoglycemia and/or early introduction of infant formula. The cascade of these events can hinder the breastfeeding establishment when it is most needed. The control of diabetes was not found to have impact on DOL II. Further research needs to be done in this regard. Early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers.

The effect of perceived social support on fatigue in mothers having twin infants: the mediating role of sleep quality

ABSTRACT The aim of this study is to investigate the mediating role of sleep quality in the relationship between multidimensional perceived social support and fatigue among mothers of twin infants. One hundred and six (106) twin mothers participated in this cross-sectional study, who completed the Descriptive Information Form, Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Checklist Individual Strength. The scale score averages of the mothers in the study are as follows: social support, 61.41 ± 23.86; fatigue, 77.64 ± 28.68; and sleep quality, 8.26 ± 2.38. According to the path model, perceived social support has a negative effect on poor sleep quality (p = .001, Beta = −0.411), and poor sleep quality has a positive effect on fatigue (p = .001, Beta = 0.335). Sleep quality also mediates the effect of multidimensional perceived social support on mothers’ fatigue levels (p = .001, Beta = −0.138). The study results suggest that the perceived social support and fatigue levels of twin mothers are moderate, while their sleep quality is poor. Therefore, mothers of twin infants may benefit from increased social support to alleviate fatigue and enhance sleep quality.

Femoral Facial Syndrome in an Infant of Diabetic Mother

Femoral Facial Syndrome in an Infant of Diabetic Mother

Maternal gestational diabetes mellitus associates with altered gut microbiome composition and head circumference abnormalities in male offspring

The impact of gestational diabetes mellitus (GDM) on maternal or infant microbiome trajectory remains poorly understood. Utilizing large-scale longitudinal fecal samples from 264 mother-baby dyads, we present the gut microbiome trajectory of the mothers throughout pregnancy and infants during the first year of life. GDM mothers had a distinct microbiome diversity and composition during the gestation period. GDM leaves fingerprints on the infant's gut microbiome, which are confounded by delivery mode. Further, Clostridium species positively correlate with a larger head circumference at month 12 in male offspring but not females. The gut microbiome of GDM mothers with male fetuses displays depleted gut-brain modules, including acetate synthesis I and degradation and glutamate synthesis II. The gut microbiome of female infants of GDM mothers has higher histamine degradation and dopamine degradation. Together, our integrative analysis indicates that GDM affects maternal and infant gut composition, which is associated with sexually dimorphic infant head growth.

Neonatal B-Cell Levels and Infant Health in Newborns Potentially Exposed to Anti-CD20 Monoclonal Antibodies During Pregnancy or Lactation.

To report CD19+ B-cell counts and possible adverse effects on infants of mothers exposed to anti-CD20 mAbs ≤6 months before/during pregnancy or lactation. We conducted a retrospective study using data from the German nationwide neuroimmunologic pregnancy registry. Inclusion criteria involved infants whose mothers received anti-CD20 mAbs ≤6 months before/during pregnancy or lactation, with ≥1 postnatal CD19+ B-cell count. Main outcomes were absolute and relative CD19+ B-cell counts. Comparison with reference values was performed conservatively in a subgroup with maternal exposure ≤3 months before/during pregnancy. Additional outcomes included pregnancy results, severe infections, and lymphocyte counts. The cohort comprised 49 infants (F:M 25:24) exposed to anti-CD20 mAbs ≤6 months before/during pregnancy or lactation. CD19+ B-cell and lymphocyte counts in 40 infants with maternal exposure ≤3 months before/during pregnancy were comparable with normative values. Only 2 cases of complete CD19+ B-cell depletion occurred after second-trimester and third-trimester ocrelizumab exposure, with repopulation observed within 2 months. Exclusive lactation exposure had no significant effect on infants' absolute CD19+ B-cell counts. Administering anti-CD20 mAbs before or at the pregnancy onset, or during lactation, seems safe without significant impact on infant B-cell development. However, second-trimester or third-trimester exposure can cause CD19+ B-cell depletion due to placental transfer, necessitating monitoring and postponing live vaccines.

Maternal Stress Mediates Association of Infant Socioemotional Development with Perinatal Mental Health in Socioeconomically Vulnerable Peruvian Settings.

Increased maternal mental health during the perinatal period has been widely associated with a variety of positive outcomes for both mothers and infants. However, no studies in Peru have yet focused on studying maternal mental health and related psychological variables during this stage. Thus, the aim of this study was to test a model to associate a mother's parental stress with infant socioemotional difficulties and maternal mental health. The sample included 988 mothers of infants aged 6 to 18 months from Peru, all from socioeconomically vulnerable settings. The findings showed that infant socioemotional difficulties were associated with poorer maternal mental health through the mother's parental stress (χ2(7) = 28.89, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). These results provide a better understanding of the key elements associated with maternal mental health during the perinatal period in Peru and offer valuable insights for developing interventions and support strategies for socioeconomically vulnerable mothers and their young children.

Association of Umbilical Cord Perilipin 2 Levels with Neonatal Anthropometric Measurements in Infants of Diabetic Mothers.

Perilipin 2 (PLIN2) is a protein that contributes to the formation and stability of lipid droplets. It has been associated with the development of several diseases, particularly related to glucose and lipid metabolism. In infants of diabetic mother (IDM), fetal hyperinsulinaemia leads to increased adipose tissue and macrosomia. The aim of this study was to investigate the relationship between PLIN2 levels and anthropometric measurements in the IDM and to investigate the relationship between PLIN2 levels and IGF-1, IGF-2 and leptin levels. The study group consisted of IDMs, while the control group consisted of infants born to non-diabetic mother, matched for gestational week and gender. Cord blood samples were collected from all patients to determine PLIN2, IGF-1, IGF-2 and leptin levels. Anthropometric measurements were taken for all patients at birth. There were no differences between the groups in birth weight, birth length, head circumference and body mass index (BMI), but middle arm circumference, triceps, biceps, subscapular and suprailiac skinfold thickness were significantly higher in the IDM. While PLIN2, IGF-1, IGF-2 and leptin levels were similar between groups, there was a strong correlation between PLIN2 levels and IGF-2 and leptin levels. Even if IDMs were not macrosomic, the presence of high subcutaneous adipose tissue was not associated with PLIN2.

Feeding Practices of Infants and Young Children in Pokhara Metropolitan City.

For children to grow and develop normally, appropriate feeding practices are essential, especially in the first two years of their lives. These practices can vary depending on the different sociodemographic factors. This study aims to study the feeding practices of infants and young children in different wards of Pokhara Metropolitan City. A community-based cross-sectional study was conducted and 280 mothers of infants and young children 0-23 months of age were interviewed using a semi-structured questionnaire. Data were entered and cleaned in Ms-Excel and then exported to SPSS version 21.0 for statistical analysis. Binary logistic regression analysis was used to find the association of feeding practices with different independent variables. Only 32.3% of children 0-5 months of age were found to be appropriately breastfed, and 41.8% of children 6-23 months of age were found to have appropriate complementary feeding practices. Children delivered by normal vaginal delivery (AOR 18.118, p < 0.01, 95% CI 3.831 - 85.689) were more likely to have appropriate breastfeeding practices than those delivered by caesarean section. Children of birth order two or more (AOR 2.226, p = 0.016, 95% CI 1.171 - 4.620) and living in nuclear families (AOR 2.488, p = 0.013, 95% CI 1.120 - 5.116) were found to have appropriate complementary feeding practices. This study concludes that the feeding practices of the majority of the infants and young children in Pokhara are not adequate as per the WHO and UNICEF standards.

Effect of brewer’s yeast or beta-glucan on breast milk supply following preterm birth: the BLOOM study – protocol for a multicentre randomised controlled trial

BackgroundMany individuals who experience preterm birth struggle with early breast milk supply, which can translate into suboptimal longer-term breastfeeding outcomes. Further investigations into the potential role of early non-pharmacological and pharmacological interventions in improving breast milk production soon after birth is growing. While natural galactagogues, such as brewer’s yeast, are widely perceived by women to be safer than pharmaceutical galactagogues and are taken by many women, evidence to support their efficacy is largely absent. The BLOOM study has been designed to determine the efficacy and safety of brewer’s yeast and beta-glucans, derived from Saccharomyces cerevisiae, when administered soon after birth for increasing early breast milk supply in mothers who have delivered preterm.MethodsThe BLOOM study is a multicentre, double-blinded, randomised controlled trial that will assess if brewer’s yeast or beta-glucan can increase early breast milk production following preterm birth. Target population are mothers of preterm infants born at less than 34 weeks’ gestation who intend to provide breast milk for their infant, are less than 72 h following birth and able to give informed consent. Participants will be randomly allocated into three parallel groups at 1:1:1 ratio (n = 33 per group) to receive either brewer’s yeast, beta-glucan or placebo capsules for seven days. The primary outcome is total expressed breast milk volume over a 24-hour period on day 7 of intervention. Participants and their infants will be followed until the infant reaches term corrected age or is discharged home from the neonatal unit (whichever occurs first).DiscussionThe use of brewer’s yeast as a galactagogue to enhance milk production is extremely common amongst breastfeeding mothers, however, there are no trials evaluating its efficacy and safety. This will be the first randomised controlled trial to evaluate the efficacy and safety of two commonly used galactagogues, brewer’s yeast and beta-glucan, compared with placebo in improving maternal breast milk supply following preterm birth. The trial will also evaluate whether early intervention with galactagogues soon after a preterm birth improves longer-term breastfeeding outcomes.Trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12622000968774 (registered on 8 July 2022) and UTN U1111-1278-8827.

Infants’ cortisol reactivity and infant–mother cortisol synchrony in urban Chinese families: The role of maternal control strategy

Maternal control strategy refers to a mother’s practices used to impel, inhibit, guide, or shape their children’s behaviors during mother-child interaction. The present study examined control strategies used by Chinese urban mothers and how they associated with infants’ cortisol trajectory and infant-mother cortisol synchrony during a separation task. Participants were 115 infant-mother dyads. Maternal control strategy was assessed during mother-infant free-play when the infants were 6 months (T1) and 1 year (T2) old. Salivary cortisol samples were collected from both infants and mothers during a stress-inducing task at T2. The results indicated that mothers most frequently adopted the moderate power control strategy, at both T1 and T2. T1 maternal low control strategy significantly predicted infants’ cortisol response curve, namely infants of mothers who predominantly adopted a low power control strategy had a more dynamic reactivity and recovery in their cortisol response to the separation task. Positive cortisol synchrony was observed between mothers and infants during the separation stress condition. In addition, T2 maternal high power control strategy accounted for inter-individual variations in infant-mother cortisol synchrony, such that mothers who predominantly adopted a high power control strategy exhibited a heightened level of cortisol synchrony with their infants. Our findings suggest that targeted training in maternal control strategies could help mothers calibrate their infants’ adrenocortical regulation.

Attachment security and disorganization in infants of mothers with severe psychiatric disorder: Exploring the role of comorbid personality disorder

The aim of this preliminary study was to explore infant-mother attachment quality in a Dutch clinical sample of mothers with severe psychiatric disorder, with or without comorbid personality disorder. Thirty-two mothers were recruited through specialized secondary and tertiary outpatient clinics and mental health institutions. Maternal psychiatric and personality diagnoses were verified with structured clinical interviews during pregnancy. Maternal concurrent level of psychiatric symptoms was assessed by self-report and infant-mother attachment quality by observation in the Strange Situation Procedure at 14 months postpartum. In the full sample, almost half of the infants were classified as disorganized. All infants of mothers with a comorbid personality disorder were classified as either insecure or disorganized. Infants of mothers with a comorbid personality disorder had a significantly higher disorganization score than infants of mothers with a psychiatric disorder only. Continuous attachment security scores did not differ significantly between groups. In the full sample, continuous infant attachment security and disorganization score were not significantly correlated with the level of maternal concurrent psychiatric symptoms. Our exploratory findings suggest a specific link between maternal psychiatric and comorbid personality disorder and attachment disorganization. Moreover, chronicity of symptoms appears more relevant for attachment behaviors than the severity of concurrent psychiatric symptoms. Maternal personality disorder may have a strong formative impact on infant attachment security and disorganization, which warrants further research to inform clinical practice, in order to reduce the risk of intergenerational transmission of maternal psychopathology.

Perinatal Outcomes of Immigrant Mothers and Their Infants Born Very Preterm across Germany.

In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers' immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children's mothers' countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers' L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants.

Prenatal family income, but not parental education, is associated with resting brain activity in 1-month-old infants

Childhood socioeconomic disadvantage is associated with disparities in development and health, possibly through adaptations in children’s brain function. However, it is not clear how early in development such neural adaptations might emerge. This study examined whether prenatal family socioeconomic status, operationalized as family income and average years of parental education, prospectively predicts individual differences in infant resting electroencephalography (EEG; theta, alpha, beta, and gamma power) at approximately 1 month of age (N = 160). Infants of mothers reporting lower family income showed more lower-frequency (theta) and less higher-frequency (beta and gamma) power. These associations held when adjusting for other prenatal and postnatal experiences, as well as infant demographic and health-related factors. In contrast, parental education was not significantly associated with infant EEG power in any frequency band. These data suggest that lower prenatal family income is associated with developmental differences in brain function that are detectable within the first month of life.

Establishing correlates of maternal-fetal cytomegalovirus transmission-one step closer through predictive modeling.

Determinants of maternal-fetal cytomegalovirus (CMV) transmission and factors influencing the severity of congenital CMV (cCMV) infection are not well understood. We conducted a descriptive, multi-center study in pregnant women ≥18 years old with primary CMV infection and their newborns (NCT01251744) to explore maternal immune responses to CMV and determine potential immunologic/virologic correlates of cCMV following primary infection during pregnancy. We developed alternative approaches looking into univariate/multivariate factors associated with cCMV, including a participant clustering/stratification approach and an interpretable predictive model-based approach using trained decision trees for risk prediction (post-hoc analyses). Pregnant women were grouped in three distinct clusters with similar baseline characteristics, particularly gestational age at diagnosis. We observed a trend for higher viral loads in urine and saliva samples from mothers of infants with cCMV versus without cCMV. When using a trained predictive-model approach that accounts for interaction effects between variables, anti-pentamer IgG antibody concentration and viral load in saliva were identified as biomarkers jointly associated with the risk of maternal-fetal CMV transmission. We identified biomarkers of CMV maternal-fetal transmission. After validation in larger studies, our findings will guide the management of primary infection during pregnancy and the development of vaccines against cCMV.

Achieving sufficient milk supply supports mothers to cope with premature birth.

To explore whether and how expressing breast milk is perceived as helpful in coping with negative emotions due to premature birth by mothers of very low birth weight (VLBW) infants. Qualitative interviews and a retrospective cross-sectional questionnaire with mothers of VLBW infants were conducted and analysed using an exploratory sequential mixed-method design. Hypotheses were built using qualitative content analysis and quantitatively tested using multivariate regression analysis. Interviews with 12 mothers and questionnaires of 518 mothers were analysed. Coping with prematurity by expressing milk was seen as a way to maintain the caregiving role for the mothers, where three relevant factors arouse: making up for what happened, providing the best for their infant and fear of low milk supply. Quantitative analysis showed that mothers with a high milk supply (Coef. = 1.1, p < 0.000) and more feelings of guilt due to premature birth (Coef. = -0.1; p = 0.015) perceived expressing breast milk significantly more as a resource for coping. This study adds knowledge on how expressing breast milk for their VLBW infant may support mothers in coping with premature birth, by revealing the association with milk supply and feelings of guilt due to premature birth.

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.