Infants Of Mothers Research Articles

Development and psychometric evaluation of "Caring Ability of Mother with Preterm Infant Scale" (CAMPIS): a sequential exploratory mixed-method study.

Caring ability is one of the most important indicators regarding care outcomes. A valid and reliable scale for the evaluation of caring ability in mothers with preterm infants is lacking. The present study was conducted with the aim of designing and psychometric evaluation of the tool for assessing caring ability in mothers with preterm infants. A mixed-method exploratory design was conducted from 2021 to 2023. First the concept of caring ability of mothers with preterm infants was clarified using literature review and comparative content analysis, and a pool of items was created. Then, in the quantitative study, the psychometric properties of the scale were evaluated using validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 401 mothers with the mean age of 31.67 ± 6.14years to assess the construct validity. Initial caring ability of mother with preterm infant scale (CAMPIS) was developed with 64 items by findings of the literature review, comparative content analysis, and other related questionnaire items, on a 5-point Likert scale to be psychometrically evaluated. Face, content, and construct validity, as well as reliability, were measured to evaluate the psychometric properties of CAMPIS. So, the initial survey yielded 201 valid responses. The three components: 'cognitive ability'; knowledge and skills abilities'; and 'psychological ability'; explained 47.44% of the total observed variance for CAMPIS with 21 items. A subsequent survey garnered 200 valid responses. The confirmatory factor analysis results indicated: χ2/df = 1.972, comparative fit index (CFI) = 0.933, and incremental fit index (IFI) = 0.933. These results demonstrate good structural, convergent, discriminant validity and reliability. OMEGA, average inter-item correlation (AIC), intraclass correlation coefficients (ICC) for the entire scale were at 0.900, 0.27 and 0.91 respectively. Based on the results of the psychometric evaluation of CAMPIS, it was found that the concept of caring ability in the Iranian mothers with preterm infants is a multi-dimensional concept, which mainly focuses on cognitive ability, technical ability, and psychological ability. The designed scale has acceptable validity and reliability characteristics that can be used in future studies to assess this concept in the mothers of preterm infants.

Patterns of Human Milk Oligosaccharides in Mature Milk Are Associated with Certain Gut Microbiota in Infants.

Human milk oligosaccharides (HMOs) are complexes that play a crucial role in shaping the early-life gut microbiota. This study intends to explore whether HMO patterns are associated with the gut microbiota of infants. We included 96 Chinese breastfeeding mother-infant dyads. Breast milk and infant faecal samples were collected and tested. With milk 2'-fucosyllactose, difucosyllactose, and lacto-N-fucopentaose-I as biomarkers, we divided the mothers into secretor and non-secretor groups. HMO patterns were extracted using principal component analysis. The majority (70.7%) of mothers were categorised as secretor and five different HMO patterns were identified. After adjustment, the infants of secretor mothers exhibited a lower relative abundance of Bifidobacterium bifidum (β = -0.245, 95%CI: -0.465~-0.025). An HMO pattern characterised by high levels of 3-fucosyllactose, lacto-N-fucopentaose-III, and lacto-N-neodifucohexaose-II was positively associated with the relative abundance of Bifidobacterium breve (p = 0.014), while the pattern characterised by lacto-N-neotetraose, 6'-sialyllactose, and sialyllacto-N-tetraose-b was negatively associated with Bifidobacterium breve (p = 0.027). The pattern characterised by high levels of monofucosyl-lacto-N-hexaose-III and monofucosyl-lacto-N-neohexaose was positively associated with Bifidobacterium dentium (p = 0.025) and Bifidobacterium bifidum (p < 0.001), respectively. This study suggests that HMO patterns from mature breast milk were associated with certain gut microbiota of breastfed infants.

Post-discharge Care Practices, Challenges, and Outcomes in Newborn Infants of Mothers With SARS-CoV-2 Infection: Insights From Public Hospitals.

Background The data regarding the care at home and outcomes in infants of mothers infected with SARS-CoV-2 continueto evolve. There is a paucity of studies beyond the immediate newborn period. Our research aims to improve the understanding in these areas by studying the newborn population discharged from public hospitals in several boroughs of New York City (NYC) through the first year of the COVID-19pandemic. Objective The objective of this study is to assess parental perspective and describe post-discharge care practices, patterns of healthcare utilization, challenges in obtaining care, and outcomes in infants between six and 12 months of age born to mothers infected with SARS-CoV-2 at the time of delivery. Methods We conducted an institutional review board (IRB)-approved multi-center retrospective cohort study of infants born to SARS-CoV-2-positive mothers at five NYC public hospitals between March and December of 2020. Clinical and demographic data were collected from electronic medical records. A phone interview of the caregivers using a standard questionnaire was conducted to collect data about care at home, healthcare utilization patterns, and challenges with access to healthcare. Results Our study cohort included 216 infants born to SARS-CoV-2-positive mothers with 16 (7.4%) mothers being symptomatic at discharge. Ten infants tested positive, and two showed symptoms before discharge. Two hundred seven (95.8%) infants were discharged home to their parents, and eight (3.7%) were transferred to other facilities. One hundred thirty-eight(66%) infants had at least one visit to the emergency room (ER) for various complaints where two were found to have COVID-19 with one needing hospitalization. One hundred seventy-two (79.6%) families responded to the phone interview. Most mothers (78%) cohabitated with their infants at home, and 70.3% elected to breastfeed. However, only 56.3% of mothers reported using all the recommended infection prevention practices at home. More than half (57%) of the families reported financial hardship related to the pandemic. Although 46.2% of patients missed their in-person health maintenance visits, telemedicine was highly utilized for follow-up with most being phone visits (70.3%). The majority of the infants (95.5%) remained up-to-date with their routine immunizations. Conclusions Our results suggest that infants born to SARS-CoV-2-infected mothers showed increased utilization of medical care and telemedicine between six and 12 months of age. Mothers reported low adherence to infection prevention practices at home; however, infants rarely showed clinically significant SARS-CoV-2 infection while maintaining high breastfeeding rates after discharge.

Contribution of the Pilot Study for Methodological Enrichment of the Main Study

Introduction: A Pilot Study (PS) is useful for the assessment of the practicability of the methods and processes as well as the management of challenges before the main final study. The PS was conducted for the preparation of the mixed-method study related to nurses’ and parents’ perspectives regarding preterm infants’ care practice in neonatal care units (NCUs) in Nepal. Methods: Mixed method PS was conducted among nurses and mothers of preterm infants (PTIs) admitted to a NCU of an academic tertiary hospital. For data collection among nurses, a self-administered questionnaire and focus group discussion (FGD) were used in the quantitative and qualitative phases respectively. Whereas in-person interviews and in-depth interviews (IDIs) were conducted among mothers in the quantitative and qualitative phases respectively. Data were analyzed using descriptive statistics and content analysis methods. Results: The major amendments based on PS findings were the study design from convergent parallel to exploratory sequential mixed-method design for contextual instrument development, the addition of the observation method of data collection for enhancing the validity of the findings related to care practice, and the inclusion of both parents of PTIs instead of only mothers. The PS was also useful for providing the experience of qualitative and mixed-method study for the researcher for the final study, especially for the qualitative part. Conclusion: This article reflects the contribution of the PS to the main mixed-method study. Therefore, it is worthy to conduct the PS to enhance the methodological rigor of the study. It is commendable to discuss and disseminate the PS findings.

Human Breast Milk Exosomal miRNAs are Influenced by Premature Delivery and Affect Neurodevelopment.

This study investigates the exosomal microRNA (miRNA) profiles of term and preterm breast milk, including the most abundant and differentially expressed (DE) miRNAs, and their impact on neurodevelopment in infants. Mature milk is collected from the mothers of term and preterm infants. Using high-throughput sequencing and subsequent data analysis, exosomal miRNA profiles of term and preterm human breast milk (HBM) are acquired and it is found that the let-7 and miR-148 families are the most abundant miRNAs. Additionally, 23 upregulated and 15 downregulated miRNAs are identified. MiR-3168 is the most upregulated miRNA in preterm HBM exosome, exhibiting targeting activity toward multiple genes involved in the SMAD and MAPK signaling pathways and playing a crucial role in early neurodevelopment. Additionally, the effects of miR-3168 on neurodevelopment is confirmed and it is determined that it is an essential factor in the differentiation of neural stem cells (NSCs). This study demonstrates that miRNA expression in breast milk exosomes can be influenced by preterm delivery, thereby potentially impacting neurodevelopment in preterm infants.

The relationship between maternal-infant bonding and postpartum depression/anxiety: moderating effect of childhood psychological abuse and validation of the Mother-to-Infant Bonding scale (MIBS-8) in Arabic

BackgroundThe emotional bond that a mother senses to her infant is essential to their social, emotional, and cognitive development. Understanding the level of mother-infant bonding plays an imperative role in the excellence of care. However, in Lebanon, there is a paucity of information about mother-infant bonding in the postpartum period. Given that Lebanese pregnant women constitute an important part of the population to look at, the objectives of the study were to (1) validate the Arabic version of the mother–infant bonding scale and (2) the relation between mother-infant bond and postpartum depression/anxiety; (3) the moderating effect of child abuse in the association between mother-infant bond and postpartum depression/anxiety.MethodsThis cross-sectional study was conducted from September 2022 until June 2023, enrolling 438 women 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years). To examine the factor structure of the mother-infant bond scale, we used an Exploratory-Confirmatory (EFA-CFA) strategy. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ2/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsEFA was conducted on the first subsample. Three items were removed. The five items remaining loaded on one factor, which explained 73.03% of the common variance (ω = .91 / α = .90). After adding a correlation between residuals for items 2–7 and 5–8, fit indices of the CFA results were acceptable: χ2/df = 6.97/3 = 2.32, RMSEA = .068 (90% CI .001, .135), SRMR = .017, CFI = .996, TLI = .988. The interaction maternal-infant bonding by child psychological abuse was significantly associated with depression and anxiety respectively. At low, moderate and high levels of child psychological abuse, higher maternal-infant bonding scores (greater difficulty in bonding) were significantly associated with higher depression and higher anxiety respectively.ConclusionThis study provides, for the first time, a specific Arabic scale to assess mother-infant bonding reliably and validly. Furthermore, our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese postpartum women, namely a history of psychological child abuse. Therefore, laborious awareness programs and healthcare services need to be implemented in order to prevent maternal mental health disorders from being unrecognized and left untreated.

Breastfeeding practices and social norms in Kinshasa, Democratic Republic of the Congo: A qualitative study.

Breastfeeding has many benefits for both mothers and children. The World Health Organization recommends exclusive breastfeeding for the first six months of life. However, in the Democratic Republic of the Congo, slightly under half of children under six months are exclusively breastfed. This study aimed to describe breastfeeding practices and to explore perceived social norms regarding breastfeeding among mothers in Kinshasa. A qualitative descriptive study was conducted in Kinshasa from June to July 2013. This study purposively sampled 54 mothers of infants aged 6 to 12 months, who participated in six focus group discussions. Based on the Theory of Planned Behaviour, the discussion guide explored infant feeding in the first six months, knowledge of breastfeeding, perception of the feasibility of exclusive breastfeeding, and perception of the social norms with regard to exclusive breastfeeding. The content analysis approach was used to analyse data. Mothers had good breastfeeding knowledge; however, few of them had practised exclusive breastfeeding as recommended during the first six months. Exclusive breastfeeding was considered unfeasible in their context. Barriers to exclusive breastfeeding were reported as baby's cries, social pressure, warm climate, and poor maternal diet. Social norms were supportive of breastfeeding but unfavourable to exclusive breastfeeding. In Kinshasa, mothers have a good knowledge of breastfeeding. However, few practise exclusive breastfeeding. Social pressure plays an important role in the cessation of exclusive breastfeeding before six months. In order to improve the practice of exclusive breastfeeding in this context, social and behaviour change programmes should target the entire population rather than mothers only.

Maternal Sleep Health, Social Support, and Distress: A Mixed–Methods Analysis of Mothers of Infants and Young Children in Rural US

ABSTRACT Objectives The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population. Methods 39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design. Results Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers. Conclusions Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.

Case report: Congenital multidrug-resistant tuberculosis

Congenital multidrug-resistant tuberculosis (MDR-TB) is a rare disease with high mortality. We report a case of a neonate girl with congenital MDR-TB. The infant's mother underwent in vitro fertilization–embryo transfer and did not show any symptoms prior to delivery. After the 14th day of life, the infant had a fever and worsening difficulty breathing despite antibiotic treatment. She was then confirmed to have congenital MDR-TB and received ventilation and anti-TB treatment. When the infant's TB was diagnosed, her mother was screened for TB and found to have MDR-TB, affecting both her lungs and reproductive system. They both recovered and were discharged from the hospital, with anti-TB treatment ongoing.

Knowledge on Use of Diaper and Its Impact on Child Health among Mothers of Infants

The present study aims to assess the knowledge on use of diaper and its impact on child health among mothers of infants. The objectives of the study was to assess the knowledge on use of diaper and its impact on child health among mothers of infants and to find out the association between the knowledge onuse of diaper and its impact of child health among the mothers of infants and selected socio personal variables. Non experimental descriptive study design was used in the study. The data was collected by using a semi structured questionnaire. The collected data was analysed using descriptive and inferential statistics. The result shows that out of 50 samples majority of the children are of age range 0-2 months, 52% were male children and was first born (54%). Majority of the sample are at age group 26-30 years ( 36%) , 58% samples are educated upto graduate level, 42% of samples were housewives and 48% have family income above 30,000, 94% of children were using disposable diapers ,42% of children using diapers for 3-4 hours and 80% children had no exposure to diaper rash.Among the samples, 56% of mother had moderate knowledge, 34% of mothers had poor knowledge and, 10% of mothers had good knowledge. There is significant association between the age of mother and occupation of mother and there is no association between age of child, sex of child, birth order of child, education of mother, income of family, type of diaper used, duration of diaper used, previous exposure to diaper rash.

The Role of Maternal Secretor Status and Human Milk Oligosaccharides on Early Childhood Development: A Systematic Review and Meta-Analysis.

Background: Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. Aims: To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. Study Design: A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. Results: The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, I2 = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; p = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. Conclusions: According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.

Gaps in the prevention of mother-to-child transmission of syphilis: a review of reported cases, South Africa, January 2020-June 2022.

Congenital syphilis (CS) is preventable through timely antenatal care (ANC), syphilis screening and treatment among pregnant women. Robust CS surveillance can identify gaps in this prevention cascade. We reviewed CS cases reported to the South African notifiable medical conditions surveillance system (NMCSS) from January 2020 to June 2022. CS cases are reported using a case notification form (CNF) containing limited infant demographic and clinical characteristics. During January 2020-June 2022, healthcare workers supplemented CNFs with a case investigation form (CIF) containing maternal and infant testing and treatment information. We describe CS cases with/without a matching CIF and gaps in the CS prevention cascade among those with clinical information. During January 2020-June 2022, 938 CS cases were reported to the NMCSS with a median age of 1 day (interquartile range: 0-5). Nine percent were diagnosed based on clinical signs and symptoms only. During January 2020-June 2022, 667 CIFs were reported with 51% (343) successfully matched to a CNF. Only 57% of mothers of infants with a matching CIF had an ANC booking visit (entry into ANC). Overall, 87% of mothers were tested for syphilis increasing to 98% among mothers with an ANC booking visit. Median time between first syphilis test and delivery was 16 days overall increasing to 82 days among mothers with an ANC booking visit. Only 37% of CS cases had accompanying clinical information to support evaluation of the prevention cascade. Mothers with an ANC booking visit had increased syphilis screening and time before delivery to allow for adequate treatment.

A Descriptive Survey to Assess and Compare the Breastfeeding Practices among Working and Non-Working Mothers of Infants (6-12 Months) Attending Well Baby Clinic of Selected Hospitals and MCH Centre

The findings of the study revealed that majority of the mothers 98 mothers (49%) had LSCS, 88 mothers (44%) had normal vaginal delivery and 14 mothers (7%) had abnormal delivery,180 mothers (90%) mothers delivered at full term whereas 13(6.5%) mothers delivered at preterm. 52(26%) mothers were giving water in between feeds to their infant who were less than 6 months and on exclusive breastfeeding. 108(74%) mothers used bottle for top feeding. 135(67.5%) mothers clean the utensils used for feeding by boiling. 16(32%) working mothers gave honey/ghutti immediately to their infants after birth whereas the number was 60(40%) for the non-working mothers. 20(40%) working mothers started complementary feeding within 4-6 months of their delivery whereas it was 95(63.3%) for non- working mothers. 18(36%) working mothers gave mashed food as complementary feed to their infants in the age group of 6-9 months whereas 32(21.3%) non-working mothers gave above items. Working mothers were giving better complementary feed to their infants but were having difficulty continuing breast feeding. The study findings revealed that there is need to impart knowledge on practice of mothers on infant feeding.

An epidemiological examination of neonatal opioid withdrawal syndrome and maternal and infant characteristics.

Analyze maternal and infant characteristics by Neonatal Opioid Withdrawal Syndrome (NOWS) status and examine the association between mothers with Hepatitis C Virus (HCV) and infants diagnosed with NOWS. Hospital discharge diagnoses of low-income women in Tennessee were used to identify NOWS cases (n = 1,369) in 2013 and 2014 and randomly selected controls (n = 1,369) were matched on county of residence and birth year. Maternal and infant characteristics were obtained by linking these data to birth certificate data. Of Tennessee's 683 cases of NOWS in 2013 and 686 in 2014, most (69%) occurred in Eastern Tennessee. Mothers of infants with NOWS were more likely to be older, unmarried, and white than mothers of infants without NOWS. Mothers of infants with NOWS also faced greater health risk: more smoking, HCV, herpes simplex diagnosis, and no or less frequent prenatal care (p < .0001). Infants with NOWS were more likely to present with infection, be admitted into the NICU, have lower birth weight, be enrolled in TennCare, but less likely to be breastfed than infants without NOWS (p < .0001). After adjusting for demographic factors and smoking, compared to mothers of infants without NOWS, mothers of infants with NOWS had an alarmingly increased odds of HCV [OR = 12.97 (95% CI 7.42, 22.66)]. This study emphasizes the complexity of challenges facing families impacted by NOWS, the importance of multifaceted prevention, and the need to conduct HCV testing in NOWS infants.

Compassionate Care: Listening Visits Provided by Neonatal Intensive Care Unit Nurses.

Although mothers of infants hospitalized in a neonatal intensive care unit (NICU) often experience clinically significant levels of depression symptoms, accessing mental-health treatment may be difficult. NICU mothers need emotional support that is conveniently delivered at the infant's point-of-care by a trusted professional who is knowledgeable about the medical and nursing care in the NICU. Listening Visits are an effective and accessible, nurse-delivered depression intervention, yet little is known about what mothers discuss during these sessions. This analysis of sessions recorded during the randomized controlled trial evaluation of Listening Visits in the NICU provides a glimpse into NICU mothers' concerns and experiences. This is a secondary, qualitative case analysis of the recorded Listening Visits sessions of four depressed NICU mothers as indicated by a score of 12 or above on the Edinburgh Postnatal Depression Scale. The mothers, who were all White, varied in their economic resources, educational level, availability of support, and infant illness severity. Mothers discussed similar concerns and experiences, often at analogous temporal points in the six Listening Visit sessions, as well as one common concern they voiced throughout: family and friends do not understand what it is like to have an infant in the NICU. For mildly to moderately depressed mothers of infants hospitalized in the NICU, Listening Visits provide a way for bedside nurses to deliver compassionate care by listening to mothers' concerns and experiences.

The biological modifications of milk are linked to mental health of mothers of infants affected by bronchiolitis

IntroductionBreast milk is a dynamic type of nourishment that changes based on the needs of the child. An increasing amount of data suggests that mental health may be an important factor in such modulation. In addition, breast milk contains extracellular vesicles (EVs), which are currently considered an important dynamic system of communication between cells, even of different individuals.ObjectivesPurpose of this article is to investigate whether changes in breast milk in terms of EVs concentrations are related to maternal mental health.MethodsThis is a case-control study for which we enrolled mothers of infants with bronchiolitis (N=33) and mothers of healthy infants (N=13). Breast milk samples were taken and EVs concentrations were quantified. Maternal mental health was assessed by administration of five different psychometric scales: Edinburgh Postnatal Depression Scale (EPDS), State Trait Anxiety Inventory (STAI-S, STAI-T), Barkin Index of Maternal Functioning (BIMF), The Connor-Davidson Resilience Scale 10 items (CD-RISC). Subsequently, scale scores were related to evs concentrations by negative binomial regressions adjusted for case-control.ResultsAs maternal resilience increases, the EVs of neutrophilic origin (p=0.0447) and those of endothelial origin (p=0.0078) decrease¹. In contrast, an increased EPDS score is associated with higher levels of B-lymphocyte EVs (p=0.0376). Scores on the STAI-S scale impact many more populations of EVs²: we observed an increased Incidence Rate Ratio (IRR) of neutrophil-derived EVs (p&lt;0.0001), T-lymphocyte- derived EVs (p=0.0214), NK-cell-derived EVs (p=0.0202), T-reg CD4+ CD25+ (p=0.0141) and endothelial marked EVs (p=0.0180). An increase in STAI-T scale scores also was associated with a significant increase in CD177+ neutrophil-derived EVs (p=0.0028) and endothelial-derived EVs (p=0.0111)³.Image:Image 2:Image 3:ConclusionsEVs concentrations in breast milk are associated with maternal mental health. Specifically, stress and related severity of anxiety is able to increase the concentrations of EVs derived from inflammatory cells, which suggests an increase in their number and activity. Further research is needed to confirm these preliminary findings.Disclosure of InterestNone Declared

Neonatal Outcomes in Different Maternal Diabetes Types: Experience from a Tertiary Care Unit

Objective: Infants of mothers with diabetes (IMD) may require hospitalization in neonatal intensive care units (NICU) for various reasons. In our study, our objective was to compare clinical and laboratory findings, as well as malformations and morbidities among IMD based on the types of maternal diabetes. Material and Methods: The diabetic status of mothers of 4713 infants admitted to tertiary neonatal intensive care unit (NICU) at Ankara Bilkent City Hospital between January 1, 2020, and January 1, 2022, was examined. We retrospectively analyzed demographic data, clinical and laboratory characteristics, and morbidities for 616 infants born to mothers with impaired glucose tolerance (IGT), gestational diabetes mellitus (GDM), or pre-existing gestational diabetes mellitus (Pre-GDM). Results: Of the 616 cases, 167 (27.1%) were infants of mothers with IGT, 394 (64%) with GDM and 55 (8.9%) with Pre-GDM. The prevalence of macrosomia was significantly higher in Pre-GDM (30.9%) than in the IGT (15%) and GDM (19.3%) groups (p=0.033). The most common malformations in the cases were related to the cardiovascular system (CVS) (77.4%). The frequency of septal hypertrophy was significantly higher in the Pre-GDM group compared to the IGT and GDM groups, and in the GDM group compared to the IGT group (p&amp;lt;0.001). The rates of septal hypertrophy, CVS malformation, LGA/macrosomia, and hypocalcemia were found to be significantly higher in infants of mothers with insulin requirement and high HbA1c levels, particularly in Pre-GDM group (p&amp;lt;0.001). According to the ROC analysis for the optimum maternal HbA1c value predicting septal hypertrophy, the threshold value was found to be 6% (AUC=0.693) with 62% sensitivity and 66% specificity. In logistic regression analysis, macrosomia and maternal HbA1c ≥6% were determined as independent risk factors for the presence of septal hypertrophy. Conclusion: Despite variations in the type of maternal diabetes, IDM experience significant clinical challenges when hospitalized and monitored in the NICU. Infants born to mothers with IGT may also be subjected to maternal hyperglycemia. The likelihood of certain complications rises in infants born to pregnant women with inadequate glycemic control, particularly those with elevated HbA1c levels. By ensuring maternal glycemic control and closely monitoring these infants, it is possible to reduce both mortality and morbidity.

95 Maternal Epidemiology of Brachial Plexus Birth Injuries in California: 1996-2012

OBJECTIVES/GOALS: To evaluate the incidence of brachial plexus birth injury (BPBI) and its associations with maternal demographic factors. Additionally, we sought to determine whether longitudinal changes in BPBI incidence differed by maternal demographics. METHODS/STUDY POPULATION: We conducted a retrospective cohort study of over 8 million maternal-infant pairs using California’s Office of Statewide Health Planning and Development Linked Birth Files from 1991-2012. Descriptive statistics were used to determine BPBI incidence and the prevalence of maternal demographic factors (race, ethnicity, age). Multivariable logistic regression was used to determine associations of year, maternal race, ethnicity, and age with BPBI. Excess population level risk associated with these characteristics was determined by calculating population attributable fractions. RESULTS/ANTICIPATED RESULTS: The incidence of BPBI between 1991-2012 was 1.28 per 1000 live births, with peak incidence of 1.84 per 1000 in 1998 and low of 0.9 per 1000 in 2008. Incidence varied by demographic group, with infants of Black (1.78 per 1000) and Hispanic (1.34 per 1000) mothers having the highest incidences. Controlling for relevant covariates, infants of Black (AOR=1.88, 95% CI 1.70, 2.08), Hispanic (AOR=1.25, 95% CI 1.18, 1.32) and advanced-age mothers (AOR=1.16, 95% CI 1.09, 1.25) were at increased risk. Disparities in risk experienced by Black, Hispanic, and advanced-age mothers contributed to a 5%, 10%, and 2% excess risk at the population level, respectively. Longitudinal trends in incidence did not vary among demographic groups. Population-level changes in maternal demographics did not explain changes in incidence over time. DISCUSSION/SIGNIFICANCE: Although BPBI incidence has decreased in California, demographic disparities exist. Infants of Black, Hispanic, and advanced-age mothers are at increased BPBI risk compared to White, Non-Hispanic, and younger mothers.

Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center.

Postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality around the world, with rates increasing in the United States. The objective of this study was to determine predictors of, and outcomes associated with, PPH at a Midwest academic health center. Demographic and clinical data were obtained from the electronic medical record on all consecutive delivering patients between May 1, 2020, and April 30, 2021. Associations between PPH and perinatal characteristics and outcomes were assessed using logistic regression models. A significance threshold of 0.05 was used for all comparisons. Of the 2497 delivering patients during the study period, 437 (18%) experienced PPH. Chronic hypertension, gestational hypertension, and preeclampsia with and without severe features were all associated with increased odds of PPH (odds rations [ORs], respectively, 1.61 (95% CI:1.13-2.24, p = 0.006), 1.62 (95% CI 1.18-2.21, p = 0.003), 1.81 (95% CI 1.14-2.80, p ≤ 0.001), and 1.92 (95% CI 1.29-2.82, p = 0.009). There were also increased odds of PPH with type I diabetes: 2.83 (95% CI 1.45-5.30, p = 0.001), type II diabetes: 2.14 (95% CI 1.15-3.82, p = 0.012), twin delivery: 3.20 (95% CI 2.11-4.81, p ≤ 0.001), cesarean delivery: 5.66 (95% CI 4.53-7.09, p ≤ 0.001), and assisted vaginal delivery: 3.12 (95% CI1.95-4.88, p ≤ 0.001). Infants of mothers with PPH had high odds of NICU admission (CI = 1.34-2.07, p < 0.001) and hypoxic ischemic encephalopathy (CI = 1.64-7.14, p < 0.001). Our findings confirm previous literature that preexisting and pregnancy-related hypertension, diabetes mellitus, multiple gestation, cesarean delivery, and assisted vaginal delivery are important predictors of PPH. In addition, we found that neonates of mothers with PPH had more adverse outcomes. These results may help to inform clinical care as rates of PPH continue to rise in the United States.

Infants of mothers with early remitted clinical depression and mothers with no postpartum depression: Adaptive functioning in the second year of life.

Whether and how remitted clinical depression in postpartum motherhood contributes to poor infant adaptive functioning is inconclusive. The present longitudinal study examines adaptive functioning in infants of mothers diagnosed as clinically depressed at 5 months but remitted at 15 and 24 months. Fifty-five U. S. mothers with early, remitted clinical depression and 132 mothers without postpartum depression completed the Vineland Adaptive Behavior Scales about their infants at 15 and 24 months. Between groups, mothers were equivalent in age, ethnicity, marital status, and receptive vocabulary (a proxy for verbal intelligence), and infants were equivalent in age and distribution of gender. Controlling for maternal education and parity, mothers with early, remitted clinical depression and mothers with no postpartum depression rated their infants similarly on communication, daily living skills, and socialization. Mothers with early, remitted clinical depression rated their infants poorer in motor skills. Girls were rated more advanced than boys in communication at 24 months and daily living skills at 15 and 24 months. Rated infant adaptive behavior skills increased from 15 to 24 months. With exceptions, adaptive functioning in infants may be robust to early, remitted maternal depression, and adaptive functioning presents a domain to promote positive development in this otherwise vulnerable population.