Infant Serum Research Articles

The pesticide paradox: Metabolomics insights into N-Methyl-2-pyrrolidone (NMP) exposure as a culprit of infant undernourishment

N-methyl-2-pyrrolidone (NMP) is widely used in various industrial applications as a solvent, due to its effectiveness. However, its excessive use might end up with harmful effects on human health. In this investigation, we explored the association between infant serum metabolites and undernourishment among infants born to mothers exposed to pesticides from pregnancy to 6 months of breastfeeding. Using an untargeted metabolomics approach, we analyzed 171 serum samples from infants aged 3-6 months, comprising 149 cases of undernutrition (WHZ < − 2) and 22 controls (WHZ > 0). After performing statistical analysis, 9 metabolites exhibited significance at a p-value of < 0.05. Notably, one of these metabolites, N-methyl-2-pyrrolidone (NMP) a well-known pesticide adjuvant, is found to be significantly elevated among undernourished infants. NMP is recognized for its potential toxic effects and adverse health consequences. This is the first study in which its effect on humans is observed, as previous studies were conducted on animal models. Moreover, two essential fatty acids, stearic acid and heneicosanoic acid, are found to be lower in undernourished infants. This finding raises questions about the mothers' diet, in addition to pesticide exposure, particularly since all infants were exclusively breastfed. Further studies are needed to understand the long-term impact of pesticide exposure on pregnant mothers as well as the aftermath on their infants. Overall our findings highlight NMP's industrial utility and its detrimental health consequences potentially creating a paradox, highlighting the conflicting interests between industrial and health sectors regarding the same chemical.

005. The Role of Interleukin-8 in Assisting the Diagnosis of Necrotizing Enterocolitis (NEC) Bell’s Stage I and II in Premature Infants: Literature Review

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of morbidity and mortality in infants, commonly associated with extremely low birth weight (ELBW), low birth weight (LBW), and prematurity. The clinical symptoms are nonspecific and various. This poses a challenge in the early diagnosis. The incidence worldwide ranges from 0.3 to 2.4 per 1,000 live births, with mortality rates reaching 50%. This study aims to assess the role of biomarker IL-8 in diagnosing NEC Bell's stage I and II. Methods: This study is a literature review, conducted electronically in databases including Cochrane Library, PubMed, ScienceDirect, and EBSCO using the keywords: ("Interleukin-8" OR "IL-8") AND ("Necrotizing enterocolitis" OR "NEC" OR “Early NEC” OR “Stage I-II NEC”). Inclusion criteria are study in human, English fulltext within 5 years. Exclusion criteria is comparing NEC any stage with control patients, Results: Based on a review of 23 literatures, there were 6 studies met the inclusion criteria for analysis. IL-8 shows varying sensitivity and specificity as a serum biomarker for diagnosing NEC. Statistical evaluations in previous studies emphasized that significantly elevated levels of biomarker IL-8 were predominantly found in the serum of premature infants with NEC, indicating it could be a potential biomarker for diagnosis with NEC Bell's stage I and II. Conclusion: The measurement of biomarker IL-8 in blood has not yet been established as a reliable diagnostic modality for NEC Bell's stage I and II, indicating the need for further investigation.

Human milk feeding practices and serum immune profiles of one-year-old infants in the CHILD birth cohort study

BackgroundBreastfeeding and human milk consumption are associated with immune system development; however, the underlying mechanisms and the impact of different infant feeding practices are unclear. ObjectivesThis study aimed to investigate how current human milk feeding (HMF) status is related to infant immune biomarker profiles, as well as explore relationships with HMF history (i.e., duration, exclusivity, and method: directly from the breast or pumped and bottled). MethodsThis observational birth cohort study involved 605 infants from the Canadian CHILD Cohort Study. Infant feeding was captured from hospital birth records and parent questionnaires. Ninety-two biomarkers reflecting immune system activity and development were measured in serum collected at 1 y (12.6 ± 1.4 mo) using the Olink Target 96 Inflammation panel. Associations were determined using multivariable regression (adjusted for sex, time until blood sample centrifugation, and study site). ResultsNearly half (42.6%) of infants were still receiving HMF at the time of blood sampling. Compared with non-HMF infants, HMF infants had higher levels of serum fibroblast growth factor 21 (FGF-21, adjusted standardized β coefficient: 0.56; 95% CI: 0.41, 0.72), cluster of differentiation 244 (CD244, β: 0.35; 95% CI: 0.19, 0.50), chemokine ligand 6 (CXCL6, β: 0.34; 95% CI: 0.18, 0.50), and chemokine ligand 20 (CCL20, β: 0.26; 95% CI: 0.09, 0.42) and lower extracellular newly identified receptor for advanced glycation end-products binding protein (EN-RAGE, β: −0.16; 95% CI: −0.29, −0.03). Among non-HMF infants, serum interleukin 7 (IL-7) had a marginally positive association with past HMF duration (β: 0.05; 95% CI: 0.02, 0.08) that persisted for ≤5 mo post-HMF cessation. Exclusive HMF duration and HMF method (at 3 mo of age) were not associated with any biomarkers. ConclusionsCurrent HMF status and (to a lesser extent) HMF history are associated with several inflammation-associated biomarkers in 1-y-old infants. These results provide new evidence that HMF impacts immune activity and development and suggest hypotheses about the underlying mechanisms. They also highlight the importance of including current HMF status in immune system–focused infant serum proteomic studies.

To Study the Correlation of Maternal Serum Vitamin D Levels and Infant Serum Vitamin D Levels With Infant Birth Weight: A Single-Centre Experience From the Bundelkhand Region, India.

Vitamin D deficiency during pregnancy can have severe effects on both the mother and the newborn child. The main aim of this study was to assess the impact of maternal vitamin D levels on the birth weight of the newborn by analysing the vitamin D levels in pregnant women at full term and their newborn. The cross-sectional, hospital-based study was conducted with 150 consecutive women in labour presenting with a singleton term pregnancy at a large tertiary centre in the Bundelkhand region, India. Maternal and infant blood samples were obtained at the time of delivery. Umbilical cord blood was collected from infants, while maternal venous blood was drawn simultaneously. All relevant data were gathered, including the assessment of 25-hydroxy vitamin D3 levels in both mother and infant. The birth weight of the infant was measured, and statistical analysis was performed to find an association between maternal vitamin D level to birth weight and vitamin D level of the infant. Most pregnant women had low vitamin D levels in this study. The results revealed a significant positive correlation between maternal serum vitamin D levels and infant birth weight (p < 0.001), suggesting that lower maternal vitamin D levels were associated with low birth weight in infants. Additionally, infant serum vitamin D levels showed a positive correlation with maternal vitamin D levels (p < 0.001), indicating that higher maternal vitamin D levels tend to have infants with higher vitamin D levels at birth. These findings suggest a potential correlation of maternal vitamin D status to birth weight and vitamin D level of newborns, and further research is needed to confirm and better understand this relationship. Additionally, other factors such as maternal nutrition, genetics, lifestyle factors, and environmental influences may contribute to birth weight outcomes.

Enhanced D614G and Omicron Variants Antibody Persistence in Infants at 2 Months of Age Following Maternal mRNA Booster Vaccination During Pregnancy or Postpartum

Background: Following maternal COVID-19 vaccination, the persistence of antibodies in sera and breast milk for mothers and infants is not well characterized. We sought to describe the persistence of antibodies through 2 months after delivery in maternal and infant serum and breast milk following maternal COVID-19 mRNA vaccination and to examine differences by receipt of booster dose during pregnancy or postpartum. Methods: This is a prospective cohort study with enrollment from July 2021 to January 2022 at 9 US academic sites. Pregnant or postpartum participants and their infants were enrolled after COVID-19 mRNA monovalent vaccination during pregnancy (primary 2-dose series) with booster (third dose) vaccination during pregnancy or within 2 months post-partum. SARS-CoV-2–binding and functional antibody responses at delivery and 2 months after delivery in mothers and infants were measured by spike and receptor-binding domain immunoglobulin (Ig) G, pseudovirus and live neutralizing antibody (nAb) titers to ancestral and Omicron BA.1 and BA.5 strains. Breast milk spike and receptor-binding domain IgG and IgA titers were also measured. Results: A total of 237 maternal/infant dyads were included (110 primary series during pregnancy, 99 pregnancy booster and 28 postpartum booster). A pregnancy booster resulted in 2.2-4.7-fold higher IgG and nAb at delivery and 2 months for both mothers and infants compared to the primary series alone (P &lt; 0.001 for all comparisons). While infant IgG and nAb titers decreased by 2 months of age, the proportion of infants with detectable nAb at 2 months was greater in infants of mothers boosted during pregnancy compared with primary series for all variants (D614G: 99% vs. 56%; BA.1: 56% vs. 4% and BA.5: 57% vs. 9%; P &lt; 0.001 for all comparisons). Breast milk spike IgA and IgG were present in 64%-100% and 100% of participants, respectively, and those boosted during pregnancy or postpartum had 3.1-4.6-fold higher levels of breast milk antibodies at 2 months compared to primary series during pregnancy (P &lt; 0.001). Conclusions: mRNA COVID-19 monovalent booster vaccination during pregnancy results in significantly higher maternal and infant serum–binding IgG and nAb titers compared to a primary 2-dose series, including against Omicron variants, through 2 months of age. Breast milk antibodies following maternal vaccination during pregnancy or postpartum may provide additional protection during early infancy.

Retrospective Review of Postpartum Lithium Use Including During Lactation.

Introduction: Lithium remains a gold standard treatment for bipolar disorder including during peripartum. Historically, guidelines advised against breastfeeding while taking lithium though recent data suggest it is acceptable for a healthy infant. Lack of awareness of acceptability contributes to decreased patient and clinician comfort and low breastfeeding rates. We report current breastfeeding rates, monitoring practices, and infant outcomes with lithium exposure in breastmilk at our institution. Methods: A retrospective chart review was conducted at a single academic medical center using records from 2013 to 2023. Electronic medical records were queried to identify patients prescribed lithium postpartum. Data were collected on timing of lithium initiation, lithium dose and concentration, breastfeeding status, and infant outcomes. Results: A total of 18 cases of lithium use in the postpartum period were identified. A total of 39% (n = 7) of patients taking lithium postpartum breastfed. Most patients, 61% (n = 11), initiated lithium prior to pregnancy, 11% (n = 2) initiated during pregnancy and 27% (n = 5) started postpartum. Four infant charts were reviewed with no reports of adverse events. Of these infants, average maternal lithium dose was 750 mg daily, with an average maternal serum lithium concentration of 0.62 mmol/L and average infant serum lithium concentration of 0.16 mmol/L. Conclusion: Our data demonstrate most patients using lithium postpartum have been taking lithium long-term and are not breastfeeding. Lithium exposure in breastmilk appears to be tolerated by healthy infants. There is a need for ongoing research and education on acceptability and infant monitoring recommendations to support patients who would like to breastfeed while on lithium.

Prevalence of sexually transmitted infection in pregnancy and their association with adverse birth outcomes: a case–control study at Queen Elizabeth Central Hospital, Blantyre, Malawi

BackgroundThere are limited data on the epidemiology of sexually transmitted infections (STI) and their contribution to adverse birth outcomes (ABO) in sub-Saharan Africa (SSA). We performed a case–control study to...

Genetic characterization and estimated 4CMenB vaccine strain coverage of 284 Neisseria meningitidis isolates causing invasive meningococcal disease in Argentina in 2010–2014

ABSTRACT Meningococcal (Neisseria meningitidis) serogroup B (MenB) strain antigens are diverse and a limited number of strains can be evaluated using the human serum bactericidal antibody (hSBA) assay. The genetic Meningococcal Antigen Typing System (gMATS) was developed to predict the likelihood of coverage for large numbers of isolates by the 4CMenB vaccine, which includes antigens Neisseria adhesin A (NadA), Neisserial Heparin-Binding Antigen (NHBA), factor H-binding protein (fHbp), and Porin A (PorA). In this study, we characterized by whole-genome analyses 284 invasive MenB isolates collected from 2010 to 2014 by the Argentinian National Laboratories Network (52–61 isolates per year). Strain coverage was estimated by gMATS on all isolates and by hSBA assay on 74 randomly selected isolates, representative of the whole panel. The four most common clonal complexes (CCs), accounting for 81.3% of isolates, were CC-865 (75 isolates, 26.4%), CC-32 (59, 20.8%), CC-35 (59, 20.8%), and CC-41/44 (38, 13.4%). Vaccine antigen genotyping showed diversity. The most prevalent variants/peptides were fHbp variant 2, NHBA peptides 24, 21, and 2, and PorA variable region 2 profiles 16–36 and 14. The nadA gene was present in 66 (23.2%) isolates. Estimated strain coverage by hSBA assay showed 78.4% of isolates were killed by pooled adolescent sera, and 51.4% and 64.9% (based on two different thresholds) were killed by pooled infant sera. Estimated coverage by gMATS (61.3%; prediction interval: 55.5%, 66.7%) was consistent with the infant hSBA assay results. Continued genomic surveillance is needed to evaluate the persistence of major MenB CCs in Argentina.

Lymphocytic Choriomeningitis Virus Infections in Hungary between 2017-2023-Investigation of the First Congenital Infections.

Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus, primarily spread by common house mouse species. Acquired human infections range from asymptomatic to mild flu-like symptoms and self-resolving neurological diseases. In contrast, intrauterine LCMV infection is associated with high mortality and morbidity. Infection of the fetus often leads to fetal death, and surviving fetuses may develop vision impairment and central nervous system developmental disorders. LCMV is mainly diagnosed by serological methods using in-house indirect immunofluorescence assays. LCMV nucleic acid is detected by the nested RT-PCR method and confirmed by Sanger sequencing. In Hungary, 23 acquired lymphocytic choriomeningitis cases were diagnosed between 2017 and 2023. Ten out of 23 confirmed patients proved to be positive by the PCR method. Two cases of intrauterine LCMV infections were detected in 2019 and 2021, respectively. The IgG antibody titers measured in the infant's serum samples were much higher than the IgG titers of the maternal serum samples. Both IgM and IgA antibodies were detectable in the infants' sera. As the microbiological diagnosis of LCMV is rather challenging and the symptoms are very similar to the clinical picture of other common teratogenic pathogens such as cytomegalovirus or Toxoplasma gondii, intrauterine LCMV infections might still be underdiagnosed.

Virus neutralization assays for human respiratory syncytial virus using airway organoids

Neutralizing antibodies are considered a correlate of protection against severe human respiratory syncytial virus (HRSV) disease. Currently, HRSV neutralization assays are performed on immortalized cell lines like Vero or A549 cells. It is known that assays on these cell lines exclusively detect neutralizing antibodies (nAbs) directed to the fusion (F) protein. For the detection of nAbs directed to the glycoprotein (G), ciliated epithelial cells expressing the cellular receptor CX3CR1 are required, but generation of primary cell cultures is expensive and labor-intensive. Here, we developed a high-throughput neutralization assay based on the interaction between clinically relevant HRSV grown on primary cells with ciliated epithelial cells, and validated this assay using a panel of infant sera. To develop the high-throughput neutralization assay, we established a culture of differentiated apical-out airway organoids (Ap-O AO). CX3CR1 expression was confirmed, and both F- and G-specific monoclonal antibodies neutralized HRSV in the Ap-O AO. In a side-by-side neutralization assay on Vero cells and Ap-O AO, neutralizing antibody levels in sera from 125 infants correlated well, although titers on Ap-O AO were consistently lower. We speculate that these lower titers might be an actual reflection of the neutralizing antibody capacity in vivo. The organoid-based neutralization assay described here holds promise for further characterization of correlates of protection against HRSV disease.

Ocular Effects of Prenatal Carotenoid Supplementation in the Mother and Her Child: The Lutein and Zeaxanthin in Pregnancy (L-ZIP) Randomized Trial - Report Number 2

PurposeLutein and zeaxanthin are xanthophyll carotenoids that have been promoted to enhance maternal health and infant visual and neurodevelopment. In this study, we determined the effects of prenatal lutein and zeaxanthin supplementation on systemic and ocular carotenoid status in the mother and her newborn infant (NCT03750968). This report focuses on the ocular effects of prenatal carotenoid supplementation. DesignA prospective randomized clinical trial with 47 subjects randomly assigned by 1:1 allocation to receive standard-of-care prenatal vitamins along with 10 mg lutein and 2 mg zeaxanthin softgel (Carotenoid Group) or standard-of-care prenatal vitamins with a placebo softgel (Control Group) starting in the first trimester. SubjectsWe enrolled low-risk pregnancy subjects aged 18 years and above from the obstetrics and gynecology clinic of the University of Utah Hospital. MethodsMaternal macular, skin, and serum carotenoid concentrations were measured using autofluorescence imaging, resonance Raman spectroscopy, and high-performance liquid chromatography, respectively. Infants’ ocular carotenoids and retinal architecture were measured by blue light reflectance imaging and spectral domain optical coherence tomography, respectively. Main Outcome MeasuresChanges in maternal and infant macular pigment, skin, and serum carotenoid status over the study period. Differences in infants’ retinal maturity indicators between the two study groups. ResultsFollowing supplementation, there was a statistically significant increase in maternal macular pigment optical volume (p < 0.001) in the Carotenoid Group relative to the Control Group at all study time points, and there was no detectable maternal ocular carotenoid depletion. Infant skin and serum carotenoids increased significantly in the Carotenoid Group compared to the Control Group. As exploratory endpoints, infants in the Carotenoid Group had a 20% increase in macular pigment optical density (p = 0.242) and more mature foveal parameters compared to those in the Control Group. ConclusionPrenatal carotenoid supplementation significantly increased maternal and infant systemic carotenoids and caused a pattern of increased infant ocular carotenoid status, which may benefit both mothers and their infants’ ocular development and function. This study provides important data to design and power a future multicenter study of prenatal carotenoid supplementation in higher-risk pregnancies.

Interlaboratory comparison of a multiplex immunoassay that measures human serum IgG antibodies against six-group B streptococcus polysaccharides

ABSTRACT Measurement of IgG antibodies against group B streptococcus (GBS) capsular polysaccharide (CPS) by use of a standardized and internationally accepted multiplex immunoassay is important for the evaluation of candidate maternal GBS vaccines in order to compare results across studies. A standardized assay is also required if serocorrelates of protection against invasive GBS disease are to be established in infant sera for the six predominant GBS serotypes since it would permit the comparison of results across the six serotypes. We undertook an interlaboratory study across five laboratories that used standardized assay reagents and protocols with a panel of 44 human sera to measure IgG antibodies against GBS CPS serotypes Ia, Ib, II, III, IV, and V. The within-laboratory intermediate precision, which included factors like the lot of coated beads, laboratory analyst, and day, was generally below 20% relative standard deviation (RSD) for all six serotypes, across all five laboratories. The cross-laboratory reproducibility was < 25% RSD for all six serotypes, which demonstrated the consistency of results across the different laboratories. Additionally, anti-CPS IgG concentrations for the 44-member human serum panel were established. The results of this study showed assay robustness and that the resultant anti-CPS IgG concentrations were reproducible across laboratories for the six GBS CPS serotypes when the standardized assay was used.

Comparison of serum and salivary creatinine levels in preterm neonates

&lt;b&gt;Introduction:&lt;/b&gt; In recent years, saliva has been frequently tested as an alternative biological sample for diagnosing various diseases. Various substances reach the saliva through endogenous synthesis in acinar cells or from plasma. Passive diffusion, transudation, diffusion, or selective transport are how these substances cross from plasma to saliva. There are a small number of studies in children and adults that have examined renal function and the ratio of serum and salivary creatinine. To date, no study has been conducted that examined the existence of this correlation in neonates. Our study aimed to examine whether there is a correlation between serum and salivary creatinine values in preterm infants.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; We conducted a prospective study that included 30 neonates, in whom serum and salivary creatinine levels were measured simultaneously in two-time spots.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The mean value of salivary to serum creatinine (sCr) ratio was 0.700. Salivary to sCr ratio was statistically significantly higher in newborns of gestational age (GA)&amp;lt;28 gestational weeks (mean value 0.825), compared to children with GA≥28 gestational weeks (mean value 0.566), student t-test; p=0.003. Logistic regression showed that the correlation between serum and salivary creatinine levels was more coherent in newborns with GA&amp;lt;28 weeks.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; In this study, it was examined for the first time whether there is a correlation between the values of serum and salivary creatinine in preterm infants. We found that the correlation between serum and salivary creatinine levels is strong in newborns with GA&amp;lt;28 weeks.

Metformin Is the First Choice of Oral Medicated Breastfeeding Mothers

Diabetes mellitus (DM) is a group of metabolic disorders in which there are high levels of glucose in the blood. The effects of DM are long-term damage, dysfunction and failure of various organs. Metformin is a common first-line treatment for type 2 diabetes (T2D) patients. It is one of the oldest treatments for diabetes, dating back to the 1960s. Some scholars in their studies have found that Metformin used by mothers is safe for their breastfeed infants. Most T2D breastfeeding mothers choice Metformin for their initial treatment of diabetes. Sometimes Metformin is found in low levels in the serum of breastfed infants. But no adverse effects are seen when breastfeeding women use Metformin as an oral medication. Although metformin does not lower plasma glucose, it should be used by breastfeeding mothers very carefully and should stop immediately if any side effect is observable.

The Impact of Prenatal Alcohol Exposure on Longitudinal Growth, Nutritional Status, and Insulin-Like Growth Factor 1 in Early Childhood in Leyte, the Philippines

To assess the impact and potential mechanistic pathways of prenatal alcohol exposure (PAE) on longitudinal growth and nutritional status in early childhood. A cohort of 296 mother-infant dyads (32% with PAE vs 68% unexposed) were recruited in Leyte, the Philippines, and followed from early gestation through 24months of age. PAE was assessed using serum phosphatidylethanol (PEth) captured twice prenatally and in cord blood and supplemented with self-reported alcohol consumption. Linear mixed models were used to examine longitudinal effects of PAE on growth from birth through 2years including key potential mediating factors (placental histopathology, and infant serum leptin and Insulin-like Growth Factor 1 [IGF-1]). After adjusting for potential confounders, we found that PAE was significantly associated with a delayed blunting of linear growth trajectories (height-for-age z-score, body length) and weight (weight-for-age z-score, body weight) that manifested between 4 and 6months and continued through 12-24months. PAE was also associated with a decreased rate of mid-upper-arm circumference growth from birth to 12months, and a lower mean IGF-1 levels at birth and 6months. This study demonstrates a delayed impact of PAE on growth that manifested around 6months of age, underscoring the importance of routine clinical monitoring in early childhood. Furthermore, the findings supported prior animal model findings that suggest a mechanistic role for IGF-1 in PAE-induced growth delay.

Mothers Practices and Factors Affecting Sunlight Exposure of Their Infants in Adami Tulu Jido Kombolcha District, East Shoa Zone, Oromia Region, Ethiopia, 2022: A Community Based Cross-Sectional Study.

Background. Vitamin D deficiency (VDD) is a global health concern affecting people of all ages. The Ethiopian guidelines recommend sun exposure for neonates starting from 2 weeks old, with 15 to 20 minutes per day. However, evidence suggests that the implementation of this recommendation is inconsistent. Most studies conducted in Ethiopia regarding infant sunlight exposure have been limited to health facilities and towns. Objective. this study aimed to assess mothers' practice, and factors affecting the sunlight exposure of their infants in Adami Tulu Jido Kombolcha district, East Shoa Zone, Oromia Region, Ethiopia, 2022. Method. A community based cross-sectional study design was conducted among 575 mothers with their infant's from March 11 to 25, 2022. A lottery method sampling technique was employed to select local administrative units and systematic random sampling employed to select study participants. Practices and knowledge were assessed by categorizing mothers based on their responses to practice and knowledge questions, respectively. Mothers who scored above the mean value of 4.5 were classified as having good practice, while those who scored 6.9 or below on the knowledge questions were classified as having poor knowledge. Data were collected through face-to-face interviews using both semi-structured and structured questionnaires. The data were then entered into EPI Data version 3.1 and exported to SPSS version 25 for analysis. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P-value less than <.05. Result. All 575 mothers were interviewed and responded 100%. Out of 567 mothers, 55.2% had good practice of infant sunlight exposure. Lack of advice at health facility (AOR = 3.05, 95% CI: 1.08, 8.60), absence of postnatal care follow up (AOR = 2.38, 95% CI: 1.15, 4.94) and poor knowledge about sunlight exposure (AOR = 1.70, 95% CI: 1.15, 2.50) were factors associated with practice of infant sunlight exposure. Conclusions. In this study, more than half of the mothers had good practice of infants' sunlight exposure. This study highlights the importance of improving maternal knowledge and healthcare practices related to infant sunlight exposure. Key factors affecting these practices include lack of advice at health facilities, absence of postnatal care follow-up, and poor maternal knowledge. To address these issues, healthcare providers, local health offices, and mass media should focus on educational programs and strengthening advice during health visits. Future research should use validated tools and mixed-method approaches to better understand the social and cultural factors at play. Establishing national guidelines and studying infant serum vitamin D levels can further enhance community awareness and promote the benefits of sunlight exposure.

Therapeutic monitoring of lacosamide, perampanel, and zonisamide during breastfeeding

ObjectiveTo provide additional information on the transport of the new anti-seizure medications lacosamide, perampanel, and zonisamide in breast milk and breastfed infants. MethodsBetween 2013 and 2022, concentrations of anti-seizure medications were measured in six women with epilepsy (each drug in two patients) using high-performance liquid chromatography. Additionally, concentrations were determined after two consecutive pregnancies in women receiving lacosamide and one woman receiving zonisamide. In all cases, anti-seizure medication concentrations were measured in the maternal serum and breast milk, and five cases, in the infant serum. ResultsFor lacosamide, the ratios of breast milk/maternal serum concentration varied between 0.77 and 0.93, the ratios of infant/maternal serum concentrations were 0.16 and 0.35, and the ratios of infant serum/milk concentrations were 0.21 and 0.38. For perampanel, the ratios of breast milk/maternal serum concentration were 0.01 and 0.10 and the ratio of infant/maternal serum concentration was 0.36. For zonisamide, the ratios of breast milk/maternal serum concentration varied between 0.76 and 1.26, the ratios of infant/maternal serum concentrations between 0.44 and 0.85, and the ratios of infant serum/milk concentrations between 0.55 and 1.05. ConclusionsBreastfeeding is recommended for women using lacosamide, perampanel, and zonisamide. However, the actual exposure can only be accurately evaluated by determining the serum concentration of anti-seizure medication in breastfed infants.

Maternal mRNA COVID-19 Vaccination During Pregnancy and Delta or Omicron Infection or Hospital Admission in Infants: Test Negative Design Study

(BMJ. 2023;380:e074035) Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rates are higher in infants than in older children. Passive immunity has been shown to help prevent other infections, such as pertussis, in infants through the transfer of maternal antibodies following vaccination during pregnancy. SARS-CoV-2 antibodies are found to be present in breastmilk, umbilical cord blood, and infant serum specimens following maternal vaccination during pregnancy and infection, and emerging research suggests maternal COVID-19 vaccination reduces infant infection and hospital admission rates. This study aimed to determine whether maternal vaccination during pregnancy with 2 primary doses or 2 primary doses plus booster of the mRNA COVID-19 vaccine series reduces the infection of omicron and delta SARS-CoV-2 and hospital admission of infants within 6 months following delivery.

Exploring the long-term seroprevalence of SARS-CoV-2 antibodies in infants born to women with clinical or laboratory-confirmed COVID-19

IntroductionInfants are at a higher risk of severe illness with COVID-19 infection compared to older children. While COVID-19 vaccination is not recommended for young infants, they can acquire maternally-derived anti-SARS-CoV-2 antibodies passively through the placenta and breastmilk. We described the persistence of infection-induced maternal antibodies in infant circulation at 9–12 months of age. MethodologyThis was a cross-sectional study nested within the INTERCOVID multinational cohort study. For each COVID positive pregnant woman, two unmatched consecutive COVID negative pregnant women were enrolled between April and September 2020. Women with a positive PCR test, radiographic signs consistent with COVID-19, or at least 2 predefined symptoms of COVID-19 were considered as COVID positive. For this nested cross-sectional study, all COVID positive and either one of the COVID negative participants recruited from the Aga Khan University, Pakistan were approached 9–12 months after delivery, and maternal and infant sera were collected for antibody detection. ResultsAltogether, 83 mothers provided consent, of whom 32 (38.6 %) were COVID positive and 51 (61.4 %) were COVID negative during pregnancy. Anti-SARS-CoV-2 antibodies were present in 13 (41 %) infants born to COVID positive and 19 (39 %) infants born to COVID negative mothers (p = 0.87). The presence of reactive antibodies in infants at follow-up was associated with maternal antibodies at follow-up (OR:9.50, 95 % CI:2.03–44.42; p = 0.004). COVID infection occurred in 3 (6 %) infants born to COVID negative mothers while no infant born to a COVID positive mother had a history of infection (p = 0.27). ConclusionThe presence of reactive anti-SARS-CoV-2 antibodies in infants at 9–12 months of age is associated with maternal seropositivity 9–12 months after delivery rather than maternal infection during pregnancy. Further studies are required to validate these findings and assess whether passive immunity in infants is protective against COVID-19 infection.

Correlations Among Maternal and Infant Factors, Lead Exposure, and Serum Prolactin Levels During Lactation: A Cross-sectional Study in Indonesia.

Prolactin is vital for breastfeeding and milk production, and its secretion is influenced by factors related to the mother, infant, and environment. To date, no study has concurrently investigated the correlation of these factors with serum prolactin levels during lactation. Therefore, the objective of this study was to investigate the correlations among maternal and infant factors, lead exposure, and serum prolactin levels during lactation. A cross-sectional approach was employed in Surabaya, Indonesia, among 110 exclusively lactating mothers. The mothers' daily diets were determined using multiple 24-hour recalls, while blood lead levels were measured with inductively coupled plasma mass spectrometry. Serum prolactin levels were assessed using the electrochemiluminescence immunoassay. For bivariate analysis, we employed the Spearman correlation, Mann-Whitney, and Kruskal-Wallis tests, while for multivariate analysis, we utilized multiple linear regression. The average serum prolactin level of the lactating mothers was 129.19±88.96 ng/mL. Positive correlations were found between serum prolactin levels and breastfeeding frequency (p < 0.001), protein intake (p < 0.001), and calcium intake (p = 0.011) but had negative correlation with blood lead levels (p < 0.001) and vitamin B6 intake (p = 0.003). Additionally, prolactin levels were not significantly associated with maternal age; parity; intake of calories, vitamin D, vitamin E, zinc, folic acid, magnesium, or iron; infant age; or infant sex. Breastfeeding frequency had a stronger positive relationship with serum prolactin levels than protein and calcium intake. However, lead exposure was associated with reduced serum prolactin levels during lactation. Consequently, specific interventions from policymakers are necessary to manage breastfeeding in mothers exposed to lead.