Postpartum Day Research Articles

Neonatal Anoxia Impacts Rats’ Maternal Behavior and Offspring Development due to Ultrasonic Vocalization’s Impairment

Hypoxic-ischemic encephalopathy is a severe clinical condition, among others, affecting the brain after offspring exposure to neonatal anoxia, which causes persistent sensorimotor and cognitive deficits. During peripartum, maternal behaviors are crucial for the healthy development of the offspring. In rats, the vocalization of newborns, around 40 kHz, corresponds to separation calls that encourage their mothers to retrieve them. Alterations in this pattern affect the maternal behavior addressed to the offspring. This study aimed to evaluate the maternal behavior of primiparous rats whose offspring were exposed to neonatal anoxia in P2 (postpartum day) during the lactation period, to assess mother-pup interactions through the pups’ vocalization from P3 to P18. It also intends to quantify eventual neuronal alterations in the mothers’ medial preoptic area after the last weaning (P21) through FOS protein expression. Anoxia offspring were found to reduce maternal behaviors toward them, increased frequency of separation calls in the male anoxia group, and reduced vocalization rate in the female anoxia group compared to their respective controls. Body weight gain reduction of males’ and females’ anoxia was observed. We concluded that anoxia exerts deleterious effects on the vocalization patterns of the pups, with sex differences that alter maternal behavior toward them. Impaired USV makes an additional negative impact on the already noxious effects of neonatal anoxia. Understanding those phenomena applies/contributes to guiding procedures and strategies to mitigate the deleterious outcomes and orient research concerning the complexity of neonatal anoxia events and the influence of maternal care quality concerning the pups, which should also be considered sex differences.

An exploratory analysis of leukocyte telomere length among pregnant and non-pregnant people

BackgroundLeukocyte telomere length (LTL) is a biomarker that is affected by older age, psychosocial stress, and medical comorbidities. Despite the relevance of these factors to obstetric practice, little is known about LTL in pregnancy. Our study explored longitudinal LTL dynamics in pregnant and non-pregnant people. ObjectiveThis pilot study compares changes in LTL between pregnant and non-pregnant people over time, explores potential correlations between LTL and mental health measures, and investigates associations between short first-trimester LTL and adverse pregnancy outcomes. Study designThis was a prospective pilot cohort study of nulliparous pregnant and non-pregnant people between ages 18 and 50 who presented for care at a single institution from January to November 2020. Pregnant people were enrolled between 10 and 14 weeks gestation. Participants had two blood samples drawn for LTL; the first on the day of enrollment and the second on postpartum day 1 (pregnant cohort) or 7 months later (non-pregnant cohort). LTL was measured using quantitative PCR. The primary outcome was the difference between pregnant and non-pregnant people in LTL change between the two timepoints (basepair difference per 30-day period). Secondary outcomes included differences in responses to the Patient Health Questionnaire-9 (PHQ-9) and a survey about stress related to COVID-19. Differences in LTL were tested using t-tests and linear regression models, both crude and adjusted for age. A subgroup analysis was conducted within the pregnant cohort to examine whether shorter first-trimester LTL was associated with adverse pregnancy outcomes. We conducted t-tests to compare LTL between people with and without each categorical outcome and computed Pearson correlation coefficients between LTL and continuous outcomes such as gestational age at delivery. Results46 pregnant and 30 non-pregnant people were enrolled; 44 pregnant and 18 non-pregnant people completed all LTL assessments. There were no between-group differences in LTL change (−4.2 ± 22.2 bp per 30 days pregnant versus −6.4 ± 11.2 bp per 30 days non-pregnant, adjusted beta 2.1, 95% CI -9.0-13.2, p = 0.60). The prevalence of depression and pandemic-related stress were both low overall. The two groups did not differ in PHQ-9 scores, and no correlations were significant between LTL and PHQ-9 scores. Among the 44 pregnant people, shorter first-trimester LTL was significantly correlated with earlier gestational age at delivery (r = 0.35, p = 0.02). ConclusionIn this exploratory pilot cohort of reproductive-aged people with low levels of psychological stress, we described baseline changes in LTL over time in pregnant and non-pregnant participants. We found a correlation between shorter first-trimester LTL and earlier gestational age at delivery, which warrants further investigation in a larger cohort.

Individuals' Experiences of Having an Unplanned Cesarean Birth: A Qualitative Analysis.

The experience of an unplanned cesarean birth may be a risk factor for mood disorders and other challenges in the postpartum period, yet qualitative data on the patient experience are limited. We sought to understand individuals' experiences of having an unplanned cesarean birth. This was a secondary analysis of a prospective qualitative investigation among low-income postpartum individuals at a single-, tertiary-care center in which the primary aim was to evaluate patients' postpartum pain experience after a cesarean birth. Participants completed a 60-minute face-to-face interview on postpartum days 2 to 3. Only participants who labored prior to their cesarean birth were included in this analysis. Transcripts were analyzed by two separate authors using the constant comparative method. Themes are illustrated using direct quotes. A total of 22 individuals were included in this analysis; the majority (n=16, 72.7%) experienced a primary cesarean birth. Over half (n=12, 54.5%) identified as Hispanic and one-third (n=7, 31.8%) identified as non-Hispanic Black race and ethnicity. Four themes regarding the experience of a cesarean birth after labor were identified, including feelings of anguish, belief that vaginal birth is "normal," poor experiences with care teams, and feelings of self-efficacy. Subthemes were identified and outlined. In this cohort, individuals who experienced an unplanned cesarean birth after labor expressed feelings of self-blame, failure, and mistrust. Given the association of unplanned cesarean birth with mood disorders in the postpartum period, efforts to enhance communication and support may offer a means of improving individual experiences. · In this cohort, many individuals expressed negative feelings after an unplanned cesarean birth.. · Conversely, positive themes related to feelings of self-efficacy were identified.. · Efforts to enhance communication and support after an unplanned cesarean birth are warranted..

Lactogenesis and breastfeeding after immediate vs delayed birth-hospitalization insertion of etonogestrel contraceptive implant: a noninferiority trial

Initiating a progestin-based contraceptive before the drop in progesterone required to start lactogenesis stage II could theoretically affect lactation. Previous studies have shown that initiating progestin-based contraception in the postnatal period before birth-hospitalization discharge has no detrimental effects on breastfeeding initiation or continuation compared with outpatient interval initiation. However, there are currently no breastfeeding data on the impact of initiating the etonogestrel contraceptive implant in the early postnatal period immediately in the delivery room. This study examined the effect of delivery room vs delayed birth-hospitalization contraceptive etonogestrel implant insertion on breastfeeding outcomes. This was a noninferiority randomized controlled trial to determine if time to lactogenesis stage II (initiation of copious milk secretion) differs by timing of etonogestrel implant insertion during the birth-hospitalization. We randomly assigned pregnant people to insertion at 0 to 2 hours (delivery room) vs 24 to 48 hours (delayed) postdelivery. Participants intended to breastfeed, desired a contraceptive implant for postpartum contraception, were fluent in English or Spanish, and had no allergy or contraindication to the etonogestrel implant. We collected demographic information and breastfeeding intentions at enrollment. Onset of lactogenesis stage II was assessed daily using a validated tool. The noninferiority margin for the mean difference in time to lactogenesis stage II was defined as 12 hours in a per-protocol analysis. Additional electronic surveys collected data on breastfeeding and contraceptive continuation at 2 and 4 weeks, and 3, 6, and 12 months. We enrolled and randomized 95 participants; 77 participants were included in the modified intention-to-treat analysis (n=38 in the delivery room group and n=39 in the delayed group) after excluding 18 because of withdrawing consent, changing contraceptive or breastfeeding plans, or failing to provide primary outcome data. A total of 69 participants were included in the as-treated analysis (n=35 delivery room, n=34 delayed); 8 participants who received the etonogestrel implant outside the protocol windows were excluded, and 2 participants from the delivery room group received the etonogestrel implant at 24 to 48 hours and were analyzed with the delayed group. Participants were similar between groups in age, gestational age, and previous breastfeeding experience. Delivery room insertion was noninferior to delayed birth-hospitalization insertion in time to lactogenesis stage II (delivery room [mean±standard deviation], 65±25 hours; delayed, 73±61 hours; mean difference,-9 hours; 95% confidence interval,-27 to 10). Onset of lactogenesis stage II by postpartum day 3 was not significantly different between the groups. Lactation failure occurred in 5.5% (n=2) participants in the delayed group. Ongoing breastfeeding rates did not differ between the groups, with decreasing rates of any/exclusive breastfeeding over the first postpartum year. Most people continued to use the implant at 12 months, which did not differ by group. Delivery room insertion of the contraceptive etonogestrel implant does not delay the onset of lactogenesis when compared with initiation later in the birth-hospitalization and therefore should be offered routinely as part of person-centered postpartum contraceptive counseling, regardless of breastfeeding intentions.

The association between tryptophan levels and postpartum mood disorders: a systematic review and meta-analysis

Over 50% of women experience mood disturbance in the postpartum period, with significant implications for maternal and infant health but identifying those at risk is not easily possible. The essential amino acid, tryptophan (TRP) through its neuroactive metabolites, has been implicated in the pathology of mood disorders. Thus, TRP levels tested in the peripartum period have been proposed as a potential biomarker for subsequent development of postpartum mood disturbances, in particular postpartum depression (PPD). A systematic review and meta-analysis following PROSPERO guidelines [CRD42021252462] was conducted on peer-reviewed, English language studies that measured blood levels of TRP during the postpartum period in women who were also evaluated for postpartum “blues” or PPD. Thirteen studies met the inclusion criteria, of which five studies contained sufficient data to conduct a meta-analysis. Low total TRP levels in postpartum days 1 to 5 were significantly associated with PPD (SMD: -5.39, 95%CI [-7.72, -3.05]). No significant association was found between free TRP levels in the postpartum period and PPD (SMD: -3.43, 95%CI [-7.76, 0.89]). Our findings confirm the necessity for more replicable designed studies regarding TRP and its relationship to postpartum depression. If there were greater clarity regarding TRP metabolism during pregnancy, then the next step would be to consider measuring total plasma TRP levels on postpartum days 1 to 5 to identify women at greater risk of developing PPD.

Iodine Metabolism and Thyroid Function During the Perinatal Period: Maternal-Neonatal Correlation and Effects of Topical Povidone-Iodine Skin Disinfectants.

An adequate maternal iodine intake during pregnancy and lactation is essential for growth and mental development in fetuses and newborns. There are limited data on perinatal iodine metabolism in mothers and infants, as well as the effect of povidone-iodine (PVP-I) antiseptics used in cesarean delivery. The urinary iodine concentration (UIC), serum iodine, thyrotropin (TSH), free thyroxine (FT4), and breast milk iodine concentration (BMIC) were measured consecutively in a total of 327 mothers and 249 term-infants in two prospective studies. The maternal median UIC was 164μg/L in the third trimester, increased to 256μg/L at 44h after birth, and then decreased to 116μg/L 1month later. The BMIC on the 4th and 32th postpartum days was 17.6 and 13.5μg/100g, respectively. In neonatal infants born to the mothers unexposed to PVP-I, the median UIC was 131μg/L in the first voiding urine and increased to 272μg/L on day 4 and then slightly decreased to 265μg/L on day 28 suggesting sufficient iodine reserve at birth. PVP-I antiseptics containing 1g of iodine for skin preparation at cesarean delivery transiently increased maternal serum iodine concentration (1.9-fold), UIC (7.8-fold) at 41 h after surgery and BMIC, while it had little effect on maternal TSH, FT4, and neonatal UIC, TSH, or FT4. The iodine status of pregnant women and their infants was adequate in this population; however, the UIC in lactating mothers at one postpartum month was low enough to suggest iodine deficiency or near iodine deficiency. Further studies are necessary.

Protracted Postpartum Urinary Retention: Incidence, Risk Factors, and Natural History of a Rare Postpartum Urinary Retention Subtype.

Postpartum urinary retention (PUR) is a multifactorial condition that requires a high degree of clinical suspicion for timely diagnosis and proper intervention. The aims of the study are to describe PUR incidence and to compare natural history, obstetric characteristics, and associated risk factors for protracted PUR (extending ≥3 days postpartum) versus PUR. This is a retrospective cross-sectional study of women who underwent an obstetric delivery over 24 months at an academic institution. International Classification of Diseases, Tenth Revision, codes were used to identify PUR. Patient characteristics, obstetric delivery data, and peripartum care surrounding delivery were collected. A P value of 0.05 or less was significant. Between January 1, 2018, and December 31, 2019, there were 23,844 deliveries (vaginal and cesarean section) and 77 patients (0.32%) experienced PUR. Within this group, 12 (0.05%) experienced protracted PUR. Patients with protracted PUR had a significantly later postpartum diagnosis day (median 1 [interquartile range, 1-2] vs 1 [0-1], P = 0.004), longer time to retention onset (22.0 [10.7-37.0] vs 10.7 [7.9-19.4] hours, P = 0.03), and greater retention duration (12.5 [5.5-17.0] vs 1.0 [0.0-1.0] days, P < 0.001) compared with those with PUR. There were no significant differences in patient or delivery characteristics for those delivering vaginally between the groups. Protracted PUR is rare, occurring in 0.05% of deliveries. Women with protracted PUR were more likely to have a greater onset time, later diagnosis date, and longer retention duration, out to 47 days, compared with women with PUR resolution before postpartum day 3.

Comparing the effect of childbirth preparation courses delivered both in-person and via social media on pregnancy experience, fear of childbirth, birth preference and mode of birth in pregnant Iranian women: A quasi-experimental study.

Rates of cesarean section in Iran are unnecessarily high largely due to fear of childbirth (FOC), yet this may be reduced through education. Iranian women are keen to obtain information about pregnancy and birth online though sources may not be reliable. Consequently, the present study aimed to compare the effect of childbirth preparation courses delivered both online via the social media platform 'Telegram' and in-person on pregnancy experience, FOC, birth preference, and mode of birth. This quasi-experimental study included 165 primiparous pregnant women referred to the prenatal clinic in Tehran, Iran. Convenience sampling was used to recruit participants, who were subsequently divided into three groups; (A) social media-based educational intervention (n = 53); (B) in-person educational intervention (n = 52), and (C) a control group who received no prenatal education (n = 50). During the 18th and 20th weeks of pregnancy, demographic questions along with the pregnancy experience scale (PES), and version A of the Wijma delivery expectancy/experience questionnaire (WDEQ‑A) were completed. In the 36th and 38th weeks of pregnancy, the PES and WDEQ‑A questionnaires, as well as birth preference form were further completed. Mode of birth was recorded in the first few days of postpartum. The Fisher's exact test, along with ANOVA and Chi-square tests were used to determine associations between variables. A paired t-test was used to examine within-group comparisons. The Kruskal-Wallis non-parametric test was used to investigate the intervening effect of economic status. Post intervention, the mean score of pregnancy experience and FOC did not differ significantly between the three groups. Also, 86.8% of participants in group A, 90.4% of participants in group B, and 62% of participants in the control group preferred to give birth vaginally, which was statistically significant (p = 0.001). Moreover, 66% of participants in group A, 61.5% of participants in group B, and 50% of participants in the control group ultimately gave birth vaginally. None of the participants in group A underwent an elective cesarean section, while this rate was 7.7% and 24% for groups B and control, respectively (p = 0.002). Despite the non-significant differences identified between the three groups in terms of pregnancy experience and FOC, prenatal education delivered via social media may be usefully offered to Iranian women keen to receive education flexibly online. Name of the Registry: Iranian Registry of Clinical Trials. Trial registration number: IRCT20180427039436N2. Date of registration: 15/06/2018. URL of trial registry record: https://www.irct.ir/trial/30890.

Abstract P2006: S100A1 And STRIT1 Redundantly Governs Responsiveness Of The Heart To Hemodynamic Stress Via Modulation Of SERCA2a Activity

Background &amp; Objectives: SR Ca2+ load, which is sustained by SERCA2a pump activity, is a critical determinant for cardiac performance regulation &amp; adaptation. Independent studies identified both S100A1 &amp; STRIT1 as molecular enhancers of SERCA2a activity in the heart. S100A1 &amp; STRIT1 decline in post-myocardial infarction hearts aggravated the transition to adverse cardiac remodelling &amp; contractile failure. We therefore hypothesized that S100A1 &amp; STRIT1 could act as independent but potentially redundant molecular switches for SERCA2a activity. Methods &amp; Results: S100a1 knock-out (SKO) mice display no overt cardiac contractile or structural abnormalities in the absence of stress. RNA-seq transcriptomic analysis of left ventricle (LV) of SKO &amp; wild type (WT) identified Strit1 amongst the top 3 most upregulated genes in SKO LV. We validated STRIT1 upregulation by RT-PCR as well as by immunoblotting (IB) that yielded a 15-fold increase compared with WT. Age lapse-resolved RT-PCR analysis showed Strit1 response to S100a1 knockout begins at post-partum day 5 &amp; reaches plateau in adulthood. Next, we generated Strit1-S100a1 double knock out mice (StSKO), which showed only a mild decline in cardiac contractile performance. Interestingly, LV tissue serin-16 phospholamban (PLN) phosphorylation levels &amp; PLNs pentameric state were found to be enhanced. WT, SKO &amp; StSKO mice were then subjected to transaortic constriction (TAC) &amp; followed for 60 days, which fully unmasked the mutually compensatory functions of S100A1 &amp; STRIT1. In TAC-StSKO hearts showed significantly higher decline in LV %EF, significantly increased LV end-systolic volume &amp; LV end-systolic diameter, &amp; significantly increased cardiac hypertrophic growth together with concordant molecular markers. TAC-SKO mice did not show any decline in STRIT1 protein upregulation, while TAC-WT hearts showed a putatively compensatory increase in the S100A1/STRIT1 protein ratio. Conclusion: Our first results indicates that STRIT1 &amp; S100A1 can act as compensatory molecular switches securing sufficient SERCA2a activity. As such, our study further sheds new light onto the novel concept of “molecular redundancy” to secure &amp; protect cardiac key effector activities to cope with distinct hemodynamic stressors

Protocol for an observational study investigating hormones triggering the onset of sustained lactation: the INSIGHT study

IntroductionLactation is a hormonally controlled process that promotes infant growth and neurodevelopment and reduces the long-term maternal risk of diabetes, cardiovascular disease and breast cancer. Hormones, such as prolactin and...

Swimming exercise strain-dependently affects maternal care and depression-related behaviors through gestational corticosterone and brain serotonin in postpartum dams

Pregnancy is a very complex and highly stressful time in which women become more physically and emotionally vulnerable. Therefore, mothers are more likely to face decreased self-esteem and increased postpartum depression. Despite the high prevalence of postpartum depression, more than 50 % of mothers are undiagnosed or untreated, showing an urgent need to explore an effective preventive strategy. A healthy lifestyle and regular physical activity have been suggested to be associated with an increased quality of life in pregnant and postpartum women. The purpose of this study was to determine whether swimming exercise before and during pregnancy can affect maternal care and postpartum depression-related behaviors in dams. To this end, female NMRI and C57BL/6 J mice were subjected to swimming exercise before conception and throughout pregnancy. On postpartum days 1–2, maternal behavior including nest building, active nursing, and licking/grooming were monitored. A battery of behavioral tests was also used to measure depression-related symptoms including anhedonia- and anxiety-like behavior, social behavior, and behavioral despair. To identify the underlying mechanisms, corticosterone and inflammatory cytokines during late pregnancy, and corticosterone and brain serotonin during the postpartum period were measured in dams. The findings indicated that swimming exercise increased gestational corticosterone, decreased maternal care and brain serotonin, and increased all depression-related behaviors in postpartum C57BL/6 J dams, while only increased licking/grooming and social behavior, and reduced anhedonia-like behavior in postpartum NMRI dams. Taken together, this study suggests that swimming exercise before and during pregnancy could alter maternal care and postpartum depression-like behavior in a strain-dependent manner.

Cacao Butter as Prophylaxis for Nipple Problems: A Pilot Randomized Controlled Study

Objective: Cacao butter is a type of oil extracted from the fruit of the Theobroma Cacao plant. This study was conducted to compare the use of breast milk and cacao butter for the prevention of nipple problems in the early postpartum period. Materials and Methods: This randomized controlled study involved 72 participants, who were randomized into the cacao and mother's milk groups. Data were collected using Descriptive questionnaire, Nipple assessment form, and IMDAT (Amount of Urine Output, Condition of Breasts, Amount of Stool, Weight Increase and Satisfaction Status). Results: On postpartum day 10, the rates of nipple pain (11.40% cacao group versus 40.50% mother's milk group), rashes (14.30% cacao group versus 35.10% mother's milk group), and cracks (14.30% cacao group versus 43.20% mother's milk group) significantly reduced in the cacao group when compared with the mother's milk group (p < 0.05). Conclusion: The application of cacao butter to the nipples is possibly a more effective method than the application of mother's milk for preventing nipple pain, rashes, or cracked nipples. Cacao butter can be used prophylactically to prevent nipple problems in the early postpartum period.

Protective Effects of Piceatannol against Selenite-Induced Cataract and Oxidative Damage in Rats

Purpose This study aimed to investigate the protective effects of piceatannol (PIC) on selenite-induced cataracts in Sprague-Dawley rats and explore its therapeutic effects as an antioxidant. Methods Thirty-two eight-day-old rat pups were randomly divided into four groups, with eight pups in each of them. Group 1, as the control group, was injected with the same amount of saline, while Groups 2–4 were administered with sodium selenite (3.46 mg/kg) subcutaneously into the neck on postpartum day 10 for cataract induction. Without further treatment, Group 2 served as the control model, while Groups 3 and 4 (low- and high-dose PIC-treated) had intraperitoneal piceatannol from day 8 to day 17 at doses of 10 mg/kg and 20 mg/kg, respectively. On postpartum day 17, after the last injection, the rat pups were examined for cataract grade by slit lamp, and the lenses of every group were isolated for oxidative damage indicators and further analysis. SRA01/04 cells were exposed to 600 μM H2O2 for 24 hours with or without pretreatment with 10μМ piceatannol. Cell viability was tested by CCK-8 assay and cell apoptosis was evaluated by AnnexinV-PE/7AAD assay. Results This study determined that compared with the model group, the degree of lens opacity was significantly reduced in PIC-treated groups. The histopathological damage of the lenses in the PIC-treated groups improved compared to the model group. There were fewer signs of lesions, such as vacuoles and atrophy. The biochemical results indicated that malondialdehyde (MDA) content of the PIC-treated groups were downregulated and the antioxidant enzyme activities (GSH and catalase) and antioxidant status (SOD) were upregulated compared with the model group. In vitro, piceatannol significantly restored cell viability and cell apoptosis under H2O2 injury. Conclusion Pretreatment with piceatannol may achieve a protective effect on cataract development through upregulating antioxidant enzyme activity.

Maternal Uyku Sorunlarının Obstetrik Sonuçlara Etkisi ve Bakım

Uyku, temel bir insan gereksinimi olup sağlıklı ve kaliteli bir yaşam için gereklidir. Kadınlar, horlama dışındaki uyku bozukluklarını, erkeklere kıyasla iki kat daha fazla yaşamaktadır. Gebelik, doğum ve doğum sonu dönemlerde var olan uyku sorunları şiddetlenmekte veya yeni başlangıçlı uyku sorunları gelişmektedir. Maternal uykudaki bozulmalar, gebeliğin ilk trimesterinde başlamakta, ikinci trimesterde azalmakta ve son trimesterde en üst seviyeye ulaşmaktadır. Doğum eylemindeki pek çok kadın; hastanede bulunma, kontraksiyonlar, yapılan müdahaleler, kullanılan ilaçlar, emosyonel sorunlar nedeniyle uyuma güçlüğü yaşamaktadır. Postpartum ilk günlerde ise emzirme ve bebek bakımı gibi nedenlerle annenin uykusu sıkça bölünmektedir. Doğumdan üç-altı ay sonra maternal uyku sorunları azalmakta fakat uyku kalitesi gebelikten önceki haline dönmemektedir. Yaşanan uyku sorununun türü, süresi, sıklığı ve şiddeti ile ilişkili olarak farklı obstetrik komplikasyonlar gelişebilmektedir. Bu duruma bağlı olarak hem maternal hem de fetal morbidite ve mortalite hızları artmaktadır. Maternal uyku sorunları, erken dönemde tanılanıp uygun şekilde yönetildiğinde ise bu sorunların, anne, fetüs ve yenidoğan sağlığına olan olumsuz etkileri azaltılabilmektedir. Bu nedenle sağlık ekibi üyelerinin, özellikle de ebe ve hemşirelerin; maternal uyku sorunlarını ihmal etmemesi, erken dönemde tanılaması, uygun şekilde yönetmesi ve kadınların başa çıkma mekanizmalarını arttırması gerekmektedir.

Postpartum Assessment of the Correlation between Serum Hormone Levels of Estradiol, Progesterone, Prolactin and ß-HCG and Blood Pressure Measurements in Pre-Eclampsia Patients.

Background: Preeclampsia is a pregnancy-related hypertensive disease. Aberrant hormone levels have been implicated in blood pressure disorders. This study investigated the association of postpartum maternal serum hormone levels of estradiol, progesterone, prolactin, and ß-HCG with poorer PE-related complications including arterial hypertension. Methods: Thirty patient women with preeclampsia, and twenty women with uncomplicated pregnancy were included in this study. Serum levels of estradiol, progesterone, prolactin, and ß-HCG were determined immediately after delivery, and on the first and third postpartum days by means of ECLIA. Results: Compared with normal pregnancy cases, preeclampsia cases had higher serum levels of ß-HCG levels on Day-0 (319%), of progesterone on Day-0 (207%) and Day-1 (178%), and of estradiol on Day-1 (187%) and Day-3 (185%). Increased prolactin levels were positively associated with disease severity and estradiol and progesterone levels were decreased in poorer preeclampsia features including disease onset and IUGR diagnosis. No significant correlation between different hormone levels and blood pressure measurements was reported. Conclusions: This study is the first that detected postpartum maternal serum hormone levels and their correlation with blood pressure measurements in preeclampsia. We believe that the persistent arterial hypertension in the puerperium in preeclampsia as well as poorer disease specifications are most likely not of hormonal origin. Larger, well-defined prospective studies are recommended.

Altered MRI Diffusion Properties of the White Matter Tracts Connecting Frontal and Thalamic Brain Regions in First-Episode, Drug-Naïve Patients With Postpartum Depression.

Although progress has been made in exploring postpartum depression (PPD), the involvement of cerebral structure connectivity in PPD patients keeps unclear. To explore structural connectivity alternations in mothers with PPD, diffusion tensor imaging (DTI) and automated fiber quantification (AFQ) were used to calculate brain white matter microstructure properties. Cross-sectional. A total of 51 women with first-episode, treatment-näive PPD, and 49 matched healthy postpartum women (HPW) controls. A 3.0 T; single-shot echo-planar imaging sequence. DTI measurements of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were obtained for 18 specific white matter tracts. The relationship between PDD symptoms, hormone levels, and postpartum days was also investigated. Two sample t test and Pearson's correlation analysis. The analysis was performed by using a permutation-based multiple-comparison correction approach, with the threshold of P < 0.05 (family wise error corrected [FWE-corrected]) separately across the four different outcome measures. Women with PPD showed significantly increased FA and AD in right anterior thalamic radiation (ATR) tract and significantly increased FA and significantly reduced RD in the cingulum tract, compared to women without PPD. The RD values of right cingulum were significantly positively correlated with postpartum days in HPW (r=0.39). There were no significant relationships between brain measures and hormone levels in either patients or controls. DTI measures have revealed altered integrity in the white matter of the cortical-thalamic circuits in women with PPD compared to HPW. Damage to these circuits may be a structural basis for the impaired emotional regulation and blunted mother-infant bonding in mothers with PPD and a potential target for the development of new treatments. 2 TECHNICAL EFFICACY: Stage 3.

STUDI KASUS PELAKSANAAN INISIASI MENYUSU DINI DAN BOUNDING ATTACHMENT PADA IBU POST PARTUM DI PUSKESMAS DINOYO KOTA MALANG

The bounding process on newborns is needed to establish a bond between mother and child that enhances the connection between mother and child at birth and afterwards by giving the mother an Initiation of Early Breastfeeding (IMD). The purpose of this research is for know the bounding attachment on post partum mother by doing IMD immediately after the baby is born. This research using case study type with participative observational methods using two research subjects with focus study of successful infants and IMD infants who are not successful. Interviews and observations are performed using anecdotal record instruments, checklists and ordinal dimension assessment scales. Conducted by doing qualitative analysis, the data presented in the form of narration. The results of the case study showed that, when the IMD the bounding observation on subjects 1 (Mrs. S parietas G9P8Ab000) whose baby successfully performed IMD within 47 minutes with a score of 5, was observed until the third day of post partum got score 7, range score 5-7 (the need for support for bounding is extra) the closeness of the mother and baby is still lacking and needs to be improved. While the bounding observation when the IMD on subject 2 (Mrs. C parietas G3P2Ab000) whose baby failed to perform IMD until 90 minutes with a score of 8, observed until the third day of post partum was score 9, range score 8-10 (requirement of support for bounding is ordinary) that is good mother and baby closeness and need to be keep up. The conclusion of a successful baby and a non-successful baby doing an IMD does not affect the bounding attachment process of the post partum mother. Discussion for further researcher is a similar study focus by adding maternal knowledge criteria and support of health workers when they facilitating IMD maternal parietas multi/grandemultipara against bounding attachment.

Immunological and Nutritional Characterization of Bovine Colostrum: Effect of Some Variation Factors

Background: The importance of colostrum is twofold: it plays a role in the metabolism and nutrition of the newborn, in addition to its immediate supply of functional immunoglobulins. The current paper aims to study the main factors of variation in the nutritional and immunological bovine colostrum values at the Centre National de l’Insémination Artificielle et d’Amélioration Génétique (CNIAAG) of Baba Ali (Algiers, Algeria). Methods: The study was conducted on 23 colostrum samples from cows of different breeds (Prim-Holstein pie rouge, Prim-Holstein pie noire and Fleckvieh), from calving until the 11th day of milking. These females have calved during March 2020. Result: The results obtained indicate that the chemical composition of colostrum changes during milkings. The average rates of dry matter, protein and mineral matter, at the 1st milking, respectively 20; 9.70 and 0.95 g/100 g tend to decrease to reach milk standards. Unlike lactose rate which gradually increase from milking to another. The average concentration of colostrum in immunoglobulins, evaluated at 34.3 g/L at birth, decreases during the milkings that follow. The fall is considerable (89%) from the 2nd post-partum day.

The Impact of Maternal SARS-CoV-2 Infection Next to Pre-Immunization with Gam-COVID-Vac (Sputnik V) Vaccine on the 1-Day-Neonate’s Blood Plasma Small Non-Coding RNA Profile: A Pilot Study

The antenatal and postnatal effects of maternal SARS-CoV-2 on the fetus outcomes, especially in the case of maternal pre-vaccination against this infection, are still under investigation. Such effects may be due to placental insufficiency caused by maternal hypoxia and inflammatory response associated with SARS-CoV-2, and/or be a direct cytopathic effect of the virus. In this work, we studied the profile of small non-coding RNAs (sncRNAs) in the blood plasma of a newborn from a mother who had SARS-CoV-2 at the 22nd week of gestation after immunization with Gam-COVID-Vac (Sputnik V). The fetus had ultrasound signs of hypertrophy of the right heart and hydropericardium 4 weeks after infection of the mother with SARS-CoV-2, as well as cysts of the cerebral vascular plexuses by the time of birth. Taking this into account, we compared the sncRNA profile of this newborn on the first postpartum day with that of neonates born to COVID-19-negative women with different perinatal outcomes: severe cardiovascular and/or neurological disorders, or absence of any perinatal complications. According to next-generation sequencing data, we found that the fetus born to a COVID-19-affected mother pre-immunized with Gam-COVID-Vac (Sputnik V) vaccine differs from newborns with severe cardiovascular and/or nervous system abnormalities either in multidirectional changes in circulating sncRNAs or in less pronounced unidirectional changes in the level of sncRNAs relative to control samples. Considering this, it can be concluded that maternal vaccination against SARS-CoV-2 before pregnancy has a protective effect in preventing antenatal development of pathological processes in the cardiovascular and nervous systems of the neonate associated with COVID-19.

Abstract 5814: Lack of breast feeding may contribute to increased breast cancer risk by altering metabolism

Abstract Purpose: Epidemiological data links lack of breastfeeding with increased risk of breast cancer, particularly triple negative breast cancer (TNBC). The involution process is characterized by mammary tissue remodeling, including adipocyte repopulation and re-differentiation fueled by metabolic rewiring. Our mouse model mimicking short-term breast feeding that leads to abrupt involution (AI) revealed a chronic inflammatory state in the mammary gland (MG) (Basree, et al. Breast Cancer Research; 2019). As metabolic dysfunction is linked to increased BC risk, we sought to elucidate the effects of AI and gradual involution (GI) on MG energy metabolism and associated oxidative stress. In addition, we evaluated the impact of AI and GI on whole body glucose metabolism and insulin response/resistance. Methods: FVB/n mice (8week old) were paired for breeding. At partum, dams were randomized to AI or GI cohort and standardized to 6 pups per dam. AI mice had pups removed on postpartum day 7 (d7) to mimic short-term breastfeeding. GI mice had 3 pups removed on day 28 and 31 each to mimic gradual weaning. MGs were harvested on d28, 56, and 120 postpartum. Prior to harvest, mice underwent an echoMRI and insulin tolerance test (ITT). At harvest, mice were fasted for 4 hours, and blood was collected for serum insulin measurement using Ultra-Sensitive Insulin ELISA. Lipid peroxidation (MDA) and DNA adduct formation (8-OHdG), which represent chronic oxidative stress, were measured in MG by ELISA. Whole MG RNA were subjected to affymetrix followed by gene set enrichment analyses (GSEA) and qPCR for target validation. MGs were also subjected to untargeted metabolomics analysis and Mitofuel flex assay to assess substrate dependence by Seahorse Bioanalyzer. Results: GSEA and qPCR revealed enrichment of fatty acid oxidation (FAO) and mitochondrial oxidative phosphorylation (OXPHOS) pathways in AI MGs at d28, further validated by expression of genes (PGC-1α, Cpt-2, Srebp1c, and Chrebp). Metabolites associated with FAO were enriched in AI MGs at d28 and 56. Mitofuel flex assay indicated a significantly higher dependence on FAO in AI MGs. On d56, fasted blood glucose was significantly higher in AI mice with serum insulin and HOMA-IR trending to be higher than in GI mice. Level of 8-OHdG was elevated in AI MGs at d120. AI mice trended to be heavier, have greater body fat, and lower lean mass than GI Mice at d120. Body weight and percent body fat on d120 were positively correlated to MDA concentration in the mammary gland. Conclusion: Our mouse models of AI and GI revealed early MG specific metabolic shift towards increased FAO and OXPHOS that persists over time in AI glands. Similarly, increased oxidative stress and its association with adiposity at d120 indicates continued effect of AI. This change in adiposity, altered systemic glucose metabolism and metabolic shift seen in AI mice may contribute to the higher risk of breast cancer. [K.O. and K.K. are co-first authors.] Citation Format: Kate Ormiston, Kirti Kaul, Neelam Shinde, Allen Zhang, Morgan Bauer, Hee Kyung Kim, Ramesh K. Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Lack of breast feeding may contribute to increased breast cancer risk by altering metabolism [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5814.