Maternal ethanol ingestion: effect on maternal and neonatal glucose balance

International Nuclear Information System (INIS)

Witek-Janusek, L.

1986-01-01

Liver glycogen availability in the newborn is of major importance for the maintenance of postnatal blood glucose levels. This study examined the effect of maternal ethanol ingestion on maternal and neonatal glucose balance in the rate. Female rats were placed on 1) the Lieber-DeCarli liquid ethanol diet, 2) an isocaloric liquid pair-diet, or 3) an ad libitum rat chow diet at 3 wk before mating and throughout gestation. Blood and livers were obtained from dams and rat pups on gestational days 21 and 22. The pups were studied up to 6 h in the fasted state and up to 24 h in the fed state. Maternal ethanol ingestion significantly decreased litter size, birth weight, and growth. A significantly higher mortality during the early postnatal period was seen in the prenatal ethanol exposed pups. Ethanol significantly decreased fed maternal liver glycogen stores but not maternal plasma glucose levels. The newborn rats from ethanol ingesting dams also had significantly decreased liver glycogen stores. Despite mobilizing their available glycogen, these prenatal ethanol exposed pups became hypoglycemic by 6 h postnatal. This was more marked in the fasted pups. Ethanol did not affect maternal nor neonatal plasma insulin levels. Thus maternal ethanol ingestion reduces maternal and neonatal liver glycogen stores and leads to postnatal hypoglycemia in the newborn rat

Effects of early maternal employment on maternal health and well-being

Science.gov (United States)

Markowitz, Sara; Brooks-Gunn, Jeanne

2012-01-01

This study uses data from the National Institute of Child Health and Human Development Study on Early Child Care to examine the effects of maternal employment on maternal mental and overall health, self-reported parenting stress, and parenting quality. These outcomes are measured when children are 6 months old. Among mothers of 6-month-old infants, maternal work hours are positively associated with depressive symptoms and parenting stress and negatively associated with self-rated overall health. However, maternal employment is not associated with quality of parenting at 6 months, based on trained assessors’ observations of maternal sensitivity. PMID:23645972

Maternal sensitivity: a concept analysis.

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Shin, Hyunjeong; Park, Young-Joo; Ryu, Hosihn; Seomun, Gyeong-Ae

2008-11-01

The aim of this paper is to report a concept analysis of maternal sensitivity. Maternal sensitivity is a broad concept encompassing a variety of interrelated affective and behavioural caregiving attributes. It is used interchangeably with the terms maternal responsiveness or maternal competency, with no consistency of use. There is a need to clarify the concept of maternal sensitivity for research and practice. A search was performed on the CINAHL and Ovid MEDLINE databases using 'maternal sensitivity', 'maternal responsiveness' and 'sensitive mothering' as key words. The searches yielded 54 records for the years 1981-2007. Rodgers' method of evolutionary concept analysis was used to analyse the material. Four critical attributes of maternal sensitivity were identified: (a) dynamic process involving maternal abilities; (b) reciprocal give-and-take with the infant; (c) contingency on the infant's behaviour and (d) quality of maternal behaviours. Maternal identity and infant's needs and cues are antecedents for these attributes. The consequences are infant's comfort, mother-infant attachment and infant development. In addition, three positive affecting factors (social support, maternal-foetal attachment and high self-esteem) and three negative affecting factors (maternal depression, maternal stress and maternal anxiety) were identified. A clear understanding of the concept of maternal sensitivity could be useful for developing ways to enhance maternal sensitivity and to maximize the developmental potential of infants. Knowledge of the attributes of maternal sensitivity identified in this concept analysis may be helpful for constructing measuring items or dimensions.

How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

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Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

2017-12-01

This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

Maternal Mortality in Texas.

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Baeva, Sonia; Archer, Natalie P; Ruggiero, Karen; Hall, Manda; Stagg, Julie; Interis, Evelyn Coronado; Vega, Rachelle; Delgado, Evelyn; Hellerstedt, John; Hankins, Gary; Hollier, Lisa M

2017-05-01

A commentary on maternal mortality in Texas is provided in response to a 2016 article in Obstetrics & Gynecology by MacDorman et al. While the Texas Department of State Health Services and the Texas Maternal Mortality and Morbidity Task Force agree that maternal mortality increased sharply from 2010 to 2011, the percentage change or the magnitude of the increase in the maternal mortality rate in Texas differs depending on the statistical methods used to compute and display it. Methodologic challenges in identifying maternal death are also discussed, as well as risk factors and causes of maternal death in Texas. Finally, several state efforts currently underway to address maternal mortality in Texas are described. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rural maternity care.

Science.gov (United States)

Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

2012-10-01

To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

Maternal adiposity and maternal and cord blood concentrations of vitamin D [25(OHD3

Directory of Open Access Journals (Sweden)

Fernanda F.A. Simões

2016-10-01

Full Text Available Obesity is associated with lower concentrations of vitamin D [25(OHD3] in children, adolescents and adults, but it remains unclear whether maternal adiposity influences maternal and foetal concentrations of this vitamin. The objective of this cross-sectional study was to assess the relationship between maternal adiposity and maternal and cord blood concentrations of vitamin D. It involved 101 mother–newborn pairs from a public maternity in Sao Paulo city, Brazil. Demographic, socioeconomic and obstetric data, as well as anthropometry, physical activity and vitamin D supplementation during pregnancy, were investigated. Maternal adiposity was assessed by bioelectrical impedance. Maternal and cord blood concentrations of vitamin D were measured by high-performance liquid chromatography. Two multiple linear regression models that included maternal and cord blood vitamin D concentrations as outcomes and maternal adiposity as independent variable were used. No association was observed between maternal adiposity and maternal or cord blood concentrations of vitamin D. Maternal vitamin D concentration was associated with race, physical activity and vitamin D supplementation (adj. R2 = 0.74. Cord blood vitamin D concentration was associated with maternal vitamin D concentration (adj. R2 = 0.24. Although fat mass quantification is important to understand vitamin D status during all stages of life, this may not be true in pregnancy as race, vitamin D supplementation and physical activity appeared to be more relevant to vitamin D status. Understanding vitamin D metabolism in pregnancy may elucidate how or if adiposity influences maternal vitamin D status and how it impacts vitamin D transport to the foetus.

Maternal Emotional Availability and Its Association with Maternal Psychopathology, Attachment Style Insecurity and Theory of Mind.

Science.gov (United States)

Licata, Maria; Zietlow, Anna-Lena; Träuble, Birgit; Sodian, Beate; Reck, Corinna

High maternal emotional availability (EA) positively affects various domains of child development. However, the question of which factors promote or hinder maternal EA has not been investigated systematically. The present study investigated several maternal characteristics, namely maternal psychopathology, maternal attachment style insecurity, and theory of mind (ToM) as possible factors that influence maternal EA. The sample was comprised of 56 mothers and their preschool-aged children. Half of the mothers were diagnosed with postpartum depression and or anxiety disorders according to DSM-IV, and the other half were healthy controls. The results showed that both low maternal attachment style insecurity and high ToM skills significantly predicted maternal EA sensitivity, independently from maternal postpartum and concurrent psychopathology and education. Moreover, maternal attachment style insecurity fully mediated the link between maternal postpartum psychopathology and sensitivity. The findings suggest that maternal attachment style security can buffer negative effects of maternal psychopathology on maternal sensitivity in the mother-child interaction. © 2016 S. Karger AG, Basel.

[Time perception, maternal tasks, and maternal role behavior among pregnant Japanese women].

Science.gov (United States)

Yamamoto, A

1996-01-01

The relationship of time perception, maternal tasks, and maternal role behavior was examined in 140 pregnant Japanese women with a short-term longitudinal design. A model developed by Rubin provided the conceptual framework for this research. The Time Perception Scale. Time Production Method, and the Prefatory Maternal Response measured the study variables. Study results revealed significant differences in duration of time, time production, maternal-fetal attachment, and maternal role behavior before and after quickening(fetal movement)occurred. Medium to strong positive relationships among time orientation, maternal-fetal attachment, gratification, and maternal role behavior were found before and after movement. After quickening, a weak relationship between time orientation and duration was found. After controlling maternal-fetal attachment and gratification in pregnancy and maternal role, orientation in time perception accounted for significant amounts of variance in maternal role behavior before and after fetal movement. Results show that the process of becoming a mother, which started before quickening, increased in magnitude after fetal movement. The function of fetal movement is important in developing motherhood. In the process of becoming a mother, cognitive, emotional, and behavioral aspects in becoming a mother are inseparable from each other. Future orientation of time perception contributes to development of maternal role behavior. Having a future orientation during pregnancy may indicate hope or positive expectation. Based on these findings, several recommendations were proposed: (a)to study further the general process of becoming a mother and the role of time perception in developing motherhood, (b)to disseminate information to the general public about the process in development of motherhood, (c)to construct theory to explain the process of becoming a mother, and(d)to conduct future research to clarify the construct of time perception and attachment.

Are species differences in maternal effects arising from maternal care adaptive?

Science.gov (United States)

Benowitz, K M; Moody, K J; Moore, A J

2015-02-01

Parental care benefits offspring through maternal effects influencing their development, growth and survival. However, although parental care in general is likely the result of adaptive evolution, it does not follow that specific differences in the maternal effects that arise from care are also adaptive. Here, we used an interspecific cross-fostering design in the burying beetle species Nicrophorus orbicollis and N. vespilloides, both of which have elaborate parental care involving direct feeding of regurgitated food to offspring, to test whether maternal effects are optimized within a species and therefore adaptive. Using a full-factorial design, we first demonstrated that N. orbicollis care for offspring longer regardless of recipient species. We then examined offspring development and mass in offspring reared by hetero- or conspecific parents. As expected, there were species-specific direct effects independent of the maternal effects, as N. orbicollis larvae were larger and took longer to develop than N. vespilloides regardless of caregiver. We also found significant differences in maternal effects: N. vespilloides maternal care caused more rapid development of offspring of either species. Contrary to expectations if maternal effects were species-specific, there were no significant interactions between caretaker and recipient species for either development time or mass, suggesting that these maternal effects are general rather than optimized within species. We suggest that rather than coadaptation between parents and offspring performance, the species differences in maternal effects may be correlated with direct effects, and that their evolution is driven by selection on those direct effects. © 2014 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

Maternal Depression, Maternal Expressed Emotion, and Youth Psychopathology

Science.gov (United States)

Tompson, Martha C.; Pierre, Claudette B.; Boger, Kathryn Dingman; McKowen, James W.; Chan, Priscilla T.; Freed, Rachel D.

2010-01-01

Across development, maternal depression has been found to be a risk factor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two…

Association between Maternal Smoking during Pregnancy and Low Birthweight: Effects by Maternal Age.

Directory of Open Access Journals (Sweden)

Wei Zheng

Full Text Available Maternal smoking during pregnancy has been consistently related to low birthweight. However, older mothers, who are already at risk of giving birth to low birthweight infants, might be even more susceptible to the effects of maternal smoking. Therefore, this study aimed to examine the modified association between maternal smoking and low birthweight by maternal age.Data were obtained from a questionnaire survey of all mothers of children born between 2004 and 2010 in Okinawa, Japan who underwent medical check-ups at age 3 months. Variables assessed were maternal smoking during pregnancy, maternal age, gestational age, parity, birth year, and complications during pregnancy. Stratified analyses were performed using a logistic regression model.In total, 92641 participants provided complete information on all variables. Over the 7 years studied, the proportion of mothers smoking during pregnancy decreased from 10.6% to 5.0%, while the prevalence of low birthweight did not change remarkably (around 10%. Maternal smoking was significantly associated with low birthweight in all age groups. The strength of the association increased with maternal age, both in crude and adjusted models.Consistent with previous studies conducted in Western countries, this study demonstrates that maternal age has a modifying effect on the association between maternal smoking and birthweight. This finding suggests that specific education and health care programs for older smoking mothers are important to improve their foetal growth.

Influences of maternal overprotection.

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Parker, G; Lipscombe, P

1981-04-01

While maternal overprotection appears associated with several neurotic and psychotic disorders, little is known about determinants of such a parental characteristic. Several hypotheses have been tested in a large nonclinical sample. Maternal and cultural factors seemed of greater relevance than characteristics in the child. Overprotective mothers gave evidence of marked maternal preoccupations before having children, of showing a capacity to be overprotective after the active stage of mothering, and of having personality characteristics of high anxiety, obsessionality and a need to control. Maternal overprotection appears associated with low, rather than with high maternal care. This has important primary prevention and treatment implications.

Maternal passive smoking and its effect on maternal, neonatal and placental parameters.

Science.gov (United States)

Ramesh, K N; Vidyadaran, M K; Goh, Y M; Nasaruddin, A A; Jammal, A B E; Zainab, S

2005-08-01

A study was undertaken to 1) determine the effects of tobacco smoke exposure on maternal and neonatal weight and body mass index (BMI) and placental weight, volume and surface area and 2) establish any correlations between the placental surface area, volume and weight with maternal and neonatal body weight and BMI in mothers exposed to cigarette smoke. A total of 154 full-term placentae, 65 from mothers exposed to tobacco smoke and 89 from non-exposed mothers were collected from Kuala Lumpur Maternity Hospital. The placental surface area was determined using a stereological grid, the volume by Scherle's method and the weight by using an electronic weighing machine. In general there were no differences in maternal, placental and neonatal parameters between the exposed and non-exposed groups. However, there were significant correlations between placental weight with maternal weight and maternal BMI in both exposed (r = 0.315; p = 0.013) and (r = 0.265; p = 0.038), and non-exposed (r = 0.224; p = 0.035) and (r = 0.241; p = 0.023) mothers. It was also found that the maternal weight on admission correlated significantly with placental weight in both Malay (r = 0.405; p = 0.020) and Indian (r = 0.553; p = 0.050) passive smokers. Correcting the placental parameters for the maternal weight had no effect on the results.

Severe maternal morbidity associated with maternal birthplace in three high-immigration settings

DEFF Research Database (Denmark)

Urquia, Marcelo L; Glazier, Richard H; Mortensen, Laust

2015-01-01

BACKGROUND: Maternal mortality and morbidity vary substantially worldwide. It is unknown if these geographic differences translate into disparities in severe maternal morbidity among immigrants from various world regions. We assessed disparities in severe maternal morbidity between immigrant women...... from various world regions giving birth in three high-immigration countries. METHODS: We used population-based delivery data from Victoria; Australia and Ontario, Canada and national data from Denmark, in the most recent 10-year period ending in 2010 available to each participating centre. Each centre...... provided aggregate data according to standardized definitions of the outcome, maternal regions of birth and covariates for pooled analyses. We used random effects and stratified logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (95% CIs), adjusted for maternal age, parity...

Improved performance of maternal-fetal medicine staff after maternal cardiac arrest simulation-based training.

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Fisher, Nelli; Eisen, Lewis A; Bayya, Jyothshna V; Dulu, Alina; Bernstein, Peter S; Merkatz, Irwin R; Goffman, Dena

2011-09-01

To determine the impact of simulation-based maternal cardiac arrest training on performance, knowledge, and confidence among Maternal-Fetal Medicine staff. Maternal-Fetal Medicine staff (n = 19) participated in a maternal arrest simulation program. Based on evaluation of performance during initial simulations, an intervention was designed including: basic life support course, advanced cardiac life support pregnancy modification lecture, and simulation practice. Postintervention evaluative simulations were performed. All simulations included a knowledge test, confidence survey, and debriefing. A checklist with 9 pregnancy modification (maternal) and 16 critical care (25 total) tasks was used for scoring. Postintervention scores reflected statistically significant improvement. Maternal-Fetal Medicine staff demonstrated statistically significant improvement in timely initiation of cardiopulmonary resuscitation (120 vs 32 seconds, P = .042) and cesarean delivery (240 vs 159 seconds, P = .017). Prompt cardiopulmonary resuscitation initiation and pregnancy modifications application are critical in maternal and fetal survival during cardiac arrest. Simulation is a useful tool for Maternal-Fetal Medicine staff to improve skills, knowledge, and confidence in the management of this catastrophic event. Published by Mosby, Inc.

Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety.

Science.gov (United States)

Kerns, Caroline E; Pincus, Donna B; McLaughlin, Katie A; Comer, Jonathan S

2017-08-01

Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3-8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers' affective states, mothers' ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers' resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e., using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Effect of Marital Violence on Maternal Parenting Style and Maternal Stress.

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Niesman, Cindy S.

A study examined the effect of extreme marital discord, involving abuse of the mother, on maternal parenting style and level of maternal stress. It was hypothesized that battered women experience a higher level of maternal stress and choose an authoritarian parenting style as a consequence of marital discord. Subjects were 30 mothers of children…

The relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants.

Science.gov (United States)

Chen, C W; Conrad, B

2001-09-01

The purpose of this study was to examine the relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants. The research instruments administered included: a demographic sheet, the Maternal Self-Report Inventory (MSRI), Rosenberg Self-Esteem Scale, and Leifer's How I Feel About My Baby Now Scale. Thirty-two mothers whose premature infants were medically stable and hospitalized in the NICU were studied. Two hypotheses on the positive relationships between maternal self-esteem and maternal attachment, and global self-esteem and maternal attachment could not be tested by correlational analyses due to the inadequate internal consistency of the How I Feel About My Baby Now Scale. A significant correlation was found between maternal self-esteem and global self-esteem. Thus, maternal role influenced general self-concept in mothers. In addition, it was found that there were no significant correlations between the MSRI and demographic variables, such as: maternal age, marital status, income, and educational level. Another result indicated that increased global self-esteem was correlated (p attachment behaviors.

Maternity Protection at Work.

Science.gov (United States)

World of Work, 1998

1998-01-01

Discusses the need for maternity benefits for working women. Suggests that although most countries provide paid maternity leave by law, there is a gap between that law and practice. Includes a chart depicting maternity protection (length of leave, cash benefits, who pays) around the world. (JOW)

Maternal employment, breastfeeding, and health: evidence from maternity leave mandates.

Science.gov (United States)

Baker, Michael; Milligan, Kevin

2008-07-01

Public health agencies around the world have renewed efforts to increase the incidence and duration of breastfeeding. Maternity leave mandates present an economic policy that could help achieve these goals. We study their efficacy, focusing on a significant increase in maternity leave mandates in Canada. We find very large increases in mothers' time away from work post-birth and in the attainment of critical breastfeeding duration thresholds. We also look for impacts of the reform on self-reported indicators of maternal and child health captured in our data. For most indicators we find no effect.

Maternal mortality and severe maternal morbidity from acute fatty liver of pregnancy in the Netherlands

NARCIS (Netherlands)

Dekker, Ruth R.; Schutte, Joke M.; Stekelenburg, Jelle; Zwart, Joost J.; van Roosmalen, Jos

Objective: To assess maternal death and severe maternal morbidity from acute fatty liver of pregnancy (AFLP) in the Netherlands. Study design: A retrospective study of all cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of severe maternal morbidity in the

AN AUDIT OF MATERNAL DEATHS

Directory of Open Access Journals (Sweden)

Basavana Gowda

2015-03-01

Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

Pathways from maternal effortful control to child self-regulation: The role of maternal emotional support.

Science.gov (United States)

Zeytinoglu, Selin; Calkins, Susan D; Swingler, Margaret M; Leerkes, Esther M

2017-03-01

This study examined the direct and indirect pathways from maternal effortful control to 2 aspects of children's self-regulation-executive functioning and behavioral regulation-via maternal emotional support. Two hundred seventy-eight children and their primary caregivers (96% mothers) participated in laboratory visits when children were 4 and 5 years, and teachers reported on children's behavior at kindergarten. At the 4-year assessment, maternal effortful control was measured using the Adult Temperament Questionnaire (Evans & Rothbart, 2007) and maternal emotional support was observed during a semistructured mother-child problem-solving task. At the 5-year assessment, children's executive functioning was measured using laboratory tasks designed to assess updating/working memory, inhibitory control, and cognitive flexibility, whereas behavioral regulation was assessed via teacher-report questionnaires on children's attention control, discipline and persistence, and work habits. Results from structural equation modeling indicated that, after controlling for child gender and minority status, and maternal education, maternal effortful control was indirectly associated with both child executive functioning and behavioral regulation through maternal emotional support. Maternal effortful control had a direct association with children's teacher-reported behavioral regulation but not observed executive functioning. These findings suggest that maternal effortful control may be a key contributing factor to the development of children's self-regulatory competencies through its impact on maternal emotional support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Paid Maternity Leave in the United States: Associations with Maternal and Infant Health.

Science.gov (United States)

Jou, Judy; Kozhimannil, Katy B; Abraham, Jean M; Blewett, Lynn A; McGovern, Patricia M

2018-02-01

Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.

Maternal vitamin D supplementation during pregnancy prevents vitamin D deficiency in the newborn: an open-label randomized controlled trial.

Science.gov (United States)

Rodda, C P; Benson, J E; Vincent, A J; Whitehead, C L; Polykov, A; Vollenhoven, B

2015-09-01

To determine whether maternal vitamin D supplementation, in the vitamin D deficient mother, prevents neonatal vitamin D deficiency. Open-label randomized controlled trial. Metropolitan Melbourne, Australia, tertiary hospital routine antenatal outpatient clinic. Seventy-eight women with singleton pregnancies with vitamin D deficiency/insufficiency (serum 25-OH Vit D l) at their first antenatal appointment at 12-16-week gestation were recruited. Participants were randomized to vitamin D supplementation (2000-4000 IU cholecalciferol) orally daily until delivery or no supplementation. The primary outcome was neonatal serum 25-OH vit D concentration at delivery. The secondary outcome was maternal serum 25-OH vit D concentration at delivery. Baseline mean maternal serum 25-OH vit D concentrations were similar (P = 0·9) between treatment (32 nmol/l, 95% confidence interval 26-39 nmol/l) and control groups (33 nmol/l, 95% CI 26-39 nmol/l). Umbilical cord serum 25-OH vit D concentrations at delivery were higher (P l, 95% CI; 70-91 nmol/l) compared with neonates of control group mothers (42 nmol/l, 95% CI; 34-50 nmol/l) with a strongly positive correlation between maternal serum 25-OH Vit D and umbilical cord serum 25-OH vit D concentrations at delivery (Spearman rank correlation coefficient 0·88; P l, 95% CI; 62-81 nmol/l) compared with the control group (36 nmol/l, 95% CI; 29-42 nmol/l). Vitamin D supplementation of vitamin D deficient pregnant women prevents neonatal vitamin D deficiency. © 2015 John Wiley & Sons Ltd.

Maternal scaffolding behavior: links with parenting style and maternal education.

Science.gov (United States)

Carr, Amanda; Pike, Alison

2012-03-01

The purpose of this study was to specify the relationship between positive and harsh parenting and maternal scaffolding behavior. A 2nd aim was to disentangle the effects of maternal education and parenting quality, and a 3rd aim was to test whether parenting quality mediated the association between maternal education and scaffolding practices. We examined associations between positive and harsh parenting practices and contingent and noncontingent tutoring strategies. Ninety-six mother-child dyads (49 boys, 47 girls) from working- and middle-class English families participated. Mothers reported on parenting quality at Time 1 when children were 5 years old and again approximately 5 years later at Time 2. Mother-child pairs were observed working together on a block design task at Time 2, and interactions were coded for contingent (contingent shifting) and noncontingent (fixed failure feedback) dimensions of maternal scaffolding behavior. Positive and harsh parenting accounted for variance in contingent behavior over and above maternal education, whereas only harsh parenting accounted for unique variance in noncontingent scaffolding practices. Our findings provide new evidence for a more differentiated model of the relation between general parenting quality and specific scaffolding behaviors. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Maternal feeding controls fetal biological clock.

Directory of Open Access Journals (Sweden)

Hidenobu Ohta

Full Text Available BACKGROUND: It is widely accepted that circadian physiological rhythms of the fetus are affected by oscillators in the maternal brain that are coupled to the environmental light-dark (LD cycle. METHODOLOGY/PRINCIPAL FINDINGS: To study the link between fetal and maternal biological clocks, we investigated the effects of cycles of maternal food availability on the rhythms of Per1 gene expression in the fetal suprachiasmatic nucleus (SCN and liver using a transgenic rat model whose tissues express luciferase in vitro. Although the maternal SCN remained phase-locked to the LD cycle, maternal restricted feeding phase-advanced the fetal SCN and liver by 5 and 7 hours respectively within the 22-day pregnancy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that maternal feeding entrains the fetal SCN and liver independently of both the maternal SCN and the LD cycle. This indicates that maternal-feeding signals can be more influential for the fetal SCN and particular organ oscillators than hormonal signals controlled by the maternal SCN, suggesting the importance of a regular maternal feeding schedule for appropriate fetal molecular clockwork during pregnancy.

Neuroendocrine Regulation of Maternal Behavior

Science.gov (United States)

Bridges, Robert S.

2015-01-01

The expression of maternal behavior in mammals is regulated by the developmental and experiential events over a female’s lifetime. In this review the relationships between the endocrine and neural systems that play key roles in these developmental and experiential that affect both the establishment and maintenance of maternal care are presented. The involvement of the hormones estrogen, progesterone, and lactogens are discussed in the context of ligand, receptor, and gene activity in rodents and to a lesser extent in higher mammals. The roles of neuroendocrine factors, including oxytocin, vasopressin, classical neurotransmitters, and other neural gene products that regulate aspects of maternal care are set forth, and the interactions of hormones with central nervous system mediators of maternal behavior are discussed. The impact of prior developmental factors, including epigenetic events, and maternal experience on subsequent maternal care are assessed over the course of the female’s lifespan. It is proposed that common neuroendocrine mechanisms underlie the regulation of maternal care in mammals. PMID:25500107

Maternal nutrition and birth outcomes.

Science.gov (United States)

Abu-Saad, Kathleen; Fraser, Drora

2010-01-01

In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

The evolution of multivariate maternal effects.

Directory of Open Access Journals (Sweden)

Bram Kuijper

2014-04-01

Full Text Available There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

The evolution of multivariate maternal effects.

Science.gov (United States)

Kuijper, Bram; Johnstone, Rufus A; Townley, Stuart

2014-04-01

There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M) in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

Maternal Concern for Child Undereating.

Science.gov (United States)

Brown, Callie L; Pesch, Megan H; Perrin, Eliana M; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine; Lumeng, Julie C

To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates. Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43-0.77) and picky eating (OR = 2.41; 95% CI, 1.26-4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55-2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50-4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08-3.36) during mealtimes. Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

Directory of Open Access Journals (Sweden)

Heather N Bader

2014-07-01

Full Text Available Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal PTSD appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: 95 Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluations, and 24 hour urinary cortisol was assayed by RIA. Offspring completed the Parental PTSD Questionnaire to assess maternal PTSD status. Maternal Holocaust exposure was identified as having occurred in childhood, adolescence or adulthood and examined in relation to offspring psychobiology. Results: Urinary cortisol levels did not differ for Holocaust offspring and comparison subjects but differed significantly in offspring based on maternal age of exposure and maternal PTSD status. Increased maternal age of exposure and maternal PTSD were each associated with lower urinary cortisol in offspring, but did not exhibit a significant interaction. In addition, offspring PTSD-associated symptom severity increased with maternal age at exposure and PTSD diagnosis. A regression analysis of correlates of offspring cortisol indicated that both maternal age of exposure and maternal PTSD were significant predictors of lower offspring urinary cortisol, whereas childhood adversity and offspring PTSD symptoms were not. Conclusions: Offspring low cortisol and PTSD-associated symptom expression are related to maternal age of exposure, with the greatest effects associated with increased age at exposure. These effects are relatively independent of the negative consequences of being raised by a trauma survivor. These observations highlight the importance of maternal age of exposure in determining a psychobiology in offspring that is consistent with increased risk for stress

Maternal Age at Holocaust Exposure and Maternal PTSD Independently Influence Urinary Cortisol Levels in Adult Offspring

Science.gov (United States)

Bader, Heather N.; Bierer, Linda M.; Lehrner, Amy; Makotkine, Iouri; Daskalakis, Nikolaos P.; Yehuda, Rachel

2014-01-01

Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal posttraumatic stress disorder (PTSD) appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: Ninety-five Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluations, and 24 h urinary cortisol was assayed by RIA. Offspring completed the parental PTSD questionnaire to assess maternal PTSD status. Maternal Holocaust exposure was identified as having occurred in childhood, adolescence, or adulthood and examined in relation to offspring psychobiology. Results: Urinary cortisol levels did not differ for Holocaust offspring and comparison subjects but differed significantly in offspring based on maternal age of exposure and maternal PTSD status. Increased maternal age of exposure and maternal PTSD were each associated with lower urinary cortisol in offspring, but did not exhibit a significant interaction. In addition, offspring PTSD-associated symptom severity increased with maternal age at exposure and PTSD diagnosis. A regression analysis of correlates of offspring cortisol indicated that both maternal age of exposure and maternal PTSD were significant predictors of lower offspring urinary cortisol, whereas childhood adversity and offspring PTSD symptoms were not. Conclusion: Offspring low cortisol and PTSD-associated symptom expression are related to maternal age of exposure, with the greatest effects associated with increased age at exposure. These effects are relatively independent of the negative consequences of being raised by a trauma survivor. These observations highlight the importance of maternal age of exposure in determining a psychobiology in offspring that is consistent with increased

The effects of maternal haemoglobin as an indicator of maternal ...

African Journals Online (AJOL)

EB

relationship could exist between MMA of mother-infant pairs and maternal nutritional indicator (haemoglobin). Objectives: This study reviewed the effects of maternal haemoglobin (Hb) on MMA of mother-infant pairs at birth. Methods: One hundred and fifty three mother-infant pairs were enrolled in this study using the ...

[Precautionary maternity leave in Tirol].

Science.gov (United States)

Ludescher, K; Baumgartner, E; Roner, A; Brezinka, C

1998-01-01

Under Austrian law, precautionary maternity leave is a decree issued by the district public health physician. It forbids a pregnant woman to work and mandates immediate maternity leave. Regular maternity leave for all women employed in all jobs begins at 32 weeks of gestation. Women who work in workplaces deemed dangerous and women with a history of obstetric problems such as premature or growth-retarded babies from previous pregnancies are regularly 'sent' into precautionary maternity leave. The public health physicians of Tirol's nine administrative districts were interviewed and supplied data on precautionary maternity leave from their districts. In 100 women who attended the clinic for pregnancies at risk of the Obstetrics/Gynecology Department of Innsbruck University Hospital and who had already obtained precautionary maternity leave, the medical/administrative procedure was studied in each case and correlated with pregnancy outcome. The town district of Innsbruck and the district that comprises the suburbs of the provincial capital had the highest rates of precautionary maternity leave. The town district of Innsbruck had a rate of 24.3% of all pregnant women (employed and not employed) in precautionary maternity leave in 1997, whereas the whole province of Tirol had 13.4%. More than 80% of decrees for precautionary maternity leave are issued by district public health physicians on the basis of written recommendations from gynecologists. One third of women who are sent into precautionary maternity leave are issued the decree prior to 12 weeks of gestation - mostly cases of multiple pregnancies and women with previous miscarriages. The present system of precautionary maternity leave appears to work in the sense that most working pregnant women with risk factors are correctly identified - with most errors on the side of caution. As the system also helps employers - the employee's pay is paid from the federal family support fund and state insurance once she is in

Measuring maternal satisfaction with maternity care: A systematic integrative review: What is the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care?

Science.gov (United States)

Perriman, Noelyn; Davis, Deborah

2016-06-01

The objective of this systematic integrative review is to identify, summarise and communicate the findings of research relating to tools that measure maternal satisfaction with continuity of maternity care models. In so doing the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care will be determined. A systematic integrative review of published and unpublished literature was undertaken using selected databases. Research papers were included if they measured maternal satisfaction in a continuity model of maternity care, were published in English after 1999 and if they included (or made available) the instrument used to measure satisfaction. Six hundred and thirty two unique papers were identified and after applying the selection criteria, four papers were included in the review. Three of these originated in Australia and one in Canada. The primary focus of all papers was not on the development of a tool to measure maternal satisfaction but on the comparison of outcomes in different models of care. The instruments developed varied in terms of the degree to which they were tested for validity and reliability. Women's satisfaction with maternity services is an important measure of quality. Most satisfaction surveys in maternity appear to reflect fragmented models of care though continuity of care models are increasing in line with the evidence demonstrating their effectiveness. It is important that robust tools are developed for this context and that there is some consistency in the way this is measured and reported for the purposes of benchmarking and quality improvement. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Maternal-foetal attachment independently predicts the quality of maternal-infant bonding and post-partum psychopathology.

Science.gov (United States)

Petri, Eleonora; Palagini, Laura; Bacci, Olivia; Borri, Chiara; Teristi, Valentina; Corezzi, Camilla; Faraoni, Sara; Antonelli, Paolo; Cargioli, Claudio; Banti, Susanna; Perugi, Giulio; Mauri, Mauro

2017-08-21

The aim of this study was to evaluate the association of maternal antenatal attachment and post-partum psychopathology, maternal-infant bonding, while checking for antenatal psychopathology, for lifetime psychiatric diagnosis and for the known risk factors for peripartum depression. One hundred and six women recruited at the first month of pregnancy (T0) were evaluated with the structured interview for DSM-IV TR (SCID-I) to assess the presence of lifetime psychiatric diagnosis and with the Perinatal Depression Predictor Inventory-Revised (PDPI-R), the Edinburgh Postnatal Depression Scale (EPDS), and the State-Trait Anxiety Inventory (STAI). At the sixth month of pregnancy (T1) and at the first month post-partum (T2), all patients were evaluated with the PDPI-R, the EPDS, the STAI, at T1, with the Maternal Antenatal Attachment Scale (MAAS), and at T2 with the Maternal Postnatal Attachment Scale (MPAS). Multivariate regression analyses showed that maternal-foetal attachment was the variable most significantly associated with postnatal symptoms of depression and anxiety and with quality of maternal-infant attachment. The logistic regression analyses showed that antenatal attachment may predict postnatal depressive and anxiety symptoms (respectively, OR: 0.83 - IC [0.74 - 0.95], p = .005, OR: 0.88 - IC [0.79 - 0.98], p = .02), and the quality of maternal postnatal attachment (OR: 1.17 - IC [1.08 - 1.27], p depression, the sociodemographic variables and lifetime psychiatric diagnosis. The quality of maternal-foetal bonding may independently predict the quality of maternal-infant attachment and post-partum depressive and anxiety symptoms. A comprehensive assessment of maternal risk factors for perinatal psychopathology during pregnancy should include the evaluation of antenatal attachment that could be modifiable by specific interventions promoting the quality of maternal bonding.

Maternal behavior of the mouse dam toward pups: implications for maternal separation model of early life stress.

Science.gov (United States)

Orso, Rodrigo; Wearick-Silva, Luis Eduardo; Creutzberg, Kerstin Camile; Centeno-Silva, Anderson; Glusman Roithmann, Laura; Pazzin, Rafaelly; Tractenberg, Saulo Gantes; Benetti, Fernando; Grassi-Oliveira, Rodrigo

2018-01-01

Maternal care is essential for an adequate pup development, as well as for the health of the dam. Exposure to stress in early stages of life can disrupt this dam-pup relationship promoting altered neurobiological and behavioral phenotypes. However, there is a lack of consensus regarding the effects of daily maternal separation (MS) on the pattern of maternal behavior. The aim of this study is to compare the patterns of maternal behavior between mice exposed to MS and controls. BALB/c mice were subjected to MS for a period of 180 min/day from postnatal day 2-7 (n = 17) or designated to be standard animal facility reared (AFR) controls (n = 19). Maternal behaviors were computed as frequency of nursing, licking pups and contact with pups, and nonmaternal behaviors were computed as frequency of actions without interaction with pups and eating/drinking. A total of 18 daily observations of maternal behavior were conducted during these six days, and considering the proportion of maternal and nonmaternal behaviors, an index was calculated. There was no difference when comparing the global index of maternal behavior between the AFR and MS animals by the end of the observed period. However, the pattern of maternal behavior between groups was significantly different. While MS dams presented low frequency of maternal behavior within the first couple days of the stress protocol, but increasing over time, AFR dams showed higher maternal behavior at the beginning, reducing over time. Together, our results indicate that MS alters the maternal behavior of the dams toward pups throughout the first week of the stress protocol and provoked some anxiety-related traits in the dams. The inversion of maternal behavior pattern could possibly be an attempt to compensate the low levels of maternal care observed in the first days of MS.

Maternal effects and maternal selection arising from variation in allocation of free amino acid to eggs

Science.gov (United States)

Newcombe, Devi; Hunt, John; Mitchell, Christopher; Moore, Allen J

2015-01-01

Maternal provisioning can have profound effects on offspring phenotypes, or maternal effects, especially early in life. One ubiquitous form of provisioning is in the makeup of egg. However, only a few studies examine the role of specific egg constituents in maternal effects, especially as they relate to maternal selection (a standardized selection gradient reflecting the covariance between maternal traits and offspring fitness). Here, we report on the evolutionary consequences of differences in maternal acquisition and allocation of amino acids to eggs. We manipulated acquisition by varying maternal diet (milkweed or sunflower) in the large milkweed bug, Oncopeltus fasciatus. Variation in allocation was detected by examining two source populations with different evolutionary histories and life-history response to sunflower as food. We measured amino acids composition in eggs in this 2 × 2 design and found significant effects of source population and maternal diet on egg and nymph mass and of source population, maternal diet, and their interaction on amino acid composition of eggs. We measured significant linear and quadratic maternal selection on offspring mass associated with variation in amino acid allocation. Visualizing the performance surface along the major axes of nonlinear selection and plotting the mean amino acid profile of eggs from each treatment onto the surface revealed a saddle-shaped fitness surface. While maternal selection appears to have influenced how females allocate amino acids, this maternal effect did not evolve equally in the two populations. Furthermore, none of the population means coincided with peak performance. Thus, we found that the composition of free amino acids in eggs was due to variation in both acquisition and allocation, which had significant fitness effects and created selection. However, although there can be an evolutionary response to novel food resources, females may be constrained from reaching phenotypic optima with

Regional differences in Dutch maternal mortality

NARCIS (Netherlands)

de Graaf, J.P.; Schutte, J.M.; Poeran, J.J.; van Roosmalen, J.; Bonsel, G.J.; Steegers, E.A.P.

2012-01-01

Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of maternal mortality. Setting Nationwide. Population A total of 3 108 235 live births and 337 maternal deaths. Methods Data analysis of all maternal deaths in the period

Maternal responsive-didactic caregiving in play interactions with 10-month-olds and cognitive development at 18 months

OpenAIRE

Mermelshtine, Roni; Barnes, Jacqueline

2016-01-01

Maternal responsive-didactic caregiving (RDC) and infant advanced object play were investigated in a sample of 400 mothers and their 10-month-old infants during video-recorded semi-structured play interactions. Three maternal behaviours: contingent response, cognitively stimulating language and autonomy promoting speech were coded and infant object play. Factor analysis confirmed the three maternal behaviours loaded onto one underlying factor, labelled RDC. Based on ecological and transaction...

Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress.

Science.gov (United States)

Baor, Liora; Soskolne, Varda

2010-06-01

This study explores the differences in prenatal maternal expectations, coping resources and maternal stress between first time mothers of IVF twins and first time mothers of spontaneously conceived twins. The role of prenatal maternal expectations in the prediction of maternal stress was examined, as well as the mediating and moderating effect of coping resources on the association between pregnancy-type group and maternal stress. Mothers of twins from various regions in Israel were included in this prospective and cross-sectional study in which 88 mothers of IVF-conceived twins and 98 mothers of spontaneously conceived twins were interviewed twice. First, at 33-36 weeks of their pregnancy they completed a socio-demographic questionnaire and the maternal expectations questionnaire; then at 6 months after birth they completed a questionnaire regarding the delivery and medical condition of the infants, and their coping resources and maternal stress. Compared with mothers who conceived spontaneously, IVF mothers had more positive prenatal maternal expectations, but poorer coping resources and higher levels of maternal stress 6 months after birth. Maternal expectations had no predictive power regarding maternal stress, although the mother's coping resources were significantly related to maternal stress and mediated the association between pregnancy type and maternal stress. IVF-pregnant women bearing twins should be considered a high-risk group. Early identification of these mothers is essential for timely psychosocial interventions in order to enhance their resources and decrease maternal stress. Further longitudinal studies are required to determine causality in more ethnically-diverse mothers of twins.

[Maternal death: unequal risks].

Science.gov (United States)

Defossez, A C; Fassin, D

1989-01-01

Nearly 99% of maternal deaths in the world each year occur in developing countries. New efforts have recently been undertaken to combat maternal mortality through research and action. The medical causes of such deaths are coming to be better understood, but the social mechanisms remain poorly grasped. Maternal mortality rates in developing countries are difficult to interpret because they tend to exclude all deaths not occurring in health care facilities. The countries of Europe and North America have an average maternal mortality rate of 30/100,000 live births, representing about 6000 deaths each year. The developing countries of Asia, Africa, and Latin America have rates of 270-640/100,000, representing some 492,000 deaths annually. For a true comparison of the risks of maternal mortality in different countries, the risk itself and the average number of children per woman must both be considered. A Nigerian woman has 375 times greater risk of maternal death than a Swedish woman, but since she has about 4 times more children, her lifetime risk of maternal death is over 1500 times greater than that of the Swedish woman. The principal medical causes of maternal death are known: hemorrhages due to placenta previa or retroplacental hematoma, mechanical dystocias responsible for uterine rupture, toxemia with eclampsia, septicemia, and malaria. The exact weight of abortion in maternal mortality is not known but is probably large. The possible measures for improving such rates are of 3 types: control of fertility to avoid early, late, or closely spaced pregnancies; effective medical surveillance of the pregnancy to reduce the risk of malaria, toxemia, and hemorrhage, and delivery in an obstetrical facility, especially for high-risk pregnancies. Differential access to high quality health care explains much of the difference between mortality rates in urban and rural, wealthy and impoverished areas of the same country. The social determinants of high maternal mortality

Maternal health Indicators Signal Optimism

African Journals Online (AJOL)

user

Maternal health Indicators Signal Optimism. Abraham Haileamlak, MD, Professor of Pediatrics and Child Health. Maternal health is a major health priority for international agencies and the Ethiopian. Government. Many low income countries including. Ethiopia, made substantial improvements in maternal health achieving ...

Factors Influencing Maternal Behavioral Adaptability: Maternal Depressive Symptoms and Child Negative Affect.

Science.gov (United States)

Hummel, Alexandra C; Kiel, Elizabeth J

2016-01-01

In early childhood, parents play an important role in children's socioemotional development. As such, parent training is a central component of many psychological interventions for young children (Reyno & McGrath, 2006). Maternal depressive symptoms have consistently been linked to maladaptive parenting behaviors (e.g., disengagement, intrusiveness), as well as to lower parent training efficacy in the context of child psychological intervention, suggesting that mothers with higher symptomatology may be less able to be adapt their behavior according to situational demands. The goal of the current study was to examine both maternal and child factors that may influence maternal behavioral adaptability. Ninety-one mothers and their toddlers ( M = 23.93 months, 59% male) participated in a laboratory visit during which children engaged in a variety of novelty episodes designed to elicit individual differences in fear/withdrawal behaviors. Mothers also completed a questionnaire battery. Maternal behavioral adaptability was operationalized as the difference in scores for maternal involvement, comforting, and protective behavior between episodes in which mothers were instructed to refrain from interaction and those in which they were instructed to act naturally. Results indicated that when children displayed high levels of negative affect in the restricted episodes, mothers with higher levels of depressive symptoms were less able to adapt their involved behavior because they exhibited low rates of involvement across episodes regardless of instruction given. The current study serves as an intermediary step in understanding how maternal depressive symptoms may influence daily interactions with their children as well as treatment implementation and outcomes, and provides initial evidence that maternal internalizing symptoms may contribute to lower behavioral adaptability in the context of certain child behaviors due to consistent low involvement.

An investigation of maternal food intake and maternal food talk as predictors of child food intake.

Science.gov (United States)

DeJesus, Jasmine M; Gelman, Susan A; Viechnicki, Gail B; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine L; Lumeng, Julie C

2018-08-01

Though parental modeling is thought to play a critical role in promoting children's healthy eating, little research has examined maternal food intake and maternal food talk as independent predictors of children's food intake. The present study examines maternal food talk during a structured eating protocol, in which mothers and their children had the opportunity to eat a series of familiar and unfamiliar vegetables and desserts. Several aspects of maternal talk during the protocol were coded, including overall food talk, directives, pronoun use, and questions. This study analyzed the predictors of maternal food talk and whether maternal food talk and maternal food intake predicted children's food intake during the protocol. Higher maternal body mass index (BMI) predicted lower amounts of food talk, pronoun use, and questions. Higher child BMI z-scores predicted more first person pronouns and more wh-questions within maternal food talk. Mothers of older children used fewer directives, fewer second person pronouns, and fewer yes/no questions. However, maternal food talk (overall and specific types of food talk) did not predict children's food intake. Instead, the most robust predictor of children's food intake during this protocol was the amount of food that mothers ate while sitting with their children. These findings emphasize the importance of modeling healthy eating through action and have implications for designing interventions to provide parents with more effective tools to promote their children's healthy eating. Copyright © 2018 Elsevier Ltd. All rights reserved.

Longitudinal relations among maternal depressive symptoms, maternal mind-mindedness, and infant attachment behavior.

Science.gov (United States)

Bigelow, Ann E; Beebe, Beatrice; Power, Michelle; Stafford, Anna-Lee; Ewing, Julie; Egleson, Anna; Kaminer, Tammy

2018-05-01

The relations among maternal depression risk, maternal mind-mindedness, and infants' attachment behavior were longitudinally examined in a community sample of mother-infant dyads. Maternal self-reported depression risk was measured at the infant ages of 6 weeks, 4 months, and 12 months. Maternal mind-mindedness, assessed from mothers' comments about infants' mental states (e.g., infants' thoughts, desires, or emotions), was measured during mother-infant interactions when infants were 4 months. Infants' attachment behavior was assessed at one year. Mothers' depression risk decreased over the infants' first year, with the sharpest decline between 6 weeks and 4 months. Mothers at risk for depression when infants were 6 weeks showed less appropriate mind-mindedness at 4 months. Mind-mindedness was not related to maternal depression risk at the infant age of 4 months or 12 months. Infants' degree of disorganized attachment behavior at one year was positively associated with maternal depression risk at 6 weeks and negatively associated with maternal appropriate mind-mindedness at 4 months. Mothers who are at risk for depression in their infants' early lives may be hampered in their capacity to respond appropriately to their infants' mental states. Infants with mothers who have difficulty responding appropriately to their mental states, as suggested by low appropriate mind-mindedness, may feel less known and recognized by their mothers, a key theme in the origins of disorganized attachment. Copyright © 2018 Elsevier Inc. All rights reserved.

Wired for motherhood: induction of maternal care but not maternal aggression in virgin female CD1 mice.

Science.gov (United States)

Martín-Sánchez, Ana; Valera-Marín, Guillermo; Hernández-Martínez, Adoración; Lanuza, Enrique; Martínez-García, Fernando; Agustín-Pavón, Carmen

2015-01-01

Virgin adult female mice display nearly spontaneous maternal care towards foster pups after a short period of sensitization. This indicates that maternal care is triggered by sensory stimulation provided by the pups and that its onset is largely independent on the physiological events related to gestation, parturition and lactation. Conversely, the factors influencing maternal aggression are poorly understood. In this study, we sought to characterize two models of maternal sensitization in the outbred CD1 strain. To do so, a group of virgin females (godmothers) were exposed to continuous cohabitation with a lactating dam and their pups from the moment of parturition, whereas a second group (pup-sensitized females), were exposed 2 h daily to foster pups. Both groups were tested for maternal behavior on postnatal days 2-4. Godmothers expressed full maternal care from the first test. Also, they expressed higher levels of crouching than dams. Pup-sensitized females differed from dams in all measures of pup-directed behavior in the first test, and expressed full maternal care after two sessions of contact with pups. However, both protocols failed to induce maternal aggression toward a male intruder after full onset of pup-directed maternal behavior, even in the presence of pups. Our study confirms that adult female mice need a short sensitization period before the onset of maternal care. Further, it shows that pup-oriented and non-pup-oriented components of maternal behavior are under different physiological control. We conclude that the godmother model might be useful to study the physiological and neural bases of the maternal behavior repertoire.

The mediated effects of maternal depression and infant temperament on maternal role.

Science.gov (United States)

Rode, Jennifer L; Kiel, Elizabeth J

2016-02-01

We examined prenatal depression, postpartum depression, and infant temperament, respectively, in a mediated process model to predict maternal role. Using a prospective, observational design, we surveyed 168 women during pregnancy and then in postpartum. Data analyses supported the contribution of each variable in an ascending fashion (ab = -0.01, SE = 0.004, 95 % CI [-0.021, -0.004]), such that infant temperament had the strongest effects (sr(2) = .124, p maternal role with both direct effects and indirect effects via infant temperament. These results highlighted the significant impact postpartum depression may have on maternal role. Future interventions targeting mothers experiencing or who are at risk for depression may consider tools to improve mother-baby interactions. The effects of such intervention may subsequently improve both infant temperament and maternal role evaluation.

Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study

Directory of Open Access Journals (Sweden)

Al Chamat Ahmad

2010-10-01

Full Text Available Abstract Background Investigating severe maternal morbidity (near-miss is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities. Methods Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005 including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR, maternal near miss ratio (MNMR, mortality indices and proportion of near-miss cases and mortality cases to hospital admissions. Results There were 28 025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100 000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52% and haemorrhage (34% were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60% while sepsis had the highest mortality index (7.4%. Most cases (93% were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%, primary (5% and secondary (10% healthcare unites and private practices (11%. 26% of near-miss cases were admitted to Intensive Care Unit (ICU. Conclusion Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to

Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study.

Science.gov (United States)

Almerie, Yara; Almerie, Muhammad Q; Matar, Hosam E; Shahrour, Yasser; Al Chamat, Ahmad Abo; Abdulsalam, Asmaa

2010-10-19

Investigating severe maternal morbidity (near-miss) is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities. Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005) including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR), maternal near miss ratio (MNMR), mortality indices and proportion of near-miss cases and mortality cases to hospital admissions. There were 28,025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100,000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52%) and haemorrhage (34%) were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60%) while sepsis had the highest mortality index (7.4%). Most cases (93%) were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%), primary (5%) and secondary (10%) healthcare unites and private practices (11%). 26% of near-miss cases were admitted to Intensive Care Unit (ICU). Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to prevent/manage post-partum haemorrhage and training health

Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity.

Science.gov (United States)

Roberts, Christine L; Ford, Jane B; Algert, Charles S; Bell, Jane C; Simpson, Judy M; Morris, Jonathan M

2009-02-25

Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI) developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH). We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000) suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3-5.3%). This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was entirely among women who experienced a PPH. Reducing or stabilising

Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity

Directory of Open Access Journals (Sweden)

Algert Charles S

2009-02-01

Full Text Available Abstract Background Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH. Methods We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Results Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000 suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3–5.3%. This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Conclusion Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was

Maternal Employment: 1979.

Science.gov (United States)

Hoffman, Lois Wladis

1979-01-01

Maternal employment is a part of modern family life, a response to changes such as smaller families and more efficient household management. Not only does maternal employment meet parents' needs, but it is a pattern better suited for socializing the child for the adult role s/he will occupy. (Author/GC)

Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status.

Science.gov (United States)

Lin, Wan-Chien; Chang, Shin-Yow; Chen, Yi-Ting; Lee, Hsin-Chien; Chen, Yi-Hua

2017-09-01

Recently, studies have begun emphasizing paternal involvement during the perinatal period and its impact on maternal health. However, most studies have assessed maternal perception and focused on adolescents or minority groups in Western countries. Therefore, the current study investigated the association between paternal involvement and maternal postnatal depression and anxiety, along with the effects of maternal job status in the Asian society of Taiwan. This study recruited pregnant women in the first trimester of pregnancy as well as their partners on prenatal visits from July 2011 to September 2013 at four selected hospitals in metropolitan areas of Taipei, Taiwan. In total, 593 parental pairs completed the first interview and responded to the follow-up questionnaires until 6 months postpartum. Self-reported data were collected, and multiple logistic regression models were used for analyses. Lower paternal childcare and nursing frequency was independently associated with an increased risk of maternal postpartum depression (adjusted odds ratio (OR) =4.33, 95% confidence interval (CI)=1.34-13.98), particularly among unemployed mothers. Furthermore, among unemployed mothers, the risk of postnatal anxiety was 3.14 times higher in couples with fathers spending less time with the child, compared with couples with fathers spending more time (95% CI=1.10-8.98). However, no significant findings were obtained for employed mothers. The high prevalence of maternal postnatal emotional disturbances warrants continual consideration. Higher paternal involvement in childcare arrangements should be emphasized to aid in ameliorating these maternal emotional disturbances, particularly among unemployed mothers. Copyright © 2017 Elsevier B.V. All rights reserved.

The perinatal and maternal outcome in pregnancy with advanced maternal age 35 years and >35 years

OpenAIRE

Pallavi S. Kalewad; Trupti Nadkarni

2016-01-01

Background: Purpose of this study is to evaluate maternal and perinatal outcome in advanced maternal age women. As numbers of pregnancies in advanced maternal age continue to grow, obstetric care provider would benefit from up to date outcome data to enhance their preconceptional and antenatal counseling. Methods: It is observational prospective analytic study, conducted in Nowrosjee Wadia maternity hospital, Parel, Mumbai. Total 100 patients were included in study, fulfilling inclusion cr...

A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland.

Science.gov (United States)

Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

2016-07-08

Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

Goodness of fit between prenatal maternal sleep and infant sleep: Associations with maternal depression and attachment security

Science.gov (United States)

Newland, Rebecca P.; Parade, Stephanie H.; Dickstein, Susan; Seifer, Ronald

2016-01-01

The current study prospectively examined the ways in which goodness of fit between maternal and infant sleep contributes to maternal depressive symptoms and the mother-child relationship across the first years of life. In a sample of 173 mother-child dyads, maternal prenatal sleep, infant sleep, maternal depressive symptoms, and mother-child attachment security were assessed via self-report, actigraphy, and observational measures. Results suggested that a poor fit between mothers’ prenatal sleep and infants’ sleep at 8 months (measured by sleep diary and actigraphy) was associated with maternal depressive symptoms at 15 months. Additionally, maternal depression mediated the association between the interplay of mother and infant sleep (measured by sleep diary) and mother-child attachment security at 30 months. Findings emphasize the importance of the match between mother and infant sleep on maternal wellbeing and mother-child relationships and highlight the role of mothers’ perceptions of infant sleep. PMID:27448324

Impact of maternal prenatal psychosocial stress and maternal obesity on infant microbiota

NARCIS (Netherlands)

Browne, P.D.; Berg, E. van den; Weerth, C. de; Browne, P.D.; Claassen, E.; Cabena, M.D.

2017-01-01

The prenatal period is a critical window of development for all major physiological systems in the human body. During pregnancy, maternal prenatal psychosocial stress (PNS) and maternal obesity are identified as risk factors for infant and child health. Several possible mechanisms have been

Maternal mortality and serious maternal morbidity in Jehovah's witnesses in The Netherlands

NARCIS (Netherlands)

van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; van Roosmalen, J.

2009-01-01

To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in The Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in The Netherlands. All

Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the Netherlands

NARCIS (Netherlands)

Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. A retrospective study of case notes. All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. All

One in Five Maternal Deaths in Bangladesh Associated with Acute Jaundice: Results from a National Maternal Mortality Survey.

Science.gov (United States)

Shah, Rupal; Nahar, Quamrun; Gurley, Emily S

2016-03-01

We estimated the proportion of maternal deaths in Bangladesh associated with acute onset of jaundice. We used verbal autopsy data from a nationally representative maternal mortality survey to calculate the proportion of maternal deaths associated with jaundice and compared it to previously published estimates. Of all maternal deaths between 2008 and 2010, 23% were associated with jaundice, compared with 19% from 1998 to 2001. Approximately one of five maternal deaths was preceded by jaundice, unchanged in 10 years. Our findings highlight the need to better understand the etiology of these maternal deaths in Bangladesh. © The American Society of Tropical Medicine and Hygiene.

Maternal and child dietary intake: The role of maternal healthy-eater self-schema.

Science.gov (United States)

Kueppers, Julie; Stein, Karen Farchaus; Groth, Susan; Fernandez, I Diana

2018-06-01

Mothers play a key role in shaping the dietary intake of their young children through their own dietary intake and the foods they make available at home. Therefore, understanding the mechanisms underlying maternal food choices is crucial. Cognitions about the self as a healthy eater, referred to as healthy-eater self-schema (HESS), predict dietary intake in diverse samples, but the linkage has not been investigated in mothers and their feeding behaviors. This study examined the relationship between a maternal HESS, maternal and child intake of fruits, vegetables, saturated fat, and added sugar, and home food availability. A cross-sectional, descriptive design was used with mothers and their 2-5 year old children (N = 124 dyads). Kendzierski's Healthy-Eater Self-Schema questionnaire was used to measure HESS. Block Food Frequency Screeners were used to measure diets (mother and child) and the Home Environment Survey was used to measure home availability of fruits/vegetables and fats/sweets. Multiple regression and multiple mediation analyses were performed. Maternal HESS was positively associated with maternal intake of fruits and vegetables, and negatively associated with intake of added sugar. Maternal HESS was not directly associated with child dietary intake, but was indirectly associated with child intake of fruits, vegetables, and added sugar through maternal intake of the same foods. Home food availability was not significantly associated with HESS. This study found that a mother's HESS was positively associated with her diet, which was subsequently associated with aspects of her child's diet. Interventions to foster development of HESS in mothers may be an effective means to promote healthy dietary intake in mothers and their young children. Copyright © 2018 Elsevier Ltd. All rights reserved.

Maternity-care: measuring women's perceptions.

Science.gov (United States)

Clark, Kim; Beatty, Shelley; Reibel, Tracy

2016-01-01

Achieving maternity-care outcomes that align with women's needs, preferences and expectations is important but theoretically driven measures of women's satisfaction with their entire maternity-care experience do not appear to exist. The purpose of this paper is to outline the development of an instrument to assess women's perception of their entire maternity-care experience. A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory factor analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire. Nine theoretically informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women's expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care. Reliable and valid tools for monitoring the extent to which services respond to women's expectations of their entire maternity care form part of the broader toolkit required to adequately manage health-care quality. This study offers guidance on the make-up of such tools. The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.

Evidence from Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

Science.gov (United States)

Baker, Michael; Milligan, Kevin

2010-01-01

We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent 48-58 percent more time not working in their children's first year of life. This extra maternal care primarily crowded out home-based care by unlicensed…

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.

Science.gov (United States)

Haider, Mohammad Rifat; Rahman, Mohammad Masudur; Moinuddin, Md; Rahman, Ahmed Ehsanur; Ahmed, Shakil; Khan, M Mahmud

2017-01-01

Despite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization. Two surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index. Mean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370). Overall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups

Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology

DEFF Research Database (Denmark)

Wennberg, Anna Lena; Opdahl, Signe; Bergh, Christina

2016-01-01

weeks), low birth weight (LBW; mortality (≥28 weeks). Adjusted odds ratios (AORs) were calculated. Associations between maternal age and outcomes were analyzed. RESULT(S): The risk of placenta previa (AOR 4.11-6.05), cesarean delivery (AOR 1......OBJECTIVE: To compare the effect of maternal age on assisted reproductive technology (ART) and spontaneous conception (SC) pregnancies regarding maternal and neonatal complications. DESIGN: Nordic retrospective population-based cohort study. Data from national ART registries were cross.......18-1.50), PTB (AOR 1.23-2.19), and LBW (AOR 1.44-2.35) was significantly higher in ART than in SC pregnancies for most maternal ages. In both ART and SC pregnancies, the risk of HDP, placenta previa, cesarean delivery, PTB, LBW, and SGA changed significantly with age. The AORs for adverse neonatal outcomes...

Goodbye, Mandatory Maternity Leaves

Science.gov (United States)

Nation's Schools, 1972

1972-01-01

In precedent-setting decrees, courts and federal and State authorities have branded compulsory maternity leaves either unconstitutional or illegal. School administrators are urged to prod boards of education to adopt more lenient maternity leave policies -- now. (Author)

Goodness of fit between prenatal maternal sleep and infant sleep: Associations with maternal depression and attachment security.

Science.gov (United States)

Newland, Rebecca P; Parade, Stephanie H; Dickstein, Susan; Seifer, Ronald

2016-08-01

The current study prospectively examined the ways in which goodness of fit between maternal and infant sleep contributes to maternal depressive symptoms and the mother-child relationship across the first years of life. In a sample of 173 mother-child dyads, maternal prenatal sleep, infant sleep, maternal depressive symptoms, and mother-child attachment security were assessed via self-report, actigraphy, and observational measures. Results suggested that a poor fit between mothers' prenatal sleep and infants' sleep at 8 months (measured by sleep diary and actigraphy) was associated with maternal depressive symptoms at 15 months. Additionally, maternal depression mediated the association between the interplay of mother and infant sleep (measured by sleep diary) and mother-child attachment security at 30 months. Findings emphasize the importance of the match between mother and infant sleep on maternal wellbeing and mother-child relationships and highlight the role of mothers' perceptions of infant sleep. Copyright © 2016 Elsevier Inc. All rights reserved.

Poverty and Maternal Responsiveness: The Role of Maternal Stress and Social Resources

Science.gov (United States)

Evans, Gary W.; Boxhill, Louise; Pinkava, Michael

2008-01-01

One of the main reasons poverty is bad for children's development is because it reduces maternal responsiveness. This study addresses a heretofore unanswered question: why do low-income children experience diminished maternal responsiveness compared with their more affluent counterparts? In addition, we examine this question among a largely…

Maternal mortality and maternity care from 1990 to 2005: uneven but important gains.

Science.gov (United States)

Shah, Iqbal H; Say, Lale

2007-11-01

Maternal mortality continues to be the major cause of death among women of reproductive age in many countries. Data from published studies and Demographic and Health Surveys show that gains in reducing maternal mortality between 1990 and 2005 have been modest overall. In 2005, there were about 536,000 maternal deaths, and the maternal mortality ratio was estimated at 400 per 100,000 live births, compared to 430 in 1990. Noteworthy declines took place in east Asia (4% per year) and north Africa (3% per year). Maternal deaths and mortality ratios were highest in sub-Saharan Africa and southeast Asia and low in east Asia and Latin America/Caribbean. In 11 of 53 countries with data, fewer than 25% of women had had at least four antenatal visits. About 63% of births were attended by a skilled attendant: from 47% in Africa to 88% in Latin America/Caribbean. In 16 of 23 countries with data, less than 50% of the recommended levels of emergency obstetric care had been fulfilled. Only 61% of women who delivered in a health facility in 30 developing countries received post-partum care, and far fewer who gave birth at home. Countries with maternal mortality ratios of 750+ per 100,000 live births shared problems of high fertility and unplanned pregnancies, poor health infrastructure with limited resources and low availability of health personnel. The task ahead is enormous.

Rise in maternal mortality in the Netherlands

NARCIS (Netherlands)

Schutte, J. M.; Steegers, E. A. P.; Schuitemaker, N. W. E.; Santema, J. G.; de Boer, K.; Pel, M.; Vermeulen, G.; Visser, W.; van Roosmalen, J.

2010-01-01

To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. Nationwide in the Netherlands. 2,557,208 live births. Data analysis of all maternal deaths in the period 1993-2005. Maternal mortality.

Problems of contemporary maternity: psychological aspect

Directory of Open Access Journals (Sweden)

I. V. Puz

2013-08-01

Full Text Available This article deals with the problems of modern motherhood and studies the phenomenon of deviant maternal behavior. Based on the literature, present study analyzes such forms of violation of maternal behavior as mother's refusal from a baby; mother's cruel treatment of a baby; frequent abortions; maternity in the early reproductive age; conscious maternity postponement for a later reproductive age. Also the factors that contribute to various manifestations of deviant motherhood are described.

Maternal cardiac metabolism in pregnancy

Science.gov (United States)

Liu, Laura X.; Arany, Zolt

2014-01-01

Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

Maternal Support of Children's Early Numerical Concept Learning Predicts Preschool and First-Grade Math Achievement.

Science.gov (United States)

Casey, Beth M; Lombardi, Caitlin M; Thomson, Dana; Nguyen, Hoa Nha; Paz, Melissa; Theriault, Cote A; Dearing, Eric

2018-01-01

The primary goal in this study was to examine maternal support of numerical concepts at 36 months as predictors of math achievement at 4½ and 6-7 years. Observational measures of mother-child interactions (n = 140) were used to examine type of support for numerical concepts. Maternal support that involved labeling the quantities of sets of objects was predictive of later child math achievement. This association was significant for preschool (d = .45) and first-grade math (d = .49), controlling for other forms of numerical support (identifying numerals, one-to-one counting) as well as potential confounding factors. The importance of maternal support of labeling set sizes at 36 months is discussed as a precursor to children's eventual understanding of the cardinal principle. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Associations between maternal hormonal biomarkers and maternal mental and physical health of very low birth weight infants

Directory of Open Access Journals (Sweden)

June Cho

2016-12-01

Full Text Available The purpose of this study was to determine whether maternal mental and physical health is associated with maternal testosterone and cortisol levels, parenting of very low birth weight infants, physical exercise, and White vs non-White race. A total of 40 mothers of very low birth weight infants were recruited from a neonatal intensive care unit at a University Hospital in the Southeast United States. Data were collected through a review of medical records, standardized questionnaires, and biochemical measurement. Maternal mental and physical health status using questionnaires as well as maternal testosterone and cortisol levels using an enzyme immunoassay were measured four times (birth, 40 weeks postmenstrual age [PMA], and 6 and 12 months [age of infant, corrected age]. General linear models showed that higher testosterone levels were associated with greater depressive symptoms, stress, and poorer physical health at 40 weeks PMA, and at 6 and 12 months. High cortisol levels were associated with greater anxiety at 40 weeks PMA; however, with better mental and physical health at 40 weeks PMA, and 6 and 12 months. Physical activity was associated with lower maternal perceived stress at 12 months. Maternal health did not differ by race, except anxiety, which was higher in White than non-White mothers after birth. As very low birth weight infants grew up, maternal physical health improved but mental health deteriorated. Testosterone and cortisol levels were found to be positively correlated in women but testosterone was more predictive of maternal mental and physical health than cortisol. Indeed testosterone consistently showed its associations with maternal health. Maternal stress might be improved through regular physical exercise.

PPO.02 Severe maternal morbidity in Ireland

NARCIS (Netherlands)

Manning, E.; Lutomski, J.E.; O'Connor, L.; Corcoran, P.; Greene, R.

2014-01-01

OBJECTIVE: To assess the incidence of severe maternal morbidity (SMM) and examine associated factors in Ireland. METHODS: In 2011, 67,806 maternities were reported from 19 maternity units, representing 93% of maternities in Ireland. SMM was classified as the presence of one or more of 15 categories

Maternal Characteristics Predicting Young Girls’ Disruptive Behavior

Science.gov (United States)

van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

2011-01-01

Little is known about the relative predictive utility of maternal characteristics and parenting skills on the development of girls’ disruptive behavior. The current study used five waves of parent and child-report data from the ongoing Pittsburgh Girls Study to examine these relationships in a sample of 1,942 girls from age 7 to 12 years. Multivariate Generalized Estimating Equation (GEE) analyses indicated that European American race, mother’s prenatal nicotine use, maternal depression, maternal conduct problems prior to age 15, and low maternal warmth explained unique variance. Maladaptive parenting partly mediated the effects of maternal depression and maternal conduct problems. Both current and early maternal risk factors have an impact on young girls’ disruptive behavior, providing support for the timing and focus of the prevention of girls’ disruptive behavior. PMID:21391016

Maternal burn-out: an exploratory study.

Science.gov (United States)

Séjourné, N; Sanchez-Rodriguez, R; Leboullenger, A; Callahan, S

2018-02-21

Maternal burn-out is a psychological, emotional and physiological condition resulting from the accumulation of various stressors characterised by a moderate but also a chronic and repetitive dimension. Little research has focused on this syndrome. The current study aims to assess maternal burn-out rate and to identify factors associated with this state of exhaustion. 263 French mothers aged between 20 and 49 years answered five scales quantifying maternal burn-out, perceived social support, parental stress, depression and anxiety symptoms and history of postnatal depression. About 20% of mothers were affected by maternal burn-out. The main factors related to maternal burn-out were having a child perceived as difficult, history of postnatal depression, anxiety, satisfaction of a balance between professional and personal life and parental stress. This research shows the need for further work on maternal burn-out to better understand and prevent this syndrome.

The relations among maternal depressive disorder, maternal Expressed Emotion, and toddler behavior problems and attachment

OpenAIRE

Gravener, Julie A.; Rogosch, Fred A.; Oshri, Assaf; Narayan, Angela J.; Cicchetti, Dante; Toth, Sheree L.

2012-01-01

Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior prob...

Relations among Intimate Partner Violence, Maternal Depressive Symptoms, and Maternal Parenting Behaviors

Science.gov (United States)

Gustafsson, Hanna C.; Cox, Martha J.

2012-01-01

The authors examined the relations among intimate partner violence (IPV), maternal depressive symptoms, and maternal harsh intrusive parenting. Using a cross-lagged, autoregressive path model, they sought to clarify the directionality of the relations among these 3 variables over the first 2 years of the child's life. The results indicated that,…

Trajectories of parenting behavior and maternal depression.

Science.gov (United States)

Azak, Schale; Raeder, Sabine

2013-06-01

This study investigated trajectories of maternal parenting behavior across the infants' first 18 months of life in relation to maternal depression. Furthermore, predictors of the quality of the mother-infant relationship at 18 months were examined. Participants consisted of three types of mother-infant dyads: mothers with comorbid depression and anxiety (n=19), mothers with depression (n=7) and nondepressed mothers (n=24). Maternal behaviors and the quality of relationship were rated on a global scale (NICHD) from video-taped mother-infant interactions. Maternal behaviors rated at six, 12 and 18 months were collapsed into a composite variable maternal style. The quality of the relationship captured as dyadic mutuality was rated at 18 months. Comorbid and depressed mothers showed lower quality in maternal style compared with the nondepressed mothers at six months. Over the follow-up the comorbid mothers were lower in maternal style compared to the nondepressed mothers, but the comorbid mothers increased significantly in maternal style despite elevated depression symptoms. Mean maternal style and infant cognitive skills predicted the quality in relationship at 18 months suggesting that the mother-toddler relationship depends on contributions from the mother and the child. Higher growth in maternal style despite of depression symptoms among comorbid mothers was interpreted against the background that the majority of the comorbid mother-infant dyads received several treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on the offspring

Directory of Open Access Journals (Sweden)

Jocelien DA Olivier

2013-05-01

Full Text Available It has been estimated that 20% of pregnant women suffer from depression and it is well documented that maternal depression can have long-lasting effects on the child. Currently, common treatment for maternal depression has been the selective serotonin reuptake inhibitor medications (SSRIs which are used by 2-3% of pregnant women in the Nordic countries and by up to 10% of pregnant women in the United States. Antidepressants cross the placenta and are transferred to the fetus, thus, the question arises as to whether children of women taking antidepressants are at risk for altered neurodevelopmental outcomes and, if so, whether the risks are due to SSRI medication exposure or to the underlying maternal depression. This review considers the effects of maternal depression and SSRI exposure on offspring development in both clinical and preclinical populations. As it is impossible in humans to study the effects of SSRIs without taking into account the possible underlying effects of maternal depression (healthy pregnant women do not take SSRIs, animal models are of great value. For example, rodents can be used to determine the effects of maternal depression and/or perinatal SSRI exposure on offspring outcomes. Unraveling the joint (or separate effects of maternal depression and SSRI exposure will provide more insights into the risks or benefits of SSRI exposure during gestation and will help women make informed decisions about using SSRIs during pregnancy.

Intergenerational Transmission of Internalizing Behavior: The Role of Maternal Psychopathology, Child Responsiveness and Maternal Attachment Style Insecurity.

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Reck, Corinna; Nonnenmacher, Nora; Zietlow, Anna-Lena

Maternal depression and anxiety disorders are risk factors for the development of internalizing disorders in offspring. Maternal attachment has been discussed as one factor accounting for transmission. The aim of this study was to investigate child internalizing behavior at preschool age on a symptomatic and behavioral level and possible links to maternal mental health over time and maternal attachment style insecurity in a sample of postpartum depressed and anxious mothers. Child internalizing behavior at preschool age was rated by the Child Behavior Checklist (CBCL), the Caregiver-Teacher Report Form (C-TRF), and during a mother-child free-play situation. We focused on child responsiveness as it has been linked to child internalizing behavior. Maternal attachment style insecurity was tested to mediate the link between maternal mental health (assessed postpartum and at preschool age with the Structured Clinical Interview for DSM-IV Axis-I Disorders, SCID-I) and child internalizing behavior/child responsiveness. Of the overall sample (n = 58), 28 women were diagnosed with postpartum depression and/or anxiety disorders according to DSM-IV, and 30 were healthy controls. Data were collected 3-9 months after delivery and at preschool age (mean = 4.6 years). At preschool age, children of postpartum depressed and anxious mothers were rated significantly higher on child internalizing behavior by mothers, fathers, and additional caregivers compared to the control group. Child internalizing behavior rated by mothers was influenced by current psychiatric symptoms; maternal attachment style insecurity did not mediate this link. During interaction, children in the clinical group displayed significantly less child responsiveness compared to the control group. Maternal attachment style insecurity mediated the relationship between maternal mental health over time and child responsiveness. The results emphasize the need for interventions focusing on mother-child interaction and

Infant feeding-related maternity care practices and maternal report of breastfeeding outcomes.

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Nelson, Jennifer M; Perrine, Cria G; Freedman, David S; Williams, Letitia; Morrow, Brian; Smith, Ruben A; Dee, Deborah L

2018-02-07

Evidence-based maternity practices and policies can improve breastfeeding duration and exclusivity. Maternity facilities report practices through the Maternity Practices in Infant Nutrition and Care (mPINC) survey, but individual outcomes, such as breastfeeding duration and exclusivity, are not collected. mPINC data on maternity care practices for 2009 were linked to data from the 2009 Pregnancy Risk Assessment Monitoring System (PRAMS), which collects information on mothers' behaviors and experiences around pregnancy. We calculated total mPINC scores (range 0-100). PRAMS data on any and exclusive breastfeeding at 8 weeks were examined by total mPINC score quartile. Of 15 715 women in our sample, 53.7% were breastfeeding any at 8 weeks, and 29.3% were breastfeeding exclusively. They gave birth at 1016 facilities that had a mean total mPINC score of 65/100 (range 19-99). Care dimension subscores ranged from 41 for facility discharge care to 81 for breastfeeding assistance. In multivariable analysis adjusting for covariates, a positive relationship was found between total mPINC score quartile and both any breastfeeding (quartile 2: odds ratio [OR] 1.40 [95% confidence interval {CI} 1.08-1.83], quartile 3: OR 1.50 [95% CI 1.15-1.96], quartile 4: OR 2.12 [95% CI 1.61-2.78] vs quartile 1) and exclusive breastfeeding (quartile 3: OR 1.41 [95% CI 1.04-1.90], quartile 4: OR 1.89 [95% CI 1.41-2.55] vs quartile 1) at 8 weeks. These data demonstrate that evidence-based maternity care practices and policies are associated with better breastfeeding outcomes. Maternity facilities may evaluate their practices and policies to ensure they are helping mothers achieve their breastfeeding goals. © 2018 Wiley Periodicals, Inc.

The maternal early warning criteria: a proposal from the national partnership for maternal safety.

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Mhyre, Jill M; D'Oria, Robyn; Hameed, Afshan B; Lappen, Justin R; Holley, Sharon L; Hunter, Stephen K; Jones, Robin L; King, Jeffrey C; D'Alton, Mary E

2014-01-01

Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems, describes The Maternal Early Warning Criteria, and provides considerations for local implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Food availability and maternal immunization affect transfer and persistence of maternal antibodies in nestling pigeons.

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Ahmad Ismail

Full Text Available The ability of mothers to transfer antibodies (Abs to their young and the temporal persistence of maternal Abs in offspring constitute important life-history traits that can impact the evolution of host-parasite interactions. Here, we examined the effects of food availability and parental immunization on the transfer and persistence of maternal antibodies in nestling pigeons (Columba livia. This species can transmit maternal Abs to offspring before hatching through the egg yolk and potentially after hatching through crop milk. However, the role of this postnatal substance in immunity remains elusive. We used a full cross-fostering design to disentangle the effects of food limitation and parental immunization both before and after hatching on the levels and persistence of maternal Abs in chicks. Parents were immunized via injection with keyhole limpet hemocyanin antigens. Using an immunoassay that specifically detected the IgY antibodies that are known to be transmitted via the yolk, we found that the levels of anti-KLH Abs in newly hatched chicks were positively correlated with the levels of anti-KLH Abs in the blood of their biological mothers. However, this correlation was not present between chicks and their foster parents, suggesting limited IgY transfer via crop milk to the chick's bloodstream. Interestingly, biological mothers subjected to food limitation during egg laying transferred significantly fewer specific maternal Abs, which suggests that the transfer of antibodies might be costly for them. In addition, the persistence of maternal Abs in a chick's bloodstream was not affected by food limitation or the foster parents' anti-KLH Ab levels; it was only affected by the initial level of maternal anti-KLH Abs that were present in newly hatched chicks. These results suggest that the maternal transfer of Abs could be costly but that their persistence in an offspring's bloodstream may not necessarily be affected by environmental conditions.

National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity

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Gülmezoglu A Metin

2005-12-01

Full Text Available Abstract Background Despite the worldwide commitment to improving maternal health, measuring, monitoring and comparing maternal mortality estimates remain a challenge. Due to lack of data, international agencies have to rely on mathematical models to assess its global burden. In order to assist in mapping the burden of reproductive ill-health, we conducted a systematic review of incidence/prevalence of maternal mortality and morbidity. Methods We followed the standard methodology for systematic reviews. This manuscript presents nationally representative estimates of maternal mortality derived from the systematic review. Using regression models, relationships between study-specific and country-specific variables with the maternal mortality estimates are explored in order to assist further modelling to predict maternal mortality. Results Maternal mortality estimates included 141 countries and represent 78.1% of the live births worldwide. As expected, large variability between countries, and within regions and subregions, is identified. Analysis of variability according to study characteristics did not yield useful results given the high correlation with each other, with development status and region. A regression model including selected country-specific variables was able to explain 90% of the variability of the maternal mortality estimates. Among all country-specific variables selected for the analysis, three had the strongest relationships with maternal mortality: proportion of deliveries assisted by a skilled birth attendant, infant mortality rate and health expenditure per capita. Conclusion With the exception of developed countries, variability of national maternal mortality estimates is large even within subregions. It seems more appropriate to study such variation through differentials in other national and subnational characteristics. Other than region, study of country-specific variables suggests infant mortality rate, skilled birth

Maternal mood and concordant maternal and infant salivary cortisol during heel lance while in kangaroo care.

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Castral, T C; Warnock, F; Dos Santos, C B; Daré, M F; Moreira, A C; Antonini, S R R; Scochi, C G S

2015-03-01

Maternal kangaroo care (MKC) is a naturalistic intervention that alleviates neonatal pain, and mothers are assumed to play a stress regulatory role in MKC. Yet, no MKC infant pain study has examined relationship between maternal and infant stress reactivity concurrently, or whether post-partum depression and/or anxiety (PPDA) alters maternal and neonatal stress response and the regulatory effects of MKC. To examine the concordance of salivary cortisol reactivity between 42 mothers and their stable preterm infants during routine infant heel lance (HL) while in MKC and to compare salivary cortisol between groups of mothers with and without PPDA and their infants. Maternal and infant salivary cortisol samples were collected pre-HL and 20 min post-HL with two additional maternal samples at night and in the morning. Mothers and infants were allocated to with PPDA versus without PPDA study groups on the basis of maternal post-natal mental health assessment scores. Higher mothers' cortisol pre-HL was weakly associated with higher infants' salivary cortisol in response to the HL procedure. Maternal depression and/or anxiety were not associated with infants' cortisol. During HL, both groups of mothers and infants showed no change in salivary cortisol. Concordance between mother and infant salivary cortisol supports the maternal stress regulatory role in MKC. MKC may have stress regulatory benefits for mothers and their preterm infants during HL independent of PPDA. Future MKC studies that target mothers with altered mood will help to build on these findings. © 2014 European Pain Federation - EFIC®

Maternal bereavement and cryptorchidism in offspring

DEFF Research Database (Denmark)

Ingstrup, Katja Glejsted; Olsen, Jørn; Wu, Chunsen

2015-01-01

BACKGROUND: Cryptorchidism (undescended testis) is a common anomaly with largely unexplained etiology. Animal studies have suggested maternal emotional stress as a potential risk factor, but this has not been studied in humans. We aimed to investigate whether maternal bereavement due to the death...... interval = 0.92-1.14]). Results were similar when the diagnosis was verified with surgery. We adjusted for maternal and paternal age, birth year, and family history of cryptorchidism. CONCLUSION: We observed no association between maternal bereavement before and during pregnancy and the occurrence...

Dopamine antagonists during parturition disrupt maternal care and the retention of maternal behavior in rats.

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Byrnes, Elizabeth M; Rigero, Beth A; Bridges, Robert S

2002-11-01

Brief contact with pups at parturition enables the female rat to establish and retain the full repertoire of maternal behaviors, allowing her to respond rapidly to pups in the future. To determine whether the dopamine system is involved in the retention of maternal behavior, females were continuously infused with dopamine antagonists during the periparturitional period and then allowed either a brief interaction period with pups (3 h) or no interaction with pups (pups removed as they were born). Females were exposed to either the D1-like antagonist SCH 23390 (0.1 or 1.0 mg/kg/day) or the D2-like antagonist clebopride (0.5 or 1.0 mg/kg/day). The high dose of either DA antagonist resulted in significant attenuation of maternal care immediately postpartum. When tested for the retention of maternal behavior 7 days later, however, only the females exposed to the D2 antagonist displayed a delayed response to shown full maternal behavior (FMB) towards donor pups. Thus, while both dopamine receptor subtypes appear necessary for the full and rapid expression of maternal behavior during the early postpartum period, only the D2 receptor subtype appears to be involved in the retention of this behavior.

Oxytocin in the medial prefrontal cortex regulates maternal care, maternal aggression and anxiety during the postpartum period

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Sabihi, Sara; Dong, Shirley M.; Durosko, Nicole E.; Leuner, Benedetta

2014-01-01

The neuropeptide oxytocin (OT) acts on a widespread network of brain regions to regulate numerous behavioral adaptations during the postpartum period including maternal care, maternal aggression, and anxiety. In the present study, we examined whether this network also includes the medial prefrontal cortex (mPFC). We found that bilateral infusion of a highly specific oxytocin receptor antagonist (OTR-A) into the prelimbic (PL) region of the mPFC increased anxiety-like behavior in postpartum, but not virgin, females. In addition, OTR blockade in the postpartum mPFC impaired maternal care behaviors and enhanced maternal aggression. Overall, these results suggest that OT in the mPFC modulates maternal care and aggression, as well as anxiety-like behavior, during the postpartum period. Although the relationship among these behaviors is complicated and further investigation is required to refine our understanding of OT actions in the maternal mPFC, these data nonetheless provide new insights into neural circuitry of OT-mediated postpartum behaviors. PMID:25147513

Maternal depression and co-occurring antisocial behaviour: testing maternal hostility and warmth as mediators of risk for offspring psychopathology.

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Sellers, Ruth; Harold, Gordon T; Elam, Kit; Rhoades, Kimberly A; Potter, Robert; Mars, Becky; Craddock, Nick; Thapar, Anita; Collishaw, Stephan

2014-01-01

Disruption in the parent-child relationship is a commonly hypothesized risk factor through which maternal depression may increase risk for offspring psychopathology. However, maternal depression is commonly accompanied by other psychopathology, including antisocial behaviour. Few studies have examined the role of co-occurring psychopathology in depressed mothers. Using a longitudinal study of offspring of mothers with recurrent depression, we aimed to test whether maternal warmth/hostility mediated links between maternal depression severity and child outcomes, and how far direct and indirect pathways were robust to controls for co-occurring maternal antisocial behaviour. Mothers with a history of recurrent major depressive disorder and their adolescent offspring (9-17 years at baseline) were assessed three times between 2007 and 2010. Mothers completed questionnaires assessing their own depression severity and antisocial behaviour at Time 1 (T1). The parent-child relationship was assessed using parent-rated questionnaire and interviewer-rated 5-min speech sample at Time 2 (T2). Offspring symptoms of depression and disruptive behaviours were assessed using the Child and Adolescent Psychiatric Assessment at Time 3 (T3). Maternal hostility and warmth, respectively, mediated the association between maternal depression severity and risk for offspring psychopathology. However, the effects were attenuated when maternal antisocial behaviour was included in the analysis. In tests of the full theoretical model, maternal antisocial behaviour predicted both maternal hostility and low warmth, maternal hostility predicted offspring disruptive behaviour disorder symptoms, but not depression, and maternal warmth was not associated with either child outcome. Parenting interventions aimed at reducing hostility may be beneficial for preventing or reducing adolescent disruptive behaviours in offspring of depressed mothers, especially when depressed mothers report co

Maternal response to child affect: Role of maternal depression and relationship quality.

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Morgan, Judith K; Ambrosia, Marigrace; Forbes, Erika E; Cyranowski, Jill M; Amole, Marlissa C; Silk, Jennifer S; Elliott, Rosalind D; Swartz, Holly A

2015-11-15

Maternal depression is associated with negative outcomes for offspring, including increased incidence of child psychopathology. Quality of mother-child relationships can be compromised among affectively ill dyads, such as those characterized by maternal depression and child psychopathology, and negatively impact outcomes bidirectionally. Little is known about the neural mechanisms that may modulate depressed mothers' responses to their psychiatrically ill children during middle childhood and adolescence, partially because of a need for ecologically valid personally relevant fMRI tasks that might most effectively elicit these neural mechanisms. The current project evaluated maternal response to child positive and negative affective video clips in 19 depressed mothers with psychiatrically ill offspring using a novel fMRI task. The task elicited activation in the ventral striatum when mothers viewed positive clips and insula when mothers viewed negative clips of their own (versus unfamiliar) children. Both types of clips elicited activation in regions associated with affect regulation and self-related and social processing. Greater lifetime number of depressive episodes, comorbid anxiety, and poor mother-child relationship quality all emerged as predictors of maternal response to child affect. Findings may be specific to dyads with psychiatrically ill children. Altered neural response to child affect may be an important characteristic of chronic maternal depression and may impact mother-child relationships negatively. Existing interventions for depression may be improved by helping mothers respond to their children's affect more adaptively. Copyright © 2015 Elsevier B.V. All rights reserved.

Maternity leave in normal pregnancy.

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Leduc, Dean

2011-08-01

To assist maternity care providers in recognizing and discussing health- and illness-related issues in pregnancy and their relationship to maternity benefits. Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2009 using appropriate controlled vocabulary (e.g., maternity benefits) and key words (e.g., maternity, benefits, pregnancy). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2009. Grey (unpublished) literature was identified through searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.

Maternal Feeding Goals and Restaurant Menu Choices for Young Children.

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Domoff, Sarah E; Kiefner-Burmeister, Allison; Hoffmann, Debra A; Musher-Eizenman, Dara

2015-08-01

Childhood obesity remains a major public health issue. One recent effort to improve the obesogenic environment is mandating that restaurants provide calorie and other nutritional content on menus. Little is known about whether maternal feeding for young children is influenced by calorie disclosure on menus. This study examined (1) whether maternal feeding goals associate with mothers' food selections for their young children and (2) whether mothers change entrée and side selections for their children when calories/fat grams are listed on menus. One-hundred seventy mothers of children ages of 3-6 years participated in an online survey. Most participants identified as white (76.5%), with a mean BMI of 25.68 (standard deviation=5.94). Mothers were presented two menus (one with and one without calorie/fat information). The goal of feeding for the child's familiarity with the food was significantly associated with mothers' selection of original side dish and entrées, with greater endorsement of this goal associated with choosing high-calorie/-fat sides and entrées. Feeding for natural content was associated with mothers' selection of original entrée, with greater endorsement of this goal associated with choosing low-calorie/-fat entrées. Significantly fewer mothers chose a higher-calorie entrée when there was menu labeling. Maternal feeding goals are associated with mothers' selection of entrée and side dishes on restaurant menus. Results from this study suggest that menu labeling of calories and fat grams may influence entrée choices by mothers. Targeting mothers' feeding goals and labeling restaurant menus may improve the diets of young children.

Measures of Maternal Socioeconomic Status in Yemen and Association with Maternal and Child Health Outcomes.

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Alosaimi, Abdullah N; Luoto, Riitta; Al Serouri, Abdul Wahed; Nwaru, Bright I; Mouniri, Halima

2016-02-01

Reliable measurement of socioeconomic status (SES) in health research requires extensive resources and can be challenging in low-income countries. We aimed to develop a set of maternal SES indices and investigate their associations with maternal and child health outcomes in rural Yemen. We applied factor analysis based on principal component analysis extraction to construct the SES indices by capturing household attributes for 7295 women of reproductive age. Data were collected from a sub-national household survey conducted in six rural districts in four Yemeni provinces in 2008-2009. Logistic regression models were fitted to estimate the associations between the SES indices and maternal mortality, spontaneous abortion, stillbirth, neonatal and infant mortality. Three SES indices (wealth, educational and housing quality) were extracted, which together explained 54 % of the total variation in SES. Factor scores were derived and categorized into tertiles. After adjusting for potential confounding factors, higher tertiles of all the indices were inversely associated with spontaneous abortion. Higher tertiles of wealth and educational indices were inversely associated with stillbirth, neonatal and infant mortality. None of the SES indices was strongly associated with maternal mortality. By subjecting a number of household attributes to factor analysis, we derived three SES indices (wealth, educational, and housing quality) that are useful for maternal and child health research in rural Yemen. The indices were worthwhile in predicting a number of maternal and child health outcomes. In low-income settings, failure to account for the multidimensionality of SES may underestimate the influence of SES on maternal and child health.

Maternal mortality in Denmark, 1985-1994

DEFF Research Database (Denmark)

Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit

2008-01-01

fortuitous causes. Hypertensive disorders of pregnancy were the major cause of direct maternal deaths. The rate of maternal deaths constituted 9.8/100,000 maternities (i.e. the number of women delivering registrable live births at any gestation or stillbirths at 24 weeks of gestation or later). CONCLUSION......: This is the first systematic report on deaths in Denmark based on data from national registries. The maternal mortality rate in Denmark is comparable to the rates in other developed countries. Fortunately, statistics are low, but each case represents potential learning. Obstetric care has changed and classification...

Epidemiology of Maternal Mortality in Malawi

African Journals Online (AJOL)

live births. Causes and determinants of maternal mortal- ity. Global causes of maternal mortality. Across the globe the causes of maternal deaths are strik- ..... at home”. Findings from Thyolo, Mangochi and Chik- wawa were similar". Perceived qua/ity of care. Like anywhere in the world, the perceived quality of care in ...

KEMATIAN MATERNAL DI NUSA TENGGARA TIMUR

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Emiliana Tjitra

2012-09-01

Full Text Available A prospective study was carried out in villages around health centers, which were distributed over 10 regencies in Timor island of East Nusa Tenggara province. All deaths occurring in 1986 were recorded and reported to the health centers. Each case was investigated by the health center doctor to identify the multiple causes of death as well as its related factors. Pregnancy and delivery histories of maternal deaths were analysed. In the study area, the maternal mortality ratio was found to be 1346 per 100,000 live births, and the maternal mortality rate was 101 per 100,000 women aged 15-49 years. The maternal mortality ratio, among women under 20 years of age, was 3390 per 100,000 live births; and 4545 per 100,000 live births among women aged 40 years and over. The predominant factor as a risk of maternal deaths was attributable to delivery assistance by non medical personnel, which was 71%. Maternal deaths attributable to the first parities was 40%, and to pregnancies without antenatal care was 20.1%}. The most prevalent disease causing maternal deaths were haemorrhage 46.2%}, postpartum infections 30.8% and retained placenta 30.8%. To reduce maternal mortality, the most important intervention is to provide qualified delivery assistants especially for the first parities, and the provision of accessible delivery centers for emergency cases in addition to provision of appropriate antenatal care for early detection of high risk pregnancies. Family planning programs will have to be more specified towards high risk groups, i.e women aged under 20 years or 35 years and over, as well as women of high parity. A similar study is recommended to be conducted throughout the other parts of East Nusa Tenggara islands in order to evaluate the general maternal health status of the province.

The role of maternal stress during pregnancy, maternal discipline, and child COMT Val158Met genotype in the development of compliance.

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Kok, Rianne; Bakermans-Kranenburg, Marian J; van Ijzendoorn, Marinus H; Velders, Fleur P; Linting, Mariëlle; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2013-07-01

Maternal discipline is an important predictor of child committed compliance. Maternal stress can affect both parenting and child development. In a large population-based cohort study (N = 613) we examined whether maternal discipline mediated the association between maternal stress during pregnancy and child compliance, and whether COMT or DRD4 polymorphisms moderated the association between maternal discipline and child compliance. Family-related and general stress were measured through maternal self-report and genetic material was collected through cord blood sampling at birth. Mother-child dyads were observed at 36 months in disciplinary tasks in which the child was not allowed to touch attractive toys. Maternal discipline and child compliance were observed in two different tasks and independently coded. The association between family stress during pregnancy and child committed compliance was mediated by maternal positive discipline. Children with more COMT Met alleles seemed more susceptible to maternal positive discipline than children with more COMT Val alleles. Copyright © 2012 Wiley Periodicals, Inc.

The Relations among Maternal Depression, Maternal Criticism, and Adolescents' Externalizing and Internalizing Symptoms.

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Frye, Alice A.; Garber, Judy

2005-01-01

This study examined the relations between maternal criticism and externalizing and internalizing symptoms in adolescents who varied in their risk for psychopathology. Both maternal-effects and child-effects models were examined. The sample consisted of 194 adolescents (mean age = 11.8 years) and their mothers: 146 mothers had a history of…

Influence of maternity leave on exclusive breastfeeding.

Science.gov (United States)

Monteiro, Fernanda R; Buccini, Gabriela Dos S; Venâncio, Sônia I; da Costa, Teresa H M

To describe the profile of women with children aged under 4 months living in the Brazilian state capitals and in the Federal District according to their working status and to analyze the influence of maternity leave on exclusive breastfeeding (EBF) among working women. This was a cross-sectional study with data extracted from the II National Maternal Breastfeeding Prevalence Survey carried out in 2008. Initially, a descriptive analysis of the profile of 12,794 women was performed, according to their working status and maternity leave and the frequency of maternity leave in the Brazilian regions and capitals. The study used a multiple model to identify the influence of maternity leave on EBF interruption, including 3766 women who declared they were working and were on maternity leave at the time of the interview. The outcome assessed in the study was the interruption of the EBF, classified by the WHO. Regarding the working status of the mothers, 63.4% did not work outside of their homes and among those who worked, 69.8% were on maternity leave. The largest prevalence among workers was of women older than 35 years of age, with more than 12 years of schooling, primiparous and from the Southeast and South regions. The lack of maternity leave increased by 23% the chance of EBF interruption. Maternity leave contributed to increase the prevalence of EBF in the Brazilian states capitals, supporting the importance of increasing the maternity leave period from four to six months. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Influence of maternity leave on exclusive breastfeeding

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Fernanda R. Monteiro

Full Text Available Abstract Objectives: To describe the profile of women with children aged under 4 months living in the Brazilian state capitals and in the Federal District according to their working status and to analyze the influence of maternity leave on exclusive breastfeeding (EBF among working women. Methods: This was a cross-sectional study with data extracted from the II National Maternal Breastfeeding Prevalence Survey carried out in 2008. Initially, a descriptive analysis of the profile of 12,794 women was performed, according to their working status and maternity leave and the frequency of maternity leave in the Brazilian regions and capitals. The study used a multiple model to identify the influence of maternity leave on EBF interruption, including 3766 women who declared they were working and were on maternity leave at the time of the interview. The outcome assessed in the study was the interruption of the EBF, classified by the WHO. Results: Regarding the working status of the mothers, 63.4% did not work outside of their homes and among those who worked, 69.8% were on maternity leave. The largest prevalence among workers was of women older than 35 years of age, with more than 12 years of schooling, primiparous and from the Southeast and South regions. The lack of maternity leave increased by 23% the chance of EBF interruption. Conclusion: Maternity leave contributed to increase the prevalence of EBF in the Brazilian states capitals, supporting the importance of increasing the maternity leave period from four to six months.

Maternal Mortality – A Challenge?

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Shital G. Sonone

2013-01-01

Full Text Available Background : The current maternal mortality rate (MMR in Maharashtra is 104/100000 live births, ranking 3rd in India. There is scope for reducing it as majority of the causes of MMR are preventable and curable. Aims and Objectives: To study the sociodemographic profile and causes of maternal deaths at Dr. V. M. Govt. Medical College, Solapur. Material and Methods: The study population included all deliveries i.e. women admitted in the hospital during pregnancy, child-birth or within 42 days of termination of pregnancy from any cause related to or aggravated due to pregnancy during the period of 2 years from 1st August 2009 to 31st July 2011. IPD case records and autopsy reports of all maternal deaths were taken and various variables were studied. The present study is prospective study of maternal mortality conducted in Dept. of Obstetrics and Gynaecology, Dr. V. M. Medical College Solapur. Cases were distributed ac-cording to their age, literacy rate, residence,socioeconomic status, ante-natal care, gestational age, gravida/parity, place of referral, pregnancy outcome, and place of delivery, perinatal outcome and etiological factors. This study also suggests the measures to reduce maternal mortality. Results: The total number of live births during the study period were 13,188 and total number of maternal deaths were 63 and MMR was 477 per 1, 00,000 live births. In the maternal deaths studied, 1/3rd of the women were illiterate, half of the women belonged to urban slum areas and of lower socioeconomic class.1/3rd of the deaths occurred in primigravida,within 24 hrs from admission, 58.73% of the patients were referred from outside. Out of that 86.49% of women were sent from private hospital and died in post partum period, having poor perinatal outcome. Haemorrhage (28.57% and hypertension (12.69% are two direct causes and severe anemia (33.33% is most common in direct cause of maternal death in our study.

The effect of maternal role training program on role attainment and maternal role satisfaction in nulliparous women with unplanned pregnancy

OpenAIRE

Kordi, Masoumeh; Fasanghari, Maryam; Asgharipour, Negar; Esmaily, Habibollah

2017-01-01

INTRODUCTION: The maternal role is one of the most basic and important roles played by women during their lifetime. The process of the maternal role starts during pregnancy and to continue and develop after postpartum with the growth of suckling. However, unplanned pregnancy may jeopardize achieving the maternal role and reduce maternal role satisfaction. Therefore, the researcher conducted the present study to determine the impact of maternal role training program on attainment of role and r...

Effects of Maternal Anxiety Disorders on Infant Self-Comforting Behaviors: The Role of Maternal Bonding, Infant Gender and Age.

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Müller, Mitho; Tronick, Ed; Zietlow, Anna-Lena; Nonnenmacher, Nora; Verschoor, Stephan; Träuble, Birgit

We investigated the links between maternal bonding, maternal anxiety disorders, and infant self-comforting behaviors. Furthermore, we looked at the moderating roles of infant gender and age. Our sample (n = 69) comprised 28 mothers with an anxiety disorder (according to DSM-IV criteria) and 41 controls, each with their 2.5- to 8-month-old infant (41 females and 28 males). Infant behaviors were recorded during the Face-to-Face Still-Face paradigm. Maternal bonding was assessed by the Postpartum Bonding Questionnaire. Conditional process analyses revealed that lower maternal bonding partially mediated between maternal anxiety disorders and increased self-comforting behaviors but only in older female infants (over 5.5 months of age). However, considering maternal anxiety disorders without the influence of bonding, older female infants (over 5.5 months of age) showed decreased rates of self-comforting behaviors, while younger male infants (under 3 months of age) showed increased rates in the case of maternal anxiety disorder. The results suggest that older female infants (over 5.5 months of age) are more sensitive to lower maternal bonding in the context of maternal anxiety disorders. Furthermore, results suggest a different use of self-directed regulation strategies for male and female infants of mothers with anxiety disorders and low bonding, depending on infant age. The results are discussed in the light of gender-specific developmental trajectories. © 2016 S. Karger AG, Basel.

The unintended consequences of maternity leaves: How agency interventions mitigate the negative effects of longer legislated maternity leaves.

Science.gov (United States)

Hideg, Ivona; Krstic, Anja; Trau, Raymond N C; Zarina, Tanya

2018-06-07

To support women in the workplace, longer legislated maternity leaves have been encouraged in Scandinavian countries and recently in Canada. Yet, past research shows that longer legislated maternity leaves (i.e., 1 year and longer) may unintentionally harm women's career progress. To address this issue, we first sought to identify one potential mechanism underlying negative effects of longer legislated maternity leaves: others' lower perceptions of women's agency. Second, we utilize this knowledge to test interventions that boost others' perceptions of women's agency and thus mitigate negative effects of longer legislated maternity leaves. We test our hypotheses in three studies in the context of Canadian maternity leave policies. Specifically, in Study 1, we found that others' lower perceptions of women's agency mediated the negative effects of a longer legislated maternity leave, that is, 1 year (vs. shorter, i.e., 1 month maternity leave) on job commitment. In Study 2, we found that providing information about a woman's agency mitigates the unintended negative effects of a longer legislated maternity leave on job commitment and hireability. In Study 3, we showed that use of a corporate program that enables women to stay in touch with the workplace while on maternity leave (compared to conditions in which no such program was offered; a program was offered but not used by the applicant; and the program was offered, but there was no information about its usage by the applicant) enhances agency perceptions and perceptions of job commitment and hireability. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Maternal Support of Children's Early Numerical Concept Learning Predicts Preschool and First-Grade Math Achievement

Science.gov (United States)

Casey, Beth M.; Lombardi, Caitlin M.; Thomson, Dana; Nguyen, Hoa Nha; Paz, Melissa; Theriault, Cote A.; Dearing, Eric

2018-01-01

The primary goal in this study was to examine maternal support of numerical concepts at 36 months as predictors of math achievement at 4.5 and 6-7 years. Observational measures of mother-child interactions (n = 140) were used to examine type of support for numerical concepts. Maternal support that involved labeling the quantities of sets of…

Maternal dietary intake and pregnancy outcome.

Science.gov (United States)

Ferland, Suzanne; O'Brien, Huguette Turgeon

2003-02-01

To study the relationship between maternal diet and infant anthropometric measurements in 56 women, aged 28 +/- 5.1 years, with singleton pregnancies. The overall quality of the diet (three 24-hour recalls), including supplementation, was evaluated at 34 +/- 1.3 weeks using a total mean adequacy ratio (TMAR) of 12 nutrients. Specific interviewing techniques were used to minimize social desirability bias. Anthropometric measurements of both parents and maternal lifestyle practices were also obtained. Infant weight, crown-heel length and head circumference were measured 14.6 +/- 4.4 days after birth. Stepwise multiple regression analysis revealed that maternal diet quality (TMAR) was significantly related to infant weight (r = .039, P = .036) and crown-heel length (r = .071, P = .007). Other significant predictors included gestational age, maternal height, sex, smoking and physical activity. Maternal diet was positively associated with infant weight and crown-heel length.

Maternal deaths in the Nordic countries

DEFF Research Database (Denmark)

Vangen, Siri; Bødker, Birgit; Ellingsen, Liv

2017-01-01

reporting from hospitals. Each case was then assessed to determine the cause of death, and level of care provided. Potential improvements to care were evaluated. RESULTS: We registered 168 maternal deaths, 90 direct and 78 indirect cases. The maternal mortality ratio was 7.2/100 000 live births ranging from......INTRODUCTION: Despite the seriousness of the event, maternal deaths are substantially underreported. There is often a missed opportunity to learn from such tragedies. The aim of the study was to identify maternal deaths in the five Nordic countries, to classify causes of death based...... on internationally acknowledged criteria, and to identify areas that would benefit from further teaching, training or research to possibly reduce the number of maternal deaths. MATERIAL AND METHODS: We present data for the years 2005-2013. National audit groups collected data by linkage of registers and direct...

Maternal Eating Disorders and Infant Feeding Difficulties: Maternal and Child Mediators in a Longitudinal General Population Study

Science.gov (United States)

Micali, Nadia; Simonoff, Emily; Stahl, Daniel; Treasure, Janet

2011-01-01

Background: Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternal factors. We aimed to determine the role of…

[Maternal deaths due to infectious cause, results from the French confidential enquiry into maternal deaths, 2010-2012].

Science.gov (United States)

Rigouzzo, A; Tessier, V; Zieleskiewicz, L

2017-12-01

Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period. The main infectious agents involved in maternal deaths from direct causes were Streptococcus A, Escherichia Coli and Clostridium perfringens: these bacterias were responsible for toxic shock syndrome, severe sepsis, secondary in some cases to cellulitis or necrotizing fasciitis. Of the 6 deaths due to direct infection, 4 were considered avoidable because of inadequate management: delayed or missed diagnosis, delayed or inadequate initiation of a specific medical and/or surgical treatment. Of the 16 indirect maternal deaths due to infection causes, the most often involved infectious agents were influenza A (H1N1) virus and Streptococcus pneumonia with induced purpura fulminans: the absence of influenza vaccination during pregnancy, delayed diagnosis and emergency initiation of a specific treatment, were the main contributory factors to these deaths and their avoidability in 70% of the cases analyzed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Analysis of preventability of stroke-related maternal death from the nationwide registration system of maternal deaths in Japan.

Science.gov (United States)

Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

2018-08-01

The number of stroke-related maternal deaths is increasing in Japan. We investigated methods to reduce maternal death from stroke. We analyzed stroke-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor, and Welfare from 2010 to 2014 inclusive. A total of 35 cases were identified. The median maternal age was 35 years (range 22-45) and the incidence of stoke in women ≥40 was seven-fold higher than in death from stroke.

The Longitudinal Interplay of Maternal Warmth and Adolescents' Self-Disclosure in Predicting Maternal Knowledge

Science.gov (United States)

Blodgett Salafia, Elizabeth H.; Gondoli, Dawn M.; Grundy, Amber M.

2009-01-01

This study examined the longitudinal associations among maternal warmth, adolescents' self-disclosure, and maternal knowledge during the transition to adolescence. Three years of self-report data were collected from 131 married mothers and their adolescents. Results from longitudinal analysis using adolescent reports indicated that greater…

Associations between Parents' Marital Functioning, Maternal Parenting Quality, Maternal Emotion and Child Cortisol Levels

Science.gov (United States)

Pendry, Patricia; Adam, Emma K.

2007-01-01

Associations between family functioning and children's stress hormone levels are explored, by examining how aspects of the interparental relationship (parents' marital satisfaction and parent conflict styles), the mother-child relationship (maternal involvement and warmth) and maternal emotional functioning (depression, anxiety and self-esteem)…

Maternal Mortality and Serious Maternal Morbidity in Jehovah's Witnesses in The Netherlands EDITORIAL COMMENT

NARCIS (Netherlands)

Van Wolfswinkel, M. E.; Zwart, J. J.; Schutte, J. M.; Duvekot, J. J.; Pel, M.; Van Roosmalen, J.

2009-01-01

Refusal of blood by women with major obstetric hemorrhage who are Jehovah's witnesses increases their risk of maternal death. This retrospective study of case notes assessed the risk of maternal morbidity and mortality from major obstetric hemorrhage in Jehovah's witnesses. The data was obtained

Association of maternal diabetes and child asthma.

Science.gov (United States)

Azad, Meghan B; Becker, Allan B; Kozyrskyj, Anita L

2013-06-01

Perinatal programming is an emerging theory for the fetal origins of chronic disease. Maternal asthma and environmental tobacco smoke (ETS) are two of the best-known triggers for the perinatal programming of asthma, while the potential role of maternal diabetes has not been widely studied. To determine if maternal diabetes is associated with child asthma, and if so, whether it modifies the effects of ETS exposure and maternal asthma. We studied 3,574 Canadian children, aged 7-8 years, enrolled in a population-based birth cohort. Standardized questionnaires were completed by the children's parents, and data were analyzed by multivariable logistic regression. Asthma was reported in 442 children (12.4%). Compared to those without asthma, asthmatic children were more likely to have mothers (P = 0.003), but not fathers (P = 0.89), with diabetes. Among children without maternal history of diabetes, the likelihood of child asthma was 1.4-fold higher in those exposed to ETS (adjusted odds ratio, 1.40; 95% confidence interval, 1.13-1.73), and 3.6-fold higher in those with maternal asthma (3.59; 2.71-4.76). Among children born to diabetic mothers, these risks were amplified to 5.7-fold (5.68; 1.18-27.37) and 11.3-fold (11.30; 2.26-56.38), respectively. In the absence of maternal asthma or ETS, maternal diabetes was not associated with child asthma (0.65, 0.16-2.56). Our findings suggest that maternal diabetes may contribute to the perinatal programming of child asthma by amplifying the detrimental effects of ETS exposure and maternal asthma. Copyright © 2012 Wiley Periodicals, Inc.

Maternal inflammation during pregnancy and childhood adiposity

NARCIS (Netherlands)

R. Gaillard (Romy); S.L. Rifas-Shiman (Sheryl); W. Perng (Wei); E. Oken (Emily); M.W. Gillman (Matthew W.)

2016-01-01

textabstractObjective: Maternal pre-pregnancy obesity is associated with offspring obesity. Underlying mechanisms may involve a maternal obesity-mediated proinflammatory state during pregnancy. Maternal C-reactive protein (CRP) level during pregnancy is a biomarker of low-grade systemic

Maternal singing during kangaroo care led to autonomic stability in preterm infants and reduced maternal anxiety.

Science.gov (United States)

Arnon, Shmuel; Diamant, Chagit; Bauer, Sofia; Regev, Rivka; Sirota, Gisela; Litmanovitz, Ita

2014-10-01

Kangaroo care (KC) and maternal singing benefit preterm infants, and we investigated whether combining these benefitted infants and mothers. A prospective randomised, within-subject, crossover, repeated-measures study design was used, with participants acting as their own controls. We evaluated the heart rate variability (HRV) of stable preterm infants receiving KC, with and without maternal singing. This included low frequency (LF), high frequency (HF) and the LF/HF ratio during baseline (10 min), singing or quiet phases (20 min) and recovery (10 min). Physiological parameters, maternal anxiety and the infants' behavioural state were measured. We included 86 stable preterm infants, with a postmenstrual age of 32-36 weeks. A significant change in LF and HF, and lower LF/HF ratio, was observed during KC with maternal singing during the intervention and recovery phases, compared with just KC and baseline (all p-values singing than just KC (p = 0.04). No differences in the infants' behavioural states or physiological parameters were found, with or without singing. Maternal singing during KC reduces maternal anxiety and leads to autonomic stability in stable preterm infants. This effect is not detected in behavioural state or physiological parameters commonly used to monitor preterm infants. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Reducing Maternal Mortality by Strengthening Community Maternal ...

African Journals Online (AJOL)

AJRH Managing Editor

translated from Hausa to English language. Using a pre-determined coding framework, coding and thematic analyses were carried out on the qualitative data collected from the baseline. LGA. Community. Estimated. Community. Population. Community maternal support systems established. Community savings. Emergency.

Social competence of elementary-school children: relationships to maternal authoritativeness, supportive maternal responses and children's coping strategies.

Science.gov (United States)

Chan, S M

2011-07-01

Although the influences of parenting on children's development of social competence have been well established, research on the underlying mechanisms of this link is relatively limited. The present study examined children's coping strategies as a mediator of the effects of maternal authoritativeness and maternal inductive responses on their social competence. The mothers of 183 Hong Kong Chinese children aged 6 to 8 years (89 girls and 94 boys) reported on their adoption of authoritative parenting and their responses to their children's expressions of emotion, and rated their children's adoption of constructive coping strategies. The children's teachers reported on the children's prosocial behaviour, and rated their level of peer acceptance at school. A model of maternal authoritativeness and supportive maternal responses affecting children's social competence is presented. The study results show that the effects of authoritative parenting on children's adoption of constructive coping strategies were mediated by supportive maternal responses to children's expression of emotion, and that the effects of maternal authoritativeness and maternal responses on children's social competence were mediated by children's coping strategies. These results suggest that school personnel should organize training programmes on emotion-coping strategies for both parents and children. The findings imply that positive parenting facilitates children's acquisition of constructive emotion-coping strategies. Programmes on emotion-coping strategies should be introduced for both parents and school children. © 2011 Blackwell Publishing Ltd.

Does prenatal care benefit maternal health? A study of post-partum maternal care use.

Science.gov (United States)

Liu, Tsai-Ching; Chen, Bradley; Chan, Yun-Shan; Chen, Chin-Shyan

2015-10-01

Most studies on prenatal care focus on its effects on infant health, while studying less about the effects on maternal health. Using the Longitudinal Health Insurance claims data in Taiwan in a recursive bivariate probit model, this study examines the impact of adequate prenatal care on the probability of post-partum maternal hospitalization during the first 6 months after birth. The results show that adequate prenatal care significantly reduces the probability of post-partum maternal hospitalization among women who have had vaginal delivery by 43.8%. This finding suggests that the benefits of prenatal care may have been underestimated among women with vaginal delivery. Timely and adequate prenatal care not only creates a positive impact on infant health, but also yields significant benefits for post-partum maternal health. However, we do not find similar benefits of prenatal care for women undergoing a cesarean section. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Maternal identity of women in the postpartum period

OpenAIRE

Maria B. Perun

2013-01-01

The article provides a theoretical analysis of the notions of “maternity”, “maternal sphere”, “maternal role” and “maternal identity”. The place of maternal identity in the system of a woman’s identities is determined. This article provides a brief description of the structural elements (cognitive, emotional, behavioural and axiological) of maternal identity. It also emphasizes the significance of the postpartum period in a women’s psychic life and stresses its pivotal role in the devel...

Maternal obesity, caesarean delivery and caesarean delivery on maternal request: a cohort analysis from China.

Science.gov (United States)

Zhou, Yubo; Blustein, Jan; Li, Hongtian; Ye, Rongwei; Zhu, Liping; Liu, Jianmeng

2015-05-01

To quantify the association between maternal obesity and caesarean delivery, particularly caesarean delivery on maternal request (CDMR), a fast-growing component of caesarean delivery in many nations. We followed 1,019,576 nulliparous women registered in the Perinatal Healthcare Surveillance System during 1993-2010. Maternal body mass index (BMI, kg/m(2) ), before pregnancy or during early pregnancy, was classified as underweight (obese (≥27.5), consistent with World Health Organization guidelines for Asian people. The association between maternal obesity and overall caesarean and its subtypes was modelled using log-binomial regression. During the 18-year period, 404,971 (39.7%) caesareans and 93,927 (9.2%) CDMRs were identified. Maternal obesity was positively associated with overall caesarean and CDMR. Adjusted risk ratios for overall caesarean in the four ascending BMI categories were 0.96 [95% confidence interval (CI) 0.94, 0.97], 1.00 (Reference), 1.16 [95% CI 1.14, 1.18], 1.39 [95% CI 1.43, 1.54], and for CDMR were 0.95 [95% CI 0.94, 0.96], 1.00 (Reference), 1.20 [95% CI 1.18, 1.22], 1.48 [95% CI 1.433, 1.54]. Positive associations were consistently found in women residing in southern and northern provinces and in subgroups stratified by year of delivery, urban or rural residence, maternal age, education, level of delivering hospital, and birthweight. In a large Chinese cohort study, maternal obesity was associated with an increased risk of caesarean delivery and its subtypes, including CDMR. Given the rising global prevalence of obesity, and in view of the growth of CDMR, it seems likely that caesarean births will increase, unless there are changes in obstetrical practice. © 2015 John Wiley & Sons Ltd.

Maternal Depression and Parent Management Training Outcomes.

Science.gov (United States)

Dempsey, Jack; McQuillin, Samuel; Butler, Ashley M; Axelrad, Marni E

2016-09-01

This study examines the impact of maternal depression on reductions in children's behavior problems severity following implementation of the Brief Behavioral Intervention-a brief, manualized parent management training treatment. The parents of 87 children aged 2-6 years of age received parent management training at a metropolitan hospital. Parents of participants completed measures of externalizing behavior and maternal depression. The association between pre-post treatment change in externalizing behavior and maternal depression was examined using an autoregressive cross-lagged model. Results showed that self-reported maternal depressive symptoms at pre-treatment negatively influenced the overall magnitude of reduction of reported externalizing behaviors in children following treatment. Results indicate that aspects of family functioning not specifically targeted by parent management training, such as maternal depression, significantly affect treatment outcomes. Clinicians providing parent management training may benefit from assessing for maternal depression and modifying treatment as indicated.

Emerging effortful control in toddlerhood: the role of infant orienting/regulation, maternal effortful control, and maternal time spent in caregiving activities.

Science.gov (United States)

Bridgett, David J; Gartstein, Maria A; Putnam, Samuel P; Lance, Kate Oddi; Iddins, Erin; Waits, Robin; Vanvleet, Jessica; Lee, Lindsay

2011-02-01

Latent growth modeling (LGM) was used to examine the contribution of changes in infant orienting/regulation (O/R) to the emergence of toddler effortful control (EC), the contributions of maternal EC to the development of infant O/R and the emergence of toddler EC, the influence of maternal time spent in caregiving activities on toddler EC and the slope of infant O/R, and the contribution of maternal EC to subsequent maternal time spent in caregiving activities. Mothers from 158 families completed a self-report measure of EC when their infants were 4 months of age, a measure of infant O/R when their infants were 4, 6, 8, 10, and 12 months of age, and a measure of toddler EC when their children reached 18 months of age. Information concerning maternal time spent in various interactive caregiving activities was collected when infants were 6 months old. Results indicated higher maternal EC predicted interindividual differences in the intercept (i.e., higher intercepts), but not slope, of infant O/R and that higher maternal EC, higher infant O/R intercept, and higher infant O/R slope contributed to higher toddler EC. Furthermore, higher maternal EC predicted greater maternal time spent in interactive caregiving activities with their infants and greater maternal time in interactive caregiving with infants also contributed to higher toddler EC after controlling for maternal EC. These findings contribute to the understanding of the influence of maternal EC, directly and through caregiving, on toddler EC. Additional implications as they are related to early developing regulatory aspects of temperament are discussed. Copyright © 2010 Elsevier Inc. All rights reserved.

Burden of maternal bipolar disorder on at-risk offspring: a controlled study on family planning and maternal care.

Science.gov (United States)

Moreno, Doris Hupfeld; Bio, Danielle Soares; Petresco, Sandra; Petresco, Denise; Gutt, Elisa Kijner; Soeiro-de-Souza, Márcio Gerhardt; Moreno, Ricardo Alberto

2012-12-20

Bipolar disorder (BD) is a highly incapacitating disease typically associated with high rates of familial dysfunction. Despite recent literature suggesting that maternal care is an important environmental factor in the development of behavioral disorders, it is unclear how much maternal care is dysfunctional in BD subjects. The objective of this study was to characterize maternal care in DSM-IV/SCID diagnosed BD type I subjects compared to healthy controls with (PD) and without (NPD) other psychiatric diagnoses. Thirty-four BD mothers and 106 controls underwent an interview about family planning and maternal care, obstetrical complications, and mother-child interactions. K-SADS-PL questions about violence exposure were used to ascertain domestic violence and physical/sexual abuse. BD mothers were less likely to have stable unions (45.5%; pmothers. Due to BD mothers' symptoms, 33.3% of offspring suffered physical and/or psychological abuse. Post hoc analysis, and the use of questions as a surrogate of symptoms as opposed to validated instruments. This is one of few reports confirming that maternal care given by BD women is dysfunctional. BD psychopathology can lead to poor maternal care and both should be considered important environmental risk factors in BD, suggesting that BD psychoeducation should include maternal care orientation. Copyright © 2012 Elsevier B.V. All rights reserved.

PCR/LDR/capillary electrophoresis for detection of single-nucleotide differences between fetal and maternal DNA in maternal plasma.

Science.gov (United States)

Yi, Ping; Chen, Zhuqin; Zhao, Yan; Guo, Jianxin; Fu, Huabin; Zhou, Yuanguo; Yu, Lili; Li, Li

2009-03-01

The discovery of fetal DNA in maternal plasma has opened up an approach for noninvasive diagnosis. We have now assessed the possibility of detecting single-nucleotide differences between fetal and maternal DNA in maternal plasma by polymerase chain reaction (PCR)/ligase detection reaction((LDR)/capillary electrophoresis. PCR/LDR/capillary electrophoresis was applied to detect the genotype of c.454-397T>gene (ESR1) from experimental DNA models of maternal plasma at different sensitivity levels and 13 maternal plasma samples.alphaC in estrogen receptor. (1) Our results demonstrated that the technique could discriminate low abundance single-nucleotide mutation with a mutant/normal allele ratio up to 1:10 000. (2) Examination of ESR1 c.454-397T>C genotypes by using the method of restriction fragment length analysis was performed in 25 pregnant women, of whom 13 pregnant women had homozygous genotypes. The c.454-397T>C genotypes of paternally inherited fetal DNA in maternal plasma of these 13 women were detected by PCR/LDR/capillary electrophoresis, which were accordant with the results of umbilical cord blood. PCR/LDR/capillary electrophoresis has very high sensitivity to distinguish low abundance single nucleotide differences and can discriminate point mutations and single-nucleotide polymorphisms(SNPs) of paternally inherited fetal DNA in maternal plasma.

Leader of the Maternity care: Doctors or midwives

DEFF Research Database (Denmark)

Wagle, Rajendra R.

2004-01-01

Technology of delivery of health care for developing countries is not a resolved issue. Moreover, maternity care differs from other areas of health care in many ways. Developing countries have to carefully adapt to what has been done in developed countries. Recent debate and data on maternity...... health care organisation have been in favour of midwifery-led maternity care. Midwifery-led maternity care is described as the best and necessary part of the sufficiently and thus inevitably health producing maternity health care organisation....

Maternity Leave Policies

Science.gov (United States)

Strang, Lucy; Broeks, Miriam

2017-01-01

Abstract Over recent years many European Union countries have made changes to the design of the maternity leave provision. These policy developments reflect calls for greater gender equality in the workforce and more equal share of childcare responsibilities. However, while research shows that long period of leave can have negative effects on women's labour market attachment and career advancements, early return to work can be seen as a factor preventing exclusive breastfeeding, and therefore, potentially having negative health impacts for babies. Indeed, the World Health Organisation recommends exclusive breastfeeding up to 6 months of age to provide babies with the nutrition for healthy growth and brain development, protection from life-threatening ailments, obesity and non-communicable diseases such as asthma and diabetes. Therefore, labour market demands on women may be at odds with the health benefits for children gained by longer periods of maternity leave. The aim of this article is to examine the relationship between leave provision and health benefits for children. We examine maternity and parental leave provision across European countries and its potential impact on the breastfeeding of very young babies (up to 6-months of age). We also consider economic factors of potential extension of maternity leave provision to 6 months, such as costs to businesses, effects on the female labour market attachment, and wider consequences (benefits and costs) for individuals, families, employers and the wider society. PMID:28983432

Longitudinal associations between maternal disrupted representations, maternal interactive behavior and infant attachment: a comparison between full-term and preterm dyads.

Science.gov (United States)

Hall, R A S; Hoffenkamp, H N; Tooten, A; Braeken, J; Vingerhoets, A J J M; van Bakel, H J A

2015-04-01

This prospective study examined whether or not a mother's representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and infant attachment. The participants were mothers of full-term (n = 75), moderately preterm (n = 68) and very preterm infants (n = 67). Maternal representations were assessed by the Working Model of the Child Interview at 6 months post-partum. Maternal interactive behavior was evaluated at 6 and 24 months post-partum, using the National Institute of Child Health and Human Development Early Care Research Network mother-infant observation scales. Infant attachment was observed at 24 months post-partum and was coded by the Attachment Q-Set. The results reveal that a premature childbirth does not necessarily generate disrupted maternal representations of the infant. Furthermore, maternal interactive behavior appears to be an important mechanism through which maternal representations influence the development of infant attachment in full-term and preterm infants. Early assessment of maternal representations can identify mother-infant dyads at risk, in full-term and preterm samples.

[Effects of Kangaroo Care on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants].

Science.gov (United States)

Lee, Sang Bok; Shin, Hye Sook

2007-10-01

The purpose of this study was to examine the effects of Kangaroo Care(KC) on anxiety, maternal role confidence, and maternal infant attachment of mothers who delivered preterm infants. The research design was a nonequivalent control group pretest-posttest. Data was collected from September 1. 2006 to June 20. 2007. The participants were 22 mothers in the experimental group and 21 in the control group. KC was applied three times per day, for a total of ten times in 4 days to the experimental group. The degree of anxiety was statistically significantly different between the two groups but maternal role confidence and maternal infant attachment was statistically insignificant. This data suggests that KC was effective for mothers anxiety relief but it was not effective for maternal role confidence and maternal infant attachment of mothers. The implications for nursing practice and directions for future research need to be discussed.

Investigating Maternal Mortality in a Public Teaching Hospital ...

African Journals Online (AJOL)

Background: Maternal mortality in sub.Saharan Africa has remained high and this is a reflection of the poor quality of maternal services. Aim: To determine the causes, trends, and level of maternal mortality rate in Abakaliki, Ebonyi. Materials and Methods: This was a review of the records of all maternal deaths related to ...

Prenatal Maternal Stress Programs Infant Stress Regulation

Science.gov (United States)

Davis, Elysia Poggi; Glynn, Laura M.; Waffarn, Feizal; Sandman, Curt A.

2011-01-01

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.…

Biobehavioral Factors in Child Health Outcomes: The Roles of Maternal Stress, Maternal-Child Engagement, Salivary Cortisol, and Salivary Testosterone.

Science.gov (United States)

Clowtis, Licia M; Kang, Duck-Hee; Padhye, Nikhil S; Rozmus, Cathy; Barratt, Michelle S

2016-01-01

Exposure to high levels of maternal stress and ineffective maternal-child engagement (MC-E) may adversely affect child health-related outcomes. The aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother-child dyads of preschool children (3-5.9 years) in a low socioeconomic setting. Observational and biobehavioral data were collected from 50 mother-child dyads in a preschool setting. Assessments included maternal stress with the Perceived Stress Scale, child health outcomes with the Pediatric Quality of Life Inventory, and MC-E with videotaped mother-child interactions and scored with the Keys to Interactive Parenting Scale. Morning and evening saliva samples were collected from mother and child for biological assays. Maternal stress was negatively correlated with MC-E (r = -.32, p health outcome (r = -.33, p health outcome. Maternal stress and MC-E during mother-child interactions play a significant role in the regulation of child stress physiology and child health outcome. Elevated cortisol and testosterone related to high maternal stress and low MC-E may increase the child's vulnerability to negative health outcomes-if sustained. More biobehavioral research is needed to understand how parent-child interactions affect child development and health outcomes in early childhood.

National level maternal health decisions

NARCIS (Netherlands)

Koduah, A.

2016-01-01

Maternal and neonatal deaths and morbidity still pose an enormous challenge for health authorities in Ghana, a lower middle income country. Despite massive investments in maternal and neonatal health and special attention through Millennium Development Goals (MDG) 4

Maternal Involvement and Academic Achievement.

Science.gov (United States)

Lopez, Linda C.; Holmes, William M.

The potential impact of several maternal involvement behaviors on teachers' ratings of children's academic skills was examined through statistical analyses. Data, based on mothers' responses to selected questions concerning maternal involvement and on teachers' ratings on the Classroom Behavior Inventory, were obtained for 115 kindergarten…

Maternal air pollution exposure and preterm birth in Wuxi, China: Effect modification by maternal age.

Science.gov (United States)

Han, Yingying; Jiang, Panhua; Dong, Tianyu; Ding, Xinliang; Chen, Ting; Villanger, Gro Dehli; Aase, Heidi; Huang, Lu; Xia, Yankai

2018-08-15

Numerous studies have investigated prenatal air pollution and shown that air pollutants have adverse effect on birth outcomes. However, which trimester was the most sensitive and whether the effect was related to maternal age is still ambiguous. This study aims to explore the association between maternal air pollution exposure during pregnancy and preterm birth, and if this relationship is modified by maternal age. In this retrospective cohort study, we examine the causal relationship of prenatal exposure to air pollutants including particulate matters, which are less than 10 µm (PM 10 ), and ozone (O 3 ), which is one of the gaseous pollutants, on preterm birth by gestational age. A total of 6693 pregnant women were recruited from Wuxi Maternal and Child Health Care Hospital. The participants were dichotomized into child-bearing age group ( = 35 years old) in order to analyze the effect modification by maternal age. Logistic and linear regression models were performed to assess the risk for preterm birth (gestational age air pollution exposure. With adjustment for covariates, the highest level of PM 10 exposure significantly increased the risk of preterm birth by 1.42-fold (95% CI: 1.10, 1.85) compared those with the lowest level in the second trimester. Trimester-specific PM 10 exposure was positively associated with gestational age, whereas O 3 exposure was associated with gestational age in the early pregnancy. When stratified by maternal age, PM 10 exposure was significantly associated with an increased risk of preterm birth only in the advanced age group during pregnancy (OR:2.15, 95% CI: 1.13, 4.07). The results suggested that PM 10 exposure associated with preterm birth was modified by advanced maternal age (OR interaction = 2.00, 95% CI: 1.02, 3.91, P interaction = 0.032). Prenatal air pollution exposure would increase risk of preterm birth and reduced gestational age. Thus, more attention should be paid to the effects of ambient air pollution

Maternal Death Reviews of a Tertiary Care Hospital

Directory of Open Access Journals (Sweden)

Indira Upadhyaya

2014-03-01

Full Text Available Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH" Thapathali Kathmandu, Nepal. Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period. Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year were 36.36%. Primipara accounted for more deaths (51.51%. Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS. Haemorrhage is the main contributing cause behind maternal mortality.

Who are the Gatekeepers? Predictors of Maternal Gatekeeping.

Science.gov (United States)

Schoppe-Sullivan, Sarah J; Altenburger, Lauren E; Lee, Meghan A; Bower, Daniel J; Kamp Dush, Claire M

The goal of this study was to identify determinants of maternal gatekeeping at the transition to parenthood. Participants included 182 different-gender dual-earner couples. During pregnancy, expectant parents completed questionnaires regarding their psychological functioning, attitudes, and expectations, and at 3 months postpartum questionnaires regarding maternal gatekeeping behavior and gate closing attitudes. SEM analyses revealed that mothers were more likely to close the gate to fathers when mothers held greater perfectionistic expectations for fathers' parenting, had poorer psychological functioning, perceived their romantic relationship as less stable, and had higher levels of parenting self-efficacy. In contrast, fathers with lower parenting self-efficacy appeared to elicit greater maternal gate closing behavior. Mothers who engaged in greater gate opening behavior were more religious. Maternal gatekeeping may be more strongly associated with maternal expectations and psychological functioning than with maternal traditional gender attitudes. Fathers' characteristics are less predictive of maternal gatekeeping than mothers' characteristics.

[Beneficial effect of maternity leave on delivery].

Science.gov (United States)

Xu, Qian; Séguin, Louise; Goulet, Lise

2002-01-01

To identify the contribution of the duration of the prenatal maternity leave on term delivery. Characteristics of the prenatal maternity leave and delivery among 363 working women who had delivered a full-term infant at 1 of 4 hospitals in Montreal during 1996 were studied. The presence of an intervention or complication during delivery was observed in 68.9% of the participants. The average duration of the prenatal maternity leave was about 8 weeks (SD = 7). The adjusted risk of a difficult delivery decreased significantly with the duration of the prenatal maternity leave (OR = 0.96; 95% CI: 0.93-0.99). The duration of the maternity leave before delivery is associated with an easier term delivery for working women.

Maternal DRD2, SLC6A3, and OXTR genotypes as potential moderators of the relation between maternal history of care and maternal cortisol secretion in the context of mother-infant separation.

Science.gov (United States)

Ludmer, Jaclyn A; Jamieson, Brittany; Gonzalez, Andrea; Levitan, Robert; Kennedy, James; Villani, Vanessa; Masellis, Mario; Basile, Vincenzo S; Atkinson, Leslie

2017-10-01

A mother's cortisol secretion is importantly associated with her own mental health and her infant's cortisol secretion. This study investigated the influences of maternal history of care and maternal DRD2, SLC6A3, and OXTR genotypes on maternal cortisol in the context of infant stress. A community sample of 296 mother-infant dyads completed a maternal separation at infant age 17 months. Maternal salivary cortisol, buccal cells, and self-reported history of care were collected. Multilevel models revealed that history of care had a greater influence on maternal baseline cortisol (but not cortisol trajectory) for mothers with more plasticity alleles of SLC6A3 (10R) and OXTR (G), relative to mothers with fewer or no plasticity alleles. Findings indicate that a mother's history of care is related to her cortisol secretion in anticipation of infant stress, but that this relation depends on her genetic characteristics. Findings are discussed in relation to the maternal protective system and anticipatory cortisol secretion. Copyright © 2017 Elsevier B.V. All rights reserved.

Early maternal depressive symptom trajectories: Associations with 7-year maternal depressive symptoms and child behavior.

Science.gov (United States)

Buckingham-Howes, Stacy; Oberlander, Sarah E; Wang, Yan; Black, Maureen M

2017-06-01

This study examines potential mechanisms linking maternal depressive symptoms over 2 years postpartum with child behavior problems at school-age in a sample of adolescent mothers and their first-born child. Potential mechanisms include: mother-reported caregiving engagement at 6 months; observed parental nurturance and control, and child competence and affect at 24 months; and mother-reported resilience at 7 years based on achievement of adult developmental tasks. One hundred eighteen low-income African American adolescent mothers were recruited at delivery and followed through child age 7 years. Maternal depressive symptom trajectories over 24 months were estimated (low, medium, and high) based on mother-reported depressive symptoms. Direct and indirect associations between depressive symptom trajectories with 7-year maternal depressive symptoms and child behavior problems were examined. The high maternal depressive symptom trajectory was associated with 7-year maternal depressive symptoms (b = 5.52, SE = 1.65, p child internalizing problems (b = 7.60, SE = 3.12, p = .02) and externalizing problems (b = 6.23, SE = 3.22, p = .05). Caregiving engagement among high depressive symptom trajectory mothers was significantly associated with observed child affect (b = -0.21, SE = 0.11, p = 0.05). Parental nurturance in toddlerhood mediated the association between high maternal depressive symptom trajectory and child internalizing problems at 7 years (indirect effect b = 2.33, 95% CI: 0.32-5.88). Findings suggest that family based interventions to promote parenting and adolescent resiliency strengthening may be beneficial in this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Maternal Employment and Adolescent Development.

Science.gov (United States)

Montemayor, Raymond; Clayton, Mark D.

1983-01-01

The relationship between maternal employment and adolescent development is enormously complex, and no simple generalizations are possible. Many intervening variables alter the impact that maternal employment has on adolescent development. There is an urgent need to discover what impact this arrangement has on adolescent development. (CJ)

Maternal role development: the impact of maternal distress and social support following childbirth.

Science.gov (United States)

Emmanuel, Elizabeth N; Creedy, Debra K; St John, Winsome; Brown, Claire

2011-04-01

to explore the relationship between maternal role development (MRD), maternal distress (MD) and social support following childbirth. prospective longitudinal survey. three public hospital maternity units in Brisbane, Australia. 630 pregnant women were invited to participate in the study, with a 77% (n=473) completion rate. to measure MRD, the Prenatal Maternal Expectation Scale was used at 36 weeks of pregnancy, and the revised What Being the Parent of a New Baby is Like (with subscales of evaluation, centrality and life change) was used at six and 12 weeks post partum. At all three data collection points, the Edinburgh Postnatal Depression Scale was used to measure MD, and the Maternal Social Support Scale was used to measure social support. at 36 weeks of gestation, optimal scaling for MRD produced a parsimonious model with MD providing 39% of predictive power. At six weeks post partum, similar models predicting MRD were found (evaluation: r(2)=0.14, MD providing 64% of predictive power; centrality: r(2)=0.07, MD providing 11% of predictive power; life change: r(2)=0.26, MD providing 59% of predictive power). At 12 weeks post partum, MD was a predictor for evaluation (r(2)=0.11) and life change (r(2)=0.26, 54% of predictive power). there is a statistically significant but moderate correlation between MRD and MD. The transition to motherhood can be stressful, but may be facilitated by appropriate acknowledgement and support with an emphasis on MRD. Copyright © 2009 Elsevier Ltd. All rights reserved.

Maternal hormones meet environmental variability : Context-dependent effects of maternal hormones in avian egg yolks

NARCIS (Netherlands)

Hsu, Bin-Yan

2016-01-01

In the past few decades, maternal effects have been widely recognized as an important way through which mothers can modify offspring phenotypes above and over direct genetic effects. As a wide variety of animals are prenatal exposed to maternal hormones, accumulating evidences also suggest that

Longitudinal Associations between Maternal Solicitation, Perceived Maternal Acceptance, Adolescent Self-Disclosure, and Adolescent Externalizing Behaviors

Science.gov (United States)

Garthe, Rachel C.; Sullivan, Terri N.; Kliewer, Wendy

2018-01-01

The current study examined prospective associations between maternal solicitation and acceptance, adolescent self-disclosure, and adolescent externalizing behaviors. Participants included 357 urban adolescents (46% male; 92% African American) and their maternal caregivers. Participants provided data annually (three waves across 2-year time frame).…

Birthing Centers and Hospital Maternity Services

Science.gov (United States)

... Educators Search English Español Birthing Centers and Hospital Maternity Services KidsHealth / For Parents / Birthing Centers and Hospital Maternity Services What's in this article? Giving Birth at ...

Reducing maternal mortality in Nigeria: the need for urgent changes in financing for maternal health in the Nigerian health system.

Science.gov (United States)

Ebeigbe, P N

2013-06-01

Nigeria's maternal mortality indices are among the worst in the world. Various approaches aimed at combatting the persistently high maternal mortality rates in the past have been ineffective. The objective of this article was to evaluate the fairness and equitability of financing for maternal health in the Nigerian health system. A review of the performance of the Nigerian Health system with regards to financing for maternal healthcare and comparison with other health systems utilising internationally accepted criteria was done. Household out-of -pocket payment was found to be the largest source of health care financing in the Nigerian health system contributing as much as 65.6 % of total health expenditure. This is in sharp contrast to the performance of more effective health systems like that in South Africa where health care is free for pregnant and breast feeding mothers. The result is that South Africa reports less than a tenth of total maternal mortalities reported from Nigeria annually. The current Nigeria health financing system is not equitable and appears to encourage maternal mortalities since it does not cater for the most vulnerable. There is an urgent need for a review of financing of maternal health in Nigeria to achieve universal access to maternal health care. An urgent overhaul of the currently under performing National Health Insurance scheme or adoption of the simpler system based on funding from taxation with universal access for health care including maternal care and services free at the point of access is suggested.

Maternal postpartum distress and childhood overweight

DEFF Research Database (Denmark)

Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted

2010-01-01

We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

Maternal employment and childhood overweight in Germany.

Science.gov (United States)

Meyer, Sophie-Charlotte

2016-12-01

A widespread finding among studies from the US and the UK is that maternal employment is correlated with an increased risk of child overweight, even in a causal manner, whereas studies from other countries obtain less conclusive results. As evidence for Germany is still scarce, the purpose of this study is to identify the effect of maternal employment on childhood overweight in Germany using two sets of representative micro data. We further explore potential underlying mechanisms that might explain this relationship. In order to address the selection into maternal full-time employment, we use an instrumental variable strategy exploiting the number of younger siblings in the household as an instrument. While the OLS models suggest that maternal full-time employment is related to a 5 percentage point higher probability of the child to be overweight, IV estimates indicate a 25 percentage points higher overweight probability due to maternal full-time employment. Exploring various possible pathways, we find that maternal full-time employment promotes unhealthy dietary and activity behavior which might explain the positive effect of maternal employment on child overweight to some extent. Although there are limitations to our IV approach, several sensitivity analyses confirm the robustness of our findings. Copyright © 2016 Elsevier B.V. All rights reserved.

The National Partnership for Maternal Safety.

Science.gov (United States)

DʼAlton, Mary E; Main, Elliott K; Menard, M Kathryn; Levy, Barbara S

2014-05-01

Recognition of the need to reduce maternal mortality and morbidity in the United States has led to the creation of the National Partnership for Maternal Safety. This collaborative, broad-based initiative will begin with three priority bundles for the most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism. In addition, three unit-improvement bundles for obstetric services were identified: a structured approach for the recognition of early warning signs and symptoms, structured internal case reviews to identify systems improvement opportunities, and support tools for patients, families, and staff that experience an adverse outcome. This article details the formation of the National Partnership for Maternal Safety and introduces the initial priorities.

Components of Maternal Healthcare Delivery System Contributing to ...

African Journals Online (AJOL)

Components of Maternal Healthcare Delivery System Contributing to Maternal Deaths ... transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal ...

Maternal transfer of mercury to songbird eggs.

Science.gov (United States)

Ackerman, Joshua T; Hartman, C Alex; Herzog, Mark P

2017-11-01

We evaluated the maternal transfer of mercury to eggs in songbirds, determined whether this relationship differed between songbird species, and developed equations for predicting mercury concentrations in eggs from maternal blood. We sampled blood and feathers from 44 house wren (Troglodytes aedon) and 34 tree swallow (Tachycineta bicolor) mothers and collected their full clutches (n = 476 eggs) within 3 days of clutch completion. Additionally, we sampled blood and feathers from 53 tree swallow mothers and randomly collected one egg from their clutches (n = 53 eggs) during mid to late incubation (6-10 days incubated) to evaluate whether the relationship varied with the timing of sampling the mother's blood. Mercury concentrations in eggs were positively correlated with mercury concentrations in maternal blood sampled at (1) the time of clutch completion for both house wrens (R 2  = 0.97) and tree swallows (R 2  = 0.97) and (2) during mid to late incubation for tree swallows (R 2  = 0.71). The relationship between mercury concentrations in eggs and maternal blood did not differ with the stage of incubation when maternal blood was sampled. Importantly, the proportion of mercury transferred from mothers to their eggs decreased substantially with increasing blood mercury concentrations in tree swallows, but increased slightly with increasing blood mercury concentrations in house wrens. Additionally, the proportion of mercury transferred to eggs at the same maternal blood mercury concentration differed between species. Specifically, tree swallow mothers transferred 17%-107% more mercury to their eggs than house wren mothers over the observed mercury concentrations in maternal blood (0.15-1.92 μg/g ww). In contrast, mercury concentrations in eggs were not correlated with those in maternal feathers and, likewise, mercury concentrations in maternal blood were not correlated with those in feathers (all R 2  mercury concentrations from maternal blood to eggs

A Conceptual Model for Maternal Behavior Among Polydrug Cocaine-Using Mothers: The Role of Postnatal Cocaine Use and Maternal Depression

OpenAIRE

Eiden, Rina D.; Stevens, Arianne; Schuetze, Pamela; Dombkowski, Laura E.

2006-01-01

This study examined the association between maternal cocaine use and maternal behavior and tested a conceptual model predicting maternal insensitivity during mother–infant interactions. Participants included 130 mother–infant dyads (68 cocaine-exposed and 62 noncocaine-exposed) who were recruited after birth and assessed at 4–8 weeks of infant age. Results of model testing indicated that when the effects of prenatal cocaine use were examined in the context of polydrug use, maternal psychopath...

Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy : a prospective cohort study

OpenAIRE

Carlhäll, Sara; Bladh, Marie; Brynhildsen, Jan; Claesson, Ing-Marie; Josefsson, Ann; Sydsjö, Gunilla; Thorsell, Annika; Blomberg, Marie

2016-01-01

Background Maternal obesity is accompanied by maternal and fetal complications during and after pregnancy. The risks seem to increase with degree of obesity. Leptin has been suggested to play a role in the development of obesity related complications. Whether maternal leptin levels differ between obese and morbidly obese women, during and after pregnancy, have to our knowledge not been previously described. Neither has the association between maternal leptin levels and gestational weight gain...

Maternal exposure to UV filters: associations with maternal thyroid hormones, IGF-I/IGFBP3 and birth outcomes.

Science.gov (United States)

Krause, M; Frederiksen, H; Sundberg, K; Jørgensen, F S; Jensen, L N; Nørgaard, P; Jørgensen, C; Ertberg, P; Petersen, J H; Feldt-Rasmussen, U; Juul, A; Drzewiecki, K T; Skakkebaek, N E; Andersson, A M

2018-02-01

Several chemical UV filters/absorbers ('UV filters' hereafter) have endocrine-disrupting properties in vitro and in vivo . Exposure to these chemicals, especially during prenatal development, is of concern. To examine maternal exposure to UV filters, associations with maternal thyroid hormone, with growth factor concentrations as well as to birth outcomes. Prospective study of 183 pregnant women with 2nd trimester serum and urine samples available. Maternal concentrations of the chemical UV filters benzophenone-1 (BP-1) and benzophenone-3 (BP-3) in urine and 4-hydroxy-benzophenone (4-HBP) in serum were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The relationships between 2nd trimester maternal concentrations of the three chemical UV filters and maternal serum concentrations of thyroid hormones and growth factors, as well as birth outcomes (weight, height, and head and abdominal circumferences) were examined. Positive associations between maternal serum concentrations of 4-HBP and triiodothyronine (T 3 ), thyroxine (T 4 ), insulin-like growth factor I (IGF-I) and its binding protein IGFBP3 were observed in mothers carrying male fetuses. Male infants of mothers in the middle 4-HBP exposure group had statistically significantly lower weight and shorter head and abdominal circumferences at birth compared to the low exposure group. Widespread exposure of pregnant women to chemical UV filters and the possible impact on maternal thyroid hormones and growth factors, and on fetal growth, calls for further studies on possible long-term consequences of the exposure to UV filters on fetal development and children's health. © 2018 The authors.

Propagation of maternal behavior across generations is associated with changes in non-maternal cognitive and behavioral processes.

Science.gov (United States)

Lovic, Vedran; Fleming, Alison S

2015-08-01

Over a number of years we have studied the phenomenology of maternal behavior from endocrine, neural, experiential, and ontogenetic perspectives. Here, we focus on the effects of early life experiences with and without the mother on subsequent maternal and non-maternal behaviors of the offspring. We have used an artificial rearing procedure, which entails removing rat pups from their mother and raising them in isolation, while controlling and manipulating several aspects of their upbringing. As adults, mother-reared (MR) and artificially-reared (AR) rats are assessed on their own maternal behavior, as well several other behaviors. While both AR and MR rats nurse and successfully wean their young, the AR rats spend less time licking, grooming, and crouching over their young. Hence, being raised in social isolation does not seem to affect primary maternal motivational dynamics. Instead, isolation rearing produces alterations in the ongoing execution of the behavior and its effective organization. Here, we present evidence that changes in maternal behavior, as a result of social isolation from mother and siblings, are due to changes in top-down (e.g., sustained attention, flexibility) and bottom-up process (e.g., increased stimulus-driven behavior). These changes are likely due to alterations in brain dopamine systems, which are sensitive to early life manipulations and are modulators of bottom-up and top-down processes. Finally, we draw parallels between the rat and human maternal behavior. This article is part of a Special Issue entitled: In Honor of Jerry Hogan. Copyright © 2015 Elsevier B.V. All rights reserved.

The Relations among Maternal Depressive Disorder, Maternal Expressed Emotion, and Toddler Behavior Problems and Attachment

Science.gov (United States)

Gravener, Julie A.; Rogosch, Fred A.; Oshri, Assaf; Narayan, Angela J.; Cicchetti, Dante; Toth, Sheree L.

2012-01-01

Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n = 130) and comparison mothers (n = 68) and their toddlers (M age = 20 mo.; 53% male). Assessments…

Correlation between maternal inflammatory markers and fetomaternal adiposity.

LENUS (Irish Health Repository)

Farah, Nadine

2012-10-01

Outside pregnancy, both obesity and diabetes mellitus are associated with changes in inflammatory cytokines. Obesity in pregnancy may be complicated by gestational diabetes mellitus (GDM) and\\/or fetal macrosomia. The objective of this study was to determine the correlation between maternal cytokines and fetomaternal adiposity in the third trimester in women where the important confounding variable GDM had been excluded. Healthy women with a singleton pregnancy and a normal glucose tolerance test at 28 weeks gestation were enrolled at their convenience. Maternal cytokines were measured at 28 and 37 weeks gestation. Maternal adiposity was assessed indirectly by calculating the Body Mass Index (BMI), and directly by bioelectrical impedance analysis. Fetal adiposity was assessed by ultrasound measurement of fetal soft tissue markers and by birthweight at delivery. Of the 71 women studied, the mean maternal age and BMI were 29.1 years and 29.2 kg\\/m(2) respectively. Of the women studied 32 (45%) were obese. Of the cytokines, only maternal IL-6 and IL-8 correlated with maternal adiposity. Maternal TNF-α, IL-β, IL-6 and IL-8 levels did not correlate with either fetal body adiposity or birthweight. In this well characterised cohort of pregnant non-diabetic women in the third trimester of pregnancy we found that circulating maternal cytokines are associated with maternal adiposity but not with fetal adiposity.

Genetic variation for maternal effects on parasite susceptibility.

Science.gov (United States)

Stjernman, M; Little, T J

2011-11-01

The expression of infectious disease is increasingly recognized to be impacted by maternal effects, where the environmental conditions experienced by mothers alter resistance to infection in offspring, independent of heritability. Here, we studied how maternal effects (high or low food availability to mothers) mediated the resistance of the crustacean Daphnia magna to its bacterial parasite Pasteuria ramosa. We sought to disentangle maternal effects from the effects of host genetic background by studying how maternal effects varied across 24 host genotypes sampled from a natural population. Under low-food conditions, females produced offspring that were relatively resistant, but this maternal effect varied strikingly between host genotypes, i.e. there were genotype by maternal environment interactions. As infection with P. ramosa causes a substantial reduction in host fecundity, this maternal effect had a large effect on host fitness. Maternal effects were also shown to impact parasite fitness, both because they prevented the establishment of the parasites and because even when parasites did establish in the offspring of poorly fed mothers, and they tended to grow more slowly. These effects indicate that food stress in the maternal generation can greatly influence parasite susceptibility and thus perhaps the evolution and coevolution of host-parasite interactions. © 2011 The Authors. Journal of Evolutionary Biology © 2011 European Society For Evolutionary Biology.

Social Support and Maternal Depression from Pregnancy to Postpartum: The Association with Positive Maternal Behaviours among Brazilian Adolescent Mothers

Science.gov (United States)

Diniz, Eva; Koller, Sílvia H.; Volling, Brenda L.

2015-01-01

Adolescent motherhood is a risky situation related to poorer quality of infant caregiving. The lack of social support and increased odds for maternal depression are the main concerns. This study aimed to investigate whether maternal-foetal attachment, social support and maternal depression measured during pregnancy and after birth were associated…

Toddlers with Early Behavioral Problems at Higher Family Demographic Risk Benefit the Most from Maternal Emotion Talk.

Science.gov (United States)

Brophy-Herb, Holly E; Bocknek, Erika London; Vallotton, Claire D; Stansbury, Kathy E; Senehi, Neda; Dalimonte-Merckling, Danielle; Lee, Young-Eun

2015-09-01

To test the hypothesis that toddlers at highest risk for behavioral problems from the most economically vulnerable families will benefit most from maternal talk about emotions. This study included 89 toddlers and mothers from low-income families. Behavioral problems were rated at 2 time points by masters-level trained Early Head Start home visiting specialists. Maternal emotion talk was coded from a wordless book-sharing task. Coding focused on mothers' emotion bridging, which included labeling emotions, explaining the context of emotions, noting the behavioral cues of emotions, and linking emotions to toddlers' own experiences. Maternal demographic risk reflected a composite score of 5 risk factors. A significant 3-way interaction between Time 1 toddler behavior problems, maternal emotion talk, and maternal demographic risk (p = .001) and examination of slope difference tests revealed that when maternal demographic risk was greater, more maternal emotion talk buffered associations between earlier and later behavior problems. Greater demographic risk and lower maternal emotion talk intensified Time 1 behavior problems as a predictor of Time 2 behavior problems. The model explained 54% of the variance in toddlers' Time 2 behavior problems. Analyses controlled for maternal warmth to better examine the unique contributions of emotion bridging to toddlers' behaviors. Toddlers at highest risk, those with more early behavioral problems from higher demographic-risk families, benefit the most from mothers' emotion talk. Informing parents about the use of emotion talk may be a cost-effective, simple strategy to support at-risk toddlers' social-emotional development and reduce behavioral problems.

A CLINICAL STUDY OF MATERNAL DEATHS DUE TO PPH

Directory of Open Access Journals (Sweden)

Basavana Gowda

2015-03-01

Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal mortality is a global problem, facing every country in the world. Target specific interventions are needed for specific population. Fifth millennium development goal (MDG is to reduce maternal mortality by 75% by the year 2015, worthwhile investment for every case provider, results that investing on mothers

Analysis of preventability of hypertensive disorder in pregnancy-related maternal death using the nationwide registration system of maternal deaths in Japan.

Science.gov (United States)

Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

2018-04-26

Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged deaths in Japan. Mothers aged ≥40 years are most at risk for HDP-related maternal death. Major concerns for preventabilities were late hospitalization, maternal transportation, and termination of pregnancy for term or near-term HDP. Regular vital checks and prompt lowering of BP were lacked during labor in most cases. HELLP syndrome should be managed at a general hospital with sufficient medical resources.

Maternal mortality in Vietnam in 1994-95.

Science.gov (United States)

Hieu, D T; Hanenberg, R; Vach, T H; Vinh, D Q; Sokal, D

1999-12-01

This report presents the first population-based estimates of maternal mortality in Vietnam. All the deaths of women aged 15-49 in 1994-95 in three provinces of Vietnam were identified and classified by cause. Maternal mortality was the fifth most frequent cause of death. The maternal mortality ratio was 155 deaths per 100,000 live births. This ratio compares with the World Health Organization's estimates of 430 such deaths globally and 390 for Asia. The maternal mortality ratio in the delta regions of these provinces was half that of the mountainous and semimountainous regions. Because a larger proportion of the Vietnamese population live in delta regions than elsewhere, the maternal mortality ratio for Vietnam as a whole may be lower than that of the three provinces studied. Maternal mortality is low in Vietnam primarily because a relatively high proportion of deliveries take place in clinics and hospitals, where few women die in childbirth. Also, few women die of the consequences of induced abortion in Vietnam because the procedure is legal and easily available.

Maternal Employment and Adolescent Achievement Revisited: An Ecological Perspective.

Science.gov (United States)

Paulson, Sharon E.

1996-01-01

Explores the relation of maternal employment and attitudes toward maternal employment to adolescent achievement. Examines parenting characteristics that mediate relations between maternal employment factors and achievement. Subjects were 240 ninth graders and their parents. Findings were that maternal employment did not influence adolescent…

Maternal Depressive Symptoms, Dysfunctional Cognitions, and Infant Night Waking: The Role of Maternal Nighttime Behavior

Science.gov (United States)

Teti, Douglas M.; Crosby, Brian

2012-01-01

Mechanisms were examined to clarify relations between maternal depressive symptoms, dysfunctional cognitions, and infant night waking among 45 infants (1-24 months) and their mothers. A mother-driven mediational model was tested in which maternal depressive symptoms and dysfunctional cognitions about infant sleep predicted infant night waking via…

Prehospital maternity care in Norway.

Science.gov (United States)

Egenberg, Signe; Puntervoll, Stein Atle; Øian, Pål

2011-11-29

Out-of-hospital maternity care in Norway is randomly organised and not properly formalized. We wished to examine the extent, organisation and quality of this service. We obtained information from the Norwegian Medical Birth Registry on all unplanned out-of-hospital births in 2008. A questionnaire was sent to all maternity institutions, municipalities and emergency dispatch centres, with questions regarding the practical and formal organisation of the service using figures from 2008. 430 children, all above 22 weeks gestation, were born unplanned outside of hospitals in Norway in 2008. Of these, 194 were born unplanned at home, 189 while being transported and 47 in other locations (doctor's offices, infirmaries, unknown). Five out of 53 maternity institutions (9 %) confirmed they had a formal midwife service agreement for out-of-hospital births. 247 municipalities (79 %) claimed to have no such assistance. Of these, 33 are located at least 90 minutes away from the nearest maternity ward. Half of the emergency dispatch centres had no registration identifying formal agreements on assistance by midwives for out-of-hospital births. There is an urgent need to put in place formal agreements between the regional health authorities and the municipalities on out-of-hospital midwife services. A distance of 90 minutes' journey time to a maternity ward to fulfil the right to qualified assistance is not well-founded.

Maternal Obesity: Consequences and Prevention Strategies

OpenAIRE

Emre Yanikkerem; Selviye Mutlu

2012-01-01

Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...

Direct maternal deaths in Norway 1976-1995

DEFF Research Database (Denmark)

Andersgaard, Alice Beate; Langhoff-Roos, J.; Oian, P.

2008-01-01

AIMS: To report direct maternal mortality ratio (MMR) in Norway between 1976 and 1995 including a description of the underlying complications in pregnancy, the causes of death and assessment of standard of care. METHODS: The maternal deaths were identified through the Cause of Death Registry......, Statistics Norway, and Medical Birth Registry of Norway. We requested copies of the hospital case records and the maternal death autopsies. The direct maternal deaths were classified on the basis underlying causes and assessed for substandard care according to the guidelines at the time of death...... and preventability provided optimal conditions and up to date guidelines. RESULTS: In the period 1976-1995 we identified 61 direct maternal deaths in Norway. The direct MMR was 5.5/100,000 births. Sufficient information was available for analysis in 51 of these cases. Six deaths occurred in early pregnancy. Among...

[Mothers' adherence to "maternal love" influences emotional expression toward children: relation to maternal occupational status and satisfaction in the workplace].

Science.gov (United States)

Egami, Sonoko

2007-06-01

This study examined the impact of mothers' adherence to "maternal love" on maternal emotional expression toward their children. It was postulated that adherence to "maternal love" (defined as the tendency to accept and obey blindly the traditional maternal role and sociocultural belief in "desirable mothers") would have both positive and negative effects on maternal emotional expression, depending on the mothers' occupational status and satisfaction in workplace. The results showed an interaction between mothers' adherence to "maternal love" and the mothers' satisfaction in the workplace, which affected their expression of emotion. When satisfaction in the workplace was rated in the middle, it was positively associated with positive emotional expression. When satisfaction in the workplace was rated as high, it was both positively and negatively associated with positive emotional expression for full-time workers. Moreover, when satisfaction in the workplace was rated as in the middle, it was negatively associated with negative emotional expression, and when satisfaction in the workplace was rated as low or high, it was positively associated with negative emotional expression for all workers. These findings confirmed that mothers' adherence to "maternal love" is "the double-edged sword".

The Length of Maternity Leave and Family Health

DEFF Research Database (Denmark)

Beuchert-Pedersen, Louise Voldby; Humlum, Maria Knoth; Vejlin, Rune Majlund

We study the relationship between the length of maternity leave and the physical and psychological health of the family. Using a reform of the parental leave scheme in Denmark that increased the number of weeks of leave with full benefit compensation, we estimate the effect of the lenght...... of maternity leave on a range of health indicators including the number of hospital admissions for both mother and child and the probability of the mother receiving antidepressants. The reform led to an increase in average post-birth maternity leave matters for child or maternal health outcomes and thus we...... complement the existing evidence on maternity leave expansions that tends to find limited effects on children's later deveopmental, educational, and labor market outcomes. Our results suggest that any beneficial effects of increasing the lenght of maternity leave are greater for low-resource families....

Abortion legislation, maternal healthcare, fertility, female literacy, sanitation, violence against women and maternal deaths: a natural experiment in 32 Mexican states

OpenAIRE

Koch, Elard; Chireau, Monique; Pliego, Fernando; Stanford, Joseph; Haddad, Sebastian; Calhoun, Byron; Aracena, Paula; Bravo, Miguel; Gatica, Sebasti?n; Thorp, John

2015-01-01

Objective To test whether there is an association between abortion legislation and maternal mortality outcomes after controlling for other factors thought to influence maternal health. Design Population-based natural experiment. Setting and data sources Official maternal mortality data from 32 federal states of Mexico between 2002 and 2011. Main outcomes Maternal mortality ratio (MMR), MMR with any abortive outcome (MMRAO) and induced abortion mortality ratio (iAMR). Independent variables Abo...

Maternity waiting homes: A panacea for maternal/neonatal ...

African Journals Online (AJOL)

women to inadequately equipped delivery settings 4,5. Eritrea has made some ... Maternity waiting homes were introduced in Eritrea in 2007 as a strategy to mitigate .... 24(4):472-8. 5. Chandramohan D, Cutts F, Millard P The effect of stay in.

Paid maternity and paternity leave: rights and choices.

Science.gov (United States)

Jordan, Claire

2007-01-01

From April 2007 onwards, maternity leave will be raised to nine months Paid maternity leave is associated with significant health benefits for babies, including reduced infant mortality The Government proposes to increase paid maternity leave to one year and introduce additional paternity leave by around 2009 The U.K's provision for maternity leave and child care is more generous than the U.S.A. or Australia but less than in the Scandinavian countries

Community Level Risk Factors for Maternal Mortality in Madagascar

African Journals Online (AJOL)

AJRH Managing Editor

This paper explores the effect of risk and socioeconomic factors on maternal mortality at the ... to study maternal mortality, however, studying maternal mortality at the community ... causes of maternal mortality at the country level in ... Antananarivo, the capital city of Madagascar, .... cyclones, and crime can be associated with.

Contribution of indirect obstetric deaths to maternal mortality at ...

African Journals Online (AJOL)

Introduction: Maternal death is unacceptably high in this center like in most centers in the developing world. Objective: To determine the maternal mortality ratio and the contribution of the direct and indirect obstetric complications to maternal deaths. Method: A retrospective review of all maternal deaths at Nnamdi Azikiwe ...

Effects of L-glutamine supplementation on maternal and fetal hemodynamics in gestating ewes exposed to alcohol.

Science.gov (United States)

Sawant, Onkar B; Ramadoss, Jayanth; Hankins, Gary D; Wu, Guoyao; Washburn, Shannon E

2014-08-01

Not much is known about effects of gestational alcohol exposure on maternal and fetal cardiovascular adaptations. This study determined whether maternal binge alcohol exposure and L-glutamine supplementation could affect maternal-fetal hemodynamics and fetal regional brain blood flow during the brain growth spurt period. Pregnant sheep were randomly assigned to one of four groups: saline control, alcohol (1.75-2.5 g/kg body weight), glutamine (100 mg/kg body weight) or alcohol + glutamine. A chronic weekend binge drinking paradigm between gestational days (GD) 99 and 115 was utilized. Fetuses were surgically instrumented on GD 117 ± 1 and studied on GD 120 ± 1. Binge alcohol exposure caused maternal acidemia, hypercapnea, and hypoxemia. Fetuses were acidemic and hypercapnic, but not hypoxemic. Alcohol exposure increased fetal mean arterial pressure, whereas fetal heart rate was unaltered. Alcohol exposure resulted in ~40 % reduction in maternal uterine artery blood flow. Labeled microsphere analyses showed that alcohol induced >2-fold increases in fetal whole brain blood flow. The elevation in fetal brain blood flow was region-specific, particularly affecting the developing cerebellum, brain stem, and olfactory bulb. Maternal L-glutamine supplementation attenuated alcohol-induced maternal hypercapnea, fetal acidemia and increases in fetal brain blood flow. L-Glutamine supplementation did not affect uterine blood flow. Collectively, alcohol exposure alters maternal and fetal acid-base balance, decreases uterine blood flow, and alters fetal regional brain blood flow. Importantly, L-glutamine supplementation mitigates alcohol-induced acid-base imbalances and alterations in fetal regional brain blood flow. Further studies are warranted to elucidate mechanisms responsible for alcohol-induced programming of maternal uterine artery and fetal circulation adaptations in pregnancy.

Reverse innovation in maternal health.

Science.gov (United States)

Firoz, Tabassum; Makanga, Prestige Tatenda; Nathan, Hannah L; Payne, Beth; Magee, Laura A

2017-09-01

Reverse innovation, defined as the flow of ideas from low- to high-income settings, is gaining traction in healthcare. With an increasing focus on value, investing in low-cost but effective and innovative solutions can be of mutual benefit to both high- and low-income countries. Reverse innovation has a role in addressing maternal health challenges in high-income countries by harnessing these innovative solutions for vulnerable populations especially in rural and remote regions. In this paper, we present three examples of 'reverse innovation' for maternal health: a low-cost, easy-to-use blood pressure device (CRADLE), a diagnostic algorithm (mini PIERS) and accompanying mobile app (PIERS on the Move), and a novel method for mapping maternal outcomes (MOM).

Maternal death and near miss measurement

African Journals Online (AJOL)

ABEOLUGBENGAS

2008-05-26

May 26, 2008 ... Maternal health services need to be accountable more than ever ... of maternal death and near miss audit, surveillance and review is ..... (d) A fundamental principle of these ..... quality assurance in obstetrics in Nigeria - a.

The difficulties of conducting maternal death reviews in Malawi

Directory of Open Access Journals (Sweden)

van den Broek Nynke

2008-09-01

Full Text Available Abstract Background Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. Methods SWOT (strengths, weaknesses, opportunities and threats analysis of the process of maternal death review during a workshop in Malawi. Results Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Conclusion Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

The difficulties of conducting maternal death reviews in Malawi.

Science.gov (United States)

Kongnyuy, Eugene J; van den Broek, Nynke

2008-09-11

Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

Decay of maternal antibodies in broiler chickens.

Science.gov (United States)

Gharaibeh, Saad; Mahmoud, Kamel

2013-09-01

The objective of this study was to determine the decay rate of maternal antibodies against major broiler chicken pathogens. A total of 30 one-day-old broiler chicks were obtained from a commercial hatchery and reared in isolation. These chicks were retrieved from a parent flock that received a routine vaccination program. Chicks were bled at hatch and sequentially thereafter every 5 d through 30 d of age. Maternal antibody titers were measured by ELISA for avian encephalomyelitis (AEV), avian influenza virus (AIV), chicken anemia virus (CAV), infectious bursal disease virus (IBDV), infectious bronchitis virus (IBV), infectious laryngotracheitis virus (ILTV), Mycoplasma gallisepticum (MG), Mycoplasma synoviae (MS), and reovirus (Reo). Maternal antibody titers for Newcastle disease virus (NDV) were measured using a hemagglutination inhibition test. Half-life estimates of maternal antibody titers were 5.3, 4.2, 7, 5.1, 3.9, 3.8, 4.9, 4.1, 6.3, and 4.7 d for AEV, AIV, CAV, IBDV, IBV, ILTV, MG, MS, NDV, and Reo, respectively. The statistical analysis revealed significant differences among half-lives of maternal antibody titers against certain pathogens. Furthermore, all maternal antibody titers were depleted by 10 d of age except for IBDV.

Influence of Maternal Obesity and Gestational Weight Gain on Maternal and Foetal Lipid Profile.

Science.gov (United States)

Cinelli, Giulia; Fabrizi, Marta; Ravà, Lucilla; Ciofi Degli Atti, Marta; Vernocchi, Pamela; Vallone, Cristina; Pietrantoni, Emanuela; Lanciotti, Rosalba; Signore, Fabrizio; Manco, Melania

2016-06-15

Fatty acids (FAs) are fundamental for a foetus's growth, serving as an energy source, structural constituents of cellular membranes and precursors of bioactive molecules, as well as being essential for cell signalling. Long-chain polyunsaturated FAs (LC-PUFAs) are pivotal in brain and visual development. It is of interest to investigate whether and how specific pregnancy conditions, which alter fatty acid metabolism (excessive pre-pregnancy body mass index (BMI) or gestational weight gain (GWG)), affect lipid supply to the foetus. For this purpose, we evaluated the erythrocyte FAs of mothers and offspring (cord-blood) at birth, in relation to pre-pregnancy BMI and GWG. A total of 435 mothers and their offspring (237 males, 51%) were included in the study. Distribution of linoleic acid (LA) and α-linolenic acid (ALA), and their metabolites, arachidonic acid, dihomogamma linoleic (DGLA) and ecosapentanoic acid, was significantly different in maternal and foetal erythrocytes. Pre-pregnancy BMI was significantly associated with maternal percentage of MUFAs (Coeff: -0.112; p = 0.021), LA (Coeff: -0.033; p = 0.044) and DHA (Coeff. = 0.055; p = 0.0016); inadequate GWG with DPA (Coeff: 0.637; p = 0.001); excessive GWG with docosaexahenoic acid (DHA) (Coeff. = -0.714; p = 0.004). Moreover, pre-pregnancy BMI was associated with foetus percentage of PUFAs (Coeff: -0.172; p = 0.009), omega 6 (Coeff: -0.098; p = 0.015) and DHA (Coeff: -0.0285; p = 0.036), even after adjusting for maternal lipids. Our findings show that maternal GWG affects maternal but not foetal lipid profile, differently from pre-pregnancy BMI, which influences both.

Cesarean deliveries and maternal weight retention.

Science.gov (United States)

Kapinos, Kandice A; Yakusheva, Olga; Weiss, Marianne

2017-10-04

Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery. We used fetal malpresentation as a natural experiment as it predicts Cesarean delivery but is uncorrelated with pre-pregnancy weight or maternal health. We used hospital administrative data (including fields used in vital birth record) from the state of Wisconsin from 2006 to 2013 to create a sample of mothers with at least two births. Using propensity score methods, we compared maternal weight prior to the second pregnancy of mothers who delivered via Cesarean due to fetal malpresentation to mothers who deliver vaginally. We found no evidence that Cesarean delivery in the first pregnancy causally leads to greater maternal weight, BMI, or movement to a higher BMI classification prior to the second pregnancy. After accounting for correlations between pre-pregnancy weight, gestational weight gain, and mode of delivery, there is no evidence of a causal link between Cesarean delivery and maternal weight retention.

Placenta Praevia: Incidence, Risk Factors, Maternal and Fetal ...

African Journals Online (AJOL)

Maternal complications included post-partum anaemia, postpartum haemorrhage & operative site infection. There were two maternal deaths (1.48%) and the perinatal mortality rate was 18.7%. Conclusion: The incidence of Placenta praevia was relatively high and associated with high maternal and perinatal complications.

STUDY ON MATERNAL MORTALITY AND NEAR MISS CASE

Directory of Open Access Journals (Sweden)

Ritanjali Behera

2017-12-01

Full Text Available BACKGROUND Maternal mortality traditionally has been the indicator of maternal health. More recently the review of cases of near miss obstetric event is found to be useful to investigate maternal mortality. Cases of near miss are those, where a woman nearly died but survived a complication that occur during pregnancy or child birth. Aim and Objective 1. To analyse near miss cases and maternal deaths. 2. To determine maternal near miss indicator and to analyse the cause and contributing factors for both of them. MATERIALS AND METHODS This prospective observational study conducted in M.K.C.G. medical college, Berhampur from 1st October 2015 to 30th September 2017. All the cases of maternal deaths and near miss cases defined by WHO criteria are taken. Information regarding demographic profile and reproductive parameters are collected and results are analysed using percentage and proportion. RESULTS Out of 17977 deliveries 201 were near miss cases and 116 were maternal deaths. MMR was 681, near miss incidence 1.18, maternal death to near miss ratio was 1:1.73. Hypertensive disorder of pregnancy (37.4% was the leading cause followed by haemorrhage (17.4%. For near miss cases 101 cases fulfilled clinical criteria, 61 laboratory criteria and 131 cases management based criteria. CONCLUSION Hypertensive disorder of pregnancy and haemorrhage are the leading cause of maternal death and for near miss cases most common organ system involved was cardiovascular system. All the near miss cases should be interpreted as opportunities to improve the health care services.

Epidural Labor Analgesia and Maternal Fever.

Science.gov (United States)

Sharpe, Emily E; Arendt, Katherine W

2017-06-01

Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.

User fees and maternity services in Ethiopia.

Science.gov (United States)

Pearson, Luwei; Gandhi, Meena; Admasu, Keseteberhan; Keyes, Emily B

2011-12-01

To examine user fees for maternity services and how they relate to provision, quality, and use of maternity services in Ethiopia. The national assessment of emergency obstetric and newborn care (EmONC) examined user fees for maternity services in 751 health facilities that provided childbirth services in 2008. Overall, only about 6.6% of women gave birth in health facilities. Among facilities that provided delivery care, 68% charged a fee in cash or kind for normal delivery. Health centers should be providing maternity services free of charge (the healthcare financing proclamation), yet 65% still charge for some aspect of care, including drugs and supplies. The average cost for normal and cesarean delivery was US $7.70 and US $51.80, respectively. Nineteen percent of these facilities required payment in advance for treatment of an obstetric emergency. The health facilities that charged user fees had, on average, more delivery beds, deliveries (normal and cesarean), direct obstetric complications treated, and a higher ratio of skilled birth attendants per 1000 deliveries than those that did not charge. The case fatality rate was 3.8% and 7.1% in hospitals that did and did not charge user fees, respectively. Utilization of maternal health services is extremely low in Ethiopia and, although there is a government decree against charging for maternity service, 65% of health centers do charge for some aspects of maternal care. As health facilities are not reimbursed by the government for the costs of maternity services, this loss of revenue may account for the more and better services offered in facilities that continue to charge user fees. User fees are not the only factor that determines utilization in settings where the coverage of maternity services is extremely low. Additional factors include other out-of-pocket payments such as cost of transport and food and lodging for accompanying relatives. It is important to keep quality of care in mind when user fees are under

Disrupted Prenatal Maternal Cortisol, Maternal Obesity, and Childhood Wheeze. Insights into Prenatal Programming

Science.gov (United States)

Fisher, Kate; Chiu, Yueh-Hsiu Mathilda; Wright, Robert O.; Fein, Rebecca; Cohen, Sheldon; Coull, Brent A.

2013-01-01

Rationale: Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. Objectives: We examined associations among prenatal maternal cortisol profiles, maternal obesity, and repeated wheeze up to age 2 years (n = 261). Methods: Salivary cortisol was collected five times per day over 3 days at 29.0 ± 4.9 weeks gestation. Mothers were categorized as obese (body mass index ≥ 30 kg/m2) versus nonobese (body mass index cortisol metrics (level at each time point, morning rise, diurnal and afternoon slopes) and obesity on wheeze adjusting for covariates. Linear mixed models were implemented to examine associations between cortisol trajectories and wheezing. Interactions between maternal cortisol and obesity were considered. Measurements and Main Results: Mothers were primarily minority (56.5% Hispanic, 24.1% African American), 61% had less than or equal to 12 years of education, 34% were obese, and 8.4% of children had repeated wheeze. An interquartile range increase in mean log cortisol at bedtime (odds ratio, 2.2; 95% confidence interval, 1.09–4.09) and maternal obesity (odds ratio, 3.43; 95% confidence interval, 1.26–9.35) were independently associated with wheeze. Linear mixed models revealed an association between a flatter afternoon slope (slower decline in log cortisol per hour) and repeated wheeze in children of obese mothers (children with [−0.017 change] and without [−0.061 change] wheeze [P = 0.009 for time × wheeze interaction]), but not in children of nonobese mothers (with [−0.050 change] and without [−0.061 change] wheeze [P = 0.51]). Conclusions: Maternal prenatal cortisol disruption and obesity were independently associated with children’s wheeze. Obese women with adverse cortisol profiles were most likely to have children with repeated wheeze. PMID:23590260

Maternal psychological distress and child decision-making.

Science.gov (United States)

Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Student midwives' perceptions on the organisation of maternity care and alternative maternity care models in the Netherlands - a qualitative study.

Science.gov (United States)

Warmelink, J Catja; de Cock, T Paul; Combee, Yvonne; Rongen, Marloes; Wiegers, Therese A; Hutton, Eileen K

2017-01-11

A major change in the organisation of maternity care in the Netherlands is under consideration, going from an echelon system where midwives provide primary care in the community and refer to obstetricians for secondary and tertiary care, to a more integrated maternity care system involving midwives and obstetricians at all care levels. Student midwives are the future maternity care providers and they may be entering into a changing maternity care system, so inclusion of their views in the discussion is relevant. This study aimed to explore student midwives' perceptions on the current organisation of maternity care and alternative maternity care models, including integrated care. This qualitative study was based on the interpretivist/constructivist paradigm, using a grounded theory design. Interviews and focus groups with 18 female final year student midwives of the Midwifery Academy Amsterdam Groningen (AVAG) were held on the basis of a topic list, then later transcribed, coded and analysed. Students felt that inevitably there will be a change in the organisation of maternity care, and they were open to change. Participants indicated that good collaboration between professions, including a shared system of maternity notes and guidelines, and mutual trust and respect were important aspects of any alternative model. The students indicated that client-centered care and the safeguarding of the physiological, normalcy approach to pregnancy and birth should be maintained in any alternative model. Students expressed worries that the role of midwives in intrapartum care could become redundant, and thus they are motivated to take on new roles and competencies, so they can ensure their own role in intrapartum care. Final year student midwives recognise that change in the organisation of maternity care is inevitable and have an open attitude towards changes if they include good collaboration, client-centred care and safeguards for normal physiological birth. The graduating

Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India.

Science.gov (United States)

Anoop, S; Saravanan, B; Joseph, A; Cherian, A; Jacob, K S

2004-04-01

To determine whether current and postpartum maternal depression and low maternal intelligence are risk factors for malnutrition in children. In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence. Major depression in the postpartum period (OR 5.0, 95% CI 1.0 to 24.0), current major depression (OR 3.2, 95% CI 1.1 to 9.5), and low maternal intelligence (OR 3.8, 95% CI 1.3 to 11.1) were associated with malnutrition in the child. Low birth weight (OR 2.9, 95% CI 1.2 to 6.8) was also significantly associated with infant malnutrition. Conditional logistic regression adjusting for all other determinants yielded the following results: major depression during the postpartum period (OR 7.8; 95% CI 1.6 to 38.51), current major depression (OR 3.1; 95% CI 0.9 to 9.7), low maternal intelligence (OR 4.6; 95% CI 1.5 to 14.1), and low birth weight (OR 2.7; 95% CI 2.5 to 6.8). The interactions between current maternal depression and low birth weight and between postpartum depression and low maternal intelligence were statistically significant. The level of maternal intelligence was associated with nutritional status. The severity of malnutrition was also significantly associated with major depression during the postpartum period and low maternal intelligence. There is evidence for an association between postpartum maternal depression, low maternal intelligence, and low birth weight with malnutrition in children aged 6-12 months.

Effect of Health Insurance on the Use and Provision of Maternal Health Services and Maternal and Neonatal Health Outcomes: A Systematic Review

Science.gov (United States)

Peterson, Lauren A.; Hatt, Laurel E.

2013-01-01

Financial barriers can affect timely access to maternal health services. Health insurance can influence the use and quality of these services and potentially improve maternal and neonatal health outcomes. We conducted a systematic review of the evidence on health insurance and its effects on the use and provision of maternal health services and on maternal and neonatal health outcomes in middle- and low-income countries. Studies were identified through a literature search in key databases and consultation with experts in healthcare financing and maternal health. Twenty-nine articles met the review criteria of focusing on health insurance and its effect on the use or quality of maternal health services, or maternal and neonatal health outcomes. Sixteen studies assessed demand-side effects of insurance, eight focused on supply-side effects, and the remainder addressed both. Geographically, the studies provided evidence from sub-Saharan Africa (n=11), Asia (n=9), Latin America (n=8), and Turkey. The studies included examples from national or social insurance schemes (n=7), government-run public health insurance schemes (n=4), community-based health insurance schemes (n=11), and private insurance (n=3). Half of the studies used econometric analyses while the remaining provided descriptive statistics or qualitative results. There is relatively consistent evidence that health insurance is positively correlated with the use of maternal health services. Only four studies used methods that can establish this causal relationship. Six studies presented suggestive evidence of overprovision of caesarean sections in response to providers’ payment incentives through health insurance. Few studies focused on the relationship between health insurance and the quality of maternal health services or maternal and neonatal health outcomes. The available evidence on the quality and health outcomes is inconclusive, given the differences in measurement, contradictory findings, and

How Does Maternal Employment Affect Children's Socioemotional Functioning?

Science.gov (United States)

Lam, Gigi

2015-01-01

The maternal employment becomes an irreversible trend across the globe. The effect of maternal employment on children's socioemotional functioning is so pervasive that it warrants special attention to investigate into the issue. A trajectory of analytical framework of how maternal employment affects children's socioemotional functioning originates…

Maternal serum markers in screening for Down syndrome

DEFF Research Database (Denmark)

Nørgaard-Pedersen, B; Larsen, S O; Arends, J

1990-01-01

The addition of two new markers in maternal serum, estriol and HCG, to those already known, namely the level of maternal serum alfa-fetoprotein and maternal age, considerably improves the expected results of a screening strategy for Down syndrome. The detection rate is slightly increased from 53....

Co-variables in first trimester maternal serum screening

NARCIS (Netherlands)

de Graaf, I. M.; Cuckle, H. S.; Pajkrt, E.; Leschot, N. J.; Bleker, O. P.; van Lith, J. M.

2000-01-01

The objective of this study was to determined the influence of maternal weight, maternal smoking habits, gravidity, parity and fetal gender on the level of maternal serum marker used in first trimester screening for Down syndrome. A total of 2449 singleton unaffected pregnancies from two centres

Donor mesenchymal stem cells home to maternal wounds after transamniotic stem cell therapy (TRASCET) in a rodent model.

Science.gov (United States)

Graham, Christopher D; Shieh, Hester F; Brazzo, Joseph A; Zurakowski, David; Fauza, Dario O

2017-06-01

Transamniotic stem cell therapy (TRASCET) with amniotic fluid-derived MSCs (afMSCs) has emerged experimentally as a practical treatment strategy for congenital anomalies. In this study, we sought to determine whether afMSCs migrate to the mother following TRASCET. Pregnant rat dams were divided into three groups. Two groups received volume-matched injections into all amniotic cavities of either a suspension of afMSCs labeled with a luciferase reporter gene or the luciferase protein alone. In a third group, a suspension of labeled cells was aliquoted onto the serosal surface of the uterus. Maternal samples from the laparotomy scar (fascia and skin separately), bone marrow, and peripheral blood were procured, along with placenta and umbilical cord. Specimens were screened for luminescence via microplate luminometry. Luminescence was detected in 60% (9/15) of the fascial scars from the group receiving intraamniotic injection of afMSCs, but in none of the other groups (Pcells in the placenta and their presence in maternal fascia (Wald test=10.2; P=0.001). Amniotic mesenchymal stem cells migrate to maternal sites of injury after intraamniotic injection. Maternal homing of donor cells must be considered in the setting of transamniotic stem cell therapy. N/A (animal and laboratory study). Copyright © 2017 Elsevier Inc. All rights reserved.

Indirect causes of severe adverse maternal outcomes: a secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health.

Science.gov (United States)

Lumbiganon, P; Laopaiboon, M; Intarut, N; Vogel, J P; Souza, J P; Gülmezoglu, A M; Mori, R

2014-03-01

To assess the proportion of severe maternal outcomes resulting from indirect causes, and to determine pregnancy outcomes of women with indirect causes. Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health. A total of 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East. A total of 314 623 pregnant women admitted to the participating facilities. We identified the percentage of women with severe maternal outcomes arising from indirect causes. We evaluated the risk of severe maternal and perinatal outcomes in women with, versus without, underlying indirect causes, using adjusted odds ratios and 95% confidence intervals, by a multilevel, multivariate logistic regression model, accounting for clustering effects within countries and health facilities. Severe maternal outcomes and preterm birth, fetal mortality, early neonatal mortality, perinatal mortality, low birthweight, and neonatal intensive care unit admission. Amongst 314 623 included women, 2822 were reported to suffer from severe maternal outcomes, out of which 20.9% (589/2822; 95% CI 20.1-21.6%) were associated with indirect causes. The most common indirect cause was anaemia (50%). Women with underlying indirect causes showed significantly higher risk of obstetric complications (adjusted odds ratio, aOR, 7.0; 95% CI 6.6-7.4), severe maternal outcomes (aOR 27.9; 95% CI 24.7-31.6), and perinatal mortality (aOR 3.8; 95% CI 3.5-4.1). Indirect causes were responsible for about one-fifth of severe maternal outcomes. Women with underlying indirect causes had significantly increased risks of severe maternal and perinatal outcomes. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Maternal self-esteem, exposure to lead, and child neurodevelopment.

Science.gov (United States)

Surkan, Pamela J; Schnaas, Lourdes; Wright, Rosalind J; Téllez-Rojo, Martha M; Lamadrid-Figueroa, Héctor; Hu, Howard; Hernández-Avila, Mauricio; Bellinger, David C; Schwartz, Joel; Perroni, Estela; Wright, Robert O

2008-03-01

The notion that maternal personality characteristics influence cognitive development in their children has been grounded in stress moderation theory. Maternal personality traits, such as self-esteem, may buffer maternal stressors or lead to improved maternal-child interactions that directly impact neurodevelopment. This can be extended to suggest that maternal personality may serve to attenuate or exacerbate the effects of other neurotoxicants, although this has not been studied directly. We examined whether mothers' self-esteem had a direct or main effect on their children's cognitive outcomes. We also explored the modifying effects of maternal self-esteem on the association between exposure to lead and neurodevelopment in these children. Study participants included 379 mother-child pairs from Mexico City. Data included the Coopersmith Self-Esteem Scale in mothers, children's Bayley's Scale of Infant Development (BSID) scores, and sociodemographic information. Linear regression was used to model the relationship between maternal self-esteem and the Bayley's Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores at age 24 months using models stratified by levels of maternal self-esteem. In adjusted models, each point increase in maternal self-esteem was associated with children having 0.2 higher score on the Bayley's MDI (p=0.04). Similar results were observed using the PDI outcome. Moreover, there was evidence that maternal self-esteem attenuated the negative effects of lead exposure, although the interaction fell short of conventional levels of statistical significance.

Detection of maternal DNA in placental/umbilical cord blood by locus-specific amplification of the noninherited maternal HLA gene.

Science.gov (United States)

Scaradavou, A; Carrier, C; Mollen, N; Stevens, C; Rubinstein, P

1996-08-15

A critical issue regarding the broader utilization of placental/ umbilical cord blood (PCB) in unrelated bone marrow restoration is the possibility of contamination with maternal lymphocytes capable of immunological reactivity against the eventual recipient. On transplantation, such maternal cells might lead to graft-versus-host disease (GVHD) even if the intended donor's neonatal lymphocytes were unresponsive. We measured the proportion of PCB samples that were contaminated with maternal cells. Placental-maternal sample pairs were selected so that the mother was heterozygous for the DR53 haplotype, whereas the placental sample was DR53-negative. The PCB samples were investigated for the presence of the noninherited maternal gene DRB4, exclusive to the DR53 haplotypes. Locus-specific polymerase chain reaction amplification with DRB4 sequence-specific primers was followed by either gel electrophoresis or blotting and hybridization to an internal sequence DRB4 probe. Polymerase chain reaction products from DNA mixtures containing as low as 0.5 ng of a DRB4-positive DNA control in 1.0 microgram of a DRB4-negative DNA sample (1:2 x 10(3) dilution) showed a visible DRB4 band in agarose gels stained with ethidium bromide. Locus-specific hybridization increased the detection sensitivity to 1:10(5) (0.01 ng of the DRB4-positive DNA control). Control mixtures of known amounts of DRB4-positive and -negative DNA were included in all experiments. Comparison of the thickness of DRB4 bands after electrophoresis and the intensity of the DRB4-specific hybridization signals to the concentration controls allowed a rough estimation of the amount of maternal DNA in the placental blood specimens. A total of 213 PCB samples were tested. By gel electrophoresis, DRB4-specific bands were observed to be as strong or stronger in 23 (10.8%) samples as those in the 1:2 x 10(3) control, and 153 (17.8%) samples were negative in this test. The remaining 37 (17.3%) samples disclosed weaker DRB4

Benefits realisation in maternity information systems.

Science.gov (United States)

Betts, H J; Gunn-Russell, R

1997-01-01

This paper describes the compilation of a monograph on benefits realisation of maternity information systems from maternity services around England and Wales. It was compiled to compliment a monograph produced in June 1995 on Nursing Information Systems. The paper summarises the structure of the monograph and outlines the concept of benefits realisation. The examples featured in the monograph are not "true" benefits realisation studies and many of the accounts are anecdotal in nature. However, the paper suggests that midwives do benefit from using a maternity information system particularly in the areas of auditing practice, effortless retrieval of statistics, less duplication of data entry, summaries of care and research purposes. Managers also benefit from some of these functions and those relating to estimating workload and allocation of resources. It is suggested that any benefits for staff and management should also benefit clients and improve the provision of the maternity services.

Women's experience of maternal morbidity: a qualitative analysis.

LENUS (Irish Health Repository)

Meaney, S

2016-07-01

Maternal morbidity refers to pregnancy-related complications, ranging in severity from acute to chronic. In Ireland one in 210 maternities will experience a severe morbidity. Yet, how women internalize their experience of morbidity has gone largely unexplored. This study aimed to explore women\\'s experiences of maternal morbidity.

Maternal mortality and delay: Socio-demographic characteristics of ...

African Journals Online (AJOL)

This study assessed the contribution of delay to maternal deaths and also determined the socio¬demographic characteristics of patients with maternal deaths with associated delay. Methods: This is a cross-sectional descriptive study of all maternal deaths in Irrua specialist Teaching Hospital, Nigeria between January 1999 ...

Cerebral biochemical abnormalities in experimental maternal phenylketonuria: gangliosides and sialoglycoproteins

International Nuclear Information System (INIS)

Loo, Y.H.; Hyde, K.R.; Lin, F.H.; Wisniewski, H.M.

1985-01-01

The present study sought a biochemical explanation for retarded brain development in the heterozygous offspring of the phenylketonuric (PKU) mother. Two rat models of simulated maternal PKU, one induced by p-chloropheylalanine and phenylalanine and the other by phenylacetate, were employed in this investigation. Maternal PKU had no influence on cerebral concentrations of DNA, protein, and cholesterol, which were normal in the 2 d old pup. However, there was a noticeable disruption of the normal ganglioside pattern and a significant reduction of sialoglycoproteins. Concomitant with a delayed drop in the gangliosides Q/sub 1b/ and D 3 , was a slower rise in M 1 and D/sub 1a/. At least 66% of sialoglycoproteins located on SDS-PAGE gel chromatograms, by radioactivity incorporated in vivo from radiolabeled N-acetylmannosamine and by ( 3 H) sialic acid released by neuraminidase from periodate-( 3 H) borohydride labeled glycoproteins, have mobilites of the cell adhesion molecules N-CAM and D-CAM. Whether the reduction of the sialogylcoproteins induced by maternal PKU is mainly in these cell adhesion molecules requires further investigation. Interference with the function of gangliosides and certain sialoglycoproteins during cerebral development may contribute to the brain dysfunction observed in the offspring of PKU mothers not on diet control during pregnancy. 49 references, 2 figures, 3 tables

Emotions, stress, and maternal motivation in primates.

Science.gov (United States)

Maestripieri, Dario

2011-06-01

Recent research conducted with nonhuman primates confirms that adaptive emotional processes, such as maternal attraction arousability and maternal anxiety arousability, enhance and sustain female motivation to interact with infants, invest in them, and protect them during the postpartum period. Changes in these emotional processes, and concomitant changes in maternal motivation, facilitate the reduction and eventual termination of maternal investment associated with infant weaning. Although laboratory studies of rodents and socially deprived rhesus monkeys have suggested that nulliparous females are neophobic and find infant stimuli aversive, recent primate research indicates that neophobia or aversion to infant stimuli do not occur in females with normal developmental experience. Furthermore, although some rodent and human studies have shown that lactation is accompanied by physiological hyporesponsiveness to stress, other studies of rodents, nonhuman primates, and humans indicate that mothers are highly vulnerable to stress and that stress-induced dysregulation of emotions can interfere with maternal motivation and parenting behavior. It is possible that some aspects of the emotional and experiential regulation of maternal motivation and parental behavior are different in different mammalian species. However, variation in the environments in which subjects are tested and in their developmental experience may also be responsible for the some discrepancies between the results of different studies. © 2010 Wiley-Liss, Inc.

A First Standardized Swiss Electronic Maternity Record.

Science.gov (United States)

Murbach, Michel; Martin, Sabine; Denecke, Kerstin; Nüssli, Stephan

2017-01-01

During the nine months of pregnancy, women have to regularly visit several physicians for continuous monitoring of the health and development of the fetus and mother. Comprehensive examination results of different types are generated in this process; documentation and data transmission standards are still unavailable or not in use. Relevant information is collected in a paper-based maternity record carried by the pregnant women. To improve availability and transmission of data, we aim at developing a first prototype for an electronic maternity record for Switzerland. By analyzing the documentation workflow during pregnancy, we determined a maternity record data set. Further, we collected requirements towards a digital maternity record. As data exchange format, the Swiss specific exchange format SMEEX (swiss medical data exchange) was exploited. Feedback from 27 potential users was collected to identify further improvements. The relevant data is extracted from the primary care information system as SMEEX file, stored in a database and made available in a web and a mobile application, developed as prototypes of an electronic maternity record. The user confirmed the usefulness of the system and provided multiple suggestions for an extension. An electronical maternity record as developed in this work could be in future linked to the electronic patient record.

Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

Science.gov (United States)

Perdok, Hilde; Jans, Suze; Verhoeven, Corine; Henneman, Lidewij; Wiegers, Therese; Mol, Ben Willem; Schellevis, François; de Jonge, Ank

2016-07-26

This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the 'migration three delays' model.

Science.gov (United States)

Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit; Högberg, Ulf; Mulic-Lutvica, Ajlana; Essén, Birgitta

2014-04-12

Several European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988-2010. A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the 'migration three delays' framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context. Major and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. Suboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women.

32 CFR 728.71 - Ex-service maternity care.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Ex-service maternity care. 728.71 Section 728.71... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity... certified by medical authorities that the pregnancy existed prior to entry into service (EPTE), maternity...

Infant Communicative Behaviors and Maternal Responsiveness

Science.gov (United States)

DiCarlo, Cynthia F.; Onwujuba, Chinwe; Baumgartner, Jennifer I.

2014-01-01

Background: This study applies attachment and transactional theories in evaluating the dyadic interactions observed between a mother and her infant. Infant communication and maternal responsivity are highlighted as the medium for positive interaction. Objective: The impact of individualized maternal training on mother infant communicative…

Maternal postpartum distress and childhood overweight.

Directory of Open Access Journals (Sweden)

Teresa A Ajslev

Full Text Available OBJECTIVE: We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight. METHODS: We performed a prospective cohort study, including 21,121 mother-child-dyads from the Danish National Birth Cohort (DNBC. Maternal distress was measured 6 months postpartum by 9 items covering anxiety, depression and stress. Outcome was childhood overweight at 7-years-of age. Multiple logistic regression analyses were performed and information on maternal age, socioeconomic status, pre-pregnancy BMI, gestational weight gain, parity, smoking during pregnancy, paternal BMI, birth weight, gestational age at birth, sex, breastfeeding and finally infant weight at 5 and 12 month were included in the analyses. RESULTS: We found, that postpartum distress was not associated with childhood risk of overweight, OR 1.00, 95%CI [0.98-1.02]. Neither was anxiety, depression, or stress exposure, separately. There were no significant differences between the genders. Adjustment for potential confounders did not alter the results. CONCLUSION: Maternal postpartum distress is apparently not an independent risk factor for childhood overweight at 7-years-of-age. However, we can confirm previous findings of perinatal determinants as high maternal pre-pregnancy BMI, and smoking during pregnancy being risk factors for childhood overweight.

Congenital cataract screening in maternity wards is effective

DEFF Research Database (Denmark)

Magnusson, Gunilla; Bizjajeva, Svetlana; Haargaard, Birgitte

2013-01-01

AIM: To study which eye-screening protocol prevails in Swedish maternity/neonatal wards, evaluate efficacy in a prospective study, and compare results with earlier Swedish retrospective results. METHODS: Surveys were sent in 2006 to maternity/neonatal and women's health departments regarding...... with earlier retrospective results was performed. RESULTS: Eye screening is routine protocol at a rate of 90% of Swedish maternity wards. Sixty-one children were included in the study. An increase was shown in case referrals from maternity wards compared to ten years ago (64% versus 50%). Detection...

Maternal Psychopathology and Infant Development at 18 Months: The Impact of Maternal Personality Disorder and Depression

Science.gov (United States)

Conroy, Susan; Pariante, Carmine M.; Marks, Maureen N.; Davies, Helen A.; Farrelly, Simone; Schacht, Robin; Moran, Paul

2012-01-01

Objective: No previous longitudinal study has examined the impact of comorbid maternal personality disorder (PD) and depression on child development. We set out to examine whether maternal PD and depression assessed at 2 months post partum would be independently associated with adverse developmental outcomes at 18 months of age. Method: Women were…

Contribution of maternal age and pregnancy checkbox on maternal mortality ratios in the United States, 1978-2012.

Science.gov (United States)

Davis, Nicole L; Hoyert, Donna L; Goodman, David A; Hirai, Ashley H; Callaghan, William M

2017-09-01

Maternal mortality ratios (MMR) appear to have increased in the United States over the last decade. Three potential contributing factors are (1) a shifting maternal age distribution, (2) changes in age-specific MMR, and (3) the addition of a checkbox indicating recent pregnancy on the death certificate. To determine the contribution of increasing maternal age on changes in MMR from 1978 to 2012 and estimate the contribution of the pregnancy checkbox on increases in MMR over the last decade. Kitagawa decomposition analyses were conducted to partition the maternal age contribution to the MMR increase into 2 components: changes due to a shifting maternal age distribution and changes due to greater age-specific mortality ratios. We used National Vital Statistics System natality and mortality data. The following 5-year groupings were used: 1978-1982, 1988-1992, 1998-2002, and 2008-2012. Changes in age-specific MMRs among states that adopted the standard pregnancy checkbox onto their death certificate before 2008 (n = 23) were compared with states that had not adopted the standard pregnancy checkbox on their death certificate by the end of 2012 (n = 11) to estimate the percentage increase in the MMR due to the pregnancy checkbox. Overall US MMRs for 1978-1982, 1988-1992, and 1998-2002 were 9.0, 8.1, and 9.1 deaths per 100,000 live births, respectively. There was a modest increase in the MMR between 1998-2002 and 2008-2012 in the 11 states that had not adopted the standard pregnancy checkbox on their death certificate by the end of 2012 (8.6 and 9.9 deaths per 100,000, respectively). However, the MMR more than doubled between 1998-2002 and 2008-2012 in the 23 states that adopted the standard pregnancy checkbox (9.0-22.4); this dramatic increase was almost entirely attributable to increases in age-specific MMRs (94.9%) as opposed to increases in maternal age (5.1%), with an estimated 90% of the observed change reflecting the change in maternal death identification rather

Predictors of Maternal Sensitivity in At-Risk Families

Science.gov (United States)

Neuhauser, Alex

2018-01-01

Maternal sensitivity is of central importance to a child's healthy development. This study examines how different types of psychosocial stress originating from the child, the parents, the context, and overall stress relate to maternal sensitivity. Psychosocial stress and its impact on maternal sensitivity are assessed in an at-risk sample of 248…

Effects of Maternal Childhood Aggression and Social Withdrawal on Maternal Request Strategies and Child Compliance and Noncompliance

Science.gov (United States)

Grunzeweig, Naomi; Stack, Dale M.; Serbin, Lisa A.; Ledingham, Jane; Schwartzman, Alex E.

2009-01-01

This prospective, intergenerational study investigated the influences of maternal histories of childhood aggression and social withdrawal on maternal request strategies and child compliance and noncompliance. Seventy-four women from the Concordia Longitudinal Risk Project, who were rated during childhood using peer nomination measures of…

Maternal employment and birth outcomes

DEFF Research Database (Denmark)

Wüst, Miriam

selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (unemployed mothers and students). Given generous welfare bene ts and strict workplace regulations in Denmark, my findings support a residual......I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively...... for time-varying factors that may correlate with employment and birth outcomes, such as pre-pregnancy family income and maternal occupation, pregnancy-related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time...

Classification differences and maternal mortality

DEFF Research Database (Denmark)

Salanave, B; Bouvier-Colle, M H; Varnoux, N

1999-01-01

OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel....... This change was substantial in three countries (P statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per...... of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were...

Maternal-fetal cholesterol transport in the second half of mouse pregnancy does not involve LDL receptor-related protein 2.

Science.gov (United States)

Zwier, M V; Baardman, M E; van Dijk, T H; Jurdzinski, A; Wisse, L J; Bloks, V W; Berger, R M F; DeRuiter, M C; Groen, A K; Plösch, T

2017-08-01

LDL receptor-related protein type 2 (LRP2) is highly expressed on both yolk sac and placenta. Mutations in the corresponding gene are associated with severe birth defects in humans, known as Donnai-Barrow syndrome. We here characterized the contribution of LRP2 and maternal plasma cholesterol availability to maternal-fetal cholesterol transport and fetal cholesterol levels in utero in mice. Lrp2 +/- mice were mated heterozygously to yield fetuses of all three genotypes. Half of the dams received a 0.5% probucol-enriched diet during gestation to decrease maternal HDL cholesterol. At E13.5, the dams received an injection of D7-labelled cholesterol and were provided with 1- 13 C acetate-supplemented drinking water. At E16.5, fetal tissues were collected and maternal cholesterol transport and fetal synthesis quantified by isotope enrichments in fetal tissues by GC-MS. The Lrp2 genotype did not influence maternal-fetal cholesterol transport and fetal cholesterol. However, lowering of maternal plasma cholesterol levels by probucol significantly reduced maternal-fetal cholesterol transport. In the fetal liver, this was associated with increased cholesterol synthesis rates. No indications were found for an interaction between the Lrp2 genotype and maternal probucol treatment. Maternal-fetal cholesterol transport and endogenous fetal cholesterol synthesis depend on maternal cholesterol concentrations but do not involve LRP2 in the second half of murine pregnancy. Our results suggest that the mouse fetus can compensate for decreased maternal cholesterol levels. It remains a relevant question how the delicate system of cholesterol transport and synthesis is regulated in the human fetus and placenta. © 2016 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Association between temperature and maternal stress during pregnancy.

Science.gov (United States)

Lin, Yanfen; Hu, Wenjing; Xu, Jian; Luo, Zhongcheng; Ye, Xiaofang; Yan, Chonghuai; Liu, Zhiwei; Tong, Shilu

2017-10-01

Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy. In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress. After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (stress during pregnancy. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal cerebrovascular accidents in pregnancy: incidence and outcomes.

Science.gov (United States)

Walsh, Jennifer; Murphy, Cliona; Murray, Aoife; O'Laoide, Risteard; McAuliffe, Fionnuala M

2010-12-01

Stroke occurring during pregnancy and the postnatal period is a rare but potentially catastrophic event. The aim of this study was to examine the incidence and outcomes of pregnancies complicated by maternal stroke in a single centre. This is a prospective study of over 35,000 consecutive pregnancies over a four-year period at the National Maternity Hospital in Dublin from 2004 to 2008; in addition we also retrospectively examined all cases of maternal mortality at our institution over a 50-year period from 1959 to 2009. We prospectively identified eight cases of strokes complicating pregnancy and the postnatal period giving an overall incidence of 22.34 per 100,000 pregnancies or 24.74 per 100,000 deliveries. There were no stroke-related mortalities during that time. Retrospective analysis of maternal mortality revealed 102 maternal deaths over a 50-year period, 19 (18.6%) of which were due to cerebrovascular accidents. In conclusion, strokes complicating pregnancy and the puerperium remain a rare event and though there appears to be evidence that the incidence is increasing, the associated maternal mortality appears to be falling.

Maternal Control Behavior and Locus of Control: Examining Mechanisms in the Relation between Maternal Anxiety Disorders and Anxiety Symptomatology in Children

Science.gov (United States)

Becker, Kimberly D.; Ginsburg, Golda S.; Domingues, Janine; Tein, Jenn-Yun

2010-01-01

This study tested components of a proposed model of child anxiety and examined the mediational roles of (1) maternal control behavior, (2) maternal external locus of control, and (3) child external locus of control in the association between maternal and child anxiety. Thirty-eight clinically anxious mothers and 37 nonanxious mothers participated…

Regional differences in Dutch maternal mortality.

NARCIS (Netherlands)

Graaf, J. de; Schutte, J.; Poeran, J.; Roosmalen, J. van; Bonsel, G.; Steegers, E.

2012-01-01

Please cite this paper as: de Graaf J, Schutte J, Poeran J, van Roosmalen J, Bonsel G, Steegers E. Regional differences in Dutch maternal mortality. BJOG 2012;119:582-588. Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of

Maternal Employment and Childhood Obesity

DEFF Research Database (Denmark)

Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia

2013-01-01

The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

Maternal Employment and Childhood Obesity

DEFF Research Database (Denmark)

Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia

The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

Maternal methadone dosing schedule and fetal neurobehavior

Science.gov (United States)

Jansson, Lauren M.; DiPietro, Janet A.; Velez, Martha; Elko, Andrea; Knauer, Heather; Kivlighan, Katie T.

2008-01-01

Objective Daily methadone maintenance is the standard of care for opiate dependency during pregnancy. Previous research has indicated that single-dose maternal methadone administration significantly suppresses fetal neurobehaviors. The purpose of this study was to determine if split-dosing would have less impact on fetal neurobehavior than single-dose administration. Methods Forty methadone-maintained women were evaluated at peak and trough maternal methadone levels on single- and split-dosing schedules. Monitoring sessions occurred at 36 and 37 weeks gestation in a counterbalanced study design. Fetal measures included heart rate, variability, accelerations, motor activity and fetal movement-heart rate coupling (FM-FHR). Maternal measures included heart period, variability, skin conductance, respiration and vagal tone. Repeated measure analysis of variance was used to evaluate within-subject changes between split- and single-dosing regimens. Results All fetal neurobehavioral parameters were suppressed by maternal methadone administration, regardless of dosing regimen. Fetal parameters at peak were significantly lower during single vs. split methadone administration. FM-FHR coupling was less suppressed from trough to peak during split-dosing vs. single-dosing. Maternal physiologic parameters were generally unaffected by dosing condition. Conclusion Split- dosed fetuses displayed less neurobehavioral suppression from trough to peak maternal methadone levels as compared to single-dosed fetuses. Split-dosing may be beneficial for methadone-maintained pregnant women. PMID:19085624

Maternal near-miss in a rural hospital in Sudan

Directory of Open Access Journals (Sweden)

Adam Gamal K

2011-06-01

Full Text Available Abstract Background Investigation of maternal near-miss is a useful complement to the investigation of maternal mortality with the aim of meeting the United Nations' fifth Millennium Development Goal. The present study was conducted to investigate the frequency of near-miss events, to calculate the mortality index for each event and to compare the socio-demographic and obstetrical data (age, parity, gestational age, education and antenatal care of the near-miss cases with maternal deaths. Methods Near-miss cases and events (hemorrhage, infection, hypertensive disorders, anemia and dystocia, maternal deaths and their causes were retrospectively reviewed and the mortality index for each event was calculated in Kassala Hospital, eastern Sudan over a 2-year period, from January 2008 to December 2010. Disease-specific criteria were applied for these events. Results There were 9578 deliveries, 205 near-miss cases, 228 near-miss events and 40 maternal deaths. Maternal near-miss and maternal mortality ratio were 22.1/1000 live births and 432/100 000 live births, respectively. Hemorrhage accounted for the most common event (40.8%, followed by infection (21.5%, hypertensive disorders (18.0%, anemia (11.8% and dystocia (7.9%. The mortality index were 22.2%, 10.0%, 10.0%, 8.8% and 2.4% for infection, dystocia, anemia, hemorrhage and hypertensive disorders, respectively. Conclusion There is a high frequency of maternal morbidity and mortality at the level of this facility. Therefore maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating maternal-near miss events (hemorrhage, infections, hypertension and anemia at all care levels including primary level.

Telomere length is longer in women with late maternal age

DEFF Research Database (Denmark)

Fagan, Erin; Sun, Fangui; Bae, Harold

2017-01-01

OBJECTIVE:: Maternal age at birth of last child has been associated with maternal longevity. The aim of this study was to determine whether older women with a history of late maternal age at last childbirth had a longer leukocyte telomere length than those with maternal age at last childbirth of 29...... died, but were at least 70 years old, were studied. Logistic regression models using generalized estimating equations were used to determine the association between tertiles of telomere length and maternal age at last childbirth, adjusting for covariates. RESULTS:: Age at birth of the last child...... in the first tertile. CONCLUSIONS:: These findings show an association between longer leukocyte telomere length and a later maternal age at birth of last child, suggesting that extended maternal age at last childbirth may be a marker for longevity....

Associations of maternal nutrition during pregnancy and post-partum with maternal cognition and caregiving.

Science.gov (United States)

Prado, Elizabeth L; Ashorn, Ulla; Phuka, John; Maleta, Kenneth; Sadalaki, John; Oaks, Brietta M; Haskell, Marjorie; Allen, Lindsay H; Vosti, Steve A; Ashorn, Per; Dewey, Kathryn G

2018-04-01

Pregnant and post-partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid-based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post-partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post-partum attention and executive function. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Current Challenges and Achievements in Maternal Immunization Research

Directory of Open Access Journals (Sweden)

Flor M. Munoz

2018-03-01

Full Text Available Maternal immunization has the potential to significantly improve maternal and child health worldwide by reducing maternal and infant morbidity and mortality associated with disease caused by pathogens that are particularly relevant in the perinatal period and in early life, and for which no alternative effective preventive strategies exist. Research on all aspects related to vaccines for administration during pregnancy is ongoing with support of multiple stakeholders and global participation. Substantial progress has been made, and the availability of new vaccines licensed exclusively for use in pregnant women to protect their infants has become an achievable goal. This review provides an update of the current challenges and achievements in maternal immunization research, focusing on recent milestones that advance the field and the prospects to make maternal immunization a feasible and accessible strategy to improve global health.

Maternal Depression, Paternal Psychopathology, and Toddlers’ Behavior Problems

Science.gov (United States)

Dietz, Laura J.; Jennings, Kay Donahue; Kelley, Sue A.; Marshal, Michael

2013-01-01

This article examined the effects of maternal depression during the postpartum period (Time 1) on the later behavior problems of toddlers (Time 3) and tested if this relationship was moderated by paternal psychopathology during toddlers’ lives and/or or mediated by maternal parenting behavior observed during mother–child interaction (Time 2). Of the 101 mothers who participated in this longitudinal study with their toddlers, 51 had never experienced an episode of Major Depressive Disorder (MDD) and 50 had experienced an episode of MDD during the first 18 months of their toddlers’ lives. Maternal depression at Time 1 was significantly associated with toddlers’ externalizing and internalizing behavior problems only when paternal psychopathology was present. As predicted, maternal negativity at Time 2 was found to mediate the relationship between maternal depression at Time 1 and toddlers’ externalizing behavior problems at Time 3. PMID:19130357

ETHICAL ISSUES IN THE SURROGATE MATERNITY PRACTICE

OpenAIRE

TÜRK, Rukiye; TERZİOĞLU, Fusun

2014-01-01

The assisted reproductive technology was initially considered to be a treatment tool for infertile couples. However, as it was started in time to use the uteri of other women for the embryos of the other ones, the concept of surrogate maternity appeared.The surrogate maternity is practiced in three types. In the first type of surrogate maternity, the sperm of the spouse of the prospective mother is inseminated with the ovum of the surrogate mother. The second method is the in-vitro inseminati...

Maternal stress and high-fat diet effect on maternal behavior, milk composition, and pup ingestive behavior.

Science.gov (United States)

Purcell, Ryan H; Sun, Bo; Pass, Lauren L; Power, Michael L; Moran, Timothy H; Tamashiro, Kellie L K

2011-09-01

Chronic variable prenatal stress or maternal high-fat diet results in offspring that are significantly heavier by the end of the first postnatal week with increased adiposity by weaning. It is unclear, however, what role maternal care and diet play in the ontogenesis of this phenotype and what contributions come from differences already established in the rat pups. In the present studies, we examined maternal behavior and milk composition as well as offspring ingestive behavior. Our aim was to better understand the development of the obese phenotype in offspring from dams subjected to prenatal stress and/or fed a high-fat (HF) diet during gestation and lactation. We found that dams maintained on a HF diet through gestation and lactation spent significantly more time nursing their pups during the first postnatal week. In addition, offspring of prenatal stress dams consumed more milk at postnatal day (PND) 3 and offspring of HF dams consume more milk on PND 7 in an independent ingestion test. Milk from HF dams showed a significant increase in fat content from PND 10-21. Together these results suggest that gestational dietary or stress manipulations can alter the rat offspring's developmental environment, evidence of which is apparent by PND 3. Alterations in maternal care, milk composition, and pup consumption during the early postnatal period may contribute to long-term changes in body weight and adiposity induced by maternal prenatal stress or high-fat diet. Copyright © 2011 Elsevier Inc. All rights reserved.

Labour analgesia with intrathecal fentanyl decreases maternal stress.

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Cascio, M; Pygon, B; Bernett, C; Ramanathan, S

1997-06-01

Lumbar epidural analgesia (LEA) decreases maternal stress as measured by maternal circulating plasma catecholamine concentrations. Intrathecal fentanyl (ITF) provides effective labour analgesia but its effect on maternal epinephrine (Epi) and norepinephrine (NE) concentrations is not known. This study assesses whether ITF reduces maternal stress in the same manner as conventional LEA. Twenty-four healthy women in active labour received either 25 micrograms ITF (n = 12) or epidural lidocaine 1.5% (n = 12) for analgesia. Venous blood samples were collected before anaesthesia and at five minute intervals for 30 min following anaesthesia for the measurement of plasma Epi and NE by high performance liquid chromatography. Maternal blood pressure (BP), heart rate (HR), visual analog scores (VAS) to pain and pruritus were recorded at the same time. Both ITF and LEA decreased pain VAS scores, maternal BP, and plasma Epi concentrations with only minimal effects on plasma NE concentrations. Intrathecal fentanyl (ITF) and LEA reduced plasma epi to a similar extent, with ITF reducing the levels slightly faster than LEA. Intrathecal fentanyl(ITF) and LEA reduced plasma Epi concentrations by 52% and 51%, respectively (P value < 0.01). We conclude that ITF is as effective as LEA in producing pain relief in the labouring patient. Intrathecal Fentanyl (ITF) is also capable of reducing maternal plasma epinephrine concentration, thus avoiding the possibly deleterious side effects of excess amounts of this catecholamine during labour.

Negotiating Rights : Building Coalitions for Improving Maternal ...

International Development Research Centre (IDRC) Digital Library (Canada)

Negotiating Rights : Building Coalitions for Improving Maternal Health Services ... the state of maternal health in the country reflects poorly on public health priorities. ... A number of international agencies and civil society organizations are ...

Maternal Mortality In Imo State University Teaching Hospital, Orlu: A ...

African Journals Online (AJOL)

Background: A maternal death is a calamity particularly for the immediate family members. Maternal mortality ratio is high in most developing countries. Although many studies have been carried out on maternal mortality in many parts of Nigeria there is a dearth of information on maternal mortality ratio in Imo State.

Kesinambungan Pemanfaatan Pelayanan Kesehatan Maternal di Indonesia

Directory of Open Access Journals (Sweden)

Ning Sulistiyowati

2017-11-01

Full Text Available AbstractIn an effort to decrease the maternal mortality rate in Indonesia, the government implements a lot of strategies and health programs by means of continum of care. This article aims to determine the factors of mothers affecting sustainable maternal health services using the 2013 Riskesdasdata. Data analyses were done by calculating the difference in the percentage of coverage of health indicators in each district/city and continuing to find a model determining the relationship of maternalcharacteristics factors related to the continuation of maternal health care by logistic regression. The sustainability of maternal health service utilization in Indonesia is only 46%. The factors are the mother's education (OR = 1.79 and 2.58, the work of mothers (OR = 1.38, economic status (OR= 1.65, pregnancy status (OR = 1.33, method of delivery (OR = 0.71 and 0.37, complications of pregnancy (OR = 1.13, birth complications (OR = 0.79, the travel time to health facilities (OR = 0.61 and 1.59, age at delivery (OR = 1.23. The study reveals that continuity of maternal healthservices remain unsatisfactory. Government should pay more attention to improve the quality and access to maternal health services as to encourage mothers to sustain their health care.Keywords: continuum of care, maternal health, Riskesdas 2013AbstrakDalam upaya menurunkan angka kematian ibu di Indonesia, pemerintah melakukan banyak strategi dan program kesehatan di antaranya continum of care. Artikel ini bertujuan untuk mengetahui faktor dan karakteristik ibu yang mempengaruhi kesinambungan pelayanan kesehatan maternal. Data yang digunakan dalam analisis ini adalah data Riskesdas 2013. Analisis dilakukan dengan menghitung selisih persentase cakupan indikator kesehatan di tiap kabupaten/kota. Analisis kemudian dilanjutkandengan mencari model untuk mengetahui hubungan karakteristik ibu dan faktor terkait lain dengan kelanjutan perawatan kesehatan ibu dengan regresi logistik. Persentase

Innova ng for Maternal and Child Health in Africa

International Development Research Centre (IDRC) Digital Library (Canada)

Innova ng for Maternal and Child Health in Africa ... spacing are cri cal to maternal and child health programming. It is ... APHRC is the only African ins tu on ... Maternal death review and outcomes: An assessment in Lagos State, Nigeria.

No. 263-Maternity Leave in Normal Pregnancy.

Science.gov (United States)

Leduc, Dean

2017-10-01

To assist maternity care providers in recognizing and discussing health- and illness-related issues in pregnancy and their relationship to maternity benefits. Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2009 using appropriate controlled vocabulary (e.g., maternity benefits) and key words (e.g., maternity, benefits, pregnancy). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2009. Grey (unpublished) literature was identified through searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Copyright © 2017. Published by Elsevier Inc.

Maternal antenatal depression and infant disorganized attachment at 12 months.

Science.gov (United States)

Hayes, Lisa J; Goodman, Sherryl H; Carlson, Elizabeth

2013-01-01

Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at three months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at three months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing.

Maternal obesity in Africa: a systematic review and meta-analysis.

Science.gov (United States)

Onubi, Ojochenemi J; Marais, Debbi; Aucott, Lorna; Okonofua, Friday; Poobalan, Amudha S

2016-09-01

Maternal obesity is emerging as a public health problem, recently highlighted together with maternal under-nutrition as a 'double burden', especially in African countries undergoing social and economic transition. This systematic review was conducted to investigate the current evidence on maternal obesity in Africa. MEDLINE, EMBASE, Scopus, CINAHL and PsycINFO were searched (up to August 2014) and identified 29 studies. Prevalence, associations with socio-demographic factors, labour, child and maternal consequences of maternal obesity were assessed. Pooled risk ratios comparing obese and non-obese groups were calculated. Prevalence of maternal obesity across Africa ranged from 6.5 to 50.7%, with older and multiparous mothers more likely to be obese. Obese mothers had increased risks of adverse labour, child and maternal outcomes. However, non-obese mothers were more likely to have low-birthweight babies. The differences in measurement and timing of assessment of maternal obesity were found across studies. No studies were identified either on the knowledge or attitudes of pregnant women towards maternal obesity; or on interventions for obese pregnant women. These results show that Africa's levels of maternal obesity are already having significant adverse effects. Culturally adaptable/sensitive interventions should be developed while monitoring to avoid undesired side effects. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review.

Science.gov (United States)

Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

2016-12-01

Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations' use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations' access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Maternal morbidity and risk of death at delivery hospitalization.

Science.gov (United States)

Campbell, Katherine H; Savitz, David; Werner, Erika F; Pettker, Christian M; Goffman, Dena; Chazotte, Cynthia; Lipkind, Heather S

2013-09-01

To examine the effect of underlying maternal morbidities on the odds of maternal death during delivery hospitalization. We used data that linked birth certificates to hospital discharge diagnoses from singleton live births at 22 weeks of gestation or later during 1995-2003 in New York City. Maternal morbidities examined included prepregnancy weight more than 114 kilograms (250 pounds), chronic hypertension, pregestational or gestational diabetes mellitus, chronic cardiovascular disease, pulmonary hypertension, chronic lung disease, human immunodeficiency virus (HIV), and preeclampsia or eclampsia. Associations with maternal mortality were estimated using multivariate logistic regression. During the specified time period, 1,084,862 live singleton births and 132 maternal deaths occurred. Patients with increasing maternal age, non-Hispanic black ethnicity, self-pay or Medicaid, primary cesarean delivery, and premature delivery had higher rates of maternal mortality during delivery hospitalization. From the entire study population, 4.1% had preeclampsia or eclampsia (n=44,004), 1.8% had chronic hypertension (n=19,647), 1.1% of patients were classified as obese (n=11,936), 0.7% had pregestational diabetes (n=7,474), 0.4% had HIV (n=4,665), and 0.01% had pulmonary hypertension (n=166). Preeclampsia or eclampsia (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 5.5-12.1), chronic hypertension (adjusted OR, 7.7; 95% CI 4.7-12.5), underlying maternal obesity (adjusted OR, 2.9; 95% CI 1.1-8.1), pregestational diabetes (adjusted OR, 3.3; 95% CI 1.3-8.1), HIV (adjusted OR, 7.7; 95% CI 3.4-17.8), and pulmonary hypertension (adjusted OR, 65.1; 95% CI 15.8-269.3) were associated with an increased risk of death during the delivery hospitalization. The presence of maternal disease significantly increases the odds of maternal mortality at the time of delivery hospitalization. II.

Early transfer of mated females into the maternity unit reduces stress and increases maternal care in farm mink

DEFF Research Database (Denmark)

Malmkvist, Jens; Palme, Rupert

2015-01-01

Mated mammals on farms are typically transferred to another housing environment prior to delivery. We investigated whether the timing of this transfer – EARLY (Day −36), INTERMEDIATE (Day −18), or LATE (Day −3) relative to the expected day of birth (Day 0) – affects maternal stress, maternal care...... sized groups (n = 60): (i) ‘EARLY’, transfer to maternity unit immediately after the end of the mating period, March 23; (ii) ‘INTERMEDIATE’, transfer in the middle of the period, April 10; (iii) ‘LATE’, transfer late in the pregnancy period, April 25. Data collection included weekly determination...... of faecal cortisol metabolites (FCM) and evaluation of maternal care: nest building, in-nest temperature, plus kit-retrieval behaviour, kit mortality and growth day 0–7 postpartum. We document that mated mink females build and maintain a nest at least 1 month prior to delivery when transferred...

National data system on near miss and maternal death: shifting from maternal risk to public health impact in Nigeria

Directory of Open Access Journals (Sweden)

Oladapo Olufemi T

2009-06-01

Full Text Available Abstract Background The lack of reliable and up-to-date statistics on maternal deaths and disabilities remains a major challenge to the implementation of Nigeria's Road Map to Accelerate the Millennium Development Goal related to Maternal Health (MDG-5. There are currently no functioning national data sources on maternal deaths and disabilities that could serve as reference points for programme managers, health advocates and policy makers. While awaiting the success of efforts targeted at overcoming the barriers facing establishment of population-based data systems, referral institutions in Nigeria can contribute their quota in the quest towards MDG-5 by providing good quality and reliable information on maternal deaths and disabilities on a continuous basis. This project represents the first opportunity to initiate a scientifically sound and reliable quantitative system of data gathering on maternal health profile in Nigeria. Objective The primary objective is to create a national data system on maternal near miss (MNM and maternal mortality in Nigerian public tertiary institutions. This system will conduct periodically, both regionally and at country level, a review of the magnitude of MNM and maternal deaths, nature of events responsible for MNM and maternal deaths, indices for the quality of care for direct obstetric complications and the health service events surrounding these complications, in an attempt to collectively define and monitor the standard of comprehensive emergency obstetric care in the country. Methods This will be a nationwide cohort study of all women who experience MNM and those who die from pregnancy, childbirth and puerperal complications using uniform criteria among women admitted in tertiary healthcare facilities in the six geopolitical zones in Nigeria. This will be accomplished by establishing a network of all public tertiary obstetric referral institutions that will prospectively collect specific information on

Maternal Dispositional Empathy and Electrodermal Reactivity: Interactive Contributions to Maternal Sensitivity with Toddler-Aged Children

Science.gov (United States)

Emery, Helen T.; McElwain, Nancy L.; Groh, Ashley M.; Haydon, Katherine C.; Roisman, Glenn I.

2015-01-01

The present study investigated maternal dispositional empathy and skin conductance level (SCL) reactivity to infant emotional cues as joint predictors of maternal sensitivity. Sixty-four mother-toddler dyads (31 boys) were observed across a series of interaction tasks during a laboratory visit, and maternal sensitivity was coded from approximately 55 minutes of observation per family. In a second, mother-only laboratory visit, maternal SCL reactivity to infant cues was assessed using a cry-laugh audio paradigm. Mothers reported on their dispositional empathy via a questionnaire. As hypothesized, mothers with greater dispositional empathy exhibited more sensitive behavior at low, but not high, levels of SCL reactivity to infant cues. Analyses examining self-reported emotional reactivity to the cry-laugh audio paradigm yielded a similar finding: dispositional empathy was related to greater sensitivity when mothers reported low, but not high, negative emotional reactivity. Results provide support for Dix’s (1991) affective model of parenting that underscores the combined contribution of the parent’s empathic tendencies and his/her own emotional experience in response to child emotions. Specificity of the Empathy × Reactivity interaction is discussed with respect to the context in which reactivity was assessed (infant cry versus laugh) and the type of sensitivity examined (sensitivity to the child’s distress versus non-distress). PMID:24955589

Fetal responses to induced maternal relaxation during pregnancy.

Science.gov (United States)

DiPietro, Janet A; Costigan, Kathleen A; Nelson, Priscilla; Gurewitsch, Edith D; Laudenslager, Mark L

2008-01-01

Fetal responses to induced maternal relaxation during the 32nd week of pregnancy were recorded in 100 maternal-fetal pairs using a digitized data collection system. The 18-min guided imagery relaxation manipulation generated significant changes in maternal heart rate, skin conductance, respiration period, and respiratory sinus arrhythmia. Significant alterations in fetal neurobehavior were observed, including decreased fetal heart rate (FHR), increased FHR variability, suppression of fetal motor activity (FM), and increased FM-FHR coupling. Attribution of the two fetal cardiac responses to the guided imagery procedure itself, as opposed to simple rest or recumbency, is tempered by the observed pattern of response. Evaluation of correspondence between changes within individual maternal-fetal pairs revealed significant associations between maternal autonomic measures and fetal cardiac patterns, lower umbilical and uterine artery resistance and increased FHR variability, and declining salivary cortisol and FM activity. Potential mechanisms that may mediate the observed results are discussed.

Selected maternal, fetal and placental trace element and heavy metal and maternal vitamin levels in preterm deliveries with or without preterm premature rupture of membranes.

Science.gov (United States)

Kucukaydin, Zehra; Kurdoglu, Mertihan; Kurdoglu, Zehra; Demir, Halit; Yoruk, Ibrahim H

2018-01-25

To compare maternal, fetal and placental trace element (magnesium, zinc and copper) and heavy metal (cadmium and lead) and maternal vitamin (retinol, α [alpha]-tocopherol, vitamin D 3 , 25-hydroxyvitamin D 3 and 1,25-dihydroxyvitamin D 3 ) levels in preterm deliveries with and without preterm premature rupture of membranes (PPROM). Sixty-eight patients giving birth preterm were grouped into preterm deliveries with PPROM (n = 35) and without PPROM (n = 33). Following delivery, maternal and umbilical cord blood sera and placental tissue samples were obtained. While magnesium, zinc, copper, cadmium and lead levels were measured in all samples, the levels of retinol, α-tocopherol, vitamin D 3 , 25-hydroxyvitamin D 3 and 1,25-dihydroxyvitamin D 3 were measured only in maternal serum. While magnesium level in maternal serum and zinc levels in both maternal and umbilical cord sera were lower, placental magnesium level was higher in preterm deliveries with PPROM (P 0.05). In preterm deliveries with PPROM, 25-hydroxyvitamin D 3 and retinol levels were higher, while vitamin D 3 and 1,25-dihydroxyvitamin D 3 levels were lower in maternal serum (P < 0.05). Maternal serum α-tocopherol levels were similar between the groups. Compared to spontaneous preterm births, PPROM is associated with low maternal serum together with high placental tissue magnesium and low maternal and umbilical cord sera zinc levels. Higher retinol and 25-hydroxyvitamin D 3 and lower vitamin D 3 and 1,25-dihydroxyvitamin D 3 maternal serum levels are also evident in these patients. © 2018 Japan Society of Obstetrics and Gynecology.

Oxidative stress and maternal obesity: feto-placental unit interaction.

Science.gov (United States)

Malti, N; Merzouk, H; Merzouk, S A; Loukidi, B; Karaouzene, N; Malti, A; Narce, M

2014-06-01

To determine oxidative stress markers in maternal obesity during pregnancy and to evaluate feto-placental unit interaction, especially predictors of fetal metabolic alterations. 40 obese pregnant women (prepregnancy BMI > 30 kg/m²) were compared to 50 control pregnant women. Maternal, cord blood and placenta samples were collected at delivery. Biochemical parameters (total cholesterol and triglycerides) and oxidative stress markers (malondialdehyde, carbonyl proteins, superoxide anion expressed as reduced Nitroblue Tetrazolium, nitric oxide expressed as nitrite, reduced glutathione, catalase, superoxide dismutase) were assayed by biochemical methods. Maternal, fetal and placental triglyceride levels were increased in obese group compared to control. Maternal malondialdehyde, carbonyl proteins, nitric oxide and superoxide anion levels were high while reduced glutathione concentrations and superoxide dismutase activity were low in obesity. In the placenta and in newborns of these obese mothers, variations of redox balance were also observed indicating high oxidative stress. Maternal and placental interaction constituted a strong predictor of fetal redox variations in obese pregnancies. Maternal obesity compromised placental metabolism and antioxidant status which strongly impacted fetal redox balance. Oxidative stress may be one of the key downstream mediators that initiate programming of the offspring. Maternal obesity is associated with metabolic alterations and dysregulation of redox balance in the mother-placenta - fetus unit. These perturbations could lead to maternal and fetal complications and should be carefully considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Human Milk Macronutrients Content: Effect of Advanced Maternal Age.

Science.gov (United States)

Lubetzky, Ronit; Sever, Orna; Mimouni, Francis B; Mandel, Dror

2015-11-01

Little is known about the effect of advanced maternal age upon macronutrients of human milk. This study was designed to study contents of macronutrients (fat, lactose, and protein) in human milk collected in the first 2 weeks of life in older (≥35 years) compared with younger (Macronutrient contents were measured at 72 hours, 7 days, and 14 days after delivery using infrared transmission spectroscopy. The groups did not differ in terms of maternal prepregnancy weight, height, and diet or infant birth weight or gestational age. They differed significantly in terms of maternal age and maternal weight after pregnancy. Fat content in colostrum and carbohydrate content in mature milk were significantly higher in the older mothers group. Moreover, carbohydrates in mature milk correlated positively with maternal age. Fat content at an infant age of 7 days and 2 weeks was not affected by maternal age. There was no significant relationship between maternal body weight for height (or body mass index) and energy, protein, fat or lactose content at any stage. Fat content of colostrum and carbohydrate content of mature milk obtained from mothers with advanced age are elevated compared with those of younger mothers. Moreover, there is a positive correlation between maternal age and carbohydrate content in mature milk. The biological significance of our findings is yet to be determined.

Fetal responses to induced maternal relaxation during pregnancy

OpenAIRE

DiPietro, Janet A.; Costigan, Kathleen A.; Nelson, Priscilla; Gurewitsch, Edith D.; Laudenslager, Mark L.

2007-01-01

Fetal responses to induced maternal relaxation during the 32nd week of pregnancy were recorded in 100 maternal-fetal pairs using a digitized data collection system. The 18-minute guided imagery relaxation manipulation generated significant changes in maternal heart rate, skin conductance, respiration period, and respiratory sinus arrhythmia. Significant alterations in fetal neurobehavior were observed, including decreased fetal heart rate (FHR), increased FHR variability, suppression of fetal...

Use of sapropterin dihydrochloride in maternal phenylketonuria. A European experience of eight cases

NARCIS (Netherlands)

Feillet, Francois; Muntau, Ania C.; Debray, Francois-Guillaume; Lotz-Havla, Amelie S.; Puchwein-Schwepcke, Alexandra; Fofou-Caillierez, Ma'atem Beatrice; van Spronsen, Francjan; Trefz, Fritz Friedrich

Sapropterin dihydrochloride (SD) is the first drug treatment for phenylketonuria (PKU), but due to the lack of data, its use in maternal PKU must be undertaken with caution as noted in the FDA and EMEA labels. We collected data from eight pregnancies in PKU women treated with SD and we analysed the

Maternal fever during labor--what does it mean?

Science.gov (United States)

Churgay, C A; Smith, M A; Blok, B

1994-01-01

Several studies have shown maternal fever to be associated with chorioamnionitis and neonatal sepsis if at least two of the following five criteria are also present: maternal tachycardia, purulent or foul-smelling amniotic fluid, fetal tachycardia, uterine tenderness, or maternal leukocytosis. Less is known about the risk of neonatal sepsis when the presence of maternal fever in labor is the only criterion. A retrospective medical record review searching for women who had a fever greater than 100.4 degrees F while in the active phase of labor during a 1-year period at the University of Michigan was undertaken to investigate the relation between isolated maternal fever in labor and neonatal sepsis. Eighty-two cases of maternal fever were found. Forty-six women met the clinical criteria for chorioamnionitis, and 6 of the 7 neonates with sepsis diagnosed were born to these mothers. There were no significant differences found in admission or intrapartum factors between women who did and did not meet clinical criteria for chorioamnionitis, and there was no association between these factors and neonatal sepsis. Epidural anesthesia was administered to 91 percent of these women and might be associated with maternal fever during labor. Using maternal clinical criteria for chorioamnionitis and a neonatal band cell-total neutrophil ratio of 0.2 or greater instead of the current system to determine the need for newborn antibiotic administration would improve the positive predictive value (12.5 percent versus 9.3 percent) and specificity (34.6 percent versus 16 percent) without compromising sensitivity (100 percent). All septic and probably septic newborns would be treated, and neonatal antibiotic administration would be reduced by 17 percent. The addition of the maternal clinical criteria for chorioamnionitis to the criteria already used for diagnosing and treating neonatal sepsis could prove useful in decisions regarding the selective administration of intrapartum antibiotics

Becoming-maternal: things to do with Deleuze

Directory of Open Access Journals (Sweden)

Margrit Shildrick

2010-01-01

Full Text Available Given that psychoanalysis is so often the privileged discourse in the relation to the maternal feminine, it makes good sense to ask whether a Deleuzian alternative should be heard. The difficulty is that the whole discourse of the maternal and motherhood is represented only by silence in Deleuze’s own work, and feminist scholarship has largely failed to remark that absence. Nonetheless I look to Deleuze for an approach that decisively contests any psychoanalytic model that bases itself around the concept of lack – however that might be twisted and transformed in relation to the maternal – and that incorporates a positivity that might critically revalue the feminine. Starting with a brief excursus through phenomenology, I consider two pertinent issues: first that the ‘event’ of giving life might be rethought in the mode of the impersonal; and second that the slide from encounter to connection, and from maternal-foetal embodiment to the notion of assemblage, might open up at very least a quasi-Deleuzian notion of positive flows, desire and energies. Could becoming-maternal figure more productive pathways that transform our understanding of the materiality of motherhood?

A review of maternal mortality at Jimma Hospital, Southwestern ...

African Journals Online (AJOL)

A retrospective review of hospital maternal deaths at Jimma Hospital, Southwestern Ethiopia, covering the period from September 1990 to May 1999 was conducted with the objectives of determining the overall maternal mortality rate, observing trend of maternal mortality during the period, and identifying major causes of ...

Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.

Science.gov (United States)

Hasegawa, Junichi; Sekizawa, Akihiko; Tanaka, Hiroaki; Katsuragi, Shinji; Osato, Kazuhiro; Murakoshi, Takeshi; Nakata, Masahiko; Nakamura, Masamitsu; Yoshimatsu, Jun; Sadahiro, Tomohito; Kanayama, Naohiro; Ishiwata, Isamu; Kinoshita, Katsuyuki; Ikeda, Tomoaki

2016-03-21

To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems. Descriptive study. Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG). Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213). The preventability and problems in each maternal death. Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1-3 h. A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Family planning can reduce maternal mortality].

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Potts, M

1987-01-01

Although the maternal mortality rate receives no newspaper headlines, the number of mothers dying throughout the world is equivalent to a full jumbo jet crashing every 5 hours. Population surveys carried out between 1981-83 by Family Health International indicated maternal mortality rates of 1.9/1000 live births in Menoufia, Egypt, and 7.2/1000 in Bali, Indonesia. 20-25% of all deaths in women aged 15-49 were directly related to pregnancy and delivery, compared to 1% in western countries where there is better prenatal care, medical assistance in almost all deliveries, and elimination of most high risk pregnancies through voluntary fertility control. Maternal mortality could be controlled by teaching traditional midwives to identify high risk patients at the beginning of their pregnancies and to refer them to appropriate health services. Maternal survival would also be improved if all women were in good health at the beginning of pregnancy. Families should be taught to seek medical care for the mother in cases of prolonged labor; many women arrive at hospitals beyond hope of recovery after hours or days of futile labor. Health policy makers should set new priorities. Sri Lanka, for example, has a lower per capita income than Pakistan, but also a lower maternal mortality rate because of better use of family planning services, more emphasis on prenatal care, and a tradition of care and attention on the part of the public health services.

Good maternal nutrition

DEFF Research Database (Denmark)

Breda, Joao; Robertson, Aileen

This publication has three parts: •a summary of the results of a systematic review of the most recent evidence on maternal nutrition, the prevention of obesity and noncommunicable diseases; •a review of existing recommendations for nutrition, physical activity and weight gain during pregnancy...... in European countries; and •lists of possible opportunities for action in European countries. The overview and exploration of the national recommendations for nutrition, physical activity and weight gain during pregnancy are based on the results of a survey in which 51 of the 53 Member States in the WHO....... These are opportunities to promote nutrition and health throughout the life-course, ensure optimal diet-related fetal development and reduce the impact of morbidity and risk factors for noncommunicable diseases by improving maternal nutrition....

Estimation of maternal mortality using the indirect sisterhood method ...

African Journals Online (AJOL)

FinePrint

is also useful for monitoring the trends of maternal mortality and evaluating the impact of safe motherhood initiative and improving maternal survival and achieving the MDGs. REFERENCES. 1. Lech M and Zwane A. Survey on maternal mortality in Swaziland using the Sisterhood method. Paedr Perinat Epidemiol; 2002: 16:.

Mentors Offering Maternal Support (M.O.M.S.)

Science.gov (United States)

2011-08-02

research is needed to clarify the effect of positive versus negative remote interactions on the woman’s prenatal maternal adaptation. Of note, this...Marginal Means for the Two Significant Interaction Results…………………………… 24 1 CHAPTER I BACKGROUND Prenatal Maternal Adaptation...prenatal visit and of the length of gestation (Lederman, Weis, Camune, & Mian, 2002). Both maternal and paternal happiness about pregnancy also are

Association of Maternal Body Mass Index with Adverse Maternal and Prenatal Outcomes

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Rahele Alijahan

2013-09-01

Full Text Available Background: The present study aimed to determine association between abnormal maternal body mass index and adverse maternal/prenatal outcomesMaterials and Methods: In this descriptive-correlation study 8270 pregnant women referred to rural and urban health centers of Ardabil district (from Mar 2009 to Dec 2010 were studied. Data were collected from prenatal healthcare records using a self designed questionnaire. Women with twin pregnancy, less than 18 and above 35 of age, and women with systemic or chronic disease were excluded from the study. The variables examined in this study include, demographic information (e.g. age, social and economy status, and literacy, present pregnancy information (e.g. parity, hemoglobin level, gestational diabetes, preeclampsia and prenatal information (e.g. preterm delivery, low birth weight, and congenital malformation. Data were analyzed through Kruscal wallis, chi-square, and logistic regression tests using SPSS-16.Results: Eight point two, 25 and 15.4% pregnant of women were underweight, overweight, and obese, respectively. Obese women were at increased risk for macrosomia (OR=1.820, CI: 1.345-2.447, p=0.001, unwanted pregnancy (OR= 1.436, CI: 1.198-1.720, p=0.001, pregnancy induced hypertension (OR= 1.633, CI: 1.072-2.486, p=0.022, preeclampsia (OR= 4.666, CI: 2.353-9.2550, p=0.001, and still birth (OR= 2.602, CI: 1.306-5.184, p=0.007. However, the risk of low birth weight delivery in underweight women were 1.6 times higher than the normal cases (OR= 1.674, CI: 0962-2.912, p=0.068.Conclusion: Considering high prevalence of abnormal maternal body mass index and its associated adverse maternal and prenatal outcomes; consultation before pregnancy is recommended in order to achieve normal body mass index and reduce the relevant complications.

Physiological Reactivity to Infant Crying and Observed Maternal Sensitivity

Science.gov (United States)

Joosen, Katharina J.; Mesman, Judi; Bakermans-Kranenburg, Marian J.; Pieper, Suzanne; Zeskind, Philip S.; van IJzendoorn, Marinus H.

2013-01-01

Relations between maternal sensitivity and physiological reactivity to infant crying were examined using measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) in 49 mothers of second-born infants. Using the Ainsworth Sensitivity Scale, an independent assessment of maternal sensitivity was made during maternal free play and bathing of…

Maternity Care Services Provided by Family Physicians in Rural Hospitals.

Science.gov (United States)

Young, Richard A

The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

Latino Maternal Literacy Beliefs and Practices Mediating Socioeconomic Status and Maternal Education Effects in Predicting Child Receptive Vocabulary

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Gonzalez, Jorge E.; Acosta, Sandra; Davis, Heather; Pollard-Durodola, Sharolyn; Saenz, Laura; Soares, Denise; Resendez, Nora; Zhu, Leina

2017-01-01

Research Findings: This study investigated the association between Mexican American maternal education and socioeconomic status (SES) and child vocabulary as mediated by parental reading beliefs, home literacy environment (HLE), and parent-child shared reading frequency. As part of a larger study, maternal reports of education level, SES, HLE, and…

Prenatal Maternal Substance Use and Offspring Outcomes

NARCIS (Netherlands)

Huizink, A.C.

2015-01-01

Evidence from both human and preclinical studies seems to indicate that maternal smoking, alcohol drinking, or other drug use during pregnancy can affect offspring outcomes. It also suggests that maternal substance use during pregnancy is a major preventable cause of adverse infant outcomes.

Maternal Factors Associated With Early Spontaneous Singleton ...

African Journals Online (AJOL)

Background: Knowledge of the maternal factors predisposing to preterm deliveries should affect the anticipatory care of mothers at risk of delivering preterm babies and improve perinatal outcome. Objective: To determine the maternal socio-biological characteristics associated with the delivery of early spontaneous ...

Effect of free maternal health services on maternal mortality: An experience from Niger Delta, Nigeria

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Samuel O Azubuike

2015-01-01

Full Text Available Background: Free maternal health care was launched by Delta State Government in 2007. This development was laudable as poverty has been identified as a big hindrance to accessing health care services among mothers in rural communities. There was need, however, to ascertain the effectiveness of this program. Aim: The study aimed at determining maternal mortality rate (MMR from 2005 to 2009, its correlates, obstetric cause of death and to evaluate the effect of free maternal care on MMR. Methodology: MMRs were computed based on all maternal deaths and live births available in summary health report of Ika South local government area from 2005 to 2009. Correlational analysis was done to determine the correlates of MMRs. Statistical Package for Social Sciences (SPSS version 16 (USA, 2007 was used in the analysis. Results: There was a reduction in MMR from 932/100,000 in 2005 to 604/100,000 in 2009. This reduction negatively correlated (r =−;0.74, P = 0.15 with an increase in antenatal care registration within the period. The gradual increase in proportion of child delivery in health facilities from 59% in 2007 to 74.6% (2288/3065 in 2009 negatively correlated (r =−;0.5, P = 0.4 with a reduction in MMR from 836/100,000 to 604/100,000. The number of skilled staff employed increased by 36.4% (51/140 since 2005 and negatively correlated (r =−;0.34, P = 0.56 with MMR reduction of 328/100,000 since that period, with the employment of nurses being the stronger correlate (r =−;0.48, P = 0.41. Hemorrhage (44% was the leading obstetric cause of death. Conclusion: The study showed that MMR has been on a gradual downward trend since the introduction of free maternal health services in Delta State, Nigeria.

Maternal obesity and infant mortality: a meta-analysis.

Science.gov (United States)

Meehan, Sean; Beck, Charles R; Mair-Jenkins, John; Leonardi-Bee, Jo; Puleston, Richard

2014-05-01

Despite numerous studies reporting an elevated risk of infant mortality among women who are obese, the magnitude of the association is unclear. A systematic review and meta-analysis was undertaken to assess the association between maternal overweight or obesity and infant mortality. Four health care databases and gray literature sources were searched and screened against the protocol eligibility criteria. Observational studies reporting on the relationship between maternal overweight and obesity and infant mortality were included. Data extraction and risk of bias assessments were performed. Twenty-four records were included from 783 screened. Obese mothers (BMI ≥30) had greater odds of having an infant death (odds ratio 1.42; 95% confidence interval, 1.24-1.63; P obese (BMI >35) (odds ratio 2.03; 95% confidence interval, 1.61-2.56; P obese mothers and that this risk may increase with greater maternal BMI or weight; however, residual confounding may explain these findings. Given the rising prevalence of maternal obesity, additional high-quality epidemiologic studies to elucidate the actual influence of elevated maternal mass or weight on infant mortality are needed. If a causal link is determined and the biological basis explained, public health strategies to address the issue of maternal obesity will be needed. Copyright © 2014 by the American Academy of Pediatrics.

Learning maternity: the experiences of rural nurses.

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MacKinnon, Karen

2010-03-01

Two research studies explored rural nurses' experience with the provision of maternity care in rural British Columbia, Canada. Frontline nurses, managers, and health-care providers were interviewed and their practices observed. One of the main challenges identified by rural nurses was ensuring that a knowledgeable/skilled maternity or perinatal nurse was always available at the local hospital. Learning how to provide safe and supportive maternity care is difficult for nurses working in small rural hospitals today due to declining birth rates, increased workloads, and a decrease in opportunities for mentoring. Decisions about the allocation of time off and resources for rural nurses' continuing professional education (CPE) were structured by discourses of personal responsibility for "continuing competence." These institutional work processes increase the burden on rural nurses, negatively affecting their opportunities for CPE and their experiences of providing maternity care, with implications for both patient safety and nurse retention.

Maternal Insomnia and Children's Family Socialization Environments

Science.gov (United States)

Gregory, Alice M.; Moffitt, Terrie E.; Ambler, Antony; Arseneault, Louise; Houts, Renate M.; Caspi, Avshalom

2012-01-01

Study Objectives: To examine concurrent associations between maternal insomnia and different aspects of the family socialization environment. Design: Mothers reported on their symptoms of insomnia in a private standardized interview and interviewers evaluated the family socialization environment using the Coder's Inventory. Setting: Assessments were conducted in participants' homes within the U.K. Patients or Participants: One thousand one hundred sixteen mothers of British children enrolled in the Environmental Risk (E-Risk) study were invited to participate when their children were aged 12 years. Interventions: N/A. Measurements and Results: After controlling for family socioeconomic status (SES), mothers' relationship status, and maternal depression, maternal insomnia was associated with a poorer family socialization environment (β = −0.10, [95% confidence intervals (CI) = −0.16, −0.04], P Ambler A; Arseneault L; Houts RM; Caspi A. Maternal insomnia and children's family socialization environments. SLEEP 2012;35(4):579-582. PMID:22467996

Associations of Maternal and Infant Testosterone and Cortisol Levels With Maternal Depressive Symptoms and Infant Socioemotional Problems

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Cho, June; Su, Xiaogang; Phillips, Vivien; Holditch-Davis, Diane

2015-01-01

This study examined the associations of testosterone and cortisol levels with maternal depressive symptoms and infant socioemotional (SE) problems that are influenced by infant gender. A total of 62 mothers and their very-low-birth weight (VLBW) infants were recruited from a neonatal intensive care unit at a tertiary medical center in the southeast United States. Data were collected at three time points (before 40 weeks’ postmenstrual age [PMA] and at 3 months and 6 months of age corrected for prematurity). Measures included infant medical record review, maternal interview, biochemical assays of salivary hormone levels in mother-VLBWinfant pairs, and standard questionnaires. Generalized estimating equations with separate analyses for boys and girls showed that maternal testosterone level was negatively associated with depressive symptoms in mothers of boys, whereas infant testosterone level was negatively associated with maternal report of infant SE problems in girls after controlling for characteristics of mothers and infants and number of days post birth of saliva collection. Not surprisingly, the SE problems were positively associated with a number of medical complications. Mothers with more depressive symptoms reported that their infants had more SE problems. Mothers with higher testosterone levels reported that girls, but not boys, had fewer SE problems. In summary, high levels of testosterone could have a protective role for maternal depressive symptoms and infant SE problems. Future research need to be directed toward clinical application of these preliminary results. PMID:25954021

Maternal sensitivity and social support protect against childhood atopic dermatitis.

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Letourneau, Nicole L; Kozyrskyj, Anita L; Cosic, Nela; Ntanda, Henry N; Anis, Lubna; Hart, Martha J; Campbell, Tavis S; Giesbrecht, Gerald F

2017-01-01

Many studies have identified associations between qualities of maternal-child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal-infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal-infant relationship quality, especially

The Effect of Maternal Employment on Children's Academic Performance

DEFF Research Database (Denmark)

Nielsen, Lisbeth Palmhøj; Hansen, Anne Toft

of household control variables, instrumenting for employment with the gender- and education-specific local unemployment rate, and by including maternal fixed effects. We find that maternal employment has a positive effect on children’s academic performance in all specifications, particularly when women work...... part-time. This is in contrast with the larger literature on maternal employment, much of which takes place in other contexts, and which finds no or a small negative effect of maternal employment on children’s cognitive development and academic performance. (JEL J13, J22)...

Investigating financial incentives for maternal health: an introduction.

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Stanton, Mary Ellen; Higgs, Elizabeth S; Koblinsky, Marge

2013-12-01

Projection of current trends in maternal and neonatal mortality reduction shows that many countries will fall short of the UN Millennium Development Goal 4 and 5. Underutilization of maternal health services contributes to this poor progress toward reducing maternal and neonatal morbidity and mortality. Moreover, the quality of services continues to lag in many countries, with a negative effect on the health of women and their babies, including deterring women from seeking care. To enhance the use and provision of quality maternal care, countries and donors are increasingly using financial incentives. This paper introduces the JHPN Supplement, in which each paper reviews the evidence of the effectiveness of a specific financial incentive instrument with the aim of improving the use and quality of maternal healthcare and impact. The US Agency for International Development and the US National Institutes of Health convened a US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives on 24-25 April 2012 in Washington, DC. The Summit brought together leading global experts in finance, maternal health, and health systems from governments, academia, development organizations, and foundations to assess the evidence on whether financial incentives significantly and substantially increase provision, use and quality of maternal health services, and the contextual factors that impact the effectiveness of these incentives. Evidence review teams evaluated the multidisciplinary evidence of various financial mechanisms, including supply-side incentives (e.g. performance-based financing, user fees, and various insurance mechanisms) and demand-side incentives (e.g. conditional cash transfers, vouchers, user fee exemptions, and subsidies for care-seeking). At the Summit, the teams presented a synthesis of evidence and initial recommendations on practice, policy, and research for discussion. The Summit enabled structured

Maternal Dietary Patterns and Pregnancy Outcome

Science.gov (United States)

Chen, Xuyang; Zhao, Diqi; Mao, Xun; Xia, Yinyin; Baker, Philip N.; Zhang, Hua

2016-01-01

Maternal nutritional status during pregnancy will affect the outcomes for the mother and the baby. Many analyses of the relationship between diet and outcome are often based on a single or a few food items or nutrients. However, foods are not consumed in isolation and dietary patterns can be used to assess the whole diet consumed. The use of dietary pattern analysis to understand nutritional intake and pregnancy outcome is becoming more and more popular. Many published studies have showed the association between maternal dietary patterns and pregnancy outcome. This review examined articles about the relationship between maternal dietary patterns and pregnancy outcome. As a modifiable factor, dietary patterns may be more applicable to clinical and pregnant health interventions. PMID:27338455

Maternal deaths databases analysis: Ecuador 2003-2013

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Antonio Pino

2016-08-01

Full Text Available Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC. Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC’s website. Comparisons are based on number of deaths and use an ecological approach for geographical coincidences. Results: The study identified variable association into the maternal mortality national databases showing that to die at home or in a different place than a hospital is closely related to women’s socioeconomic characteristics; there was an association with the absence of a public health facility. Also, to die in a different place than the usual residence could mean that women and families are searching for or were referred to a higher level of attention when they face complications. Conclusions: Ecuadorian maternal deaths showed Patterns of inequity in health status, health care provision and health risks. A predominant factor seems unclear to explain the variable association found processing national databases; perhaps every pattern of health systems development played a role in maternal mortality or factors different from those registered by the statistics system may remain hidden. Some random influences might not be even considered in an explanatory model yet.

Maternal DHA levels and Toddler Free-Play Attention

OpenAIRE

Kannass, Kathleen N.; Colombo, John; Carlson, Susan E.

2009-01-01

We investigated the relationship between maternal docosahexaenoic acid (DHA) levels at birth and toddler free-play attention in the second year. Toddler free-play attention was assessed at 12 and 18 months, and maternal erythrocyte (red-blood cell; RBC) phospholipid DHA (percentage of total fatty acids) was measured from mothers at delivery. Overall, higher maternal DHA status at birth was associated with enhanced attentional functioning during the second year. Toddlers whose mothers had high...

Impact of prenatal ultrasound consultation on maternal anxiety

International Nuclear Information System (INIS)

Masroor, I.; Ajmal, F.; Ahmed, H.

2008-01-01

To determine whether ultrasound consultation reduces maternal anxiety and increases feto-maternal attachment ( the desire to care for the fetus and care for self). Patients coming for routine obstetric ultrasound at the Department of Radiology, Aga Khan University Hospital Karachi were recruited in the study. The study was carried out over the period of two months from January-February 2007 in which sixty patients were included in the study. Patients were randomly assigned to a standard care group or an ultrasound consultation group (30 patients in each arm). Both groups were required to fill a questionnaire before and after their ultrasound examination. The ultrasound consultation group in addition received counseling before they went in for the ultrasound regarding fetal development and maternal-fetal interaction. The two groups were then compared for difference of change in feto maternal attachment scores and change in anxiety levels regarding their pregnancies before and after the ultrasound. SPSS software (version 14) was used for compilation of the data and the statistical computations. Categorical data was compared using Chi-square test and continuous variables were analyzed with paired t-test. P value <0.05 was considered significant. A positive difference in feto-maternal attachment and reduction in anxiety levels was seen in both the groups but this difference was statistically significant in the ultrasound consultation group only. This study suggests that ultrasound examinations with prior consultation has a positive impact on patients as it strengthens bonding toward the fetus, reduces maternal anxiety and increases maternal investment in health during the pregnancy. (author)

Analysis of maternal death autopsies from the nationwide registration system of maternal deaths in Japan.

Science.gov (United States)

Hasegawa, Junichi; Wakasa, Tomoko; Matsumoto, Hiroshi; Takeuchi, Makoto; Kanayama, Naohiro; Tanaka, Hiroaki; Katsuragi, Shinji; Nakata, Masahiko; Murakoshi, Takeshi; Osato, Kazuhiro; Nakamura, Masamitsu; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

2018-02-01

To clarify the necessity for and problems related to autopsy for determining the cause of maternal death in Japan. Women who died during pregnancy or within a year after delivery were analyzed by the Maternal Death Exploratory Committee between 2012 and 2015 in Japan. Maternal deaths were analyzed to verify the requirement of autopsy in cases in which autopsy was performed and the need for autopsy in cases in which it was not performed. Among the 49 cases performed autopsy, the final diagnosis was compatible with the clinical course in 24 cases, while the autopsy diagnosis was incompatible with the clinical course in 13 cases. In two cases, the final diagnosis was based on the clinical course, but an autopsy could exclude other possible causes. In three cases, no exact cause of maternal death was identified after autopsy. On the other hand, in cases without an autopsy, the final diagnosis was made using ante-mortem operating findings and surgical specimens in twenty-one cases. Though, thirty-one cases were estimated diagnosis based on post-mortem imaging or ante-mortem examinations, the exact original cause of death was not determined in 25 cases, and the cause of death could not be identified in eight cases without autopsy. Because in most cases the autopsy provides an exact cause of death, the necessity of autopsies should be more widely accepted in Japan.

Huge poor-rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries

NARCIS (Netherlands)

Houweling, Tanja A. J.; Ronsmans, Carine; Campbell, Oona M. R.; Kunst, Anton E.

2007-01-01

OBJECTIVE: Progress towards the Millennium Development Goals for maternal health has been slow, and accelerated progress in scaling up professional delivery care is needed. This paper describes poor-rich inequalities in the use of maternity care and seeks to understand these inequalities through

Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

NARCIS (Netherlands)

Perdok, H.; Jans, S.; Verhoeven, C.; Henneman, L.; Wiegers, T.; Mol, B.W.; Schellevis, F.; Jonge, A. de

2016-01-01

Background: This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods: Qualitative study using

Preschoolers' Emergent Literacy Skills: The Mediating Role of Maternal Reading Beliefs

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Cottone, Elizabeth Ann

2012-01-01

Research Findings: The purpose of this paper is to explore the association between maternal reading beliefs and children's emergent literacy outcomes in light of maternal education. Furthermore, I consider whether maternal reading beliefs may mediate the association between maternal education level and children's print knowledge and phonological…

Using an Adoption–Biological Family Design to Examine Associations Between Maternal Trauma, Maternal Depressive Symptoms, and Child Internalizing and Externalizing Behaviors

Science.gov (United States)

Grabow, Aleksandria Perez; Khurana, Atika; Natsuaki, Misaki N.; Neiderhiser, Jenae M.; Harold, Gordon T.; Shaw, Daniel S.; Ganiban, Jody M.; Reiss, David; Leve, Leslie D.

2017-01-01

Maternal trauma is a complex risk factor that has been linked to adverse child outcomes, yet the mechanisms underlying this association are not well understood. This study, which included adoptive and biological families, examined the heritable and environmental mechanisms by which maternal trauma and associated depressive symptoms are linked to child internalizing and externalizing behaviors. Path analyses were used to analyze data from 541 adoptive mother–adopted child (AM–AC) dyads and 126 biological mother–biological child (BM–BC) dyads; the two family types were linked through the same biological mother. Rearing mother’s trauma was associated with child internalizing and externalizing behaviors in AM–AC and BM–BC dyads, and this association was mediated by rearing mothers’ depressive symptoms, with the exception of biological child externalizing behavior, for which biological mother trauma had a direct influence only. Significant associations between maternal trauma and child behavior in dyads that share only environment (i.e., AM–AC dyads) suggest an environmental mechanism of influence for maternal trauma. Significant associations were also observed between maternal depressive symptoms and child internalizing and externalizing behavior in dyads that were only genetically related, with no shared environment (i.e., BM–AC dyads), suggesting a heritable pathway of influence via maternal depressive symptoms. PMID:29162177

Doubts and Concerns about Isolated Maternal Hypothyroxinemia

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Mariacarla Moleti

2011-01-01

Full Text Available There is evidence that isolated maternal hypothyroxinemia may have detrimental effects on both mother and foetus. Nonetheless, this condition is still far from being universally accepted as a separate thyroid disease, and a standard definition of this state of mild thyroid underfunction is still lacking. We will review the biochemical criteria used to define isolated maternal hypothyroxinemia, together with current methodological issues related to FT4 assays. We will also discuss its epidemiological impact in both iodine-deficient and-sufficient areas, and the effectiveness of iodine prophylaxis on maternal thyroid function and neuropsychomotor development in offspring.

Low Birth Weight And Maternal Risk Factors

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Secma Nigam

2003-06-01

Full Text Available Objectives : To study tile socio-economic and maternal risk factors associated with low birth weight babies and to measure the strength of association. Study Design : Hospital based case-control study. Setting : Shri Sayajirao General Hospital, Vadodara. Sample size : 312 cases and 312 controls. Participants : Cases Mothers who delivered single, live baby less than 2500 gms i.e. low birth weight. Controls:- Mothers who delivered single live baby more than 2500 gms. Study Variable : Maternal age, literacy, anaemia, outcome of last pregnancy. Statistical Analysis : Chi-square test and odd’s ratio. Result : Among cases, 14.5% mothers had age less titan 20 yrs as compared to 7.3% mothers in control group. 68.6% mothers amongst cases were illiterate against 46.5% mothers in control group. 53.8% mothers had haemoglobin level 10gm% or less amongst cases and no statistically significant difference was found between low birth weight and outcome of last pregnancy Conclusion : The maternal risk factors associated with low birth weight in mothers attending S.S.G. hospital age maternal anaemia (OR 2.66, illiteracy (OR 2.51, maternal age less than 20 yrs. (OR 2.OS. No association was found between low birth rate and outcome of last pregnancy

Social Determinants of Maternal Health in Afghanistan: A Review.

Science.gov (United States)

Najafizada, Said Ahmad Maisam; Bourgeault, Ivy Lynn; Labonté, Ronald

2017-01-01

Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature. This narrative review was conducted using Arksey and O'Malley's framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations' long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

Maternal depression and anxiety and fetal-neonatal growth

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Tiago Miguel Pinto

2017-09-01

Conclusion: This study demonstrates the independent longitudinal effect of maternal anxiety on major markers of fetal-neonatal growth outcomes and trajectories, simultaneously considering the effect of maternal depression and anxiety.

Impact of chronic maternal stress during early gestation on maternal-fetal stress transfer and fetal stress sensitivity in sheep.

Science.gov (United States)

Dreiling, Michelle; Schiffner, Rene; Bischoff, Sabine; Rupprecht, Sven; Kroegel, Nasim; Schubert, Harald; Witte, Otto W; Schwab, Matthias; Rakers, Florian

2018-01-01

Acute stress-induced reduction of uterine blood flow (UBF) is an indirect mechanism of maternal-fetal stress transfer during late gestation. Effects of chronic psychosocial maternal stress (CMS) during early gestation, as may be experienced by many working women, on this stress signaling mechanism are unclear. We hypothesized that CMS in sheep during early gestation augments later acute stress-induced decreases of UBF, and aggravates the fetal hormonal, cardiovascular, and metabolic stress responses during later development. Six pregnant ewes underwent repeated isolation stress (CMS) between 30 and 100 days of gestation (dGA, term: 150 dGA) and seven pregnant ewes served as controls. At 110 dGA, ewes were chronically instrumented and underwent acute isolation stress. The acute stress decreased UBF by 19% in both the CMS and control groups (p stress-induced cortisol and norepinephrine concentrations indicating a hyperactive hypothalamus-pituitary-adrenal (HPA)-axis and sympathetic-adrenal-medullary system. Increased fetal norepinephrine is endogenous as maternal catecholamines do not cross the placenta. Cortisol in the control but not in the CMS fetuses was correlated with maternal cortisol blood concentrations; these findings indicate: (1) no increased maternal-fetal cortisol transfer with CMS, (2) cortisol production in CMS fetuses when the HPA-axis is normally inactive, due to early maturation of the fetal HPA-axis. CMS fetuses were better oxygenated, without shift towards acidosis compared to the controls, potentially reflecting adaptation to repeated stress. Hence, CMS enhances maternal-fetal stress transfer by prolonged reduction in UBF and increased fetal HPA responsiveness.

A review on child and maternal health status of Bangladesh

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A. H. M. Mahmudur Rahman

2018-01-01

Full Text Available Child and maternal nutritional and health status is a very much concerning issue of Bangladesh. To summarize the specific conditions of Bangladeshi child and maternal health and related issues. This is a descriptive review and overall analysis and description of the literature was done regarding child and maternal health of the general population living in Bangladesh. The evidence reflected that infant, child, and maternal mortality in Bangladesh have declined gradually at least over the past years. It is found that infant mortality 2 times, child mortality 6 times, and under five mortality rates 3 times declined comparatively than the last two decades but it is noted that maternal assassination circumstance has not declined. Knowledge on child and maternal health carries an important role in education. Health knowledge index significantly improve child and maternal health although differentially. It is obvious that poverty is one of the root causes that have led to a high child and maternal mortalities and morbidities faced by the people of Bangladesh. The requirement for socio economic relief for those living in rural Bangladesh remains one of the core issues. Recently, Bangladesh is successfully declining the total number of childhood and nutrition related mortalities despites various complexities, but maternal health status is not improving at the same pace. Nongovernment and government funded organizations and policymakers should come forward for running some effective programs to conquer the situation completely in Bangladesh.

Maternal education and intelligence predict offspring diet and nutritional status.

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Wachs, Theodore D; Creed-Kanashiro, Hilary; Cueto, Santiago; Jacoby, Enrique

2005-09-01

The traditional assumption that children's nutritional deficiencies are essentially due either to overall food scarcity or to a lack of family resources to purchase available food has been increasingly questioned. Parental characteristics represent 1 type of noneconomic factor that may be related to variability in children's diets and nutritional status. We report evidence on the relation of 2 parental characteristics, maternal education level and maternal intelligence, to infant and toddler diet and nutritional status. Our sample consisted of 241 low-income Peruvian mothers and their infants assessed from 3 to 12 mo, with a further follow-up of 104 of these infants at 18 mo of age. Using a nonexperimental design, we related measures of level of maternal education, maternal intelligence, and family socioeconomic status to infant anthropometry, duration of exclusive breast-feeding, adequacy of dietary intake, and iron status. Results indicated unique positive relations between maternal education level and the extent of exclusive breast-feeding. Significant relations between maternal education and offspring length were partially mediated by maternal height. There also were unique positive relations between maternal intelligence and quality of offspring diet and hemoglobin level. All findings remained significant even after controlling for family socioeconomic characteristics. This pattern of results illustrates the importance of parental characteristics in structuring the adequacy of offspring diet. Maternal education and intelligence appear to have unique influences upon different aspects of the diet and nutritional status of offspring.

The influence of maternal psychosocial characteristics on infant feeding styles.

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Barrett, Katherine J; Thompson, Amanda L; Bentley, Margaret E

2016-08-01

Maternal feeding styles in infancy and early childhood are associated with children's later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors-specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms-influence mothers' infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Incidence and Correlates of Maternal Near Miss in Southeast Iran

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Tayebeh Naderi

2015-01-01

Full Text Available This prospective study aimed to estimate the incidence and associated factors of severe maternal morbidity in southeast Iran. During a 9-month period in 2013, all women referring to eight hospitals for termination of pregnancy as well as women admitted during 42 days after the termination of pregnancy were enrolled into the study. Maternal near miss conditions were defined based on Say et al.’s recommendations. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25.2 per 1000 live births. This rate was 7.5 and 105 per 1000 in private and tertiary care settings, respectively. The rate of maternal death in near miss cases was 0.40% with a case:fatality ratio of 250 : 1. The most prevalent causes of near miss were severe preeclampsia (27.3%, ectopic pregnancy (18.4%, and abruptio placentae (16.2%. Higher age, higher education, and being primiparous were associated with a higher risk of near miss. Considering the high rate of maternal near miss in referral hospitals, maternal near miss surveillance system should be set up in these hospitals to identify cases of severe maternal morbidity as soon as possible.

Early Maternal Time Investment and Early Child Outcomes

OpenAIRE

Del Bono, Emilia; Francesconi, Marco; Kelly, Yvonne; Sacker, Amanda

2014-01-01

Using large longitudinal survey data from the UK Millennium Cohort Study, this paper estimates the relationship between maternal time inputs and early child development. We find that maternal time is a quantitatively important determinant of skill formation and that its effect declines with child age. There is evidence of long-term effects of early maternal time inputs on later outcomes, especially in the case of cognitive skill development. In the case of non-cognitive development, the evide...

The influence of maternal body composition on birth weight.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: To identify the maternal body composition parameters that independently influence birth weight. STUDY DESIGN: A longitudinal prospective observational study in a large university teaching hospital. One hundred and eighty-four non-diabetic caucasian women with a singleton pregnancy were studied. In early pregnancy maternal weight and height were measured digitally in a standardised way and the body mass index (BMI) was calculated. At 28 and 37 weeks\\' gestation maternal body composition was assessed using segmental multifrequency bioelectrical impedance analysis. At delivery the baby was weighed and the clinical details were recorded. RESULTS: Of the women studied, 29.2% were overweight and 34.8% were obese. Birth weight did not correlate with maternal weight or BMI in early pregnancy. Birth weight correlated with gestational weight gain (GWG) before the third trimester (r=0.163, p=0.027), but not with GWG in the third trimester. Birth weight correlated with maternal fat-free mass, and not fat mass at 28 and 37 weeks gestation. Birth weight did not correlate with increases in maternal fat and fat-free masses between 28 and 37 weeks. CONCLUSIONS: Contrary to previous reports, we found that early pregnancy maternal BMI in a non-diabetic population does not influence birth weight. Interestingly, it was the GWG before the third trimester and not the GWG in the third trimester that influenced birth weight. Our findings have implications for the design of future intervention studies aimed at optimising gestational weight gain and birth weight. CONDENSATION: Maternal fat-free mass and gestational weight gain both influence birth weight.

Prenatal maternal cortisol concentrations predict neurodevelopment in middle childhood.

Science.gov (United States)

Davis, Elysia Poggi; Head, Kevin; Buss, Claudia; Sandman, Curt A

2017-01-01

Glucocorticoids (cortisol in humans) are the end product of the hypothalamic-pituitary-adrenocortical (HPA) axis and are proposed as a key mechanism for programming fetal brain development. The present prospective longitudinal study evaluates the association between prenatal maternal cortisol concentrations and child neurodevelopment. Participants included a low risk sample of 91 mother-child pairs. Prenatal maternal plasma cortisol concentrations were measured at 19 and 31 gestational weeks. Brain development and cognitive functioning were assessed when children were 6-9 years of age. Structural magnetic resonance imaging scans were acquired and cortical thickness was determined. Child cognitive functioning was evaluated using standardized measures (Wechsler Intelligence Scale for Children IV and Expressive Vocabulary Test, Second Edition). Higher maternal cortisol concentrations during the third trimester were associated with greater child cortical thickness primarily in frontal regions. No significant associations were observed between prenatal maternal cortisol concentrations and child cortical thinning. Elevated third trimester maternal cortisol additionally was associated with enhanced child cognitive performance. Findings in this normative sample of typically developing children suggest that elevated maternal cortisol during late gestation exert lasting benefits for brain development and cognitive functioning 6-9 years later. The benefits of fetal exposure to higher maternal cortisol during the third trimester for child neurodevelopment are consistent with the role cortisol plays in maturation of the human fetus. It is plausible that more extreme elevations in maternal cortisol concentrations late in gestation, as well as exposure to pharmacological levels of synthetic glucocorticoids, may have neurotoxic effects on the developing fetal brain. Copyright © 2016. Published by Elsevier Ltd.

Maternal medical risks during pregnancy and childhood externalizing behavior.

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Jackson, Dylan B; Vaughn, Michael G

2018-04-25

Research has indicated that maternal health during the prenatal period and at delivery carries far reaching significance for the development of offspring. Even so, the role of the accumulation of maternal medical risks during pregnancy in the development of externalizing behavior during childhood has generally been overlooked. The present study investigates whether the accumulation of maternal medical risks during the prenatal period is positively associated with childhood externalizing behavior, and whether this association is stronger among male offspring. We examined a large, nationally representative sample of children who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Information concerning maternal medical history, including the presence of a number of medical risks during pregnancy, was obtained through hospital records. A subsample of children with both parent and teacher reports of externalizing behavior during kindergarten was employed in the present study. A greater number of maternal medical risks during pregnancy increased the odds of childhood externalizing behavior across settings, but only among male offspring. The predicted probability of persistent externalizing behavior among males increased from .084 in the absence of maternal medical risks during pregnancy to .241 in the presence of three or more maternal medical risks during pregnancy. Our findings suggest that maternal medical risks during the prenatal period can have far-reaching consequences for the behavioral development of male offspring. Treatment of medical risks among expectant mothers may have the added benefit of reducing the likelihood of childhood externalizing behavior among male progeny. Copyright © 2018 Elsevier Ltd. All rights reserved.

Maternal Mortality in Nepal: Unraveling the Complexity

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Suwal, Juhee V.

2008-01-01

Full Text Available EnglishMaternal mortality has been recognised as a public health problem in the developing countries. The situation concerning maternal mortality in Nepal remained unexplored and vague until the early 1990s. By using 1996 Nepal Family Health Survey, this study discusses the maternal mortality situation in Nepal and analyses the differentials in maternal mortality by place of residence,region, ethnic and religious groups, age at death, and parity. Almost 28 percent of deaths of women in reproductive age was accountable to maternal causes.Logistic regression analysis shows ‘ethnicity,’ ‘age of women,’ and ‘number of births’ as strong predictors of maternal mortality. A number of policy recommendations are suggested to help lower maternal mortality.FrenchLa mortalité liée à la maternité est un des phénomènes de santé qui a étéidentifié dans les pays en voie de développement. La situation de la mortalitéliée à la maternité au Népal est restée inexplorée et assez vague jusqu’au débutdes années 1990. En utilisant les données du Nepal Family Health Survey de1996, cet article examine la situation de la mortalité liée à la maternité au Népalet analyse les différentiels des taux de mortalité par lieu de résidence, région,groupe ethnique et religieux, âge au décès, et parité. Presque 28 pourcent desdécès de femmes en âge de procréer sont liés à la maternité. L’analyse derégression logique démontre que « l’ethnicité », « l’âge des femmes », et le« nombre de naissances » sont de forts prédicteurs du taux des mortalités liées àla maternité.

Understanding Maternal Mortality in Colombia : the Influence of ...

International Development Research Centre (IDRC) Digital Library (Canada)

Understanding Maternal Mortality in Colombia : the Influence of Health Insurance ... a mandatory social insurance program based on contributions from employees ... of maternal mortality such as socioeconomic status, physical access to care, ...

Effect of Transient Maternal Hypotension on Apoptotic Cell Death in Foetal Rat Brain

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Hamit Özyürek

2014-03-01

Full Text Available Background: Intrauterine perfusion insufficiency induced by transient maternal hypotension has been reported to be associated with foetal brain malformations. However, the effects of maternal hypotension on apoptotic processes in the foetal brain have not been investigated experimentally during the intrauterine period. Aims: The aim of this study was to investigate the effects of transient maternal hypotension on apoptotic cell death in the intrauterine foetal brain. Study Design: Animal experimentation. Methods: Three-month-old female Wistar albino rats were allocated into four groups (n=5 each. The impact of hypoxic/ischemic injury induced by transient maternal hypotension on the 15th day of pregnancy (late gestation in rats was investigated at 48 (H17 group or 96 hours (H19 group after the insult. Control groups underwent the same procedure except for induction of hypotension (C17 and H17 groups. Brain sections of one randomly selected foetus from each pregnant rat were histopathologically evaluated for hypoxic/ischemic injury in the metencephalon, diencephalon, and telencephalon by terminal transferase-mediated dUTP nick end labelling and active cysteine-dependent aspartate-directed protease-3 (caspase-3 positivity for cell death. Results: The number of terminal transferase-mediated dUTP nick end labelling (+ cells in all the areas examined was comparable in both hypotension and control groups. The H17 group had active caspase-3 (+ cells in the metencephalon and telencephalon, sparing diencephalon, whereas the C19 and H19 groups had active caspase-3 (+ cells in all three regions. The number of active caspase-3 (+ cells in the telencephalon in the H19 group was higher compared with the metencephalon and diencephalon and compared with H17 group (p<0.05. Conclusion: Our results suggest that prenatal hypoxic/ischemic injury triggers apoptotic mechanisms. Therefore, blockade of apoptotic pathways, considering the time pattern of the insult, may

Maternal Employment and Early Adolescent Substance Use.

Science.gov (United States)

Hillman, Stephen B.; Sawilowsky, Shlomo S.

1991-01-01

Examined effects of maternal employment on use of alcohol, cigarettes, marijuana, and other drugs by ninth graders (n=48). Comparison of maternal employment patterns (full-time versus part-time versus not employed outside the home) indicated no significant differences in substance use behavior among adolescents. Findings support literature on…

Autism Symptom Topography and Maternal Socioemotional Functioning

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Ekas, Naomi; Whitman, Thomas L.

2010-01-01

Researchers examining the relationship of autism "symptomatology" and maternal stress have defined symptomatology in terms of level of severity, frequency of occurrence, or symptom type. In the present study, the relationship of maternal perceptions of these dimensions, along with a fourth, symptom diversity, and negative and positive indices of…

Impact of Potential Accreditation and Certification in Family Medicine Maternity Care.

Science.gov (United States)

Eden, Aimee R; Peterson, Lars E

2017-01-01

Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ). In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached. Participants generally supported both maternity care fellowship accreditation and a CAQ and recognized multiple advantages such as legitimization of training. Many had concerns about potential negative unintended consequences such as a loss of curricular flexibility; however, most felt that these could be mediated. Only a few did not support one or both aspects of formalization. Most participants interviewed support formalizing maternity care fellowship training in family medicine through accreditation and a subsequent CAQ, if implemented with attention to minimizing the potential negative consequences. Such formalization would recognize the advanced skill and training of family physicians practicing advanced maternity care and could address some access issues to essential maternity care services for rural and other underserved populations.

Audit of Maternal Mortality Ratio and Causes of Maternal Deaths in ...

African Journals Online (AJOL)

AJRH Managing Editor

were collected from the files of the hospitalized pregnant women in the hospital. There were 38 maternal ... Mortality Ratio (MMR) is the “number of women died while ..... ASJOG, March. 2005. 4. ... World Bank, Washington DC. March 2011.

[Maternal deaths related to social vulnerabilities. Results from the French confidential enquiry into maternal deaths, 2010-2012].

Science.gov (United States)

Tessier, V; Leroux, S; Guseva-Canu, I

2017-12-01

The theme of deprivation is new for the ENCMM. In view of the perceived increase in the number of maternal deaths that may be related to a deprivation situation, we sought to understand the main dimensions that could contribute to maternal death in this context, in order to propose a definition. The selection of cases made a posteriori is mainly based on a qualitative judgment. Between 2010 and 2012, among the deaths evaluated by the CNEMM, one or more elements related to social vulnerability were identified in 8.6% of the cases (18 deaths). The direct criteria used were the concepts of "deprivation" or "social difficulties", difficulties of housing, language barriers and isolation. The absence of prenatal care was retained as an indirect marker. We excluded cases where psychiatric pathology and/or addiction were predominant. Of the 18 cases identified with deprivation factors, death was considered "unavoidable" in 2 cases (11%), "certainly avoidable" or "possibly avoidable" in 13 cases (72%). In 3 cases (17%), avoidability could not be determined. Avoidability was related to the content and adequacy of care in 11 cases out of 13 (85%) and the patient's interaction with the health care system in 10 of 18 cases (56%). The analysis of maternal deaths among women in precarious situations points out that the link between socio-economic deprivation and poor maternal health outcomes potentially includes a specific risk of maternal death. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Cues of maternal condition influence offspring selfishness.

Science.gov (United States)

Wong, Janine W Y; Lucas, Christophe; Kölliker, Mathias

2014-01-01

The evolution of parent-offspring communication was mostly studied from the perspective of parents responding to begging signals conveying information about offspring condition. Parents should respond to begging because of the differential fitness returns obtained from their investment in offspring that differ in condition. For analogous reasons, offspring should adjust their behavior to cues/signals of parental condition: parents that differ in condition pay differential costs of care and, hence, should provide different amounts of food. In this study, we experimentally tested in the European earwig (Forficula auricularia) if cues of maternal condition affect offspring behavior in terms of sibling cannibalism. We experimentally manipulated female condition by providing them with different amounts of food, kept nymph condition constant, allowed for nymph exposure to chemical maternal cues over extended time, quantified nymph survival (deaths being due to cannibalism) and extracted and analyzed the females' cuticular hydrocarbons (CHC). Nymph survival was significantly affected by chemical cues of maternal condition, and this effect depended on the timing of breeding. Cues of poor maternal condition enhanced nymph survival in early broods, but reduced nymph survival in late broods, and vice versa for cues of good condition. Furthermore, female condition affected the quantitative composition of their CHC profile which in turn predicted nymph survival patterns. Thus, earwig offspring are sensitive to chemical cues of maternal condition and nymphs from early and late broods show opposite reactions to the same chemical cues. Together with former evidence on maternal sensitivities to condition-dependent nymph chemical cues, our study shows context-dependent reciprocal information exchange about condition between earwig mothers and their offspring, potentially mediated by cuticular hydrocarbons.

Cues of maternal condition influence offspring selfishness.

Directory of Open Access Journals (Sweden)

Janine W Y Wong

Full Text Available The evolution of parent-offspring communication was mostly studied from the perspective of parents responding to begging signals conveying information about offspring condition. Parents should respond to begging because of the differential fitness returns obtained from their investment in offspring that differ in condition. For analogous reasons, offspring should adjust their behavior to cues/signals of parental condition: parents that differ in condition pay differential costs of care and, hence, should provide different amounts of food. In this study, we experimentally tested in the European earwig (Forficula auricularia if cues of maternal condition affect offspring behavior in terms of sibling cannibalism. We experimentally manipulated female condition by providing them with different amounts of food, kept nymph condition constant, allowed for nymph exposure to chemical maternal cues over extended time, quantified nymph survival (deaths being due to cannibalism and extracted and analyzed the females' cuticular hydrocarbons (CHC. Nymph survival was significantly affected by chemical cues of maternal condition, and this effect depended on the timing of breeding. Cues of poor maternal condition enhanced nymph survival in early broods, but reduced nymph survival in late broods, and vice versa for cues of good condition. Furthermore, female condition affected the quantitative composition of their CHC profile which in turn predicted nymph survival patterns. Thus, earwig offspring are sensitive to chemical cues of maternal condition and nymphs from early and late broods show opposite reactions to the same chemical cues. Together with former evidence on maternal sensitivities to condition-dependent nymph chemical cues, our study shows context-dependent reciprocal information exchange about condition between earwig mothers and their offspring, potentially mediated by cuticular hydrocarbons.

Perception and acceptability of malaria vaccine among maternal ...

African Journals Online (AJOL)

Perception and acceptability of malaria vaccine among maternal and child health clinic ... Journal of Community Medicine and Primary Health Care ... used for data collection from maternal and child health clinic attendees in Calabar, Nigeria.

Maternal depressive symptomatology and parenting behavior: exploration of possible mediators.

Science.gov (United States)

Gerdes, Alyson C; Hoza, Betsy; Arnold, L Eugene; Pelham, William E; Swanson, James M; Wigal, Timothy; Jensen, Peter S

2007-10-01

Possible mediators of the relation between maternal depressive symptomatology and parenting behavior were examined for 96 children with ADHD and their mothers drawn from the Multimodal Treatment Study of Children with ADHD (MTA) as part of an add-on investigation conducted by two of the six MTA sites. General cognitions (i.e., maternal locus of control and self-esteem) and parenting-specific factors (i.e., maternal parenting efficacy and parenting stress) were examined as possible mediators. Findings provide initial support that maternal parenting stress, as well as maternal locus of control and self-esteem mediate the relation between maternal depressive symptomatology and parenting behavior. This provides support for the argument that some families of children with ADHD may benefit from an expanded version of parent management training that includes sessions directly targeting affective and cognitive factors in parents, similar to treatment programs used to treat childhood conduct problems.

The global maternal sepsis study and awareness campaign (GLOSS): study protocol.

Science.gov (United States)

Bonet, Mercedes; Souza, Joao Paulo; Abalos, Edgardo; Fawole, Bukola; Knight, Marian; Kouanda, Seni; Lumbiganon, Pisake; Nabhan, Ashraf; Nadisauskiene, Ruta; Brizuela, Vanessa; Metin Gülmezoglu, A

2018-01-30

Maternal sepsis is the underlying cause of 11% of all maternal deaths and a significant contributor to many deaths attributed to other underlying conditions. The effective prevention, early identification and adequate management of maternal and neonatal infections and sepsis can contribute to reducing the burden of infection as an underlying and contributing cause of morbidity and mortality. The objectives of the Global Maternal Sepsis Study (GLOSS) include: the development and validation of identification criteria for possible severe maternal infection and maternal sepsis; assessment of the frequency of use of a core set of practices recommended for prevention, early identification and management of maternal sepsis; further understanding of mother-to-child transmission of bacterial infection; assessment of the level of awareness about maternal and neonatal sepsis among health care providers; and establishment of a network of health care facilities to implement quality improvement strategies for better identification and management of maternal and early neonatal sepsis. This is a facility-based, prospective, one-week inception cohort study. This study will be implemented in health care facilities located in pre-specified geographical areas of participating countries across the WHO regions of Africa, Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific. During a seven-day period, all women admitted to or already hospitalised in participating facilities with suspected or confirmed infection during any stage of pregnancy through the 42nd day after abortion or childbirth will be included in the study. Included women will be followed during their stay in the facilities until hospital discharge, death or transfer to another health facility. The maximum intra-hospital follow-up period will be 42 days. GLOSS will provide a set of actionable criteria for identification of women with possible severe maternal infection and maternal sepsis. This study

Maternal near-miss audit in the Metro West maternity service, Cape ...

African Journals Online (AJOL)

This open-access article is distributed under. Creative ... A maternal near-miss is defined as a life-threatening pregnancy-related complication where the woman survives. ..... to studies in Pakistan, India and Baghdad, with rates of 8.6, 4.4.

Effect of maternal death reviews and training on maternal mortality among cesarean delivery: post-hoc analysis of a cluster-randomized controlled trial.

Science.gov (United States)

Zongo, Augustin; Dumont, Alexandre; Fournier, Pierre; Traore, Mamadou; Kouanda, Séni; Sondo, Blaise

2015-02-01

To explore the differential effect of a multifaceted intervention on hospital-based maternal mortality between patients with cesarean and vaginal delivery in low-resource settings. We reanalyzed the data from a major cluster-randomized controlled trial, QUARITE (Quality of care, Risk management and technology in obstetrics). These subgroup analyses were not pre-specified and were treated as exploratory. The intervention consisted of an initial interactive workshop and quarterly educational clinically oriented and evidence-based outreach visits focused on maternal death reviews (MDR) and best practices implementation. The trial originally recruited 191,167 patients who delivered in each of the 46 participating hospitals in Mali and Senegal, between 2007 and 2011. The primary endpoint was hospital-based maternal mortality. Subgroup-specific Odds Ratios (ORs) of maternal mortality were computed and tested for differential intervention effect using generalized linear mixed model between two subgroups (cesarean: 40,975; and vaginal delivery: 150,192). The test for homogeneity of intervention effects on hospital-based maternal mortality among the two delivery mode subgroups was statistically significant (p-value: 0.0201). Compared to the control, the adjusted OR of maternal mortality was 0.71 (95% CI: 0.58-0.82, p=0.0034) among women with cesarean delivery. The intervention had no significant effect among women with vaginal delivery (adjusted OR 0.87, 95% CI 0.69-1.11, p=0.6213). This differential effect was particularly marked for district hospitals. Maternal deaths reviews and on-site training on emergency obstetric care may be more effective in reducing maternal mortality among high-risk women who need a cesarean section than among low-risk women with vaginal delivery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Is maternal deprivation the root of all evil?

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David R. Cross

2009-11-01

Full Text Available In this paper we seriously entertain the question, “Is maternal deprivation the root of all evil?” Our consideration of this question is broken down into three parts. In the fi rst part, we discuss the nature of evil, focusing in particular on the legal concept of depravity. In the second part, we discuss the nurture of evil, focusing in particular on the common developmental trajectory seen in those who are depraved. In the third part, we discuss the roots of evil, focusing in particular on the animal and human research regarding maternal deprivation. Our conclusion is that maternal deprivation may actually be the root of all evil, but only because depraved individuals have been deprived of normative maternal care, which is the cradle of our humanity.

Unsafe Abortion- A Tragic Saga of Maternal Suffering

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M C Regmi

2010-03-01

Full Text Available INTRODUCTION: Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. METHODS: A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. RESULTS: There were 70 unsafe abortion patients. Majority of them (52.8% were of high grade. Most of them recovered but there were total 8maternal deaths. CONCLUSIONS: Unsafe abortion is still a significant medical and social problem even in post legalization era of this country. Keywords: abortion, legalization, maternal death, unsafe.

Longitudinal associations between maternal disrupted representations, maternal interactive behavior and infant attachment: A comparison between full-term and preterm dyads

NARCIS (Netherlands)

Hall, R.A.S.; Hoffenkamp, H.N.; Tooten, A.; Braeken, J.; Vingerhoets, A.J.J.M.; van Bakel, H.J.A.

2015-01-01

This prospective study examined whether or not a mother’s representations of her infant were more often disrupted after premature childbirth. Furthermore, the study examined if different components of maternal interactive behavior mediated the relation between maternal disrupted representations and

First trimester bleeding and maternal cardiovascular morbidity

DEFF Research Database (Denmark)

Lykke, Jacob A; Langhoff-Roos, Jens

2012-01-01

First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...... to and subsequent to first trimester bleeding without miscarriage....

Maternal vaccination to prevent pertussis in infants

African Journals Online (AJOL)

2016-09-09

Sep 9, 2016 ... that maternal immunisation with the Tdap (tetanus, diphtheria and acellular pertussis) vaccine is safe. Indeed, maternal vaccination is now recommended to prevent pertussis infection in vulnerable young infants. In the USA and UK, the immunisation of pregnant women with a Tdap or dTaP/IPV (diphtheria, ...

Maternal Depression and Developmental Disability: Research Critique

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Bailey, Donald B., Jr.; Golden, Robert N.; Roberts, Jane; Ford, Amy

2007-01-01

Maternal depression in families having a child with a disability has been the subject of considerable research over the past 25 years. This review was designed to describe the literature on maternal depression, critique its research methodology, identify consensus findings across studies, and make recommendations for future research. A particular…

Maternal styles in a precocial bird

OpenAIRE

Pittet , Florent; Houdelier , Cécilia; de Margerie , Emmanuel; Le Bot , Océane; Richard-Yris , Marie-Annick; Lumineau , Sophie

2014-01-01

International audience; Care provided by females of many mammal species varies naturally between individuals; these differences in turn influence the phenotypic development of their offspring. When individual maternal behavioural traits are consistent over a number of breeding periods, maternal styles can be defined. These styles have been studied in a large range of mammalian species. Nevertheless, mammals rarely offer the possibility to dissociate mothers' behavioural influence from their g...

What influences success in family medicine maternity care education programs?

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Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David

2018-01-01

Abstract Objective To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Design Qualitative research using semistructured telephone interviews. Setting Purposive sample of 6 family medicine programs from 5 Canadian provinces. Participants Eighteen departmental leaders and program directors. METHODS Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be “successful.” Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Main findings Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program’s success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine–friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Conclusion Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. PMID:29760273

Disentangling Genetic and Prenatal Maternal Effects on Offspring Size and Survival.

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Pick, Joel L; Ebneter, Christina; Hutter, Pascale; Tschirren, Barbara

2016-12-01

Organizational processes during prenatal development can have long-term effects on an individual's phenotype. Because these early developmental stages are sensitive to environmental influences, mothers are in a unique position to alter their offspring's phenotype by differentially allocating resources to their developing young. However, such prenatal maternal effects are difficult to disentangle from other forms of parental care, additive genetic effects, and/or other forms of maternal inheritance, hampering our understanding of their evolutionary consequences. Here we used divergent selection lines for high and low prenatal maternal investment and their reciprocal line crosses in a precocial bird-the Japanese quail (Coturnix japonica)-to quantify the relative importance of genes and prenatal maternal effects in shaping offspring phenotype. Maternal but not paternal origin strongly affected offspring body size and survival throughout development. Although the effects of maternal egg investment faded over time, they were large at key life stages. Additionally, there was evidence for other forms of maternal inheritance affecting offspring phenotype at later stages of development. Our study is among the first to successfully disentangle prenatal maternal effects from all other sources of confounding variation and highlights the important role of prenatal maternal provisioning in shaping offspring traits closely linked to fitness.

Maternal Smoking during Pregnancy, Prematurity and Recurrent Wheezing in Early Childhood

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Robison, Rachel G; Kumar, Rajesh; Arguelles, Lester M; Hong, Xiumei; Wang, Guoying; Apollon, Stephanie; Bonzagni, Anthony; Ortiz, Kathryn; Pearson, Colleen; Pongracic, Jacqueline A; Wang, Xiaobin

2013-01-01

Summary Background Prenatal maternal smoking and prematurity independently affect wheezing and asthma in childhood. Objective We sought to evaluate the interactive effects of maternal smoking and prematurity upon the development of early childhood wheezing. Methods We evaluated 1448 children with smoke exposure data from a prospective urban birth cohort in Boston. Maternal antenatal and postnatal exposure was determined from standardized questionnaires. Gestational age was assessed by the first day of the last menstrual period and early prenatal ultrasound (pretermprematurity and maternal antenatal smoking on recurrent wheeze, controlling for relevant covariates. Results In the cohort, 90 (6%) children had recurrent wheezing, 147 (10%) were exposed to in utero maternal smoke and 419 (29%) were premature. Prematurity (odds ratio [OR] 2.0; 95% CI, 1.3-3.1) was associated with an increased risk of recurrent wheezing, but in utero maternal smoking was not (OR 1.1, 95% CI 0.5-2.4). Jointly, maternal smoke exposure and prematurity caused an increased risk of recurrent wheezing (OR 3.8, 95% CI 1.8-8.0). There was an interaction between prematurity and maternal smoking upon episodes of wheezing (p=0.049). Conclusions We demonstrated an interaction between maternal smoking during pregnancy and prematurity on childhood wheezing in this urban, multiethnic birth cohort. PMID:22290763

Maternal mortality: a cross-sectional study in global health.

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Sajedinejad, Sima; Majdzadeh, Reza; Vedadhir, AbouAli; Tabatabaei, Mahmoud Ghazi; Mohammad, Kazem

2015-02-12

Although most of maternal deaths are preventable, maternal mortality reduction programs have not been completely successful. As targeting individuals alone does not seem to be an effective strategy to reduce maternal mortality (Millennium Development Goal 5), the present study sought to reveal the role of many distant macrostructural factors affecting maternal mortality at the global level. After preparing a global dataset, 439 indicators were selected from nearly 1800 indicators based on their relevance and the application of proper inclusion and exclusion criteria. Then Pearson correlation coefficients were computed to assess the relationship between these indicators and maternal mortality. Only indicators with statistically significant correlation more than 0.2, and missing values less than 20% were maintained. Due to the high multicollinearity among the remaining indicators, after missing values analysis and imputation, factor analysis was performed with principal component analysis as the method of extraction. Ten factors were finally extracted and entered into a multiple regression analysis. The findings of this study not only consolidated the results of earlier studies about maternal mortality, but also added new evidence. Education (std. B = -0.442), private sector and trade (std. B = -0.316), and governance (std. B = -0.280) were found to be the most important macrostructural factors associated with maternal mortality. Employment and labor structure, economic policy and debt, agriculture and food production, private sector infrastructure investment, and health finance were also some other critical factors. These distal factors explained about 65% of the variability in maternal mortality between different countries. Decreasing maternal mortality requires dealing with various factors other than individual determinants including political will, reallocation of national resources (especially health resources) in the governmental sector, education

Associations between Maternal Hormonal Biomarkers and Maternal Mental and Physical Health of Very Low Birthweight Infants

OpenAIRE

Cho, June; Su, Xiaogang; Phillips, Vivien; Holditch-Davis, Diane

2016-01-01

The purpose of this study was to determine whether maternal mental and physical health is associated with maternal testosterone and cortisol levels, parenting of very low birth weight infants, physical exercise, and White vs non-White race. A total of 40 mothers of very low birth weight infants were recruited from a neonatal intensive care unit at a University Hospital in the Southeast United States. Data were collected through a review of medical records, standardized questionnaires, and bio...

Women's postpartum maternity benefits and work experience.

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Gjerdingen, D K; McGovern, P M; Chaloner, K M; Street, H B

1995-10-01

This study was conducted to describe women's perceptions of their maternity leave policy and its implementation, maternity leave benefits, postpartum work experience, and factors that relate to returning to work. Surveys were mailed to 436 married, recently employed, first-time mothers at 1, 3, 6, 9 and 12 months postpartum. Most respondents said they had written maternity leave policies they could understand, but they were not completely satisfied with their policies. The average 11.1-week maternity leave was considerably shorter than their 8-month ideal, and only 25.5% had the option of working part-time. A minority (35.8%) were allowed to use personal days to care for a sick infant. Most women were distressed about making child care arrangements. Compared with women who remained at home, those who returned to work complained of more respiratory, gynecologic, and breast symptoms. Relatively little is known about women's postpartum work experience. In this study, return to work after delivery was related to several demographic, occupational, and social factors and was associated with health problems and concerns about child care. With a majority of new mothers now returning to work, attention has recently been directed to factors that facilitate the merger of work and parenting roles. One such important factor is women's parental or maternity leave benefits, the focus of this study.

Progesterone promotes maternal-fetal tolerance by reducing human maternal T-cell polyfunctionality and inducing a specific cytokine profile.

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Lissauer, David; Eldershaw, Suzy A; Inman, Charlotte F; Coomarasamy, Aravinthan; Moss, Paul A H; Kilby, Mark D

2015-10-01

Progesterone is a steroid hormone essential for the maintenance of human pregnancy, and its actions are thought to include promoting maternal immune tolerance of the semiallogenic fetus. We report that exposure of maternal T cells to progesterone at physiological doses induced a unique skewing of the cytokine production profile of CD4(+) and CD8(+) T cells, with reductions not only in potentially deleterious IFN-γ and TNF-α production but also in IL-10 and IL-5. Conversely, production of IL-4 was increased. Maternal T cells also became less polyfunctional, focussing cytokine production toward profiles including IL-4. This was accompanied by reduced T-cell proliferation. Using fetal and viral antigen-specific CD8(+) T-cell clones, we confirmed that this as a direct, nonantigen-specific effect. Yet human T cells lacked conventional nuclear progesterone receptors, implicating a membrane progesterone receptor. CD4(+) and CD8(+) T cells responded to progesterone in a dose-dependent manner, with subtle effects at concentrations comparable to those in maternal blood, but profound effects at concentrations similar to those at the maternal-fetal interface. This characterization of how progesterone modulates T-cell function is important in understanding the normal biology of pregnancy and informing the rational use of progesterone therapy in pregnancies at risk of fetal loss. © 2015 The Authors. European Journal of Immunology published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Rural maternity care: can we learn from Wal-Mart?

Science.gov (United States)

van Teijlingen, E R; Pitchforth, E

2010-03-01

In many countries rural maternity care is under threat. Consequently rural pregnant women will have to travel further to attend larger maternity units to receive care and deliver their babies. This trend is not dissimilar from the disappearance of other rural services, such as village shops, banks, post offices and bus services. We use a comparative approach to draw an analogy with large-scale supermarkets, such as the Wal-Mart and Tesco and their effect on the viability of smaller rural shops, depersonalisation of service and the wider community. The closure of a community-maternity unit leads to women attending a different type of hospital with a different approach to maternity care. Thus small community-midwifery units are being replaced, not by a very similar unit that happens to be further away, but by a larger obstetric unit that operates on different models, philosophy and notions of risk. Comparative analysis allows a fresh perspective on the provision of rural maternity services. We argue that previous discussions focusing on medicalisation and change in maternity services can be enhanced by drawing on experience in other sectors and taking a wider societal lens. Copyright 2009 Elsevier Ltd. All rights reserved.

Maternal Child Abuse and its Association with Maternal Anxiety in the Socio-Cultural Context of Iran

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Zahra Esmaeili Douki

2013-11-01

Full Text Available Objectives: The prevalence of parental violence has been an area of major public concern. There are few available data detailing the ways parents and other caregivers discipline children, particularly in low and middle income countries. This study focuses on the prevalence of different types of maternal child abuse and its association with maternal anxiety in the socio-cultural context of Iran.Methods: Participants in this cross-sectional study consisted of 562 mothers with the last child aged from 1 month to 12 years old who attended the Amirkola Children’s Referral Hospital in Mazandaran Province, Iran, seeking healthcare services for their children. Demographic characteristics of the mothers, their children and reactions to conflicts with children were evaluated by a validated version of Conflict Tactics Scale for Parent and Child. Also, the relationship between maternal anxiety and child abuse was assessed using the Spielberger State-Trait Anxiety Inventory. The association between variables was examined by Pearson correlation coefficient, independent t-test, one-way ANOVA, and multivariate regression.Results: The prevalence of mother-to-child corporal punishment, severe physical abuse and very severe physical abuse were 436 (78%, 260 (46% and 180 (32%, respectively. Verbal emotional abuse was reported by 506 (90% participants and nonverbal emotional abuse was reported in 374 (67% cases. A correlation was observed between child abuse and mothers’ age (p=0.02, as well as with the number of children in the family (p=0.03, and the mothers’ trait anxiety (p<0.001.Conclusion: Overall, the assessment of maternal child abuse should be an important focus for evaluation in mothers with anxiety and vice versa, when child abuse is suspected, maternal psychological assessment should be essential.

Maternal obesity and neurodevelopmental and psychiatric disorders in offspring

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Edlow, Andrea G.

2017-01-01

There is a growing body of evidence from both human epidemiologic and animal studies that prenatal and lactational exposure to maternal obesity and high-fat diet are associated with neurodevelopmental and psychiatric disorders in offspring. These disorders include cognitive impairment, autism spectrum disorders, attention deficit hyperactivity disorder, cerebral palsy, anxiety and depression, schizophrenia, and eating disorders. This review synthesizes human and animal data linking maternal obesity and high-fat diet consumption to abnormal fetal brain development and neurodevelopmental and psychiatric morbidity in offspring. In addition, it highlights key mechanisms by which maternal obesity and maternal diet might impact fetal and offspring neurodevelopment, including neuroinflammation; increased oxidative stress, dysregulated insulin, glucose, and leptin signaling; dysregulated serotonergic and dopaminergic signaling; and perturbations in synaptic plasticity. Finally, the review summarizes available evidence regarding investigational therapeutic approaches to mitigate the harmful effects of maternal obesity on fetal and offspring neurodevelopment. PMID:27684946

Maternal hemochromatosis gene H63D single-nucleotide polymorphism and lead levels of placental tissue, maternal and umbilical cord blood

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Kayaalti, Zeliha, E-mail: kayaalti@ankara.edu.tr [Ankara University, Institute of Forensic Sciences, Ankara (Turkey); Kaya-Akyüzlü, Dilek [Ankara University, Institute of Forensic Sciences, Ankara (Turkey); Söylemez, Esma [Ankara University, Institute of Forensic Sciences, Ankara (Turkey); Middle Black Sea Passage Generation of Agricultural Research Station Director, Tokat (Turkey); Söylemezoğlu, Tülin [Ankara University, Institute of Forensic Sciences, Ankara (Turkey)

2015-07-15

Human hemochromatosis protein (HFE), a major histocompatibility complex class I-like integral membrane protein, participates in the down regulation of intestinal iron absorption by binding to transferrin receptor (TR). HFE competes with transferrin-bound iron for the TR and thus reduces uptake of iron into cells. On the other hand, a lack of HFE increases the intestinal absorption of iron similarly to iron deficiency associated with increasing in absorption and deposition of lead. During pregnancy, placenta cannot prevent transfer lead to the fetus; even low-level lead poisoning causes neurodevelopmental toxicity in children. The aim of this study was to determine the association between the maternal HFE H63D single-nucleotide polymorphism and lead levels in placental tissue, maternal blood and umbilical cord bloods. The study population comprised 93 mother–placenta pairs. Venous blood from mother was collected to investigate lead levels and HFE polymorphism that was detected by standard PCR–RFLP technique. Cord bloods and placentas were collected for lead levels which were analyzed by dual atomic absorption spectrometer system. The HFE H63D genotype frequencies of mothers were found as 75.3% homozygote typical (HH), 23.6% heterozygote (HD) and 1.1% homozygote atypical (DD). Our study results showed that the placental tissue, umbilical cord and maternal blood lead levels of mothers with HD+DD genotypes were significantly higher than those with HH genotype (p<0.05). The present study indicated for the first time that mothers with H63D gene variants have higher lead levels of their newborn's placentas and umbilical cord bloods. - Highlights: • Mothers with H63D gene variants have higher lead levels of their newborn's umbilical cord blood. • Unborn child of women with HD+DD genotypes may be at increased risk of internal exposure to lead. • Maternal HFE status may have an effect on increased placenta, maternal and cord blood lead levels. �

Maternal hemochromatosis gene H63D single-nucleotide polymorphism and lead levels of placental tissue, maternal and umbilical cord blood

International Nuclear Information System (INIS)

Kayaalti, Zeliha; Kaya-Akyüzlü, Dilek; Söylemez, Esma; Söylemezoğlu, Tülin

2015-01-01

Human hemochromatosis protein (HFE), a major histocompatibility complex class I-like integral membrane protein, participates in the down regulation of intestinal iron absorption by binding to transferrin receptor (TR). HFE competes with transferrin-bound iron for the TR and thus reduces uptake of iron into cells. On the other hand, a lack of HFE increases the intestinal absorption of iron similarly to iron deficiency associated with increasing in absorption and deposition of lead. During pregnancy, placenta cannot prevent transfer lead to the fetus; even low-level lead poisoning causes neurodevelopmental toxicity in children. The aim of this study was to determine the association between the maternal HFE H63D single-nucleotide polymorphism and lead levels in placental tissue, maternal blood and umbilical cord bloods. The study population comprised 93 mother–placenta pairs. Venous blood from mother was collected to investigate lead levels and HFE polymorphism that was detected by standard PCR–RFLP technique. Cord bloods and placentas were collected for lead levels which were analyzed by dual atomic absorption spectrometer system. The HFE H63D genotype frequencies of mothers were found as 75.3% homozygote typical (HH), 23.6% heterozygote (HD) and 1.1% homozygote atypical (DD). Our study results showed that the placental tissue, umbilical cord and maternal blood lead levels of mothers with HD+DD genotypes were significantly higher than those with HH genotype (p<0.05). The present study indicated for the first time that mothers with H63D gene variants have higher lead levels of their newborn's placentas and umbilical cord bloods. - Highlights: • Mothers with H63D gene variants have higher lead levels of their newborn's umbilical cord blood. • Unborn child of women with HD+DD genotypes may be at increased risk of internal exposure to lead. • Maternal HFE status may have an effect on increased placenta, maternal and cord blood lead levels. �

The Maternity Care Nurse Workforce in Rural U.S. Hospitals.

Science.gov (United States)

Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B

To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Divergent Trends in US Maternity and Paternity Leave, 1994-2015.

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Zagorsky, Jay L

2017-03-01

To determine the number and type of US workers taking maternity or paternity leave. We created a publicly available ecological long-term series for measuring parental leave from 1994 to 2015 by using the Current Population Survey, which interviews about 60 000 randomly selected households monthly. The average month from 1994 to 2015 saw 273 000 women and 13 000 men on maternity or paternity leave. Maternity leave rates per 10 000 births showed no trend over 22 years (mean = 677.6). Paternity figures increased by a factor of 3, but started from a small base (14.7-54.6). We observed no national impact on maternity or paternity leave after implementation of state laws that provided paid leave. About half (51.1%) of employees on maternity or paternity leave during 2015 received paid time off. The typical woman on maternity leave was older, more likely married, more likely non-Hispanic White, and more educated than the typical woman who gave birth. Although the US economy has expanded dramatically since 1994, this improvement does not appear to have translated into more women taking maternity leave.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

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Hendrick, C Emily; Marteleto, Leticia

2017-06-01

Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

Adaptation to Temporally Fluctuating Environments by the Evolution of Maternal Effects.

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Snigdhadip Dey

2016-02-01

Full Text Available All organisms live in temporally fluctuating environments. Theory predicts that the evolution of deterministic maternal effects (i.e., anticipatory maternal effects or transgenerational phenotypic plasticity underlies adaptation to environments that fluctuate in a predictably alternating fashion over maternal-offspring generations. In contrast, randomizing maternal effects (i.e., diversifying and conservative bet-hedging, are expected to evolve in response to unpredictably fluctuating environments. Although maternal effects are common, evidence for their adaptive significance is equivocal since they can easily evolve as a correlated response to maternal selection and may or may not increase the future fitness of offspring. Using the hermaphroditic nematode Caenorhabditis elegans, we here show that the experimental evolution of maternal glycogen provisioning underlies adaptation to a fluctuating normoxia-anoxia hatching environment by increasing embryo survival under anoxia. In strictly alternating environments, we found that hermaphrodites evolved the ability to increase embryo glycogen provisioning when they experienced normoxia and to decrease embryo glycogen provisioning when they experienced anoxia. At odds with existing theory, however, populations facing irregularly fluctuating normoxia-anoxia hatching environments failed to evolve randomizing maternal effects. Instead, adaptation in these populations may have occurred through the evolution of fitness effects that percolate over multiple generations, as they maintained considerably high expected growth rates during experimental evolution despite evolving reduced fecundity and reduced embryo survival under one or two generations of anoxia. We develop theoretical models that explain why adaptation to a wide range of patterns of environmental fluctuations hinges on the existence of deterministic maternal effects, and that such deterministic maternal effects are more likely to contribute to

Maternal Pseudo-Bartter Syndrome Associated with Severe Perinatal Brain Injury.

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Vora, Shrenik; Ibrahim, Thowfique; Rajadurai, Victor Samuel

2017-09-15

Maternal electrolyte imbalance is rarely reported as causative factor of severe perinatal brain injury. This case outlines a unique maternal and neonatal pseudo-Bartter syndrome presented with metabolic alkalosis and hypochloremia due to maternal severe vomiting. Neonatal MRI brain revealed extensive brain hemorrhages with porencephalic cysts. Subsequent investigation workup points towards maternal severe metabolic alkalosis as its cause. Careful medical attention should be paid to pregnant women with excessive vomiting to ensure a healthy outcome for both the mother and the baby.

Cryptorchidism and maternal alcohol consumption during pregnancy

DEFF Research Database (Denmark)

Damgaard, Ida N; Jensen, Tina Kold; Petersen, Jørgen H

2007-01-01

Prenatal exposure to alcohol can adversely affect the fetus. We investigated the association between maternal alcohol consumption during pregnancy and cryptorchidism (undescended testis) among newborn boys.......Prenatal exposure to alcohol can adversely affect the fetus. We investigated the association between maternal alcohol consumption during pregnancy and cryptorchidism (undescended testis) among newborn boys....

Commentary Improving child outcomes through maternal mental ...

African Journals Online (AJOL)

This commentary will provide a general overview of the public health considerations of maternal mental illness, both from a global perspective as well as from the South African context. The paper will outline the consequences of maternal mental illness for mothers as well as their offspring, through the life stages from ...

Determinants of Maternal Healthcare Utilization in Nigeria ...

African Journals Online (AJOL)

Reproductive healthcare has remained a point of concern in sub-Saharan Africa due to the prevailing high maternal mortality rate. Despite the fact that the utilization of maternal healthcare services is a curbing solution, the records of utilization still remains low. This paper examined the determinants of the decision to use ...

Maternal death and the Millennium Development Goals

DEFF Research Database (Denmark)

Rasch, Vibeke

2007-01-01

Maternal health is one of the main global health challenges and reduction of the maternal mortality ratio, from the present 0.6 mio. per year, by three-quarters by 2015 is the target for the fifth Millennium Development Goal (MDG 5). However this goal is the one towards which the least progress h...

The Maternity Benefit (Amendment Bill, 2016: A Critical Analysis

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Suman Singh

2016-11-01

Full Text Available On 11 August 2016, amending the Maternity Benefit Act, 1961, the new bill, The Maternity Benefit (Amendment Bill, 2016 was introduced and passed in the Rajya Sabha (or Council of States, the upper house of the Parliament of India. Central aim of this article is to critically review the amendments to the bill regarding geographies of maternity leave and its associated facilities.

Maternal Mortality in Women with Epilepsy

LENUS (Irish Health Repository)

Holohan, M

2016-10-01

It is estimated that, in Ireland, there are 10,000 women with epilepsy of childbearing potential1. In this paper the maternal mortality rate for women with epilepsy attending the Rotunda Hospital Epilepsy Clinic 2004 - 2013 was determined. There were 3 maternal deaths in women with epilepsy during this time, which represents a mortality rate of 0.8%. In those women who died, there were concerns in relation to risks to the foetus by taking Anti-Epileptic Drugs (AED) and also issues with access to neurology services before pregnancy, acceptance of specialist support and lack of consistency in advice from health care professionals outside of Ireland. Implementing the nationally agreed care plan for women with epilepsy will improve the quality of care given and potentially we will see a reduction in maternal mortality in these women.

More than a name: Heterogeneity in characteristics of models of maternity care reported from the Australian Maternity Care Classification System validation study.

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Donnolley, Natasha R; Chambers, Georgina M; Butler-Henderson, Kerryn A; Chapman, Michael G; Sullivan, Elizabeth A

2017-08-01

Without a standard terminology to classify models of maternity care, it is problematic to compare and evaluate clinical outcomes across different models. The Maternity Care Classification System is a novel system developed in Australia to classify models of maternity care based on their characteristics and an overarching broad model descriptor (Major Model Category). This study aimed to assess the extent of variability in the defining characteristics of models of care grouped to the same Major Model Category, using the Maternity Care Classification System. All public hospital maternity services in New South Wales, Australia, were invited to complete a web-based survey classifying two local models of care using the Maternity Care Classification System. A descriptive analysis of the variation in 15 attributes of models of care was conducted to evaluate the level of heterogeneity within and across Major Model Categories. Sixty-nine out of seventy hospitals responded, classifying 129 models of care. There was wide variation in a number of important attributes of models classified to the same Major Model Category. The category of 'Public hospital maternity care' contained the most variation across all characteristics. This study demonstrated that although models of care can be grouped into a distinct set of Major Model Categories, there are significant variations in models of the same type. This could result in seemingly 'like' models of care being incorrectly compared if grouped only by the Major Model Category. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Causes of maternal mortality decline in Matlab, Bangladesh.

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Chowdhury, Mahbub Elahi; Ahmed, Anisuddin; Kalim, Nahid; Koblinsky, Marge

2009-04-01

Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and 215,779 pregnancy records from the Health and Demographic Surveillance System (HDSS) and other sources of safe motherhood data in the ICDDR,B and government service areas in Matlab during 1976-2005. The major interventions that took place in both the areas since the early 1980s were the family-planning programme plus safe menstrual regulation services and safe motherhood interventions (midwives for normal delivery in the ICDDR,B service area from the late 1980s and equal access to comprehensive emergency obstetric care [EmOC] in public facilities for women from both the areas). National programmes for social development and empowerment of women through education and microcredit programmes were implemented in both the areas. The quantitative findings were supplemented by a qualitative study by interviewing local community care providers for their change in practices for maternal healthcare over time. After the introduction of the safe motherhood programme, reduction in maternal mortality was higher in the ICDDR,B service area (68.6%) than in the government service area (50.4%) during 1986-1989 and 2001-2005. Reduction in the number of maternal deaths due to the fertility decline was higher in the government service area (30%) than in the ICDDR,B service area (23%) during 1979-2005. In each area, there has been substantial reduction in abortion-related mortality--86.7% and 78.3%--in the ICDDR,B and government service areas respectively. Education of women was a strong predictor

The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health

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Gülmezoglu A Metin

2011-07-01

Full Text Available Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America and 2007-2008 (in Asia as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years, those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects

Altered dopamine signaling in naturally occurring maternal neglect.

Directory of Open Access Journals (Sweden)

Stephen C Gammie

2008-04-01

Full Text Available Child neglect is the most common form of child maltreatment, yet the biological basis of maternal neglect is poorly understood and a rodent model is lacking.The current study characterizes a population of mice (MaD1 which naturally exhibit maternal neglect (little or no care of offspring at an average rate of 17% per generation. We identified a set of risk factors that can predict future neglect of offspring, including decreased self-grooming and elevated activity. At the time of neglect, neglectful mothers swam significantly more in a forced swim test relative to nurturing mothers. Cross-fostered offspring raised by neglectful mothers in turn exhibit increased expression of risk factors for maternal neglect and decreased maternal care as adults, suggestive of possible epigenetic contributions to neglect. Unexpectedly, offspring from neglectful mothers elicited maternal neglect from cross-fostered nurturing mothers, suggesting that factors regulating neglect are not solely within the mother. To identify a neurological pathway underlying maternal neglect, we examined brain activity in neglectful and nurturing mice. c-Fos expression was significantly elevated in neglectful relative to nurturing mothers in the CNS, particularly within dopamine associated areas, such as the zona incerta (ZI, ventral tegmental area (VTA, and nucleus accumbens. Phosphorylated tyrosine hydroxylase (a marker for dopamine production was significantly elevated in ZI and higher in VTA (although not significantly in neglectful mice. Tyrosine hydroxylase levels were unaltered, suggesting a dysregulation of dopamine activity rather than cell number. Phosphorylation of DARPP-32, a marker for dopamine D1-like receptor activation, was elevated within nucleus accumbens and caudate-putamen in neglectful versus nurturing dams.These findings suggest that atypical dopamine activity within the maternal brain, especially within regions involved in reward, is involved in naturally

Maternal abuse history and self-regulation difficulties in preadolescence.

Science.gov (United States)

Delker, Brianna C; Noll, Laura K; Kim, Hyoun K; Fisher, Philip A

2014-12-01

Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24-36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N=488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9-11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

A new approach to maternal mortality: the role of HIV in pregnancy

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Gorman SE

2013-05-01

Full Text Available Sara E GormanDepartment of Epidemiology, Harvard University, Boston, MA, USAAbstract: As 2015 quickly approaches, we have been made increasingly aware of our progress toward Millennium Development Goals (MDGs. However, one MDG has been particularly recalcitrant to progress: MDG 5, namely, improving maternal health. Few countries are on track to achieve the first part of MDG 5's goals, reducing maternal mortality by 75%. This article addresses the key priority issues of maternal health as part of sexual and reproductive health issues and maternal health and communicable diseases. It argues that only an integrative approach to the twin challenges of HIV and maternal mortality can help reduce devastatingly high rates of maternal deaths worldwide, especially in sub-Saharan Africa. The article reenvisions the MDGs not as separate, independent tasks, but as related, cohesive issues for which a holistic approach is needed. New causes of the relationship between HIV and maternal mortality are considered, and possible solutions are broached.Keywords: HIV, maternal mortality, Millennium Development Goals, integrated approach to maternal health

Factors Contributing to Maternal Mortality in Uganda | Atuhaire ...

African Journals Online (AJOL)

. It was guided by the following objectives; to investigating whether the number of antenatal Care visits, maternal education, age, area and region of residence had any effect on maternal mortality in Uganda. Descriptive statistics are used to ...

Measles vaccination in the presence or absence of maternal measles antibody

DEFF Research Database (Denmark)

Aaby, Peter; Martins, Cesário L; Garly, May-Lill

2014-01-01

vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal...... mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. CONCLUSIONS: Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4......BACKGROUND: Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. METHODS: To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data...

78 FR 37553 - Maternal Health Town Hall Listening Session; Notice of Meeting

Science.gov (United States)

2013-06-21

... public on HRSA's strategic thinking around a national strategy to reduce maternal morbidity and mortality... strengthen HRSA's strategic thinking related to maternal health using input from maternal health experts...) strategic direction for the National Maternal Health Initiative including mission, goals and objectives; and...

Maternal cortisol and offspring birthweight: results from a large prospective cohort study

NARCIS (Netherlands)

Goedhart, G.; Vrijkotte, T.G.M.; Roseboom, T.J.; van der Wal, M.F.; Cuijpers, P.; Bonsel, G.J.

2010-01-01

Maternal psychosocial problems may affect fetal growth through maternal cortisol. This large prospective cohort study examined among 2810 women (1) the association of maternal cortisol levels with offspring birthweight and small for gestational age (SGA) risk and (2) the mediating role of maternal

Atrial natriuretic factor in maternal and fetal sheep

International Nuclear Information System (INIS)

Cheung, C.Y.; Gibbs, D.M.; Brace, R.A.

1987-01-01

To determine atrial natriuretic factor (ANF) concentrations in the circulation and body fluids of adult pregnant sheep and their fetuses, pregnant ewes were anesthetized with pentobarbital sodium, and the fetuses were exteriorized for sampling. ANF concentration, as measured by radioimmunoassay, was 47 +/- 6 (SE) pg/ml in maternal plasma, which was significantly higher than the 15 +/- 3 pg/ml in maternal urine. In the fetus, plasma ANF concentration was 265 +/- 49 pg/ml, 5.6 times that in maternal plasma. No umbilical arterial and venous difference in ANF concentration was observed. Fetal urine ANF concentration was significantly lower than that in fetal plasma, and was similar to that measured in amniotic and allantoic fluid. In chronically catheterized maternal and fetal sheep, fetal plasma ANF was again 5.1 times that in maternal plasma, and these levels were not different from those measured in acutely anesthetized animals. These results demonstrate that immunoreactive ANF is present in the fetal circulation at levels higher than those found in the mother. The low concentration of ANF in fetal urine suggests that ANF is probably metabolized and/or reabsorbed by the fetal kidney

Women at risk: Gender inequality and maternal health.

Science.gov (United States)

Banda, Pamela C; Odimegwu, Clifford O; Ntoimo, Lorretta F C; Muchiri, Evans

2017-04-01

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.

Maternal health in Gujarat, India: a case study.

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Mavalankar, Dileep V; Vora, Kranti S; Ramani, K V; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

2009-04-01

Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness.

Choice in maternity: rhetoric, reality and resistance.

Science.gov (United States)

Mander, Rosemary; Melender, Hanna-Leena

2009-12-01

to inform the organisation of the maternity services in Scotland, a phenomenological study was planned to examine maternity decision making in two similarly small countries. The aim was to examine the experience of contributing to decisions at clinical, organisational and policy-making levels. When examples were needed the informants were asked to use their experience of place of birth decisions. a hermeneutic phenomenological approach was employed. In-depth, semi-structured conversations were used. The fieldwork extended over a 4-month period in 2005. The data were analysed using Colaizzi's method. Finland and New Zealand were chosen because the parallels in their health care and maternity care systems would limit disparities. In one of the Finnish centres, the findings were particularly homogeneous and exemplified many of the issues arising in other settings. The findings of the fieldwork in this Finnish centre are the focus of this paper. the informants were mothers, midwife managers/policy makers, midwives and other maternity care providers. The findings of 12 conversations, including mothers and all groups of staff, are reported here. the background theme which emerged was 'trusting the system'. The informants were aware of the extent to which change is happening. One of the sub-themes contrasted the informants' perceptions of their lack of strength and courage with Finnish stereotypes. Being safe proved to be another crucial issue. The final sub-theme was 'playing the system'. trust in a well-respected health-care system was necessary for the informants to be able to subvert or resist that system. While such resistance has been documented in other disciplines, such as nursing, reference has not been found in relation to maternity. The resistance to the system was, at the time of the fieldwork, neither co-ordinated nor collaborative. the findings of this study carry important implications for women's and midwives' input into maternity care.

Advanced Maternal Age Worsens Postpartum Vascular Function

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Jude S. Morton

2017-06-01

Full Text Available The age at which women experience their first pregnancy has increased throughout the decades. Pregnancy has an important influence on maternal short- and long-term cardiovascular outcomes. Pregnancy at an advanced maternal age increases maternal risk of gestational diabetes, preeclampsia, placenta previa and caesarian delivery; complications which predict worsened cardiovascular health in later years. Aging also independently increases the risk of cardiovascular disease; therefore, combined risk in women of advanced maternal age may lead to detrimental cardiovascular outcomes later in life. We hypothesized that pregnancy at an advanced maternal age would lead to postpartum vascular dysfunction. We used a reproductively aged rat model to investigate vascular function in never pregnant (virgin, previously pregnant (postpartum and previously mated but never delivered (nulliparous rats at approximately 13.5 months of age (3 months postpartum or equivalent. Nulliparous rats, in which pregnancy was spontaneously lost, demonstrated significantly reduced aortic relaxation responses (methylcholine [MCh] Emax: 54.2 ± 12.6% vs. virgin and postpartum rats (MCh Emax: 84.8 ± 3.5% and 84.7 ± 3.2% respectively; suggesting pregnancy loss causes a worsened vascular pathology. Oxidized LDL reduced relaxation to MCh in aorta from virgin and postpartum, but not nulliparous rats, with an increased contribution of the LOX-1 receptor in the postpartum group. Further, in mesenteric arteries from postpartum rats, endothelium-derived hyperpolarization (EDH-mediated vasodilation was reduced and a constrictive prostaglandin effect was apparent. In conclusion, aged postpartum rats exhibited vascular dysfunction, while rats which had pregnancy loss demonstrated a distinct vascular pathology. These data demonstrate mechanisms which may lead to worsened outcomes at an advanced maternal age; including early pregnancy loss and later life cardiovascular dysfunction.

Maternal BMI during Pregnancy: Effect on trace elements Status and ...

African Journals Online (AJOL)

Maternal BMI was significantly positively related to age, parity and socioeconomic status. While a negative relationship was found between plasma copper and maternal BMI, significantly (p < 0.05) lower zinc levels were found in underweight and obese women when compared to women with normal BMI. Maternal anaemia ...

hiv-aids related maternal mortality in benin city, ni- geria

African Journals Online (AJOL)

David Ofori-Adjei

2011-06-01

Jun 1, 2011 ... SUMMARY. Objective: To determine the causes and characteristics of maternal deaths in HIV-infected women. Design: A retrospective study of maternal deaths in a cohort of HIV-infected women. Setting: A facility-based maternal death review using case records and mortality summaries. Methods: Thirty ...

Student midwives' perceptions on the organisation of maternity care and alternative maternity care models in the Netherlands - a qualitative study.

NARCIS (Netherlands)

Warmelink, J.C.; Cock, T.P. de; Combee, Y.; Rongen, M.; Wiegers, T.A.; Hutton, E.K.

2017-01-01

BACKGROUND: A major change in the organisation of maternity care in the Netherlands is under consideration, going from an echelon system where midwives provide primary care in the community and refer to obstetricians for secondary and tertiary care, to a more integrated maternity care system

The Association of Maternal Depressive Symptoms with Child Externalizing Problems: The Role of Maternal Support Following Child Sexual Abuse

Science.gov (United States)

Rakow, Aaron; Smith, Daniel; Begle, Angela M.; Ayer, Lynsay

2011-01-01

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother-child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found…

The Effect of Maternal Employment on Children’s Academic Performance

DEFF Research Database (Denmark)

Dunifon, Rachel; Toft Hansen, Anne; Nicholson, Sean

of household control variables, instrumenting for employment with the gender- and education-specific local unemployment rate, and by including maternal fixed effects. We find that maternal employment has a positive effect on children’s academic performance in all specifications, particularly when women work...... part-time. This is in contrast with the larger literature on maternal employment, much of which takes place in other contexts, and which finds no or a small negative effect of maternal employment on children’s cognitive development and academic performance....

Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.

LENUS (Irish Health Repository)

Cantwell, Roch

2011-03-01

In the triennium 2006-2008, 261 women in the UK died directly or indirectly related to pregnancy. The overall maternal mortality rate was 11.39 per 100,000 maternities. Direct deaths decreased from 6.24 per 100,000 maternities in 2003-2005 to 4.67 per 100,000 maternities in 2006–2008 (p = 0.02). This decline is predominantly due to the reduction in deaths from thromboembolism and, to a lesser extent, haemorrhage. For the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group. Despite a decline in the overall UK maternal mortality rate, there has been an increase in deaths related to genital tract sepsis, particularly from community acquired Group A streptococcal disease. The mortality rate related to sepsis increased from 0.85 deaths per 100,000 maternities in 2003-2005 to 1.13 deaths in 2006-2008, and sepsis is now the most common cause of Direct maternal death. Cardiac disease is the most common cause of Indirect death; the Indirect maternal mortality rate has not changed significantly since 2003-2005. This Confidential Enquiry identified substandard care in 70% of Direct deaths and 55% of Indirect deaths. Many of the identified avoidable factors remain the same as those identified in previous Enquiries. Recommendations for improving care have been developed and are highlighted in this report. Implementing the Top ten recommendations should be prioritised in order to ensure the overall UK maternal mortality rate continues to decline.

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Hemorrhage.

Science.gov (United States)

Main, Elliott K; Goffman, Dena; Scavone, Barbara M; Low, Lisa Kane; Bingham, Debra; Fontaine, Patricia L; Gorlin, Jed B; Lagrew, David C; Levy, Barbara S

2015-07-01

Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and System Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. References contain sample resources and "Potential Best Practices" to assist with implementation.

Genetic, Maternal, and Environmental Risk Factors for Cryptorchidism

DEFF Research Database (Denmark)

Barthold, Julia Spencer; Reinhardt, Susanne; Thorup, Jorgen

2016-01-01

genetic risk, multiple susceptibility loci, and a role for the maternal environment. Epidemiologic studies have identified low birth weight or intrauterine growth retardation as factors most strongly associated with cryptorchidism, with additional evidence suggesting that maternal smoking and gestational...

Maternal Silences: Motherhood and Voluntary Childlessness in Contemporary Christianity

Directory of Open Access Journals (Sweden)

Dawn Llewellyn

2016-06-01

Full Text Available In Christianity, there is an ideology of motherhood that pervades scripture, ritual, and doctrine, yet there is an academic silence that means relatively little space has been given to motherhood and mothering, and even less to voluntary childlessness, from a faith perspective. By drawing on qualitative in-depth interviews with Christian women living in Britain, narrating their experiences of motherhood and voluntary childlessness, I suggest there are also lived maternal silences encountered by women in contemporary Christianity. There is a maternal expectation produced through church teaching, liturgy and culture that constructs women as ‘maternal bodies’ (Gatrell 2008; this silences and marginalises women from articulating their complex relationship with religion, motherhood, and childlessness in ways that challenge their spiritual development. However, this article also introduces the everyday and intentional tactics women employ to disrupt the maternal expectation, and hereby interrupt the maternal silence.

Quality maternity care for every woman, everywhere: a call to action.

Science.gov (United States)

Koblinsky, Marjorie; Moyer, Cheryl A; Calvert, Clara; Campbell, James; Campbell, Oona M R; Feigl, Andrea B; Graham, Wendy J; Hatt, Laurel; Hodgins, Steve; Matthews, Zoe; McDougall, Lori; Moran, Allisyn C; Nandakumar, Allyala K; Langer, Ana

2016-11-05

To improve maternal health requires action to ensure quality maternal health care for all women and girls, and to guarantee access to care for those outside the system. In this paper, we highlight some of the most pressing issues in maternal health and ask: what steps can be taken in the next 5 years to catalyse action toward achieving the Sustainable Development Goal target of less than 70 maternal deaths per 100 000 livebirths by 2030, with no single country exceeding 140? What steps can be taken to ensure that high-quality maternal health care is prioritised for every woman and girl everywhere? We call on all stakeholders to work together in securing a healthy, prosperous future for all women. National and local governments must be supported by development partners, civil society, and the private sector in leading efforts to improve maternal-perinatal health. This effort means dedicating needed policies and resources, and sustaining implementation to address the many factors influencing maternal health-care provision and use. Five priority actions emerge for all partners: prioritise quality maternal health services that respond to the local specificities of need, and meet emerging challenges; promote equity through universal coverage of quality maternal health services, including for the most vulnerable women; increase the resilience and strength of health systems by optimising the health workforce, and improve facility capability; guarantee sustainable finances for maternal-perinatal health; and accelerate progress through evidence, advocacy, and accountability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Maternal Melatonin Therapy Attenuated Maternal High-Fructose Combined with Post-Weaning High-Salt Diets-Induced Hypertension in Adult Male Rat Offspring

Directory of Open Access Journals (Sweden)

You-Lin Tain

2018-04-01

Full Text Available Consumption of food high in fructose and salt is associated with the epidemic of hypertension. Hypertension can originate from early life. Melatonin, a pleiotropic hormone, regulates blood pressure. We examined whether maternal melatonin therapy can prevent maternal high-fructose combined with post-weaning high-salt diet-induced programmed hypertension in adult offspring. Pregnant Sprague-Dawley rats received either a normal diet (ND or a 60% fructose diet (HF during pregnancy and the lactation period. Male offspring were on either the ND or a high-salt diet (HS, 1% NaCl from weaning to 12 weeks of age and were assigned to five groups (n = 8/group: ND/ND, HF/ND, ND/HS, HF/HS, and HF/HS+melatonin. Melatonin (0.01% in drinking water was administered during pregnancy and lactation. We observed that maternal HF combined with post-weaning HS diets induced hypertension in male adult offspring, which was attenuated by maternal melatonin therapy. The beneficial effects of maternal melatonin therapy on HF/HS-induced hypertension related to regulating several nutrient-sensing signals, including Sirt1, Sirt4, Prkaa2, Prkab2, Pparg, and Ppargc1a. Additionally, melatonin increased protein levels of mammalian targets of rapamycin (mTOR, decreased plasma asymmetric dimethylarginine (ADMA and symmetric dimethylarginine levels, and increased the l-arginine-to-ADMA ratio. The reprogramming effects by which maternal melatonin therapy protects against hypertension of developmental origin awaits further elucidation.

Single versus Dual Paycheck: Married Parents' Attitudes about Maternal Employment.

Science.gov (United States)

Ryckebusch, Jenna-Lyn; Miller, Heather; Fulmer, Kimberly; Fontanez, Mary; Ellis, Trisha; DiBlasi, Francis Paul; Carey, Brandi; Chambliss, Catherine

This study examines attitudes about maternal employment by comparing the responses of married parents from single versus two-paycheck families. Participants in this study were 138 mothers and 120 fathers given the Beliefs About the Consequences of Maternal Employment for Children Scale (BACMEC), which assesses views about maternal employment.…

Maternal Mortality In Pakistan: Is There Any Metamorphosis Towards Betterment?

Science.gov (United States)

Nisar, Nusrat; Abbasi, Razia Mustafa; Chana, Shehla Raza; Rizwan, Noushaba; Badar, Razia

2017-01-01

Every year more than half million mother die due to pregnancy related preventable causes like haemorrhage, hypertensive disorders, sepsis, and obstructed labour and unsafe abortion. Among these deaths 99% occur in developing countries. The study was conducted to assess the maternal death rate and to analyse its trends over a period of 20 years in tertiary care hospital in Sindh Province Pakistan. A retrospective analysis of maternal mortality records were carried out for a period of 20 years from 1986-1995 and 2011-2015 at the Department of Obstetrics and gynaecology Liaquat University of Medical and Health Sciences Hyderabad Sindh Pakistan. The record retrieved was categorized into four 5 yearly periods 1986- 1990, 1991-995, 2006-2010 and 2011-2015 for comparison of trends. The cumulative maternal mortality ratio (MMR) was 1521.5 per 100,000 live births. The comparison of first 5 years' period (1986-1990) and last 5 years (2011-2015) showed downward trend in maternal mortality rate from 2368.6-1265.1. Direct causes of death have accounted for 2820 (84.78%) of total maternal death. Sepsis was the major cause of death for first 5 years accounted for 196(35.1%) of maternal death while in the last 5 years' eclampsia causes 284 (27.84%) of direct maternal deaths. The reduction in the maternal deaths has been very slow. The direct causes were still the main reasons for obstetrical deaths.

Maternal Disrupted Communication During Face-to-Face Interaction at 4 months: Relation to Maternal and Infant Cortisol Among at-Risk Families.

Science.gov (United States)

Crockett, Erin E; Holmes, Bjarne M; Granger, Douglas A; Lyons-Ruth, Karlen

2013-11-01

The study evaluated the association between maternal disrupted communication and the reactivity and regulation of the psychobiology of the stress response in infancy. Mothers and infants were recruited via the National Health Service from the 20% most economically impoverished data zones in a suburban region of Scotland. Mothers ( N = 63; M age = 25.9) and their 4-month-old infants (35 boys, 28 girls) were videotaped interacting for 8 min, including a still-face procedure as a stress inducer and a 5-min coded recovery period. Saliva samples were collected from the dyads prior to, during, and after the still-face procedure and later assayed for cortisol. Level of disruption in maternal communication with the infant was coded from the 5-min videotaped interaction during the recovery period which followed the still-face procedure. Severely disrupted maternal communication was associated with lower levels of maternal cortisol and a greater divergence between mothers' and infants' cortisol levels. Results point to low maternal cortisol as a possible mechanism contributing to the mother's difficulty in sensitively attuning to her infant's cues, which in turn has implications for the infant's reactivity to and recovery from a mild stressor in early infancy.

Infant and Maternal Sensitivity to Interpersonal Timing

Science.gov (United States)

Henning, Anne; Striano, Tricia

2011-01-01

A perturbation paradigm was employed to assess 3- and 6-month-old infants' and their mothers' sensitivity to a 3-s temporal delay implemented in an ongoing televised interaction. At both ages, the temporal delay affected infant but not maternal behavior and only when implementing the temporal delay in maternal (Experiment 1, N = 64) but not infant…

Site of delivery contribution to black-white severe maternal morbidity disparity.

Science.gov (United States)

Howell, Elizabeth A; Egorova, Natalia N; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

2016-08-01

The black-white maternal mortality disparity is the largest disparity among all conventional population perinatal health measures, and the mortality gap between black and white women in New York City has nearly doubled in recent years. For every maternal death, 100 women experience severe maternal morbidity, a life-threatening diagnosis, or undergo a life-saving procedure during their delivery hospitalization. Like maternal mortality, severe maternal morbidity is more common among black than white women. A significant portion of maternal morbidity and mortality is preventable, making quality of care in hospitals a critical lever for improving outcomes. Hospital variation in risk-adjusted severe maternal morbidity rates exists. The extent to which variation in hospital performance on severe maternal morbidity rates contributes to black-white disparities in New York City hospitals has not been studied. We examined the extent to which black-white differences in severe maternal morbidity rates in New York City hospitals can be explained by differences in the hospitals in which black and white women deliver. We conducted a population-based study using linked 2011-2013 New York City discharge and birth certificate datasets (n = 353,773 deliveries) to examine black-white differences in severe maternal morbidity rates in New York City hospitals. A mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital (n = 40). We then assessed differences in the distributions of black and white deliveries among these hospitals. Severe maternal morbidity occurred in 8882 deliveries (2.5%) and was higher among black than white women (4.2% vs 1.5%, P rates among New York City hospitals ranged from 0.8 to 5.7 per 100 deliveries. White deliveries were more likely to be delivered in low-morbidity hospitals: 65% of white vs 23% of black deliveries occurred in hospitals in the lowest

Safe motherhood : severe acute maternal morbidity: risk factors in the Netherlands and validation of the WHO Maternal Near Miss tool

NARCIS (Netherlands)

Witteveen, T.

2016-01-01

Using the results from a two-year nationwide prospective study, this thesis shows numerous (risk) factors associated with severe acute maternal morbidity (SAMM) in the Netherlands and validates the WHO Maternal Near Miss (MNM) tool to detect and monitor SAMM worldwide. The ratio behind the different

Maternal health and survival in Pakistan: issues and options.

Science.gov (United States)

Khan, Yasir P; Bhutta, Shereen Z; Munim, Shama; Bhutta, Zulfiqar A

2009-10-01

Although its measurement may be difficult, the maternal mortality ratio (MMR) is a key indicator of maternal health globally. In Pakistan each year over five million women become pregnant, and of these 700,000 (15% of all pregnant women) are likely to experience some obstetrical and medical complications. An estimated 30,000 women die each year from pregnancy-related causes, and the most recent estimates indicate that the MMR is 276 per 100,000 births annually. In this review, we describe the status of maternal health and survival in Pakistan and place it in its wider context of key determinants. We draw attention to the economic and social vulnerability of pregnant women, and stress the importance of concomitant broader strategies, including poverty reduction and women's empowerment. Undernutrition for girls, early marriage, and high fertility rates coupled with unmet needs for contraception are important determinants of maternal ill health in Pakistan. Our review also examines factors influencing the under-utilization of maternal health services among Pakistani women, such as the lack of availability of skilled care providers and poor quality services. Notwithstanding these observations, there are evidence-based interventions available that, if implemented at scale, could make important contributions towards reducing the burden of maternal mortality in Pakistan.

Perinatal Maternal Mental Health, Fetal Programming and Child Development

Directory of Open Access Journals (Sweden)

Andrew J. Lewis

2015-11-01

Full Text Available Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified.

Third delay of maternal mortality in a tertiary hospital

International Nuclear Information System (INIS)

Shah, N.; Khan, N.H.

2007-01-01

To assess the magnitude, causes and substandard care factors responsible for the third delay of maternal mortality seen in our unit III, Department of Obstetrics and Gynecology, Civil Hospital, Karachi. This Cross-sectional, retrospective study was carried out on 152 mothers who died over a period of eight years from 1997 to 2004 at Civil Hospital Karachi. Death summaries of all maternal deaths were reviewed from death registers and were studied for substandard care factors which could have been responsible for the third delay of maternal mortality. The frequency of maternal mortality was 1.3 per 100 deliveries. The mean age was 29+-6.49 years and mean parity was 3.24+-3.25. The main causes of death were hypertensive disorders in 52/152 (34.21%), hemorrhage in 40/152 (26.31%), unsafe abortion in 16/152 (10.52%), puerperal sepsis in 14/152 (9.21%) and obstructed labor in 11/152 (7.2%) cases. Substandard care factors were present in 76.7% of patients, which included inappropriate management of pulmonary edema, delay in arranging blood for hemorrhaging patients and delay in surgical intervention. Substandard care factors were present in majority of cases of maternal deaths. Improvement of maternity care services in Civil Hospital Karachi is needed on an urgent basis. (author)

Saving maternal lives in resource-poor settings: facing reality.

Science.gov (United States)

Prata, Ndola; Sreenivas, Amita; Vahidnia, Farnaz; Potts, Malcolm

2009-02-01

Evaluate safe-motherhood interventions suitable for resource-poor settings that can be implemented with current resources. Literature review to identify interventions that require minimal treatment/infrastructure and are not dependent on skilled providers. Simulations were run to assess the potential number of maternal lives that could be saved through intervention implementation according to potential program impact. Regional and country level estimates are provided as examples of settings that would most benefit from proposed interventions. Three interventions were identified: (i) improve access to contraception; (ii) increase efforts to reduce deaths from unsafe abortion; and (iii) increase access to misoprostol to control postpartum hemorrhage (including for home births). The combined effect of postpartum hemorrhage and unsafe abortion prevention would result in the greatest gains in maternal deaths averted. Bold new initiatives are needed to achieve the Millennium Development Goal of reducing maternal mortality by three-quarters. Ninety-nine percent of maternal deaths occur in developing countries and the majority of these women deliver alone, or with a traditional birth attendant. It is time for maternal health program planners to reprioritize interventions in the face of human and financial resource constraints. The three proposed interventions address the largest part of the maternal health burden.

Perinatal Maternal Mental Health, Fetal Programming and Child Development.

Science.gov (United States)

Lewis, Andrew J; Austin, Emma; Knapp, Rebecca; Vaiano, Tina; Galbally, Megan

2015-11-26

Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified.

Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction

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Solange da Cruz Chaves

2015-05-01

Full Text Available OBJECTIVE: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. METHODS: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. RESULTS: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. CONCLUSIONS: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

Maternal mortality audit in a tertiary health institution in Nigeria ...

African Journals Online (AJOL)

Introduction: Nigeria has the second highest number of maternal deaths in the world.The study aimed at determining the causes of and non-obstetric contributors to maternal mortality at a tertiary referral hospital. Materials and Methods: It was a prospective audit of all consecutive maternal deaths in the hospital over a ...

Maternity Leave Provisions for Classroom Teachers in Larger School Systems.

Science.gov (United States)

Educational Research Service Circular, 1966

1966-01-01

Maternity leave provisions for classroom teachers in 129 school systems having enrollments of 25,000 or more are reported for 1965-66 in this national survey. Tables contain information on compulsory absence prior to anticipated date of birth and earliest permissible return from maternity leaves. Brief descriptions of maternity leave practices are…

Maternal Height and Child Growth Patterns

OpenAIRE

Addo, O. Yaw; Stein, Aryeh D.; Fall, Caroline H.; Gigante, Denise P.; Guntupalli, Aravinda M.; Horta, Bernardo L.; Kuzawa, Christopher W.; Lee, Nanette; Norris, Shane A.; Prabhakaran, Poornima; Richter, Linda M.; Sachdev, Harshpal S.; Martorell, Reynaldo

2013-01-01

OBJECTIVE:\\ud To examine associations between maternal height and child growth during 4 developmental periods: intrauterine, birth to age 2 years, age 2 years to mid-childhood (MC), and MC to adulthood.\\ud \\ud STUDY DESIGN:\\ud Pooled analysis of maternal height and offspring growth using 7630 mother-child pairs from 5 birth cohorts (Brazil, Guatemala, India, the Philippines, and South Africa). We used conditional height measures that control for collinearity in height across periods. We estim...

Respectful maternity care in Ethiopian public health facilities

NARCIS (Netherlands)

Sheferaw, Ephrem D.; Bazant, Eva; Gibson, Hannah; Fenta, Hone B.; Ayalew, Firew; Belay, Tsigereda B.; Worku, Maria M.; Kebebu, Aelaf E.; Woldie, Sintayehu A.; Kim, Young-Mi; van den Akker, T.; Stekelenburg, Jelle

2017-01-01

Background: Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of

Maternal health research concerns men too | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2018-06-11

Jun 11, 2018 ... At first glance, maternal health only seems to focus on women and children. ... to maternal healthcare and to improve access to and use of services ... a program of visits to the homes of all pregnant women in the project area.

Maternal thyroid dysfunction and risk of seizure in the child

DEFF Research Database (Denmark)

Andersen, Stine Linding; Laurberg, Peter; Wu, Chunsen

2013-01-01

Thyroid hormones are essential for brain development, and maternal thyroid disease may affect child neurocognitive development. Some types of seizures may also depend upon early exposure of the developing central nervous system, and we hypothesized that maternal thyroid dysfunction could increase...... the risk of seizure in the child. In a Danish population-based study we included 1,699,693 liveborn singletons, and from the Danish National Hospital Register we obtained information on maternal diagnosis of hyper- or hypothyroidism and neonatal seizure, febrile seizure, and epilepsy in the child. Maternal...... diagnosis of thyroid dysfunction before or after birth of the child was registered in two percent of the singleton births. In adjusted analyses, maternal hyperthyroidism and hypothyroidism first time diagnosed after birth of the child were associated with a significant increased risk of epilepsy...

National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage.

Science.gov (United States)

Main, Elliott K; Goffman, Dena; Scavone, Barbara M; Low, Lisa Kane; Bingham, Debra; Fontaine, Patricia L; Gorlin, Jed B; Lagrew, David C; Levy, Barbara S

2015-01-01

Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into 4 domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. References contain sample resources and "Potential Best Practices" to assist with implementation. © 2015 by the American College of Obstetricians and Gynecologists.

Maternal-fetal hepatic and placental metabolome profiles are associated with reduced fetal growth in a rat model of maternal obesity

DEFF Research Database (Denmark)

Mumme, Karen; Gray, Clint; Reynolds, Clare M.

2016-01-01

: Metabolomic profiling was used to reveal altered maternal and fetal metabolic pathways in a model of diet induced obesity during pregnancy, leading to reduced fetal growth. Methods: We examined the metabolome of maternal and fetal livers, and placenta following a high fat and salt intake. Sprague–Dawley rats...

Long-lasting effects of maternal condition in free-ranging cervids.

Directory of Open Access Journals (Sweden)

Eric D Freeman

Full Text Available Causes of phenotypic variation are fundamental to evolutionary ecology because they influence the traits acted upon by natural selection. One such cause of phenotypic variation is a maternal effect, which is the influence of the environment experienced by a female (and her corresponding phenotype on the phenotype of her offspring (independent of the offspring's genotype. While maternal effects are well documented, the longevity and fitness impact of these effects remains unclear because it is difficult to follow free-living individuals through their reproductive lifetimes. For long-lived species, it has been suggested that maternal effects are masked by environmental variables acting on offspring in years following the period of dependence. Our objective was to use indirect measures of maternal condition to determine if maternal effects have long-lasting influences on male offspring in two species of cervid. Because antlers are sexually selected, we used measures of antler size at time of death, 1.5-21.5 years after gestation to investigate maternal effects. We quantified antler size of 11,000 male elk and mule deer born throughout the intermountain western US (6 states over nearly 30 years. Maternal condition during development was estimated indirectly using a suite of abiotic variables known to influence condition of cervids (i.e., winter severity, spring and summer temperature, and spring and summer precipitation. Antler size of male cervids was significantly associated with our indirect measure of maternal condition during gestation and lactation. Assuming the correctness of our indirect measure, our findings demonstrate that antler size is a sexually selected trait that is influenced-into adulthood-by maternal condition. This link emphasizes the importance of considering inherited environmental effects when interpreting population dynamics or examining reproductive success of long-lived organisms.

Disadvantaged populations in maternal health in China who and why?

Directory of Open Access Journals (Sweden)

Beibei Yuan

2013-04-01

Full Text Available Background: China has made impressive progress towards the Millennium Development Goal (MDG for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. Methods: We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. Results: In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Conclusions: Inequity in maternal

Disadvantaged populations in maternal health in China who and why?

Science.gov (United States)

Yuan, Beibei; Qian, Xu; Thomsen, Sarah

2013-04-03

China has made impressive progress towards the Millennium Development Goal (MDG) for maternal and reproductive health, but ensuring that progress reaches all segments of the population remains a challenge for policy makers. The aim of this review is to map disadvantaged populations in terms of maternal health in China, and to explain the causes of these inequities to promote policy action. We searched PUBMED, Popline, Proquest and WanFang and included primary studies conducted in mainland China. Experts were also contacted to identify additional studies. Disadvantaged populations in terms of MDG 5 and the reasons for this disadvantage explored by authors were identified and coded based on the conceptual framework developed by the WHO Commission on the Social Determinants of Health. In China, differences in maternal health service utilization and the maternal mortality ratio among different income groups, and among regions with different socio-economic development still exist, although these differences are narrowing. Groups with low levels of education and ethnic minorities utilize maternal health care less frequently and experience higher maternal mortality, although we could not determine whether these differences have changed in the last decade. Rural-to-urban migrants use maternal health care and contraception to a lower extent than permanent residents of cities, and differential maternal mortality shows a widening trend among these groups. Gender inequity also contributes to the disadvantaged position of women. Intermediary factors that explain these inequities include material circumstances such as long distances to health facilities for women living in remote areas, behavioral factors such as traditional beliefs that result in reduced care seeking among ethnic minorities, and health system determinants such as out-of-pocket payments posing financial barriers for the poor. Inequity in maternal health continues to be an issue worthy of greater programmatic and

Socio-Economic and Cultural Factors in Maternal Mortality in Nigeria ...

African Journals Online (AJOL)

The issue of maternal mortality has been very topical due to recent focus on sustainable development and because of the fact that maternal mortality is very high in many developing countries. In Nigeria, maternal mortality is very high and one of the highest in the world. There are cultural and social factors that exacerbate ...

Integrating Ecological and Evolutionary Context in the Study of Maternal Stress.

Science.gov (United States)

Sheriff, Michael J; Bell, Alison; Boonstra, Rudy; Dantzer, Ben; Lavergne, Sophia G; McGhee, Katie E; MacLeod, Kirsty J; Winandy, Laurane; Zimmer, Cedric; Love, Oliver P

2017-09-01

Maternal stress can prenatally influence offspring phenotypes and there are an increasing number of ecological studies that are bringing to bear biomedical findings to natural systems. This is resulting in a shift from the perspective that maternal stress is unanimously costly, to one in which maternal stress may be beneficial to offspring. However, this adaptive perspective is in its infancy with much progress to still be made in understanding the role of maternal stress in natural systems. Our aim is to emphasize the importance of the ecological and evolutionary context within which adaptive hypotheses of maternal stress can be evaluated. We present five primary research areas where we think future research can make substantial progress: (1) understanding maternal and offspring control mechanisms that modulate exposure between maternal stress and subsequent offspring phenotype response; (2) understanding the dynamic nature of the interaction between mothers and their environment; (3) integrating offspring phenotypic responses and measuring both maternal and offspring fitness outcomes under real-life (either free-living or semi-natural) conditions; (4) empirically testing these fitness outcomes across relevant spatial and temporal environmental contexts (both pre- and post-natal environments); (5) examining the role of maternal stress effects in human-altered environments-i.e., do they limit or enhance fitness. To make progress, it is critical to understand the role of maternal stress in an ecological context and to do that, we must integrate across physiology, behavior, genetics, and evolution. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Maternal weight and body composition in the first trimester of pregnancy.

LENUS (Irish Health Repository)

Fattah, Chro

2012-02-01

OBJECTIVE: Previous studies on weight gain in pregnancy suggested that maternal weight on average increased by 0.5-2.0 kg in the first trimester of pregnancy. This study examined whether mean maternal weight or body composition changes in the first trimester of pregnancy. DESIGN: Prospective observational study. POPULATION: We studied 1,000 Caucasian women booking for antenatal care in the first trimester of pregnancy. SETTING: Large university teaching hospital. METHODS: Maternal height and weight were measured digitally in a standardized way and Body Mass Index (BMI) was calculated. Maternal body composition was measured using segmental multifrequency Bioelectrical Impedance Analysis (BIA). Sonographic examination confirmed the gestational age and a normal ongoing singleton pregnancy in all subjects. MAIN OUTCOME MEASURES: Maternal weight, maternal body composition. RESULTS: The mean BMI was 25.7 kg\\/m(2) and 19.0% of the women were in the obese category (> or =30.0 kg\\/m(2)). Cross-sectional analysis by gestational age showed that there was no change in mean maternal weight, BMI, total body water, fat mass, fat-free mass or bone mass before 14 weeks gestation. CONCLUSIONS: Contrary to previous reports, mean maternal weight and mean body composition values remain unchanged in the first trimester of pregnancy. This has implications for guidelines on maternal weight gain during pregnancy. We also recommend that calculation of BMI in pregnancy and gestational weight gain should be based on accurate early pregnancy measurements, and not on self-reported or prepregnancy measurements.

Ontogeny of additive and maternal genetic effects: lessons from domestic mammals.

Science.gov (United States)

Wilson, Alastair J; Reale, Denis

2006-01-01

Evolution of size and growth depends on heritable variation arising from additive and maternal genetic effects. Levels of heritable (and nonheritable) variation might change over ontogeny, increasing through "variance compounding" or decreasing through "compensatory growth." We test for these processes using a meta-analysis of age-specific weight traits in domestic ungulates. Generally, mean standardized variance components decrease with age, consistent with compensatory growth. Phenotypic convergence among adult sheep occurs through decreasing environmental and maternal genetic variation. Maternal variation similarly declines in cattle. Maternal genetic effects are thus reduced with age (both in absolute and relative terms). Significant trends in heritability (decreasing in cattle, increasing in sheep) result from declining maternal and environmental components rather than from changing additive variation. There was no evidence for increasing standardized variance components. Any compounding must therefore be masked by more important compensatory processes. While extrapolation of these patterns to processes in natural population is difficult, our results highlight the inadequacy of assuming constancy in genetic parameters over ontogeny. Negative covariance between direct and maternal genetic effects was common. Negative correlations with additive and maternal genetic variances indicate that antagonistic pleiotropy (between additive and maternal genetic effects) may maintain genetic variance and limit responses to selection.

Association of maternal age with child health: A Japanese longitudinal study.

Directory of Open Access Journals (Sweden)

Tsuguhiko Kato

Full Text Available Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children's health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554. We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children's unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers 40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health.

Maternal leptin and body composition in the first trimester of pregnancy.

LENUS (Irish Health Repository)

Fattah, Chro

2012-02-01

BACKGROUND: Leptin is produced mainly by adipocytes. Levels are increased in women with obesity and during pregnancy. Increased levels are also associated with pregnancy complications such as, pre-eclampsia and gestational diabetes mellitus. OBJECTIVE: We studied what component of body composition correlated best with maternal leptin in the first trimester of pregnancy and, whether maternal leptin correlated better with visceral fat rather than fat distributed elsewhere. SUBJECTS AND METHODS: Women were recruited in the first trimester. Maternal adiposity was measured using body mass index and advanced bioelectrical impedance analysis. Maternal leptin was measured using an enzyme-linked immunosorbent assay technique. RESULTS: Of the 100 subjects studied, the mean leptin concentration was 37.7 ng\\/ml (range: 2.1-132.8). Leptin levels did not correlate with gestational age in the first trimester, maternal age, parity or birth weight. Serum leptin correlated positively with maternal weight and body mass index, and with the different parameters of body composition. On multiple regression analysis, serum leptin correlated with visceral fat but not fat distributed elsewhere. CONCLUSIONS: Visceral fat is the main determinant of circulating maternal leptin in the first trimester of pregnancy. This raises the possibility that maternal leptin in early pregnancy may be a marker for the development of metabolic syndrome, including diabetes mellitus.

Improving maternal mortality at a university teaching hospital in Nnewi, Nigeria.

Science.gov (United States)

Igwegbe, Anthony O; Eleje, George U; Ugboaja, Joseph O; Ofiaeli, Robinson O

2012-03-01

To evaluate the impact of the introduction of the Service Compact with all Nigerians (SERVICOM) contract on maternal health at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. A retrospective and comparative study of maternal deaths between 2004 and 2010 was carried out. The main outcome measures were yearly maternal mortality ratio (MMR), relative risk (RR) of maternal mortality, and presentation-intervention interval. The yearly MMR and the RR of maternal mortality were compared with the figures from 2004, which represented the pre-SERVICOM era. There were 4916 live births and 54 maternal deaths during the study period, giving an MMR of 1098 per 100,000 live births. Pre-eclampsia/eclampsia was the most common direct cause (25.0%), followed by hemorrhage (18.8%) and sepsis (8.3%). Anemia (12.5%) was the most common indirect cause. There was a progressive reduction in MMR and RR of maternal mortality, with a corresponding increase in live births. The presentation-intervention interval improved significantly from 2006. A positive change in the attitude of health workers and the elimination of fee-for-service in emergency obstetric care would reduce type 3 delays in public health facilities, and consequently reduce maternal mortality. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Impact of reproductive laws on maternal mortality: the chilean natural experiment.

Science.gov (United States)

Koch, Elard

2013-05-01

Improving maternal health and decreasing morbidity and mortality due to induced abortion are key endeavors in developing countries. One of the most controversial subjects surrounding interventions to improve maternal health is the effect of abortion laws. Chile offers a natural laboratory to perform an investigation on the determinants influencing maternal health in a large parallel time-series of maternal deaths, analyzing health and socioeconomic indicators, and legislative policies including abortion banning in 1989. Interestingly, abortion restriction in Chile was not associated with an increase in overall maternal mortality or with abortion deaths and total number of abortions. Contrary to the notion proposing a negative impact of restrictive abortion laws on maternal health, the abortion mortality ratio did not increase after the abortion ban in Chile. Rather, it decreased over 96 percent, from 10.8 to 0.39 per 100,000 live births. Thus, the Chilean natural experiment provides for the first time, strong evidence supporting the hypothesis that legalization of abortion is unnecessary to improve maternal health in Latin America.

Maternal-child health fellowship: maintaining the rigor of family medicine obstetrics.

Science.gov (United States)

Magee, Susanna R; Radlinski, Heidi; Nothnagle, Melissa

2015-01-01

The United States has a growing shortage of maternity care providers. Family medicine maternity care fellowships can address this growing problem by training family physicians to manage high-risk pregnancies and perform cesarean deliveries. This paper describes the impact of one such program-the Maternal Child Health (MCH) Fellowship through the Department of Family Medicine at Brown University and the careers of its graduates over 20 years (1991--2011). Fellowship graduates were mailed a survey regarding their training, current practice and teaching roles, and career satisfaction. Seventeen of 23 fellows (74%) responded to the survey. The majority of our fellowship graduates provide maternity care. Half of our respondents are primary surgeons in cesarean sections, and the majority of these work in community hospitals. Nearly all of our graduates maintain academic appointments and teach actively in their respective departments of family medicine. Our maternal child health fellowship provides family physicians with the opportunity to develop advanced skills needed to provide maternity care for underserved communities and teaching skills to train the next generation of maternal child health care providers.

Identification of maternally-loaded RNA transcripts in unfertilized eggs of Tribolium castaneum

Directory of Open Access Journals (Sweden)

Preuss Kevin M

2012-11-01

Full Text Available Abstract Background Maternal RNAs play a critical role in early development. Variation in the diversity and levels of maternally derived gene transcripts may be central to the origin of phenotypic novelty -- a longstanding problem in evolution and development. By studying maternal transcriptomes within and between divergent species, a better understanding of the evolutionary forces acting on maternal RNA allocation is possible. Results We present the first maternal transcriptome of the red flour beetle, Tribolium castaneum. Using a tiled whole-genome microarray, we found that 58.2% of T. castaneum genes are maternally loaded into eggs. Comparison of known Drosophila melanogaster maternal genes to our results showed widespread conservation of maternal expression with T. castaneum. Additionally, we found that many genes previously reported as having sex or tissue specific expression in T. castaneum were also maternally loaded. Identification of such pleiotropy is vital for proper modeling and testing of evolutionary theory using empirical data. The microarray design also allowed the detection of 2315 and 4060 novel transcriptionally active regions greater in length than 100 bp in unfertilized and fertilized T. castaneum eggs, respectively. These transcriptionally active regions represent novel exons of potentially unknown genes for future study. Conclusions Our results lay a foundation for utilizing T. castaneum as a model for understanding the role of maternal genes in evolution.

[Prenatal care and hospital maternal mortality in Tijuana, Baja California, Mexico].

Science.gov (United States)

Gonzaga-Soriano, María Rode; Zonana-Nacach, Abraham; Anzaldo-Campos, María Cecilia; Olazarán-Gutiérrez, Asbeidi

2014-01-01

To describe the prenatal care (PC) received in women with maternal hospital deaths from 2005 to 2011 in Tijuana, Baja California, Mexico. Were reviewed the medical chars and registrations of the maternal deaths by the local Committees of Maternal Mortality. There were 44 maternal hospital deaths. Thirty (68%) women assisted to PC appointments during pregnancy, the average number of PC visits was 3.8 and 18 (41%) had an adequate PC (≥ 5 visits). Six (14%) women didn't know they were pregnant; 19 (43%), 21 (48%) y 4 (9%) maternal deaths were due to direct, indirect obstetric cause or non-obstetric causes. Eighteen (18%), 2 (4 %) and 34 (77%) of the maternal deaths occurred during pregnancy, delivery or puerperium. It is necessary pregnancy women have an early, periodic and systematic PC to identify opportunely risk factors associated with pregnancy complications.

The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study.

Science.gov (United States)

Boito, S M E; Struijk, P C; Pop, G A M; Visser, W; Steegers, E A P; Wladimiroff, J W

2004-04-01

To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia. In 13 pre-eclamptic women maternal and fetal hemodynamics were established by means of combined measurement of maternal arterial blood pressure (BP), WBV, hematocrit and uterine artery (UtA) resistance index (RI) in addition to umbilical artery (UA) pulsatility index (PI) and UV volume flow obtained from UV vessel area and UV time-averaged flow velocity. In each woman all parameters were measured four times at baseline, after PVE, after DH and 24 h after the start of treatment. Maternal diastolic BP, hematocrit and WBV display a significant reduction after PVE. In the fetus UA PI decreases significantly whereas a significant increase in UV cross-sectional area was detected. After maternal DH administration, arterial systolic and diastolic BP and UA PI show a significant decrease compared with the measurements following PVE. At 24 h, only maternal systolic and diastolic BP display a significant further decrease. No significant changes were established for the UtA RI, UV time-averaged velocity and UV volume flow during the entire study period. During pre-eclampsia, maternal PVE followed by DH administration results in a significant reduction in maternal diastolic BP, maternal hematocrit and WBV. Maternal PVE is associated with a significant increase in UV cross-sectional area and a non-significant rise of 11% in UV volume flow. Maternal DH administration does not result in any change in UV cross-sectional area. However, UA PI decreases significantly after both PVE and DH treatment. Copyright 2004 ISUOG.

26 CFR 1.410(a)-9 - Maternity and paternity absence.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Maternity and paternity absence. 1.410(a)-9... Maternity and paternity absence. (a) Elapsed time—(1) Rule. For purposes of applying the rules of § 1.410(a...)(5)(E) and 411(a)(6)(E) (relating to maternity or paternity absence), the severance from service date...

Effect of maternal education on the rate of childhood handicap.

Science.gov (United States)

Shawky, S; Milaat, W M; Abalkhail, B A; Soliman, N K

2001-01-01

The objectives of this study were to determine the relation between maternal education and various maternal risk factors, identify the impact of maternal education on the risk of childhood handicap and estimate the proportion of childhood handicap that can be prevented by maternal education. Data was collected from all married women attending the two major maternity and child hospitals in Jeddah during April 1999. Women with at least one living child were interviewed for sociodemographic factors and having at least one handicapped child. The risk of having a handicapped child and the population attributable risk percent were calculated. Some potential risk factors are dominant in our society as approximately 30% of women did not attend school and 84% did not work. Consanguineous marriages accounted for about 43%. Pre-marriage counseling was limited as only 10% of women counseled before marriage. The proportion of unemployment and consanguineous marriages decreased significantly by increase in maternal education level. Conversely, the proportion of women reporting pre-marriage counseling increased significantly by increase in maternal education level. Approximately, 7% of women reported having at least one handicapped child. The risk of having a handicapped child showed a significant sharp decline with increase in maternal education level. At least 25% of childhood handicap can be prevented by achieving female primary education and up to half of cases can be prevented if mothers finish their intermediate education. Female education plays a major role in child health. The results of this study suggest investment in female education, which would have substantial positive effects in reducing incidence of childhood handicap in Jeddah.

Maternal and littermate deprivation disrupts maternal behavior and social-learning of food preference in adulthood: tactile stimulation, nest odor, and social rearing prevent these effects.

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Melo, Angel I; Lovic, Vedran; Gonzalez, Andrea; Madden, Melissa; Sinopoli, Katia; Fleming, Alison S

2006-04-01

Maternal and littermate (social) separation, through artificial rearing (AR), disrupts the development of subsequent maternal behavior and social learning in rats. The addition of maternal-licking-like stimulation during AR, partially reverses some of these effects. However, little is know about the role of social stimuli from littermates and nest odors during the preweaning period, in the development of the adult maternal behavior and social learning. The purpose of this study was to examine the effects of peer- and peer-and-odor rearing on the development of maternal behavior and social learning in rats. Female pups were reared with mothers (mother reared-MR) or without mothers (AR) from postnatal day (PND) 3. AR rats received three different treatments: (1) AR-CONTROL group received minimal tactile stimulation, (2) AR-ODOR females received exposure to maternal nest material inside the AR-isolation-cup environment, (3) AR-SOCIAL group was reared in the cup with maternal nest material and a conspecific of the same-age and same-sex and received additional tactile stimulation. MR females were reared by their mothers in the nest and with conspecifics. In adulthood, rats were tested for maternal behavior towards their own pups and in a social learning task. Results confirm our previous report that AR impairs performance of maternal behavior and the development of a social food preference. Furthermore, social cues from a littermate, in combination with tactile stimulation and the nest odor, reversed the negative effects of complete isolation (AR-CONTROL) on some of the above behaviors. Exposure to the odor alone also had effects on some of these olfactory-mediated behaviors. These studies indicate that social stimulation from littermates during the preweaning period, in combination with odor from the nest and tactile stimulation, contributes to the development of affiliative behaviors. Copyright (c) 2006 Wiley Periodicals, Inc.

Influence of maternity leave on exclusive breastfeeding

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Fernanda R. Monteiro

2017-09-01

Full Text Available Objectives: To describe the profile of women with children aged under 4 months living in the Brazilian state capitals and in the Federal District according to their working status and to analyze the influence of maternity leave on exclusive breastfeeding (EBF among working women. Methods: This was a cross-sectional study with data extracted from the II National Maternal Breastfeeding Prevalence Survey carried out in 2008. Initially, a descriptive analysis of the profile of 12,794 women was performed, according to their working status and maternity leave and the frequency of maternity leave in the Brazilian regions and capitals. The study used a multiple model to identify the influence of maternity leave on EBF interruption, including 3766 women who declared they were working and were on maternity leave at the time of the interview. The outcome assessed in the study was the interruption of the EBF, classified by the WHO. Results: Regarding the working status of the mothers, 63.4% did not work outside of their homes and among those who worked, 69.8% were on maternity leave. The largest prevalence among workers was of women older than 35 years of age, with more than 12 years of schooling, primiparous and from the Southeast and South regions. The lack of maternity leave increased by 23% the chance of EBF interruption. Conclusion: Maternity leave contributed to increase the prevalence of EBF in the Brazilian states capitals, supporting the importance of increasing the maternity leave period from four to six months. Resumo: Objetivos: Descrever perfil das mulheres com filhos menores de 4 meses residentes nas capitais brasileiras e no Distrito Federal segundo situação de trabalho e analisar a influência da licença-maternidade sobre o aleitamento materno exclusivo entre as mulheres trabalhadoras. Métodos: Trata-se de um estudo transversal com dados extraídos da II Pesquisa Nacional de Prevalência do Aleitamento Materno realizada em 2008

An Internatioal Comparison and Assessment of Maternity Leave Regulation

OpenAIRE

Dorothea Alewell, Kerstin Pull

2001-01-01

Provisions for maternity leave are common among industrialized countries, but their institutional design varies distinctly from country to country. Developing our theory on the impact on maternity leave regulations on women's labor market situation, we argue that a woman on leave creates a re-organization problem for her employer. The costs of re-organization will not simply increase with the duration of maternity leave, but display a hump-shaped curvature which peeks at medium-leave duration...

Severe maternal morbidity and breastfeeding outcomes in the early post-natal period: a prospective cohort study from one English maternity unit.

Science.gov (United States)

Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

2016-10-01

Previous research has identified potential issues of establishing and maintaining breastfeeding among women who experience severe maternal morbidity associated with pregnancy and birth, but evidence in the UK maternity population was scarce. We explored the association between severe maternal morbidity and breastfeeding outcomes (uptake and prevalence of partial and exclusive breastfeeding) at 6 to 8 weeks post-partum in a UK sample. Data on breastfeeding outcomes were obtained from a large cohort study of women who gave birth in one maternity unit in England to assess the impact of women's experiences of severe maternal morbidity (defined as major obstetric haemorrhage, severe hypertensive disorder or high dependency unit/intensive care unit admission) on their post-natal health and other important outcomes including infant feeding. Results indicated that among women who responded (n = 1824, response rate = 53%), there were no statistically significant differences in breastfeeding outcomes between women who did or did not experience severe morbidity, except for women with severe hypertensive disorder who were less likely to breastfeed either partially or exclusively at 6 to 8 weeks post-partum. Rather, breastfeeding outcomes were related to multi-dimensional factors including sociodemographic (age, ethnicity, living arrangement), other pregnancy outcomes (neonatal intensive care unit admission, mode of birth, women's perceived control during birth) and post-natal psychological factors (depressive symptoms). Women who experience severe maternal morbidity can be reassured that establishing successful breastfeeding can be achieved. More studies are required to understand what support is best for women who have complex health/social needs to establish breastfeeding. © 2015 John Wiley & Sons Ltd.

Role of Baby-Friendly Hospital Care in Maternal Role Competence.

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Barabach, Lynn; Ludington-Hoe, Susan M; Dowling, Donna; Lotas, Marilyn

The objective of this pilot study was to determine women's perceptions of their levels of maternal role competence at discharge from a Baby-Friendly hospital. A convenience sample of 30 women completed two self-report questionnaires: a demographic questionnaire and the Perceived Maternal Parenting Self-Efficacy scale. Women report that they perceived high levels of maternal role competence with a mean total score of 69.80 (standard deviation = 6.86) out of 80. As women experience breastfeeding in Baby-Friendly hospitals, maternal role competence may develop with appropriate support. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

The Virtual Maternity Clinic: a teaching and learning innovation for midwifery education.

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Phillips, Diane; Duke, Maxine; Nagle, Cate; Macfarlane, Susie; Karantzas, Gery; Patterson, Denise

2013-10-01

There are challenges for midwifery students in developing skill and competency due to limited placements in antenatal clinics. The Virtual Maternity Clinic, an online resource, was developed to support student learning in professional midwifery practice. Identifying students' perceptions of the Virtual Maternity Clinic; learning about the impact of the Virtual Maternity Clinic on the students' experience of its use and access; and learning about the level of student satisfaction of the Virtual Maternity Clinic. Two interventions were used including pre and post evaluations of the online learning resource with data obtained from questionnaires using open ended and dichotomous responses and rating scales. The pre-Virtual Maternity Clinic intervention used a qualitative design and the post-Virtual Maternity Clinic intervention applied both qualitative and quantitative approaches. Three campuses of Deakin University, located in Victoria, Australia. Midwifery students enrolled in the Bachelor of Nursing/Bachelor of Midwifery and Graduate Diploma of Midwifery were recruited across three campuses of Deakin University (n=140). Thematic analysis of the pre-Virtual Maternity Clinic intervention (return rate n=119) related to students' expectations of this resource. The data for the post-Virtual Maternity Clinic intervention (return rate n=42) including open-ended responses were thematically analysed; dichotomous data examined in the form of frequencies and percentages of agreement and disagreement; and 5-rating scales were analysed using Pearson's correlations (α=.05, two-tailed). Results showed from the pre-Virtual Maternity Clinic intervention that students previously had placements in antenatal clinics were optimistic about the online learning resource. The post-Virtual Maternity Clinic intervention results indicated that students were satisfied with the Virtual Maternity Clinic as a learning resource despite some technological issues. The Virtual Maternity Clinic