Prenatal Involvement Research Articles

Clinical spectrum of rare bone fragility disorders and response to bisphosphonate treatment: a retrospective study.

Osteogenesis Imperfecta (OI) is a clinically and genetically heterogeneous group of diseases characterized by brittle bones. Though genetic mutations in COL1A1 and COL1A2 account for approximately 85-90% of OI cases, there are now more than twenty genes described, responsible for rare forms of OI. Treatment is based on the use of bisphosphonates and though it is well established that they increase lumbar spine (LS) bone mineral density (BMD), the clinical impact on fracture reduction is still debated.In this study, we investigated the clinical characteristics of 38 patients with a bone fragility disorder that had variants in non-COL1A1/COL1A2 genes in order to study genotype-phenotype correlations, as the natural history of these rare forms is still not well known. We then studied the usefulness of bisphosphonate treatment by evaluating the effects on LS BMD, annual non-vertebral fracture rate, bone turnover markers and height. This study enabled us to better define the natural history of patients with non-COL1 pathogenic variants. Patients with CRTAP and TMEM38B variants consistently had a prenatal presentation with a short (<3rd p) and bowed femur. Importantly, this prenatal involvement does not predict the postnatal severity of the disease. Regarding treatment by bisphosphonates, all patients showed a significant increase in LS BMD while treated and this increase was dependent on the dose received. The increase in LS BMD also translated in a reduction of fracture rate during treatment. Finally, our study showed that the earlier bisphosphonates are initiated, the greater the fracture rate is reduced.

Clinical, radiological, biochemical and molecular characterization of a new case with multiple mitochondrial dysfunction syndrome due to IBA57: Lysine and tryptophan metabolites as potential biomarkers

Iron‑sulfur clusters (FeS) are one of the most primitive and ubiquitous cofactors used by various enzymes in multiple pathways. Biosynthesis of FeS is a complex multi-step process that is tightly regulated and requires multiple machineries. IBA57, along with ISCA1 and ISCA2, play a role in maturation of [4Fe-4S] clusters which are required for multiple mitochondrial enzymes including mitochondrial Complex I, Complex II, lipoic acid synthase, and aconitase. Pathogenic variants in IBA57 have been associated with multiple mitochondrial dysfunctions syndrome 3 (MMDS3) characterized by infantile to early childhood-onset psychomotor regression, optic atrophy and nonspecific dysmorphism. Here we report a female proband who had prenatal involvement including IUGR and microcephaly and developed subacute psychomotor regression at the age of 5 weeks in the setting of preceding viral infection. Brain imaging revealed cortical malformation with polymicrogyria and abnormal signal alteration in brainstem and spinal cord. Biochemical analysis revealed increased plasma glycine and hyperexcretion of multiple organic acids in urine, raising the concern for lipoic acid biosynthesis defects and mitochondrial FeS assembly defects. Molecular analysis subsequently detected compound heterozygous variants in IBA57, confirming the diagnosis of MMDS3. Although the number of MMDS3 patients are limited, certain degree of genotype-phenotype correlation has been observed. Unusual brain imaging in the proband highlights the need to include mitochondrial disorders as differential diagnoses of structural brain abnormalities. Lastly, in addition to previously known biomarkers including high blood lactate and plasma glycine levels, the increase of 2-hydroxyadipic and 2-ketoadipic acids in urine organic acid analysis, in the appropriate clinical context, should prompt an evaluation for the lipoic acid biosynthesis defects and mitochondrial FeS assembly defects.

Fathers’ sensitive parenting enhanced by prenatal video-feedback: a randomized controlled trial using ultrasound imaging

BackgroundThe aim of this study was to evaluate an interaction-based prenatal parenting intervention program aimed at promoting parental sensitivity and involvement in expectant fathers using ultrasound images: Prenatal Video-Feedback Intervention to Promote Positive Parenting (VIPP-PRE).MethodsIn this randomized controlled trial, 73 first-time, healthy expectant fathers were enrolled. Participants were randomly assigned to the VIPP-PRE intervention (n = 39) or a dummy intervention (n = 34). Parental sensitivity was coded from video-recorded 10-min interactions with an infant simulator at a prenatal pretest and with fathers’ own infant at a postnatal posttest. Prenatal and postnatal involvement was assessed via an application on participants’ smartphones.ResultsFathers receiving VIPP-PRE demonstrated increased sensitivity across the perinatal period, relative to fathers receiving a dummy intervention. Fathers’ involvement with the infant increased significantly from the prenatal to postnatal period, regardless of the intervention.ConclusionsPrenatal video-feedback using ultrasound imaging of the unborn child has the potential to promote the quality of parenting in an important, but understudied, population and period: men in the transition to fatherhood. Future research should examine the long-term effectiveness of VIPP-PRE and its effectiveness in increasing parenting quality in at-risk families.ImpactThis study identifies a brief and focused prenatal intervention using assisted interactions between the father and his baby by means of ultrasound imaging as a promising strategy to improve sensitive fathering in the early postnatal phase.Our study shows that pregnancy provides a window of opportunity for promoting prenatal involvement and bonding in expectant fathers, with potential long-term benefits for the future father–child relationship.Ultrasound measures are currently used to monitor fetal growth and development, but our results suggest that they may also create an opportunity for stimulating father–infant interaction to promote postnatal caregiving quality.

Father Involvement Among Nonresident Dads: Does Paternity Leave Matter?

AbstractObjectiveThis article examines whether paternity leave influences father involvement among nonresident fathers, if associations differ by coresidential status, and whether leave is a stronger predictor of nonresident father involvement than other indicators of father identity or interest.BackgroundFathering promotes child development, yet many children are born to unmarried parents and do not live with their fathers. Paternity leave may increase fathering among nonresident fathers, but extant research has largely overlooked these fathers.MethodUsing the Fragile Families and Child Wellbeing Study (N∼2,000), a longitudinal birth cohort of largely low‐income families, this study examines the link between paternity leave and parenting using regression analyses.ResultsLeave‐taking was associated with higher reports of engagement for both coresident and nonresident fathers, but for maternal reports of trust, coparenting, and responsibility, the positive associations with leave‐taking were concentrated among nonresident fathers. Nonresident fathers who took leave were more likely to provide in‐kind child support but not monetary support. Although leave, prenatal involvement, and being at the birth were all associated with greater involvement among nonresident fathers, mothers' reports of fathering were more strongly influenced by prenatal involvement and being at the hospital for the birth than leave.ConclusionLeave‐taking is associated with maternal reports of trust, coparenting, and responsibility for nonresident fathers but not coresident fathers. Leave and prenatal involvement predict nonresident father involvement.

Possible Selves and Prenatal Father Involvement

Research increasingly indicates that father involvement during pregnancy influences outcomes for mothers, fathers, and children. However, little is known about what factors are associated with prenatal involvement. Here, the idea of fathers’ possible selves was used to guide an investigation of the importance fathers assign to becoming a parent and mothers’ expectations of father competence, and their individual and interactive associations with father reports of prenatal involvement. Neither variable was associated with prenatal involvement individually, but the interaction term was significant. When mothers viewed fathers as competent parents, fathers were uniformly highly involved. However, when mothers reported low levels of perceived father competence, then the level of prenatal involvement was significantly associated with fathering importance. Findings are discussed in terms of the need for dyadic research as well as their implications for interventions.

Fathers' Involvement in Child Health Care: Associations with Prenatal Involvement, Parents' Beliefs, and Maternal Gatekeeping

Using data from 182 dual-earner couples experiencing the transition to parenthood, this study examined associations between prenatal involvement, gender role beliefs, and maternal gatekeeping and new fathers' involvement in child health care. Results indicated that prenatal father involvement was associated with both fathers' direct engagement in child health care and fathers' perceived influence in child health-related decision-making. Fathers also demonstrated greater direct engagement in child health care when mothers held more nontraditional beliefs about gender roles. Moreover, when mothers were more encouraging of fathers' involvement in childrearing, fathers felt more influential in child health-related decision-making, whereas when mothers engaged in greater gate closing behavior, fathers with more traditional gender role beliefs felt less influential in child health-related decision-making. This study suggests that fathers' prenatal involvement, mothers' beliefs, and maternal gatekeeping may play a role in the development of new fathers' involvement in child health care at the transition to parenthood.

Adolescent Parents’ Partner Conflict and Parenting Alliance, Fathers’ Prenatal Involvement, and Fathers’ Engagement With Infants

The present study modeled the associations between adolescent mothers’ and young fathers’ perceptions of partner conflict, parenting alliance, fathers’ prenatal involvement, and father engagement with infants using a sample of 127 adolescent mothers and their partners. This study hypothesized that (a) higher quality parenting alliances would be associated with increased father engagement with infants, (b) prenatal partner conflict would have a negative spillover effect on the parenting alliance and father engagement during infancy, and (c) fathers’ prenatal involvement would be positively associated with parenting alliance and engagement during infancy. The results showed that mothers’ perceptions of parenting alliance during infancy were robust correlates of father engagement, mothers’ perceptions of prenatal partner conflict had a negative spillover effect on parenting alliance and father engagement with the infant as perceived by mothers, and fathers’ and mothers’ perceptions of fathers’ prenatal involvement were directly linked to engagement with infants.

Fathers’ Involvement in Child Health Care: Associations with Prenatal Involvement, Parents’ Beliefs, and Maternal Gatekeeping

Fathers’ Involvement in Child Health Care: Associations with Prenatal Involvement, Parents’ Beliefs, and Maternal Gatekeeping

Father Involvement in Immigrant and Ethnically Diverse Families from the Prenatal Period to the Second Year: Prediction and Mediating Mechanisms

This longitudinal study focused on fathers’ involvement from the prenatal period through infants’ first year in Dominican immigrants (n = 73), Mexican immigrants (n = 65) and African Americans (n = 66) residing in New York City. Fathers’ prenatal involvement, the quality of the mother–father relationship, fathers’ postnatal involvement with their 1- and 6 month olds and fathers’ involvement with their 14 month-olds (i.e., time spent with infant; eating meals with infant; activities with infant) were examined. Father involvement was uniformly high and stable. Fathers’ prenatal involvement predicted involvement at 14 months, and the quality of the mother–father relationship mediated these associations. Father ethnicity and residency moderated associations between the father–mother relationship, father postnatal involvement and father involvement with 14 month olds.

Who Stays and Who Leaves? Father Accessibility Across Children's First 5 Years

SYNOPSIS Objective . This longitudinal investigation examines whether fathers' prenatal involvement (e.g., attending doctor appointments and discussing pregnancy with mother) and residence status at infant's birth predict the first time a father becomes inaccessible to his child (defined as seeing child fewer than a few times per month) at six developmental time points in children's first 5 years. Design . Data were gathered from 2,160 ethnically diverse mothers (i.e., European American, African American, and Latin American) who participated in the National Early Head Start Research and Evaluation Project. Survival analysis was used to predict the timing of father inaccessibility based on interviews. Results . By prekindergarten, fathers' residence at birth and prenatal involvement decreased their risk of being inaccessible to their children for the first time by 71% and 47%, respectively, after adjusting for all other variables in the model. Residence at birth was a stronger predictor of the timing of father inaccessibility than was prenatal involvement for European American and Latin American fathers; for African American fathers, prenatal involvement was a stronger predictor of the timing of father inaccessibility than nonresidential status at birth. Nearly 65% of fathers who were engaged in both prenatal activities remained consistently accessible to their child through child age of 63 months, whereas nearly 50% of fathers who were not prenatally involved were already inaccessible by the time infants were 3 months. Conclusion . These findings have implications for early intervention programs aimed at strengthening the role of fathers in their families from the prenatal period.

Mexican American Mothers and Fathers’ Prenatal Attitudes and Father Prenatal Involvement: Links to Mother–Infant Interaction and Father Engagement

The present study examines the associations between Mexican American mothers' and fathers' pregnancy intentions, fathers' participation in prenatal activities and mother-infant interactions and father engagement with 9 month-old infants in a nationally representative sample of 735 infants and their parents participating in the Early Childhood Longitudinal Study - Birth Cohort. After controlling for a host of variables, multiple regressions revealed that when mothers wanted the pregnancy, fathers engaged in more literacy and caregiving activities than when mothers did not want the pregnancy. When couples disagreed about wanting the pregnancy, fathers engaged in more literacy activities and showed more warmth than when they agreed. Relationship quality significantly moderated the effects of parents' wantedness on mother-infant interactions and fathers' engagement in literacy activities.

Explaining the Long Reach of Fathers’ Prenatal Involvement on Later Paternal Engagement

The present study examined the association between unmarried fathers' prenatal involvement and fathers' engagement later in the child's life. The study sample consisted of 1,686 fathers from the Fragile Families and Child Wellbeing Study. Findings using multiple regressions revealed that fathers' prenatal involvement is significantly and positively associated with levels of fathers' engagement at years 1 and 3. This association was partially explained by fathers' transitions from unemployment to employment and to a greater extent by fathers' transitions from nonresidential to residential relationships with the child's mother.

Why Should We Encourage Unmarried Fathers to Be Prenatally Involved?

We appreciate the opportunity to write a rejoinder to the thoughtful and insightful comments of Professors Doherty and Marsiglio. Their comments place our findings in the context of research and policy and, as such, offer a springboard from which to think about current policy applications of our study and future data needs, especially longitudinal data that can enable researchers to examine causal explanations and trajectories of fatherhood. Doherty points out that a more specific way to frame our findings would be by stating that unmarried fathers' greater reliability and helpfulness during the pregnancy is associated with more positive face-to-face interaction with the child 1 and 3 years later and that fathers who are more reliably helpful during the pregnancy are more apt to be positively involved with their child if the father and mother continue living together or start to Uve together. We agree that these termsreliable, helpful, and face-to-face-interactionconvey the behaviors that the broad constructs of prenatal involvement and father engagement in the Fragile Families and Child Wellbeing data set are designed to measure. These terms, however, do not convey some of the complexity and emotional connection that may be driving these behaviors (although the broad constructs fail at this, too). It is not just being reliable and helpful that leads fathers to more frequent faceto-face interaction with their children. Men who are prenatally involved seem to be motivated to commit to their partner and child and to be engaged in their lives, which lead to establishing or maintaining more committed partner relationships following the child's birth. We suggest that a father's reliable and helpful behavior toward the mother during the pregnancy has special meaning during the transition to fatherhood; for example, a man may begin to think of himself as a father (i.e., identify with the role) and reflect on how he will fulfill this new role. Thus unmarried fathers' prenatal involvement is meant to convey not only reliable behaviors but also a motivation to be committed to his partner and child, which may make them feel they have more control over the upbringing of their child (Weiss & Willis, 1985). And this leads us to Marsiglio's important point that the Fragile Families data do not provide the proper tools to assess these behaviors and motivations as men transition into fatherhood. The implications that Doherty draws for policy are equally important. Our research suggests that family structure matters; couples who live together (cohabiting or married) are more likely to be actively involved with their children during the first 3 years of life. The available research literature, however, has already established this association. Our contribution is to suggest that unmarried fathers' involvement with the mother during the pregnancy leads to couples establishing residential relationships when they did not previously, and it is the establishment of a residential relationship that partially explains why prenatal involvement is associated with higher levels of paternal engagement as the child grows older. We agree that at some level combining cohabiting and married couples is an apples and oranges phenomenon. We did, however, examine the effects of marriage versus cohabitation on later involvement and found no differences. It did not matter whether couples established marriage or cohabiting relationships after the child's birth; residence regardless of marital status mediated the association between father's early commitment and later father involvement. A cautionary note: We need to remember that in our study marriage and cohabitation were not static states; our variables assessed the transition to residential living arrangements. It is the decision that couples make to strengthen commitment and either stay married or move together that is important rather than status per se. Our study shows that in order to understand the meaning of marriage and cohabiting for how couples parent, we need to look at these variables in a dynamic way. …

Public Policy and Couple Relationships: A Commentary on Cabrera et al. (2008)

The Fragile Families Study is changing the way we think about fathers and mothers in lowincome communities. Other national family data sets have only relatively small numbers of lowincome, unmarried couples, and mostly they have produced a picture of absent fathers and single mothers. The Fragile Families Study has given us a nationally representative sample of urban couples recruited at the birth of the child and followed for 4 years. In their excellent article, Cabrera, Fagan, and Farrie (2008) use the Fragile Families Study to look at the missing side of fathering and couple relationships in urban communities: the active of many fathers and the endurance of many couple relationships. Although there are inseminate and leave fathers out there, they are not the majority, even in the most stressed communities (Carlson, McLanahan, & Englund, 2004). From both research and public policy perspectives, attention must be paid to fathers and couple relationships in fragile families. If the first generation of Fragile Families investigations established a baseline of father and couple relationships, the second generation of studies has used longitudinal designs to take a more complex, theory-based examination of predictors of enduring father involvement. In this case, Cabrera et al. ask a standard question in the fathering field-about the relationship between and subsequent with the child-and they go further to ask a new question, namely, what explains the association between pre- and post-natal involvement. They wisely focus on the couple relationship because we know that fathering is especially sensitive to the quality and endurance of the father-mother relationship (Doherty, Erickson, & Kouneski, 1998). But prior cross-sectional research has not been able to tease out the causal aspects of the relationship between father and the couple relationship. This study's most important contribution, then, is its demonstration of how the couple relationship impacts the father-child relationship over time, specifically, that the residential status of the father and mother is an important influence on the relationship between and postnatal father involvement. The authors conclude that a man who is prenatally involved appears to put himself on a positive trajectory with the mother and with his child. Specifically, if he continues to live with the mother or transitions into cohabitation or marriage, he is likely to be an active, involved father to his young child. I will make one scientific comment on the article and then focus on policy implications. Father has meant many things to many people in the fatherhood research arena (Hawkins & Palkovitz, 1999). In this case, the variable that the authors label prenatal involvement is assessed by summing three items: Were you present at birth? During me baby's mother's pregnancy, did you give her money or buy things for the baby? and Did you help in other ways, like providing transportation/doing chores? These items appear to tap the father's reliability and helpfulness: Was he around and did he help the mother in concrete ways? Similarly, the dependent variable, paternal engagement, taps a specific dimension of engagement: face-to-face interaction in activities such as play, reading stories, and physical affection. Other major dimensions of father were not assessed, for example, the father's accessibility to the child even when not interacting with the child and the father's responsibility for decisionmaking related to child rearing (Lamb, Pleck, Charnov, & Levine, 1985) or financial responsibility for the child. Thus, a grounded way to describe the study's first major finding would be as follows: Fathers' greater reliability and helpfulness during the pregnancy is associated with more positive face-to-face interaction with the child 1 and 3 years later. The second finding is that fathers who are more reliably helpful during pregnancy are more apt to be positively involved with their child if the father and mother continue living together or begin living together. …

Adolescent Fathers' Parenting Stress, Social Support, and Involvement with Infants

The present study examined the relationship between concurrent measures of adolescent fathers' parenting stress, social support, and fathers' care‐giving involvement with the 3‐month‐old infant, controlling for fathers' prenatal involvement. The study sample consisted of 50 teenage father–mother dyads. Findings from multivariate regression revealed that fathers' parenting stress was significantly and negatively related to fathers' care giving as perceived by both fathers and mothers. The relationship between support for father involvement provided by the young man's parents and father reported care‐giving involvement approached significance. Social support from both teenagers' parents buffered the negative influence of parenting stress on fathers' involvement with the baby. Policy and intervention implications are discussed.

Prenatal Involvement of Adolescent Unmarried Fathers

This study investigated factors associated with adolescent unmarried, nonresident fathers’ prenatal involvement with the teenaged mother. The sample consisted of 57 adolescent couples. Father characteristics and social-context factors were expected to predict fathers’ prenatal involvement. Results of the multivariate analysis revealed a significant relationship between romantic involvement and fathers’ prenatal involvement. Also, interparental conflict was negatively associated with father’s prenatal involvement after controlling for romantic involvement. In addition, teenage fathers were less likely to be involved when the young mother had friends with children born outside of marriage, when the adolescent father was unemployed, and when the father scored lower on a measure of empathy.

La place du pédiatre en prénatal. L'exemple de la consultation de neurologie foetale

Fetal neurology as en example of prenatal Involvement of the pediatrician. This short paper in the form of an editorial serves as an introduction to a dossier of four articles devoted to fetal neurology.

The Father's Role During Infancy

To describe factors that influence maternal expectations of the father's role during infancy. Cross-sectional survey. Postpartum obstetric ward of an inner-city teaching hospital. Mothers who were residents in the inner-city communities that surround the hospital and who were recently delivered of a newborn. Consecutive sampling from March to May 1992. Through structured maternal interviews, the father's expected role was measured in terms of accessibility, engagement in child care tasks, and decision-making responsibility. Influences included demographics, the mother's desire for the father's involvement, and her perceptions of his motivation, prenatal support, and ability to parent. Of 226 eligible mothers, 197 (87%) were interviewed. Expectations varied widely. Concerning accessibility, 48% and 18% of the mothers expected to see the father daily and less than weekly, respectively. Concerning engagement, 81% of the mothers expected some paternal involvement; the average mother assumed that the father would participate in one third of child care tasks. Concerning decision-making responsibility, 34% of the mothers expected to share all decisions; 30% expected to share none. In all areas, expectations were positively associated with the mother's desires, the strength of the parents' relationship, and the mother's perceptions of the father's motivation and ability to parent and the father's prenatal involvement (all, P < .001). Expected accessibility and engagement were greater for fathers who worked; expected engagement and decision-making responsibility were greater for fathers without children from other relationships (all, P < .03). The maternal desire for the father's participation, the strength of the parents' relationship, the mother's perception of the father as a parent, and the father's prenatal involvement are all consistently associated with the maternal expectations of the father's role. The demographic characteristics of either parent are not as strongly or consistently associated with the maternal expectations.

Employment and the pregnant adolescent: A health risk?

Background Prior studies suggest that youth who are employed ≥ 15 hours per week are at increased risk for substance use and decreased school involvement. Research examining the effects of employment on adolescent pregnancy are absent from the literature. The purpose of this study was to compare pregnant teens who worked ≥ 15 hours per week with nonworking pregnant teens on substance use, pregnancy complications (preterm labor delivery, maternal anemia, or chorioamnionitis), birth outcomes (miscarriage, birth weight, SGA, and head circumference), and related prenatal factors (number of clinic visils and gestational age at firsl visit). Methods We conducted a prospective study of 533 tri-ethnic adolescents, aged 12–17 years, who completed a structured questionnaire at their first obstetric visit between January 1992 and December 1994. Elicited information included demographic and reproductive characteristics; recent substance use and high-risk sexual behaviors. Medical charts were reviewed to obtain information on pregnancy complications and birth outcomes. Results Comparisons were made between the 61 teens who reported being employed ≥ 15 hours and the 450 teens who denied current employment uSing chi-square, student's t-tests, and logistic regression analyses. Working, as compared to nonworking teens were significantly older at their first prenatal visit (16.5 vs. 15.8 yr), were of higher financial status (31% vs. 14%), entered into care at an earlier gestational age (12.1 Vs. 15.4 wk), had more prenatal visits (10.1 vs. 8.5), were more likely to be enrolled in school (83% vs. 68%), and were less likely to have a positive chlamdia culture at first visit (7% vs. 20%). Cigarette, alcohol, or marijuana use since last menstrual period and use in the last 30 days; ethnicity; gravidity; and parity did not significantly differ between groups. Although a trend for miscarriage was found (13.5 vs. 6.7, P=.08), no otner differences in other birth outcomes or pregnancy complications were detected. Logistic regression analyses revealed that pregnant adolescents working ≥ 15 hours were more likely to be enrolled in school (OR 3.4), enter into care at Conclusions These data suggest that employment does not increase pregnant adolescents risk of substance use, prenatal complications, or poor birth outcomes. In fact, employment was strongly associated with earlier entry into prenatal care and school involvement.

Correlates of Parenting on a Neonatal Intensive Care Unit: Maternal Characteristics and Family Resources

The association of maternal characteristics, family resources, and receipt of prenatal care with parenting behaviors observed in a neonatal intensive care unit (NICU; n = 383) was assessed. The parenting behavior of mothers not receiving prenatal care (n = 128) was compared to that of mothers of the preceding and subsequent admissions (n = 256) by retrospective chart review. Parenting variables included frequency of visits to the NICU and evaluative ratings of parents' involvement with their infant. Parenting of the no-prenatal-care group was significantly less favorable than the control on all comparisons. Factor analysis supported a priori grouping of parenting variables. A stepwise multiple regression of maternal and family characteristics to the factor-derived variable, parenting, showed significant contributions for prenatal drug use and father involvement. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.