Prenatal Stages Research Articles

Interaction of prenatal maternal selenium and manganese levels on child neurodevelopmental trajectories-the Shanghai birth cohort study

ObjectiveThe fetal brain is particularly plastic, and may be concurrently affected by chemical exposure and malnutritional factors. Selenium is essential for the developing brain, and excess manganese exposure may exert neurotoxic effects. However, few epidemiological studies have evaluated the interaction of manganese and selenium assessed in different prenatal stages on postnatal neurodevelopmental trajectories. MethodsThis study contained 1024 mother-child pairs in the Shanghai-birth-cohort study from 2013 to 2016 recruited since early/before pregnancy with complete data on manganese and selenium levels in different prenatal stages and infant neurodevelopmental trajectories. Whole blood manganese and selenium in early pregnancy and around birth were measured by inductively-coupled-plasma-mass-spectrometry (ICP-MS), children's cognitive development was evaluated at 6, 12, and 24 months of age using Age & Stage-Questionnaire (ASQ)-3 and Bayley-III. Multiple linear regression was used to investigate the interaction of prenatal selenium and manganese on neurodevelopmental trajectories. ResultsThe prenatal manganese and selenium levels were 1.82 ± 0.98 μg/dL and 13.53 ± 2.70 μg/dL for maternal blood in early pregnancy, and 5.06 ± 1.67 μg/dL and 11.81 ± 3.35 μg/dL for umbilical cord blood, respectively. Higher prenatal Se levels were associated with better neurocognitive performances or the consistently-high-level trajectory (P < 0.05), with more significant associations observed in early pregnancy than around birth. However, such positive relationships became non-significant or even adverse in high (vs. low) manganese status, and the effect differences between low and high manganese were more significant in early pregnancy. ConclusionsPrenatal Selenium was positively associated with child neurodevelopment, but prenatal high manganese may mitigate such favorable effects. The effects were mainly observed in earlier prenatal stage.

Critical Changes in the Maternal Health Landscape: Community Care, Doulas, and Coverage

In this commentary, we present an overview of the accelerating trend toward community-based models for pregnancy care. Doula services, as part of community care programs, are the major target for new coverage changes. Obstetric professionals who include community care providers in their treatment plans can benefit from these local resources in the prenatal, birthing, and postpartum stages of patient management. Including community care programs may help achieve goals of improving health outcomes and health equity.

Proangiogenic Macrophage Development in Human Prenatal Stage: A Key Element in Maternal-Fetal Medicine Puzzle

Abstract Macrophages are a major immune cell type constituting the human innate immune system that is involved in various physiological processes, including tissue development, remodeling, homeostasis, and repair, which are essential to maintain the normal growth and development of embryos/fetuses. They exhibit a diverse range of phenotypes influenced by their cellular origin and the specific environments within different tissues. Additionally, there exist distinct macrophage subtypes that can be found in multiple organs. Our recent study published in Cell has provided a developmental atlas of the human prenatal immune system, which collected nearly 300,000 immune cells from 19 tissues spanning 18 gestational time points from postconceptional 4 to 26 weeks, using single-cell transcriptome sequencing analysis. This study has also provided new insights into the differentiation, spatial distribution, functional traits, and transcriptional regulation mechanisms of different macrophage subtypes during development, which have shed light on the intricate processes involved in macrophage development during the human prenatal stage. Additionally, we have also identified two new macrophage subtypes, with one of them being proangiogenic macrophages (PraMs), which possess the capability to promote angiogenesis. These PraM cells were found to be distributed across various tissues, indicating their importance in the development and maintenance of blood vessels during the prenatal stage. Understanding the role of prenatal PraMs in promoting angiogenesis and vasculogenesis in the fetus and placenta can help better comprehend the pathogenesis of adverse pregnancy outcomes. Furthermore, the investigation into the origins of PraMs from different sites highlights the importance of considering the heterogeneity of these cells. In conclusion, the study of prenatal PraMs emerges as a crucial piece of the puzzle and provides insights into the field of maternal-fetal medicine. It also offers promising directions for future research and interventions aimed at improving maternal and fetal health.

An investigation on the alterations in Wnt signaling in ADHD across developmental stages

The canonical Wnt signaling pathway plays a vital role in the developmental processes of the Central Nervous System throughout both prenatal and postnatal stages, as well as in maintaining homeostasis during adulthood. Its complex intracellular cascade involves the participation of key proteins (i.e., GSK3β and β-catenin) to activate the transcription of Wnt target genes. These genes subsequently control processes like cell proliferation, maturation, and the determination of cell fate. Previous studies suggest that this pathway can also be associated with Attention-Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder with multifactorial etiology. This study aimed to clarify if and at what developmental stage the Wnt pathway is altered in ADHD. Accordingly, we carried out proteomic and functional assessments of the Wnt pathway using Western Blot and reporter assays, respectively. These assessments were performed at the induced pluripotent stem cell (iPSC), neural stem cell (NSC), and neuronal phases. IPSCs were generated from somatic cells retrieved from 5 controls and 5 patients diagnosed with ADHD. As opposed to the developmental stage of iPSCs, ADHD NSCs showed alterations in the protein expression of both GSK3β and β-catenin, suggesting increased Wnt activity in the ADHD group. Moreover, Wnt reporter assays confirmed higher Wnt activity in ADHD NSCs. Our molecular findings in NSCs correlated with genetic predisposition to ADHD and clinical traits displayed by their respective donors. In conclusion, these results suggest that a crucial cellular pathway is disrupted in patient-specific NSCs, potentially explaining the developmental deficits clinically exhibited by ADHD patients.

The dual journey: The development of twins' relationships throughout childhood.

Twin bonds, likely the most enduring of human relationships, provide both solace and rivalry for twins. Using an evolutionary psychology perspective, this chapter scrutinizes twins' bonds from prenatal stages to childhood to better understand their unique relationships. Twins' interactions, which begin in the womb, establish patterns of cooperation and competition. The initial years pose parenting challenges that shape the twins' experiences of dependency and rivalry. As twins grow, five dimensions-closeness, dependence, conflict, rivalry, and dominance-emerge, evolving distinctly between monozygotic twins (MZ: sharing close to 100% of their genes) and dizygotic twins (DZ: sharing on average 50% of their genetic variance). The chapter notes the closer relationship MZ twins share compared to DZ twins. While the closeness and dependence among DZ twins decline throughout childhood, these elements remain stable in MZ twins. The effect of zygosity on conflict and rivalry is less clear. For both MZ and DZ twins, conflict stays steady, while rivalry intensifies with school entry, probably driven by external comparisons, but lessens as twins develop into late childhood. Unlike singletons, where birth order dictates dominance dynamics, in twins, this dynamic is more variable and becomes more defined by around 6.5 years of age. Several factors are presented as impacting the nature of the twins' relationships: the evolvement of 'twin language', the parenting style and the differential parenting they receive. This exploration into the development of twins' relationships underlines the importance of tailored caregiving and invites further research into the genetic and environmental factors that shape close bonds.

Phases of human development: Comparing Western and Islamic theories and the implication in Islamic education

The physical, cognitive, and socio-emotional development determine every aspect of human life, including education. Providing appropriate education for children is determined by the child's developmental stage. The current study aims to describe the stages of human development according to Western and Islamic concepts and their implications in Islamic education. To ensure a comprehensive investment in human beings, attention to religious education and introducing religious instruction from the prenatal stage is deemed necessary, as this period forms the foundation for further development. The research methodology employed in this study is a Systematic Literature Review (SLR). After reviewing various literature sources, the researchers selected several references that were relevant to the topic. The study's results indicate that the prenatal phase in Islamic psychology is more extended than Western psychology's. The tamyiz and amrad phases, viewed in Islamic psychology as preparations for entering adulthood, correspond to the Western psychological perspective of puberty. The futuh phase, or the phase of wisdom in Islamic psychology, occurs when a person ages 40, whereas Western psychology labels this as the adult phase. The phase of the Hereafter is considered crucial in Islamic psychology, while Western psychology lacks an afterlife phase. Consequently, Muslims undergo lifelong education from early birth to death. In conclusion, every phase of human life must be educated according to the level of maturity, starting from prenatal, infant, early childhood, school age, adolescent, young adult, mature adult, to late adult.

Enhancing Child Development: Assessing the Impact of Monitoring Programs on Growth in Kendari City's Children Aged 6-59 Months

Growth serves as a crucial indicator of good nutritional status, attainable through adequate nutrition from an early age. Insufficient nutrition from the prenatal stage through birth can lead to various health issues that impede the growth and development of children. This study aims to analyze the effects of a monitoring program on toddler growth in Kendari City. Conducted between January and March 2023, this analytical observational study employed a cross-sectional design involving 120 respondents from the Benu-benua Health Center and Nambo Health Center in Kendari City, Southeast Sulawesi, Indonesia. The research data underwent processing and analysis using Chi-square tests and multiple linear regression. The findings revealed that knowledge, perceptions, family support, and the involvement of community health workers significantly impacted infant growth within the working areas of Puskesmas Benu-Benua and Puskesmas Nambo. Keywords: Influence, Monitoring, growth, Toddlers

A novel de novo CLTC variant altering RNA splicing causes fetal developmental abnormalities

BackgroundAbout 31 individuals with CLTC variants have been reported worldwide, and all reported individuals have motor and mental retardation. CLTC is known to lead to intellectual developmental disorder, autosomal dominant 56. Few studies are focusing on the prenatal stage of the disease.MethodAn ultrasound examination was performed to obtain the prenatal phenotype. Whole-exome sequencing was used to find the pathogenic variant. Multiple computational tools predicted the conservation and deleteriousness. Minigene assay and western blot were utilized to investigate the effect on splicing of mRNA and protein expression.ResultHere we found a novel de novo variant of CLTC in a fetus. The fetus manifested bilateral choroid plexus cysts of the brain, hyperechogenic kidneys, and ventricular septal defect. A heterozygous variant c.3249 + 1G > C was identified in the fetus. This position was conserved and the variant was predicted to be deleterious. Minigene assay revealed the presence of a truncating transcript with the retention of intron 20. Western blot result showed the c.3249 + 1G > C variant elicited degradation of the protein.ConclusionTo the best of our knowledge, our study identified a novel de novo variant of CLTC and provided the earliest clinical characteristic of the CLTC variant at the prenatal stage. The functional experiment suggested the variant caused the altering of the RNA splicing and the protein expression. We extended the mutational spectrum of CLTC and provided guidance on genetic counseling.

The adverse effects of vitrification on mouse embryo development and metabolic phenotype in offspring.

Embryo vitrification is a standard procedure in assisted reproductive technology. Previous studies have shown that frozen embryo transfer is associated with an elevated risk of adverse maternal and neonatal outcomes. This study aimed to explore the effects of mouse blastocyst vitrification on the phenotype of vitrified-warmed blastocysts, their intrauterine and postnatal development, and the long-term metabolic health of the derived offspring. The vitrified-warmed blastocysts (IVF + VT group) exhibited reduced mitochondrial activity, increased apoptotic levels, and decreased cell numbers when compared to the fresh blastocysts (IVF group). Implantation rates, live pup rates, and crown-rump length at E18.5 were not different between the two groups. However, there was a significant decrease in fetal weight and fetal/placental weight ratio in the IVF + VT group. Furthermore, the offspring of the IVF + VT group at an age of 36 weeks had reduced whole energy consumption, impaired glucose and lipid metabolism when compared with the IVF group. Notably, RNA-seq results unveiled disturbed hepatic gene expression in the offspring from vitrified-warmed blastocysts. This study revealed the short-term negative impacts of vitrification on embryo and fetal development and the long-term influence on glucose and lipid metabolism that persist from the prenatal stage into adulthood in mice.

Neuronal Gtf2i deletion alters mitochondrial and autophagic properties

Gtf2i encodes the general transcription factor II-I (TFII-I), with peak expression during pre-natal and early post-natal brain development stages. Because these stages are critical for proper brain development, we studied at the single-cell level the consequences of Gtf2i’s deletion from excitatory neurons, specifically on mitochondria. Here we show that Gtf2i’s deletion resulted in abnormal morphology, disrupted mRNA related to mitochondrial fission and fusion, and altered autophagy/mitophagy protein expression. These changes align with elevated reactive oxygen species levels, illuminating Gtf2i’s importance in neurons mitochondrial function. Similar mitochondrial issues were demonstrated by Gtf2i heterozygous model, mirroring the human condition in Williams syndrome (WS), and by hemizygous neuronal Gtf2i deletion model, indicating Gtf2i’s dosage-sensitive role in mitochondrial regulation. Clinically relevant, we observed altered transcript levels related to mitochondria, hypoxia, and autophagy in frontal cortex tissue from WS individuals. Our study reveals mitochondrial and autophagy-related deficits shedding light on WS and other Gtf2i-related disorders.

URGENCY OF THE DRAFT STATUTE ON MATERNAL AND CHILD WELFARE FOR FEMALE EMPLOYEES

The ongoing deliberations involve the Draft Statute on Maternal and Child Welfare, with particular emphasis on several regulations that prioritize the well-being of mothers and children. This study emphasizes the initial 1000 days of an individual’s life, commencing from the prenatal stage, commonly referred to as the "golden age," with the objective of cultivating a high-caliber generation. The objective of this study is to examine the underlying justifications for the necessity of the Draft Statute on Maternal and Child Welfare, as well as the obstacles encountered during the implementation of said legislation. The study employed normative legal research methodology, adopting a statutory approach and utilizing secondary data collection through a literature review employing qualitative descriptive data analysis techniques. The findings of this study indicate that the implementation of the Draft Statute on Maternal and Child Welfare is necessary in order to facilitate the development of Indonesia’s future generations. Nevertheless, the implementation of the Draft Statute on Maternal and Child Welfare may pose a challenge in terms of reduced female employee recruitment, as it is perceived to have negative implications for companies. This will serve as the foundation for companies to establish specific measures in the recruitment of female employees.

The risk of pediatric cardiovascular diseases in offspring born to mothers with systemic lupus erythematosus: a nationwide study.

Systemic lupus erythematosus (SLE), a common autoimmune disease predominantly affecting women, has been linked to various complications during pregnancy. The transfer of anti-Ro/SSA antibodies from SLE-affected mothers to their offspring can lead to neonatal lupus and cardiac issues. This study investigated the association between maternal SLE and the risk of pediatric cardiovascular disorders. The study utilized South Korea's National Health Insurance Service (NHIS) database, covering 3,505,737 children born between 2007 and 2017 and tracked until 2020. Maternal SLE cases were identified using the World Health Organization's International Classification of Diseases Tenth revision (ICD-10) codes and linked with delivery records. Cardiologic disorders were categorized into congenital heart disease (CHD), arrhythmic disorders, and acquired heart disease. Propensity score matching with 1:4 ratios was applied to the set control group. Among 3,505,737 children, 0.7% (n = 23,330) were born to mothers with SLE. The incidence of preterm birth was significantly higher in the maternal SLE group (5.9% vs. 3.0%). Compared with the control group, children born to mothers with SLE exhibited a significantly elevated risk of overall CHDs (5.5%, adjusted odds ratio [aOR] 1.21; 95% confidence interval [CI] 1.14-1.29), including atrial septal defect (1.18; 1.09-1.28) and patent ductus arteriosus (1.15; 1.03-1.30). In addition, a notably higher risk was observed in arrhythmic disorders (complete atrioventricular block 7.20; 2.41-21.49) and acquired cardiac disorders, including cardiomyopathy (1.40; 1.17-1.68) and mucocutaneous lymph node syndrome (MCLS) (1.27; 1.15-1.43). Maternal SLE is associated with congenital and acquired cardiac disorders in offspring, including structural, arrhythmic, and MCLS. This study highlights the need for continuous cardiovascular monitoring from the prenatal stage to preadolescence in these children due to multifactorial influences involving maternal autoantibodies, genetic predisposition, and environmental factors.

Analysis of OCT4 and PGP9.5 gene expression in prenatal and postnatal buffalo (Bubalus bubalis) testes

This study aimed to investigate and characterize the spermatogonial stem cells (SSCs) in buffaloes at different stages of development, including prenatal, neonatal, prepubertal, and adult testes. We sought a comprehensive understanding of these cells through a combination of histological, immunohistochemical, and ultrastructural analyses. Specifically, we examined changes in the expression of two potential SSC markers, OCT4 and PGP9.5, using immunohistochemistry. Additionally, we conducted a real-time quantitative polymerase chain reaction (RT-qPCR) to assess the relative gene expression of OCT4 and PGP9.5. The relative expression of the OCT4 gene was down-regulated in the adult testes compared to its expression during prepubertal and neonatal life. The relative expression of the PGP9.5 gene was up-regulated in the neonatal testes and down-regulated in the prepubertal and adult testes. The spermatogonia were round, oval-to-ellipsoidal cells lying over the basement membrane (BM) with a round-to-oval nucleus. Based on the immunoexpression of the putative SSC markers, OCT4 and PGP9.5, we concluded that the proportion of stem cells was highest during the neonatal stage, followed by the prepubertal and prenatal stages. This finding sheds light on the dynamics of spermatogonial stem cells in buffalo testes at different developmental stages, providing valuable insights into these cells’ regulation and potential applications.

Mothers in a cooperatively breeding bird increase investment per offspring at the pre-natal stage when they will have more help with post-natal care.

In many cooperative societies, including our own, helpers assist with the post-natal care of breeders' young and may thereby benefit the post-natal development of offspring. Here, we present evidence of a novel mechanism by which such post-natal helping could also have beneficial effects on pre-natal development: By lightening post-natal maternal workloads, helpers may allow mothers to increase their pre-natal investment per offspring. We present the findings of a decade-long study of cooperatively breeding white-browed sparrow-weaver, Plocepasser mahali, societies. Within each social group, reproduction is monopolized by a dominant breeding pair, and non-breeding helpers assist with nestling feeding. Using a within-mother reaction norm approach to formally identify maternal plasticity, we demonstrate that when mothers have more female helpers, they decrease their own post-natal investment per offspring (feed their nestlings at lower rates) but increase their pre-natal investment per offspring (lay larger eggs, which yield heavier hatchlings). That these plastic maternal responses are predicted by female helper number, and not male helper number, implicates the availability of post-natal helping per se as the likely driver (rather than correlated effects of group size), because female helpers feed nestlings at substantially higher rates than males. We term this novel maternal strategy "maternal front-loading" and hypothesize that the expected availability of post-natal help either allows or incentivizes helped mothers to focus maternal investment on the pre-natal phase, to which helpers cannot contribute directly. The potential for post-natal helping to promote pre-natal development further complicates attempts to identify and quantify the fitness consequences of helping.

Cardiovascular Risk in Pediatrics: A Dynamic Process during the First 1000 Days of Life.

The early childhood period, encompassing prenatal and early stages, assumes a pivotal role in shaping cardiovascular risk factors. We conducted a narrative review, presenting a non-systematic summation and analysis of the available literature, focusing on cardiovascular risk from prenatal development to the first 1000 days of life. Elements such as maternal health, genetic predisposition, inadequate fetal nutrition, and rapid postnatal growth contribute to this risk. Specifically, maternal obesity and antibiotic use during pregnancy can influence transgenerational risk factors. Conditions at birth, such as fetal growth restriction and low birth weight, set the stage for potential cardiovascular challenges. To consider cardiovascular risk in early childhood as a dynamic process is useful when adopting a personalized prevention for future healthcare and providing recommendations for management throughout their journey from infancy to early adulthood. A comprehensive approach is paramount in addressing early childhood cardiovascular risks. By targeting critical periods and implementing preventive strategies, healthcare professionals and policymakers can pave the way for improved cardiovascular outcomes. Investing in children's health during their early years holds the key to alleviating the burden of cardiovascular diseases for future generations.

Sucrose consumption modifies the urethrogenital reflex and histological organization of the bulbospongiosus muscle in the male rat

Disorders of the bulbospongiosus muscle (Bsm) are associated with male sexual dysfunction, such as premature ejaculation. We determined the effect of sucrose-water consumption during pregnancy-lactation and postnatal on reflex responses and morphology of Bsm fibers in adult male Wistar rat offspring. Female rats were mated and grouped into consumed tap water mothers and sucrose-water (5 %) mothers during pregnancy-lactation to obtain experimental groups. Male pups were weaned and assigned into four groups (n = 12; each group). Those from control mothers who continued drinking tap water (CM–CO group) or sucrose water (CM–SO group), and those from sucrose mothers who drank tap water (SM–CO group) or continued drinking sucrose water (SM–SO group) until adult life. In male rat offspring (n = 6 per group) was recorded the electrical activity of Bsm was recorded during penile stimulation and urethrogenital reflex (UGR). Other male rat offspring were designated for histological analysis (n = 6 per group). Sucrose consumption during prenatal stages increased the frequency of the Bsm during UGR, while pre and postnatal consumption modified muscle fiber cross-sectional area and increased the collagen content, suggesting that a combination of a diet with pre- and postnatal sucrose changes the Bsm morphophysiology possibly causing male sexual dysfunctions.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959–1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963–1965), famine cohorts (1959–1962) were 4.74 times (95% CI = 1.28–8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.

Effects of prenatal dichromatic light exposure on hatching results and post-hatch performance of Japanese quail.

Present study evaluated the effect of lighted incubation on pre- and post-hatch performance of Japanese quail. In a completely randomized design, 1200 eggs were evenly divided into 4 treatments groups having six replicates (each tray was considered as replicate), 50 eggs each. Different dichromatic lights (Green + Red; GR, Green + Blue; GB, and Blue + Red; BR) of 250 lux were provided during incubation for 12 h daily and effects of these lights very evaluated on hatching results and post-hatch growth. After hatch, 600 quail chicks were divided into 4 treatments, 6 replicates, and 25 birds each. Regarding hatching traits, better hatchability was found in the GR group compared to GB, BR, and dark group; while early embryonic mortality was lower in BR, GB, and dark group than GR; mid embryonic mortality was lower in dark group and late embryonic mortality was noted in the GR group than those of other treatment groups. In addition, moisture loss during incubation was minimum in BR and dark groups; however, chick spread was better in the GR group. In terms of growth performance, weight gain was better in the GR group; feed intake in dark, feed conversion ratio in BR, and livability were better in BR and GR group. In morphometrics, keel and shank length were higher in all the colored groups (GB, BR, and GR) whereas body length, wing spread, shank circumference, drumstick length, and circumference were higher in the GR group. Regarding serum chemistry, glucose, albumin, and globulin levels were higher in the GR group. It was concluded that under the experimental conditions, GR light at the prenatal stage to Japanese quail eggs positively influenced hatching performance and post-hatch growth.

Optimizing the utilization of maternal and reproductive healthcare services among women in low-resourced Nigerian settings

IntroductionQuality care delivery is an essential lifesaving interventions for maternal healthcare and reduction in mortality from preventable reproductive conditions. In African countries like Nigeria, numerous perceptions and militating factors present unique challenges in optimizing the utilization of maternal and reproductive healthcare services. As women continuously evolve away from the utilization of healthcare services, achieving universal health coverage for all emerges as a matter of concern.MethodA phenomenological and descriptive research design was used. The study participants comprised a total of 38 women selected from primary and tertiary healthcare institutions. They were purposively selected from four healthcare institutions in Nsukka, Enugu State, Nigeria.ResultFindings revealed that most rural women at the prenatal stage, utilize maternal healthcare services, but at the postnatal stage, they reject reproductive healthcare services owing to certain perceptions. Concerns about sub-optimal utilization of maternal and reproductive healthcare services were found under enabling, predisposing and need factors. Evidence-based interventions included instituting health insurance policies, improving the healthcare sector, personnel, collaboration among stakeholders, and grass-roots community education. Participants showed little knowledge of social workers’ engagement in healthcare institutions.ConclusionFunctional network of care between private and public healthcare system is the key to optimizing maternal and reproductive healthcare utilization. The study recommends stakeholder and community engagement in achieving functional networks of care, strengthening relational linkages between frontline health workers and equip rural women with better knowledge. All these are geared toward achieving optimal utilization of maternal and reproductive healthcare services among women in low-resourced Nigerian settings.

Single-cell analysis of prenatal and postnatal human cortical development.

We analyzed >700,000 single-nucleus RNA sequencing profiles from 106 donors during prenatal and postnatal developmental stages and identified lineage-specific programs that underlie the development of specific subtypes of excitatory cortical neurons, interneurons, glial cell types, and brain vasculature. By leveraging single-nucleus chromatin accessibility data, we delineated enhancer gene regulatory networks and transcription factors that control commitment of specific cortical lineages. By intersecting our results with genetic risk factors for human brain diseases, we identified the cortical cell types and lineages most vulnerable to genetic insults of different brain disorders, especially autism. We find that lineage-specific gene expression programs up-regulated in female cells are especially enriched for the genetic risk factors of autism. Our study captures the molecular progression of cortical lineages across human development.