Maternal cell phone use during pregnancy and child behavioral problems in five birth cohorts.

Science.gov (United States)

Birks, Laura; Guxens, Mònica; Papadopoulou, Eleni; Alexander, Jan; Ballester, Ferran; Estarlich, Marisa; Gallastegi, Mara; Ha, Mina; Haugen, Margaretha; Huss, Anke; Kheifets, Leeka; Lim, Hyungryul; Olsen, Jørn; Santa-Marina, Loreto; Sudan, Madhuri; Vermeulen, Roel; Vrijkotte, Tanja; Cardis, Elisabeth; Vrijheid, Martine

2017-07-01

Previous studies have reported associations between prenatal cell phone use and child behavioral problems, but findings have been inconsistent and based on retrospective assessment of cell phone use. This study aimed to assess this association in a multi-national analysis, using data from three cohorts with prospective data on prenatal cell phone use, together with previously published data from two cohorts with retrospectively collected cell phone use data. We used individual participant data from 83,884 mother-child pairs in the five cohorts from Denmark (1996-2002), Korea (2006-2011), the Netherlands (2003-2004), Norway (2004-2008), and Spain (2003-2008). We categorized cell phone use into none, low, medium, and high, based on frequency of calls during pregnancy reported by the mothers. Child behavioral problems (reported by mothers using the Strengths and Difficulties Questionnaire or Child Behavior Checklist) were classified in the borderline/clinical and clinical ranges using validated cut-offs in children aged 5-7years. Cohort specific risk estimates were meta-analyzed. Overall, 38.8% of mothers, mostly from the Danish cohort, reported no cell phone use during pregnancy and these mothers were less likely to have a child with overall behavioral, hyperactivity/inattention or emotional problems. Evidence for a trend of increasing risk of child behavioral problems through the maternal cell phone use categories was observed for hyperactivity/inattention problems (OR for problems in the clinical range: 1.11, 95%CI 1.01, 1.22; 1.28, 95%CI 1.12, 1.48, among children of medium and high users, respectively). This association was fairly consistent across cohorts and between cohorts with retrospectively and prospectively collected cell phone use data. Maternal cell phone use during pregnancy may be associated with an increased risk for behavioral problems, particularly hyperactivity/inattention problems, in the offspring. The interpretation of these results is unclear

Elevated Maternal C-Reactive Protein is Associated with Increased Risk of Schizophrenia in a National Birth Cohort

Science.gov (United States)

Canetta, Sarah; Sourander, Andre; Surcel, Helja-Marja; Hinkka-Yli-Salomäki, Susanna; Leiviskä, Jaana; Kellendonk, Christoph; McKeague, Ian W.; Brown, Alan S.

2014-01-01

Objective The goal of the present study was to investigate an association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large national birth cohort with an extensive serum biobank. Methods This study utilized a nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort. 777 schizophrenia cases (630 with schizophrenia, 147 with schizoaffective disorder) that had maternal sera available for CRP testing were identified and matched to 777 controls in the analysis. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens. Results Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio (OR)=1.31, 95% confidence interval (CI)=1.10-1.56, p=0.003). This finding remained significant after adjusting for potential confounders including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. Conclusion This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders. PMID:24969261

Maternal death audit in Rwanda 2009-2013: a nationwide facility-based retrospective cohort study.

Science.gov (United States)

Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

2016-01-22

Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Nationwide facility-based retrospective cohort study. All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. 987 audited cases of maternal death. Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to

Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand-clinical outcomes.

Science.gov (United States)

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Daellenbach, Rea; Kensington, Mary; Monk, Amy; Schmied, Virginia

2017-08-29

To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. Prospective cohort study. 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors. Mode of birth, Apgar score of less than 7 at 5 min and neonatal unit admission. labour onset, analgesia, blood loss, third stage of labour management, perineal trauma, non-pharmacological pain relief, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality. Women who planned a PMU birth were significantly more likely to have a spontaneous vaginal birth (77.9%vs62.3%, adjusted OR (AOR) 1.61, 95% CI 1.08 to 2.39), and significantly less likely to have an instrumental assisted vaginal birth (10.3%vs20.4%, AOR 0.59, 95% CI 0.37 to 0.93). The emergency and elective caesarean section rates were not significantly different (emergency: PMU 11.6% vs TMH 17.5%, AOR 0.88, 95% CI 0.55 to 1.40; elective: PMU 0.7% vs TMH 2.1%, AOR 0.34, 95% CI 0.08 to 1.41). There were no significant differences between the cohorts in rates of 5 min Apgar score of maternity units as physically safe places for well women to plan to give birth, with these women having higher rates of spontaneous vaginal births and lower rates of interventions and their associated morbidities than those who planned a tertiary hospital birth, with no differences in neonatal outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

46 CFR Exhibit 1 to Part 530 - Service Contract Registration [Form FMC-83

Science.gov (United States)

2010-10-01

.... Registrant. This must be the full legal name of the firm or individual registering for the FMC's Service Contract Filing System and any trade names. The registrant name should match the corporate charter or business license, conference membership, etc. It should be noted that the registrant name cannot be changed...

Maternal thyroid function and child educational attainment: prospective cohort study.

Science.gov (United States)

Nelson, Scott M; Haig, Caroline; McConnachie, Alex; Sattar, Naveed; Ring, Susan M; Smith, George D; Lawlor, Debbie A; Lindsay, Robert S

2018-02-20

To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Prospective cohort study. Avon Longitudinal Study of Parents and Children cohort in the UK. 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Maternal thyroid dysfunction in early pregnancy does not have a

Maternal thyroid disorder in pregnancy and risk of cerebral palsy in the child: a population-based cohort study.

Science.gov (United States)

Petersen, Tanja Gram; Andersen, Anne-Marie Nybo; Uldall, Peter; Paneth, Nigel; Feldt-Rasmussen, Ulla; Tollånes, Mette Christophersen; Strandberg-Larsen, Katrine

2018-05-31

Cerebral palsy is the most frequent motor disability in childhood, but little is known about its etiology. It has been suggested that cerebral palsy risk may be increased by prenatal thyroid hormone disturbances. The objective of this study was to investigate whether maternal thyroid disorder is associated with increased risk of cerebral palsy. A population-based cohort study using two study populations. 1) 1,270,079 children born in Denmark 1979-2007 identified in nationwide registers, and 2) 192,918 children born 1996-2009 recruited into the Danish National Birth Cohort and The Norwegian Mother and Child Cohort study, combined in the MOthers and BAbies in Norway and Denmark (MOBAND) collaboration cohort. Register-based and self-reported information on maternal thyroid disorder was studied in relation to risk of cerebral palsy and its unilateral and bilateral spastic subtypes using multiple logistic regression. Children were followed from the age of 1 year to the age of 6 years, and cerebral palsy was identified in nationwide registers with verified diagnoses. In register data, hypothyroidism was recognized in 12,929 (1.0%), hyperthyroidism in 9943 (0.8%), and unclassifiable thyroid disorder in 753 (cerebral palsy was 1.0 (95% CI: 0.7-1.5). Maternal thyroid disorder identified during pregnancy was associated with elevated risk of unilateral spastic cerebral palsy (odds ratio 3.1 (95% CI: 1.2-8.4)). In MOBAND, 3042 (1.6%) of the mothers reported a thyroid disorder in pregnancy, which was not associated with cerebral palsy overall (odds ratio 1.2 (95% CI: 0.6-2.4)). Maternal thyroid disorder overall was not related to bilateral spastic cerebral palsy, but maternal thyroid disorder identified in pregnancy was associated with increased risk of unilateral spastic cerebral palsy. These findings should be replicated in studies making use of maternal blood samples.

Maternal employment and child socio-emotional behaviour in the UK: longitudinal evidence from the UK Millennium Cohort Study.

Science.gov (United States)

McMunn, Anne; Kelly, Yvonne; Cable, Noriko; Bartley, Mel

2012-07-01

Mothers of young children are increasingly combining paid work with childrearing. Empirical evidence on the effects of maternal employment on children is contradictory and little work has considered the impact of maternal employment within the context of the employment patterns of both parents. Data on parental employment across three sweeps (when children were in infancy, age 3 and age 5 y) of the Millennium Cohort Study, a large nationally representative prospective birth cohort study, were used to investigate the relation between parental employment and child socio-emotional behaviour at age 5 years independent of maternal education, maternal depression or household income. The cumulative effect of maternal employment across the early years was investigated. The impact of maternal employment in the first year of life was separately examined as a potentially 'sensitive period'. There was no evidence of detrimental effects of maternal employment in the early years on subsequent child socio-emotional behaviour. There were significant gender differences in the effects of parental employment on behavioural outcomes. The most beneficial working arrangement for both girls and boys was that in which both mothers and fathers were present in the household and in paid work independent of maternal educational attainment and household income. No detrimental effects of maternal employment in the early years were seen. There were important gender differences in relationships between parental working arrangements and child socio-emotional outcomes.

The impact of maternal employment on breast-feeding duration in the UK Millennium Cohort Study.

Science.gov (United States)

Hawkins, Summer Sherburne; Griffiths, Lucy Jane; Dezateux, Carol; Law, Catherine

2007-09-01

To examine the relationship of maternal employment characteristics, day care arrangements and the type of maternity leave pay to breast-feeding for at least 4 months. Cohort study. Babies aged 9 months in the Millennium Cohort Study, born between September 2000 and January 2002. A total of 6917 British/Irish white employed mothers with singleton babies. Mothers employed part-time or self-employed were more likely to breast-feed for at least 4 months than those employed full-time (adjusted rate ratio (aRR) and 95% confidence interval (CI) 1.30 (1.17-1.44) and 1.74 (1.46-2.07), respectively). The longer a mother delayed her return to work postpartum, the more likely she was to breast-feed for at least 4 months (P for trend employer offered family-friendly (aRR 1.14, 95% CI 1.02-1.27) or flexible work arrangements (aRR 1.24, 95% CI 1.00-1.55), or they received Statutory Maternity Pay (SMP) plus additional pay during their maternity leave rather than SMP alone (aRR 1.13, 95% CI 1.02-1.26). These findings were independent of confounding factors, such as socio-economic status and maternal education. Current policies may encourage mothers to enter or return to employment postpartum, but this may result in widening inequalities in breast-feeding and persistence of low rates. Policies should aim to increase financial support and incentives for employers to offer supportive work arrangements.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

NARCIS (Netherlands)

Kuppens, S.M.I.; Kooistra, L.; Hasaart, T.H.M.; Donk, M.W.; Vader, H.; Oei, S.G.; Pop, V.J.

2011-01-01

Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Methods Prospective cohort study in 141 women (= 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were

Maternal mortality in Mexico, beyond millennial development objectives: An age-period-cohort model.

Science.gov (United States)

Rodríguez-Aguilar, Román

2018-01-01

The maternal mortality situation is analyzed in México as an indicator that reflects the social development level of the country and was one of the millennial development objectives. The effect of a maternal death in the related social group has multiplier effects, since it involves family dislocation, economic impact and disruption of the orphans' normal social development. Two perspectives that causes of maternal mortality were analyzed, on one hand, their relationship with social determinants and on the other, factors directly related to the health system. Evidence shows that comparing populations based on group of selected variables according to social conditions and health care access, statistically significant differences prevail according to education and marginalization levels, and access to medical care. In addition, the Age-Period-Cohort model raised, shows significant progress in terms of a downward trend in maternal mortality in a generational level. Those women born before 1980 had a greater probability of maternal death in relation to recent generations, which is a reflection of the improvement in social determinants and in the Health System. The age effect shows a problem in maternal mortality in women under 15 years old, so teen pregnancy is a priority in health and must be addressed in short term. There is no clear evidence of a period effect.

Maternal depression and child development: Evidence from São Paulo’s Western Region Cohort Study

OpenAIRE

Brentani,Alexandra; Fink,Günther

2016-01-01

Summary Introduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children’s early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children’s development at age one using data from the São Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré’ region of São Pa...

Maternal depression and child development: Evidence from São Paulo’s Western Region Cohort Study

OpenAIRE

Brentani, Alexandra; Fink, Günther

2016-01-01

Summary Introduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children’s early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children’s development at age one using data from the São Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré’ region of São Paulo were assessed ...

Ethnic disparity in severe acute maternal morbidity: A nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; Roosmalen, J. van

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Ethnic disparity in severe acute maternal morbidity: a nationwide cohort study in the Netherlands

NARCIS (Netherlands)

Zwart, J.J.; Jonkers, M.D.; Richters, A.; Öry, F.; Bloemenkamp, K.W.; Duvekot, J.J.; van Roosmalen, J.

2011-01-01

Background: There are concerns about ethnic disparity in outcome of obstetric health care in high-income countries. Our aim was to assess these differences in a large cohort of women having experienced severe acute maternal morbidity (SAMM) during pregnancy, delivery and puerperium. Methods: All

Association Between Prepartum Maternal Iron Deficiency and Offspring Risk of Schizophrenia: Population-Based Cohort Study With Linkage of Danish National Registers

DEFF Research Database (Denmark)

Sørensen, Holger J; Nielsen, Philip R; Pedersen, Carsten B

2010-01-01

Recent findings suggest that maternal iron deficiency may increase the risk of schizophrenia-spectrum disorder in offspring. We initiated this study to determine whether maternal prepartum anemia influences offspring risk of schizophrenia. We conducted a population-based study with individual...... a 1.60-fold (95% confidence interval = 1.16-2.15) increased risk of schizophrenia. Although the underlying mechanisms are unknown and independent replication is needed, our findings suggest that maternal iron deficiency increases offspring risk of schizophrenia....... record linkage of the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register. In a cohort of 1 115 752 Danish singleton births from 1978 to 1998, cohort members were considered as having a maternal history of anemia if the mother had received...

Association Between Prepartum Maternal Iron Deficiency and Offspring Risk of Schizophrenia: Population-Based Cohort Study With Linkage of Danish National Registers

DEFF Research Database (Denmark)

Sørensen, Holger J; Nielsen, Philip R; Pedersen, Carsten B

2011-01-01

Recent findings suggest that maternal iron deficiency may increase the risk of schizophrenia-spectrum disorder in offspring. We initiated this study to determine whether maternal prepartum anemia influences offspring risk of schizophrenia. We conducted a population-based study with individual...... a 1.60-fold (95% confidence interval = 1.16-2.15) increased risk of schizophrenia. Although the underlying mechanisms are unknown and independent replication is needed, our findings suggest that maternal iron deficiency increases offspring risk of schizophrenia....... record linkage of the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register. In a cohort of 1 115 752 Danish singleton births from 1978 to 1998, cohort members were considered as having a maternal history of anemia if the mother had received...

Maternal Risk Exposure and Adult Daughters’ Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries

Science.gov (United States)

Li, Qingfeng; Tsui, Amy O.

2016-01-01

This study analyzes the relationships between maternal risk factors present at the time of daughters’ births—namely, young mother, high parity, and short preceding birth interval—and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency. PMID:27154342

Maternal Risk Exposure and Adult Daughters' Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries.

Science.gov (United States)

Li, Qingfeng; Tsui, Amy O

2016-06-01

This study analyzes the relationships between maternal risk factors present at the time of daughters' births-namely, young mother, high parity, and short preceding birth interval-and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency.

Evaluating Maternity Units: a prospective cohort study of freestanding midwife-led primary maternity units in New Zealand—clinical outcomes

Science.gov (United States)

Grigg, Celia P; Tracy, Sally K; Tracy, Mark; Daellenbach, Rea; Kensington, Mary; Monk, Amy; Schmied, Virginia

2017-01-01

Objective To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. Design Prospective cohort study. Participants 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010–2011. All of the women planning a TMH birth were ‘low risk’, and 29 of the PMU cohort had identified risk factors. Primary outcomes Mode of birth, Apgar score of less than 7 at 5 min and neonatal unit admission. Secondary outcomes: labour onset, analgesia, blood loss, third stage of labour management, perineal trauma, non-pharmacological pain relief, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality. Results Women who planned a PMU birth were significantly more likely to have a spontaneous vaginal birth (77.9%vs62.3%, adjusted OR (AOR) 1.61, 95% CI 1.08 to 2.39), and significantly less likely to have an instrumental assisted vaginal birth (10.3%vs20.4%, AOR 0.59, 95% CI 0.37 to 0.93). The emergency and elective caesarean section rates were not significantly different (emergency: PMU 11.6% vs TMH 17.5%, AOR 0.88, 95% CI 0.55 to 1.40; elective: PMU 0.7% vs TMH 2.1%, AOR 0.34, 95% CI 0.08 to 1.41). There were no significant differences between the cohorts in rates of 5 min Apgar score of <7 (2.0%vs2.1%, AOR 0.82, 95% CI 0.27 to 2.52) and neonatal unit admission (5.9%vs4.9%, AOR 1.44, 95% CI 0.70 to 2.96). Planning to give birth in a primary unit was associated with similar or reduced odds of intrapartum interventions and similar odds of all measured neonatal well-being indicators. Conclusions The results of this study support freestanding midwife-led primary-level maternity units as physically safe places for well women to plan to give birth, with these women having

Maternal Infections, Antibiotics, and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study.

Science.gov (United States)

Mårild, Karl; Kahrs, Christian R; Tapia, German; Stene, Lars C; Størdal, Ketil

2017-05-01

Infections in pregnancy are common, may affect fetal development, and have been linked to offspring autoimmunity. We aimed to determine whether maternal infections, the use of antibiotics, and use of paracetamol in pregnancy are associated with the risk of offspring celiac disease (CD). The nationwide Norwegian Mother and Child Cohort Study includes 84,274 children born in the period from 2000 to 2009 with prospectively collected questionnaire data on maternal infections and medication use in pregnancy. CD was identified through questionnaires and the Norwegian Patient Register. Logistic regression yielded odds ratios adjusted for age and sex (aORs). During a median follow-up of 8.5 years, 617 children (0.7%) were diagnosed with CD. The aOR for offspring CD per increase in number of maternal infections was 1.07 (95% confidence interval [CI] = 1.01-1.13), but not significantly increased for categories 1 infection (1.01 [95% CI = 0.82-1.25]) and ≥2 infections (1.22 [95% CI = 1.00-1.49]) versus no infection. We found the same pattern for respiratory tract infections, but not for gastrointestinal infections. The aORs were broadly consistent across pregnancy periods of exposure. The use of antibiotics and paracetamol was, compared with no use, not associated with offspring CD (aOR = 1.16 [95% CI = 0.94-1.43] and aOR = 1.13 [95% CI = 0.96-1.33], respectively; P values for trend >0.2). In this large pregnancy cohort we found no clear association between maternal infections in pregnancy and offspring CD, but considering the marginal significance in some of our results maternal infections cannot be ruled out as a risk factor. Reassuringly for both parents-to-be and clinicians, the use of antibiotics and paracetamol in pregnancy was not a significant risk factor.

Associations of maternal prenatal smoking with umbilical cord blood hormones: the Project Viva cohort.

Science.gov (United States)

Fleisch, Abby F; Rifas-Shiman, Sheryl L; Rokoff, Lisa B; Hivert, Marie-France; Mantzoros, Christos S; Oken, Emily

2017-07-01

Maternal smoking during pregnancy is associated with low fetal growth and adverse cardiometabolic health in offspring. However, hormonal pathways underlying these associations are unclear. Therefore, we examined maternal smoking habits and umbilical cord blood hormone profiles in a large, prospective cohort. We studied 978 mother/infant pairs in Project Viva, a Boston-area cohort recruited 1999-2002. We categorized mothers as early pregnancy smokers, former smokers, or never smokers. Outcomes were cord blood concentrations of IGF-1, IGF-2, IGFBP-3, leptin, adiponectin, insulin, and C-peptide. We used linear regression models adjusted for maternal pre-pregnancy body mass index (BMI), race/ethnicity, parity, education, and infant sex. We conducted analyses in the full cohort and stratified by infant sex. Thirteen percent of women were early pregnancy smokers, 20% former smokers, and 68% never smokers. Infants of early pregnancy smokers had lower IGF-1 adjusted for IGFBP-3 [-5.2ng/mL (95% CI: -8.6, -1.7)], with more pronounced associations in girls [-10.7ng/mL (95% CI: -18.5, -2.9) vs. -4.0ng/mL (95% CI: -8.4, 0.4) for boys]. Early pregnancy smoking was not associated with cord blood hormones other than IGF-1. Infants of former smokers had a cord blood hormone profile similar to infants of never smokers. As compared to mothers who never smoked, early pregnancy smokers had infants with lower cord blood IGF-1 which could prime adverse metabolic outcomes. This provides further reason to support smoking cessation programs in women of reproductive age. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal Depression Increases Childhood Dental Caries: A Cohort Study in Brazil.

Science.gov (United States)

Dos Santos Pinto, Gabriela; de Ávila Quevedo, Luciana; Britto Correa, Marcos; Sousa Azevedo, Marina; Leão Goettems, Marília; Tavares Pinheiro, Ricardo; Demarco, Flávio Fernando

2017-01-01

To investigate the relationship between maternal depression and childhood caries in a cohort of adolescent mothers. This cross-sectional study nested in a cohort evaluated a sample of 538 mother/child dyads. When the children were 24-36 months of age, data regarding oral health from children and mothers were collected by clinical dental examination. A mother's major depressive disorder was assessed by using the Mini International Neuropsychiatric Interview (MINI [Plus]), at the current moment. Independent variables were obtained by using questionnaires. The outcome on dental caries experience was dichotomized by using 2 cut points: dmfs ≥1 and dmfs ≥3. Poisson regression analysis, using a hierarchical approach, was applied to assess the association between major depressive disorder in mothers with and those without caries experience and the outcome. The prevalence of dental caries in children was 15.1% (n = 82). The mean dmfs index was 1.12 (SD = 3.72). The prevalence of major depressive disorder was 32.6% (n = 168). An interaction between caries status and depressive disorder was found, and after adjusted analysis, children from mothers with major depressive disorder with negative caries experience presented a higher caries prevalence (prevalence ratio 4.00, 95% confidence interval 1.29-12.41). Our findings suggest that maternal psychiatric disorders could have a negative impact on children's oral health. © 2016 S. Karger AG, Basel.

Maternal depression and bullying victimization among adolescents: Results from the 2004 Pelotas cohort study.

Science.gov (United States)

Azeredo, Catarina Machado; Santos, Iná S; Barros, Aluísio J D; Barros, Fernando C; Matijasevich, Alicia

2017-10-01

Maternal depression impacts on several detrimental outcomes during a child's life course, and could increase their risk of victimization. This longitudinal study examined the association between antenatal maternal depression, postnatal trajectories, and current maternal depression and offspring bullying victimization at 11 years. We included 3,441 11-year-old adolescents from the 2004 Pelotas Cohort Study. Antenatal maternal depression, postnatal trajectories, and current maternal depression data were assessed during the follow-up waves. Bullying victimization was self-reported by the adolescents. We used ordinal logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CIs), for the association between maternal depression and offspring bullying victimization. The most prevalent type of bullying was verbal victimization (37.9%). We observed a positive association between antenatal maternal depression, postnatal trajectories, and current maternal depression and physical bullying victimization. Maternal mood symptoms during pregnancy were associated with physical (OR = 1.30, 95%CI = 1.11-1.53), verbal (OR = 1.29, 95%CI = 1.12-1.49), and any victimization (OR = 1.22, 95%CI = 1.05-1.41). Severe current maternal depression was associated with physical (OR = 1.34, 95%CI = 1.10-1.62), social manipulation (OR = 1.29, 95%CI = 1.08-1.53), attacks on property (OR = 1.30, 95%CI = 1.08-1.57) and any victimization (OR = 1.32, 95%CI = 1.12-1.56). Regarding maternal depression trajectories, the "chronic-high" group was associated with higher risk of social manipulation, attacks on property and any victimization, than the "low" group. Our results strengthen the evidence of association between maternal depression and offspring bullying victimization, and physical victimization appears to be the main component. Further studies are warranted to confirm our findings and to elucidate the theoretical pathways for this longitudinal association. © 2017 Wiley

Maternal SSRI discontinuation, use, psychiatric disorder and the risk of autism in children: a meta-analysis of cohort studies.

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Kaplan, Yusuf Cem; Keskin-Arslan, Elif; Acar, Selin; Sozmen, Kaan

2017-12-01

We undertook an exclusive meta-analysis of cohort studies investigating the possible link between prenatal selective serotonin reuptake inhibitor (SSRI) exposure and autism spectrum disorders (ASD) in children to further investigate our previous suggestion of confounding by indication. The point estimates regarding the following cohorts were extracted and pooled: (1) pregnant women who discontinued SSRI until 3 months before pregnancy; (2) pregnant women who were exposed to SSRI during pregnancy; and (3) pregnant women with maternal psychiatric disorder but no exposure to SSRI during pregnancy. Although the pooled point estimate of the first cohort showed a trend for increase, it did not reach significance. The pooled point estimates of the latter cohorts showed a significant association with ASD which strengthens our previous suggestion of confounding by indication. Future studies should be adequately designed to differentiate whether the previously suggested association is a result of maternal psychiatric disorder or SSRI exposure or both. © 2017 The British Pharmacological Society.

Maternal pre-pregnancy BMI and intelligence quotient (IQ) in 5-year-old children: a cohort based study.

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Bliddal, Mette; Olsen, Jørn; Støvring, Henrik; Eriksen, Hanne-Lise F; Kesmodel, Ulrik S; Sørensen, Thorkild I A; Nøhr, Ellen A

2014-01-01

An association between maternal pre-pregnancy BMI and childhood intelligence quotient (IQ) has repeatedly been found but it is unknown if this association is causal or due to confounding caused by genetic or social factors. We used a cohort of 1,783 mothers and their 5-year-old children sampled from the Danish National Birth Cohort. The children participated between 2003 and 2008 in a neuropsychological assessment of cognitive ability including IQ tests taken by both the mother and the child. Linear regression analyses were used to estimate the associations between parental BMI and child IQ adjusted for a comprehensive set of potential confounders. Child IQ was assessed with the Wechsler Primary and Preschool Scales of Intelligence--Revised (WPPSI-R). The crude association between maternal BMI and child IQ showed that BMI was adversely associated with child IQ with a reduction in IQ of -0.40 point for each one unit increase in BMI. This association was attenuated after adjustment for social factors and maternal IQ to a value of -0.27 (-0.50 to -0.03). After mutual adjustment for the father's BMI and all other factors except maternal IQ, the association between paternal BMI and child IQ yielded a regression coefficient of -0.26 (-0.59 to 0.07), which was comparable to that seen for maternal BMI (-0.20 (-0.44 to 0.04)). Although maternal pre-pregnancy BMI was inversely associated with the IQ of her child, the similar association with paternal BMI suggests that it is not a specific pregnancy related adiposity effect.

Maternal use of fertility drugs and risk of cancer in children--a nationwide population-based cohort study in Denmark

DEFF Research Database (Denmark)

Hargreave, Marie; Jensen, Allan; Nielsen, Thor Schütt Svane

2015-01-01

Large population-based studies are needed to examine the effect of maternal use of fertility drugs on the risk of cancer in children, while taking into account the effect of the underlying infertility. A cohort of 123,322 children born in Denmark between 1964 and 2006 to 68,255 women who had been...... evaluated for infertility was established. We used a case-cohort design and calculated hazard ratios (HRs) for cancer in childhood (0-19 years) and in young adulthood (20-29 years) associated with maternal use of six groups of fertility drugs (clomiphene, gonadotropins [i.e., human menopausal gonadotropins...... and follicle-stimulating hormone], gonadotropin-releasing hormone analogs, human chorionic gonadotropins, progesterone and other fertility drugs). We found no statistically significant association between maternal use of fertility drugs and risk for overall cancer in childhood or young adulthood. However...

Trajectories of maternal depression and offspring psychopathology at 6 years: 2004 Pelotas cohort study

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Matijasevich, Alicia; Murray, Joseph; Cooper, Peter J.; Anselmi, Luciana; Barros, Aluísio J.D.; Barros, Fernando C.; Santos, Iná S.

2015-01-01

Background Few studies have addressed the course and severity of maternal depression and its effects on child psychiatric disorders from a longitudinal perspective. This study aimed to identify longitudinal patterns of maternal depression and to evaluate whether distinct depression trajectories predict particular psychiatric disorders in offspring. Methods Cohort of 4231 births followed-up in the city of Pelotas, Brazil. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, 24 and 48 months and 6 years after delivery. Psychiatric disorders in 6-year-old children were evaluated through the development and well-being assessment (DAWBA) instrument. Trajectories of maternal depression were calculated using a group-based modelling approach. Results We identified five trajectories of maternal depressive symptoms: a “low” trajectory (34.8%), a “moderate low” (40.9%), a “increasing” (9.0%), a “decreasing” (9.9%), and a “high-chronic” trajectory (5.4%). The probability of children having any psychiatric disorder, as well as both internalizing and externalizing problems, increased as we moved from the “low” to the “high-chronic” trajectory. These differences were not explained by maternal and child characteristics examined in multivariate analyses. Limitations Data on maternal depression at 3-months was available on only a sub-sample. In addition, we had to rely on maternal report of child’s behavior alone. Conclusions The study revealed an additive effect on child outcome of maternal depression over time. We identified a group of mothers with chronic and severe symptoms of depression throughout the first six years of the child life and for this group child psychiatric outcome was particularly compromised. PMID:25553403

Associations of maternal organophosphate pesticide exposure and PON1 activity with birth outcomes in SAWASDEE birth cohort, Thailand

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Naksen, Warangkana; Prapamontol, Tippawan; Mangklabruks, Ampica; Chantara, Somporn; Thavornyutikarn, Prasak; Srinual, Niphan; Panuwet, Parinya; Ryan, P. Barry; Riederer, Anne M.; Barr, Dana Boyd

2015-01-01

Prenatal organophosphate (OP) pesticide exposure has been reported to be associated with adverse birth outcomes and neurodevelopment. However, the mechanisms of toxicity of OP pesticides on human fetal development have not yet been elucidated. Our pilot study birth cohort, the Study of Asian Women and Offspring’s Development and Environmental Exposures (SAWASDEE cohort) aimed to evaluate environmental chemical exposures and their relation to birth outcomes and infant neurodevelopment in 52 pregnant farmworkers in Fang district, Chiang Mai province, Thailand. A large array of data was collected multiple times during pregnancy including approximately monthly urine samples for evaluation of pesticide exposure, three blood samples for pesticide-related enzyme measurements and questionnaire data. This study investigated the changes in maternal acetylcholinesterase (AChE) and paraoxonase 1 (PON1) activities and their relation to urinary diakylphosphates (DAPs), class-related metabolites of OP pesticides, during pregnancy. Maternal AChE, butyrylcholinesterase (BChE) and PON1 activities were measured three times during pregnancy and urinary DAP concentrations were measured, on average, 8 times from enrollment during pregnancy until delivery. Among the individuals in the group with low maternal PON1 activity (n = 23), newborn head circumference was negatively correlated with log10 maternal ΣDEAP and ΣDAP at enrollment (gestational age=12±3 weeks; β = −1.0 cm, p = 0.03 and β = −1.8 cm, p <0.01, respectively) and at 32 weeks pregnancy (β = −1.1 cm, p = 0.04 and β = −2.6 cm, p = 0.01, respectively). Furthermore, among these mothers, newborn birthweight was also negatively associated with log10 maternal ΣDEAP and ΣDAP at enrollment (β = −219.7 g, p = 0.05 and β = −371.3 g, p = 0.02, respectively). Associations between maternal DAP levels and newborn outcomes were not observed in the group of participants with high maternal PON1 activity. Our results

Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study

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2012-01-01

Background To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW) infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge. Methods Retrospective cohort study. Results 171 infants with median gestational age 27 weeks (IQR 25.4, 28.9) and median birthweight 899 g (IQR 724, 1064) were included. 97% of infants received human milk, 51% received > 75% of all enteral intake as human milk. 16% of infants were small-for-gestational age (SGA, 75% human milk had a greater negative change in weight z-score from birth to discharge compared to infants receiving human milk fortifier was related to human milk intake (p = 0.04). Among infants receiving > 75% human milk, there was no significant difference in change in weight z-score by milk type (donor −0.84, maternal −0.56, mixed −0.45, p = 0.54). Infants receiving >75% donor milk had higher rates of SGA status at discharge than those fed maternal or mixed milk (56% vs. 35% (maternal), 21% (mixed), p = 0.08). Conclusions VLBW infants can grow appropriately when fed predominantly fortified human milk. However, VLBW infants fed >75% human milk are at greater risk of poor growth than those fed less human milk. This risk may be highest in those fed predominantly donor human milk. PMID:22900590

Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study

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Colaizy Tarah T

2012-08-01

Full Text Available Abstract Background To determine the effect of human milk, maternal and donor, on in-hospital growth of very low birthweight (VLBW infants. We performed a retrospective cohort study comparing in-hospital growth in VLBW infants by proportion of human milk diet, including subgroup analysis by maternal or donor milk type. Primary outcome was change in weight z-score from birth to hospital discharge. Methods Retrospective cohort study. Results 171 infants with median gestational age 27 weeks (IQR 25.4, 28.9 and median birthweight 899 g (IQR 724, 1064 were included. 97% of infants received human milk, 51% received > 75% of all enteral intake as human milk. 16% of infants were small-for-gestational age (SGA, th percentile at birth, and 34% of infants were SGA at discharge. Infants fed >75% human milk had a greater negative change in weight z-score from birth to discharge compared to infants receiving 75% human milk, there was no significant difference in change in weight z-score by milk type (donor −0.84, maternal −0.56, mixed −0.45, p = 0.54. Infants receiving >75% donor milk had higher rates of SGA status at discharge than those fed maternal or mixed milk (56% vs. 35% (maternal, 21% (mixed, p = 0.08. Conclusions VLBW infants can grow appropriately when fed predominantly fortified human milk. However, VLBW infants fed >75% human milk are at greater risk of poor growth than those fed less human milk. This risk may be highest in those fed predominantly donor human milk.

Maternal employment and early childhood overweight: findings from the UK Millennium Cohort Study.

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Hawkins, S S; Cole, T J; Law, C

2008-01-01

In most developed countries, maternal employment has increased rapidly. Changing patterns of family life have been suggested to be contributing to the rising prevalence of childhood obesity. Our primary objective was to examine the relationship between maternal and partner employment and overweight in children aged 3 years. Our secondary objective was to investigate factors related to early childhood overweight only among mothers in employment. Cohort study. A total of 13 113 singleton children aged 3 years in the Millennium Cohort Study, born between 2000 and 2002 in the United Kingdom, who had complete height/weight data and parental employment histories. Parents were interviewed when the child was aged 9 months and 3 years, and the child's height and weight were measured at 3 years. Overweight (including obesity) was defined by the International Obesity Task Force cut-offs. A total of 23% (3085) of children were overweight at 3 years. Any maternal employment after the child's birth was associated with early childhood overweight (odds ratio (OR) [95% confidence interval (CI)]; 1.14 [1.00, 1.29]), after adjustment for potential confounding and mediating factors. Children were more likely to be overweight for every 10 h a mother worked per week (OR [95% CI]; 1.10 [1.04, 1.17]), after adjustment. An interaction with household income revealed that this relationship was only significant for children from households with an annual income of pound33 000 ($57 750) or higher. There was no evidence for an association between early childhood overweight and whether or for how many hours the partner worked, or with mothers' or partners' duration of employment. These relationships were also evident among mothers in employment. Independent risk factors for early childhood overweight were consistent with the published literature. Long hours of maternal employment, rather than lack of money may impede young children's access to healthy foods and physical activity. Policies

Severe maternal morbidity and breastfeeding outcomes in the early post-natal period: a prospective cohort study from one English maternity unit.

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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.

Maternal Dietary Patterns and Gestational Diabetes Mellitus in a Multi-Ethnic Asian Cohort: The GUSTO Study

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Jamie de Seymour

2016-09-01

Full Text Available Gestational Diabetes Mellitus (GDM is associated with an increased risk of perinatal morbidity and long term health issues for both the mother and offspring. Previous research has demonstrated associations between maternal diet and GDM development, but evidence in Asian populations is limited. The objective of our study was to examine the cross-sectional relationship between maternal dietary patterns during pregnancy and the risk of GDM in a multi-ethnic Asian cohort. Maternal diet was ascertained using 24-h dietary recalls from participants in the Growing up in Singapore towards healthy outcomes (GUSTO study—a prospective mother-offspring cohort, and GDM was diagnosed according to 1999 World Health Organisation guidelines. Dietary patterns were identified using factor analysis, and multivariate regression analyses performed to assess the association with GDM. Of 909 participants, 17.6% were diagnosed with GDM. Three dietary patterns were identified: a vegetable-fruit-rice-based-diet, a seafood-noodle-based-diet and a pasta-cheese-processed-meat-diet. After adjusting for confounding variables, the seafood-noodle-based-diet was associated with a lower likelihood of GDM (Odds Ratio (95% Confidence Interval = 0.74 (0.59, 0.93. The dietary pattern found to be associated with GDM in our study was substantially different to those reported previously in Western populations.

A Prospective Birth Cohort Study on Maternal Cholesterol Levels and Offspring Attention Deficit Hyperactivity Disorder: New Insight on Sex Differences.

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Ji, Yuelong; Riley, Anne W; Lee, Li-Ching; Volk, Heather; Hong, Xiumei; Wang, Guoying; Angomas, Rayris; Stivers, Tom; Wahl, Anastacia; Ji, Hongkai; Bartell, Tami R; Burd, Irina; Paige, David; Fallin, Margaret D; Zuckerman, Barry; Wang, Xiaobin

2017-12-23

Growing evidence suggests that maternal cholesterol levels are important in the offspring's brain growth and development. Previous studies on cholesterols and brain functions were mostly in adults. We sought to examine the prospective association between maternal cholesterol levels and the risk of attention deficit hyperactivity disorder (ADHD) in the offspring. We analyzed data from the Boston Birth Cohort, enrolled at birth and followed from birth up to age 15 years. The final analyses included 1479 mother-infant pairs: 303 children with ADHD, and 1176 neurotypical children without clinician-diagnosed neurodevelopmental disorders. The median age of the first diagnosis of ADHD was seven years. The multiple logistic regression results showed that a low maternal high-density lipoprotein level (≤60 mg/dL) was associated with an increased risk of ADHD, compared to a higher maternal high-density lipoprotein level, after adjusting for pertinent covariables. A "J" shaped relationship was observed between triglycerides and ADHD risk. The associations with ADHD for maternal high-density lipoprotein and triglycerides were more pronounced among boys. The findings based on this predominantly urban low-income minority birth cohort raise a new mechanistic perspective for understanding the origins of ADHD and the gender differences and future targets in the prevention of ADHD.

Persistent maternal depressive symptoms trajectories influence children's IQ: The EDEN mother-child cohort.

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van der Waerden, Judith; Bernard, Jonathan Y; De Agostini, Maria; Saurel-Cubizolles, Marie-Josèphe; Peyre, Hugo; Heude, Barbara; Melchior, Maria

2017-02-01

This study assessed the association between timing and course of maternal depression from pregnancy onwards and children's cognitive development at ages 5 to 6. Potential interaction effects with child sex and family socioeconomic status were explored. One thousand thirty-nine mother-child pairs from the French EDEN mother-child birth cohort were followed from 24 to 28 weeks of pregnancy onwards. Based on Center for Epidemiological Studies Depression (CES-D) and Edinburgh Postnatal Depression Scale (EPDS) scores assessed at six timepoints, longitudinal maternal depressive symptom trajectories were calculated with a group-based semiparametric method. Children's cognitive function was assessed at ages 5 to 6 by trained interviewers with the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III), resulting in three composite scores: Verbal IQ (VIQ), Performance IQ (PIQ), and Full-Scale IQ (FSIQ). Five trajectories of maternal symptoms of depression could be distinguished: no symptoms, persistent intermediate-level depressive symptoms, persistent high depressive symptoms, high symptoms in pregnancy only, and high symptoms in the child's preschool period only. Multiple linear regression analyses showed that, compared to children of mothers who were never depressed, children of mothers with persistent high levels of depressive symptoms had reduced VIQ, PIQ, and FSIQ scores. This association was moderated by the child's sex, boys appearing especially vulnerable in case of persistent maternal depression. Chronicity of maternal depression predicts children's cognitive development at school entry age, particularly in boys. As maternal mental health is an early modifiable influence on child development, addressing the treatment needs of depressed mothers may help reduce the associated burden on the next generation. © 2016 Wiley Periodicals, Inc.

Maternal singing of lullabies during pregnancy and after birth: Effects on mother-infant bonding and on newborns' behaviour. Concurrent Cohort Study.

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Persico, Giuseppina; Antolini, Laura; Vergani, Patrizia; Costantini, Walter; Nardi, Maria Teresa; Bellotti, Lidia

2017-08-01

Mother-infant bonding is of great importance for the development and the well-being of the baby. The aim of this Concurrent Cohort Study was to investigate the effects of mothers singing lullabies on bonding, newborns' behaviour and maternal stress. Eighty-three (singing cohort) and 85 (concurrent cohort) women were recruited at antenatal classes at 24 weeks g.a. and followed up to 3 months after birth. The Prenatal Attachment Inventory (PAI) and the Mother-to-Infant Bonding Scale (MIBS) were used to assess maternal-foetal attachment and postnatal bonding. No significant influence was found on Prenatal Attachment; by contrast, Postnatal Bonding was significantly greater (i.e. lower MIBS) in the singing group 3 months after birth (mean 1.28 vs 1.96; p=0.001). In the same singing group, the incidence of neonatal crying episodes in the first month was significantly lower (18.5% vs 28.2; psinging group, even in the second month after birth (22.8% vs 36.5; p=0.002). At the same time, a reduction was observed in the neonatal nightly awakening (1.5% vs 4.7; psinging lullabies could improve maternal-infant bonding. It could also have positive effects on neonatal behaviour and maternal stress. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Effect of maternal intravenous fluid therapy on external cephalic version at term: a prospective cohort study.

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Burgos, Jorge; Quintana, Eider; Cobos, Patricia; Osuna, Carmen; Centeno, María del Mar; Melchor, Juan Carlos

2014-12-01

We sought to analyze whether maternal intravenous fluid therapy prior to external cephalic version (ECV) increases the amount of amniotic fluid and the success rate of the procedure. This was a prospective single-center cohort study of 200 women with a consecutive cohort of 100 pregnant women with a breech presentation at term who were administered intravenous fluid therapy with 2 L of hypotonic saline before the version attempt, compared to a control cohort of 100 pregnant women not given hydration treatment. The mean increase in the amniotic fluid index (AFI) after intravenous maternal hydration was 3.75 ± 2.71 cm. The amount of fluid before hydration was the only variable found to be associated with increases in amniotic fluid levels, both in absolute and relative terms (odds ratio, -0.21; 95% confidence interval, -0.37 to -0.05 and odds ratio, -4.62; 95% confidence interval, -6.17 to -3.06; P < .01, respectively). We did not observe any severe complications secondary to the intravenous fluid therapy. The ECV success rate was 43% in the study group compared to 47% in the control group (P = .67). The success rate was significantly lower the larger the relative increase in the AFI, although no correlation was found in absolute terms (χ(2) for linear trend = 0.03 and 0.34, respectively). Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to ECV is an effective and safe technique for increasing the AFI. However, its use in ECV does not increase the success rate of the procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study.

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Vizzini, L; Popovic, M; Zugna, D; Vitiello, B; Trevisan, M; Pizzi, C; Rusconi, F; Gagliardi, L; Merletti, F; Richiardi, L

2018-04-18

Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother-child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms. The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente') cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive-impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy. The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3-27.9%), sleep disorders (35.7%; 95% CI 10.7-66.5%) and depression (17.5%; 95% CI 3.2-33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period. Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

Maternal thyroid function, prepregnancy obesity and gestational weight gain-The Generation R Study: A prospective cohort study.

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Collares, Fernanda M; Korevaar, Tim I M; Hofman, Albert; Steegers, Eric A P; Peeters, Robin P; Jaddoe, Vincent W V; Gaillard, Romy

2017-12-01

Maternal prepregnancy obesity and excessive gestational weight gain are associated with pregnancy complications. Thyroid function is related to differences in body mass index (BMI) in adult populations. We examined the associations of maternal thyroid function in early pregnancy with maternal BMI and weight gain during pregnancy. In a population-based prospective cohort study among 5726 mothers, we measured maternal TSH and FT4 levels at 13.5 weeks of gestation (95% range: 9.7-17.6 weeks). Maternal weight was assessed before pregnancy and in each trimester. Higher maternal TSH levels were associated with higher prepregnancy BMI (difference: 0.18 kg/m 2 [95% CI: 0.01, 0.36] per SD increase in maternal TSH level) and higher total gestational weight gain (difference: 0.02 kg/wk [95% CI: 0.01, 0.03] per SD increase in maternal TSH level). Higher maternal FT4 levels were associated with lower prepregnancy BMI (difference: -0.44 kg/m 2 [95% CI: -0.63, -0.26] per SD increase in maternal FT4 level) and lower total gestational weight gain (difference: -0.01 kg/wk [95% CI: -0.02, -0.01] per SD increase in maternal FT4 level). The associations of maternal thyroid function with weight gain in early pregnancy were stronger than those with weight gain in mid and late-pregnancy. Maternal hypothyroidism was associated with higher prepregnancy BMI and early pregnancy weight gain, whereas opposite effects were observed for maternal hyperthyroidism (Pgain. Further studies are needed to explore maternal and foetal consequences. © 2017 John Wiley & Sons Ltd.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

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van der Donk Riet W

2011-01-01

Full Text Available Abstract Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%, 41/48 (85% in multipara and 36/93 (39% in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555

Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts

NARCIS (Netherlands)

Casas, Maribel; Cordier, Sylvaine; Martínez, David; Barros, Henrique; Bonde, Jens Peter; Burdorf, Alex; Costet, Nathalie; dos Santos, Ana Cristina; Danileviciute, Asta; Eggesbø, Merete; Fernandez, Mariana; Fevotte, Joelle; García, Ana M.; Gražuleviciene, Regina; Hallner, Eva; Hanke, Wojciech; Kogevinas, Manolis; Kull, Inger; Stemann Larsen, Pernille; Melaki, Vasiliki; Monfort, Christine; Nordby, Karl-Christian; Nybo Andersen, Anne-Marie; Patelarou, Evridiki; Polanska, Kinga; Richiardi, Lorenzo; Santa Marina, Loreto; Snijder, Claudia; Tardón, Adonina; van Eijsden, Manon; Vrijkotte, Tanja G. M.; Zugna, Daniela; Nieuwenhuijsen, Mark; Vrijheid, Martine

2015-01-01

We assessed whether maternal employment during pregnancy - overall and in selected occupational sectors - is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. We used data

Fetal organ dosimetry for the Techa River and Ozyorsk Offspring Cohorts. Pt. 2. Radionuclide S values for fetal self-dose and maternal cross-dose

International Nuclear Information System (INIS)

Maynard, Matthew R.; Bolch, Wesley E.; Shagina, Natalia B.; Tolstykh, Evgenia I.; Degteva, Marina O.; Fell, Tim P.

2015-01-01

One of the many objectives of the European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project is to quantify the radiation dose-response following chronic in utero exposures to ionizing radiation. The project is presently conducting a pooled analysis of two cohorts of individuals born to exposed mothers - the Techa River Offspring Cohort (TROC) and the Ozyorsk Offspring Cohort (OOC). The TROC includes the offspring of mothers with external exposures to contaminated riverbanks and internal ingestions of 89 Sr, 90 Sr/ 90 Y, and 137 Cs/ 137m Ba, while the OOC includes the offspring of mothers with external exposures seen within the Mayak plutonium production facilities and internal inhalation of 239 Pu and possibly 131 I. In the present study, a newly created Urals-based series of fetal and maternal models is employed to assess S values for all seven radionuclides. Among all fetal ages, S values ranged in magnitude from 10 -14 to 10 -10 Gy per Bq-s for fetal source organs and from 10 -18 to 10 -14 Gy per Bq-s from maternal source organs, depending upon particle type, particle energy, and fetal age. For a given radionuclide and fetal age, S values for fetal source organs were approximately two orders of magnitude higher than for maternal source organs. Little variation in S values was observed among fetal source organs, while variations of over 100 % with respect to the mean were observed for maternal source organs near the fetus. S value variations from maternal cross-fire were highly dependent on fetal position and separation distance from the maternal source organ. These radionuclide S values have been coupled with biokinetic models for use in cohort dose assessment within the SOLO project. (orig.)

Effects of Antenatal Maternal Depression and Anxiety on Children’s Early Cognitive Development: A Prospective Cohort Study

Science.gov (United States)

Ibanez, Gladys; Bernard, Jonathan Y.; Rondet, Claire; Peyre, Hugo; Forhan, Anne; Kaminski, Monique; Saurel-Cubizolles, Marie-Josèphe

2015-01-01

Introduction Studies have shown that depression or anxiety occur in 10–20% of pregnant women. These disorders are often undertreated and may affect mothers and children’s health. This study investigates the relation between antenatal maternal depression, anxiety and children’s early cognitive development among 1380 two-year-old children and 1227 three-year-old children. Methods In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development. Results We found strong significant associations between maternal antenatal anxiety and poorer children’s cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children’s cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%. Discussion The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed. PMID:26317609

Maternal and paternal age at delivery, birth order, and risk of childhood onset type 1 diabetes: population based cohort study

Science.gov (United States)

Stene, Lars C; Magnus, Per; Lie, Rolv T; Søvik, Oddmund; Joner, Geir

2001-01-01

Objective To estimate the associations of maternal and paternal age at delivery and of birth order with the risk of childhood onset type 1 diabetes. Design Cohort study by record linkage of the medical birth registry and the national childhood diabetes registry in Norway. Setting Norway. Subjects All live births in Norway between 1974 and 1998 (1.4 million people) were followed for a maximum of 15 years, contributing 8.2 million person years of observation during 1989-98. 1824 cases of type 1 diabetes diagnosed between 1989 and 1998 were identified. Main outcome measures Incidence of type 1 diabetes. Results There was no association between maternal age at delivery and type 1 diabetes among firstborn children, but among fourthborn children there was a 43.2% increase in incidence of diabetes for each five year increase in maternal age (95% confidence interval 6.4% to 92.6%). Each increase in birth order was associated with a 17.9% reduction in incidence (3.2% to 30.4%) when maternal age was 20-24 years, but the association was weaker when maternal age was 30 years or more. Paternal age was not associated with type 1 diabetes after maternal age was adjusted for. Conclusions Intrauterine factors and early life environment may influence the risk of type 1 diabetes. The relation of maternal age and birth order to risk of type 1 diabetes is complex. What is already known on this topicMaternal age at birth is positively associated with risk of childhood onset type 1 diabetesStudies of the effect of birth order on risk of type 1 diabetes have given inconsistent resultsWhat does this study add?In a national cohort, risk of diabetes in firstborn children was not associated with maternal ageIncreasing maternal age was a risk factor in children born second or laterThe strength of the association increased with increasing birth order PMID:11509426

Delivery outcomes for nulliparous women at the extremes of maternal age - a cohort study.

LENUS (Irish Health Repository)

Vaughan, DA

2013-06-12

OBJECTIVE: To examine the associations between extremes of maternal age (≤17 years or ≥40 years) and delivery outcomes. DESIGN: Retrospective cohort study. SETTING: Urban maternity hospital in Ireland. POPULATION: A total of 36 916 nulliparous women with singleton pregnancies who delivered between 2000 and 2011. METHODS: The study population was subdivided into five maternal age groups based on age at first booking visit: ≤17 years, 18-19 years, 20-34 years, 35-39 years and women aged ≥40 years. Logistic regression analyses were performed to examine the associations between extremes of maternal age and delivery outcomes, adjusting for potential confounding factors. MAIN OUTCOME MEASURES: Preterm birth, admission to the neonatal unit, congenital anomaly, caesarean section. RESULTS: Compared with maternal age 20-34 years, age ≤17 years was a risk factor for preterm birth (adjusted odds ratio [adjOR] 1.83, 95% confidence interval [95% CI] 1.33-2.52). Babies born to mothers ≥40 years were more likely to require admission to the neonatal unit (adjOR 1.35, 95% CI 1.06-1.72) and to have a congenital anomaly (adjOR 1.71, 95% CI 1.07-2.76). The overall caesarean section rate in nulliparous women was 23.9% with marked differences at the extremes of maternal age; 10.7% at age ≤17 years (adjOR 0.46, 95% CI 0.34-0.62) and 54.4% at age ≥40 years (adjOR 3.24, 95% CI 2.67-3.94). CONCLUSIONS: Extremes of maternal age need to be recognised as risk factors for adverse delivery outcomes. Low caesarean section rates in younger women suggest that a reduction in overall caesarean section rates may be possible.

Maternal use of fertility drugs and risk of cancer in children--a nationwide population-based cohort study in Denmark.

Science.gov (United States)

Hargreave, Marie; Jensen, Allan; Nielsen, Thor Schütt Svane; Colov, Emilie Palmgren; Andersen, Klaus Kaae; Pinborg, Anja; Kjaer, Susanne Krüger

2015-04-15

Large population-based studies are needed to examine the effect of maternal use of fertility drugs on the risk of cancer in children, while taking into account the effect of the underlying infertility. A cohort of 123,322 children born in Denmark between 1964 and 2006 to 68,255 women who had been evaluated for infertility was established. We used a case-cohort design and calculated hazard ratios (HRs) for cancer in childhood (0-19 years) and in young adulthood (20-29 years) associated with maternal use of six groups of fertility drugs (clomiphene, gonadotropins [i.e., human menopausal gonadotropins and follicle-stimulating hormone], gonadotropin-releasing hormone analogs, human chorionic gonadotropins, progesterone and other fertility drugs). We found no statistically significant association between maternal use of fertility drugs and risk for overall cancer in childhood or young adulthood. However, with regard to specific cancers in childhood, our results showed that maternal use of progesterone before childbirth markedly increased the risks of their offspring for acute lymphocytic leukemia (any use: HR, 4.95; 95% CI, 1.69-14.54; ≥ three cycles of use: HR, 9.96; 95% CI, 2.63-37.77) and for sympathetic nervous system tumors (any use: HR, 5.79; 95% CI, 1.23-27.24; ≥ three cycles of use: HR, 8.51; 95% CI, 1.72-42.19). These findings show that maternal use of progesterone may increase the risk for specific cancers in the offspring. Additional large epidemiological studies are urgently needed to confirm our finding. © 2014 UICC.

Maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia: a population cohort record linkage study.

Science.gov (United States)

Hafekost, Katherine; Lawrence, David; O'Leary, Colleen; Bower, Carol; Semmens, James; Zubrick, Stephen R

2017-07-11

Examine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia. Population cohort study. Routinely collected linked administrative health, education and child protection data. Those in-scope for the study were women with a birth recorded on the Western Australian Midwives Notification System (1989-2007). Women who had an alcohol-related diagnosis (International Classification of Diseases Revisions 9/10) recorded on the Hospital Morbidity, Mental Health Inpatients and Outpatients, and Drug and Alcohol Office data sets formed the exposed group. The comparison cohort was frequency-matched to the exposed cohort based on maternal age within Indigenous status and child's year of birth. Child's school attendance was obtained from the Department of Education (2008-2012). Poor attendance was defined as alcohol use disorder was significantly associated with increased odds of poor attendance (non-Indigenous: OR=1.61, 95% CI 1.50 to 1.74; Indigenous: OR=1.66, 95% CI 1.54 to 1.79). With adjustment for maternal and child factors, there was no significant difference between the timing of alcohol diagnosis relative to pregnancy and attendance outcomes. The population attributable fraction was higher in the Indigenous cohort than the non-Indigenous cohort (6.0% vs 1.3%). Maternal alcohol use disorder was associated with a significantly increased odds of poor school attendance for non-Indigenous and Indigenous children. There was no significant difference between the timing of diagnoses and odds of poor school attendance. This suggests that the effect of maternal alcohol use disorder may not be driven by the neurodevelopmental effects of alcohol exposure in utero, but may be mediated through family or social factors for which we were unable to adjust. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

Maternal Hb during pregnancy and offspring's educational achievement: a prospective cohort study over 30 years.

Science.gov (United States)

Fararouei, Mohammad; Robertson, Claire; Whittaker, John; Sovio, Ulla; Ruokonen, Aimo; Pouta, Anneli; Hartikainen, Anna-Liisa; Jarvelin, Marjo-Riitta; Hyppönen, Elina

2010-11-01

The aim of the present study was to examine the association between maternal Hb levels during pregnancy and educational achievement of the offspring in later life. We analysed data obtained from the Northern Finnish Birth Cohort Study conducted in 1966, in which, data on mothers and offspring from pregnancy through to the age of 31 years were collected. The cohort comprised 11 656 individuals born from singleton births (51 % males and 49 % females). Maternal Hb levels were available from the third, seventh and ninth gestational months. Educational achievement was measured as school scores (range 4-10) taken at the ages of 14 (self-reported questionnaires) and 16 (school reports) years as well as the highest level of education at the age of 31 years. The present results showed a direct positive association between Hb levels and educational achievement in later life. After adjustment for sex, birth weight, birth month and a wide range of maternal factors (parity, smoking, mental status, whether pregnancy was wanted or not, education, social class and marital status), only maternal Hb levels that were measured at the ninth month were significantly associated with the offspring's school performance. If the levels were ≥ 110 g/l at all the three measurement points, offspring not only had better school scores at the ages of 14 and 16 years (β = 0·048, P = 0·04 and β = 0·68, P = 0·007, respectively), but also had an increased odds of having a higher level of education at the age of 31 years (OR = 1·14, P = 0·04). The present study suggests that low maternal Hb levels at the final stages of pregnancy are linked to the poorer educational achievement of the offspring. If our observation is confirmed, it would suggest that Fe prophylaxis even at fairly late stages of pregnancy may be beneficial for the subsequent health of the offspring. However, more studies are needed to fully establish the potential pathways and the clinical importance of the

Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil

Directory of Open Access Journals (Sweden)

Hallal Pedro C

2010-07-01

Full Text Available Abstract Background We investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP and diastolic (DBP blood pressure at 11 years of age, in a prospective cohort study. Methods All hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births. In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents. Results Independent variables analyzed included maternal prepregnancy weight and body mass index (BMI and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3 and 63.4 mmHg (SD 9.9, respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males. Conclusions Adequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children.

Postpartum maternal separation anxiety, overprotective parenting, and children's social-emotional well-being: longitudinal evidence from an Australian cohort.

Science.gov (United States)

Cooklin, Amanda R; Giallo, Rebecca; D'Esposito, Fabrizio; Crawford, Sharinne; Nicholson, Jan M

2013-08-01

Postpartum maternal separation anxiety refers to a mothers' experience of worry and concern about leaving her child for short-term separations. The long-term effects of high maternal separation anxiety on maternal parenting behaviors and child outcomes have been not been established empirically. The aim of this study was to ascertain the prospective relationships between maternal separation anxiety during the child's first year of life, and overprotective parenting and children's social and emotional functioning at age 2-3 years. Structural equation modeling with a large representative cohort of Australian mother-child dyads (N = 3,103) indicated that high maternal separation anxiety was associated with more overprotective parenting behaviors and poorer child socioemotional functioning at age 2-3 years. Findings suggest women with high postpartum maternal separation anxiety may sustain this vigilance across the first years following birth, promoting overprotective behaviors, and resulting in increased behavior problems in their children. Support for women around negotiating separation from their children early in parenthood may prevent the establishment of a repertoire of parenting behaviors that includes unnecessarily high vigilance, monitoring, and anxiety about separation. © 2013 American Psychological Association

Associations of maternal o,p'-DDT and p,p'-DDE levels with birth outcomes in a Bolivian cohort

DEFF Research Database (Denmark)

Arrebola, Juan P.; Cuellar, Miriam; Bonde, Jens Peter

2016-01-01

This study examined the potential association of maternal serum levels of o,p'-DDT and p,p'-DDE with gestation time and with anthropometric measurements and thyroid-stimulating hormone (TSH) levels of newborns in a Bolivian birth cohort. Two hundred mothers were consecutively recruited between Ja...

Maternal Iodine Intake and Offspring Attention-Deficit/Hyperactivity Disorder: Results from a Large Prospective Cohort Study

Science.gov (United States)

Abel, Marianne Hope; Aase, Heidi; Reichborn-Kjennerud, Ted

2017-01-01

Current knowledge about the relationship between mild to moderately inadequate maternal iodine intake and/or supplemental iodine on child neurodevelopment is sparse. Using information from 77,164 mother-child pairs in the Norwegian Mother and Child Cohort Study, this study explored associations between maternal iodine intake and child attention-deficit/hyperactivity disorder (ADHD) diagnosis, registered in the Norwegian Patient Registry and maternally-reported child ADHD symptoms at eight years of age. Pregnant women reported food and supplement intakes by questionnaire in gestational week 22. In total, 1725 children (2.2%) were diagnosed with ADHD. In non-users of supplemental iodine (53,360 mothers), we found no association between iodine intake from food and risk of child ADHD diagnosis (p = 0.89), while low iodine from food (<200 µg/day) was associated with higher child ADHD symptom scores (adjusted difference in score up to 0.08 standard deviation (SD), p < 0.001, n = 19,086). In the total sample, we found no evidence of beneficial effects of maternal use of iodine-containing supplements (n = 23,804) on child ADHD diagnosis or symptom score. Initiation of iodine supplement use in gestational weeks 0–12 was associated with an increased risk of child ADHD (both measures). In conclusion, insufficient maternal iodine intake was associated with increased child ADHD symptom scores at eight years of age, but not with ADHD diagnosis. No reduction of risk was associated with maternal iodine supplement use. PMID:29137191

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study

Science.gov (United States)

2011-01-01

Background To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Methods Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. Results ECV success rate was 77/141 (55%), 41/48 (85%) in multipara and 36/93 (39%) in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p breech (OR: 0.30, 95% CI: 0.10-0.93) and placenta anterior (OR: 0.31, 95% CI: 0.11-0.85) were independently related to ECV success. Conclusions Higher TSH levels increase the risk of ECV failure. Trial registration number ClinicalTrials.gov: NCT00516555 PMID:21269431

Patterns of the Demographics, Clinical Characteristics, and Resource Utilization Among Maternal Decedents in Texas, 2001 - 2010: A Population-Based Cohort Study.

Science.gov (United States)

Oud, Lavi

2015-12-01

Contemporary reporting of maternal mortality is focused on single, mutually exclusive causes of death among a minority of maternal decedents (pregnancy-related deaths), reflecting initial events leading to death. Although obstetric patients are susceptible to the lethal effects of downstream, more proximate contributors to death and to conditions not caused or precipitated by pregnancy, the burden of both categories and related patients' attributes is invisible to clinicians and healthcare policy makers with the current reporting system. Thus, the population-level demographics, clinical characteristics, and resource utilization associated with pregnancy-associated deaths in the United States have not been adequately characterized. We used the Texas Inpatient Public Use Data File to perform a population-based cohort study of the patterns of demographics, chronic comorbidity, occurrence of early maternal demise, potential contributors to maternal death, and resource utilization among maternal decedents in the state during 2001 - 2010. There were 557 maternal decedents during study period. Chronic comorbidity was reported in 45.2%. Most women (74.1%) were admitted to an ICU. Hemorrhage (27.8%), sepsis (23.5%), and cardiovascular conditions (22.6%) were the most commonly reported potential contributing conditions to maternal death, varying across categories of pregnancy-associated hospitalizations. More than one condition was reported in 39% of decedents. One in three women died during their first day of hospitalization, with no significant change over the past decade. The mean hospital length of stay was 7.9 days and total hospital charges were $250,000 or higher in 65 (11.7%) women. The findings of the high burden of chronic illness, patterns of occurrence of a broad array of potential contributing conditions to pregnancy-associated death, and the resource-intensive needs of a large contemporary population-based cohort of maternal decedents may better inform

Maternal systemic or cord blood inflammation is associated with birth anthropometry in a Tanzanian prospective cohort.

Science.gov (United States)

Wilkinson, A L; Pedersen, S H; Urassa, M; Michael, D; Andreasen, A; Todd, J; Kinung'hi, S M; Changalucha, J; McDermid, J M

2017-01-01

HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for foetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort. A 9-plex panel of maternal plasma cytokines in HIV-positive (n = 44) and HIV-negative (n = 70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed. Linear regression modelled associations between maternal or cord blood cytokines and birth anthropometry. Health indicators (haemoglobin, mid-upper-arm circumference, body mass index) in HIV-positive mothers without considerable immunosuppression did not differ from HIV-negative women. Despite this, HIV-exposed infants had lower birthweight and length. Subgroup analyses indicated that HIV management using HAART was associated with lower plasma TNF-α, as were longer durations of any antiretroviral therapy (≥2 months). Greater maternal plasma TNF-α was associated with earlier delivery (-1.7 weeks, P = 0.039) and lower birthweights (-287 g; P = 0.020), while greater umbilical cord TNF-α (-1.43 cm; P = 0.036) and IL-12p70 (-2.4 cm; P = 0.008) were associated with shorter birth length. Birthweight was inversely associated with cord IL-12p70 (-723 g; P = 0.001) and IFN-γ (-482 g, P = 0.007). Maternal cytokines during pregnancy did not correlate with umbilical cord cytokines at delivery. Systemic inflammation identified in maternal plasma or umbilical cord blood was associated with poorer birth anthropometrics in HIV-exposed and HIV-unexposed infants. Controlling maternal and/or foetal systemic inflammation may improve birth anthropometry. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Examining Non-Participation to the Maternal Follow-up Within the Danish National Birth Cohort

DEFF Research Database (Denmark)

Bliddal, Mette; Liew, Zeyan; Pottegård, Anton

2018-01-01

A follow-up questionnaire on maternal health has been distributed within the Danish National Birth Cohort (established 1996-2002) 14 years after the index birth. Answers were obtained for 41,466 of 78,010 (53.2%) eligible mothers. To ensure the appropriate use of these data, the possibility...... of selection bias due to non-participation must be evaluated. We estimated four selected exposure-outcome associations (pre-pregnancy weight - depression; exercise - degenerative musculoskeletal conditions; smoking - heart disease; and alcohol consumption - breast cancer). We adjusted for several factors...

Association between maternal diet quality and offspring diet quality assessed at age 14 years: longitudinal study in a large contemporary cohort

DEFF Research Database (Denmark)

Bjerregaard, Anne Ahrendt; Halldorsson, Thorhallur I.; Tetens, Inge

2017-01-01

-pregnancy BMI, level of education, and maternal smoking. Interpretation  This is the first study, to our knowledge, to examine associations between maternal dietary habits during pregnancy and offspring dietary habits during adolescent years in a large contemporary cohort. Diet quality during pregnancy......Background  Emerging evidence suggests that exposures in fetal life may have an impact many years later on the individual's susceptibility to diseases. Study of diet–disease associations over long time-spans is a major methodological challenge. We examined whether overall diet quality during...... pregnancy was associated with adolescent diet quality 15 years later in a prospective cohort representing a typical high-income population. Methods  Dietary intake assessed with a 360-item food frequency questionnaire during mid-pregnancy (1996–2003) was matched with offspring dietary intake assessed...

Effects of child long-term illness on maternal employment: longitudinal findings from the UK Millennium Cohort Study

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Pearce, Anna; Whitehead, Margaret; Law, Catherine

2017-01-01

Background: Maternal employment has increased in European countries, but levels of employment are lower among mothers whose children have a limiting long-term illness or disability. However, we do not know whether having a child with a limiting illness prevents take-up or maintenance of paid employment or whether ‘common causes’, such as lack of qualifications or maternal disability lead to both maternal unemployment and childhood illness. Longitudinal data have the potential to distinguish between these. Methods: We analyzed four waves (3, 5, 7 and 11 years) of the Millennium Cohort Study (MCS) to examine the relationship between childhood limiting illness and maternal employment, unadjusted and adjusted for covariates. Multinomial regression models were used to test the association between child illness and trajectories of maternal employment. Fixed effects models assessed whether a new report of a child illness increased the odds of a mother exiting employment. Results: At every wave, maternal employment was more likely if the child did not have a limiting illness. After adjustment for covariates, childhood illness was associated with risks of continuous non-employment (adjusted Relative Risk Ratio = 1.46 [Confidence Interval: 1.21, 1.76]) or disrupted employment (aRRR = 1.26 [CI: 1.06, 1.49]), compared with entering or maintaining employment. If a child developed a limiting long-term illness, the likelihood of their mother exiting employment increased (adjusted Odds Ratio = 1.27 [CI: 1.05, 1.54]). Conclusions: ‘Common causes’ did not fully account for the association between child illness and maternal employment. Having a child with a limiting illness potentially reduces maternal employment opportunities. PMID:28177497

Polybrominated diphenyl ethers in paired samples of maternal and umbilical cord blood plasma and associations with house dust in a Danish cohort

DEFF Research Database (Denmark)

Frederiksen, Marie; Thomsen, Cathrine; Frøshaug, May

2010-01-01

determined in placental tissue from the same individuals, and the relationship with the external exposure from house dust from the participants' homes was explored. Samples of maternal and umbilical cord plasma from a cohort of 51 pregnant women from the Copenhagen area were collected. Paired maternal...... and umbilical cord plasma were analysed for BDE-28, 37, 47, 85, 99, 100, 119, 138, 153, 154, 183, 209 and the brominated biphenyl BB-153 using automated SPE extraction and GC-HRMS for the tri- to hepta-BDEs and GC-LRMS (ECNI) for BDE-209. PBDEs were detected in all maternal and umbilical cord plasma samples...

Maternal depression and child development: Evidence from São Paulo's Western Region Cohort Study.

Science.gov (United States)

Brentani, Alexandra; Fink, Günther

2016-09-01

While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children's early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children's development at age one using data from the São Paulo Western Region Cohort project. Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré' region of São Paulo were assessed through a home visit between January and March 2015. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers were classified as "possibly depressed" if their EPDS score was between 10 and 13 and as "likely depressed" if their EPDS score was > 13. The child outcomes analyzed were height, weight, and overall development as assessed by the Ages and Stages Questionnaire (ASQ). Height and weight were age-normalized using WHO growth standards. Stunting was defined as height-for-age z-score (HAZ) Obesity was defined as body mass index z-score (BMIZ) > 2. Adjusted and unadjusted linear regression models were used to assess the associations between Edinburgh scores and child outcomes. No association was found between maternal depression variables and children's height, weight, stunting, and obesity. Positive associations were found between possible depression and ASQ (delta = 0.33; 95CI 0.11-0.54; p-valuedepression and any of the outcomes analyzed. The results from this study suggest that symptoms of maternal depression are not associated with delays in child development in the study setting analyzed. Further research will be needed to understand this lack of association: while it is possible that caregivers' mental health did not affect caregiving behavior, it is possible that the effect of maternal depression can vary according to timing, persistence, and intensity. It is also possible that the EPDS instrument may fail to identify mothers with clinical depression, or

Development and validation of the Family Motivational Climate Questionnaire (FMC-Q).

Science.gov (United States)

Alonso Tapia, Jesús; Simón Rueda, Cecilia; Asensio Fuentes, César

2013-01-01

The goal of this study was to develop and validate the Family Motivational Climate Questionnaire (FMCQ). Parental involvement (PI) affects children's academic orientations. However, PI questionnaires had not considered parenting behaviours from the perspective of motivational theories. It was therefore decided to develop the FMCQ. 570 Secondary-School students formed the sample. To validate the FMCQ, confirmatory factor analyses, reliability analysis and correlation and regression analyses were conducted. Children's attribution to parents of perceived change in motivational variables affecting achievement, were used as external criteria. Results support most of the hypotheses either related to the FMCQ structure or to its moderating role as predictor of school achievement and of attribution to parents of changes in different motivational variables --interest, effort, perceived ability, success expectancies, resilience, and satisfaction. The results underline the importance of acting on FMC-components in order to improve Children's motivation and achievement.

The effect of a transition into poverty on child and maternal mental health: a longitudinal analysis of the UK Millennium Cohort Study.

Science.gov (United States)

Wickham, Sophie; Whitehead, Margaret; Taylor-Robinson, David; Barr, Ben

2017-03-01

Whether or not relative measures of income poverty effectively reflect children's life chances has been the focus of policy debates in the UK. Although poverty is associated with poor child and maternal mental health, few studies have assessed the effect of moving into poverty on mental health. To inform policy, we explore the association between transitions into poverty and subsequent mental health among children and their mothers. In this longtitudinal analysis, we used data from the UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK between Sept 1, 2000, and Jan 11, 2002, who participated in five survey waves as they progressed from 9 months of age to 11 years of age. Our analysis included all children and mothers who were free from mental health problems and not in poverty when the children were aged 3 years. We only included singletons (ie, not twins or other multiple pregnancies) and children for whom the mother was the main respondent to the study. The main outcomes were child socioemotional behavioural problems (Strengths and Difficulties Questionnaire) at ages 5 years, 7 years, and 11 years and maternal psychological distress (Kessler 6 scale). Using discrete time-hazard models, we followed up families without mental health problems at baseline and estimated odds ratios for subsequent onset of maternal and child mental health problems associated with first transition into poverty, while adjusting for confounders, including employment transitions. We further assessed whether or not change in maternal mental health explained any effect on child mental health. Of the 6063 families in the UK Millennium Cohort study at 3 years who met our inclusion criteria, 844 (14%) had a new transition into poverty compared with 5219 (86%) who remained out of poverty. After adjustment for confounders, transition into poverty increased the odds of socioemotional behavioural problems in children (odds ratio 1·41 [95% CI 1·02-1·93

Mutation risk associated with paternal and maternal age in a cohort of retinoblastoma survivors.

Science.gov (United States)

Mills, Melissa B; Hudgins, Louanne; Balise, Raymond R; Abramson, David H; Kleinerman, Ruth A

2012-07-01

Autosomal dominant conditions are known to be associated with advanced paternal age, and it has been suggested that retinoblastoma (Rb) also exhibits a paternal age effect due to the paternal origin of most new germline RB1 mutations. To further our understanding of the association of parental age and risk of de novo germline RB1 mutations, we evaluated the effect of parental age in a cohort of Rb survivors in the United States. A cohort of 262 Rb patients was retrospectively identified at one institution, and telephone interviews were conducted with parents of 160 survivors (65.3%). We classified Rb survivors into three groups: those with unilateral Rb were classified as sporadic if they had no or unknown family history of Rb, those with bilateral Rb were classified as having a de novo germline mutation if they had no or unknown family history of Rb, and those with unilateral or bilateral Rb, who had a family history of Rb, were classified as familial. We built two sets of nested logistic regression models to detect an increased odds of the de novo germline mutation classification related to older parental age compared to sporadic and familial Rb classifications. The modeling strategy evaluated effects of continuous increasing maternal and paternal age and 5-year age increases adjusted for the age of the other parent. Mean maternal ages for survivors classified as having de novo germline mutations and sporadic Rb were similar (28.3 and 28.5, respectively) as were mean paternal ages (31.9 and 31.2, respectively), and all were significantly higher than the weighted general US population means. In contrast, maternal and paternal ages for familial Rb did not differ significantly from the weighted US general population means. Although we noted no significant differences between mean maternal and paternal ages between each of the three Rb classification groups, we found increased odds of a survivor being in the de novo germline mutation group for each 5-year increase in

Effect of maternal gestational weight gain on offspring DNA methylation: a follow-up to the ALSPAC cohort study.

Science.gov (United States)

Bohlin, Jon; Andreassen, Bettina K; Joubert, Bonnie R; Magnus, Maria C; Wu, Michael C; Parr, Christine L; Håberg, Siri E; Magnus, Per; Reese, Sarah E; Stoltenberg, Camilla; London, Stephanie J; Nystad, Wenche

2015-07-29

Several epidemiologic studies indicate that maternal gestational weight gain (GWG) influences health outcomes in offspring. Any underlying mechanisms have, however, not been established. A recent study of 88 children based on the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort examined the methylation levels at 1,505 Cytosine-Guanine methylation (CpG) loci and found several to be significantly associated with maternal weight gain between weeks 0 and 18 of gestation. Since these results could not be replicated we wanted to examine associations between 0 and 18 week GWG and genome-wide methylation levels using the Infinium HumanMethylation450 BeadChip (450K) platform on a larger sample size, i.e. 729 newborns sampled from the Norwegian Mother and Child Cohort Study (MoBa). We found no CpG loci associated with 0-18 week GWG after adjusting for the set of covariates used in the ALSPAC study (i.e. child's sex and maternal age) and for multiple testing (q > 0.9, both 1,505 and 473,731 tests). Hence, none of the CpG loci linked with the genes found significantly associated with 0-18 week GWG in the ALSPAC study were significant in our study. The inconsistency in the results with the ALSPAC study with regards to the 0-18 week GWG model may arise for several reasons: sampling from different populations, dissimilar methylome coverage, sample size and/or false positive findings.

Maternal weight gain and associations with longitudinal fetal growth in dichorionic twin pregnancies: a prospective cohort study.

Science.gov (United States)

Hinkle, Stefanie N; Hediger, Mary L; Kim, Sungduk; Albert, Paul S; Grobman, William; Newman, Roger B; Wing, Deborah A; Grewal, Jagteshwar; Zhang, Cuilin; Buck Louis, Germaine M; Grantz, Katherine L

2017-12-01

Background: Maternal metabolic demands are much greater with twin gestations; however, there are no accepted recommendations for maternal weight gain in twin pregnancies. Objective: We assessed the association of maternal weight gain and fetal growth in dichorionic twins throughout pregnancy. Design: This was a prospective US cohort study ( n = 143, 2012-2013) of dichorionic twin pregnancies with known birth outcomes followed from enrollment (11-13 wk) and for ≤6 research visits throughout gestation. Maternal prepregnancy weight was self-reported, and current weight was measured at each research visit and abstracted from prenatal records. Fetal biometry was assessed by ultrasound at each research visit. Maternal weight and twin-pair fetal size trajectories across gestation were modeled. The adjusted associations between maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk and fetal growth at the subsequent week (i.e., 14, 21, 28, and 35 wk, respectively) were estimated with the use of linear regression. Results: The mean ± SD maternal weight gain from 0 to 13, 14 to 20, 21 to 27, and 28 to 34 wk was 2.8 ± 3.0 kg, 3.9 ± 1.2 kg, 3.8 ± 1.4 kg, and 4.4 ± 2.2 kg, respectively, with a total gain of 17.7 ± 7.4 kg. Maternal weight gain from 0 to 13 wk (first trimester) was not associated with fetal size at 14 wk. Maternal weight gain from 14 to 20 and 21 to 27 wk (second trimester) was significantly associated with increased fetal weight at 21 wk [increase of 10.5 g/kg maternal weight gain (95% CI: 1.2, 19.8 g)] and 28 wk [increase of 21.3 g/kg maternal weight gain (95% CI: 0.6, 42.0 g)]. Maternal weight gain from 14 to 20 wk was associated with increased twin abdominal circumference (AC) and biparietal diameter at 21 wk. Maternal weight gain from 21 to 27 wk was associated with increased femur and humerus lengths at 28 wk. Conclusion: Maternal weight gain was associated with dichorionic twin fetal growth in the second trimester only, driven by an

Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study

NARCIS (Netherlands)

de Jonge, J.; Mesman, J.A.J.M.; Manniën, J.; Zwart, J.J.; van Dillen, J.; van Roosmalen, J.

2013-01-01

Objectives: To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Design: Cohort study

Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring: A Cohort Study.

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Katja Glejsted Ingstrup

Full Text Available Maternal emotional stress during pregnancy has previously been associated with congenital neural malformations, but most studies are based on data collected retrospectively. The objective of our study was to investigate associations between antenatal maternal bereavement due to death of a close relative and neural tube defects (NTDs in the offspring.We performed a register-based cohort study including all live-born children (N = 1,734,190 from 1978-2008. Exposure was bereavement due to loss of a close relative from one year before conception to the end of the first trimester of pregnancy. The outcome was NTDs in the offspring according to the International Classification of Disease. We used multivariate logistic regression to estimate prevalence odds ratios (ORs.A total of 2% children were born to mothers who lost a close relative prenatally. During 30 years of follow-up, 1,115 children were diagnosed with any NTDs: spina bifida (n = 889, anencephaly (n = 85 and encephalocele (n = 164. And 23 children were diagnosed with two types of NTDs. Overall, when comparing bereaved mothers to non-bereaved mothers, no significant increased prevalence of NTDs in the offspring was seen (OR = 0.84; 95% confidence interval: 0.52-1.33.Overall maternal bereavement in the antenatal period was not related to NTDs in liveborn offspring.

Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The Infancia y Medio Ambiente Cohort, Spain.

Science.gov (United States)

León, Gemma; Murcia, Mario; Rebagliato, Marisa; Álvarez-Pedrerol, Mar; Castilla, Ane M; Basterrechea, Mikel; Iñiguez, Carmen; Fernández-Somoano, Ana; Blarduni, Elizabeth; Foradada, Carles M; Tardón, Adonina; Vioque, Jesús

2015-03-01

Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of mild thyroid dysfunctions are not yet well established. The aim was to evaluate the association of maternal thyroid function during the first half of pregnancy with birthweight and preterm delivery. We analysed data on 2170 pregnant women and their children from a prospective population-based cohort study in four Spanish areas. Mid-gestation maternal serum and urine samples were gathered to determine thyroid-stimulating hormone (TSH), free thyroxine (fT4 ), and urinary iodine concentration (UIC). Thyroid status was defined according to percentile distribution as: euthyroid (TSH and fT4 >5th and 95th percentile and fT4 normal or 95 th percentile and TSH normal), and hyperthyroidism (TSH 95th percentile). Response variables were birthweight, small and large for gestational age (SGA/LGA), and preterm delivery. An inverse association of fT4 and TSH with birthweight was found, the former remaining when restricted to euthyroid women. High fT4 levels were also associated with an increased risk of SGA [odds ratio, 95% confidence interval (CI) 1.28 (95% CI 1.08, 1.51)]. Mean birthweight was higher in the hypothyroxinaemic group (β = 109, P < 0.01). Iodine intake and UIC were not associated with birth outcomes. High maternal fT4 levels during the first half of pregnancy were related to lower birthweight and increased risk of SGA newborns, suggesting that maternal thyroid function may affect fetal growth, even within the normal range. © 2015 John Wiley & Sons Ltd.

Impact of the Jamaican birth cohort study on maternal, child and adolescent health policy and practice.

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McCaw-Binns, A; Ashley, D; Samms-Vaughan, M

2010-01-01

The Jamaica Perinatal Morbidity and Mortality Survey (JPMMS) was a national study designed to identify modifiable risk factors associated with poor maternal and perinatal outcome. Needing to better understand factors that promote or retard child development, behaviour and academic achievement, we conducted follow-up studies of the birth cohort. The paper describes the policy developments from the JPMMS and two follow-up rounds. The initial study (1986-87) documented 94% of all births and their outcomes on the island over 2 months (n = 10 508), and perinatal (n = 2175) and maternal deaths (n = 62) for a further 10 months. A subset of the birth cohort, identified by their date of birth through school records, was seen at ages 11-12 (n = 1715) and 15-16 years (n = 1563). Findings from the initial survey led to, inter alia, clinic-based screening for syphilis, referral high-risk clinics run by visiting obstetricians, and the redesign and construction of new labour wards at referral hospitals. The follow-up studies documented inadequate academic achievement among boys and children attending public schools, and associations between under- and over-nutrition, excessive television viewing (>20 h/week), inadequate parental supervision and behavioural problems. These contributed to the development of a television programming code for children, a National Parenting Policy, policies aimed at improving inter-sectoral services to children from birth to 5 years (Early Childhood Commission) and behavioural interventions of the Violence Prevention Alliance (an inter-sectoral NGO) and the Healthy Lifestyles project (Ministry of Health). Indigenous maternal and child health research provided a local evidence base that informed public policy. Collaboration, good communication, being vigilant to opportunities to influence policy, and patience has contributed to our success.

Maternal use of antibiotics and the risk of childhood febrile seizures: a Danish population-based cohort.

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Jessica E Miller

Full Text Available OBJECTIVE: In a large population-based cohort in Denmark to examine if maternal use of antibiotics during pregnancy, as a marker of infection, increases the risk of febrile seizures in childhood in a large population-based cohort in Denmark. METHODS: All live-born singletons born in Denmark between January 1, 1996 and September 25, 2004 and who were alive on the 90(th day of life were identified from the Danish National Birth Registry. Diagnoses of febrile seizures were obtained from the Danish National Hospital Register and maternal use of antibiotics was obtained from the National Register of Medicinal Product Statistics. Hazard ratios (HR and 95% confidence intervals (95% CI were estimated by Cox proportional hazard regression models. RESULTS: We followed 551,518 singletons for up to 5 years and identified a total of 21,779 children with a diagnosis of febrile seizures. Slightly increased hazard ratios were observed among most exposure groups when compared to the unexposed group, ex. HR 1.08 95% CI: 1.05-1.11 for use of any systemic antibiotic during pregnancy. CONCLUSION: We found weak associations between the use of pharmacologically different antibiotics during pregnancy and febrile seizures in early childhood which may indicate that some infections, or causes or effects of infections, during pregnancy could affect the fetal brain and induce susceptibility to febrile seizures.

Risk factors and consequences of maternal anaemia and elevated haemoglobin levels during pregnancy: a population-based prospective cohort study.

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Gaillard, Romy; Eilers, Paul H C; Yassine, Siham; Hofman, Albert; Steegers, Eric A P; Jaddoe, Vincent W V

2014-05-01

To determine sociodemographic and life style-related risk factors and trimester specific maternal, placental, and fetal consequences of maternal anaemia and elevated haemoglobin levels in pregnancy. In a population-based prospective cohort study of 7317 mothers, we measured haemoglobin levels in early pregnancy [gestational age median 14.4 weeks (inter-quartile-range 12.5-17.5)]. Anaemia (haemoglobin ≤11 g/dl) and elevated haemoglobin levels (haemoglobin ≥13.2 g/dl) were defined according to the WHO criteria. Maternal blood pressure, placental function and fetal growth were measured in each trimester. Data on gestational hypertensive disorders and birth outcomes was collected from hospitals. Older maternal age, higher body mass index, primiparity and European descent were associated with higher haemoglobin levels (P pregnancy (mean differences 5.1 mmHg, 95% confidence interval [CI] 3.8, 6.5 and 4.1 mmHg, 95% CI 3.0, 5.2, respectively) and with a higher risk of third trimester uterine artery notching (RR 1.3, 95% CI 1.0, 1.7). As compared with maternal normal haemoglobin levels, not anaemia, but elevated haemoglobin levels were associated with fetal head circumference, length, and weight growth restriction from third trimester onwards (P pregnancy. Elevated haemoglobin levels are associated with increased risks of maternal, placental, and fetal complications. © 2014 John Wiley & Sons Ltd.

Effect of maternal country of birth on breastfeeding practices: results from Portuguese GXXI birth cohort.

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Kana, Musa Abubakar; Rodrigues, Carina; Fonseca, Maria João; Santos, Ana Cristina; Barros, Henrique

2018-01-01

Maternal country of birth has been associated with perinatal health outcomes but less is known regarding breastfeeding practices in contemporary European settings. This study investigated effect of maternal country of birth on breastfeeding initiation and duration by comparing native Portuguese and migrant mothers. We analyzed data of 7065 children of the Generation XXI (GXXI) birth cohort recruited at birth (2005-06) and followed-up 4 years later. Logistic regression was used to assess the effect of maternal country of birth on breastfeeding initiation. Kaplan-Meier estimate was used to compare breastfeeding duration by maternal country of birth and length of residence by migrant mothers in Portugal. Breastfeeding initiation and the type of breastfeeding practice were similar for native Portuguese and migrant mothers. The migrants had significantly higher median duration in months of any breastfeeding (Odds Ratio [OR] 6.0, 95% Confidence Interval [CI] 5.4,6.6) and exclusive breastfeeding (OR 4.0, 95% CI 3.8,4.2) than native Portuguese mothers (OR 4.0, 95% CI 3.8,4.2 and OR 3.0, 95% CI 2.9,3.0). Migrant mothers who resided in Portugal for either ≤5 years (OR 5.0, 95% CI 3.9,6.1 and OR 4.0, 95% CI 3.8,4.2) or >  5 years (OR 6.0, 95% CI 5.5,6.5 and OR 4.0, 95% CI 3.7,4.3) years had similar duration of any breastfeeding or exclusive breastfeeding, in both cases higher than the native Portuguese mothers. No significant differences were found when world regions were compared. Maternal country of birth does not influence breastfeeding initiation and type of feeding practice. However, migrant mothers have longer breastfeeding duration of either exclusive or any breastfeeding, which was not changed by length of residence in Portugal.

Maternal depression and child development: Evidence from São Paulo’s Western Region Cohort Study

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Alexandra Brentani

Full Text Available Summary Introduction: While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children’s early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children’s development at age one using data from the São Paulo Western Region Cohort project. Method: Seven hundred and ninety-eight (798 mother-child dyads living in the Butantã-Jaguaré’ region of São Paulo were assessed through a home visit between January and March 2015. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS. Mothers were classified as “possibly depressed” if their EPDS score was between 10 and 13 and as “likely depressed” if their EPDS score was > 13. The child outcomes analyzed were height, weight, and overall development as assessed by the Ages and Stages Questionnaire (ASQ. Height and weight were age-normalized using WHO growth standards. Stunting was defined as height-for-age z-score (HAZ 2. Adjusted and unadjusted linear regression models were used to assess the associations between Edinburgh scores and child outcomes. Results: No association was found between maternal depression variables and children’s height, weight, stunting, and obesity. Positive associations were found between possible depression and ASQ (delta = 0.33; 95CI 0.11-0.54; p-value<0.01; no associations were found between likely depression and any of the outcomes analyzed. Conclusion: The results from this study suggest that symptoms of maternal depression are not associated with delays in child development in the study setting analyzed. Further research will be needed to understand this lack of association: while it is possible that caregivers’ mental health did not affect caregiving behavior, it is possible that the effect of maternal depression can vary according to timing, persistence, and intensity. It is also possible that

Analytic models of spectral responses of fiber-grating-based interferometers on FMC theory.

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Zeng, Xiangkai; Wei, Lai; Pan, Yingjun; Liu, Shengping; Shi, Xiaohui

2012-02-13

In this paper the analytic models (AMs) of the spectral responses of fiber-grating-based interferometers are derived from the Fourier mode coupling (FMC) theory proposed recently. The interferometers include Fabry-Perot cavity, Mach-Zehnder and Michelson interferometers, which are constructed by uniform fiber Bragg gratings and long-period fiber gratings, and also by Gaussian-apodized ones. The calculated spectra based on the analytic models are achieved, and compared with the measured cases and those on the transfer matrix (TM) method. The calculations and comparisons have confirmed that the AM-based spectrum is in excellent agreement with the TM-based one and the measured case, of which the efficiency is improved up to ~2990 times that of the TM method for non-uniform-grating-based in-fiber interferometers.

Lack of Association Between Maternal or Neonatal Vitamin D Status and Risk of Childhood Type 1 Diabetes: A Scandinavian Case-Cohort Study.

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Thorsen, Steffen U; Mårild, Karl; Olsen, Sjurdur F; Holst, Klaus K; Tapia, German; Granström, Charlotta; Halldorsson, Thorhallur I; Cohen, Arieh S; Haugen, Margaretha; Lundqvist, Marika; Skrivarhaug, Torild; Njølstad, Pål R; Joner, Geir; Magnus, Per; Størdal, Ketil; Svensson, Jannet; Stene, Lars C

2018-06-01

Studies on vitamin D status during pregnancy and risk of type 1 diabetes mellitus (T1D) lack consistency and are limited by small sample sizes or single measures of 25-hydroxyvitamin D (25(OH)D). We investigated whether average maternal 25(OH)D plasma concentrations during pregnancy are associated with risk of childhood T1D. In a case-cohort design, we identified 459 children with T1D and a random sample (n = 1,561) from the Danish National Birth Cohort (n = 97,127) and Norwegian Mother and Child Cohort Study (n = 113,053). Participants were born between 1996 and 2009. The primary exposure was the estimated average 25(OH)D concentration, based on serial samples from the first trimester until delivery and on umbilical cord plasma. We estimated hazard ratios using weighted Cox regression adjusting for multiple confounders. The adjusted hazard ratio for T1D per 10-nmol/L increase in the estimated average 25(OH)D concentration was 1.00 (95% confidence interval: 0.90, 1.10). Results were consistent in both cohorts, in multiple sensitivity analyses, and when we analyzed mid-pregnancy or cord blood separately. In conclusion, our large study demonstrated that normal variation in maternal or neonatal 25(OH)D is unlikely to have a clinically important effect on risk of childhood T1D.

The influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive): data from a prospective birth cohort

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Wright, C M; Parkinson, K N; Drewett, R F

2006-01-01

Aims To study the influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive) in the first year of life. Methods The Gateshead Millennium Baby Study is a population birth cohort in northeast England studied prospectively from birth, via parental questionnaires and a health check aged 13 months. Data were collected on maternal education, deprivation, eating attitudes, and depression, using the Edinburgh Post Natal Depression Scale (EPDS) at 3 months. Weight gain was assessed using change in weight SD score, conditional on birth weight (Thrive Index); weight faltering was defined as conditional weight gain below the 5th centile. Results Of 923 eligible infants born at term, 774 (84%) had both weight and questionnaire data. Replicating a previous finding, both the highest and the lowest levels of deprivation were associated with weight faltering; this was independent of the type of milk feeding. No relation was found with maternal educational status. Maternal eating restraint was unrelated to weight gain. Infants of mothers with high depression symptom scores (EPDS >12) had significantly slower weight gain and increased rates of weight faltering up to 4 months (relative risk 2.5), especially if they came from deprived families, but by 12 months they were no different from the remainder of the cohort. Conclusions In this setting, social and maternal characteristics had little influence on infants' weight gain, apart from a strong, but transient effect of postnatal depression. PMID:16397011

Prospective population-based cohort study of maternal obesity as a source of error in gestational age estimation at 11-14weeks

DEFF Research Database (Denmark)

Bak, Geske S; Sperling, Lene; Källén, Karin

2016-01-01

IntroductionAn impact of maternal obesity on ultrasound dating of pregnancy at 11-14 gestational weeks is possible and was investigated. Material and methodsA prospective cohort study based on the Danish national population during a 4-year period in which we entered all mothers with singleton pre...

Cohort profile: maternal lifestyle and diet in relation to pregnancy, postpartum and infant health outcomes in Vietnam: A multicentre prospective cohort study.

Science.gov (United States)

Nguyen, Cong Luat; Nguyen, Phung Thi Hoang; Chu, Tan Khac; Ha, Anh Vo Van; Pham, Ngoc Minh; Duong, Dat Van; Do, Dung Van; Tang, Hong Kim; Binns, Colin W; Lee, Andy H

2017-09-05

To determine modifiable maternal risk factors for adverse pregnancy, postpartum maternal and child health outcomes in Vietnam. This prospective cohort study included pregnant women seeking prenatal care at six hospitals in three large cities in Vietnam. After enrolment, eligible participants who gave their consent to participate in the study were interviewed at 24-28 weeks' gestation. Glucose testing was conducted and blood pressure was measured during this period. Each participant will be assessed prospectively during their postnatal visits at delivery, 1, 3, 6, 12, 18 and 24 months, and will be followed up for 5 years. Of 2248 eligible pregnant women, 2030 were recruited (participation rate 90.3%) between August 2015 and July 2016. All participants completed the baseline assessment. Their mean (SD) age was 27.6 (5.3) years. The mean pre-pregnancy body mass index (BMI) was 20.2 (SD 2.6) kg/m 2 , with nearly two-thirds of participants having a normal pre-pregnancy BMI (18.5 to pregnancy BMI pregnancy BMI ≥23.0 kg/m 2 ) accounted for 12.8%. No pregnant women reported smoking during their pregnancy while 13.4% of them had continued drinking. 22.8% of participants had hyperglycaemia. Their mean systolic blood pressure was 105.6 (SD 8.2) mm Hg, and diastolic blood pressure was 67.4 (SD 7.5) mm Hg. The relationships of maternal lifestyle and nutritional status with the health outcomes of pregnancy, postpartum maternity and infants will be analysed. Meanwhile, participants will be closely tracked to minimise loss to follow-up. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts

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Rodriguez, A; Miettunen, J.; Henriksen, Tine Brink

2007-01-01

Objectives:We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring.Design:Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within...... in this range). Logistic regression and latent class analyses were used to examine maternal pregnancy weight in relation to children's ADHD core symptoms.Results:Teacher rated 12 556 school-aged children. Gestational weight gain outside of the Institute of Medicine guidelines was not related to ADHD symptoms...... the Nordic Network on ADHD.Methods:Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as 'severe' and two as 'present' (approximately 10% of children scored...

Neonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a retrospective cohort study.

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Linehan, Laura Aoife; Walsh, Jennifer; Morris, Aoife; Kenny, Louise; O'Donoghue, Keelin; Dempsey, Eugene; Russell, Noirin

2016-01-29

Preterm premature rupture of membranes (PPROM) complicates 1% of all pregnancies and occurs in one third of all preterm deliveries. Midtrimester PPROM is often followed by spontaneous miscarriage and elective termination of ongoing pregnancies is offered in many countries. The aim of this retrospective descriptive cohort study was to investigate the natural history of midtrimester PPROM in a jurisdiction where termination of pregnancy in the absence of maternal compromise is unavailable. Cases of midtrimester PPROM diagnosed between 14 and 23 + 6 weeks' gestation during April 2007 to June 2012 were identified following a manual search of all birth registers, pregnancy loss registers, annual reports, ultrasound reports, emergency room registers and neonatal death certificates at Cork University Maternity Hospital - a large (circa 8500 births per annum) tertiary referral maternity hospital in southwest Ireland. Cases where delivery occurred within 24 h of PPROM were excluded. The prevalence of midtrimester PPROM was 0.1% (42 cases/44,667 births). The mean gestation at PPROM was 18 weeks. The mean gestation at delivery was 20 + 5 weeks, with an average latency period of 13 days. Ten infants were born alive (23%; 10/42). The remainder (77%; 32/42) died in utero or intrapartum. Nine infants were resuscitated. Two infants survived to discharge. The overall mortality rate was 95% (40/42). Five women had clinical chorioamnionitis (12%; 5/42) but 69% demonstrated histological chorioamnionitis. One woman developed sepsis (2.4%; 1/42). Other maternal complications included requirement of intravenous antibiotic treatment (38%; 17/42), retained placenta (21%, 9/42) and post-partum haemorrhage (12%; 5/42). This study provides useful and contemporary data on midtrimester PPROM. Whilst fetal and neonatal mortality is high, long-term survival is not impossible. The increased risk of maternal morbidity necessitates close surveillance.

Maternal Fish Consumption and Infant Birth Size and Gestation: New York State Angler Cohort Study

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Weiner John M

2003-06-01

Full Text Available Abstract Background The scientific literature poses a perplexing dilemma for pregnant women with respect to the consumption of fish from natural bodies of water. On one hand, fish is a good source of protein, low in fat and a rich source of other nutrients all of which have presumably beneficial effects on developing embryos and fetuses. On the other hand, consumption of fish contaminated with environmental toxicants such as polychlorinated biphenyls (PCBs has been associated with decrements in gestation and birth size. Methods 2,716 infants born between 1986–1991 to participants of the New York State Angler Cohort Study were studied with respect to duration of maternal consumption of contaminated fish from Lake Ontario and its tributaries and gestation and birth size. Hospital delivery records (maternal and newborn were obtained for 92% of infants for the ascertainment of gestation (weeks, birth size (weight, length, chest, and head circumference and other known determinants of fetal growth (i.e., maternal parity, history of placental infarction, uterine bleeding, pregnancy loss or cigarette smoking and infant's race, sex and presence of birth defect. Duration of maternal fish consumption prior to the index infant's birth was categorized as: none; 1–2, 3–7, 8+ years, while birth weight (in grams, birth length (in centimeters, and head and chest circumference (in centimeters were left as continuous variables in multiple linear regression models. Birth size percentiles, ponderal indices and head to chest circumference ratios were computed to further assess proportionality and birth size in relation to gestational age. Results Analysis of variance failed to identify significant mean differences in gestation or any measure of birth size in relation to duration of maternal lifetime fish consumption. Multiple linear regressions identified gestational age, male sex, number of daily cigarettes, parity and placental infarction, as significant

Maternal Thyroid Function in Early Pregnancy and Child Neurodevelopmental Disorders

DEFF Research Database (Denmark)

Andersen, Stine Linding; Andersen, Stig; Vestergaard, Peter

2018-01-01

of abnormal maternal thyroid function was 12.5% in the sub-cohort and significantly higher among cases of ASD (17.9%; aHR = 1.5 [CI 1.1-2.1]), but not among other types of neurodevelopmental disorders (febrile seizures: 12.7%; epilepsy: 13.1%; SDD: 12.6%; and ADHD: 14.0%). However, evaluation of subtypes......: The design was a case-cohort study within the Danish National Birth Cohort (1997-2003). From the eligible cohort of 71,706 women, a random 12% sub-cohort (n = 7624) was selected, and all women (n = 2276) whose child was diagnosed with seizures, specific developmental disorder (SDD), autism spectrum disorder......BACKGROUND: Maternal thyroid dysfunction may adversely affect fetal brain development, but more evidence is needed to refine this hypothesis. The aim of this study was to evaluate potential fetal programming by abnormal maternal thyroid function on child neurodevelopmental disorders. METHODS...

Maternal use of selective serotonin reuptake inhibitors during pregnancy is associated with Hirschsprung's disease in newborns - a nationwide cohort study

DEFF Research Database (Denmark)

Nielsen, Sebastian Werngreen; Møller Ljungdalh, Pernille; Nielsen, Jan

2017-01-01

of the association between maternal use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and development of Hirschsprung's Disease in the newborn child. The study examined a nationwide, unselected cohort of children born in Denmark from 1 January 1996 until 12 March 2016 (n = 1,256,317). We...... of Hirschsprung's disease was 16/19.807 (0.08%) compared to 584/1.236.510 (0.05%) in the unexposed cohort. In women who redeemed a minimum of one prescription of selective serotonin reuptake inhibitors, the adjusted odds ratio for development of Hirschsprung's disease was 1.76 (95%CI: 1.07-2.92). In women who...

Maternal caffeine consumption from coffee and tea during pregnancy and behavioural disorders in 11-year-old offspring; a Danish national birth cohort study

DEFF Research Database (Denmark)

Mikkelsen, Susanne Hvolgaard; Obel, Carsten; Olsen, Jørn

2017-01-01

Objective: To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioural disorders. Methods: We studied 47491 children enrolled in the Danish National Birth Cohort between 1996-2002. Data on maternal coffee and tea consumption...... consumed ≥8 cups/day of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/day at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR: 1.47 (1.18; 1.83)), conduct-oppositional disorders (RR: 1.22 (1.01; 1.48)) and any psychiatric disorder (RR: 1.......23 (1.08; 1.40)). Maternal tea consumption ≥8 cups/day at 15 weeks of gestation was associated with increased risk of anxiety-depressive disorders (RR: 1.28 (1.09; 1.52)) and any psychiatric disorder (RR: 1.24 (1.11; 1.40)). An increased risk of hyperactivity-inattention disorder was observed...

Markovian Monte Carlo program EvolFMC v.2 for solving QCD evolution equations

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Jadach, S.; Płaczek, W.; Skrzypek, M.; Stokłosa, P.

2010-02-01

We present the program EvolFMC v.2 that solves the evolution equations in QCD for the parton momentum distributions by means of the Monte Carlo technique based on the Markovian process. The program solves the DGLAP-type evolution as well as modified-DGLAP ones. In both cases the evolution can be performed in the LO or NLO approximation. The quarks are treated as massless. The overall technical precision of the code has been established at 5×10. This way, for the first time ever, we demonstrate that with the Monte Carlo method one can solve the evolution equations with precision comparable to the other numerical methods. New version program summaryProgram title: EvolFMC v.2 Catalogue identifier: AEFN_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEFN_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including binary test data, etc.: 66 456 (7407 lines of C++ code) No. of bytes in distributed program, including test data, etc.: 412 752 Distribution format: tar.gz Programming language: C++ Computer: PC, Mac Operating system: Linux, Mac OS X RAM: Less than 256 MB Classification: 11.5 External routines: ROOT ( http://root.cern.ch/drupal/) Nature of problem: Solution of the QCD evolution equations for the parton momentum distributions of the DGLAP- and modified-DGLAP-type in the LO and NLO approximations. Solution method: Monte Carlo simulation of the Markovian process of a multiple emission of partons. Restrictions:Limited to the case of massless partons. Implemented in the LO and NLO approximations only. Weighted events only. Unusual features: Modified-DGLAP evolutions included up to the NLO level. Additional comments: Technical precision established at 5×10. Running time: For the 10 6 events at 100 GeV: DGLAP NLO: 27s; C-type modified DGLAP NLO: 150s (MacBook Pro with Mac OS X v.10

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

Science.gov (United States)

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 weight prior and during pregnancy and offspring's BMI and adiposity at 5-6 years in the EDEN mother-child cohort.

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Jacota, M; Forhan, A; Saldanha-Gomes, C; Charles, M A; Heude, B

2017-08-01

Beyond pre-pregnancy BMI, maternal weight change before and during pregnancy may also affect offspring adiposity. To investigate the relationship between maternal weight history before and during pregnancy with children's adiposity at 5-6 years. In 1069 mother-child dyads from the EDEN Cohort, we examined by linear regression the associations of children's BMI, fat mass and abdominal adiposity at 5-6 years with maternal pre-pregnancy BMI, pre-pregnancy average yearly weight change from age 20 and gestational weight gain. The shapes of relationships were investigated using splines and polynomial functions were tested. Children's BMI and adiposity parameters were positively associated with maternal pre-pregnancy BMI, but these relationships were mainly seen in thin mothers, with no substantial variation for maternal BMI ranging from 22 to 35 kg/m 2 . Gestational weight gain was positively associated with children's BMI Z-score, but again more so in thin mothers. We found no association with pre-pregnancy weight change. Before the adiposity rebound, maternal pre-pregnancy thinness explains most of the relationship with children's BMI. The relationship may emerge at older ages in children of overweight and obese mothers, and this latency may be an obstacle to early prevention. © 2016 World Obesity Federation.

Acute maternal stress in pregnancy and schizophrenia in offspring: A cohort prospective study

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Fennig S

2008-08-01

Full Text Available Abstract Schizophrenia has been linked with intrauterine exposure to maternal stress due to bereavement, famine and major disasters. Recent evidence suggests that human vulnerability may be greatest in the first trimester of gestation and rodent experiments suggest sex specificity. We aimed to describe the consequence of an acute maternal stress, through a follow-up of offspring whose mothers were pregnant during the Arab-Israeli war of 1967. A priori, we focused on gestational month and offspring's sex. Method In a pilot study linking birth records to Israel's Psychiatric Registry, we analyzed data from a cohort of 88,829 born in Jerusalem in 1964–76. Proportional hazards models were used to estimate the relative risk (RR of schizophrenia, according to month of birth, gender and other variables, while controlling for father's age and other potential confounders. Other causes of hospitalized psychiatric morbidity (grouped together were analyzed for comparison. Results There was a raised incidence of schizophrenia for those who were in the second month of fetal life in June 1967 (RR = 2.3, 1.1–4.7, seen more in females (4.3, 1.7–10.7 than in males (1.2, 0.4–3.8. Results were not explained by secular or seasonal variations, altered birth weight or gestational age. For other conditions, RRs were increased in offspring who had been in the third month of fetal life in June 1967 (2.5, 1.2–5.2, also seen more in females (3.6, 1.3–9.7 than males (1.8, 0.6–5.2. Conclusion These findings add to a growing literature, in experimental animals and humans, attributing long term consequences for offspring of maternal gestational stress. They suggest both a sex-specificity and a relatively short gestational time-window for gestational effects on vulnerability to schizophrenia.

Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China

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Min-Shan Lu

2016-04-01

Full Text Available There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns. The following six dietary patterns were identified: “Cereals, eggs, and Cantonese soups” (n 1026, 14.8%, “Dairy” (n 1020, 14.7%, “Fruits, nuts, and Cantonese desserts” (n 799, 11.5%, “Meats” (n 1066, 15.3%, “Vegetables” (n 1383, 19.9%, and “Varied” (n 1224, 17.6%. The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the “Fruits, nuts, and Cantonese desserts” and “Varied” groups had significantly heavier infants compared with those in the “Cereals, eggs, and Cantonese soups” group. Compared with women in the “Cereals, eggs, and Cantonese soups” group, those in the “Varied” group had marginally significantly lower odds of having a small-for-gestational age (SGA infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08. These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.

Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China.

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Lu, Min-Shan; Chen, Qiao-Zhu; He, Jian-Rong; Wei, Xue-Ling; Lu, Jin-Hua; Li, Sheng-Hui; Wen, Xing-Xuan; Chan, Fan-Fan; Chen, Nian-Nian; Qiu, Lan; Mai, Wei-Bi; Zhang, Rui-Fang; Hu, Cui-Yue; Xia, Hui-Min; Qiu, Xiu

2016-04-28

There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns. The following six dietary patterns were identified: "Cereals, eggs, and Cantonese soups" (n 1026, 14.8%), "Dairy" (n 1020, 14.7%), "Fruits, nuts, and Cantonese desserts" (n 799, 11.5%), "Meats" (n 1066, 15.3%), "Vegetables" (n 1383, 19.9%), and "Varied" (n 1224, 17.6%). The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the "Fruits, nuts, and Cantonese desserts" and "Varied" groups had significantly heavier infants compared with those in the "Cereals, eggs, and Cantonese soups" group. Compared with women in the "Cereals, eggs, and Cantonese soups" group, those in the "Varied" group had marginally significantly lower odds of having a small-for-gestational age (SGA) infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08). These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.

SCHIZOPHRENIA AND BIRTHPLACE OF PATERNAL AND MATERNAL GRANDFATHER IN THE JERUSALEM PERINATAL COHORT PROSPECTIVE STUDY

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Harlap, S; Perrin, M C; Deutsch, L; Kleinhaus, K; Fennig, S; Nahon, D; Teitelbaum, A; Friedlander, Y; Malaspina, D

2009-01-01

Some forms of epigenetic abnormalities transmitted to offspring are manifest in differences in disease incidence that depend on parent-of-origin. To explore whether such phenomena might operate in schizophrenia spectrum disorders, we estimated the relative incidence of these conditions in relation to parent-of-origin by considering the two grandfathers' countries of birth. In a prospective cohort of 88,829 offspring, born in Jerusalem in 1964–76 we identified 637 cases through Israel's psychiatric registry. Relative risks (RR) were estimated for paternal and maternal grandfathers' countries of birth using proportional hazards methods, controlling for parents' ages, low social class and duration of marriage. After adjusting for multiple observations, we found no significant differences between descendants of maternal or paternal grandfathers born in Iraq, Iran, Turkey, Syria, Yemen, Morocco, Algeria, Tunisia, Libya/Egypt, Poland, USSR, Czechoslovakia, Germany or the USA. Those with paternal grandfathers from Romania (RR=1.9, 95% CI=1.3–2.8) or Hungary (1.6, 1.0–2.6) showed an increased incidence; however, those with maternal grandfathers from these countries experienced reduced incidence (RR=0.5, 0.3–0.8 and 0.4, 0.2–0.8). In post-hoc analyses we found that results were similar whether the comparison groups were restricted to descendants of other Europeans or included those from Western Asia and North Africa; and effects of paternal grandfathers from Romania/Hungary were more pronounced in females, while effects of maternal grandfathers from these countries were similar in males and females. These post-hoc “hypothesis-generating” findings lead one to question whether some families with ancestors in Romania or Hungary might carry a variant or mutation at a parentally imprinted locus that is altering susceptibility to schizophrenia. Such a locus, if it exists, might involve the X chromosome. PMID:19361958

Schizophrenia and birthplace of paternal and maternal grandfather in the Jerusalem perinatal cohort prospective study.

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Harlap, S; Perrin, M C; Deutsch, L; Kleinhaus, K; Fennig, S; Nahon, D; Teitelbaum, A; Friedlander, Y; Malaspina, D

2009-06-01

Some forms of epigenetic abnormalities transmitted to offspring are manifested in differences in disease incidence that depend on parent-of-origin. To explore whether such phenomena might operate in schizophrenia spectrum disorders, we estimated the relative incidence of these conditions in relation to parent-of-origin by considering the two grandfathers' countries of birth. In a prospective cohort of 88,829 offspring, born in Jerusalem in 1964-76 we identified 637 cases through Israel's psychiatric registry. Relative risks (RR) were estimated for paternal and maternal grandfathers' countries of birth using proportional hazards methods, controlling for parents' ages, low social class and duration of marriage. After adjusting for multiple observations, we found no significant differences between descendants of maternal or paternal grandfathers born in Iraq, Iran, Turkey, Syria, Yemen, Morocco, Algeria, Tunisia, Libya/Egypt, Poland, USSR, Czechoslovakia, Germany or the USA. Those with paternal grandfathers from Romania (RR=1.9, 95% CI=1.3-2.8) or Hungary (1.6, 1.0-2.6) showed an increased incidence; however, those with maternal grandfathers from these countries experienced reduced incidence (RR=0.5, 0.3-0.8 and 0.4, 0.2-0.8). In post-hoc analyses we found that results were similar whether the comparison groups were restricted to descendants of other Europeans or included those from Western Asia and North Africa; and effects of paternal grandfathers from Romania/Hungary were more pronounced in females, while effects of maternal grandfathers from these countries were similar in males and females. These post-hoc "hypothesis-generating" findings lead one to question whether some families with ancestors in Romania or Hungary might carry a variant or mutation at a parentally imprinted locus that is altering susceptibility to schizophrenia. Such a locus, if it exists, might involve the X chromosome.

Maternal Arsenic Exposure, Arsenic Methylation Efficiency, and Birth Outcomes in the Biomarkers of Exposure to ARsenic (BEAR) Pregnancy Cohort in Mexico

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Laine, Jessica E.; Bailey, Kathryn A.; Rubio-Andrade, Marisela; Olshan, Andrew F.; Smeester, Lisa; Drobná, Zuzana; Herring, Amy H.; Stýblo, Miroslav; García-Vargas, Gonzalo G.

2014-01-01

Background: Exposure to inorganic arsenic (iAs) from drinking water is a global public health problem, yet much remains unknown about the extent of exposure in susceptible populations. Objectives: We aimed to establish the Biomarkers of Exposure to ARsenic (BEAR) prospective pregnancy cohort in Gómez Palacio, Mexico, to better understand the effects of iAs exposure on pregnant women and their children. Methods: Two hundred pregnant women were recruited for this study. Concentrations of iAs in drinking water (DW-iAs) and maternal urinary concentrations of iAs and its monomethylated and dimethylated metabolites (MMAs and DMAs, respectively) were determined. Birth outcomes were analyzed for their relationship to DW-iAs and to the concentrations and proportions of maternal urinary arsenicals. Results: DW-iAs for the study subjects ranged from iAs that exceeded the World Health Organization’s recommended guideline of 10 μg As/L. DW-iAs was significantly associated with the sum of the urinary arsenicals (U-tAs). Maternal urinary concentrations of MMAs were negatively associated with newborn birth weight and gestational age. Maternal urinary concentrations of iAs were associated with lower mean gestational age and newborn length. Conclusions: Biomonitoring results demonstrate that pregnant women in Gómez Palacio are exposed to potentially harmful levels of DW-iAs. The data support a relationship between iAs metabolism in pregnant women and adverse birth outcomes. The results underscore the risks associated with iAs exposure in vulnerable populations. Citation: Laine JE, Bailey KA, Rubio-Andrade M, Olshan AF, Smeester L, Drobná Z, Herring AH, Stýblo M, García-Vargas GG, Fry RC. 2015. Maternal arsenic exposure, arsenic methylation efficiency, and birth outcomes in the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort in Mexico. Environ Health Perspect 123:186–192; http://dx.doi.org/10.1289/ehp.1307476 PMID:25325819

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

NARCIS (Netherlands)

Brocklehurst, P.; Kwee, A.; Birthplace in England Collaborative Group

2011-01-01

Objective: To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design: Prospective cohort study. Setting: England: all NHS trusts providing intrapartum care at home,

Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

LENUS (Irish Health Repository)

Murphy, Cliona M

2012-02-01

OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

Association between maternal urinary chromium and premature rupture of membranes in the Healthy Baby Cohort study in China.

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Huang, Sha; Xia, Wei; Li, Yuanyuan; Zhang, Bin; Zhou, Aifen; Zheng, Tongzhang; Qian, Zhengmin; Huang, Zheng; Lu, Shi; Chen, Zhong; Wang, Youjie; Pan, Xinyun; Huo, Wenqian; Jin, Shuna; Jiang, Yangqian; Xu, Shunqing

2017-11-01

Chromium exposure from increasing industrial releases has become a threat for pregnant women due to the potential health effects on vulnerable embryos. Previous studies have suggested that maternal chromium exposure is associated with adverse birth outcomes, but no epidemiological research has been conducted to examine the relationship between chromium exposure and premature rupture of membranes (PROM). This study aimed at investigating the association of maternal urinary chromium exposure levels with PROM and was performed with 5408 pregnant women recruited from 2012 to 2014 in the city of Wuhan, China. Maternal urinary chromium collected before labor was adjusted with creatinine, and its association with PROM was evaluated using logistic regression. Each one unit increase in the natural logarithm transformed maternal urinary chromium concentration (μg/g creatinine), an odds ratio (OR) of 1.47 [95% confidence interval (CI): 1.36, 1.58] for PROM was observed. Compared to the lowest tertile of maternal urinary chromium, PROM was positively correlated with increased urinary levels of chromium (adjusted OR = 1.42; 95% CI: 1.09, 1.84 for the medium tertile; adjusted OR = 2.77; 95% CI: 2.18, 3.52 for the highest tertile). Additionally, the association of chromium with PROM appeared to be more significant among male infants (adjusted OR = 3.52; 95% CI: 2.51, 4.94 for the highest tertile) than female infants (adjusted OR = 2.16; 95% CI: 1.52, 3.06 for the highest tertile) (p for interaction = 0.05). Our large birth cohort showed an association between maternal urinary chromium levels and PROM, and the association may differ by infant gender. Further studies from different populations are needed to confirm the observed association. Copyright © 2017 Elsevier Ltd. All rights reserved.

[A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old].

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Li, F; Tian, Y P; Liu, X M; Xia, R L; Jin, L M; Sun, X W; Song, X X; Yuan, W; Liang, H

2018-04-10

Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios ( RR s) and 95% CI s, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc ., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional ( RR =2.61, 95% CI : 1.36-4.99) and internalizing problems ( RR =1.94, 95% CI : 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional ( RR =6.46, 95% CI : 3.09-13.53), withdrawn ( RR =2.42, 95% CI : 1.16-5.02), aggressive ( RR =2.93, 95% CI : 1.45-5.94), internalizing ( RR =1.79, 95% CI : 1.01-3.16) or externalizing problems ( RR =2.56, 95% CI :1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In

Association of maternal age with child health: A Japanese longitudinal study.

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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.

Effects of maternal epidural analgesia on the neonate--a prospective cohort study.

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Shrestha, Bikash; Devgan, Amit; Sharma, Mukti

2014-12-10

Epidural analgesia is one of the most popular modes of analgesia for child birth. There are controversies regarding adverse effects and safety of epidural analgesia. This study was conducted to study the immediate effects of the maternal epidural analgesia on the neonate during early neonatal phase. A prospective cohort study of 100 neonates born to mothers administered epidural analgesia were compared with 100 neonates born to mothers not administered epidural analgesia in terms of passage of urine, initiation of breast feeding, birth asphyxia and incidence of instrumentation. There was significant difference among the two groups in the passage of urine (P value 0.002) and incidence of instrumentation (P value 0.010) but there was no significant difference in regards to initiation of breast feeding and birth asphyxia. Epidural analgesia does not have any effect on the newborns in regards to breast feeding and birth asphyxia but did have effects like delayed passage of urine and increased incidence of instrumentation.

Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil

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Vanessa Polina Pereira COSTA

2017-11-01

Full Text Available Abstract Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers’ children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05. At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children’s dental fear was positively associated with mothers’ presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child’s perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

Socio-occupational class, region of birth and maternal age

DEFF Research Database (Denmark)

Hougaard, Karin Sørig; Larsen, Ann Dyreborg; Hannerz, Harald

2014-01-01

for time to detection of cryptorchidism. Parental employment in the calendar year preceding birth was grouped into one of five socio-occupational classes. Geographical region was defined by place of birth in one of 15 Danish counties. Detection rate ratios of cryptorchidism were analyzed as a function......BACKGROUND: Cryptorchidism (undescended testes) is associated with poor male fertility, but can be alleviated and fertility preserved to some degree by early detection and treatment. Here we assess the influence of socio-occupational class, geographical region, maternal age and birth cohort on time...... of parental socio-occupational group, county, maternal age and birth cohort by use of Poisson regression. RESULTS: Some 6,059 boys in the early and 5,947 boys in the late cohort received a diagnosis of cryptorchidism. Time to detection was independent of parental socio-occupational group and maternal age...

Maternal caffeine intake during pregnancy and childhood growth and overweight: results from a large Norwegian prospective observational cohort study

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Botton, Jérémie; Brantsæter, Anne-Lise; Haugen, Margaretha; Alexander, Jan; Meltzer, Helle Margrete; Bacelis, Jonas; Elfvin, Anders; Jacobsson, Bo; Sengpiel, Verena

2018-01-01

Objectives To study the association between maternal caffeine intake during pregnancy and the child’s weight gain and overweight risk up to 8 years. Design Prospective nationwide pregnancy cohort. Setting The Norwegian Mother and Child Cohort Study. Participants A total of 50 943 mothers recruited from 2002 to 2008 and their children, after singleton pregnancies, with information about average caffeine intake assessed at mid-pregnancy. Outcome measure Child’s body size information at 11 age points from 6 weeks to 8 years. We defined excess growth in infancy as a WHO weight gain z-score of >0.67 from birth to age 1 year, and overweight according to the International Obesity Task Force. We used a growth model to assess individual growth trajectories. Results Compared with pregnant women with low caffeine intake (200 mg/day had consistently higher weight. Very high caffeine exposures were associated with higher weight gain velocity from infancy to age 8 years. Conclusion Any caffeine consumption during pregnancy is associated with a higher risk of excess infant growth and of childhood overweight, mainly at preschool ages. Maternal caffeine intake may modify the overall weight growth trajectory of the child from birth to 8 years. This study adds supporting evidence for the current advice to reduce caffeine intake during pregnancy. PMID:29685923

Maternal depression and personality traits in association with child neuropsychological and behavioral development in preschool years: Mother-child cohort (Rhea Study) in Crete, Greece.

Science.gov (United States)

Koutra, Katerina; Roumeliotaki, Theano; Kyriklaki, Andriani; Kampouri, Mariza; Sarri, Katerina; Vassilaki, Maria; Bitsios, Panos; Kogevinas, Manolis; Chatzi, Leda

2017-08-01

Poor perinatal maternal mental health has been linked with negative outcomes on early child development; however, the importance of maternal personality has been neglected thus far. We aimed to examine the effects of antenatal and postnatal maternal mental health, including assessment of maternal personality characteristics, on child neuropsychological and behavioral development at preschool years in a population based mother-child cohort (Rhea Study) in Crete, Greece. Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of 288 women at 28-32 weeks of gestation. A larger sample of 642 mothers completed the EPDS scale at 8 weeks postpartum. Children's neuropsychological (MSCA) and behavioral (ADHDT and SDQ) development were assessed at 4 years of age. Linear regression analyses were used to estimate the associations between the exposures and outcomes of interest after adjustment for potential confounders. Regarding child neuropsychological development, increased postnatal depressive symptoms were associated with child's perceptual performance, whereas increased maternal psychoticism was linked with child's motor ability at 4 years of age. Furthermore, elevated levels of maternal depression during pregnancy and postpartum, and the predisposing personality characteristics of trait anxiety and neuroticism, were associated with children's behavioral difficulties. A clinical diagnostic instrument for maternal mental health was not used and assessment of children's behavior was based on maternal report. These findings suggest that poor perinatal maternal mental health and an adverse personality profile may be associated with impaired child neuropsychological and behavioral development at preschool years. Copyright © 2017 Elsevier B.V. All rights reserved.

Maternal-infant relationship quality and risk of obesity at age 5.5 years in a national US cohort

Science.gov (United States)

2014-01-01

Background Poor quality relationships between mothers and toddlers have been associated with higher risk for childhood obesity, but few prospective studies of obesity have assessed maternal-child relationship quality in infancy. In addition it is not known whether the increased risk is associated with the mother’s or the child’s contribution to the relationship quality. Methods We analyzed data (n = 5650) from the Early Childhood Longitudinal Study, Birth Cohort, a national study of U.S. children born in 2001 and followed until they entered kindergarten. At 9 months of age, the Nursing Child Assessment Teaching Scale (NCATS) was used to assess the quality of observed playtime interactions between mothers and infants, yielding separate scores for maternal and infant behaviors. Obesity (BMI ≥95th percentile) at age 5.5 years was based on measured weight and height. Results The prevalence (95% confidence interval) of obesity at 5.5 years of age was higher among children in the lowest quartile of maternal NCATS score (20.2% [95% CI: 17.2%, 23.2%]) than in the highest quartile (13.9% [11.3%, 16.5%]), but maternal NCATS score was not significantly associated with obesity after adjustment for race/ethnicity, maternal education and household income. The prevalence of obesity at 5.5 years of age was similar among children in the lowest quartile of infant NCATS score (17.4% [14.4%, 20.3%]) and in the highest quartile (17.6% 14.4%, 20.8%]), and was not changed with covariate adjustment. Conclusions Maternal-infant relationship quality, assessed by direct observation at 9 months of age in a national sample, was not associated with an increased risk of obesity at age 5.5 years after controlling for sociodemographic characteristics. PMID:24564412

Maternal perception of the occurrence of traumatic dental injuries in children: a cohort study of south Brazil.

Science.gov (United States)

Costa, Vanessa Polina Pereira; Amaral, Cassia Cardoso; Goettems, Marília Leão; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando

2016-06-01

Adolescent mothers may have an inaccurate perception and awareness of dental trauma occurrence in children, which may influence whether or not they seek treatment. This study evaluated maternal perception of traumatic dental injury (TDI) occurrence and related factors in children, 24-36 months of age, of adolescent mothers from a cohort in the city of Pelotas/RS, Brazil. Clinical data from 508 children were collected through physical examination; demographic variables (including socio-economic status) and maternal perception of trauma occurrence were collected through interviews with the children's mothers. Statistical analysis was performed using STATA 12.0. The prevalence of dental trauma was 12.6% (64). A total of 291 (57.9%) mothers reported that their child had hit his or her teeth/mouth at least once. Only 69 (24.8%) mothers who perceived a TDI sought care. The maternal perception of dental trauma experienced by children showed no relationship with diagnosis on clinical examination. Enamel fracture was the most prevalent type of trauma (71.6%), and the maxillary central incisors were the teeth most affected. Owing to lack of awareness about TDI, the adolescent mothers in this study sample did not seek treatment for their children. Awareness campaigns for parents and caregivers about the possible consequences of TDI and the importance of follow up after dental trauma are required. © 2016 FDI World Dental Federation.

Family income, maternal psychological distress and child socio-emotional behaviour: Longitudinal findings from the UK Millennium Cohort Study.

Science.gov (United States)

Noonan, Katharine; Burns, Richéal; Violato, Mara

2018-04-01

The association between low family income and socio-emotional behaviour problems in early childhood has been well-documented, and maternal psychological distress is highlighted as central in mediating this relationship. However, whether this relationship holds for older children, and the precise mechanisms by which income may influence child behaviour is unclear. This study investigated the relationship between family income and child socio-emotional behaviour at 11 years of age, and examined the mediating role of maternal psychological distress over time using the UK Millennium Cohort Study. The primary outcome was parent-reported behavioural problems, as captured by the Total Difficulties Score (TDS), derived from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcomes were the emotional, peer-related, conduct, and hyperactivity/inattention problems subscales of the SDQ; and teacher-reported TDS. Permanent family income was the primary exposure variable; frequency of poverty up to age 11 years was the secondary exposure variable. Maternal psychological distress was operationalised to reflect the trajectory from child birth to age 11. Multivariable logistic regression models were used to estimate the effect of permanent family income on child behaviour at age 11, controlling for maternal psychological distress and other relevant covariates. Results showed a statistically significant protective effect of increased permanent family income on the likelihood of behavioural problems at age 11. This finding was consistent for all SDQ subscales apart from emotional problems, and was strongest for teacher-reported behavioural problems. Maternal distress was an important mediator in the income-child behaviour relationship for parent-reported, but not teacher-reported, behavioural problems. The results of this study strengthen empirical evidence that the child behaviour-income gradient is maintained in older childhood. Mother's psychological distress

Family income, maternal psychological distress and child socio-emotional behaviour: Longitudinal findings from the UK Millennium Cohort Study

Directory of Open Access Journals (Sweden)

Katharine Noonan

2018-04-01

Full Text Available The association between low family income and socio-emotional behaviour problems in early childhood has been well-documented, and maternal psychological distress is highlighted as central in mediating this relationship. However, whether this relationship holds for older children, and the precise mechanisms by which income may influence child behaviour is unclear.This study investigated the relationship between family income and child socio-emotional behaviour at 11 years of age, and examined the mediating role of maternal psychological distress over time using the UK Millennium Cohort Study.The primary outcome was parent-reported behavioural problems, as captured by the Total Difficulties Score (TDS, derived from the Strengths and Difficulties Questionnaire (SDQ. Secondary outcomes were the emotional, peer-related, conduct, and hyperactivity/inattention problems subscales of the SDQ; and teacher-reported TDS. Permanent family income was the primary exposure variable; frequency of poverty up to age 11 years was the secondary exposure variable. Maternal psychological distress was operationalised to reflect the trajectory from child birth to age 11. Multivariable logistic regression models were used to estimate the effect of permanent family income on child behaviour at age 11, controlling for maternal psychological distress and other relevant covariates.Results showed a statistically significant protective effect of increased permanent family income on the likelihood of behavioural problems at age 11. This finding was consistent for all SDQ subscales apart from emotional problems, and was strongest for teacher-reported behavioural problems. Maternal distress was an important mediator in the income-child behaviour relationship for parent-reported, but not teacher-reported, behavioural problems.The results of this study strengthen empirical evidence that the child behaviour-income gradient is maintained in older childhood. Mother’s psychological

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.

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 ...

Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil.

Science.gov (United States)

Costa, Vanessa Polina Pereira; Correa, Marcos Britto; Goettems, Marília Leão; Pinheiro, Ricardo Tavares; Demarco, Flávio Fernando

2017-11-06

Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

Maternal region of birth and stillbirth in Victoria, Australia 2000-2011: A retrospective cohort study of Victorian perinatal data.

Science.gov (United States)

Davies-Tuck, Miranda L; Davey, Mary-Ann; Wallace, Euan M

2017-01-01

There is growing evidence from high-income countries that maternal country of birth is a risk factor for stillbirth. We aimed to examine the association between maternal region of birth and stillbirth between 2000 and 2011 inclusive in Victoria, Australia. Retrospective population based cohort study of all singleton births at 24 or more weeks gestational age from 2000-2011 in Victoria, Australia. Stillbirths due to termination of pregnancy, babies with congenital anomalies and Indigenous mothers were excluded. Main Outcome Measure: Stillbirth. Over the 12-year period there were 685,869 singleton births and 2299 stillbirths, giving an overall stillbirth rate of 3·4 per 1000 births. After adjustment for risk factors, compared to women born in Australia/New Zealand, women born in South Asia (aOR 1.27, 95% CI 1.01-1.53, p = 0.01), were more likely to have a stillbirth whereas women born in South East and East Asia were (aOR 0.60, (95% CI 0.49-0.72, pAsian compared to Australian/New Zealand born women. The following risk factors were also significantly associated with an increased odds of stillbirth in multivariate analyses: maternal age <20 and 35 years and more, nulliparity, low socio-economic status, previous stillbirth, no ultrasound reported in 1st trimester, pre-existing hypertension, antepartum haemorrhage and failure to detect growth restriction antenatally. Maternal region of birth is an independent risk factor for stillbirth. Improvements in the rate of stillbirth, particularly late pregnancy stillbirth, are likely to be gained in high-income settings where clinical care is informed by maternal region of birth.

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...

Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study : Protocol of birth cohort at Bangalore, India.

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Babu, Giridhara R; Murthy, Gvs; Deepa, R; Yamuna; Prafulla; Kumar, H Kiran; Karthik, Maithili; Deshpande, Keerti; Benjamin Neelon, Sara E; Prabhakaran, D; Kurpad, Anura; Kinra, Sanjay

2016-10-14

India is experiencing an epidemic of obesity-hyperglycaemia, which coincides with child bearing age for women. The epidemic can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, we developed the protocol for the proposed birth cohort of 5000 women, the recruitment for which will start in April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years. The institutional review board at The Indian Institute of Public Health (IIPH)-H, Bangalore, Public Health Foundation of India has approved the protocol. All participants are required to provide written informed consent. The findings from this study may help to address important questions on screening and management of high blood sugar in pregnancy. It

The association of maternal vitamin D status with infant birth outcomes, postnatal growth and adiposity in the first 2 years of life in a multi-ethnic Asian population: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study.

Science.gov (United States)

Ong, Yi Lin; Quah, Phaik Ling; Tint, Mya Thway; Aris, Izzuddin M; Chen, Ling Wei; van Dam, Rob M; Heppe, Denise; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap Seng; Yap, Fabian; Lee, Yung Seng; Foong-Fong Chong, Mary

2016-08-01

Maternal vitamin D status during pregnancy has been associated with infant birth and postnatal growth outcomes, but reported findings have been inconsistent, especially in relation to postnatal growth and adiposity outcomes. In a mother-offspring cohort in Singapore, maternal plasma vitamin D was measured between 26 and 28 weeks of gestation, and anthropometric measurements were obtained from singleton offspring during the first 2 years of life with 3-month follow-up intervals to examine birth, growth and adiposity outcomes. Associations were analysed using multivariable linear regression. Of a total of 910 mothers, 13·2 % were vitamin D deficient (growth outcomes - weight-for-age z-scores, length-for-age z-scores, circumferences of the head, abdomen and mid-arm at birth or postnatally - and adiposity outcomes - BMI, and skinfold thickness (triceps, biceps and subscapular) at birth or postnatally. Maternal vitamin D status in pregnancy did not influence infant birth outcomes, postnatal growth and adiposity outcomes in this cohort, perhaps due to the low prevalence (1·6 % of the cohort) of severe maternal vitamin D deficiency (defined as of population.

Maternal smoking during pregnancy and academic achievement of offspring over time: A registry data-based cohort study.

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Kristjansson, Alfgeir L; Thomas, Sabena; Lilly, Christa L; Thorisdottir, Ingibjorg E; Allegrante, John P; Sigfusdottir, Inga Dora

2018-08-01

Few studies have assessed the cumulative impact of maternal smoking during pregnancy (MSDP) on scholastic outcomes over time. We examined the relations between MSDP and academic achievement in the 4th, 7th and 10th grades using registry data collected at birth, during the neonatal period, and at each grade level from the 2000, LIFECOURSE study birth cohort in Reykjavik, Iceland (N = 1151, girls = 49.3%). Latent growth modeling showed that MSDP influenced Icelandic achievement scores, standardized to a range from 0 to 60, at baseline (β = -0.04), and over time (β = -0.05). Likewise, MSDP was negatively associated with standardized mathematics scores at baseline (ß = -0.09) and continued to exert a negative impact on mathematics scores over time (ß = -0.08) after controlling for gender, income, cohabitation, and baseline mathematics and Icelandic achievement scores. Results provide evidence of the persistent negative impact of MSDP on academic achievement in offspring. Findings support the proposition that children whose mothers smoke during the first trimester of pregnancy are, on average, at greater risk for poor scholastic outcomes over time than children whose mothers do not smoke during their first trimester. To our knowledge, this is the first study using a longitudinal cohort design to assess whether the impacts of maternal smoking during pregnancy may persist over time. This study contributes to the current state of knowledge by providing an assessment that focuses on the impact of smoking during pregnancy on academic achievement from childhood into early adolescence. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

The emotional-behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study.

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Giallo, Rebecca; Woolhouse, Hannah; Gartland, Deirdre; Hiscock, Harriet; Brown, Stephanie

2015-10-01

Children exposed to maternal depression during pregnancy and in the postnatal period are at increased risk of a range of health, wellbeing and development problems. However, few studies have examined the course of maternal depressive symptoms in the perinatal period and beyond on children's wellbeing. The present study aimed to explore the relationship between both the severity and chronicity of maternal depressive symptoms across the early childhood period and children's emotional-behavioural difficulties at 4 years of age. Data from over 1,085 mothers and children participating in a large Australian prospective pregnancy cohort were used. Latent class analysis identified three distinct trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum: (1) no or few symptoms (61%), (2) persistent subclinical symptoms (30%), and (3) increasing and persistently high symptoms (9%). Regression analyses revealed that children of mothers experiencing subclinical and increasing and persistently high symptoms were at least two times more likely to have emotional-behavioural difficulties than children of mothers reporting minimal symptoms, even after accounting for known risk factors for poor outcomes for children. These findings challenge policy makers and health professionals to consider how they can tailor care and support to mothers experiencing a broader spectrum of depressive symptoms across the early childhood period, to maximize opportunities to improve both short-and long-term maternal and child health outcomes.

Maternal caffeine intake during pregnancy and childhood growth and overweight: results from a large Norwegian prospective observational cohort study.

Science.gov (United States)

Papadopoulou, Eleni; Botton, Jérémie; Brantsæter, Anne-Lise; Haugen, Margaretha; Alexander, Jan; Meltzer, Helle Margrete; Bacelis, Jonas; Elfvin, Anders; Jacobsson, Bo; Sengpiel, Verena

2018-04-23

To study the association between maternal caffeine intake during pregnancy and the child's weight gain and overweight risk up to 8 years. Prospective nationwide pregnancy cohort. The Norwegian Mother and Child Cohort Study. A total of 50 943 mothers recruited from 2002 to 2008 and their children, after singleton pregnancies, with information about average caffeine intake assessed at mid-pregnancy. Child's body size information at 11 age points from 6 weeks to 8 years. We defined excess growth in infancy as a WHO weight gain z-score of >0.67 from birth to age 1 year, and overweight according to the International Obesity Task Force. We used a growth model to assess individual growth trajectories. Compared with pregnant women with low caffeine intake (200 mg/day had consistently higher weight. Very high caffeine exposures were associated with higher weight gain velocity from infancy to age 8 years. Any caffeine consumption during pregnancy is associated with a higher risk of excess infant growth and of childhood overweight, mainly at preschool ages. Maternal caffeine intake may modify the overall weight growth trajectory of the child from birth to 8 years. This study adds supporting evidence for the current advice to reduce caffeine intake during pregnancy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Maternal complications in pregnancy and wheezing in early childhood

DEFF Research Database (Denmark)

Zugna, Daniela; Galassi, Claudia; Annesi-Maesano, Isabella

2015-01-01

BACKGROUND: Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient. METHODS: A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy comp...

Comparison of associations of maternal peri-pregnancy and paternal anthropometrics with child anthropometrics from birth through age 7 y assessed in the Danish National Birth Cohort

DEFF Research Database (Denmark)

Sorensen, Thorkild I. A.; Ajslev, Teresa Adeltoft; Angquist, Lars

2016-01-01

body mass index (BMI) with child anthropometric measurements from birth through infancy and at 7 y of age exceed those of paternal associations. Design: In the Danish National Birth Cohort, information on parental and child anthropometric measures is available for 30,655 trio families from maternal...

The impact of maternal celiac disease on birthweight and preterm birth: a Danish population-based cohort study.

LENUS (Irish Health Repository)

Khashan, A S

2012-01-31

BACKGROUND: Adverse pregnancy outcomes have been associated with maternal celiac disease (CD). In this study, we investigate the effect of treated and untreated maternal CD on infant birthweight and preterm birth. METHODS: A population-based cohort study consisted of all singleton live births in Denmark between 1 January 1979 and 31 December 2004 was used. A total of 1,504,342 babies were born to 836,241 mothers during the study period. Of those, 1105 babies were born to women with diagnosed CD and 346 were born to women with undiagnosed CD. Women with diagnosed CD were considered as treated with a gluten free diet while women with undiagnosed CD were considered as untreated. The outcome measures were: birthweight, small for gestational age (SGA: birthweight <10th centile), very small for gestational age (VSGA: birthweight <5th centile) and preterm birth. We compared these measures in treated and untreated women with those of a reference group (no history of CD). RESULTS: Women with untreated CD delivered smaller babies [difference = -98 g (95% CI: -130, -67)], with a higher risk of SGA infants [OR = 1.31 (95% CI: 1.06, 1.63)], VSGA infants [OR = 1.54 (95% CI: 1.17, 2.03)] and preterm birth [OR = 1.33 (95% CI: 1.02, 1.72)] compared with women without CD. Women with treated CD had no increased risk of reduced mean birthweight, risk of delivering SGA and VSGA infants or preterm birth compared with women without CD. CONCLUSION: Untreated maternal CD increases the risk of reduced birthweight, the risk of delivering SGA and VSGA infants and preterm birth. Diagnosis and presumed treatment of maternal CD with a gluten-free diet appeared to result in a birthweight and preterm birth rate similar to those in women without CD.

The effects of labor and delivery on maternal and neonatal outcomes in term twins: a retrospective cohort study.

Science.gov (United States)

Wenckus, D J; Gao, W; Kominiarek, M A; Wilkins, I

2014-08-01

To compare maternal and neonatal outcomes in twins undergoing a trial of labor versus pre-labor caesarean. Retrospective cohort study. 19 US hospitals from the Consortium on Safe Labor. Of 2225 twin sets ≥36 weeks' gestation. Maternal (abruption, estimated blood loss, postpartum haemorrhage, transfusion, chorioamnionitis, hysterectomy, ICU admission, death) and neonatal outcomes (birth injury, 5-minute Apgar <7, NICU admission, RDS, TTN, sepsis, asphyxia, NICU length of stay, death) were compared between the trial of labour and pre-labour caesarean groups with univariate and multivariate logistic and linear regression analyses. Similar analyses were performed for actual delivery modes. Maternal and neonatal outcomes. Among the 2225 twin sets, 1078 had a trial of labour, and 65.9% of those delivered vaginally. There was an increased risk for postpartum haemorrhage [OR 2.5, 95% confidence interval (CI) 1.4-4.5] and blood transfusion (OR 1.9, 95%CI 1.2-3.2) for the trial of labour compared with pre-labour caesarean groups. Birth injury only occurred in the trial of labour group, 1% Twin A, 0.4% Twin B. Both twins had a higher risk of 5-minute Apgar <7 with trial of labour compared to pre-labour caesarean (A: OR 3.9, 95%CI 1.05-14.5; B: OR 3.9, 95%CI 1.3-12.3). Term twins undergoing a trial of labour have increased maternal haemorrhage and transfusions along with neonatal birth trauma and lower Apgar scores, but these absolute neonatal occurrences were rare. Trial of labour in twins remains a safe and reasonable option in appropriately selected cases. © 2014 Royal College of Obstetricians and Gynaecologists.

Maternal Caffeine Consumption during Pregnancy and Behavioral Disorders in 11-Year-Old Offspring: A Danish National Birth Cohort Study.

Science.gov (United States)

Hvolgaard Mikkelsen, Susanne; Obel, Carsten; Olsen, Jørn; Niclasen, Janni; Bech, Bodil Hammer

2017-10-01

To examine the association between maternal caffeine consumption from coffee and tea during pregnancy and offspring behavioral disorders. We studied 47 491 children enrolled in the Danish National Birth Cohort between 1996 and 2002. Data on maternal coffee and tea consumption was collected at 15 and 30 weeks of gestation. When the child was 11 years old, the Strength and Difficulties Questionnaire was filled in by children, parents, and teachers. We estimated risk ratios (RRs) for offspring behavioral disorders. At 15 weeks of gestation 3% and 4% of the pregnant women consumed ≥8 cups/d of coffee or tea, respectively. Maternal coffee consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of hyperactivity-inattention disorder (RR 1.47; 95% CI 1.18-1.83), conduct-oppositional disorders (RR 1.22; 95% CI 1.01-1.48), and any psychiatric disorder (RR 1.23; 95% CI 1.08-1.40). Maternal tea consumption ≥8 cups/d at 15 weeks of gestation was associated with increased risk of anxiety-depressive disorders (RR 1.28; 95% CI 1.09-1.52) and any psychiatric disorder (RR 1.24; 95% CI 1.11-1.40). An increased risk of hyperactivity-inattention disorder was observed with increasing daily caffeine consumption at 15 weeks of gestation. High maternal caffeine consumption from coffee and tea at 15 weeks of gestation was associated with behavioral disorders in 11-year-old offspring. We hypothesize that caffeine exposure may affect the fetal brain and program for behavioral disorders later in life. The fetal brain seems to be more sensitive to caffeine exposure at 15 weeks of pregnancy compared with 30 weeks of gestation. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal region of birth and stillbirth in Victoria, Australia 2000-2011: A retrospective cohort study of Victorian perinatal data.

Directory of Open Access Journals (Sweden)

Miranda L Davies-Tuck

Full Text Available There is growing evidence from high-income countries that maternal country of birth is a risk factor for stillbirth. We aimed to examine the association between maternal region of birth and stillbirth between 2000 and 2011 inclusive in Victoria, Australia.Retrospective population based cohort study of all singleton births at 24 or more weeks gestational age from 2000-2011 in Victoria, Australia. Stillbirths due to termination of pregnancy, babies with congenital anomalies and Indigenous mothers were excluded. Main Outcome Measure: Stillbirth.Over the 12-year period there were 685,869 singleton births and 2299 stillbirths, giving an overall stillbirth rate of 3·4 per 1000 births. After adjustment for risk factors, compared to women born in Australia/New Zealand, women born in South Asia (aOR 1.27, 95% CI 1.01-1.53, p = 0.01, were more likely to have a stillbirth whereas women born in South East and East Asia were (aOR 0.60, (95% CI 0.49-0.72, p<0.001 less likely to have a stillbirth. Additionally, the increasing rate of stillbirth as gestation length progressed began to rise earlier and more steeply in the South Asian compared to Australian/New Zealand born women. The following risk factors were also significantly associated with an increased odds of stillbirth in multivariate analyses: maternal age <20 and 35 years and more, nulliparity, low socio-economic status, previous stillbirth, no ultrasound reported in 1st trimester, pre-existing hypertension, antepartum haemorrhage and failure to detect growth restriction antenatally.Maternal region of birth is an independent risk factor for stillbirth. Improvements in the rate of stillbirth, particularly late pregnancy stillbirth, are likely to be gained in high-income settings where clinical care is informed by maternal region of birth.

Levonorgestrel used for emergency contraception during lactation-a prospective observational cohort study on maternal and infant safety.

Science.gov (United States)

Polakow-Farkash, Sharon; Gilad, Oded; Merlob, Paul; Stahl, Bracha; Yogev, Yariv; Klinger, Gil

2013-02-01

To identify possible effects of levonorgestrel used as an emergency contraceptive during breastfeeding on mothers and their infants. A prospective observational cohort study of all women who contacted the Teratology Information Service between January, 2005 and January, 2010. Breastfeeding women who used levonorgestrel as an emergency contraceptive (study group) were compared to breastfeeding women who used either ethynodiol diacetate or desogestrel (control group). Women were followed for 6-24 months. Main outcome measures were adverse maternal and infant effects and continuation of breastfeeding. We followed 71 of 128 study group women and 72 of 100 control group women. Maternal adverse effects were mainly vaginal bleeding, which was less frequent in the study vs. control group (16 of 71 vs. 27 of 72, p = 0.068). Decreased lactation was uncommon and similar in both groups. Breastfeeding was reinitiated within less than 8 h in 75% of the levonorgestrel group women. Adverse infant effects were rare (0 of 72 infants vs. 2 of 72 infants, p = 0.5 in the study vs. control group). Our findings support the safety of using levonorgestrel as an emergency contraceptive during lactation without the need for withholding breastfeeding.

Cohort profile

DEFF Research Database (Denmark)

Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg

2016-01-01

PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norweg......PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts......-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. FINDINGS TO DATE: Initial harmonisation of data from the 2 cohorts...... has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies...

Risk of childhood injuries after prenatal exposure to maternal bereavement: a Danish National Cohort Study.

Science.gov (United States)

Virk, Jasveer; Li, Jiong; Lauritsen, Jens; Olsen, Jørn

2013-01-01

The aim of this study was to assess the risk of injuries among children exposed to a stressful life exposure (defined as bereavement) before conception or during fetal life. Population-based cohort study. Denmark. All singleton births in Denmark between 1 January 1995 and 31 December 2006 were identified. These newborns were then linked to mothers, fathers, grandparents and siblings using individually assigned civil personal registration numbers. We identified that data on childhood injuries were obtained from the Danish National Patient Registry, which contains data on all hospital stays and outpatient visits. Incidence rate ratios (IRRs) were estimated from birth using log-linear Poisson regression models, and person-years were used as the offset variable. Age, residence, calendar period, maternal education, maternal income and parental-cohabitation status are treated as time-dependent variables (records were extracted from the offspring's birth year). Exposure to maternal bereavement due to a father's death had the strongest association with childhood injuries, especially when the cause of death was due to a traumatic event (adjusted estimates of IRR (aIRR): 1.25, 95%CI: 0.99 to 1.58). We did not find an association for childhood injuries and maternal bereavement due to grandparent's death, and we only found an association for sibling death when restricting to deaths due to traumatic events (aIRR: 1.20, 95%CI:1.03 to 1.39). The aetiology of childhood injuries is complex and may be related to events that take place during prenatal life. This study suggests that exposure to a stressful life event during gestation may be linked to injury susceptibility in childhood. However, changes in postnatal family conditions related to loss or genetic factors may also play a role. Developmental plasticity related to early life exposures leading to disease programming in offspring is a theory with substantial theoretical and empirical support. Prenatal stress exposure has been

Inequities in maternal postnatal visits among public and private patients: 2004 Pelotas cohort study

Directory of Open Access Journals (Sweden)

Marco Paula L

2009-09-01

Full Text Available Abstract Background The postnatal period is the ideal time to deliver interventions to improve the health of both the newborn and the mother. However, postnatal care shows low-level coverage in a large number of countries. The objectives of this study were to: 1 investigate inequities in maternal postnatal visits, 2 examine differences in postnatal care coverage between public and private providers and 3 explore the relationship between the absence of maternal postnatal visits and exclusive breastfeeding, use of contraceptive methods and maternal smoking three months after birth. Methods In the calendar year of 2004 a birth cohort study was started in the city of Pelotas, Brazil. Mothers were interviewed soon after delivery and at three months after birth. The absence of postnatal visits was defined as having no consultations between the time of hospital discharge and the third month post-partum. Logistic regression analysis was used to estimate the association between absence of postnatal visits and type of insurance scheme adjusting for potential confounding factors. Results Poorer women, black/mixed, those with lower level of education, single mothers, adolescents, multiparae, smokers, women who delivered vaginally and those who were not assisted by a physician were less likely to attend postnatal care. Postnatal visits were also less frequent among women who relied in the public sector than among private patients (72.4% vs 96% among public and private patients, respectively, x2 p Conclusion Postpartum care is available for every woman free of charge in the Brazilian Publicly-funded health care system. However, low levels of postpartum care were seen in the study (77%. Efforts should be made to increase the percentage of women receiving postpartum care, particularly those in socially disadvantaged groups. This could include locally-adapted health education interventions that address women's beliefs and attitudes towards postpartum care. There

The association between maternal serious psychological distress and child obesity at 3 years: a cross-sectional analysis of the UK Millennium Cohort Data.

Science.gov (United States)

Ramasubramanian, L; Lane, S; Rahman, A

2013-01-01

  The prevalence of child obesity is increasing rapidly worldwide. Early childhood has been identified as a critical time period for the development of obesity. Maternal mental health and early life environment are crucial factors and have been linked to adverse child outcomes. The objective of the study was to examine the relationship between maternal serious psychological distress and obesity in early childhood.   A cross-sectional analysis of data from the Millennium Cohort Study was conducted. Subjects consisted of all natural mothers (n= 10 465) who had complete and plausible data for Kessler-6 scores, socio-demographic and anthropometric variables, and their children for whom anthropometric measurements were completed at age 3. Maternal serious psychological distress was defined as a score of 13 or more on the Kessler-6 scale. Obesity was defined as body mass index ≥95th centile of the 1990 reference chart for age and sex in children. The data were analysed using spss 16. Maternal socio-demographic factors that are known to influence maternal mental health and child obesity were identified and adjusted using multivariate logistic regression.   Of the 10 465 mother-child dyads, 3.5% of mothers had serious psychological distress and 5.5% of children were obese at 3 years of age. Logistic regression analysis showed that maternal serious psychological distress was associated with early childhood obesity (P= 0.01; OR 1.62, 95% CI 1.11, 2.37). After adjusting for potential confounding factors using multivariate logistic regression, maternal serious psychological distress remained significantly associated with early childhood obesity (P= 0.01; OR 1.59, 95% CI 1.08, 2.34).   The results show that maternal serious psychological distress is independently associated with early childhood obesity. © 2011 Blackwell Publishing Ltd.

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...

Inequality in malnutrition by maternal education levels in early childhood: the Prospective Cohort of Thai Children (PCTC).

Science.gov (United States)

Hong, Seo Ah; Winichagoon, Pattanee; Mongkolchati, Aroonsri

2017-05-01

As tackling socioeconomic inequality in child malnutrition still remains one of the greatest challenges in developing countries, we examined maternal educational differences in malnutrition and the magnitude of its inequality among 4,198 children from the Prospective Cohort study of Thai Children (PCTC). Prevalence of stunting, underweight, and wasting from birth to 24 months was calculated using the new WHO growth chart. The Relative Index of Inequality (RII) was used to examine the magnitude and trend of inequality in malnutrition between maternal educational levels. The low education group had lower weight and height in most ages than the high education group. Faltering in height was observed in all education levels, but was most remarkable in the low education group. On the other hand, while upward trends for weight-for-age and weight-for-height across ages were observed in the high education group, a marked decline between 6 to 12 months was observed in the low education group. An increasing trend in inequality in The RII revealed an increasing trend in inequality in stunting, underweight, and wasting by maternal education levels was observed during infancy with an almost monotonic increase until 24 months, although the inequality in wasting decreased after 18 months of age. Inequality in malnutrition remarkably increased during infancy, and for stunting and underweight it remained until 24 months. These findings shed light on the extent of malnutrition inequality during the first 2 years of life and they suggest sustainable efforts must be established at the national level to tackle the malnutrition inequality in infancy.

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...

Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.

Science.gov (United States)

Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

2015-04-01

To explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth. Prospective cohort study. OUs and planned home births in England. 8180 'higher risk' women in the Birthplace cohort. We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Composite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births. The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John

Prenatal Exposure to Maternal Cigarette Smoking and DNA Methylation: Epigenome-Wide Association in a Discovery Sample of Adolescents and Replication in an Independent Cohort at Birth through 17 Years of Age

Science.gov (United States)

Lee, Ken W.K.; Richmond, Rebecca; Hu, Pingzhao; French, Leon; Shin, Jean; Bourdon, Celine; Reischl, Eva; Waldenberger, Melanie; Zeilinger, Sonja; Gaunt, Tom; McArdle, Wendy; Ring, Susan; Woodward, Geoff; Bouchard, Luigi; Gaudet, Daniel; Smith, George Davey; Relton, Caroline; Paus, Tomas

2014-01-01

Background: Prenatal exposure to maternal cigarette smoking (prenatal smoke exposure) had been associated with altered DNA methylation (DNAm) at birth. Objective: We examined whether such alterations are present from birth through adolescence. Methods: We used the Infinium HumanMethylation450K BeadChip to search across 473,395 CpGs for differential DNAm associated with prenatal smoke exposure during adolescence in a discovery cohort (n = 132) and at birth, during childhood, and during adolescence in a replication cohort (n = 447). Results: In the discovery cohort, we found five CpGs in MYO1G (top-ranking CpG: cg12803068, p = 3.3 × 10–11) and CNTNAP2 (cg25949550, p = 4.0 × 10–9) to be differentially methylated between exposed and nonexposed individuals during adolescence. The CpGs in MYO1G and CNTNAP2 were associated, respectively, with higher and lower DNAm in exposed versus nonexposed adolescents. The same CpGs were differentially methylated at birth, during childhood, and during adolescence in the replication cohort. In both cohorts and at all developmental time points, the differential DNAm was in the same direction and of a similar magnitude, and was not altered appreciably by adjustment for current smoking by the participants or their parents. In addition, four of the five EWAS (epigenome-wide association study)–significant CpGs in the adolescent discovery cohort were also among the top sites of differential methylation in a previous birth cohort, and differential methylation of CpGs in CYP1A1, AHRR, and GFI1 observed in that study was also evident in our discovery cohort. Conclusions: Our findings suggest that modifications of DNAm associated with prenatal maternal smoking may persist in exposed offspring for many years—at least until adolescence. Citation: Lee KW, Richmond R, Hu P, French L, Shin J, Bourdon C, Reischl E, Waldenberger M, Zeilinger S, Gaunt T, McArdle W, Ring S, Woodward G, Bouchard L, Gaudet D, Davey Smith G, Relton C, Paus T

FAM-FMC system as an alternative element of the software used in a grain and flour milling enterprise

Directory of Open Access Journals (Sweden)

Szymon T. Dziuba

2014-10-01

Full Text Available Processes of computerization have become a standard in contemporary production plant methods. Implementation of these processes is aimed at limiting activities which had up to that point, been performed manually. Dedicated computer systems are being developed according to the requirements imposed on concrete enterprises with consideration of their manufacturing specificity. These adjusted systems facilitate and accelerate production and improve its performance while helping maintain a consistent level of quality for the final product. Flour mill laboratories use the software to record and facilitate computation of the measurements. This study is aimed at analysing the potential for implementation of the FAM-FMC system as a tool to support production of flour with parameters that match specific customer expectations.

Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration).

Science.gov (United States)

Fall, Caroline H D; Sachdev, Harshpal Singh; Osmond, Clive; Restrepo-Mendez, Maria Clara; Victora, Cesar; Martorell, Reynaldo; Stein, Aryeh D; Sinha, Shikha; Tandon, Nikhil; Adair, Linda; Bas, Isabelita; Norris, Shane; Richter, Linda M

2015-07-01

Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs. In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)-a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, waist circumference, fat, and lean mass), and cardiometabolic risk factors (blood pressure and fasting plasma glucose concentration), along with binary variables derived from these. Analyses were unadjusted and adjusted for maternal socioeconomic status, height and parity, and breastfeeding duration. We obtained data for 22 188 mothers from the five cohorts, enrolment into which took place at various times between 1969 and 1989. Data for maternal age and at least one outcome were available for 19 403 offspring (87%). In unadjusted analyses, younger (≤19 years) and older (≥35 years) maternal age were associated with lower birthweight, gestational age, child nutritional status, and schooling. After adjustment, associations with younger maternal age remained for low birthweight (odds ratio [OR] 1·18 (95% CI 1·02-1·36)], preterm birth (1·26 [1·03-1·53]), 2-year stunting (1·46 [1·25-1·70]), and failure to complete secondary schooling (1·38 [1·18-1·62]) compared with mothers aged 20-24 years. After adjustment, older maternal age remained associated with increased risk of preterm birth (OR 1

Maternal vitamin D status and infant outcomes in rural Vietnam: a prospective cohort study.

Science.gov (United States)

Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Thuy, Tran T; Khuong, Nguyen C; Thoang, Dang D; Tran, Thach D; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann

2014-01-01

Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD) in late pregnancy and early infant growth and developmental outcomes in rural Vietnam. A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age. 60% (582/960) of women had 25-OHD levels language scores compared to those born to women who were vitamin D replete (≥75 nmol/L) (Mean Difference (MD) -3.48, 95% Confidence Interval (CI) -5.67 to -1.28). For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decreased by 0.08 (95% CI -0.15 to -0.02). Low maternal 25- hydroxyvitamin D levels during late pregnancy are of concern in rural Vietnam, and are associated with reduced language developmental outcomes at 6 months of age. Our findings strengthen the evidence for giving vitamin D supplementation during pregnancy.

Maternal employment and breast-feeding initiation: findings from the Millennium Cohort Study.

Science.gov (United States)

Hawkins, Summer S; Griffiths, Lucy J; Dezateux, Carol; Law, Catherine

2007-05-01

Maternal employment rates have increased rapidly in recent years and little is known about how this influences whether women start breast feeding. We examined data from the Millennium Cohort Study to determine whether a mother's employment status (full-time, part-time, self-employed, on leave, not employed/student) and employment characteristics are related to breast-feeding initiation. This analysis comprised 14 830 white mothers from Britain and Ireland (6917 employed) with singleton babies, born from 2000 to 2002. Information was obtained on infant feeding history and mother's employment when the cohort child was 9 months old. We found that women employed full-time were less likely to initiate breast feeding than mothers who were not employed/students, after adjustment for confounding factors [adjusted rate ratio (aRR) = 0.92; 95% confidence interval (CI) 0.89, 0.96]; however, there were no differences in breast-feeding initiation between mothers employed part-time, self-employed, or on leave and mothers who were not employed/students. Among employed mothers, those who returned to work within 4 months postpartum were less likely to start breast feeding than women who returned at 5 or 6 months [aRR = 0.95; 95% CI 0.92, 0.99], and women who returned within the first 6 weeks were much less likely to start breast feeding [aRR = 0.85; 95% CI 0.77, 0.94]. Mothers returning for financial reasons were also less likely to initiate breast feeding [aRR = 0.96; 95% CI 0.93, 0.99] than those who returned for other reasons. Policies to increase breast feeding should address how both the time and circumstances of a mother's return to employment postpartum influence whether she decides to start breast feeding.

Maternal Blood Pressure Rise During Pregnancy and Offspring Obesity Risk at 4 to 7 Years Old: The Jiaxing Birth Cohort.

Science.gov (United States)

Zheng, Ju-Sheng; Liu, Huijuan; Ong, Ken K; Huang, Tao; Guan, Yuhong; Huang, Yuan; Yang, Bo; Wang, Fenglei; Li, Duo

2017-11-01

Maternal hypertensive disorders during pregnancy are suggested to affect obesity risk in offspring. However, little is known about the prospective association of rise in maternal blood pressure within normal range during pregnancy with this risk for obesity. To clarify the associations of diastolic and systolic blood pressure during pregnancy among normotensive women with the risk for obesity in offspring. Prospective cohort study. Southeast China. Up to 2013, a total of 88,406 mother-child pairs with anthropometric measurements of offspring age 4 to 7 years were included in the present analysis. Overweight/obesity risk in offspring. Among normotensive women, second- and third-trimester diastolic and systolic blood pressures were positively associated with risk for overweight/obesity in offspring: odds ratios per 10-mm Hg higher second- and third-trimester diastolic blood pressure were 1.05 [95% confidence interval (CI), 1.01 to 1.09] and 1.05 (95% CI, 1.02 to 1.10), respectively, and for systolic blood pressure were 1.08 (95% CI, 1.05 to 1.11) and 1.06 (95% CI, 1.03 to 1.09). Each 10-mm Hg greater rise in blood pressure between first and third trimesters was associated with a higher risk for offspring overweight/obesity: diastolic, 1.06 (95% CI, 1.01 to 1.10); systolic, 1.05 (95% CI, 1.02 to 1.07). Among all women (combining normotensive and hypertensive women), maternal hypertension in the second and third trimesters was associated with 49% and 14% higher risks for overweight/obesity in offspring, respectively. These results suggest that rise in maternal blood pressure during pregnancy and hypertension during pregnancy, independent of maternal body size before pregnancy, are risk factors for offspring childhood obesity.

The maternal health outcomes of paid maternity leave: a systematic review.

Science.gov (United States)

Aitken, Zoe; Garrett, Cameryn C; Hewitt, Belinda; Keogh, Louise; Hocking, Jane S; Kavanagh, Anne M

2015-04-01

Paid maternity leave has become a standard benefit in many countries throughout the world. Although maternal health has been central to the rationale for paid maternity leave, no review has specifically examined the effect of paid maternity leave on maternal health. The aim of this paper is to provide a systematic review of studies that examine the association between paid maternity leave and maternal health. We conducted a comprehensive search of electronic databases (Medline, Embase, CINAHL, PsycINFO, Web of Science, Sociological Abstracts) and Google Scholar. We searched websites of relevant organisations, reference lists of key papers and journals, and citation indices for additional studies including those not in refereed journals. There were no language restrictions. Studies were included if they compared paid maternity leave versus no paid maternity leave, or different lengths of paid leave. Data were extracted and an assessment of bias was performed independently by authors. Seven studies were identified, with participants from Australia, Sweden, Norway, USA, Canada, and Lebanon. All studies used quantitative methodologies, including cohort, cross-sectional, and repeated cross-sectional designs. Outcomes included mental health and wellbeing, general health, physical wellbeing, and intimate partner violence. The four studies that examined leave at an individual level showed evidence of maternal health benefits, whereas the three studies conducting policy-level comparisons reported either no association or evidence of a negative association. The synthesis of the results suggested that paid maternity leave provided maternal health benefits, although this varied depending on the length of leave. This has important implications for public health and social policy. However, all studies were subject to confounding bias and many to reverse causation. Given the small number of studies and the methodological limitations of the evidence, longitudinal studies are

Association of maternal depression with dietary intake, growth, and development of preterm infants: a cohort study in Beijing, China.

Science.gov (United States)

Wang, Han; Zhou, Hong; Zhang, Yan; Wang, Yan; Sun, Jing

2017-11-27

This study aimed to explore the association of maternal depression with nutrient intake, growth, and development of preterm infants. A cohort study of 201 infants was conducted in Beijing. Based on the gestational age of an infant and status of the mother, the infants were divided into four groups: non-depression-fullterm (64), non-depression-preterm (70), depression-fullterm (36), and depression-preterm (31). Data on sociodemographic characteristics, nutritional intake, growth, and developmental status of children at 8 months (corrected ages) were collected using a quantitative questionnaire, a 24-Hour Dietary Recall, anthropometric measurements, and the Bayley-III scale. A multivariate analysis was used to evaluate the effects of maternal depression and preterm birth on infant growth and development. The energy, protein, and carbohydrate intake in the depression group was lower than the recommended amounts. The depression preterm groups indicated the lowest Z-scores for length and weight and the lowest Bayley-III scores. Preterm infants of depressed mothers are at high risks of poor growth and development delay.

An Age-Period-Cohort Analysis

OpenAIRE

Ananth, Cande V.; Keyes, Katherine M.; Hamilton, Ava; Gissler, Mika; Wu, Chunsen; Liu, Shiliang; Luque-Fernandez, Miguel Angel; Skjaerven, Rolv; Williams, Michelle A.; Tikkanen, Minna; Cnattingius, Sven

2015-01-01

Background. Although rare, placental abruption is implicated in disproportionately high rates of perinatal morbidity and mortality. Understanding geographic and temporal variations may provide insights into possible amenable factors of abruption. We examined abruption frequencies by maternal age, delivery year, and maternal birth cohorts over three decades across seven countries. Methods. Women that delivered in the US (n = 863,879; 1979–10), Canada (4 provinces, n = 5,407,463; 1982–11), ...

Maternal employment and atopic dermatitis in children: a prospective cohort study.

Science.gov (United States)

Wang, I J; Wen, H J; Chiang, T L; Lin, S J; Chen, P C; Guo, Y L

2013-04-01

Considering the early onset of atopic dermatitis (AD), which most often arises in the first year of life, risk factors occurring very early in life must be considered. Little is known about the effects of maternal occupational exposure on the development of atopic disorders in children. The aim of this study was to evaluate associations between maternal employment and childhood AD. We used multistage stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth register. Information on maternal occupation categories, work stress, working time, shift work and potential confounders during pregnancy was gathered by questionnaires after birth. At 3 years of age, information on the development of AD was assessed by home interviews. Multiple logistic regression analysis was performed to estimate the association of maternal employment and AD. Overall, 11,962 out of 19,381 mothers (61·7%) worked during pregnancy. The children of mothers who worked during pregnancy had an increased risk of AD compared with those whose mothers did not work [odds ratio (OR) 1·38, 95% confidence interval (CI) 1·25-1·53]. The children of mothers with a professional or technical occupation had a higher risk of AD (OR 1·64, 95% CI 1·44-1·87). The risk of AD was found to increase with maternal work stress during pregnancy in a dose-response manner (P(trend)maternal shift work was found. Working in professional or technical occupations increased the risk of childhood AD in addition to work stress during pregnancy. © 2013 The Authors. BJD © 2013 British Association of Dermatologists.

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...

Perinatal and maternal outcomes in planned home and obstetric unit births in women at ‘higher risk’ of complications: secondary analysis of the Birthplace national prospective cohort study

Science.gov (United States)

Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

2015-01-01

Objective To explore and compare perinatal and maternal outcomes in women at ‘higher risk’ of complications planning home versus obstetric unit (OU) birth. Design Prospective cohort study. Setting OUs and planned home births in England. Population 8180 ‘higher risk’ women in the Birthplace cohort. Methods We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Main outcome measures Composite perinatal outcome measure encompassing ‘intrapartum related mortality and morbidity’ (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. Results The risk of ‘intrapartum related mortality and morbidity’ or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31–0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure ‘intrapartum related mortality and morbidity’ (RR adjusted for parity 1.92, 95% CI 0.97–3.80). Maternal interventions were lower in planned home births. Conclusions The babies of ‘higher risk’ women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between

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

Science.gov (United States)

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.

Maternal and obstetrical predictors of sudden infant death syndrome (SIDS).

Science.gov (United States)

Friedmann, Isabel; Dahdouh, Elias M; Kugler, Perlyne; Mimran, Gracia; Balayla, Jacques

2017-10-01

Public Health initiatives, such as the "Safe to Sleep" campaign, have traditionally targeted infants' risk factors for the prevention of Sudden Infant Death Syndrome (SIDS). However, controversy remains regarding maternal and obstetrical risk factors for SIDS. In our study, we sought out to determine both modifiable and non-modifiable obstetrical and maternal risk factors associated with SIDS. We conducted a population-based cohort study using the CDC's Linked Birth-Infant Death data from the United States for the year 2010. The impact of several obstetrical and maternal risk factors on the risk of overall infant mortality and SIDS was estimated using unconditional regression analysis, adjusting for relevant confounders. Our cohort consisted of 4,007,105 deliveries and 24,174 infant deaths during the first year of life, of which 1991 (8.2%) were due to SIDS. Prominent risk factors for SIDS included (OR [95% CI]): black race, 1.89 [1.68-2.13]; maternal smoking, 3.56 [3.18-3.99]; maternal chronic hypertension, 1.73 [1.21-2.48]; gestational hypertension, 1.51 [1.23-1.87]; premature birth <37 weeks, 2.16 [1.82-2.55]; IUGR, 2.46 [2.14-2.82]; and being a twin, 1.81 [1.43-2.29], p < 0.0001. Relative to a cohort of infants who died of other causes, risk factors with a predilection for SIDS were maternal smoking, 2.48 [2.16-2.83] and being a twin, 1.52 [1.21-1.91], p < 0.0001. Conclusions for practice: While certain socio-demographic and gestational characteristics are important risk factors, maternal smoking remains the strongest prenatal modifiable risk factor for SIDS. We recommend the continuation of Public Health initiatives that promote safe infant sleeping practices and smoking cessation during and after pregnancy.

Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation

DEFF Research Database (Denmark)

Sharp, Gemma C; Salas, Lucas A; Monnereau, Claire

2017-01-01

-analysed the association between pre-pregnancy maternal BMI and methylation at over 450,000 sites in newborn blood DNA, across 19 cohorts (9,340 mother-newborn pairs). We attempted to infer causality by comparing the effects of maternal versus paternal BMI and incorporating genetic variation. In four additional cohorts (1......,817 mother-child pairs), we meta-analysed the association between maternal BMI at the start of pregnancy and blood methylation in adolescents. In newborns, maternal BMI was associated with small (.... Adjustment for estimated cell proportions greatly attenuated the number of significant CpGs to 104, including 86 sites common to the unadjusted model. At 72/86 sites, the direction of the association was the same in newborns and adolescents, suggesting persistence of signals. However, we found evidence...

HFE gene variants modify the association between maternal lead burden and infant birthweight: a prospective birth cohort study in Mexico City, Mexico.

Science.gov (United States)

Cantonwine, David; Hu, Howard; Téllez-Rojo, Martha Maria; Sánchez, Brisa N; Lamadrid-Figueroa, Héctor; Ettinger, Adrienne S; Mercado-García, Adriana; Hernández-Avila, Mauricio; Wright, Robert O

2010-07-26

Neonatal growth is a complex process involving genetic and environmental factors. Polymorphisms in the hemochromatosis (HFE) iron regulatory genes have been shown to modify transport and toxicity of lead which is known to affect birth weight. We investigated the role of HFE C282Y, HFE H63 D, and transferrin (TF) P570 S gene variants in modifying the association of lead and infant birthweight in a cohort of Mexican mother-infant pairs. Subjects were initially recruited between 1994-1995 from three maternity hospitals in Mexico City and 411 infants/565 mothers had archived blood available for genotyping. Multiple linear regression models, stratified by either maternal/infant HFE or TF genotype and then combined with interaction terms, were constructed examining the association of lead and birthweight after controlling for covariates. 3.1%, 16.8% and 17.5% of infants (N=390) and 1.9%, 14.5% and 18.9% of mothers (N=533) carried the HFE C282Y, HFE H63D, and TF P570 S variants, respectively. The presence of infant HFE H63 D variants predicted 110.3 g (95% CI -216.1, -4.6) decreases in birthweight while maternal HFE H63 D variants predicted reductions of 52.0 g (95% CI -147.3 to 43.2). Interaction models suggest that both maternal and infant HFE H63 D genotype may modify tibia lead's effect on infant birthweight in opposing ways. In our interaction models, maternal HFE H63 D variant carriers had a negative association between tibia lead and birthweight. These results suggest that the HFE H63 D genotype modifies lead's effects on infant birthweight in a complex fashion that may reflect maternal-fetal interactions with respect to the metabolism and transport of metals.

Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China

Science.gov (United States)

Wang, Shiwen; Wang, Tongzhan; Zhang, Wenqiang; Liu, Xiaolin; Wang, Xiaofang; Wang, Haiyan; He, Xiaozhou; Zhang, Shunxian; Xu, Shuhui; Yu, Yang; Jia, Xingbing; Wang, Maolin; Xu, Aiqiang; Ma, Wei; Amin, Minal M.; Bialek, Stephanie R.; Dollard, Sheila C.; Wang, Chengbin

2017-01-01

Abstract Congenital cytomegalovirus (CMV) infection is the leading viral cause of birth defects and developmental disabilities in developed countries. However, CMV seroprevalence and burden of congenital CMV infection are not well defined in China. Cohort of newborns from 5 birthing hospitals in 2 counties of Shandong Province, China, were enrolled from March 2011 to August 2013. Dried blood spots (DBS) and saliva were collected within 4 days after birth for IgG testing for maternal seroprevalence and real-time PCR testing for congenital CMV infection, respectively. Among 5020 newborns tested for CMV IgG, 4827 were seropositive, resulting in CMV maternal seroprevalence of 96.2% (95% confidence interval [CI]:95.6%–96.7%). Of the 10,933 newborns screened for congenital CMV infection, 75 had CMV detected, resulting in an overall prevalence of 0.7% (95% CI: 0.5%–0.9%), with prevalences of 0.4% (14/3995), 0.6% (66/10,857), and 0.7% (52/7761) for DBS, wet saliva, and dried saliva specimens screened, respectively. Prevalence of congenital CMV infection decreased with increasing maternal age (0.9%, 0.6%, and 0.3% among newborns delivered from mothers aged 16–25, 26–35, and >35 years, respectively; P = 0.03), and was higher among preterm infants than full term infants (1.3% vs 0.6%, P = 0.04), infants with intrauterine growth restriction (IUGR) than those without (1.8% vs 0.7%, P = 0.03), and twins or triplets than singleton pregnancies (2.8% vs 0.7%, P = 0.04). None of the 75 newborns exhibited symptomatic congenital CMV infection, and there was no difference in clinical characteristics and newborn hearing screening results between infants with and without congenital CMV infection at birth. Congenital CMV infection prevalence was lower and the clinical manifestations were milder in this relatively developed region of China compared to populations from other countries with similarly high maternal seroprevalence. Follow-up on children with congenital

Maternal mental health and its association with infant growth at 6 months in ethnic groups: results from the Born-in-Bradford birth cohort study.

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Gemma D Traviss

Full Text Available To identify factors associated with infant growth up to 6 months, with a particular focus on maternal distress, and to explore the effect of ethnicity on any relation between maternal distress and infant growth.Cohort study recruiting White and Pakistani women in the United Kingdom (UK. Infant growth was measured at birth and 6 months. Standard assessment of mental health (GHQ-28 was undertaken in pregnancy (26-28 weeks gestation and 6 months postpartum. Modelling included social deprivation, ethnicity, and other known influences on infant growth such as maternal smoking and alcohol consumption.Maternal distress improved markedly from pregnancy to 6 months postpartum. At both times Pakistani women had more somatic and depression symptoms than White women. Depression in pregnancy (GHQ subscale D was associated with lower infant growth at 6 months. Self-reported social dysfunction in pregnancy (GHQ subscale C was associated with lower gestational age.. Pakistani women reported higher GHQ scores during pregnancy associated with smaller infants at birth. They lived in areas of higher social deprivation, reported less alcohol consumption and smoking postnatally, all independent influences on growth at 6 months.Maternal mental health in pregnancy is an independent influence on infant growth up to 6 months and is associated with ethnicity which was itself associated with deprivation in our sample. There is a complex relationship between symptoms of maternal distress, ethnicity, deprivation, health behaviours, and early infant growth. Measures should include both emotional and somatic symptoms and interventions to reduce risks of poor early growth need to include psychological and social components.

Prenatal exposure to maternal bereavement and childbirths in the offspring: a population-based cohort study.

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Plana-Ripoll, Oleguer; Olsen, Jørn; Andersen, Per Kragh; Gómez, Guadalupe; Cnattingius, Sven; Li, Jiong

2014-01-01

The decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring. This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement. A total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3%) were exposed and 981,989 (23.8%) had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR) [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96-1.01] and 1.01 [0.98-1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94-0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04-1.14]), the spouse (HR = 1.29 [1.12-1.48]) or a sibling (HR = 1.13 [1.01-1.27]). Our results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a firmer conclusion.

Referral for Fetal Echocardiography is Associated with Increased Maternal Anxiety

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Rosenberg, Katherine B.; Monk, Catherine; Kleinman, Charles S.; Glickstein, Julie S.; Levasseur, Stephanie M.; Simpson, Lynne L.; Williams, Ismee A.

2010-01-01

Background Referral for fetal echocardiography is an acute stressor that may induce significant maternal anxiety. To promote good clinical management of expectant mothers in this situation, including adequate screening for possible psychiatric interventions, data is needed regarding the psychosocial functioning of women scheduled for fECHO procedures. Objective To investigate the association between fECHO and maternal anxiety. Methods Pregnant women answered two questionnaires prior to first fECHO. The Spielberger State-Trait Anxiety Inventory (STAI) assessed how subjects feel “now” (state) versus how they “usually feel” (trait). Separate state and trait anxiety scores were calculated; scores were compared between the study cohort and a gestational age-matched historical cohort of 31 pregnant women who did not undergo fECHO. A second questionnaire developed by the investigators ascertained pregnancy specific concerns and characteristics. Results 40 subjects were enrolled. The mean state score of the fECHO cohort (42.1±15.1) differed from the historical cohort (32.8±11.3; p=0.006); however there was no difference between trait scores (34.7±10.8 vs. 35.4 ±12.8; p=0.8). A multivariate linear regression model controlling for race and maternal age demonstrated that fECHO was a strong independent predictor of maternal state anxiety score (p=0.004, β=10.4). Conclusions Pregnant women presenting for fECHO report high anxiety levels compared with women not presenting for fECHO. Clinician awareness and sensitivity is recommended and further investigation of modifiers of anxiety in this high risk group should be explored. PMID:20443657

A cohort study of maternal and neonatal morbidity in relation to use of sequential instruments at operative vaginal delivery.

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Murphy, Deirdre J

2012-02-01

OBJECTIVE: To evaluate the risk factors and maternal and neonatal morbidity associated with sequential use of instruments (vacuum and forceps) at operative vaginal delivery. STUDY DESIGN: A cohort study of 1360 nulliparous women delivered by a single instrument (vacuum or forceps) or by both instruments, within two university teaching hospitals in Scotland and England. Outcomes were compared for use of sequential instruments versus use of any single instrument. A sub-group analysis compared sequential instruments versus forceps alone. Outcomes of interest included anal sphincter tears, postpartum haemorrhage, urinary retention, urinary incontinence, prolonged hospital admission, neonatal trauma, low Apgar scores, abnormal cord bloods and admission to the neonatal intensive care unit (NICU). RESULTS: Use of sequential instruments at operative vaginal delivery was associated with fetal malpositions, Odds Ratio (OR) 1.8 (95% Confidence Interval (CI) 1.3-2.6), and large neonatal head circumference (>37 cm) (OR 5.0, 95% CI 2.6-9.7) but not with maternal obesity or grade of operator. Sequential use of instruments was associated with greater maternal and neonatal morbidity than single instrument use (anal sphincter tear 17.4% versus 8.4%, adjusted OR 2.1, 95% CI 1.2-3.3; umbilical artery pH <7.10, 13.8% versus 5.0%, adjusted OR 3.3, 95% CI 1.7-6.2). Sequential instrument use had greater morbidity than single instrument use with forceps alone (anal sphincter tear OR 1.8, 95% CI 1.1-2.9; umbilical artery pH <7.10 OR 3.0, 95% CI 1.7-5.5). CONCLUSIONS: The use of sequential instruments significantly increases maternal and neonatal morbidity. Obstetricians need training in the appropriate selection and use of instruments with the aim of completing delivery safely with one instrument.

PPO.46 Risk of Miscarriage associated with Maternal and Paternal Smoking

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Meaney, S.; Corcoran, P.; Lutomski, J.E.; Spillane, N.; O'Donoghue, K.

2014-01-01

OBJECTIVE: Maternal smoking has been associated with increased risk of miscarriage. However little is known about the influence of paternal smoking. The study aimed to examine maternal and paternal smoking as risk factors for miscarriage. STUDY DESIGN: A cohort study was conducted in a large,

Maternal filicide in a cohort of English Serious Case Reviews.

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Sidebotham, Peter; Retzer, Ameeta

2018-03-02

A national mixed-methods study of English Serious Case Reviews (SCRs) was carried out to better understand the characteristics and circumstances of maternally perpetrated filicides, to compare these with paternally perpetrated cases, and to identify learning points for mental health professionals. Published reports for all SCRs of children in England dying as a result of abuse or neglect from 2011 to 2014 were subject to qualitative analysis using a system of layered reading and inductive thematic analysis, along with descriptive and comparative quantitative analysis. There were 86 deaths directly attributable to child maltreatment within the immediate family. The mother was the suspected perpetrator in 20. Twelve of the mother perpetrators were victims of domestic violence, while 15 of the father perpetrators were known to be perpetrators of domestic violence. Those deaths resulting from impulsive violence or severe, persistent cruelty are almost exclusively perpetrated by males, while those with an apparent intent to kill the child are slightly more likely to be perpetrated by mothers. Four key themes were identified through the qualitative analysis: domestic violence, maternal mental illness, separation and maternal isolation, and the invisibility of the child. These findings highlight the important role of domestic violence and its interaction with maternal mental health. Professionals working with mothers with mental health problems need to adopt a supportive but professionally curious stance, to be alert to signs of escalating stress or worsening mental ill-health, and to provide supportive and accessible structures for at-risk families.

Case-control study of fetal microchimerism and breast cancer.

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Vijayakrishna K Gadi

2008-03-01

Full Text Available Prior pregnancy is known to protect against development of breast cancer. Recent studies have demonstrated that pregnancy has the capacity to establish small numbers of immunologically active fetal-derived cells in the mother, a phenomenon known as fetal microchimerism (FMc. We asked whether presence of FMc, routinely acquired during pregnancy, is a protective factor for breast cancer.DNA extracts from peripheral blood specimens were obtained from a population-based case-control study of risk factors for breast cancer in women 21 to 45 years old. Specimens were tested with quantitative PCR for presence and concentrations of male DNA presumed to derive from prior pregnancies with a male fetus. Odds ratios (OR and 95% confidence intervals (CI were estimated with consideration of multiple established reproductive and environmental risk factors for breast cancer. FMc results were generated on 99 parous women, 54 with primary invasive breast cancer and 45 general population controls. FMc prevalence was 56% (25/45 and 26% (14/54 in controls and cases, respectively. Women harboring FMc were less likely to have had breast cancer (OR = 0.29, 95% CI 0.11-0.83; p = 0.02, adjusting for age, number of children, birth of a son, history of miscarriage, and total DNA tested. In addition, FMc concentrations were higher in controls versus cases (p = 0.01. Median concentrations were 2 (0-78 and 0 (0-374 fetal genomes/10(6 maternal genomes in controls and cases, respectively.Results suggest that the enigma of why some parous women are not afforded protection from breast cancer by pregnancy might in part be explained by differences in FMc. Mechanistic studies of FMc-derived protection against breast cancer are warranted.

A Study on Mediation by Offspring BMI in the Association between Maternal Obesity and Child Respiratory Outcomes in the Amsterdam Born and Their Development Study Cohort.

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Harskamp-van Ginkel, Margreet W; London, Stephanie J; Magnus, Maria C; Gademan, Maaike G; Vrijkotte, Tanja G

2015-01-01

A causal relationship between maternal obesity and offspring asthma is hypothesized to begin during early development, but no underlying mechanism for the found association is identified. We quantitatively examined mediation by offspring body mass index (BMI) in the association of maternal pre-pregnancy BMI on risk of asthma and wheezing during the first 7-8 years of life in a large Amsterdam born birth cohort. For 3185 mother-child pairs, mothers reported maternal pre-pregnancy BMI and offspring outcomes "ever being diagnosed with asthma" and "wheezing in the past 12 months" on questionnaires. We measured offspring height and weight at age 5-6 years. We performed a multivariate log linear regression comparing outcomes in offspring of mothers with different BMI categories. For each category we quantified and tested mediation by offspring BMI and also investigated interaction by parental asthma. At the age of 7-8 years, 8% of the offspring ever had asthma and 7% had current wheezing. Maternal pre-pregnancy obesity was associated with higher risks of asthma (adjusted RR 2.32 (95% CI: 1.49-3.61) and wheezing (adjusted RR 2.16 (95% CI: 1.28-3.64). Offspring BMI was a mediator in the association between maternal BMI and offspring wheezing, but not for asthma. There was no interaction by parental asthma. Maternal pre-pregnancy obesity was associated with higher risks of offspring asthma and wheezing. The association between maternal obesity and offspring wheezing was both direct and indirect (mediated) through the child's own BMI.

Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study.

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Auger, Nathalie; Le, Thi Uyen Nhi; Park, Alison L; Luo, Zhong-Cheng

2011-10-04

Preterm birth (PTB) is a major cause of infant morbidity and mortality, but the relationship between comorbidity and PTB by clinical subtype and severity of gestational age remains poorly understood. We evaluated associations between maternal comorbidities and PTB by clinical subtype and gestational age. We conducted a retrospective cohort study of 1,329,737 singleton births delivered in hospitals in the province of Québec, Canada, 1989-2006. PTB was classified by clinical subtype (medically indicated, preterm premature rupture of membranes (PPROM), spontaneous preterm labour) and gestational age (PTBs across all gestational ages (OR > 2.0). At the population level, several major comorbidities (placental abruption, chorioamnionitis, oliogohydramnios, structural abnormality, cervical incompetence) were key contributors to all clinical subtypes of PTB, especially at PTBs. The relationship between comorbidity and clinical subtypes of PTB depends on gestational age. Prevention of PPROM and spontaneous PTB may benefit from greater attention to preeclampsia, anemia and comorbidities localized to the reproductive system.

Associations between maternal lifestyle factors and neonatal body composition in the Screening for Pregnancy Endpoints (Cork) cohort study.

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Dahly, Darren L; Li, Xia; Smith, Hazel A; Khashan, Ali S; Murray, Deirdre M; Kiely, Mairead E; O'B Hourihane, Jonathan; McCarthy, Fergus P; Kenny, Louise C; Kearney, Patricia M

2018-02-01

Neonatal body composition likely mediates fetal influences on life long chronic disease risk. A better understanding of how maternal lifestyle is related to newborn body composition could thus inform intervention efforts. Using Cork participant data (n = 1754) from the Screening for Pregnancy Endpoints (SCOPE) cohort study [ECM5(10)05/02/08], we estimated how pre-pregnancy body size, gestational weight gain, exercise, alcohol, smoking and diet were related to neonatal fat and fat-free mass, as well as length and gestational age at birth, using quantile regression. Maternal factors were measured by a trained research midwife at 15 gestational weeks, in addition to a 3rd trimester weight measurement used to calculate weight gain. Infant body composition was measured using air-displacement plethysmography. Healthy (versus excess) gestational weight gain was associated with lower median fat-free mass [-112 g, 95% confidence interval (CI): -47 to -176) and fat mass (-33 g, 95% CI: -1 to -65) in the offspring; and a 103 g decrease in the 95th centile of fat mass (95% CI: -33 to -174). Maternal normal weight status (versus obesity) was associated with lower median fat mass (-48 g, 95% CI: -12 to -84). At the highest centiles, fat mass was lower among infants of women who engaged in frequent moderate-intensity exercise early in the pregnancy (-92 g at the 95th centile, 95% CI: -168 to -16). Lastly, women who never smoked tended to have longer babies with more fat mass and fat-free mass. No other lifestyle factors were strongly related to infant body composition. These results suggest that supporting healthy maternal lifestyles could reduce the risk of excess fat accumulation in the offspring, without adversely affecting fat-free mass development, length or gestational age. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Maternal smoking in pregnancy and risk for congenital malformations: results of a Danish register-based cohort study.

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Leite, Mimmi; Albieri, Vanna; Kjaer, Susanne K; Jensen, Allan

2014-08-01

To examine the association between maternal smoking during pregnancy and risk for congenital malformations. Population-based prospective cohort study. Denmark. A total of 838 265 singleton liveborn babies delivered in Denmark between 1997 and 2010 and registered in the Danish Medical Birth Register containing detailed information on smoking during pregnancy and congenital malformations. Associations [odds ratios (OR) with 95% CI] between maternal smoking and risk for various groups of congenital malformations, investigated using the generalized estimating equation for binary outcomes, with adjustment for potential confounders. Groups of congenital malformations. Ever smoking during pregnancy did not increase the overall risk for congenital malformations, but increased risks were observed for multiple malformations (i.e. when two or more malformations are diagnosed in a child) (odds ratio 1.06, 95% confidence interval 1.01-1.10) and various main groups of congenital malformations including the cardiovascular system (odds ratio 1.13, 95% confidence interval 1.07-1.19), the respiratory system (odds ratio 1.25, 95% confidence interval 1.11-1.41), the digestive system (odds ratio 1.15, 95% confidence interval 1.07-1.24) and oral clefts (odds ratio 1.29, 95% confidence interval 1.14-1.46), as well as for some specific congenital malformations including cardiac septal defects, malformations of the pulmonary and tricuspid valves, malformations of the great arteries, pyloric stenosis and clubfoot. Infants of women who quit smoking during the first two trimesters had no increased risk for most groups of congenital malformations. Maternal smoking increases the risk for a number of congenital malformations. Future smoking cessation programs should focus on this adverse health aspect in order to encourage more women to quit smoking before or in early pregnancy. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Maternal first-trimester diet and childhood bone mass: The Generation R Study

NARCIS (Netherlands)

D.H.M. Heppe (Denise); M.C. Medina-Gomez (Carolina); A. Hofman (Albert); O.H. Franco (Oscar); F. Rivadeneira Ramirez (Fernando); V.W.V. Jaddoe (Vincent)

2013-01-01

textabstractBackground: Maternal diet during pregnancy has been suggested to influence bone health in later life. Objective: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. Design: In a prospective cohort study in 2819 mothers and

Social Disparities in Maternal Smoking during Pregnancy: Comparison of Two Birth Cohorts (1996-2002 and 2003-2012) Based on Data from the German KiGGS Study.

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Kuntz, B; Lampert, T

2016-03-01

Background: Maternal smoking during pregnancy represents a significant developmental risk for the unborn child. This study investigated social differences in maternal smoking behavior during pregnancy in mothers living in Germany. The study focused on maternal age at delivery, social status and migration background. Method: The evaluation of data was based on two surveys carried out as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) carried out in 2003-2006 and in 2009-2012. The study compared the information given by parents of children aged between 0 and 6 years who were born either in the period from 1996 to  2002 (KiGGS baseline study, n = 4818) or in the period from 2003 to 2012 (KiGGS Wave 1, n = 4434). Determination of social status was based on parental educational levels, occupational position and income. Children classified as having a two-sided migration background either had parents, both of whom had immigrated to Germany, or were born abroad and had one parent who had immigrated to Germany; children classified as having a one-sided migration background had been born in Germany but had one parent who had immigrated to Germany. Results: The percentage of children whose mothers had smoked during pregnancy was 19.9 % for the older birth cohort and 12.1 % for the younger birth cohort. In both birth cohorts, the probability of being exposed to tobacco smoke was twice as high for children whose mothers were aged migration background was associated with a lower risk of exposure to smoking. Conclusions: The KiGGS results are in accordance with the results of other national and international studies which have shown that the percentage of mothers who smoke during pregnancy is declining. Because of a change in the method how data are collected for the KiGGS survey (written questionnaire vs. telephone interview) the trend results must be interpreted with caution. Measures aimed at preventing smoking and

Maternal age and offspring developmental vulnerability at age five: A population-based cohort study of Australian children.

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Kathleen Falster

2018-04-01

Full Text Available In recent decades, there has been a shift to later childbearing in high-income countries. There is limited large-scale evidence of the relationship between maternal age and child outcomes beyond the perinatal period. The objective of this study is to quantify a child's risk of developmental vulnerability at age five, according to their mother's age at childbirth.Linkage of population-level perinatal, hospital, and birth registration datasets to data from the Australian Early Development Census (AEDC and school enrolments in Australia's most populous state, New South Wales (NSW, enabled us to follow a cohort of 99,530 children from birth to their first year of school in 2009 or 2012. The study outcome was teacher-reported child development on five domains measured by the AEDC, including physical health and well-being, emotional maturity, social competence, language and cognitive skills, and communication skills and general knowledge. Developmental vulnerability was defined as domain scores below the 2009 AEDC 10th percentile cut point. The mean maternal age at childbirth was 29.6 years (standard deviation [SD], 5.7, with 4,382 children (4.4% born to mothers aged <20 years and 20,026 children (20.1% born to mothers aged ≥35 years. The proportion vulnerable on ≥1 domains was 21% overall and followed a reverse J-shaped distribution according to maternal age: it was highest in children born to mothers aged ≤15 years, at 40% (95% CI, 32-49, and was lowest in children born to mothers aged between 30 years and ≤35 years, at 17%-18%. For maternal ages 36 years to ≥45 years, the proportion vulnerable on ≥1 domains increased to 17%-24%. Adjustment for sociodemographic characteristics significantly attenuated vulnerability risk in children born to younger mothers, while adjustment for potentially modifiable factors, such as antenatal visits, had little additional impact across all ages. Although the multi-agency linkage yielded a broad range of

Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China

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Gao Xiao-ling

2010-12-01

Full Text Available Abstract Background Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery. Methods An indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR directly. Adjusted RRs were calculated adjusting for propensity score and medical indications. Results The incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4. The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9. The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9 than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications

Associations between maternal long-chain polyunsaturated fatty acid concentrations and child cognition at 7 years of age: The MEFAB birth cohort.

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Brouwer-Brolsma, E M; van de Rest, O; Godschalk, R; Zeegers, M P A; Gielen, M; de Groot, R H M

2017-11-01

Concentrations of the fish fatty acids EPA and DHA are low among Dutch women of reproductive age. As the human brain incorporates high concentrations of these fatty acids in utero, particularly during third trimester of gestation, these low EPA and DHA concentrations may have adverse consequences for fetal brain development and functioning. Analyses were conducted using longitudinal observational data of 292 mother-child pairs participating in the MEFAB cohort. Maternal AA, DHA, and EPA were determined in plasma phospholipids - obtained in three trimesters - by gas-liquid chromatography. Cognitive function was assessed at 7 years of age, using the Kaufman Assessment Battery for Children, resulting in three main outcome parameters: sequential processing (short-term memory), simultaneous processing (problem-solving skills), and the mental processing composite score. Spline regression and linear regression analyses were used to analyse the data, while adjusting for potential relevant covariates. Only 2% of the children performed more than one SD below the mental processing composite norm score. Children with lower test scores (children with higher test scores (≥25%). Fully-adjusted linear regression models did not show associations of maternal AA, DHA, or EPA status during any of the pregnancy trimesters with childhood sequential and simultaneous processing. Maternal fatty acid status during pregnancy was not associated with cognitive performance in Dutch children at age 7. Copyright © 2017 Elsevier Ltd. All rights reserved.

Maternal overweight before pregnancy and asthma in offspring followed for 8 years.

NARCIS (Netherlands)

Scholtens, S.; Wijga, A.H.; Brunekreef, B.; Kerkhof, M.; Postma, D.S.; Oldenwening, M.; de Jongste, J.C.; Smit, H.A.

2010-01-01

OBJECTIVE: The aim of this study was to investigate the association between maternal overweight before pregnancy and offspring asthma in an ongoing birth cohort study. Maternal overweight may affect the pulmonary and immunological development of the fetus in utero because of the increased levels of

Maternal overweight before pregnancy and asthma in offspring followed for 8 years

NARCIS (Netherlands)

Scholtens, S.; Wijga, A. H.; Brunekreef, B.; Kerkhof, M.; Postma, D. S.; Oldenwening, M.; de Jongste, J. C.; Smit, H. A.

Objective: The aim of this study was to investigate the association between maternal overweight before pregnancy and offspring asthma in an ongoing birth cohort study. Maternal overweight may affect the pulmonary and immunological development of the fetus in utero because of the increased levels of

Maternal Nonstandard Work Schedules and Breastfeeding Behaviors.

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Zilanawala, Afshin

2017-06-01

Objectives Although maternal employment rates have increased in the last decade in the UK, there is very little research investigating the linkages between maternal nonstandard work schedules (i.e., work schedules outside of the Monday through Friday, 9-5 schedule) and breastfeeding initiation and duration, especially given the wide literature citing the health advantages of breastfeeding for mothers and children. Methods This paper uses a population-based, UK cohort study, the Millennium Cohort Study (n = 17,397), to investigate the association between types of maternal nonstandard work (evening, night, away from home overnight, and weekends) and breastfeeding behaviors. Results In unadjusted models, exposure to evening shifts was associated with greater odds of breastfeeding initiation (OR 1.71, CI 1.50-1.94) and greater odds of short (OR 1.55, CI 1.32-1.81), intermediate (OR 2.01, CI 1.64-2.47), prolonged partial duration (OR 2.20, CI 1.78-2.72), and prolonged exclusive duration (OR 1.53, CI 1.29-1.82), compared with mothers who were unemployed and those who work other types of nonstandard shifts. Socioeconomic advantage of mothers working evening schedules largely explained the higher odds of breastfeeding initiation and duration. Conclusions Socioeconomic characteristics explain more breastfeeding behaviors among mothers working evening shifts. Policy interventions to increase breastfeeding initiation and duration should consider the timing of maternal work schedules.

Maternal vitamin D status and infant outcomes in rural Vietnam: a prospective cohort study.

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Sarah Hanieh

Full Text Available Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD in late pregnancy and early infant growth and developmental outcomes in rural Vietnam.A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age.60% (582/960 of women had 25-OHD levels <75 nmol/L at 32 weeks gestation. Infants born to women with 25-OHD deficiency (<37.5 nmol/L had reduced developmental language scores compared to those born to women who were vitamin D replete (≥75 nmol/L (Mean Difference (MD -3.48, 95% Confidence Interval (CI -5.67 to -1.28. For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decreased by 0.08 (95% CI -0.15 to -0.02.Low maternal 25- hydroxyvitamin D levels during late pregnancy are of concern in rural Vietnam, and are associated with reduced language developmental outcomes at 6 months of age. Our findings strengthen the evidence for giving vitamin D supplementation during pregnancy.

Maternity Leave in Taiwan

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Feng, Joyce Yen; Han, Wen-Jui

2010-01-01

Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

Genetic testing of newborns for type 1 diabetes susceptibility: a prospective cohort study on effects on maternal mental health

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Magnus Per

2010-07-01

Full Text Available Abstract Background Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about their children. Methods The study was based on questionnaire data from the Norwegian Mother and Child Cohort (MoBa study conducted by the Norwegian Institute of Public Health. Many of the mothers in the MoBa study also took part in the MIDIA study, in which their newborn children were tested for HLA-conferred genetic susceptibility for type 1 diabetes. We used MoBa questionnaire data from the 30th week of pregnancy (baseline and 6 months post-partum (3-3.5 months after disclosure of test results. We measured maternal symptoms of anxiety and depression (SCL-8, maternal self-esteem (RSES, and satisfaction with life (SWLS. The mothers also reported whether they were seriously worried about their child 6 months post-partum. We compared questionnaire data from mothers who had received information about having a newborn with high genetic risk for type 1 diabetes (N = 166 with data from mothers who were informed that their baby did not have a high-risk genotype (N = 7224. The association between genetic risk information and maternal mental health was analysed using multiple linear regression analysis, controlling for baseline mental health scores. Results Information on genetic risk in newborns was found to have no significant impact on maternal symptoms of anxiety and depression (p = 0.9, self-esteem (p = 0.2, satisfaction with life (p = 0.2, or serious worry about their child (OR = 0.98, 95% CI 0.64-1.48. Mental health before birth was strongly associated with mental health after birth. In addition, an increased

Maternal obesity, environmental factors, cesarean delivery and breastfeeding as determinants of overweight and obesity in children: results from a cohort.

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Portela, Daniel S; Vieira, Tatiana O; Matos, Sheila Ma; de Oliveira, Nelson F; Vieira, Graciete O

2015-04-15

Overweight and obesity are a public health problem with a multifactorial aetiology. The objective of this study was to evaluate risk factors for overweight and obesity in children at 6 years of age, including type of delivery and breastfeeding. This study relates to a cohort of 672 mother-baby pairs who have been followed from birth up to 6 years of age. The sample included mothers and infants seen at all ten maternity units in a large Brazilian city. Genetic, socioeconomic, demographic variables and postnatal characteristics were analyzed. The outcome analyzed was overweight and/or obesity defined as a body mass index greater than or equal to +1 z-score. The sample was stratified by breastfeeding duration, and a descriptive analysis was performed using a hierarchical logistic regression. P-values of obesity among the children were 15.6% and 12.9%, respectively. Among the subset of breastfed children, factors associated with the outcome were maternal overweight and/or obesity (PR 1.92; 95% confidence interval "95% CI" 1.15-3.24) and lower income (PR 0.50; 95% CI 0.29-0.85). Among children who had not been breastfed or had been breastfed for shorter periods (less than 12 months), predictors were mothers with lower levels of education (PR 0.39; 95% CI 0.19-0.78), working mothers (PR 1.83; 95% CI 1.05-3.21), caesarean delivery (PR 1.98; 95% CI 1.14 - 3.50) and maternal obesity (PR 3.05; 95% CI 1.81 - 5.25). Maternal obesity and caesarean delivery were strongly associated with childhood overweight and/or obesity. Lower family income and lower levels of education were identified as protective factors. Breastfeeding duration appeared to modify the association between overweight/obesity and the other predictors studied.

Protective factors for child development at age 2 in the presence of poor maternal mental health: results from the All Our Babies (AOB) pregnancy cohort

OpenAIRE

McDonald, Sheila W; Kehler, Heather L; Tough, Suzanne C

2016-01-01

Objective To identify the combination of factors most protective of developmental delay at age 2 among children exposed to poor maternal mental health. Design Observational cohort study. Setting Pregnant women were recruited from primary healthcare offices, the public health laboratory service and community posters in Calgary, Alberta, Canada. Participants 1596 mother?child dyads who participated in the All Our Babies study and who completed a follow-up questionnaire when their child was 2?ye...

Prospective study of maternal alcohol intake during pregnancy or lactation and risk of childhood asthma: the Norwegian Mother and Child Cohort Study.

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Magnus, Maria C; DeRoo, Lisa A; Håberg, Siri E; Magnus, Per; Nafstad, Per; Nystad, Wenche; London, Stephanie J

2014-04-01

Many women drink during pregnancy and lactation despite recommendations to abstain. In animals, alcohol exposure during pregnancy and lactation influences lung and immune development, plausibly increasing risk of asthma and lower respiratory tract infections (LRTIs). Studies in humans are few. In the Norwegian Mother and Child Cohort Study, we examined maternal alcohol intake during pregnancy and lactation in relation to risk of current asthma at 36 months (49,138 children), recurrent LRTIs by 36 months (39,791 children), and current asthma at 7 years (13,253 children). Mothers reported frequency and amount of alcohol intake each trimester and the first 3 months following delivery. We calculated adjusted relative risk (aRR), comparing children of drinkers to nondrinkers, using Generalized Linear Models. A total of 31.8% of mothers consumed alcohol during first trimester, 9.7% during second trimester, and 15.6% during third trimester. Infrequent and low-dose prenatal alcohol exposure showed a modest statistically significant inverse association with current asthma at 36 months (aRRs ~ 0.85). No association was seen with the highest alcohol intakes during the first trimester when alcohol consumption was most common. RRs of maternal alcohol intake during pregnancy with recurrent LRTIs were ~1, with sporadic differences in risk for some metrics of intake, but without any consistent pattern. For current asthma at 7 years, similar inverse associations were seen as with current asthma at 36 months but were not statistically significant. Among children breastfed throughout the first 3 months of life, maternal alcohol intake during this time was not significantly associated with any of the 3 outcomes. The low levels of alcohol exposure during pregnancy or lactation observed in this cohort were not associated with increased risk of asthma or recurrent LRTIs. The slight inverse associations of infrequent or low-dose prenatal alcohol exposure with asthma may not be causal

Maternal Caffeine Consumption and Infant Nighttime Waking: Prospective Cohort Study

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Santos, Iná S.; Matijasevich, Alicia

2012-01-01

OBJECTIVE: Coffee and other caffeinated beverages are commonly consumed in pregnancy. In adults, caffeine may interfere with sleep onset and have a dose-response effect similar to those seen during insomnia. In infancy, nighttime waking is a common event. With this study, we aimed to investigate if maternal caffeine consumption during pregnancy and lactation leads to frequent nocturnal awakening among infants at 3 months of age. METHODS: All children born in the city of Pelotas, Brazil, during 2004 were enrolled on a cohort study. Mothers were interviewed at delivery and after 3 months to obtain information on caffeine drinking consumption, sociodemographic, reproductive, and behavioral characteristics. Infant sleeping pattern in the previous 15 days was obtained from a subsample. Night waking was defined as an episode of infant arousal that woke the parents during nighttime. Multivariable analysis was performed by using Poisson regression. RESULTS: The subsample included 885 of the 4231 infants born in 2004. All but 1 mother consumed caffeine in pregnancy. Nearly 20% were heavy consumers (≥300 mg/day) during pregnancy and 14.3% at 3 months postpartum. Prevalence of frequent nighttime awakeners (>3 episodes per night) was 13.8% (95% confidence interval: 11.5%–16.0%). The highest prevalence ratio was observed among breastfed infants from mothers consuming ≥300 mg/day during the whole pregnancy and in the postpartum period (1.65; 95% confidence interval: 0.86–3.17) but at a nonsignificant level. CONCLUSIONS: Caffeine consumption during pregnancy and by nursing mothers seems not to have consequences on sleep of infants at the age of 3 months. PMID:22473365

Prenatal exposure to maternal bereavement and childbirths in the offspring: a population-based cohort study.

Directory of Open Access Journals (Sweden)

Oleguer Plana-Ripoll

Full Text Available The decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring.This population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement.A total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3% were exposed and 981,989 (23.8% had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96-1.01] and 1.01 [0.98-1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94-0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04-1.14], the spouse (HR = 1.29 [1.12-1.48] or a sibling (HR = 1.13 [1.01-1.27].Our results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a firmer conclusion.

Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

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de Jonge, Ank; Mesman, Jeanette A J M; Manniën, Judith; Zwart, Joost J; van Dillen, Jeroen; van Roosmalen, Jos

2013-06-13

To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Cohort study using a linked dataset. Information on all cases of severe acute maternal morbidity in the Netherlands collected by the national study into ethnic determinants of maternal morbidity in the netherlands (LEMMoN study), 1 August 2004 to 1 August 2006, merged with data from the Netherlands perinatal register of all births occurring during the same period. 146 752 low risk women in primary care at the onset of labour. Severe acute maternal morbidity (admission to an intensive care unit, eclampsia, blood transfusion of four or more packed cells, and other serious events), postpartum haemorrhage, and manual removal of placenta. Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe acute maternal morbidity among planned primary care births was 2.0 per 1000 births. For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95% confidence interval 0.56 to 1.06), relative risk reduction 25.7% (95% confidence interval -0.1% to 53.5%), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5%, -6.8% to 7.9%), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8%, -6.1% to 11.8%). For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3%, 33.2% to 87.5%), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9%, 41.2% to 54.7%), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9%, 47.9% to 66.3%). Low risk

Exclusive breastfeedingand postnatal changes in maternal ...

African Journals Online (AJOL)

To evaluate the impact of exclusive breastfeeding (EBFing) practice on maternal anthropometry during the first 6months of birth. Measurement of weight, height, triceps skin-fold thickness (TST), and mid-arm circumference (MAC) was carried out in a matched cohort of women practicing EBFing and those using other ...

Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population-based cohort study on 7.7 million births.

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Schneiderman, M; Czuzoj-Shulman, N; Spence, A R; Abenhaim, H A

2017-10-01

To assess if pregnancies among women with Addison's disease (AD) are at higher risk of adverse maternal and neonatal outcomes. Population-based retrospective cohort study. All births in the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011. Baseline characteristics were compared between women with AD and those without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI). We calculated a prevalence of AD in pregnancy of 5.5/100 000, increasing from 5.6 to 9.6/100 000 (P = 0.0001) over the 9-year study period. Compared with women without AD, women with AD were more likely to deliver preterm (OR 1.50, 95% CI 1.16-1.95), deliver by caesarean section (OR 1.32, 95% CI 1.08-1.61), have impaired wound healing (OR 4.28, 95% CI 2.55-7.18), develop infections (OR 2.44, 95% CI 1.66-3.58) and develop thromboembolism (OR 5.21, 95% CI 2.15-12.63), require transfusions (OR 6.69, 95% CI 4.69-9.54), and have prolonged postpartum hospital admissions (OR 5.71, 95% CI 4.37-7.47). Maternal mortality was significantly higher than in the comparison group (OR 22.30, 95% CI 6.82-72.96). Congenital anomalies (OR 3.62, 95% CI 2.05-6.39) and small-for-gestational age infants (OR 1.78, 95% CI 1.15-2.75) were more likely in these pregnancies. Addison's disease significantly increases the risk of severe adverse maternal and neonatal outcomes, so pregnant women with AD are best managed in tertiary-care centres. Pregnancies complicated by Addison's disease have an increased risk of adverse maternal and neonatal outcomes. © 2016 Royal College of Obstetricians and Gynaecologists.

Impact of Low Maternal Education on Early Childhood Overweight and Obesity in Europe.

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Ruiz, Milagros; Goldblatt, Peter; Morrison, Joana; Porta, Daniela; Forastiere, Francesco; Hryhorczuk, Daniel; Antipkin, Youriy; Saurel-Cubizolles, Marie-Josèphe; Lioret, Sandrine; Vrijheid, Martine; Torrent, Maties; Iñiguez, Carmen; Larrañaga, Isabel; Bakoula, Chryssa; Veltsista, Alexandra; van Eijsden, Manon; Vrijkotte, Tanja G M; Andrýsková, Lenka; Dušek, Ladislav; Barros, Henrique; Correia, Sofia; Järvelin, Marjo-Riitta; Taanila, Anja; Ludvigsson, Johnny; Faresjö, Tomas; Marmot, Michael; Pikhart, Hynek

2016-05-01

Comparable evidence on adiposity inequalities in early life is lacking across a range of European countries. This study investigates whether low maternal education is associated with overweight and obesity risk in children from distinct European settings during early childhood. Prospective data of 45 413 children from 11 European cohorts were used. Children's height and weight obtained at ages 4-7 years were used to assess prevalent overweight and obesity according to the International Obesity Task Force definition. The Relative/Slope Indices of Inequality (RII/SII) were estimated within each cohort and by gender to investigate adiposity risk among children born to mothers with low education as compared to counterparts born to mothers with high education. Individual-data meta-analyses were conducted to obtain aggregate estimates and to assess heterogeneity between cohorts. Low maternal education yielded a substantial risk of early childhood adiposity across 11 European countries. Low maternal education yielded a mean risk ratio of 1.58 (95% confidence interval (CI) 1.34, 1.85) and a mean risk difference of 7.78% (5.34, 10.22) in early childhood overweight, respectively, measured by the RII and SII. Early childhood obesity risk by low maternal education was as substantial for all cohorts combined (RII = 2.61 (2.10, 3.23)) and (SII = 4.01% (3.14, 4.88)). Inequalities in early childhood adiposity were consistent among boys, but varied among girls in a few cohorts. Considerable inequalities in overweight and obesity are evident among European children in early life. Tackling early childhood adiposity is necessary to promote children's immediate health and well-being and throughout the life course. © 2016 John Wiley & Sons Ltd.

Effects of Maternal Depression on Family Food Insecurity

OpenAIRE

Kelly Noonan; Hope Corman; Nancy E. Reichman

2014-01-01

Theory suggests that adverse life events--such as unemployment or health shocks--can result in food insecurity, which has increased substantially in the U.S. over the past decade alongside the obesity epidemic. We test this proposition by estimating the effects of a specific and salient mental health event--maternal depression during the postpartum year--on child and family food insecurity. Using data from the Early Childhood Longitudinal Study--Birth Cohort, we estimate the effects of matern...

Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks' gestation in uncomplicated twin pregnancies: A prospective cohort study.

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Yamamoto, Ryo; Ishii, Keisuke; Muto, Haruka; Ota, Shiyo; Kawaguchi, Haruna; Hayashi, Shusaku; Mitsuda, Nobuaki

2018-04-19

To elucidate the incidence of and risk factors for severe hypertensive disorders (HD) and related maternal complications in uncomplicated twin pregnancies that reached 36 weeks' gestation. We conducted a prospective cohort study of twin pregnancies delivered after 36 weeks' gestation. Cases of twin-twin transfusion syndrome, twin anemia-polycythemia sequence, malformed fetuses, monoamniotic twins, selective reduction, fetal therapy and HD or fetal death before 35 weeks' gestation were excluded. The study's primary outcome was the incidence of severe maternal complications, including severe HD, eclampsia, placental abruption, HELLP (hemolysis, elevated liver enzyme and low platelet) syndrome, pulmonary edema and cerebrovascular disease. Perinatal factors associated with the primary outcome were identified using a multivariate logistic regression model. In 330 enrolled women, the number of cases with the primary outcome was 28 (8.5%; 95% confidence interval 5.9-12.0), including 25 cases of severe HD and each one case of placental abruption, HELLP syndrome and eclampsia. The rate of severe maternal complications significantly increased with gestational age, demonstrating 1.2% at 36 weeks, 3.9% at 37 weeks and 6.4% at 38 weeks. Only gestational proteinuria was identified as the independent risk factor for severe maternal complications (adjusted odds ratio 17.1 [95% confidence interval 6.71-45.4]). Severe maternal HD and related complications increased from late preterm to early term; particularly, patients with gestational proteinuria were at high risk. © 2018 Japan Society of Obstetrics and Gynecology.

DNA methylation signatures in cord blood associated with maternal gestational weight gain: results from the ALSPAC cohort.

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Morales, Eva; Groom, Alexandra; Lawlor, Debbie A; Relton, Caroline L

2014-05-02

Epigenetic changes could mediate the association of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with adverse offspring outcomes. However, studies in humans are lacking. Here, we examined the association of maternal pre-pregnancy BMI and GWG in different periods of pregnancy with cytosine-guanine (CpG) dinucleotide site methylation differences in newborn cord blood DNA from 88 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort using the Illumina GoldenGate Panel I. Pyrosequencing was used for validation of the top associated locus and for replication in 170 non-overlapping mother-offspring pairs from the ALSPAC cohort. After correction for multiple testing greater GWG in early pregnancy (between 0 to 18 weeks of gestation) was associated with increased DNA methylation levels in four CpG sites at MMP7, KCNK4, TRPM5 and NFKB1 genes (difference in methylation >5% per 400 g/week greater GWG) (q values 0.023 -0.065). Pre-pregnancy BMI and GWG in mid- or late pregnancy were not associated with differential DNA methylation at any CpG site. Pyrosequencing showed that greater GWG in early pregnancy was associated with increased DNA methylation levels at the top associated CpG site at MMP7, although association did not reach statistical significance (p = 0.302). Greater GWG in mid- (p = 0.167) and late-pregnancy (p = 0.037) were also associated with increased DNA methylation levels at the MMP7 CpG site. In addition, newborns of mothers who exceeded the IoM-recommended GWG had higher DNA methylation levels at the MMP7 CpG site than those of mothers with IoM-recommended GWG (p = 0.080). We failed to replicate findings. Greater GWG in early pregnancy was associated with increased methylation at CpG sites at MMP7, KCNK4, TRPM5 and NFKB1 genes in offspring cord blood DNA. The specific association of GWG in early pregnancy with the top associated CpG site at MMP7 was not validated using

Implications of failure to achieve a result from prenatal maternal serum cell-free DNA testing: a historical cohort study.

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Chan, N; Smet, M-E; Sandow, R; da Silva Costa, F; McLennan, A

2017-11-01

To investigate the pregnancy outcomes in a cohort of women who failed to obtain a result in non-invasive prenatal testing (NIPT). Historical cohort study. A multicentre private practice in Sydney, Australia. Women who failed to obtain a result from NIPT (n = 131). The maternal characteristics, antenatal investigations and pregnancy outcomes for these women were compared with those who obtained a result at the same practice and to the general Australian obstetric population. Antenatal investigations: pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotrophin (β-hCG), placental growth factor (PlGF), uterine artery pulsatility index (PI), mean arterial pressure (MAP). Pregnancy outcomes: chromosomal abnormality, pre-eclampsia, gestational diabetes, small-for-gestational-age (SGA), preterm delivery. Only 1.1% of NIPT samples failed to return a result. This cohort was significantly older and had significantly increased weight compared with the general Australian obstetric population. Pregnancy outcomes were available for 94% of the cohort. There were significantly higher rates of chromosomal aneuploidies (6.5% versus 0.2%, P < 0.0001), pre-eclampsia (11% versus 1.5%, P < 0.0001) and gestational diabetes (23% versus 7.5%, P < 0.0001) compared with the general obstetric population. Rates of preterm delivery and SGA were elevated but did not reach significance. Antenatal investigations demonstrated decreased PAPP-A MoM (0.75 versus 1.14, P < 0.0001), decreased free β-hCG (0.71 versus 1.01, P < 0.0001) and increased uterine artery PI (1.79 versus 1.65, P = 0.02). Women who fail to obtain a result from NIPT are at increased risk of adverse pregnancy outcomes, in particular chromosomal aneuploidy, gestational diabetes and pre-eclampsia. None received. Women who fail to obtain a result from cell-free DNA NIPT are at increased risk of adverse pregnancy outcomes. © 2017 Royal College of Obstetricians and Gynaecologists.

Maternal pre-pregnancy body mass index and circulating microRNAs in pregnancy.

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Enquobahrie, Daniel A; Wander, Pandora L; Tadesse, Mahlet G; Qiu, Chunfang; Holzman, Claudia; Williams, Michelle A

Maternal pre-pregnancy overweight and obese status has been associated with a number of pregnancy complications and adverse offspring outcomes. Mechanisms for observed associations, however, are largely unknown. We investigated associations of pre-pregnancy body mass index with early-mid pregnancy epigenetic biomarkers, circulating microRNAs. Peripheral blood was collected from participants (16-27 weeks gestation) of two multi-racial pregnancy cohorts, the Omega Study and the Pregnancy Outcomes and Community Health Study. Plasma miRNA expression was characterised using epigenome-wide (319 miRNAs) profiling among 20 pregnant women in each cohort. Cohort-specific linear regression models that included the predictor (pre-pregnancy body mass index), the outcome (microRNA expression), and adjustment factors (maternal age, gestational age at blood collection, and race) were fit. Expression of 27 miRNAs was positively associated with pre-pregnancy body mass index in both cohorts (p-values pregnancy body mass index is associated with circulating miRNAs in early-mid pregnancy. Published by Elsevier Ltd.

Maternal Distress during Pregnancy and Offspring Childhood Overweight

DEFF Research Database (Denmark)

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

2012-01-01

Background. Maternal distress during pregnancy increases the intrauterine level of glucocorticoids, which may have long-term health consequences for the child. Objective. To examine if distress as a combined measure of anxiety, depression, and stress of the mother during pregnancy was associated...... with offspring childhood overweight at age 7. Methods. We performed a cohort study using prospective data from 37,764 women and child dyads from the Danish National Birth Cohort (1996-2002). At a telephone interview at approximately 30 weeks gestation, the women reported whether they felt anxious, depressed......, or stressed. The 95 percentile for body mass index in an international reference defined childhood overweight at any given age. Logistic regression was used for the analyses. Results. The prevalence of overweight children at 7 years of age was 9.9%. Prenatal exposure to maternal distress during pregnancy...

Malaria Parasitemia and Anaemia among Pregnant Women in ...

African Journals Online (AJOL)

A study on the prevalence of malaria parasitaemia and anaemia among pregnant women attending Federal Medical Centre (FMC), Umuahia and Nwachinemere Maternity and Child-Care (NMCCD) Ihie in Umuahia metropolis in Abia State Nigeria was carried out between April and October 2010. Blood samples were ...

Maternal lifetime history of depression and depressive symptoms in the prenatal and early postnatal period do not predict infant-mother attachment quality in a large, population-based Dutch cohort study.

Science.gov (United States)

Tharner, Anne; Luijk, Maartje P C M; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2012-01-01

We examined the effects of maternal history of depressive disorder and the effects of depressive symptoms during pregnancy and the early postpartum period on attachment insecurity and disorganization. A total of 627 mother-infant dyads from the Generation R Study participated in a population-based cohort from fetal life onwards. Maternal history of depression was assessed by diagnostic interviews during pregnancy; maternal peri- and postnatal depressive symptoms were assessed with questionnaires in 506 of these women at 20 weeks pregnancy and two months postpartum; and infant-mother attachment security was observed when infants were aged 14 months. A history of maternal depressive disorder, regardless of severity or psychiatric comorbidity, was not associated with an increased risk of infant attachment insecurity or disorganization. Likewise, maternal peri- and postnatal depressive symptoms were not related to attachment insecurity or disorganization at 14 months. These results are important because mothers from otherwise low risk backgrounds often have previously been depressed or are struggling with non-clinical depressive symptoms during pregnancy and after giving birth. Our findings are discussed in terms of protective factors that may limit the potentially negative effects of maternal depressive symptoms on the infant-mother attachment relationship in the general population. The role of selective attrition and lack of information about the mothers' attachment status for the current null-findings are also discussed.

Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden.

Science.gov (United States)

Persson, Martina; Johansson, Stefan; Villamor, Eduardo; Cnattingius, Sven

2014-05-01

Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks). A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs) with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk  = 0.8 per 1,000) and 894 had Apgar score 0-3 at 10 minutes (absolute risk  = 0.5 per 1,000). Compared with infants of mothers with normal BMI (18.5-24.9), the adjusted ORs (95% CI) for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58); BMI 30-34.9: 1.57 (1.20-2.07); BMI 35-39.9: 1.80 (1.15-2.82); and BMI ≥40: 3.41 (1.91-6.09). The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important to improve perinatal health.

Effect of miscarriage history on maternal-infant bonding during the first year postpartum in the first baby study: a longitudinal cohort study.

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Bicking Kinsey, Cara; Baptiste-Roberts, Kesha; Zhu, Junjia; Kjerulff, Kristen H

2014-07-15

Miscarriage, the unexpected loss of pregnancy before 20 weeks gestation, may have a negative effect on a mother's perception of herself as a capable woman and on her emotional health when she is pregnant again subsequent to the miscarriage. As such, a mother with a history of miscarriage may be at greater risk for difficulties navigating the process of becoming a mother and achieving positive maternal-infant bonding with an infant born subsequent to the loss. The aim of this study was to examine the effect of miscarriage history on maternal-infant bonding after the birth of a healthy infant to test the hypothesis that women with a history of miscarriage have decreased maternal-infant bonding compared to women without a history of miscarriage. We completed secondary analysis of the First Baby Study, a longitudinal cohort study, to examine the effect of a history of miscarriage on maternal-infant bonding at 1 month, 6 months, and 12 months after women experienced the birth of their first live-born baby. In a sample of 2798 women living in Pennsylvania, USA, we tested our hypothesis using linear regression analysis of Shortened Postpartum Bonding Questionnaire (S-PBQ) scores, followed by longitudinal analysis using a generalized estimating equations model with repeated measures. We found that women with a history of miscarriage had similar S-PBQ scores as women without a history of miscarriage at each of the three postpartum time points. Likewise, longitudinal analysis revealed no difference in the pattern of maternal-infant bonding scores between women with and without a history of miscarriage. Women in the First Baby Study with a history of miscarriage did not differ from women without a history of miscarriage in their reported level of bonding with their subsequently born infants. It is important for clinicians to recognize that even though some women may experience impaired bonding related to a history of miscarriage, the majority of women form a healthy bond

Maternal Employment Stability in Early Childhood: Links with Child Behavior and Cognitive Skills

Science.gov (United States)

Pilkauskas, Natasha V.; Brooks-Gunn, Jeanne; Waldfogel, Jane

2018-01-01

Although many studies have investigated links between maternal employment and children's wellbeing, less research has considered whether the stability of maternal employment is linked with child outcomes. Using unique employment calendar data from the Fragile Families and Child Wellbeing Study (N = 2,011), an urban birth cohort study of largely…

Maternal diet during pregnancy and micronuclei frequency in peripheral blood T lymphocytes in mothers and newborns (Rhea cohort, Crete)

DEFF Research Database (Denmark)

O'Callaghan-Gordo, Cristina; Kogevinas, Manolis; Pedersen, Marie

2018-01-01

PURPOSE: The study assessed whether diet and adherence to cancer prevention guidelines during pregnancy were associated with micronucleus (MN) frequency in mothers and newborns. MN is biomarkers of early genetic effects that have been associated with cancer risk in adults. METHODS: A total of 188...... mothers and 200 newborns from the Rhea cohort (Greece) were included in the study. At early-mid pregnancy, we conducted personal interviews and a validated food frequency questionnaire was completed. With this information, we constructed a score reflecting adherence to the World Cancer Research Fund...... exposure to genotoxics during pregnancy might affect differently mothers and newborns. The predictive value of MN as biomarker for childhood cancer, rather than adulthood, remains unclear. With few exceptions, the association between maternal carcinogenic exposures during pregnancy and childhood cancer...

Meal frequency patterns and glycemic properties of maternal diet in relation to preterm delivery: Results from a large prospective cohort study.

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Englund-Ögge, Linda; Birgisdottir, Bryndis Eva; Sengpiel, Verena; Brantsæter, Anne Lise; Haugen, Margareta; Myhre, Ronny; Meltzer, Helle Margrete; Jacobsson, Bo

2017-01-01

Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery. This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa). Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: "snack meal", "main meal", and "evening meal". Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at meal" pattern was associated with a reduced risk of preterm delivery, with hazard ratios (HRs) of 0.89 (95% confidence interval (CI): 0.80, 0.98) and 0.90 (95% CI: 0.81, 0.99) for the third and fourth quartiles, respectively, and p for trend of 0.028. This was mainly attributed to the group of women with BMI ≥25 kg/m2, with HRs of 0.87 (95% CI: 0.79, 0.96) and 0.89 (95% CI: 0.80, 0.98) for the third and fourth quartiles, respectively, and p for trend of 0.010. There was no association between glycemic index, glycemic load, carbohydrates, added sugar, fiber, or the remaining meal frequency patterns and preterm delivery. Regular consumption of main meals (breakfast, lunch, dinner) was associated with a lower risk of preterm delivery. Diet should be further studied as potential contributing factors for preterm delivery.

Influence of maternal adiposity, preterm birth and birth weight centiles on early childhood obesity in an Indigenous Australian pregnancy-through-to-early-childhood cohort study.

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Pringle, K G; Lee, Y Q; Weatherall, L; Keogh, L; Diehm, C; Roberts, C T; Eades, S; Brown, A; Smith, R; Lumbers, E R; Brown, L J; Collins, C E; Rae, K M

2018-05-16

Childhood obesity rates are higher among Indigenous compared with non-Indigenous Australian children. It has been hypothesized that early-life influences beginning with the intrauterine environment predict the development of obesity in the offspring. The aim of this paper was to assess, in 227 mother-child dyads from the Gomeroi gaaynggal cohort, associations between prematurity, Gestation Related-Optimal Weight (GROW) centiles, maternal adiposity (percentage body fat, visceral fat area), maternal non-fasting plasma glucose levels (measured at mean gestational age of 23.1 weeks) and offspring BMI and adiposity (abdominal circumference, subscapular skinfold thickness) in early childhood (mean age 23.4 months). Maternal non-fasting plasma glucose concentrations were positively associated with infant birth weight (P=0.005) and GROW customized birth weight centiles (P=0.008). There was a significant association between maternal percentage body fat (P=0.02) and visceral fat area (P=0.00) with infant body weight in early childhood. Body mass index (BMI) in early childhood was significantly higher in offspring born preterm compared with those born at term (P=0.03). GROW customized birth weight centiles was significantly associated with body weight (P=0.01), BMI (P=0.007) and abdominal circumference (P=0.039) at early childhood. Our findings suggest that being born preterm, large for gestational age or exposed to an obesogenic intrauterine environment and higher maternal non-fasting plasma glucose concentrations are associated with increased obesity risk in early childhood. Future strategies should aim to reduce the prevalence of overweight/obesity in women of child-bearing age and emphasize the importance of optimal glycemia during pregnancy, particularly in Indigenous women.

Maternal Thyroid Dysfunction and Risk of Seizure in the Child: A Danish Nationwide Cohort Study

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Stine Linding Andersen

2013-01-01

Full Text Available 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 in the child. Moreover, hypothyroidism diagnosed after birth of the child was associated with a significant increased risk of neonatal and febrile seizures. No significant association was seen for maternal diagnosis prior to birth of the child. We speculate if some degree of maternal thyroid dysfunction was already present during the pregnancy in mothers diagnosed after birth of the child and if this untreated condition may present a neurodevelopmental risk.

Maternal thyroid dysfunction and risk of seizure in the child: a Danish nationwide cohort study.

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Andersen, Stine Linding; Laurberg, Peter; Wu, Chun Sen; Olsen, Jørn

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 in the child. Moreover, hypothyroidism diagnosed after birth of the child was associated with a significant increased risk of neonatal and febrile seizures. No significant association was seen for maternal diagnosis prior to birth of the child. We speculate if some degree of maternal thyroid dysfunction was already present during the pregnancy in mothers diagnosed after birth of the child and if this untreated condition may present a neurodevelopmental risk.

Maternal underweight and the risk of spontaneous abortion

DEFF Research Database (Denmark)

Helgstrand, Stine; Andersen, Anne-Marie Nybo

2005-01-01

BACKGROUND: To evaluate the risk of spontaneous abortion in relation to maternal pre-pregnant underweight. METHODS: The study was designed as a cohort study within the framework of the Danish National Birth Cohort (DNBC). The participants were a total of 23 821 women recruited consecutively...... spontaneous abortion. Relative risk of spontaneous abortion was calculated as Hazard Ratios using Cox regression with delayed entry. RESULTS: The outcome measure was spontaneous abortion. The hazard ratio for spontaneous abortion in women with a pre-pregnant body mass index (BMI) below 18.5 was 1.24 (95......% confidence limits 0.95-1.63) compared to women with pre-pregnant BMI 18.5-24.9. Women with a BMI of 25 or more had a smaller increase in risk of spontaneous abortion. Adjustment for maternal age, parity, previous miscarriages, and lifestyle factors did not affect the estimates substantially, neither did...

Maternal 25-hydroxyvitamin d and preterm birth in twin gestations.

LENUS (Irish Health Repository)

Bodnar, Lisa M

2013-07-01

To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies.

Maternal Dietary Patterns during Pregnancy in Relation to Offspring Forearm Fractures: Prospective Study from the Danish National Birth Cohort

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Sesilje B. Petersen

2015-04-01

Full Text Available Limited evidence exists for an association between maternal diet during pregnancy and offspring bone health. In a prospective study, we examined the association between dietary patterns in mid-pregnancy and offspring forearm fractures. In total, 101,042 pregnancies were recruited to the Danish National Birth Cohort (DNBC during 1996–2002. Maternal diet was collected by a food frequency questionnaire. Associations were analyzed between seven dietary patterns extracted by principal component analysis and offspring first occurrence of any forearm fracture diagnosis, extracted from the Danish National Patient Register, between time of birth and end of follow-up (<16 year (n = 53,922. In multivariable Cox regression models, offspring of mothers in the fourth vs. first quintile of the Western pattern had a significant increased risk (Hazard ratio, 95% confidence interval: 1.11, 1.01–1.23 of fractures, and there was a borderline significant positive trend (p = 0.06. The other dietary patterns showed no associations and neither did supplementary analyses of macro- and micronutrients or single food groups, except for the intake of artificially sweetened soft drinks, which was positively associated with offspring forearm fractures (p = 0.02. In the large prospective DNBC high mid-pregnancy consumption of Western diet and artificially sweetened soft drinks, respectively, indicated positive associations with offspring forearm fractures, which provides interesting hypotheses for future research.

A cohort study on full breastfeeding and child neuropsychological development: the role of maternal social, psychological, and nutritional factors.

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Julvez, Jordi; Guxens, Monica; Carsin, Anne-Elie; Forns, Joan; Mendez, Michelle; Turner, Michelle C; Sunyer, Jordi

2014-02-01

This study investigated whether duration of full breastfeeding is associated with child neuropsychological development and whether this association is explained by social, psychological, and nutritional factors within families. Participants in this study were a population-based birth cohort in the city of Sabadell (Catalonia, Spain). Females were recruited during the first trimester of pregnancy between July 2004 and July 2006. Information about parental characteristics and breastfeeding was obtained through questionnaires. Full breastfeeding was categorized as never, short term (≤4mo), long term (4-6mo), or very long term (>6mo). A trained psychologist assessed the neuropsychological development of children at 4 years of age (n=434) using the McCarthy Scales of Children's Abilities (MSCA). Full breastfeeding showed an independent association with child general MSCA scores after adjusting for a range of social, psychological, and nutritional factors (>6mo, coefficient=7.4 [95% confidence interval=2.8-12.0], p=0.011). Maternal social class, education level, and IQ were also associated with child neuropsychological scores, but did not explain breastfeeding associations. Omega-3 (n3) fatty acid levels were not associated with child neuropsychological scores. Very long-term full breastfeeding was independently associated with neuropsychological functions of children at 4 years of age. Maternal indicators of intelligence, psychopathology, and colostrum n3 fatty acids did not explain this association. © 2013 Mac Keith Press.

The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study.

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Popovic, Maja; Pizzi, Costanza; Rusconi, Franca; Gagliardi, Luigi; Galassi, Claudia; Trevisan, Morena; Merletti, Franco; Richiardi, Lorenzo

2018-05-02

This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance. The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children. © 2018 Wiley Periodicals, Inc.

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.

Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile.

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Hayfaa Wahabi

Full Text Available To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant.A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated.The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%.Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.

Maternal low birth weight and adverse perinatal outcomes: the 1982 Pelotas Birth Cohort Study, Brazil El bajo peso al nacer de las madres y los desenlaces perinatales adversos: estudio de la Cohorte de Nacimientos de 1982 en Pelotas, Brasil

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Maria P. Vélez

2009-08-01

Full Text Available OBJECTIVE: To explore the association between maternal low birth weight (LBW and adverse perinatal outcomes and to discriminate between confounders and mediating factors of these associations in a population-based birth cohort of Southern Brazil. METHODS: Data from 794 female members of the 1982 Pelotas Birth Cohort Study known to have delivered a live-born singleton offspring up to December 2004 were analyzed. Maternal birth weights were recorded in 1982. The associations between maternal and offspring characteristics were estimated by Poisson regression. Confounding was tested for socioeconomic, demographic, and psychosocial factors. Maternal anthropometric characteristics and hypertensive diseases during pregnancy were considered mediating factors. RESULTS: An increase of 100 grams (g in mothers' birth weight predicted a gain of 21 g in their infants' birth weight (95% confidence interval (CI 13.0-29.0 g, P OBJETIVOS: Explorar la asociación entre el bajo peso al nacer (BPN de las madres y los desenlaces perinatales adversos y discriminar entre los factores de confusión y de mediación de estas asociaciones en un estudio poblacional de una cohorte de nacimientos en el sur de Brasil. MÉTODOS: Se analizaron los datos de 794 mujeres participantes en el Estudio de la Cohorte de Nacimientos de 1982 en Pelotas con partos únicos exitosos hasta diciembre de 2004. El peso al nacer de las mujeres se registró en 1982. Las asociaciones entre las características de las madres y sus hijos se estimaron mediante la regresión de Poisson. Como factores de confusión se probaron características socioeconómicas, demográficas y psicosociales. Como factores de mediación se consideraron las características antropométricas de la madre y la hipertensión durante el embarazo. RESULTADOS: El incremento en 100 g en el peso al nacer de las madres predijo un aumento de 21 g en el peso al nacer de sus hijos (intervalo de confianza de 95% [IC95%]: 13,0 a 29,0; P

Maternal and neonatal outcomes of antenatal anemia in a Scottish population: a retrospective cohort study.

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Rukuni, Ruramayi; Bhattacharya, Sohinee; Murphy, Michael F; Roberts, David; Stanworth, Simon J; Knight, Marian

2016-05-01

Antenatal anemia is a major public health problem in the UK, yet there is limited high quality evidence for associated poor clinical outcomes. The objectives of this study were to estimate the incidence and clinical outcomes of antenatal anemia in a Scottish population. A retrospective cohort study of 80 422 singleton pregnancies was conducted using data from the Aberdeen Maternal and Neonatal Databank between 1995 and 2012. Antenatal anemia was defined as haemoglobin ≤ 10 g/dl during pregnancy. Incidence was calculated with 95% confidence intervals and compared over time using a chi-squared test for trend. Multivariable logistic regression was used to adjust for confounding variables. Results are presented as adjusted odds ratios with 95% confidence interval. The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95% confidence interval 9.1-9.5), decreasing from 16.9/100 to 4.1/100 singleton pregnancies between 1995 and 2012 (p Scottish population. However, given that anemia is a readily correctable risk factor for major causes of morbidity and mortality in the UK, further work is required to investigate appropriate preventive measures. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Environmental Variation and Cohort Effects in an Antarctic Predator

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Garrott, Robert A.; Rotella, Jay J.; Siniff, Donald B.; Parkinson, Claire L.; Stauffer, Glenn E.

2011-01-01

Understanding the potential influence of environmental variation experienced by animals during early stages of development on their subsequent demographic performance can contribute to our understanding of population processes and aid in predicting impacts of global climate change on ecosystem functioning. Using data from 4,178 tagged female Weddell seal pups born into 20 different cohorts, and 30 years of observations of the tagged seals, we evaluated the hypothesis that environmental conditions experienced by young seals, either indirectly through maternal effects and/or directly during the initial period of juvenile nutritional independence, have long-term effects on individual demographic performance. We documented an approximately 3-fold difference in the proportion of each cohort that returned to the pupping colonies and produced a pup within the first 10 years after birth. We found only weak evidence for a correlation between annual environmental conditions during the juvenile-independence period and cohort recruitment probability. Instead, the data strongly supported an association between cohort recruitment probability and the regional extent of sea ice experienced by the mother during the winter the pup was in utero. We suggest that inter-annual variation in winter sea-ice extent influences the foraging success of pregnant seals by moderating the regional abundance of competing predators that cannot occupy areas of consolidated sea ice, and by directly influencing the abundance of mid-trophic prey species that are sea-ice obligates. We hypothesize that this environmentally-induced variation in maternal nutrition dictates the extent of maternal energetic investment in offspring, resulting in cohort variation in mean size of pups at weaning which, in turn, contributes to an individual?s phenotype and its ultimate fitness. These linkages between sea ice and trophic dynamics, combined with demonstrated and predicted changes in the duration and extent of sea

Parental depressive and anxiety symptoms during pregnancy and attention problems in children: A cross-cohort consistency study

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Batenburg-Eddes, Tamara; Brion, Maria; Henrichs, Jens; Jaddoe, Vincent; Hofman, Albert; Verhulst, Frank; Lawlor, Debbie; Davey-Smith, George; Tiemeier, Henning

2013-01-01

Background: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. Methods: This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant w...

Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study.

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Korevaar, Tim I M; Muetzel, Ryan; Medici, Marco; Chaker, Layal; Jaddoe, Vincent W V; de Rijke, Yolanda B; Steegers, Eric A P; Visser, Theo J; White, Tonya; Tiemeier, Henning; Peeters, Robin P

2016-01-01

Thyroid hormone is involved in the regulation of early brain development. Since the fetal thyroid gland is not fully functional until week 18-20 of pregnancy, neuronal migration and other crucial early stages of intrauterine brain development largely depend on the supply of maternal thyroid hormone. Current clinical practice mostly focuses on preventing the negative consequences of low thyroid hormone concentrations, but data from animal studies have shown that both low and high concentrations of thyroid hormone have negative effects on offspring brain development. We aimed to investigate the association of maternal thyroid function with child intelligence quotient (IQ) and brain morphology. In this population-based prospective cohort study, embedded within the Generation R Study (Rotterdam, Netherlands), we investigated the association of maternal thyroid function with child IQ (assessed by non-verbal intelligence tests) and brain morphology (assessed on brain MRI scans). Eligible women were those living in the study area at their delivery date, which had to be between April 1, 2002, and Jan 1, 2006. For this study, women with available serum samples who presented in early pregnancy (brain MRI scans (done at a median of 8·0 years of age [6·2-10·0]) were obtained. Analyses were adjusted for potential confounders including concentrations of human chorionic gonadotropin and child thyroid-stimulating hormone and free thyroxine. Data for child IQ were available for 3839 mother-child pairs, and MRI scans were available from 646 children. Maternal free thyroxine concentrations showed an inverted U-shaped association with child IQ (p=0·0044), child grey matter volume (p=0·0062), and cortex volume (p=0·0011). For both low and high maternal free thyroxine concentrations, this association corresponded to a 1·4-3·8 points reduction in mean child IQ. Maternal thyroid-stimulating hormone was not associated with child IQ or brain morphology. All associations remained

Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y

DEFF Research Database (Denmark)

Maslova, Ekaterina; Hansen, Susanne; Grunnet, Louise Groth

2017-01-01

in free-living populations remains limited. Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM). Design: Six hundred eight women with an index...... provide little support for an association of maternal protein intake in pregnancy with measures of offspring metabolic health. Further studies in larger cohorts are needed to determine whether low maternal protein intake in pregnancy may improve glucose homeostasis in GDM-exposed and male offspring....... pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a foodfrequency questionnaire in gestational week 25. The offspring underwent a clinical examination...

Protective factors for child development at age 2 in the presence of poor maternal mental health: results from the All Our Babies (AOB) pregnancy cohort.

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McDonald, Sheila W; Kehler, Heather L; Tough, Suzanne C

2016-11-10

To identify the combination of factors most protective of developmental delay at age 2 among children exposed to poor maternal mental health. Observational cohort study. Pregnant women were recruited from primary healthcare offices, the public health laboratory service and community posters in Calgary, Alberta, Canada. 1596 mother-child dyads who participated in the All Our Babies study and who completed a follow-up questionnaire when their child was 2 years old. Among participants who completed the 2-year questionnaire and had complete mental health data (n=1146), 305 women (27%) were classified as high maternal mental health risk. Child development at age 2 was described and a resilience analysis was performed among a subgroup of families at maternal mental health risk. The primary outcome was child development problems. Protective factors were identified among families at risk, defined as maternal mental health risk, a composite measure created from participants' responses to mental health life course questions and standardised mental health measures. At age 2, 18% of children were classified as having development problems, 15% with behavioural problems and 13% with delayed social-emotional competencies. Among children living in a family with maternal mental health risk, protective factors against development problems included higher social support, higher optimism, more relationship happiness, less difficulty balancing work and family responsibilities, limiting the child's screen time to mental health, public health and early intervention strategies that support interpersonal relationships, social support, optimism, work-life balance, limiting children's screen time and establishing good sleep habits in the child's first 2 years show promise to positively influence early child development. 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/.

Severe Adverse Maternal Outcomes among Women in Midwife-Led versus Obstetrician-Led Care at the Onset of Labour in the Netherlands: A Nationwide Cohort Study.

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Ank de Jonge

Full Text Available To test the hypothesis that it is possible to select a group of low risk women who can start labour in midwife-led care without having increased rates of severe adverse maternal outcomes compared to women who start labour in secondary care.We conducted a nationwide cohort study in the Netherlands, using data from 223 739 women with a singleton pregnancy between 37 and 42 weeks gestation without a previous caesarean section, with spontaneous onset of labour and a child in cephalic presentation. Information on all cases of severe acute maternal morbidity collected by the national study into ethnic determinants of maternal morbidity in the Netherlands (LEMMoN study, 1 August 2004 to 1 August 2006, was merged with data from the Netherlands Perinatal Registry of all births occurring during the same period. Our primary outcome was severe acute maternal morbidity (SAMM, i.e. admission to an intensive care unit, uterine rupture, eclampsia or severe HELLP, major obstetric haemorrhage, and other serious events. Secondary outcomes were postpartum haemorrhage and manual removal of placenta.Nulliparous and parous women who started labour in midwife-led care had lower rates of SAMM, postpartum haemorrhage and manual removal of placenta compared to women who started labour in secondary care. For SAMM the adjusted odds ratio's and 95% confidence intervals were for nulliparous women: 0.57 (0.45 to 0.71 and for parous women 0.47 (0.36 to 0.62.Our results suggest that it is possible to identify a group of women at low risk of obstetric complications who may benefit from midwife-led care. Women can be reassured that we found no evidence that midwife-led care at the onset of labour is unsafe for women in a maternity care system with a well developed risk selection and referral system.

Family-based exome-wide assessment of maternal genetic effects on susceptibility to childhood B-cell acute lymphoblastic leukemia in Hispanics

Science.gov (United States)

Archer, Natalie P.; Perez-Andreu, Virginia; Scheurer, Michael E.; Rabin, Karen R.; Peckham-Gregory, Erin C.; Plon, Sharon E.; Zabriskie, Ryan C.; De Alarcon, Pedro A.; Fernandez, Karen S.; Najera, Cesar R.; Yang, Jun J.; Antillon-Klussmann, Federico; Lupo, Philip J.

2016-01-01

Background Children of Hispanic ancestry have a higher incidence of acute lymphoblastic leukemia (ALL) than other ethnic groups, but the genetic basis for racial disparities remain incompletely understood. Genome-wide association studies (GWAS) of childhood ALL to date have focused on inherited genetic effects; however, maternal genetic effects (the role of maternal genotype on offspring phenotype development) may also play a role in ALL susceptibility. Methods We conducted a family-based exome-wide association study (EXWAS) of maternal genetic effects among Hispanics with childhood B-cell ALL (B-ALL) using the Illumina Human Exome BeadChip. We used a discovery cohort of 312 Guatemalan and Hispanic American families and an independent replication cohort of 152 Hispanic American families. Results Three maternal SNPs approached our threshold for significance, after correction for multiple testing (P<1.0×10−6): MTL5 rs12365708 (RR=2.62, 95% CI=1.61-4.27, P=1.8×10−5); ALKBH1 rs6494 (RR=3.77, 95% CI=1.84-7.74, P=3.7×10−5); NEUROG3 rs4536103 (RR=1.75, 95% CI=1.30-2.37, P=1.2×10−4). While effect sizes were similar, these SNPs were not nominally significant in our replication cohort. In a meta-analysis comprised of the discovery cohort and the replication cohort, these SNPs were still not statistically significant after correction for multiple comparisons (rs12365708: pooled RR=2.27, 95% CI=1.48-3.50, P=1.99×10−4; rs6494: pooled RR=2.31, 95% CI=1.38-3.85, P=0.001; rs4536103: pooled RR=1.67, 95% CI=1.29-2.16, P=9.23×10−5). Conclusions In the first family-based EXWAS to investigate maternal genotype effects associated with childhood ALL, our results did not implicate a strong role of maternal genotype on disease risk among Hispanics; however, we identified three maternal SNPs that may play a modest role in susceptibility. PMID:27529658

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.

Parental mental illness and fatal birth defects in a national birth cohort

DEFF Research Database (Denmark)

Webb, Roger; Pickles, A.R.; King-Hele, Sarah

2007-01-01

BACKGROUND: Few large studies describe links between maternal mental illness and risk of major birth defect in offspring. Evidence is sparser still for how effects vary between maternal diagnoses and no previous study has assessed risk with paternal illnesses.MethodA population-based birth cohort...... genetic effects directly linked with maternal illness, lifestyle factors (diet, smoking, alcohol and drugs), poor antenatal care, psychotropic medication toxicity, and gene-environment interactions. Further research is needed to elucidate the causal mechanisms...

Timing of first exposure to maternal depression and adolescent emotional disorder in a national Canadian cohort.

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Kiyuri Naicker

Full Text Available Correlations have been reported between behavioral and cognitive outcomes in adolescence and exposure to maternal depression during the first postpartum year, but the effects of timing of maternal depression during subsequent exposure periods have rarely been controlled for. This study aims to methodically investigate the importance of timing of initial exposure to maternal depression with respect to adolescent mental health outcomes.This study used data on 937 children from the National Longitudinal Study of Children and Youth (NLSCY, a nationally-representative longitudinal survey established in 1994 by Statistics Canada. Ordinal logistic regression was used to confirm associations between adolescent emotional disorder (at 12-13 years and initial exposure to maternal depression during 2-year intervals from birth to adolescence. Following their initial exposure to maternal depression, children were dropped from subsequent cycles. Stressful life events, chronic health conditions, maternal alcohol use, maternal marital status, gender, and SES were included as covariates.The results indicated that adolescents who were initially exposed to maternal depression between the ages of 2-3 years and 4-5 years had a two-fold increase in odds of emotional disorder. No increase in odds was observed in those initially exposed during the first postpartum year or later in childhood.The results demonstrate that a sensitive period of initial exposure to maternal depression may occur between the ages of 2 and 5, and not during the first year of life indicated by previous research. These findings are congruent with the literature on emotional and behavioral development in early childhood.

Maternal pre-pregnancy obesity and neuropsychological development in pre-school children: a prospective cohort study.

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Casas, Maribel; Forns, Joan; Martínez, David; Guxens, Mònica; Fernandez-Somoano, Ana; Ibarluzea, Jesus; Lertxundi, Nerea; Murcia, Mario; Rebagliato, Marisa; Tardon, Adonina; Sunyer, Jordi; Vrijheid, Martine

2017-10-01

BackgroundMaternal pre-pregnancy obesity may impair infant neuropsychological development, but it is unclear whether intrauterine or confounding factors drive this association.MethodsWe assessed whether maternal pre-pregnancy obesity was associated with neuropsychological development in 1,827 Spanish children. At 5 years, cognitive and psychomotor development was assessed using McCarthy Scales of Children's Abilities, attention deficit hyperactivity disorder (ADHD) symptoms using the Criteria of Diagnostic and Statistical Manual of Mental Disorders, and autism spectrum disorder symptoms using the Childhood Asperger Syndrome Test. Models were adjusted for sociodemographic factors and maternal intelligence quotient. We used paternal obesity as negative control exposure as it involves the same source of confounding than maternal obesity.ResultsThe percentage of obese mothers and fathers was 8% and 12%, respectively. In unadjusted models, children of obese mothers had lower scores than children of normal weight mothers in all McCarthy subscales. After adjustment, only the verbal subscale remained statistically significantly reduced (β: -2.8; 95% confidence interval: -5.3, -0.2). No associations were observed among obese fathers. Maternal and paternal obesity were associated with an increase in ADHD-related symptoms. Parental obesity was not associated with autism symptoms.ConclusionMaternal pre-pregnancy obesity was associated with a reduction in offspring verbal scores at pre-school age.

Medical record validation of maternally reported history of preeclampsia

NARCIS (Netherlands)

M. Coolman (Marianne); C.J.M. de Groot (Christianne); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); H. Raat (Hein); E.A.P. Steegers (Eric)

2010-01-01

textabstractObjective: In this study, we assessed the validity of maternally self-reported history of preeclampsia. Study Design and Setting: This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study.

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Lung, F-W; Shu, B-C; Chiang, T-L; Lin, S-J

2011-03-01

This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood. © 2010 Blackwell

Patterns of peripheral cytokine expression during pregnancy in two cohorts and associations with inflammatory markers in cord blood.

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Ross, Kharah MacKenzie; Miller, Gregory; Culhane, Jennifer; Grobman, William; Simhan, Hyagriv N; Wadhwa, Pathik D; Williamson, Douglas; McDade, Thomas; Buss, Claudia; Entringer, Sonja; Adam, Emma; Qadir, Sameen; Keenan-Devlin, Lauren; Leigh, Adam K K; Borders, Ann

2016-11-01

Maternal inflammation undergoes adaptations during pregnancy, and excessive inflammation has been associated with adverse outcomes. One mechanism may be maternal inflammation transmission to the fetal compartment. Links between maternal pregnancy inflammation and fetal inflammation are poorly characterized. Principal components analysis was used to extract underlying inflammation components across cytokines (IFN-γ, IL-10, IL-13, IL-6, IL-8, TNF-α) in two pregnancy cohorts (SPAH N=87, MOMS N=539) assessed during the second and third trimesters. Links between maternal inflammation over pregnancy and fetal (cord blood) inflammation were assessed. Substantial cytokine rank-order stability was observed in both cohorts, β's range .47-.96, P's blood inflammation, P's>.04. Maternal inflammation indices over pregnancy were associated with inflammation in cord blood at birth. Results have implications for understanding pregnancy inflammatory processes and how maternal inflammation may be transmitted to fetal circulation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Maternal, fetal and perinatal alterations associated with obesity, overweight and gestational diabetes: an observational cohort study (PREOBE

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Staffan K. Berglund

2016-03-01

Full Text Available Abstract Background Maternal overweight, obesity, and gestational diabetes (GD have been negatively associated with offspring development. Further knowledge regarding metabolic and nutritional alterations in these mother and their offspring are warranted. Methods In an observational cohort study we included 331 pregnant women from Granada, Spain. The mothers were categorized into four groups according to BMI and their GD status; overweight (n:56, obese (n:64, GD (n:79, and healthy normal weight controls (n:132. We assessed maternal growth and nutritional biomarkers at 24 weeks (n = 269, 34 weeks (n = 310 and at delivery (n = 310 and the perinatal characteristics including cord blood biomarkers. Results Obese and GD mothers had significantly lower weight gain during pregnancy and infant birth weight, waist circumference, and placental weight were higher in the obese group, including a significantly increased prevalence of macrosomia. Except for differences in markers of glucose metabolism (glucose, HbA1c, insulin and uric acid we found at some measures that overweight and/or obese mothers had lower levels of transferrin saturation, hemoglobin, Vitamin B12 and folate and higher levels of C-reactive protein, erythrocyte sedimentation rate, ferritin, and cortisol. GD mothers had similar differences in hemoglobin and C-reactive protein but higher levels of folate. The latter was seen also in cord blood. Conclusions We identified several metabolic alterations in overweight, obese and GD mothers compared to controls. Together with the observed differences in infant anthropometrics, these may be important biomarkers in future research regarding the programming of health and disease in children. Trial registration The trial was registered at clinicaltrials.gov, identifier ( NCT01634464 .

Maternal urinary bisphenol A levels and infant low birth weight: A nested case-control study of the Health Baby Cohort in China.

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Huo, Wenqian; Xia, Wei; Wan, Yanjian; Zhang, Bin; Zhou, Aifen; Zhang, Yiming; Huang, Kai; Zhu, Yingshuang; Wu, Chuansha; Peng, Yang; Jiang, Minmin; Hu, Jie; Chang, Huailong; Xu, Bing; Li, Yuanyuan; Xu, Shunqing

2015-12-01

Exposure to bisphenol A (BPA), a known endocrine disruptor, has been demonstrated to affect fetal development in animal studies, but findings in human studies have been inconsistent. We investigated whether maternal exposure to BPA during pregnancy is associated with an increased risk of infant low birth weight (LBW). A total 452 mother-infant pairs (113 LBW cases and 339 matched controls) were selected from the participants enrolled in the prospective Health Baby Cohort (HBC) in Wuhan city, China, during 2012-2014. BPA concentrations were measured in maternal urine samples collected at delivery, and the information of birth outcomes was retrieved from the medical records. A conditional logistic regression was used to evaluate the relationship between urinary BPA levels and LBW. Mothers with LBW infants had significantly higher urinary BPA levels (median: 4.70μg/L) than the control mothers (median: 2.25μg/L) (p<0.05). Increased risk of LBW was associated with higher maternal urinary levels of BPA [adjusted odds ratio (OR)=3.13 for the medium tertile, 95% confidence interval (CI): 1.21, 8.08; adjusted OR=2.49 for the highest tertile, 95% CI: 0.98, 6.36]. The association was more pronounced among female infants than among male infants, with a statistical evidence of heterogeneity in risk (p=0.03). Prenatal exposure to higher levels of BPA may potentially increase the risk of delivering LBW infants, especially for female infants. This is the first case-control study to examine the association in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reduction of maternal mortality with highly active antiretroviral therapy in a large cohort of HIV-infected pregnant women in Malawi and Mozambique.

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Giuseppe Liotta

Full Text Available BACKGROUND: HIV infection is a major contributor to maternal mortality in resource-limited settings. The Drug Resource Enhancement Against AIDS and Malnutrition Programme has been promoting HAART use during pregnancy and postpartum for Prevention-of-mother-to-child-HIV transmission (PMTCT irrespective of maternal CD4 cell counts since 2002. METHODS: Records for all HIV+ pregnancies followed in Mozambique and Malawi from 6/2002 to 6/2010 were reviewed. The cohort was comprised by pregnancies where women were referred for PMTCT and started HAART during prenatal care (n = 8172, group 1 and pregnancies where women were referred on established HAART (n = 1978, group 2. RESULTS: 10,150 pregnancies were followed. Median (IQR baseline values were age 26 years (IQR:23-30, CD4 count 392 cells/mm(3 (IQR:258-563, Viral Load log10 3.9 (IQR:3.2-4.4, BMI 23.4 (IQR:21.5-25.7, Hemoglobin 10.0 (IQR: 9.0-11.0. 101 maternal deaths (0.99% occurred during pregnancy to 6 weeks postpartum: 87 (1.1% in group 1 and 14 (0.7% in group 2. Mortality was 1.3% in women with maternal mortality as do CD4 counts and nutritional status. In resource-limited settings, PMTCT programs should provide universal HAART to all HIV+ pregnant women given its impact in prevention of maternal death.

IGF-I during primiparous pregnancy and maternal risk of breast cancer

OpenAIRE

Chen, Tianhui; Lukanova, Annekatrin; Grankvist, Kjell; Zeleniuch-Jacquotte, Anne; Wulff, Marianne; Johansson, Robert; Schock, Helena; Lenner, Per; Hallmans, Goran; Wadell, Goran; Toniolo, Paolo; Lundin, Eva

2009-01-01

Abstract Previously, we reported that insulin-like growth factor (IGF)-I during early pregnancy is positively associated with maternal risk of breast cancer. To further explore this association, we designed a new study limited to women who donated a blood sample during their first pregnancy ending with childbirth. A case?control study was nested within the Northern Sweden Maternity Cohort in which repository since 1975, serum specimens remaining after early pregnancy screening for ...

Systematic review of effect of community-level interventions to reduce maternal mortality

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Deeks Jonathan J

2009-01-01

Full Text Available Abstract Background The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality. Methods We searched published papers using Medline, Embase, Cochrane library, CINAHL, BNI, CAB ABSTRACTS, IBSS, Web of Science, LILACS and African Index Medicus from inception or at least 1982 to June 2006; searched unpublished works using National Research Register website, metaRegister and the WHO International Trial Registry portal. We hand searched major references. Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. We carried out study selection, data abstraction and quality assessment independently in duplicate. Results We found five cluster randomised controlled trials (RCT and eight cohort studies of community-level interventions. We summarised results as odds ratios (OR and confidence intervals (CI, combined using the Peto method for meta-analysis. Two high quality cluster RCTs, aimed at improving perinatal care practices, showed a reduction in maternal mortality reaching statistical significance (OR 0.62, 95% CI 0.39 to 0.98. Three equivalence RCTs of minimal goal-oriented versus usual antenatal care showed no difference in maternal mortality (1.09, 95% CI 0.53 to 2.25. The cohort studies were of low quality and did not contribute further evidence. Conclusion Community-level interventions of improved perinatal care practices can bring about a reduction in maternal mortality. This challenges the view that investment in such interventions is not worthwhile. Programmes to improve maternal mortality should be evaluated using randomised controlled techniques to generate further evidence.

Maternal psychological distress and child decision-making.

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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.

A state-wide assessment of the association between epidural analgesia, maternal fever and neonatal antibiotics in Colorado, 2007-2012.

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White, Alice; Olson, Daniel; Messacar, Kevin

2017-03-01

To determine if an association exists between epidural analgesia, maternal fever and neonatal antibiotic exposure in a state-wide birth cohort. We performed a retrospective cohort study of the population-based Colorado Department of Public Health and Environment birth certificate database. Data included all reported births in the state of Colorado between 2007 and 2012. Live, non-preterm, vaginal, singleton, in-hospital births were included in analysis. Maternal epidural analgesia and maternal fever. Neonatal antibiotic treatment for suspected sepsis. A stratified analysis was conducted to evaluate whether epidural use was an effect modifier of the association between maternal fever and neonatal antibiotic treatment. The final cohort included 261 457 births. 2.2% of women who received an epidural had a fever, as compared with 0.4% of women who did not receive an epidural (OR: 5.4; 95% CI 4.9 to 6.0), and neonates born to women who received an epidural had 1.26 times increased odds of antibiotic treatment (95% CI 1.1 to 1.4). Stratification by epidural use did not alter the association between maternal fever and neonatal antibiotic treatment. Colorado providers treat neonates born to mothers with maternal fever without respect to whether the mother had an epidural. Further research into improved criteria for neonatal sepsis evaluation that accounts for the contribution of maternal epidural fever should be developed to decrease unnecessary neonatal antibiotic exposure. 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/.

The Complex Interaction between Home Environment, Socioeconomic Status, Maternal IQ and Early Child Neurocognitive Development: A Multivariate Analysis of Data Collected in a Newborn Cohort Study.

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Luca Ronfani

Full Text Available The relative role of socioeconomic status (SES, home environment and maternal intelligence, as factors affecting child cognitive development in early childhood is still unclear. The aim of this study is to analyze the association of SES, home environment and maternal IQ with child neurodevelopment at 18 months.The data were collected prospectively in the PHIME study, a newborn cohort study carried out in Italy between 2007 and 2010. Maternal nonverbal abilities (IQ were evaluated using the Standard Progressive Matrices, a version of the Raven's Progressive Matrices; a direct evaluation of the home environment was carried out with the AIRE instrument, designed using the HOME (Home Observation for Measurement of the Environment model; the socioeconomic characteristics were evaluated using the SES index which takes into account parents occupation, type of employment, educational level, homeownership. The study outcome was child neurodevelopment evaluated at 18 months, with the Bayley Scales of Infant and Toddler Development Third Edition (BSID III. Linear regression analyses and mediation analyses were carried out to evaluate the association between the three exposures, and the scaled scores of the three main scales of BSID III (cognitive, language and motor scale, with adjustment for a wide range of potential explanatory variables.Data from 502 mother-child pairs were analyzed. Mediation analysis showed a relationship between SES and maternal IQ, with a complete mediation effect of home environment in affecting cognitive and language domains. A direct significant effect of maternal IQ on the BSID III motor development scale and the mediation effect of home environment were found.Our results show that home environment was the variable with greater influence on neurodevelopment at 18 months. The observation of how parents and children interact in the home context is crucial to adequately evaluate early child development.

Significant interactions between maternal PAH exposure and haplotypes in candidate genes on B[a]P-DNA adducts in a NYC cohort of non-smoking African-American and Dominican mothers and newborns

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Tang, Deliang

2014-01-01

Polycyclic aromatic hydrocarbons (PAH) are a class of chemicals common in the environment. Certain PAH are carcinogenic, although the degree to which genetic variation influences susceptibility to carcinogenic PAH remains unclear. Also unknown is the influence of genetic variation on the procarcinogenic effect of in utero exposures to PAH. Benzo[a]pyrene (B[a]P) is a well-studied PAH that is classified as a probable human carcinogen. Within our New York City-based cohort, we explored interactions between maternal exposure to airborne PAH during pregnancy and maternal and newborn haplotypes (and in one case, a single-nucleotide polymorphism) in key B[a]P metabolism genes on B[a]P-DNA adducts in paired cord blood samples. The study subjects included non-smoking African-American (n = 132) and Dominican (n = 235) women with available data on maternal PAH exposure, paired cord adducts and genetic data who resided in the Washington Heights, Central Harlem and South Bronx neighborhoods of New York City. We selected seven maternal and newborn genes related to B[a]P metabolism, detoxification and repair for our analyses: CYP1A1, CYP1A2, CYP1B1, GSTM3, GSTT2, NQO1 and XRCC1. We found significant interactions between maternal PAH exposure and haplotype on cord B[a]P-DNA adducts in the following genes: maternal CYP1B1, XRCC1 and GSTM3, and newborn CYP1A2 and XRCC1 in African-Americans; and maternal XRCC1 and newborn NQO1 in Dominicans. These novel findings highlight differences in maternal and newborn genetic contributions to B[a]P-DNA adduct formation, as well as ethnic differences in gene–environment interactions, and have the potential to identify at-risk subpopulations who are susceptible to the carcinogenic potential of B[a]P. PMID:24177223

Comparison of pregnancy outcomes between maternity waiting home users and non-users at hospitals with and without a maternity waiting home: retrospective cohort study.

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Braat, Floris; Vermeiden, Tienke; Getnet, Gashaw; Schiffer, Rita; van den Akker, Thomas; Stekelenburg, Jelle

2018-01-01

To examine the impact of a maternity waiting home (MWH) by comparing pregnancy outcomes between users and non-users at hospitals with and without an MWH. We conducted a retrospective cohort study in Ethiopia comparing one hospital with an MWH (Attat) to a second hospital without one (Butajira). A structured questionnaire among sampled women in 2014 and hospital records from 2011 to 2014 were used to compare sociodemographic characteristics and pregnancy outcomes between Attat MWH users and non-MWH users, Attat MWH users and Butajira, and Attat non-MWH users and Butajira. χ2 or ORs with 95% CIs were calculated. Compared with Attat non-MWH users (n=306) and Butajira women (n=153), Attat MWH users (n=244) were more often multiparous (multipara vs primigravida: OR 4.43 [95% CI 2.94 to 6.68] and OR 3.58 [95% CI 2.24 to 5.73]), less educated (no schooling vs secondary school: OR 2.62 [95% CI 1.53 to 4.46] and OR 5.21 [95% CI 2.83 to 9.61], primary vs secondary school: OR 4.84 [95% CI 2.84 to 8.25] and OR 5.19 [95% CI 2.91 to 9.27]), poor (poor vs wealthy: OR 8.94 [95% CI 5.13 to 15.61] and OR 12.34 [95% CI 6.78 to 22.44] and further from the hospital (2 h 27 min vs 1 h 00 min and 1 h 12 min: OR 3.08 [95% CI 2.50 to 3.80] and OR 2.18 [95% CI 1.78 to 2.67]). Comparing hospital records of Attat MWH users (n=2784) with Attat non-users (n=5423) and Butajira women (n=9472), maternal deaths were 0 vs 20 (0.4%; p=0.001) and 31 (0.3%; p=0.003), stillbirths 38 (1.4%) vs 393 (7.2%) (OR 0.18 [95% CI 0.13 to 0.25]) and 717 (7.6%) (OR 0.17 [95% CI 0.12 to 0.24]) and uterine ruptures 2 (0.1%) vs 40 (1.1%) (OR 0.05 [95% CI 0.01 to 0.19]) and 122 (1.8%) (OR 0.04 (95% CI 0.01 to 0.16]). No significant differences were found regarding maternal deaths and stillbirths between Attat non-users and Butajira women. Attat MWH users had less favourable sociodemographic characteristics but better birth outcomes than Attat non-users and Butajira women. © The Author(s) 2018. Published by Oxford

Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study.

NARCIS (Netherlands)

van Batenburg, T.; Brion, M.J.; Henrichs, J.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; Lawlor, D.A.; Davey Smith, G.; Tiemeier, H.

2013-01-01

Background: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating

Parental depressive and anxiety symptoms during pregnancy and attention problems in children: A cross-cohort consistency study

NARCIS (Netherlands)

T. van Batenburg-Eddes (Tamara); M.-J. Brion (Maria); J. Henrichs (Jens); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); F.C. Verhulst (Frank); D.A. Lawlor (Debbie); G. Davey-Smith (George); H.W. Tiemeier (Henning)

2013-01-01

textabstractBackground: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by

Meal frequency patterns and glycemic properties of maternal diet in relation to preterm delivery: Results from a large prospective cohort study.

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Linda Englund-Ögge

Full Text Available Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery.This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa. Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: "snack meal", "main meal", and "evening meal". Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at <37 gestational weeks. A Cox regression model was used to assess associations with preterm delivery.After adjustments, the "main meal" pattern was associated with a reduced risk of preterm delivery, with hazard ratios (HRs of 0.89 (95% confidence interval (CI: 0.80, 0.98 and 0.90 (95% CI: 0.81, 0.99 for the third and fourth quartiles, respectively, and p for trend of 0.028. This was mainly attributed to the group of women with BMI ≥25 kg/m2, with HRs of 0.87 (95% CI: 0.79, 0.96 and 0.89 (95% CI: 0.80, 0.98 for the third and fourth quartiles, respectively, and p for trend of 0.010. There was no association between glycemic index, glycemic load, carbohydrates, added sugar, fiber, or the remaining meal frequency patterns and preterm delivery.Regular consumption of main meals (breakfast, lunch, dinner was associated with a lower risk of preterm delivery. Diet should be further studied as potential contributing factors for preterm delivery.

Risk Factors for Conduct Problems and Depressive Symptoms in a Cohort of Ukrainian Children

Science.gov (United States)

Drabick, Deborah A. G.; Beauchaine, Theodore P.; Gadow, Kenneth D.; Carlson, Gabrielle A.; Bromet, Evelyn J.

2006-01-01

Potential risk factors for conduct problems and depressive symptoms were tested in a cohort of 10- to 12-year-old Ukrainian children (N = 544, 47.6% male). Risk factors examined were child emotional lability, child attention problems, poor mother-child communication, coercive maternal discipline, maternal depression, and low marital satisfaction.…

The effect of maternal diabetes on pre- and postnatal growth

NARCIS (Netherlands)

Hammoud, NM

2016-01-01

Background and objective: The abnormal intrauterine environment in case of maternal diabetes results in impaired perinatal outcome. In this thesis we investigated factors that were related to altered fetal growth and growth during childhood. Methods: A cohort of women with pregnancies complicated by

Maternal serum retinol and β-carotene concentrations and neonatal bone mineralization

DEFF Research Database (Denmark)

Händel, Mina N; Moon, Rebecca J.; Titcombe, Philip

2016-01-01

were assessed prepregnancy and at 11 and 34 wk of gestation. In late pregnancy, maternal serum retinol and β-carotene concentrations were measured. Offspring total body bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were measured within 2 wk after birth. RESULTS: In total......BACKGROUND: Studies in older adults and animals have suggested contrasting relations between bone health and different vitamin A compounds. To our knowledge, the associations between maternal vitamin A status and offspring bone development have not previously been elucidated. OBJECTIVE: We examined...... the associations between maternal serum retinol and β-carotene concentrations during late pregnancy and offspring bone mineralization assessed at birth with the use of dual-energy X-ray absorptiometry. DESIGN: In the Southampton Women's Survey mother-offspring birth cohort, maternal health, lifestyle, and diet...

Parental depressive and anxiety symptoms during pregnancy and attention problems in children : A cross-cohort consistency study

NARCIS (Netherlands)

van Batenburg-Eddes, T.; Brion, M.J.; Henrichs, J.; Jaddoe, V.W.; Hofman, A.; Verhulst, F.C.; Lawlor, D.A.; Davey Smith, G.; Tiemeier, H.W.

2013-01-01

Background:  Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim:  We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating

The effects of maternal weight gain patterns on term birth weight in African-American women

Science.gov (United States)

Misra, Vinod K.; Hobel, Calvin J.; Sing, Charles F.

2010-01-01

Objective The goals of our study were 1) to estimate the trends in maternal weight gain patterns and 2) to estimate the influence of variation in maternal weight and rate of weight gain over different time periods in gestation on variation in birth weight in African-American and non-African-American gravidas. Study Design and Setting Data from a prospective cohort study in which pregnant women were monitored at multiple time points during pregnancy were analyzed. Maternal weight was measured at three times during pregnancy, preconception (W0); 16-20 weeks gestation (W1); and 30-36 weeks gestation (W2), in a cohort of 435 women with full-term singleton pregnancies. The relationship between gestational age-adjusted birth weight (aBW) and measures of maternal weight and rate of weight gain across pregnancy was estimated using a multivariable longitudinal regression analysis stratified on African-American race. Results The aBW was significantly associated with maternal weight measured at any visit in both strata. For African-American women, variation in aBW was significantly associated with variation in the rate of maternal weight gain in the first half of pregnancy (W01) but not the rate of maternal weight gain in the second half of pregnancy (W12); while for non-African-American women, variation in aBW was significantly associated with W12 but not W01. Conclusion Factors influencing the relationship between aBW and maternal weight gain patterns depend on the context of the pregnancy defined by race. Clinical decisions and recommendations about maternal weight and weight gain during pregnancy may need to account for such heterogeneity. PMID:20632908

Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study

Directory of Open Access Journals (Sweden)

Mohd Noor Norhayati

2016-08-01

Full Text Available Abstract Background Given the growing interest in severe maternal morbidity (SMM, the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. Methods A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12. Results The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534 between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674 between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031, role limitations due to physical health subscale at 6-month (P = 0.019, vitality subscale at 1-month (P = 0.007 and 6-month (P = 0.008, and role limitations due to emotional problems subscales at 6-month (P = 0.008. Conclusions Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.

Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study.

Science.gov (United States)

Delamou, Alexandre; El Ayadi, Alison M; Sidibe, Sidikiba; Delvaux, Therese; Camara, Bienvenu S; Sandouno, Sah D; Beavogui, Abdoul H; Rutherford, Georges W; Okumura, Junko; Zhang, Wei-Hong; De Brouwere, Vincent

2017-04-01

The 2014 west African epidemic of Ebola virus disease posed a major threat to the health systems of the countries affected. We sought to quantify the consequences of Ebola virus disease on maternal and child health services in the highly-affected Forest region of Guinea. We did a retrospective, observational cohort study of women and children attending public health facilities for antenatal care, institutional delivery, and immunisation services in six of seven health districts in the Forest region (Beyla, Guéckédou, Kissidougou, Lola, Macenta, and N'Zérékoré). We examined monthly service use data for eight maternal and child health services indicators: antenatal care (≥1 antenatal care visit and ≥3 antenatal care visits), institutional delivery, and receipt of five infant vaccines: polio, pentavalent (diphtheria, tetanus, pertussis, hepatitis B virus, and Haemophilus influenzae type b), yellow fever, measles, and tuberculosis. We used interrupted time series models to estimate trends in each indicator across three time periods: pre-Ebola virus disease epidemic (January, 2013, to February, 2014), during-epidemic (March, 2014, to February, 2015) and post-epidemic (March, 2015, to Feb, 2016). We used segmented ordinary least-squares (OLS) regression using Newey-West standard errors to accommodate for serial autocorrelation, and adjusted for any potential effect of birth seasonality on our outcomes. In the months before the Ebola virus disease outbreak, all three maternal indicators showed a significantly positive change in trend, ranging from a monthly average increase of 61 (95% CI 38-84) institutional deliveries to 119 (95% CI 79-158) women achieving at least three antenatal care visits. These increasing trends were reversed during the epidemic: fewer institutional deliveries occurred (-240, 95% CI -293 to -187), and fewer women achieved at least one antenatal care visit (-418, 95% CI -535 to -300) or at least three antenatal care visits (-363, 95% CI -485

Maternal and Neonatal Vitamin D Status are not Associated With Risk of Childhood Type 1 Diabetes

DEFF Research Database (Denmark)

Thorsen, Steffen U; Mårild, Karl; Olsen, Sjurdur F

2018-01-01

Studies on vitamin D status during pregnancy and risk of type 1 diabetes (T1D) lack consistency, and are limited by small sample sizes or single measures of 25-hydroxyvitamin D (25(OH)D). We investigated whether average maternal 25(OH)D plasma concentrations during pregnancy are associated...... with risk of childhood T1D. In a case-cohort design, we identified 459 children with T1D and a random sample (n = 1,561) from the Danish National Birth Cohort (n = 97,127) and Norwegian Mother and Child Cohort Study (n = 113,053). Participants were born between 1996 and 2009. The primary exposure...... 25(OH)D concentration was 1.00 (95% confidence interval: 0.90, 1.10). Results were consistent in both cohorts, in multiple sensitivity analyses, and when we analyzed mid-pregnancy or cord blood separately. In conclusion, our large study demonstrated that normal variation in maternal or neonatal 25(OH...

Education in Twins and Their Parents Across Birth Cohorts Over 100 years: An Individual-Level Pooled Analysis of 42-Twin Cohorts.

Science.gov (United States)

Silventoinen, Karri; Jelenkovic, Aline; Latvala, Antti; Sund, Reijo; Yokoyama, Yoshie; Ullemar, Vilhelmina; Almqvist, Catarina; Derom, Catherine A; Vlietinck, Robert F; Loos, Ruth J F; Kandler, Christian; Honda, Chika; Inui, Fujio; Iwatani, Yoshinori; Watanabe, Mikio; Rebato, Esther; Stazi, Maria A; Fagnani, Corrado; Brescianini, Sonia; Hur, Yoon-Mi; Jeong, Hoe-Uk; Cutler, Tessa L; Hopper, John L; Busjahn, Andreas; Saudino, Kimberly J; Ji, Fuling; Ning, Feng; Pang, Zengchang; Rose, Richard J; Koskenvuo, Markku; Heikkilä, Kauko; Cozen, Wendy; Hwang, Amie E; Mack, Thomas M; Siribaddana, Sisira H; Hotopf, Matthew; Sumathipala, Athula; Rijsdijk, Fruhling; Sung, Joohon; Kim, Jina; Lee, Jooyeon; Lee, Sooji; Nelson, Tracy L; Whitfield, Keith E; Tan, Qihua; Zhang, Dongfeng; Llewellyn, Clare H; Fisher, Abigail; Burt, S Alexandra; Klump, Kelly L; Knafo-Noam, Ariel; Mankuta, David; Abramson, Lior; Medland, Sarah E; Martin, Nicholas G; Montgomery, Grant W; Magnusson, Patrik K E; Pedersen, Nancy L; Dahl Aslan, Anna K; Corley, Robin P; Huibregtse, Brooke M; Öncel, Sevgi Y; Aliev, Fazil; Krueger, Robert F; McGue, Matt; Pahlen, Shandell; Willemsen, Gonneke; Bartels, Meike; van Beijsterveldt, Catharina E M; Silberg, Judy L; Eaves, Lindon J; Maes, Hermine H; Harris, Jennifer R; Brandt, Ingunn; Nilsen, Thomas S; Rasmussen, Finn; Tynelius, Per; Baker, Laura A; Tuvblad, Catherine; Ordoñana, Juan R; Sánchez-Romera, Juan F; Colodro-Conde, Lucia; Gatz, Margaret; Butler, David A; Lichtenstein, Paul; Goldberg, Jack H; Harden, K Paige; Tucker-Drob, Elliot M; Duncan, Glen E; Buchwald, Dedra; Tarnoki, Adam D; Tarnoki, David L; Franz, Carol E; Kremen, William S; Lyons, Michael J; Maia, José A; Freitas, Duarte L; Turkheimer, Eric; Sørensen, Thorkild I A; Boomsma, Dorret I; Kaprio, Jaakko

2017-10-01

Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990-1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.

Increased maternal BMI is associated with infant wheezing in early life: a prospective cohort study

NARCIS (Netherlands)

de Vries, A.; Reynolds, R. M.; Seckl, J. R.; van der Wal, M.; Bonsel, G. J.; Vrijkotte, T. G. M.

2014-01-01

Rates of obesity are increasing in women of child bearing age with negative impacts on maternal and offspring health. Emerging evidence suggests in utero origins of respiratory health in offspring of obese mothers but mechanisms are unknown. Changes in maternal cortisol levels are one potential

Risk of Adverse Pregnancy Outcomes at Advanced Maternal Age

DEFF Research Database (Denmark)

Frederiksen, Line Elmerdahl; Ernst, Andreas; Brix, Nis

2018-01-01

prediction chart showed that advanced maternal age, use of assisted reproductive technology, nulliparous pregnancy, smoking during pregnancy, and obesity increased the absolute predictive risk of an adverse pregnancy outcome. CONCLUSION: Women older than 40 years have a higher risk of chromosomal......OBJECTIVE: To study the possible associations between advanced maternal age and risk of selected adverse pregnancy outcomes. METHODS: The study used a nationwide cohort of 369,516 singleton pregnancies in Denmark followed from 11-14 weeks of gestation to delivery or termination of pregnancy....... Pregnant women aged 35 years or older were divided into two advanced maternal age groups, 35-39 years and 40 years or older, and compared with pregnant women aged 20-34 years. Adverse pregnancy outcomes were chromosomal abnormalities, congenital malformations, miscarriage, stillbirth, and birth before 34...

Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP)

Science.gov (United States)

Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg; Petersen, Tanja Gram; Moster, Dag; Andersen, Anne-Marie Nybo; Stoltenberg, Camilla; Olsen, Jørn; Wilcox, Allen J

2016-01-01

Purpose The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. Participants MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts—the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. Findings to date Initial harmonisation of data from the 2 cohorts has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies investigating various hypotheses regarding CP aetiology are currently on-going. Future plans Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children. PMID:27591025

Maternal Employment and Overweight Among Hispanic Children of Immigrants and Children of Natives

OpenAIRE

Baker, Elizabeth; Balistreri, Kelly Stamper; Van Hook, Jennifer

2007-01-01

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hisp...

Maternal body composition, smoking, and hyperemesis gravidarum.

Science.gov (United States)

Vikanes, Ase; Grjibovski, Andrej M; Vangen, Siri; Gunnes, Nina; Samuelsen, Sven O; Magnus, Per

2010-08-01

To study associations between maternal prepregnant body mass index (BMI), smoking, and hyperemesis gravidarum (hyperemesis). The sample consisted of 33,467 primiparous women from the Norwegian Mother and Child Cohort Study (1999-2008). Data on hyperemesis, BMI, education, maternal age, eating disorders, maternal and paternal smoking habits were obtained from questionnaires. All associations were studied by logistic regression. Altogether, 353 (1.1%) women had hyperemesis. Among non-smokers, both underweight and obese women were more likely to develop hyperemesis than normal-weighted women: odds ratio (OR), 2.36; 95% confidence interval (95% CI), 1.43-3.88 and OR, 1.48; 95% CI, 1.00-2.20, respectively. No associations were found among smokers. Women who smoked daily (OR, 0.44; 95% CI, 0.32-0.60) or occasionally (OR, 0.64; 95% CI, 0.44-0.93) had lower risk of hyperemesis than non-smokers. No effect of partner's smoking habits was observed. Both underweight and obesity were associated with hyperemesis, but only among non-smokers. Maternal prepregnant smoking reduced the risk of hyperemesis, whereas partner's smoking habits had no effect. 2010 Elsevier Inc. All rights reserved.

A Birth Cohort Study of Maternal and Infant Serum PCB-153 and DDE Concentrations and Responses to Infant Tuberculosis Vaccination

Science.gov (United States)

Jusko, Todd A.; De Roos, Anneclaire J.; Lee, Sue Y.; Thevenet-Morrison, Kelly; Schwartz, Stephen M.; Verner, Marc-André; Murinova, Lubica Palkovicova; Drobná, Beata; Kočan, Anton; Fabišiková, Anna; Čonka, Kamil; Trnovec, Tomas; Hertz-Picciotto, Irva; Lawrence, B. Paige

2015-01-01

Background: Reasons for the highly variable and often poor protection conferred by the Mycobacterium bovis bacille Calmette–Guérin (BCG) vaccine are multifaceted and poorly understood. Objectives: We aimed to determine whether early-life exposure to PCBs (polychlorinated biphenyls) and DDE [1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] reduces 6-month infant BCG vaccine response. Methods: Data came from families participating in a prospective birth cohort in eastern Slovakia. At birth, maternal and cord blood were collected for chemical analyses, and infants were immunized with BCG. Blood was collected from infants for chemical analyses and to determine 6-month BCG-specific immunoglobulin (Ig) G and IgA levels. Multivariable linear regression models were fit to examine chemical–BCG associations among approximately 500 mother–infant pairs, with adjustment for confounders. Results: The median 6-month infant concentration of the prevalent congener PCB-153 was 113 ng/g lipid [interquartile range (IQR): 37–248], and 388 ng/g lipid (IQR: 115–847) for DDE. Higher 6-month infant concentrations of PCB-153 and DDE were strongly associated with lower 6-month BCG-specific antibody levels. For instance, BCG-specific IgG levels were 37% lower for infants with PCB-153 concentrations at the 75th percentile compared to the 25th percentile (95% CI: –42, –32; p PCB–DDE additivity, where exposure to both compounds reduced anti-BCG levels more than exposure to either compound alone. Conclusions: The associations observed in this study indicate that environmental exposures may be overlooked contributors to poorer responses to BCG vaccine. The overall association between these exposures and tuberculosis incidence is unknown. Citation: Jusko TA, De Roos AJ, Lee SY, Thevenet-Morrison K, Schwartz SM, Verner MA, Palkovicova Murinova L, Drobná B, Kočan A, Fabišiková A, Čonka K, Trnovec T, Hertz-Picciotto I, Lawrence BP. 2016. A birth cohort study of maternal and infant

Relation of maternal vitamin D status with gestational diabetes ...

African Journals Online (AJOL)

Objective: To investigate the relationship between maternal vitamin D status and glucose intolerance, and its impact on pregnant women and their newborns. Methods: A cohort of pregnant women were divided into three groups: women with gestational diabetes mellitus, ones with normal results both after the 50 gr and 100 ...

Maternal Concentrations of Perfluoroalkyl Substances and Fetal Markers of Metabolic Function and Birth Weight

Science.gov (United States)

Ashley-Martin, Jillian; Dodds, Linda; Arbuckle, Tye E.; Bouchard, Maryse F.; Fisher, Mandy; Morriset, Anne-Sophie; Monnier, Patricia; Shapiro, Gabriel D.; Ettinger, Adrienne S.; Dallaire, Renee; Taback, Shayne; Fraser, William; Platt, Robert W.

2017-01-01

Abstract Perfluoroalkyl substances (PFAS) are ubiquitous, persistent chemicals that have been widely used in the production of common household and consumer goods for their nonflammable, lipophobic, and hydrophobic properties. Inverse associations between maternal or umbilical cord blood concentrations of perfluorooctanoic acid and perfluorooctanesulfonate and birth weight have been identified. This literature has primarily examined each PFAS individually without consideration of the potential influence of correlated exposures. Further, the association between PFAS exposures and indicators of metabolic function (i.e., leptin and adiponectin) has received limited attention. We examined associations between first-trimester maternal plasma PFAS concentrations and birth weight and cord blood concentrations of leptin and adiponectin using data on 1,705 mother-infant pairs from the Maternal Infant Research on Environmental Chemicals (MIREC) Study, a trans-Canada birth cohort study that recruited women between 2008 and 2011. Bayesian hierarchical models were used to quantify associations and calculate credible intervals. Maternal perfluorooctanoic acid concentrations were inversely associated with birth weight z score, though the null value was included in all credible intervals (log10 β = −0.10, 95% credible interval: −0.34, 0.13). All associations between maternal PFAS concentrations and cord blood adipocytokine concentrations were of small magnitude and centered around the null value. Follow-up in a cohort of children is required to determine how the observed associations manifest in childhood. PMID:28172036

Association of Maternal Preeclampsia With Infant Risk of Premature Birth and Retinopathy of Prematurity.

Science.gov (United States)

Shulman, Julia P; Weng, Cindy; Wilkes, Jacob; Greene, Tom; Hartnett, M Elizabeth

2017-09-01

Studies report conflicting associations between preeclampsia and retinopathy of prematurity (ROP). This study provides explanations for the discrepancies to clarify the relationship between preeclampsia and ROP. To evaluate the association of maternal preeclampsia and risk of ROP among infants in an unrestricted birth cohort and a restricted subcohort of preterm, very low birth weight (P-VLBW) infants. A retrospective review of 290 992 live births within the Intermountain Healthcare System in Utah from January 1, 2001, through December 31, 2010, was performed. Generalized estimating equations for logistic regressions with covariate adjustment were applied to relate ROP to preeclampsia among the full cohort and in a subcohort of P-VLBW infants born at younger than 31 weeks' gestation and weighing less than 1500 g. The occurrence of ROP was related to maternal preeclampsia in the full cohort and in a subcohort of P-VLBW infants. In the full cohort, 51% of the infants were male and the mean (SD) gestational age was 38.38 (1.87) weeks. In the P-VLBW cohort, 55% were male and the mean (SD) gestational age was 26.87 (2.40) weeks. In the full cohort, preeclampsia was associated with an increased risk of all ROP (adjusted odds ratio [aOR], 2.46; 95% CI, 2.17-2.79; P prematurity, because prematurity is an outcome of preeclampsia.

Maternal vitamin D status and offspring bone fractures

DEFF Research Database (Denmark)

Petersen, Sesilje Bondo; Olsen, Sjurdur Frodi; Mølgaard, Christian

2014-01-01

BACKGROUND: Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results. PURPOSE: We used occurrence of bone fractures up to the age of 18 as a measure reflecting...... offspring bone mass and related that to maternal vitamin D status. METHODS: The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988-89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration...... percentile) 25(OH)D was 76.2 (23.0-152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone...

The association between maternal dietary micronutrient intake and neonatal anthropometry - secondary analysis from the ROLO study.

LENUS (Irish Health Repository)

Horan, Mary K

2015-01-01

Micronutrients are necessary for fetal growth. However increasingly pregnant women are nutritionally replete and little is known about the effect of maternal micronutrient intakes on fetal adiposity in mothers with increased BMI. The aim of this study was to examine the association of maternal dietary micronutrient intake with neonatal size and adiposity in a cohort at risk of macrosomia.

Contemporary Trends of Reported Sepsis Among Maternal Decedents in Texas: A Population-Based Study.

Science.gov (United States)

Oud, Lavi

2015-09-01

Recent studies indicate that death certificate-based single-cause-of-death diagnoses can substantially underestimate the contribution of sepsis to mortality in the general population and among maternal decedents. There are no population-based data in the United States on the patterns of the contribution of sepsis to pregnancy-associated deaths. We studied the Texas Inpatient Public Use Data File to identify pregnancy-associated hospitalizations with reported hospital death during 2001-2010. We then examined the annual reporting of sepsis, and that of other reported most common causes of maternal death, including hemorrhage, embolism, preeclampsia/eclampsia, cardiovascular conditions, cardiomyopathy, cerebrovascular accidents, and anesthesia complications. The annual rate of sepsis among decedents, its trend over time, and changes of its annual rank among other examined potential causes of maternal death were assessed. There were 557 pregnancy-associated hospital deaths during study period. Sepsis was reported in 131 (23.5%) decedents. Sepsis has been increasingly reported among decedents, rising by 9.1%/year (P = 0.0025). The rank of sepsis, as compared to the other examined potential causes of maternal death rose from the 5th in 2001 to 1st since 2008. At the end of the last decade, sepsis has been reported in 28.1% of pregnancy-associated deaths. More than one potential cause of maternal death was reported in 39% of decedents. Sepsis has become the most commonly reported potential cause of death among maternal decedents in the present cohort, noted in over 1 in 4 fatal hospitalizations by the end of the last decade. Although causality cannot be inferred from administrative data, given its known contribution to maternal death, it is likely that sepsis plays an increasing role in fatal maternal hospital outcomes. The prevalent co-reporting of multiple potential causes of maternal death in the present cohort underscores the complexity of determining the sources of

Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis.

Science.gov (United States)

Farr, Olivia M; Rifas-Shiman, Sheryl L; Oken, Emily; Taveras, Elsie M; Mantzoros, Christos S

2017-11-01

Obstructive sleep apnea (OSA), typically manifested as snoring, is closely associated with obesity. However, the directionality of associations of OSA with cardiometabolic risk markers is unclear, as obesity increases risk for OSA, and OSA results in excess weight gain and its metabolic consequences. Less is known about how obesity and OSA may relate in children and adolescents and whether maternal OSA may influence the development of obesity and cardiometabolic dysfunction in offspring. Among 1078 children from the Project Viva cohort, we examined cross-sectionally and prospectively associations of parent-reported child or maternal snoring with cardiometabolic outcomes, including adiposity, adipokines, and insulin resistance. Cross-sectionally, child snoring was related to adiposity and metabolic risk, particularly body mass index (BMI; β 0.61kg/m 2 , 95% CI 0.33, 0.89; pchild snoring at the early teen visit (~12y) after correction for covariates. Child snoring at ~9y was related to changes in adiposity between mid-childhood and early teen visits. Child but not maternal snoring, was related to child adiposity and cardiometabolic outcomes. Adiposity and child snoring are associated with each other cross-sectionally and are each predictive of the other among children/adolescents prospectively. These results suggest similar mechanisms in pediatric/adolescent populations as in adults for the development of sleep-disordered breathing and sleep apnea that will need to be confirmed in randomized clinical trials. Importantly, this research points to the need to target both sleep and obesity in order to break this vicious cycle. Copyright © 2017 Elsevier Inc. All rights reserved.

Maternal age and child morbidity

DEFF Research Database (Denmark)

Hviid, Malene Meisner; Skovlund, Charlotte Wessel; Mørch, Lina Steinrud

2017-01-01

the association between maternal age and overall child morbidity according to main diagnosis groups. MATERIAL AND METHODS: We conducted a national cohort study including 352 027 live firstborn singleton children. The children were born between Jan 1994 and Dec 2009 and followed to Dec 2012. Children were divided...... into groups according to maternal age: 15-24, 25-29, 30-34, and 35+ years. Poisson regression analyses calculated adjusted incidence rate ratios (IRR) of child morbidities according to main diagnoses groups A-Q of the International Classification of Disease 10 with adjustment for year of birth, body mass...... index, smoking, and mother's level of education. RESULTS: Average follow-up time was 11 years. Compared to children born to women 25-29 years, firstborn children to mothers aged 35+ had higher child morbidity in 8 of 19 main diagnosis groups and firstborn children to mothers 15-24 years had higher child...

Experiences and outcomes of maternal Ramadan fasting during pregnancy: results from a sub-cohort of the Born in Bradford birth cohort study.

Science.gov (United States)

Petherick, Emily S; Tuffnell, Derek; Wright, John

2014-09-26

Observing the fast during the holy month of Ramadan is one of the five pillars of Islam. Although pregnant women and those with pre-existing illness are exempted from fasting many still choose to fast during this time. The fasting behaviours of pregnant Muslim women resident in Western countries remain largely unexplored and relationships between fasting behaviour and offspring health outcomes remain contentious. This study was undertaken to assess the prevalence, characteristics of fasting behaviours and offspring health outcomes in Asian and Asian British Muslim women within a UK birth cohort. Prospective cohort study conducted at the Bradford Royal Infirmary UK from October to December 2010 comprising 310 pregnant Muslim women of Asian or Asian British ethnicity that had a live singleton birth at the Bradford Royal Infirmary. The main outcome of the study was the decision to fast or not during Ramadan. Secondary outcomes were preterm births and mean birthweight. Logistic regression analyses were used to investigate the relationship between covariables of interest and women's decision to fast or not fast. Logistic regression was also used to investigate the relationship between covariables and preterm birth as well as low birth weight. Mutually adjusted analysis showed that the odds of any fasting were higher for women with an obese BMI at booking compared to women with a normal BMI, (OR 2.78 (95% C.I. 1.29-5.97)), for multiparous compared to nulliparous women(OR 3.69 (95% C.I. 1.38-9.86)), and for Bangladeshi origin women compared to Pakistani origin women (OR 3.77 (95% C.I. 1.04-13.65)). Odds of fasting were lower in women with higher levels of education (OR 0.40 (95% C.I. 0.18-0.91)) and with increasing maternal age (OR 0.87 (95% C.I. 0.80-0.94). No associations were observed between fasting and health outcomes in the offspring. Pregnant Muslim women residing in the UK who fasted during Ramadan differed by social, demographic and lifestyle characteristics

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

Science.gov (United States)

Jain, Rajesh; Davey, Sanjeev; Davey, Anuradha; Raghav, Santosh K.; Singh, Jai V.

2016-01-01

Background: Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. Materials and Methods: A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2nd year (2013–2014) after blood sugar levels were controlled. Results: It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P 1 in every case). Moreover, perinatal mortality also increased significantly from 5.7% to 8.9% when blood sugar levels increased from 199 mg/dl and above. Perinatal and maternal outcomes in GDM cases were also significantly related to the control of blood sugar levels (P < 0.0001). Conclusion: Blood sugar levels can be an indicator of maternal and perinatal morbidity and mortality in GDM cases, provided unified diagnostic criteria are used by Indian laboratories. However, to get an accurate picture on this issue, all factors need further study. PMID:27186155

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

Directory of Open Access Journals (Sweden)

Rajesh Jain

2016-01-01

Full Text Available Background: Gestational diabetes mellitus (GDM is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. Materials and Methods: A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2nd year (2013–2014 after blood sugar levels were controlled. Results: It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P 1 in every case. Moreover, perinatal mortality also increased significantly from 5.7% to 8.9% when blood sugar levels increased from 199 mg/dl and above. Perinatal and maternal outcomes in GDM cases were also significantly related to the control of blood sugar levels (P < 0.0001. Conclusion: Blood sugar levels can be an indicator of maternal and perinatal morbidity and mortality in GDM cases, provided unified diagnostic criteria are used by Indian laboratories. However, to get an accurate picture on this issue, all factors need further study.

Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study

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Le Thi

2011-10-01

Full Text Available Abstract Background Preterm birth (PTB is a major cause of infant morbidity and mortality, but the relationship between comorbidity and PTB by clinical subtype and severity of gestational age remains poorly understood. We evaluated associations between maternal comorbidities and PTB by clinical subtype and gestational age. Methods We conducted a retrospective cohort study of 1,329,737 singleton births delivered in hospitals in the province of Québec, Canada, 1989-2006. PTB was classified by clinical subtype (medically indicated, preterm premature rupture of membranes (PPROM, spontaneous preterm labour and gestational age ( Results PTB rates were higher among mothers with comorbidity (10.9% compared to those without comorbidity (4.7%. Several comorbidities were associated with greater odds of medically indicated PTB compared with no comorbidity, but only comorbidities localized to the reproductive system were associated with spontaneous PTB. Drug dependence and mental disorders were strongly associated with PPROM and spontaneous PTBs across all gestational ages (OR > 2.0. At the population level, several major comorbidities (placental abruption, chorioamnionitis, oliogohydramnios, structural abnormality, cervical incompetence were key contributors to all clinical subtypes of PTB, especially at Conclusions The relationship between comorbidity and clinical subtypes of PTB depends on gestational age. Prevention of PPROM and spontaneous PTB may benefit from greater attention to preeclampsia, anemia and comorbidities localized to the reproductive system.

The Association Between Maternal Subclinical Hypothyroidism and Growth, Development, and Childhood Intelligence: A Meta-analysis

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Liu, Yahong; Chen, Hui; Jing, Chen; Li, FuPin

2018-06-01

To explore the association between maternal subclinical hypothyroidism (SCH) in pregnancy and the somatic and intellectual development of their offspring. Using RevMan 5.3 software, a meta-analysis of cohort studies published from inception to May 2017, focusing on the association between maternal SCH in pregnancy and childhood growth, development and intelligence, was performed. Sources included the Cochrane Library, Pub-Med, Web of Science, China National Knowledge Infrastructure and Wan Fang Data. Analysis of a total of 15 cohort studies involving 1.896 pregnant women with SCH revealed that SCH in pregnancy was significantly associated with the intelligence (p=0.0007) and motor development (pdevelopment, low birth weight, premature delivery, fetal distress and fetal growth restriction.

The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study.

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Ada Gillissen

Full Text Available Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country.We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit and mortality.247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247 versus no/late tranexamic acid (n = 984 was 0.92 (95% confidence interval (CI 0.66 to 1.27. Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0.Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing.

The effect of tranexamic acid on blood loss and maternal outcome in the treatment of persistent postpartum hemorrhage: A nationwide retrospective cohort study

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Henriquez, Dacia D. C. A.; van den Akker, Thomas; Wind, Merlijn; Zwart, Joost J.; van Roosmalen, Jos; Eikenboom, Jeroen; Bloemenkamp, Kitty W. M.; van der Bom, Johanna G.

2017-01-01

Background Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. Methods and findings We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands. The study population consisted of 1260 women with persistent postpartum hemorrhage who had received at least four units of red cells, or fresh frozen plasma or platelets in addition to red cells. A review of medical records was performed and cross-referenced with blood bank data. The composite endpoint comprised maternal morbidity (hysterectomy, ligation of the uterine arteries, emergency B-Lynch suture, arterial embolization or admission into an intensive care unit) and mortality. Results 247 women received early tranexamic acid treatment. After adjustment for confounding, odds ratio for the composite endpoint for early tranexamic acid (n = 247) versus no/late tranexamic acid (n = 984) was 0.92 (95% confidence interval (CI) 0.66 to 1.27). Propensity matched analysis confirmed the absence of a difference between women with and without tranexamic acid. Blood loss after administration of first line therapy did not differ significantly between the two groups (adjusted difference -177 mL, CI -509.4 to +155.0). Conclusions Our findings suggest that in a high-resource country the effect of tranexamic acid on both blood loss and the combined endpoint of maternal mortality and morbidity may be disappointing. PMID:29107951

The Long-Term Effects of Maternal Postnatal Depression on a Child's Intelligence Quotient: A Meta-Analysis of Prospective Cohort Studies Based on 974 Cases.

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Sui, Guoyuan; Pan, Bochen; Liu, Guangcong; Liu, Guangying; Wang, Lie

2016-11-01

Epidemiologists have explored the relationship between maternal postnatal depression (PND) and the intelligence quotient (IQ) of the resulting offspring, but the results remain inconclusive. This study aims to analyze the literature regarding the association between maternal PND and a child's IQ. A search of articles in PubMed, Web of Science, and MEDLINE databases from inception to September 2015 was conducted and supplemented by a manual search of relevant reference lists. The following search terms were used: (postpartum OR postnatal OR puerperal) AND (depression OR depressive symptoms OR blues OR dysthymia OR disorders OR psychosis) AND (intelligence quotient OR IQ OR intelligence tests OR intelligence OR cognitive OR cognition) AND (children OR child OR adolescent OR offspring) AND (cohort OR prospective OR follow-up OR follow OR longitudinal). Articles exploring the association between maternal PND and IQ of offspring aged 2 years and older were included. A total of 510 records were retrieved. Two authors independently selected eligible studies and extracted data. Three authors assessed the quality of the studies. To explore the associations between maternal PND and full IQ and verbal IQ, random-effects meta-analyses were performed, followed by subgroup analysis of impact on full IQ. Nine articles were eligible for review. On the basis of the Newcastle-Ottawa Scale, 7 studies were considered to be of high quality. When one study of participants aged 3.8 years was excluded from the meta-analysis, the pooled weighted mean difference of full IQ between the children of PND mothers and non-PND mothers was -4.086 (95% CI, -6.578 to -1.594), and the pooled standard mean difference of verbal IQ between the children of PND mothers and non-PND mothers was -0.361 (95% CI, -0.564 to -0.158). Subgroup analysis showed that the child's age at evaluation, diagnostic method of PND, study quality, and socioeconomic status did not affect the mean difference in full IQ between

Maternal malaria, birth size and blood pressure in Nigerian newborns: insights into the developmental origins of hypertension from the Ibadan growth cohort.

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Omolola O Ayoola

Full Text Available Hypertension is an increasing health issue in sub-Saharan Africa where malaria remains common in pregnancy. We established a birth cohort in Nigeria to evaluate the early impact of maternal malaria on newborn blood pressure (BP.Anthropometric measurements, BP, blood films for malaria parasites and haematocrit were obtained in 436 mother-baby pairs. Women were grouped to distinguish between the timing of malaria parasitaemia as 'No Malaria', 'Malaria during pregnancy only' or 'Malaria at delivery', and parasite density as low (<1000 parasites/µl of blood and high (≥ 1000/µl.Prevalence of maternal malaria parasitaemia was 48%, associated with younger maternal age (p<0.001, being primigravid (p = 0.022, lower haematocrit (p = 0.028. High parasite density through pregnancy had the largest effect on mean birth indices so that weight, length, head and mid-upper arm circumferences were smaller by 300 g, 1.1 cm, 0.7 cm and 0.4 cm respectively compared with 'No malaria' (all p ≤ 0.005. In babies of mothers who had 'malaria at delivery', their SBPs adjusted for other confounders were lower respectively by 4.3 and 5.7 mmHg/kg compared with 'malaria during pregnancy only' or 'none'. In contrast the mean newborn systolic (SBP and diastolic BPs (DBP adjusted for birth weight were higher by 1.7 and 1.4 mmHg/kg respectively in babies whose mothers had high compared with low parasitaemia.As expected, prenatal malarial exposure had a significant impact on fetal growth rates. Malaria at delivery was associated with the lowest newborn BPs while malaria through pregnancy, which may attenuate growth of the vascular network, generated higher newborn BPs adjusted for size. These neonatal findings have potential implications for cardiovascular health in sub-Saharan Africa.

Maternal lifestyle and nutritional status in relation to pregnancy and infant health outcomes in Western China: protocol for a prospective cohort study.

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Tang, Li; Pan, Xiong-Fei; Lee, Andy H; Binns, Colin W; Yang, Chun-Xia; Sun, Xin

2017-06-19

Improving the health and nutrition of women and children is a priority for Western China, where the economy is less developed. Due to the dynamic nature of lifestyle, modern food habits and nutrition, there is a need to update our limited knowledge and understanding of maternal lifestyle and nutritional status and their impact on pregnancy and infant health outcomes. While breast milk is the preferred feeding option, infant formula use is widespread in China. It is thus necessary to examine the effects of formula consumption on growth and morbidity. This is an ongoing prospective cohort study started in 2015 in Chengdu, Sichuan Province. A sample of 1901 pregnant women at 15-20 weeks of gestation were recruited from four maternal and child health hospitals and are followed prospectively to 12 months post partum. Detailed information on maternal lifestyle and nutritional status, obstetric complications, pregnancy outcomes, infant feeding practices, illnesses of the mother and infant and growth trajectory is collected through personal interviews, anthropometric measures and medical records and local health management system records retrieval. Multilevel mixed regression models, adjusted for clustering, will be applied to investigate the association between various exposure variables of interest and the longitudinal outcomes, taking into account the correlated data structure and the nesting of observations. Kaplan-Meier test and Cox regression analysis will be used to analyse the time-to-event data. Ethical approval has been obtained from the ethics committee of West China School of Public Health, Sichuan University and the Human Research Ethics Committee of Curtin University. Results will be presented at national and international conferences and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Meta-Analysis of Maternal Smoking during Pregnancy and Autism Spectrum Disorder Risk in Offspring

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Shiming Tang

2015-08-01

Full Text Available The association between maternal smoking during pregnancy and autism spectrum disorder (ASD risk in offspring has been investigated in several studies, but the evidence is not conclusive. We, therefore, conducted this meta-analysis to explore whether an association exists between maternal smoking during pregnancy and ASD risk in offspring. We searched PubMed, Embase, Web of Science, and the Cochrane Library for studies of maternal smoking during pregnancy and ASD risk in offspring up to 10 June 2015. The random-effects model was used to combine results from individual studies. 15 observational studies (6 cohort studies and 9 case-control studies, with 17,890 ASD cases and 1,810,258 participants were included for analysis. The pooled odds ratio (OR was 1.02 (95% confidence interval (CI: 0.93–1.13 comparing mothers who smoked during pregnancy with those who did not. Subgroup and sensitivity analysis suggested the overall result of this analysis was robust. Results from this meta-analysis indicate that maternal smoking during pregnancy is not associated with ASD risk in offspring. Further well-designed cohort studies are needed to confirm the present findings.

Post-Traumatic Stress Disorder and severe maternal morbidity: is there an association?

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Angelini, Carina R; Pacagnella, Rodolfo C; Parpinelli, Mary A; Silveira, Carla; Andreucci, Carla B; Ferreira, Elton C; Santos, Juliana P; Zanardi, Dulce M; Souza, Renato T; Cecatti, Jose G

2018-01-01

To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored. Data analysis was carried out by using χ2, Fisher's Exact test, and logistic regression analysis. There was no significant change in the prevalence of Post-Traumatic Stress Disorder related to a previous severe maternal morbidity experience. There were also no differences in diagnostic criteria for severe maternal morbidity (hypertensive syndromes, hemorrhage, surgical intervention or intensive care unit admission required, among other management criteria). Low parity (2.5-fold risk) and increasing age were factors associated with Post-Traumatic Stress Disorder. A severe maternal morbidity episode is not associated with Post-Traumatic Stress Disorder symptoms within five years of the severe maternal morbidity event and birth. However, a more advanced maternal age and primiparity increased the risk of Post-Traumatic Stress Disorder. This does not imply that women who had experienced a severe maternal morbidity event did not suffer or need differentiated care.

Determinants of cortisol during pregnancy - The ABCD cohort.

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Bleker, Laura S; Roseboom, Tessa J; Vrijkotte, Tanja G; Reynolds, Rebecca M; de Rooij, Susanne R

2017-09-01

Psychosocial stress during pregnancy has been proposed as a major contributor of glucocorticoid-mediated programming of the fetal hypothalamic-pituitary adrenal (HPA) axis, with later adverse health consequences. However, evidence linking maternal stress to maternal cortisol values during pregnancy is inconclusive. A possible explanation for this is that other maternal factors overshadow any potential effects of stress on cortisol levels. We studied a large cohort of pregnant women with extensive data on pregnancy characteristics to determine the respective contributions of biological, environmental and psychosocial stress factors to cortisol levels in pregnancy. We used data from 3039 women from the Amsterdam Born Children and their Development-study cohort. Serum cortisol was measured in blood, collected at the first prenatal visit, at different gestational ages (median=91days, range=40-256days), and at various time points during the day (median=11:45h, range=08:00-18:30h). We assessed associations between maternal serum cortisol in pregnancy and biological factors, lifestyle factors and stress factors, including depression, anxiety, pregnancy-related anxiety, work stress, parenting stress and fatigue. In multivariable analysis, variables that were associated with higher cortisol levels in pregnancy were lower maternal age [1.5nmol/l, 95%CI (0.6-2.4)], being nulliparous [21.5 nmol/l (15.9-27.1)], lower pre-pregnancy body mass index (BMI) [1.3nmol/l (0.3-2.4)], higher C-reactive protein (CRP) [1.0nmol/l (0.4-1.5)], carrying a female fetus [9.2nmol/l (1.8-16.5)], non-smoking [14.2nmol/l (0.6-27.7)], sufficient sleep [8.5nmol/l (0.9-16.1)], and being unemployed [12.7nmol/l (2.2-23.2)]. None of the psychosocial stressors was significantly associated with serum cortisol levels in pregnancy. A total of 32% of all variance in cortisol was explained by gestational age, maternal age, time of day, parity, pre-pregnancy BMI, CRP, fetal sex, smoking behavior, self

Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation: findings from the pregnancy and childhood epigenetics (PACE) consortium.

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Sharp, Gemma C; Salas, Lucas A; Monnereau, Claire; Allard, Catherine; Yousefi, Paul; Everson, Todd M; Bohlin, Jon; Xu, Zongli; Huang, Rae-Chi; Reese, Sarah E; Xu, Cheng-Jian; Baïz, Nour; Hoyo, Cathrine; Agha, Golareh; Roy, Ritu; Holloway, John W; Ghantous, Akram; Merid, Simon K; Bakulski, Kelly M; Küpers, Leanne K; Zhang, Hongmei; Richmond, Rebecca C; Page, Christian M; Duijts, Liesbeth; Lie, Rolv T; Melton, Phillip E; Vonk, Judith M; Nohr, Ellen A; Williams-DeVane, ClarLynda; Huen, Karen; Rifas-Shiman, Sheryl L; Ruiz-Arenas, Carlos; Gonseth, Semira; Rezwan, Faisal I; Herceg, Zdenko; Ekström, Sandra; Croen, Lisa; Falahi, Fahimeh; Perron, Patrice; Karagas, Margaret R; Quraishi, Bilal M; Suderman, Matthew; Magnus, Maria C; Jaddoe, Vincent W V; Taylor, Jack A; Anderson, Denise; Zhao, Shanshan; Smit, Henriette A; Josey, Michele J; Bradman, Asa; Baccarelli, Andrea A; Bustamante, Mariona; Håberg, Siri E; Pershagen, Göran; Hertz-Picciotto, Irva; Newschaffer, Craig; Corpeleijn, Eva; Bouchard, Luigi; Lawlor, Debbie A; Maguire, Rachel L; Barcellos, Lisa F; Davey Smith, George; Eskenazi, Brenda; Karmaus, Wilfried; Marsit, Carmen J; Hivert, Marie-France; Snieder, Harold; Fallin, M Daniele; Melén, Erik; Munthe-Kaas, Monica C; Arshad, Hasan; Wiemels, Joseph L; Annesi-Maesano, Isabella; Vrijheid, Martine; Oken, Emily; Holland, Nina; Murphy, Susan K; Sørensen, Thorkild I A; Koppelman, Gerard H; Newnham, John P; Wilcox, Allen J; Nystad, Wenche; London, Stephanie J; Felix, Janine F; Relton, Caroline L

2017-10-15

Pre-pregnancy maternal obesity is associated with adverse offspring outcomes at birth and later in life. Individual studies have shown that epigenetic modifications such as DNA methylation could contribute. Within the Pregnancy and Childhood Epigenetics (PACE) Consortium, we meta-analysed the association between pre-pregnancy maternal BMI and methylation at over 450,000 sites in newborn blood DNA, across 19 cohorts (9,340 mother-newborn pairs). We attempted to infer causality by comparing the effects of maternal versus paternal BMI and incorporating genetic variation. In four additional cohorts (1,817 mother-child pairs), we meta-analysed the association between maternal BMI at the start of pregnancy and blood methylation in adolescents. In newborns, maternal BMI was associated with small (effect of maternal BMI on newborn methylation at just 8/86 sites. In conclusion, this well-powered analysis identified robust associations between maternal adiposity and variations in newborn blood DNA methylation, but these small effects may be better explained by genetic or lifestyle factors than a causal intrauterine mechanism. This highlights the need for large-scale collaborative approaches and the application of causal inference techniques in epigenetic epidemiology. © The Author 2017. Published by Oxford University Press.

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

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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

Interactive Effects of Early Exclusive Breastfeeding and Pre-Pregnancy Maternal Weight Status on Young Children's BMI - A Chinese Birth Cohort.

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Hong Mei

Full Text Available To assess if the maternal pre-pregnancy weight status (MPWS alters the association of early infant feeding pattern (at one and third months with infant body mass index (BMI in the first two years of life.A cohort of 2,220 neonates were recruited in a community-based study conducted in China. Body weight and length were measured at birth, at age one and two, with BMI calculated accordingly. The BMI z-scores (BMI-Z were computed according to the World Health Organization Growth Standard (2006. Feeding patterns were classified as exclusive breastfeeding (EBF, mixed feeding (MF, and formula feeding (FF. General linear models (GLM were employed to estimate main and interaction effects of EBF and MPWS on children's BMI-Z.No main effect of MPWS was found on child BMI-Z at ages one and two, nor the feeding patterns. An interaction between MPWS and feeding patterns was detected (p<0.05. For children who were formula fed during the first month, those who were born to overweight/obesity (OW/OB mothers had a significantly greater BMI-Z at ages one and two, compared with those with underweight/normal weight (UW/NW mothers. FF children had greater BMI-Z at ages one and two compared with their EBF and MF counterparts, when they were born to OW/OB mothers.Maternal pre-pregnancy weight control and early initiation of EBF for children are essential for healthy development in children's BMI, hence the prevention of early life obesity.

Non-linear relationship between maternal work hours and child body weight: Evidence from the Western Australian Pregnancy Cohort (Raine) Study.

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Li, Jianghong; Akaliyski, Plamen; Schäfer, Jakob; Kendall, Garth; Oddy, Wendy H; Stanley, Fiona; Strazdins, Lyndall

2017-08-01

Using longitudinal data from the Western Australia Pregnancy Cohort (Raine) Study and both random-effects and fixed-effects models, this study examined the connection between maternal work hours and child overweight or obesity. Following children in two-parent families from early childhood to early adolescence, multivariate analyses revealed a non-linear and developmentally dynamic relationship. Among preschool children (ages 2 to 5), we found lower likelihood of child overweight and obesity when mothers worked 24 h or less per week, compared to when mothers worked 35 or more hours. This effect was stronger in low-to-medium income families. For older children (ages 8 to 14), compared to working 35-40 h a week, working shorter hours (1-24, 25-34) or longer hours (41 or more) was both associated with increases in child overweight and obesity. These non-linear effects were more pronounced in low-to-medium income families, particularly when fathers also worked long hours. Copyright © 2017 Elsevier Ltd. All rights reserved.

Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery.

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Seligman, K; Ramachandran, B; Hegde, P; Riley, E T; El-Sayed, Y Y; Nelson, L M; Butwick, A J

2017-05-01

Compared to vaginal delivery, women undergoing cesarean delivery are at increased risk of postpartum hemorrhage. Management approaches may differ between those undergoing prelabor cesarean delivery compared to intrapartum cesarean delivery. We examined surgical interventions, blood component use, and maternal outcomes among those experiencing severe postpartum hemorrhage within the two distinct cesarean delivery cohorts. We performed secondary analyses of data from two cohorts who underwent prelabor cesarean delivery or intrapartum cesarean delivery at a tertiary obstetric center in the United States between 2002 and 2012. Severe postpartum hemorrhage was classified as an estimated blood loss ≥1500mL or receipt of a red blood cell transfusion up to 48h post-cesarean delivery. We examined blood component use, medical and surgical interventions and maternal outcomes. The prelabor cohort comprised 269 women and the intrapartum cohort comprised 278 women. In the prelabor cohort, one third of women received red blood cells intraoperatively or postoperatively, respectively. In the intrapartum cohort, 18% women received red blood cells intraoperatively vs. 44% postoperatively (Pcesarean delivery had the highest rates of morbidity, with 18% requiring hysterectomy and 16% requiring intensive care admission. Our findings provide a snapshot of contemporary transfusion and surgical practices for severe postpartum hemorrhage management during cesarean delivery. To determine optimal transfusion and management practices in this setting, large pragmatic studies are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Maternal mental health, and child growth and development, in four low-income and middle-income countries.

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Bennett, Ian M; Schott, Whitney; Krutikova, Sofya; Behrman, Jere R

2016-02-01

Extend analyses of maternal mental health and infant growth in low- and middle-income countries (LMICs) to children through age eight years, and broaden analyses to cognitive and psychosocial outcomes. Community-based longitudinal cohort study in four LMICs (Ethiopia, India, Peru and Vietnam). Surveys and anthropometric assessments were carried out when the children were approximately ages 1, 5 and 8 years. Risk of maternal common mental disorders (rCMDs) was assessed with the Self-Reporting Questionnaire (SRQ)-20 (score ≥8). Rural and urban as well as low- and middle-income communities. 7722 mothers and their children. Child stunting and underweight (Z score ≤2 of height and weight for age), and development (Peabody Picture Vocabulary Test), and the psychosocial outcomes self pride and life satisfaction. A high rate of rCMD, stunting and underweight was seen in the cohorts. After adjusting for confounders, significant associations were found between maternal rCMDs and growth variables in the first year of life, with persistence to age 8 years in India and Vietnam, but not in the other countries. India and Vietnam also showed significant associations between rCMDs and lower cognitive development. After adjustment, rCMD was associated with low life satisfaction in Ethiopia but not in the other cohorts. Associations of maternal rCMD in the first year of life with child outcomes varied across the study cohorts and, in some cases, persisted across the first 8 years of life of the child, and included growth, cognitive development and psychosocial domains. 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/

Maternal Distress during Pregnancy and Offspring Childhood Overweight

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Katja Glejsted Ingstrup

2012-01-01

Objective. To examine if distress as a combined measure of anxiety, depression, and stress of the mother during pregnancy was associated with offspring childhood overweight at age 7. Methods. We performed a cohort study using prospective data from 37,764 women and child dyads from the Danish National Birth Cohort (1996–2002. At a telephone interview at approximately 30 weeks gestation, the women reported whether they felt anxious, depressed, or stressed. The 95 percentile for body mass index in an international reference defined childhood overweight at any given age. Logistic regression was used for the analyses. Results. The prevalence of overweight children at 7 years of age was 9.9%. Prenatal exposure to maternal distress during pregnancy was not associated with childhood overweight at 7 years of age (adjusted OR 1.06 (95% CI 0.96; 1.18. In analyses stratified on sex, a small tendency of overweight was seen in boys (OR 1.15 (0.99; 1.33, but not in girls (OR 0.98 (0.85; 1.13. Conclusions. Maternal distress during pregnancy appeared to have limited, if any, influence on the risk of overweight in offspring at 7 years of age.

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.

Preparing Leaders in Maternal-Child Health Nursing.

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Morin, Karen; Small, Leigh; Spatz, Diane L; Solomon, Julie; Lessard, Laura; Leng, Sarah Williams

2015-01-01

To describe leadership and patient outcomes from an international leadership development program undertaken by a nursing organization (Sigma Theta Tau International Honor Society of Nursing) in partnership with Johnson & Johnson Corporate Contributions to strengthen the leadership base of maternal-child bedside nurses. Pretest/posttest design with no control group program evaluation. Health care facilities, academic institutions, and public health clinics. Mentor/fellow dyads (N = 100) of the Maternal-Child Health Nurse Leadership Academy (MCHNLA). The MCHNLA engaged participants in an 18-month mentored leadership experience within the context of an interdisciplinary team project. Each mentor/fellow dyad was paired with a faculty member during the program. One hundred dyads have participated and conducted projects to improve health care for childbearing women and children up to age 5 years during the past decade. For the two cohorts for which consistent data were obtained, mentors and fellows enhanced leadership knowledge, skills, and behaviors. Review of 2010 to 2011 cohort project reports revealed they had the potential to influence more than 1000 students, 4000 nurses, and 1300 other health care students or professionals during the project period. This leadership development model is replicable in other areas of nursing and other professions. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Serum Lycopene Concentrations and Associations with Clinical Outcomes in a Cohort of Maternal-Infant Dyads

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Corrine Hanson

2018-02-01

Full Text Available Oxidative stress has been associated with adverse neonatal outcomes, and many carotenoids, including lycopene, potentially have antioxidant properties. The objective of this analysis was to explore the associations between serum lycopene concentrations, including lycopene isomers, and maternal-newborn outcomes. Maternal and cord blood samples were collected in 180 mother-infant pairs. Serum of total lycopene as well as the cis- and trans-isomers concentrations were measured using HPLC (High Performance Liquid Chromatography. Descriptive statistics were calculated; Spearman coefficients were used to assess correlations between maternal and cord concentrations. The relationship between lycopene concentration and outcomes were evaluated with linear and logistic regression models, with adjustment for relevant confounders. A p ≤ 0.05 was considered statistically significant. Maternal and cord serum lycopene concentrations were positively correlated for total lycopene (r = 0.30, p < 0.0001, cis-lycopene (r = 0.29, p = 0.0002; and trans-lycopene (r = 0.32, p < 0.0001. Maternal concentrations of cis-lycopene were significantly lower in mothers whose infants developed respiratory distress syndrome compared to those who did not (0.336 ± 0.171 vs. 0.445 ± 0.238 µmol/L, p = 0.04 and also in mothers whose babies were admitted to the newborn intensive care unit compared to those who were not (0.380 ± 0.202 vs. 0.458 ± 0.244 µmol/L, p = 0.04. Conversely, cord concentrations of trans-lycopene were significantly higher in infants who developed RDS (Respiratory Distress Syndrome (0.023 ± 0.012 vs. 0.016 ± 0.012, p = 0.007 for RDS vs. no RDS, and a similar pattern was seen NICU admission (0.023 ± 0.016 vs. 0.015 ± 0.009 µmol/L for NICU (Newborn Intensive Care Unit admission vs. no NICU admission, p = 0.007. Maternal concentrations of total and cis-lycopene were positively associated with infant birth weight, length and head circumference after

Gestational age and newborn size according to parental social mobility: an intergenerational cohort study.

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Gigante, Denise P; Horta, Bernardo L; Matijasevich, Alicia; Mola, Christian Loret de; Barros, Aluisio J D; Santos, Ina S; Barros, Fernando C; Victora, Cesar G

2015-10-01

We examined the associations between socioeconomic trajectories from birth to adulthood and gestational age and birth size in the next generation, using linked data from two population-based birth cohorts carried out in a Brazilian city. By comparing socioeconomic trajectories of mothers and fathers, we attempted to identify-specific effects of maternal and paternal socioeconomic trajectory on offspring birth weight, birth length, head circumference and gestational age at birth. 2 population-based birth cohort studies were carried out in 1982 and 2004 in Pelotas (Brazil); 156 mothers and 110 fathers from the earlier cohort had children in 2004. Gestational age and birth length, weight and head circumference were measured. Analyses were carried out separately for mothers and fathers. Mediation analyses assessed the role of birth weight and adult body mass index (BMI). Among mothers, but not for fathers, childhood poverty was strongly associated with smaller size in the next generation (about 400 g in weight and 1.5 cm in height) and shorter gestations (about 2 weeks). Adult poverty did not play a role. For mothers, the associations with gestational age, birth length and weight-but not with head circumference-persisted after adjusting for maternal birth weight and for the height and weight of the grandmother. Maternal birth weight did not mediate the observed associations, but high maternal BMI in adulthood was partly responsible for the association with gestational age. Strong effects of early poverty on gestational age and birth size in the next generation were observed among mothers, but not among fathers. These findings suggest a specific maternal effect of socioeconomic trajectory, and in particular of early poverty on offspring size and duration of pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impact of the mode of delivery on maternal and neonatal outcome in spontaneous-onset breech labor at 32+0-36+6 weeks of gestation: A retrospective cohort study.

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Toivonen, Elli; Palomäki, Outi; Korhonen, Päivi; Huhtala, Heini; Uotila, Jukka

2018-03-30

To compare neonatal and maternal outcomes in spontaneously onset preterm breech deliveries after trial of labor (BTOL) and intended cesarean section (BCS), and between BTOL and vertex control deliveries, in singleton fetuses at 32 +0 -36 +6  weeks of gestation. Retrospective single center cohort study in a Finnish University Hospital including all spontaneous-onset preterm breech deliveries with 32 completed gestational weeks in 2003-2015. The study population comprised a total of 176 preterm breech and 103 vertex control deliveries, matched by gestational age and whether the mother had given birth vaginally before or not. Infants with severe malformations and antepartum fetal distress were excluded. Subgroup analyses were made in two cohorts according to gestational age. Main outcome measures were maternal and neonatal mortality and morbidity, low cord pH and Apgar score. No mortality was observed, and severe morbidity was rare. No difference in incidence of low cord pH or five-minute Apgar score was observed between the groups. Apgar scores at the age of one minute were comparable in the breech groups but more often low in the BTOL group compared to the vertex control group. 16.5% of neonates in the BTOL group, 23.3% in the BCS group and 7.8% in the vertex group needed intensive care. In logistic regression analysis, lower gestational age and being small for gestational age were associated with the need for neonatal intensive care. Being allowed a trial of labor was not associated with the need for neonatal intensive care. Maternal morbidity was similar across the groups, but median blood loss was more pronounced in the BCS group compared to the BTOL group. In breech deliveries at 32 +0 -36 +6 gestational weeks, trial of labor did not increase neonatal morbidity compared to intended cesarean delivery. Infants born after a trial of labor in breech presentation display low one-minute Apgar score and need intensive care more often compared to vertex controls

Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years.

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Bider-Canfield, Z; Martinez, M P; Wang, X; Yu, W; Bautista, M P; Brookey, J; Page, K A; Buchanan, T A; Xiang, A H

2017-04-01

Maternal obesity, excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and breastfeeding are four important factors associated with childhood obesity. The objective of the study was to assess the interplay among these four factors and their independent contributions to childhood overweight in a cohort with standard clinical care. The cohort included 15 710 mother-offspring pairs delivered in 2011. Logistic regression was used to assess associations between maternal exposures and childhood overweight (body mass index >85th percentile) at age 2 years. Mothers with pre-pregnancy obesity or overweight were more likely to have EGWG, GDM and less likely to breastfeed ≥6 months. Mothers with GDM had 40-49% lower EGWG rates and similar breastfeeding rates compared with mothers without GDM. Analysis adjusted for exposures and covariates revealed an adjusted odds ratio (95% confidence interval) associated with childhood overweight at age 2 years of 2.34 (2.09-2.62), 1.50 (1.34-1.68), 1.23 (1.12-1.35), 0.95 (0.83-1.10) and 0.76 (0.69-0.83) for maternal obesity, overweight, EGWG, GDM and breastfeeding ≥6 months vs. maternal pre-pregnancy obesity or overweight and EGWG were independently associated with an increased risk, and breastfeeding ≥6 months was associated with a decreased risk of childhood overweight at age 2 years. © 2016 World Obesity Federation.

Effects of Antenatal Maternal Depressive Symptoms and Socio-Economic Status on Neonatal Brain Development are Modulated by Genetic Risk.

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Qiu, Anqi; Shen, Mojun; Buss, Claudia; Chong, Yap-Seng; Kwek, Kenneth; Saw, Seang-Mei; Gluckman, Peter D; Wadhwa, Pathik D; Entringer, Sonja; Styner, Martin; Karnani, Neerja; Heim, Christine M; O'Donnell, Kieran J; Holbrook, Joanna D; Fortier, Marielle V; Meaney, Michael J

2017-05-01

This study included 168 and 85 mother-infant dyads from Asian and United States of America cohorts to examine whether a genomic profile risk score for major depressive disorder (GPRSMDD) moderates the association between antenatal maternal depressive symptoms (or socio-economic status, SES) and fetal neurodevelopment, and to identify candidate biological processes underlying such association. Both cohorts showed a significant interaction between antenatal maternal depressive symptoms and infant GPRSMDD on the right amygdala volume. The Asian cohort also showed such interaction on the right hippocampal volume and shape, thickness of the orbitofrontal and ventromedial prefrontal cortex. Likewise, a significant interaction between SES and infant GPRSMDD was on the right amygdala and hippocampal volumes and shapes. After controlling for each other, the interaction effect of antenatal maternal depressive symptoms and GPRSMDD was mainly shown on the right amygdala, while the interaction effect of SES and GPRSMDD was mainly shown on the right hippocampus. Bioinformatic analyses suggested neurotransmitter/neurotrophic signaling, SNAp REceptor complex, and glutamate receptor activity as common biological processes underlying the influence of antenatal maternal depressive symptoms on fetal cortico-limbic development. These findings suggest gene-environment interdependence in the fetal development of brain regions implicated in cognitive-emotional function. Candidate biological mechanisms involve a range of brain region-specific signaling pathways that converge on common processes of synaptic development. © The Author 2017. Published by Oxford University Press.

Elevated maternal placental protein 13 serum levels at term of pregnancy in postpartum major hemorrhage (>1000 mLs). A prospective cohort study.

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Farina, Antonio; Bernabini, Dalila; Zucchini, Cinzia; De Sanctis, Paola; Quezada, Maria Soledad; Mattioli, Mara; Rizzo, Nicola

2017-09-01

To compare placental protein 13 (PP13) levels in the serum of women with primary postpartum hemorrhage (PPH) with a control population. A prospective cohort study was conducted between May 2014 and May 2016 and included 435 pregnant women at term (38 weeks gestation) without any known risk factor and with normal labor. Multiples of median (MoM) were used to evaluate differences of the PP13 values between cases and controls. PP13 concentrations were adjusted for maternal and neonatal weight. Multivariable analysis was used to detect independent contribution of predictors of PPH. Fifteen had a major PPH >1000 mLs and represented the cases of the study. They were matched with 399 controls. Twenty-one patients who had a minor PPH (500-1000 mLs) were excluded. The mean observed rank in the PPH group was higher than that of controls (28.5 vs 13.5, P-value=.01). PP13 MoM values adjusted for maternal weight were higher than expected being 1.44±0.45 in PPH cases and 1.00±0.59 in controls (P-value .008). This difference was still significant even after adjustment for neonatal weight that represented a confounding variable. Higher PP13 levels are independently associated with major PPH >1000 mLs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age.

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Andersen, Stine Linding; Andersen, Stig; Liew, Zeyan; Vestergaard, Peter; Olsen, Jørn

2018-02-01

Abnormal maternal thyroid function in pregnancy may impair fetal brain development, but more evidence is needed to refine and corroborate the hypothesis. To estimate the association between maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age. Follow-up study. A cohort of 1153 women and their children sampled from the Danish National Birth Cohort. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured in stored biobank sera from early pregnancy. Child neuropsychological test results (Wechsler Intelligence Scale/Test of Everyday Attention), test of motor function (Movement Assessment Battery), and results of parent and teacher reports (Behavior Rating Inventory of Executive Function/Strengths and Difficulties Questionnaire). Altogether 145 children (12.6%) were born to mothers with abnormal thyroid function in the early pregnancy. High maternal TSH and low fT4 were associated with lower child verbal intelligence quotient (adjusted mean difference TSH ≥ 10 mIU/L vs 0.1 to 2.49 mIU/L, -8.9 [95% confidence interval (CI), -15 to -2.4]; fT4 function was also associated with adverse motor function and teacher-reported problems of executive function and behavior, and these associations were dominated by exposure to maternal hypothyroxinemia. Maternal thyroid hormone abnormalities were associated with adverse neuropsychological function of the child at 5 years of age. For intelligence, marked hypothyroidism was important, whereas for motor function and executive and behavior problems, maternal hypothyroxinemia was predominant. Copyright © 2017 Endocrine Society

Prenatal stress exposure related to maternal bereavement and risk of childhood overweight

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Li, Jiong; Olsen, Jørn; Vestergaard, Mogens

2010-01-01

It has been suggested that prenatal stress contributes to the risk of obesity later in life. In a population-based cohort study, we examined whether prenatal stress related to maternal bereavement during pregnancy was associated with the risk of overweight in offspring during school age....

Maternal Alcohol Consumption during Pregnancy and Infant Social, Mental, and Motor Development

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Brown, Carole Williams; Olson, Heather Carmichael; Croninger, Robert G.

2010-01-01

Maternal alcohol consumption during pregnancy is a significant social problem associated with developmental difficulties in young children. Child developmental and behavioral characteristics were examined from the 9-month data point of the Early Childhood Longitudinal Studies-Birth Cohort, a prospective nationally representative study. Several…

Data collected on maternal dietary exposures in the Danish National Birth Cohort

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Olsen, Sjúrdur Fródi; Mikkelsen, Tina Broby; Knudsen, Vibeke Kildegaard

2007-01-01

Recent research suggests that the diet consumed in, or shortly before, pregnancy can potentially lead to maldevelopment and diseases in the offspring, which may become apparent at any time from the embryonic stage until old age. For example, maternal diet may affect the chance of twinning (and...

Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation: findings from the pregnancy and childhood epigenetics (PACE) consortium

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Sharp, Gemma C.; Salas, Lucas A.; Monnereau, Claire; Allard, Catherine; Yousefi, Paul; Everson, Todd M.; Bohlin, Jon; Xu, Zongli; Huang, Rae-Chi; Reese, Sarah E.; Xu, Cheng-Jian; Baïz, Nour; Hoyo, Cathrine; Agha, Golareh; Roy, Ritu; Holloway, John W.; Ghantous, Akram; Merid, Simon K.; Bakulski, Kelly M.; Küpers, Leanne K.; Zhang, Hongmei; Richmond, Rebecca C.; Page, Christian M.; Duijts, Liesbeth; Lie, Rolv T.; Melton, Phillip E.; Vonk, Judith M.; Nohr, Ellen A.; Williams-DeVane, ClarLynda; Huen, Karen; Rifas-Shiman, Sheryl L.; Ruiz-Arenas, Carlos; Gonseth, Semira; Rezwan, Faisal I.; Herceg, Zdenko; Ekström, Sandra; Croen, Lisa; Falahi, Fahimeh; Perron, Patrice; Karagas, Margaret R.; Quraishi, Bilal M.; Suderman, Matthew; Magnus, Maria C.; Jaddoe, Vincent W.V.; Taylor, Jack A.; Anderson, Denise; Zhao, Shanshan; Smit, Henriette A.; Josey, Michele J.; Bradman, Asa; Baccarelli, Andrea A.; Bustamante, Mariona; Håberg, Siri E.; Pershagen, Göran; Hertz-Picciotto, Irva; Newschaffer, Craig; Corpeleijn, Eva; Bouchard, Luigi; Lawlor, Debbie A.; Maguire, Rachel L.; Barcellos, Lisa F.; Smith, George Davey; Eskenazi, Brenda; Karmaus, Wilfried; Marsit, Carmen J.; Hivert, Marie-France; Snieder, Harold; Fallin, M. Daniele; Melén, Erik; Munthe-Kaas, Monica C.; Arshad, Hasan; Wiemels, Joseph L.; Annesi-Maesano, Isabella; Vrijheid, Martine; Oken, Emily; Holland, Nina; Murphy, Susan K.; Sørensen, Thorkild I.A.; Koppelman, Gerard H.; Newnham, John P.; Wilcox, Allen J.; Nystad, Wenche; London, Stephanie J.; Felix, Janine F.; Relton, Caroline L.

2017-01-01

Pre-pregnancy maternal obesity is associated with adverse offspring outcomes at birth and later in life. Individual studies have shown that epigenetic modifications such as DNA methylation could contribute. Within the Pregnancy and Childhood Epigenetics (PACE) Consortium, we meta-analysed the association between pre-pregnancy maternal BMI and methylation at over 450,000 sites in newborn blood DNA, across 19 cohorts (9,340 mother-newborn pairs). We attempted to infer causality by comparing the effects of maternal versus paternal BMI and incorporating genetic variation. In four additional cohorts (1,817 mother-child pairs), we meta-analysed the association between maternal BMI at the start of pregnancy and blood methylation in adolescents. In newborns, maternal BMI was associated with small (BMI unit (1 kg/m2), P BMI on newborn methylation at just 8/86 sites. In conclusion, this well-powered analysis identified robust associations between maternal adiposity and variations in newborn blood DNA methylation, but these small effects may be better explained by genetic or lifestyle factors than a causal intrauterine mechanism. This highlights the need for large-scale collaborative approaches and the application of causal inference techniques in epigenetic epidemiology. PMID:29016858

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

Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana.

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Oaks, Brietta M; Stewart, Christine P; Laugero, Kevin D; Adu-Afarwuah, Seth; Lartey, Anna; Vosti, Stephen A; Ashorn, Per; Dewey, Kathryn G

2017-10-01

Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high-income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort (n = 320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride concentrations were analyzed in plasma at ≤20and 36 weeks gestation as continuous variables and also categorized into low, referent, or high (90th percentile). At ≤20 weeks, plasma lipid concentrations were not associated with pregnancy duration. At 36 weeks, total cholesterol and triglyceride concentrations were not associated with pregnancy duration. Higher HDL-C at 36 weeks was associated with a longer pregnancy duration (adjusted β-coefficient ± standard error: 0.05 ± 0.02 days mg -1 /dL, p = .02); pregnancy duration was 5.9 ± 2.0 (mean ± standard error) days shorter among women with low HDL-C compared with the referent group (10th-90th percentile) (p = .02) and 8.6 ± 2.6 days shorter when compared with the high HDL-C group (p = .003). Pregnancy duration was 4.9 ± 2.1 days longer among women with low low-density lipoprotein cholesterol at 36 weeks gestation when compared with the referent group (p = .051). Our data suggest that low HDL-C in the third trimester of pregnancy is associated with a shorter duration of pregnancy in this study population but do not support the hypothesis that low total cholesterol is associated with a shorter pregnancy duration. © 2016 John Wiley & Sons Ltd.

Individual and combined effects of maternal anemia and prenatal infection on risk for schizophrenia in offspring.

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Nielsen, Philip R; Meyer, Urs; Mortensen, Preben B

2016-04-01

Maternal iron deficiency and infection during pregnancy have individually been associated with increased risk of schizophrenia in the offspring, but possible interactions between the two remain unidentified thus far. Therefore, we determined the individual and combined effects of maternal infection during pregnancy and prepartum anemia on schizophrenia risk in the offspring. We conducted a population-based study with individual record linkage of the Danish Civil Registration System, the Danish Hospital Register, and the Central Danish Psychiatric Register. In a cohort of Danish singleton births 1,403,183 born between 1977 and 2002, 6729 developed schizophrenia between 1987 and 2012. Cohort members were considered as having a maternal history of anemia if the mother had received a diagnosis of anemia at any time during the pregnancy. Maternal infection was defined based on infections requiring hospital admission during pregnancy. Maternal anemia and infection were both associated with increased risk of schizophrenia in unadjusted analyses (1.45-fold increase for anemia, 95% CI: 1.14-1.82; 1.32-fold increase for infection, 95% CI: 1.17-1.48). The effect of maternal infection remained significant (1.16-fold increase, 95% CI: 1.03-1.31) after adjustment for possible confounding factors. Combined exposure to anemia and an infection increased the effect size to a 2.49-fold increased schizophrenia risk (95% CI: 1.29-4.27). The interaction analysis, however, failed to provide evidence for multiplicative interactions between the two factors. Our findings indicate that maternal anemia and infection have additive but not interactive effects, and therefore, they may represent two independent risk factors of schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

Gender differences in the effects of childhood psychopathology and maternal distress on mental health in adult life.

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Flouri, Eirini; Malmberg, Lars-Erik

2011-07-01

To investigate gender differences in how emotional and behavioural problems (hyperactivity, emotional problems, and conduct problems) and maternal psychological distress, all measured at three time points in childhood (ages 5, 10, and 16), predict psychological distress in adult life (age 30). Longitudinal data from 10,444 cohort members of the 1970 British Cohort Study (BCS70) were used. Emotional problems in adolescence tended to be more strongly associated with adult psychological distress in men than in women. No gender differences in the association of adult psychological distress with maternal psychological distress in adolescence were found. In childhood and adolescence boys' externalizing behaviour problems tended to show more homotypic continuity than girls', but all heterotypic continuity (although very little) of behaviour problems was seen in girls. Maternal psychological distress in childhood tended to have a stronger effect on girls' than boys' emotional problems in adolescence. In general there was little evidence for gender differences either in the association of adult psychological distress with adolescent psychopathology or in the association of adult psychological distress with maternal psychological distress in adolescence. The continuity of emotional problems from childhood to adolescence to adult life was strong and similar for both sexes.

The absence of birthweight paradox as a marker of disadvantages faced by low maternal education children.

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Guimarães, P V; Fonseca, S C; Pinheiro, R S; Aguiar, F P; Camargo, K R; Coeli, C M

2017-12-01

This study tested the hypothesis that the birthweight paradox would not be observed when assessing the effect of maternal education on neonatal mortality in the presence of socioeconomic inequality in access to health care. Non-concurrent cohort study. Passive follow-up of live-born infants using probabilistic record linkage of birth and death records for Rio de Janeiro (2004-2010; n = 1 445 367). Maternal age, birthweight and neonatal death were evaluated according to maternal educational level strata (disadvantages faced by low maternal education women. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study.

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Lena Hohwü

Full Text Available BACKGROUND: Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. METHODS: A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group. Median body mass index (BMI and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2 and obesity (BMI≥30 kg/m2 were estimated by logistic regression analysis adjusted for maternal educational level. RESULTS: Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02 and obesity (9.8% versus 8.5%, p = 0.06 was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI: 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively. Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31. There was no elevated risk in those who experienced maternal bereavement postnatally. CONCLUSION: Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

Severe maternal stress exposure due to bereavement before, during and after pregnancy and risk of overweight and obesity in young adult men: a Danish National Cohort Study.

Science.gov (United States)

Hohwü, Lena; Li, Jiong; Olsen, Jørn; Sørensen, Thorkild I A; Obel, Carsten

2014-01-01

Perinatal stress may programme overweight and obesity. We examined whether maternal pre- and post-natal bereavement was associated with overweight and obesity in young men. A cohort study was conducted including 119,908 men born from 1976 to 1993 and examined for military service between 2006 and 2011. Among them, 4,813 conscripts were born to mothers bereaved by death of a close relative from 12 months preconception to birth of the child (exposed group). Median body mass index (BMI) and prevalence of overweight and obesity were estimated. Odds ratio of overweight (BMI≥25 kg/m2) and obesity (BMI≥30 kg/m2) were estimated by logistic regression analysis adjusted for maternal educational level. Median BMI was similar in the exposed and the unexposed group but the prevalence of overweight (33.3% versus 30.4%, p = 0.02) and obesity (9.8% versus 8.5%, p = 0.06) was higher in the exposed group. Conscripts exposed 6 to 0 months before conception and during pregnancy had a higher risk of overweight (odds ratio 1.15, 95% confidence interval (CI): 1.03; 1.27 and odds ratio 1.13, 95% CI: 1.03; 1.25, respectively). Conscripts born to mothers who experienced death of the child's biological father before child birth had a two-fold risk of obesity (odds ratio 2.00, 95% CI: 0.93; 4.31). There was no elevated risk in those who experienced maternal bereavement postnatally. Maternal bereavement during the prenatal period was associated with increased risk of overweight or obesity in a group of young male conscripts, and this may possibly be reflected to severe stress exposure early in life. However, not all associations were clear, and further studies are warranted.

Childhood asthma and smoking exposures before conception-A three-generational cohort study.

Science.gov (United States)

Bråbäck, Lennart; Lodge, Caroline J; Lowe, Adrian J; Dharmage, Shyamali C; Olsson, David; Forsberg, Bertil

2018-06-01

Some human and animal studies have recently shown that maternal grandmother's smoking during pregnancy increases the risk of asthma in the grandchildren. We have investigated whether sex of the exposed parent and/or grandchild modifies the association between grandmaternal smoking and grandchild asthma. We formed a cohort study based on linkage of national registries with prospectively collected data over three generations. Smoking habits in early pregnancy were registered since 1982 and purchases of prescribed medication since 2005. In all, 10 329 children born since 2005 had information on maternal and grandmaternal smoking on both sides and were followed from birth up to 6 years of age. Ages when medication was purchased were used to classify the cohort into never, early transient (0-3 years), early persistent (0-3 and 4-6 years), and late-onset (4-6 years) phenotypes of childhood asthma. Maternal grandmother's smoking was associated with an increased odds of early persistent asthma after adjustment for maternal smoking and other confounders (odds ratio 1.29, 95% confidence interval 1.10-1.51). Grandchild sex did not modify the association. Paternal grandmother's smoking was not associated with any of the asthma phenotypes. Maternal but not paternal exposure to nicotine before conception was related to an increased risk of early persistent childhood asthma, but not other asthma phenotypes. Our findings are possibly consistent with a sex-specific mode of epigenetic transfer. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Maternal Folic Acid and Risk of Childhood Autism

Directory of Open Access Journals (Sweden)

J. Gordon Millichap

2013-03-01

Full Text Available Researchers from the Norwegian Institute of Public Health, Oslo; Institute of Child Health, London, UK; and other centers in Norway, UK, and the US examined the association between maternal use of prenatal folic acid supplements (4 weeks before to 8 weeks after start of pregnancy and risk of autistic spectrum disorders in children derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa.

Maternal height and length of gestation: does this impact on preterm labour in Asian women?

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Chan, Ben Chong-Pun; Lao, Terence Tzu-Hsi

2009-08-01

Both maternal height and ethnicity may influence the gestation length, but their independent effect is unclear. This study was performed to examine the relationship between maternal height and gestational length in women with singleton pregnancies in a Chinese and southeast Asian population. A retrospective cohort study was performed on women carrying singleton pregnancies with spontaneous labour in a 48-month period managed under our department to determine the relationship between maternal height, expressed in quartiles, with the mean gestational age and incidence of preterm labour. Of the 16 384 women who delivered within this period, the 25th, 50th and 75th percentile values of maternal height were 153 cm, 156 cm and 160 cm respectively. Excluded from analysis were 6597 women because of multifetal pregnancy, teenage pregnancy (maternal age women with shorter stature. In our population, maternal height has an influence on gestational length, and the lower three quartiles was associated with increased odds of labour at > 32 to management and intervention.

A prospective study of maternal carboxyhemoglobin and preeclampsia risk

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Rudra, Carole B.; Williams, Michelle A.; Schiff, Melissa A.; Koenig, Jane Q.; Dills, Russell; Yu, Jianbo

2009-01-01

Summary We aimed to measure the relation between early-pregnancy maternal carboxyhemoglobin and subsequent preeclampsia risk. We conducted a nested case-control analysis using data from a western Washington State cohort study (1996–2004). We measured maternal whole blood carboxyhemoglobin in 128 women who developed preeclampsia and 419 normotensive controls (mean gestational age at blood draw, 14.8 weeks). After adjustment for confounders, high (≥1%) versus low (carboxyhemoglobin odds ratios [OR] and 95% confidence intervals [CI] were 4.09 [1.30, 12.9] in parous women, 0.53 [0.23, 1.26] in nulliparous women, and 1.11 [0.55, 2.25] in the overall study population (parity interaction p=0.01). The influence of parity on the association was unexpected. The association between high carboxyhemoglobin and preeclampsia risk in parous women implicates hypoxia at the fetal-maternal interface as a pathogenic mechanism. These results also suggest that the etiology of the disease may differ according to parity. PMID:20078828

Maternal employment and overweight among Hispanic children of immigrants and children of natives.

Science.gov (United States)

Baker, Elizabeth; Balistreri, Kelly Stamper; Van Hook, Jennifer

2009-06-01

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hispanic children of immigrants, maternal employment is associated with lower percentile BMI and this association strengthens at higher levels of income. Among Hispanic children of natives and non-Hispanic whites, maternal employment is beneficial (i.e. associated with lower percentile BMI) among low-income children but detrimental among high-income children, but this pattern is significantly greater in strength for Hispanics than non-Hispanic whites. Thus, maternal employment is associated with worse health outcomes only in the case of Hispanic children of natives, and maternal employment is associated with the best outcomes for Hispanic children of mothers from high-income families. We speculate that among children of immigrants, maternal employment may signify and/or accelerate assimilation towards middle- or upper-class American values of healthy weight and body size. Diet, meal regularity and supervision, and childcare did not mediate the relationship between maternal employment and overweight.

Serological documentation of maternal influenza exposure and bipolar disorder in adult offspring.

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Canetta, Sarah E; Bao, Yuanyuan; Co, Mary Dawn T; Ennis, Francis A; Cruz, John; Terajima, Masanori; Shen, Ling; Kellendonk, Christoph; Schaefer, Catherine A; Brown, Alan S

2014-05-01

The authors examined whether serologically confirmed maternal exposure to influenza was associated with an increased risk of bipolar disorder in the offspring and with subtypes of bipolar disorder, with and without psychotic features. The study used a nested case-control design in the Child Health and Development Study birth cohort. In all, 85 individuals with bipolar disorder were identified following extensive ascertainment and diagnostic assessment and matched to 170 comparison subjects in the analysis. Serological documentation of maternal exposure to influenza was determined using the hemagglutination inhibition assay. No association was observed between serologically documented maternal exposure to influenza and bipolar disorder in offspring. However, maternal serological influenza exposure was related to a significant fivefold greater risk of bipolar disorder with psychotic features. The results suggest that maternal influenza exposure may increase the risk for offspring to develop bipolar disorder with psychotic features. Taken together with earlier associations between prenatal influenza exposure and schizophrenia, these results may suggest that prenatal influenza is a risk factor for psychosis rather than for a specific psychotic disorder diagnosis.

Breastfeeding and its relation to maternal sensitivity and infant attachment.

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Tharner, Anne; Luijk, Maartje P C M; Raat, Hein; Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J; Moll, Henriette A; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2012-06-01

To examine the association of breastfeeding with maternal sensitive responsiveness and infant-mother attachment security and disorganization. We included 675 participants of a prospective cohort study. Questionnaires about breastfeeding practices were administered at 2 and 6 months postpartum. At 14 months, maternal sensitive responsiveness was assessed in a 13-minute laboratory procedure using Ainsworth's sensitivity scales, and attachment quality was assessed with the Strange Situation Procedure. Mothers were genotyped for oxytocin receptor genes OXTR rs53576 and OXTR rs2254298. Linear regressions and analyses of covariance adjusted for various background variables were conducted. We tested for mediation and moderation by maternal sensitive responsiveness and maternal oxytocin receptor genotype. Continuous analyses showed that longer duration of breastfeeding was associated with more maternal sensitive responsiveness (B = 0.11, 95% confidence interval [CI] 0.02; 0.20, p attachment security (B = 0.24, 95% CI = 0.02; 0.46, p attachment disorganization (B = -0.20, 95% CI -0.36; -0.03, p attachment classification, but longer duration of breastfeeding predicted a lower risk of disorganized versus secure attachment classification (n = 151; odds ratio [OR] = 0.81, 95% CI 0.66 to 0.99, p = .04). Maternal sensitive responsiveness did not mediate the associations, and maternal oxytocin receptor genotype was not a significant moderator. Although duration of breastfeeding was not associated with differences in infant-mother attachment classifications, we found subtle positive associations between duration of breastfeeding and sensitive responsiveness, attachment security, and disorganization.

Partner relationship satisfaction and maternal emotional distress in early pregnancy

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Eberhard-Gran Malin

2011-03-01

Full Text Available Abstract Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558 completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25. Other predictors were dissatisfaction at work (β = 0.11, somatic disease (β = 0.11, work related stress (β = 0.10 and maternal alcohol problems in the preceding year (β = 0.09. Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors.

Longitudinal associations between maternal feeding and overweight in low-income toddlers.

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Lumeng, Julie C; Kaciroti, Niko; Retzloff, Lauren; Rosenblum, Katherine; Miller, Alison L

2017-06-01

Maternal feeding is a frequent intervention target for the prevention of early childhood obesity but longitudinal associations between feeding and child overweight are poorly understood. This observational cohort study sought to examine the cross-lagged associations between maternal feeding and overweight across ages 21, 27, and 33 months. Feeding was measured by maternal self-report (n = 222) at each age. Child weight and length were measured. Cross-lagged analysis was used to evaluate longitudinal associations between feeding and overweight, adjusting for infant birth weight, maternal body mass index, maternal education, and maternal depressive symptoms. The sample was 50.5% white, 52.3% male and 37.8% of mothers had a high school education or less. A total of 30.6%, 29.2%, and 26.3% of the sample was overweight at each age, respectively. Pressuring to Finish, Restrictive with regard to Amount, Restrictive with regard to Diet Quality, Laissez-Faire with regard to Diet Quality, Responsiveness to Satiety, Indulgent Permissive, Indulgent Coaxing, Indulgent Soothing, and Indulgent Pampering each tracked strongly across toddlerhood. There were no significant associations between maternal feeding and child overweight either in cross-sectional or cross-lagged associations. Our results do not support a strong causal role for feeding in childhood overweight. Future work longitudinal work should consider alternative approaches to conceptualizing feeding and alternative measurement approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

Increased maternal plasma leptin in early pregnancy and risk of gestational diabetes mellitus.

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Qiu, Chunfang; Williams, Michelle A; Vadachkoria, Surab; Frederick, Ihunnaya O; Luthy, David A

2004-03-01

Emerging evidence suggests that leptin, an adipocyte-derived hormone, may have independent direct effects on both insulin secretion and action, in addition to its well documented effects on appetite and energy expenditure. Some, but not all, previously published studies suggest that maternal leptin concentrations may be increased in pregnancies complicated by gestational diabetes mellitus (GDM). We examined the association between plasma leptin concentration and GDM risk. Women were recruited before 16 weeks of gestation and were followed up until delivery. Maternal plasma leptin concentrations (collected at 13 weeks of gestation) were measured by using immunoassay. We used generalized linear models to estimate relative risks and 95% confidence intervals. GDM developed in 5.7% of the cohort (47 of 823). Elevated leptin concentrations were positively associated with GDM risk (P for trend risk of GDM (95% confidence interval 1.2, 18.0) as compared with women who had concentrations of 14.3 ng/mL or lower. We noted a strong linear component of trend in risk of GDM with increasing maternal plasma leptin concentration. Each 10-ng/mL increase in the leptin concentration was associated with a 20% increase in GDM risk (relative risk 1.2; 95% confidence interval 1.0, 1.3). Hyperleptinemia, independent of maternal adiposity, in early pregnancy appears to be predictive of an increased risk of GDM later in pregnancy. Additional larger prospective cohort studies are needed to confirm and more precisely assess the etiologic importance of hyperleptinemia in pregnancy. II-2

Prenatal Phthalate Exposures and Childhood Fat Mass in a New York City Cohort.

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Buckley, Jessie P; Engel, Stephanie M; Mendez, Michelle A; Richardson, David B; Daniels, Julie L; Calafat, Antonia M; Wolff, Mary S; Herring, Amy H

2016-04-01

Experimental animal studies and limited epidemiologic evidence suggest that prenatal exposure to phthalates may be obesogenic, with potential sex-specific effects of phthalates having anti-androgenic activity. We aimed to assess associations between prenatal phthalate exposures and childhood fat mass in a prospective cohort study. We measured phthalate metabolite concentrations in third-trimester maternal urine in a cohort of women enrolled in New York City between 1998 and 2002 (n = 404). Among 180 children (82 girls and 98 boys), we evaluated body composition using a Tanita scale at multiple follow-up visits between ages 4 and 9 years (363 total visits). We estimated associations of standard deviation differences or tertiles of natural log phthalate metabolite concentrations with percent fat mass using linear mixed-effects regression models with random intercepts for repeated outcome measurements. We assessed associations in multiple metabolite models and adjusted for covariates including prepregnancy body mass index, gestational weight gain, maternal smoking during pregnancy, and breastfeeding. We did not observe associations between maternal urinary phthalate concentrations and percent body fat in models examining continuous exposures. Fat mass was 3.06% (95% CI: -5.99, -0.09%) lower among children in the highest tertile of maternal urinary concentrations of summed di(2-ethylhexyl) phthalate (ΣDEHP) metabolites than in children in the lowest tertile. Though estimates were imprecise, there was little evidence that associations between maternal urinary phthalate concentrations and percent fat mass were modified by child's sex. Prenatal phthalate exposures were not associated with increased body fat among children 4-9 years of age, though high prenatal DEHP exposure may be associated with lower fat mass in childhood. Buckley JP, Engel SM, Mendez MA, Richardson DB, Daniels JL, Calafat AM, Wolff MS, Herring AH. 2016. Prenatal phthalate exposures and childhood fat

Adverse drug reactions to tocolytic treatment for preterm labour: Prospective cohort study

NARCIS (Netherlands)

R. de Heus (Roel); B.W.J. Mol (Ben); J.J.H.M. Erwich; H.P. van Geijn (Herman); W.J. Gyselaers (Wilfried); M. Hanssens (Myriam); L. Harmark (Linda); C.D. van Holsbeke (Caroline); J.J. Duvekot (Hans); F. Famschobben; H. Wolf (Hans Uwe); G.H. Visser (Gerhard Henk)

2009-01-01

textabstractObjective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920

Ethnic Differences in Maternal Adipokines during Normal Pregnancy

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Xinhua Chen

2015-12-01

Full Text Available Two adipokines (adiponectin and resistin have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634 were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%. Serum adiponectin and resistin were measured at entry (week 16.8 and the 3rd trimester (week 30.7 using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African American women were exceptional in that they had decreased adiponectin and increased resistin throughout the course of pregnancy (p < 0.05 to p < 0.0001 and a greater than two fold risk of simultaneously exhibiting low adiponectin (lowest tertile and high resistin (highest tertile compared to Caucasians and/or Hispanics. The cohort as a whole and each ethnic group showed similar negative correlations between adiponectin, and glucose homeostasis, blood pressure and anthropometric parameters but there was lesser correspondence with resistin. Our data underscore the need for further research on ethnic variation in adipokines and other physiologic biomarkers during complicated and uncomplicated pregnancy.

Older maternal age is associated with depression, anxiety, and stress symptoms in young adult female offspring.

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Tearne, Jessica E; Robinson, Monique; Jacoby, Peter; Allen, Karina L; Cunningham, Nadia K; Li, Jianghong; McLean, Neil J

2016-01-01

The evidence regarding older parental age and incidence of mood disorder symptoms in offspring is limited, and that which exists is mixed. We sought to clarify these relationships by using data from the Western Australian Pregnancy Cohort (Raine) Study. The Raine Study provided comprehensive data from 2,900 pregnancies, resulting in 2,868 live born children. A total of 1,220 participants completed the short form of the Depression Anxiety Stress Scale (DASS-21) at the 20-year cohort follow-up. We used negative binomial regression analyses with log link and with adjustment for known perinatal risk factors to examine the extent to which maternal and paternal age at childbirth predicted continuous DASS-21 index scores. In the final multivariate models, a maternal age of 30-34 years was associated with significant increases in stress DASS-21 scores in female offspring relative to female offspring of 25- to 29-year-old mothers. A maternal age of 35 years and over was associated with increased scores on all DASS-21 scales in female offspring. Our results indicate that older maternal age is associated with depression, anxiety, and stress symptoms in young adult females. Further research into the mechanisms underpinning this relationship is needed. (c) 2016 APA, all rights reserved.

A History of Non-Parental Care in Childhood Predicts More Positive Adult Attitudes towards Non-Parental Care and Maternal Employment

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Shpancer, Noam; Schweitzer, Stefanie N.

2018-01-01

Data were collected over a 15-year span from three comparable cohorts of students at a Midwestern university about their childcare histories and current attitudes towards non-parental childcare and maternal employment. Across cohorts, a history of non-parental childcare predicted adult attitudes towards non-parental childcare and maternal…

The Relationship Between Maternal Education and Child Health Outcomes in Urban Australian Children in the First 12 Months of Life.

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Davey, Tamzyn M; Cameron, Cate M; Ng, Shu-Kay; McClure, Rod J

2015-11-01

To describe the relationship between maternal education and child health outcomes at 12 months of age in a cohort of children in urban Australia, and to determine whether this relationship could be explained by the intermediate factors of maternal health behaviour and the social environmental context. Data were derived from The Environments for Health Living Griffith Birth Cohort Study. Women attending their third trimester antenatal appointment at one of three public hospitals were recruited between 2006 and 2010 and invited to complete a 48-item, baseline self-administered questionnaire. Twelve months following the birth of their baby, a follow-up questionnaire consisting of 63 items was distributed. Women for whom complete follow-up data were not available were different from women who did complete follow-up data. The children of women with follow-up data-whom at the time of their pregnancy had not completed school or whose highest level of education was secondary school or a trade-had respectively a 59 and 57 % increased chance of having had a respiratory/infectious disease or injury in the first year of life (according to parent proxy-reports), compared to children of women with a tertiary education. When maternal behavioural and social environmental factors during pregnancy were included in the model (n=1914), the effect of secondary education was still evident but with a reduced odds ratio of 1.35 (95 % CI 1.07-1.72) and 1.19 (95 % CI 0.87-1.64), respectively. The effect of not having completed school was no longer significant. Results indicate that the relationship between maternal education and child outcomes may be mediated by maternal social environmental and behavioural factors. Results are likely an underestimation of the effect size, given the under representation in our cohort of participants with maternal characteristics associated with elevated risk of infant morbidity.

Comprehensive maternal characteristics associated with birth weight: Bayesian modeling in a prospective cohort study from Iran

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Marjan Mansourian

2017-01-01

Full Text Available Background: In this study, we aimed to determine comprehensive maternal characteristics associated with birth weight using Bayesian modeling. Materials and Methods: A total of 526 participants were included in this prospective study. Nutritional status, supplement consumption during the pregnancy, demographic and socioeconomic characteristics, anthropometric measures, physical activity, and pregnancy outcomes were considered as effective variables on the birth weight. Bayesian approach of complex statistical models using Markov chain Monte Carlo approach was used for modeling the data considering the real distribution of the response variable. Results: There was strong positive correlation between infant birth weight and the maternal intake of Vitamin C, folic acid, Vitamin B3, Vitamin A, selenium, calcium, iron, phosphorus, potassium, magnesium as micronutrients, and fiber and protein as macronutrients based on the 95% high posterior density regions for parameters in the Bayesian model. None of the maternal characteristics had statistical association with birth weight. Conclusion: Higher maternal macro- and micro-nutrient intake during pregnancy was associated with a lower risk of delivering low birth weight infants. These findings support recommendations to expand intake of nutrients during pregnancy to high level.

Employment after childbearing and women's subsequent labour force participation: evidence from the British 1958 birth cohort.

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Joshi, H; Macran, S; Dex, S

1996-01-01

"Data on women from the British 1958 Cohort Study is used as evidence on the determinants of their labour force participation at age 33. A conventional cross-sectional model of full or part-time employment makes use of some longitudinal material not normally included in such models. Whether the woman made the hitherto customary break from employment at the time of the first maternity is included in recognition that this cohort was among the first generation to be offered Statutory Maternity Leave. Results suggest that the presence of children (still) inhibits full-time employment and raises the probability of part-time employment; that income effects on participation have continued to weaken while wage elasticity for full-time employment is high. Continuity of employment straight after childbearing raises the chances of subsequent full-time employment, but by no means guarantees it. Gains from maternity leave and other family friendly employment policies have been far from uniform." excerpt

Maternal hair and neonatal meconium to assess gestational consumption and prenatal exposure to drugs of abuse and psychoactive drugs.

Science.gov (United States)

Cortes, Laura; Almeida, Laura; Sabra, Sally; Muniesa, Marta; Busardo, Francesco Paolo; Garcia-Algar, Oscar; Gomez-Roig, Maria Dolores

2018-04-05

In the last two decades, the consumption of drugs of abuse among women of childbearing age has experienced a significant increase and results from analyses of surveys concerning maternal intake of psychoactive prescription drugs during pregnancy indicate that the rates of intake are increasing each year. Analyses of biological matrices such as maternal hair and neonatal meconium have recently been used for assessment of gestational consumption and consequent prenatal exposure to drugs of abuse in high-risk groups of women METHODS: Maternal hair and neonatal meconium were analyzed by validated chromatographic mass spectrometric methodologies to disclose gestational use of drugs of abuse and psychoactive prescription drugs and consequent prenatal exposure in a cohort of 513 mother-newborn dyads at the Sant Joan de Déu Barcelona Hospital, Spain, during 2012- 2013. A total of 3.9% the women reported drugs of abuse or prescription psychoactive drug consumption at any time during pregnancy. The prevalence of gestational consumption and consequent prenatal exposure to drugs of abuse (e.g. cannabis, cocaine and MDMA) was 1.2% in maternal hair and 0.4% in meconium; that of psychoactive prescription drugs (e.g. venlafaxine, citalopram, fluoxetine, clomipramine) was 1.7% in maternal hair and 1.2% in meconium. The prevalence of drugs of abuse and prescription psychoactive drug consumption was lower in our specific cohort of Spanish pregnant women than in other cohorts such as those from U.S. or Denmark. Analysis of materno-fetal matrices provides a viable alternative to study prenatal exposure to these substances and develop specific social and health intervention recommendations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Impact of Maternal Diet on Offspring Bone Fracture Risk During Childhood

DEFF Research Database (Denmark)

Petersen, Sesilje Elise Bondo

, including maternal diet and vitamin D status. However, few studies have investigated whether these factors during pregnancy impact offspring bone health in short as well as in the long term. The overall objective of this thesis was to investigate epidemiologically whether maternal vitamin D status...... and dietary patterns in two prospective pregnancy cohorts, were associated with offspring risk of bone fractures in childhood. Overall, our studies provided limited support to the hypothesis that fetal bone health is programmed by the maternal vitamin D status and overall diet during pregnancy. However......, there were some indications of an increased risk for fractures when the mother consumed a Western diet and had high consumption of artificially sweetened soft drinks. Further, our results indicated that mid-pregnancy use of dietary supplements with high doses of vitamin D increased the risk for offspring...

Periconception Maternal Folate Status and Human Embryonic Cerebellum Growth Trajectories : The Rotterdam Predict Study

NARCIS (Netherlands)

Koning, Irene V; Groenenberg, Irene A L; Gotink, Anniek W; Willemsen, Sten P; Gijtenbeek, Manon; Dudink, Jeroen; Go, Attie T J I; Reiss, Irwin K M; Steegers, Eric A P; Steegers-Theunissen, Régine P M

2015-01-01

We aimed to investigate whether periconceptional maternal folate status affects human embryonic cerebellar size and growth trajectories. In a prospective periconceptional cohort participants filled out questionnaires and received weekly transvaginal 3D-ultrasounds between 7+0 and 12+6 weeks

Relationship between maternal hemoglobin and perinatal outcome

International Nuclear Information System (INIS)

Bakhtiar, U.J.; Khan, Y.; Nisar, R.

2007-01-01

To Study the Relationship between Maternal Hemoglobin and Perinatal outcome in a cohort of 860 pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome. All Singleton pregnancies delivering at Pakistan Railway Hospital Rawalpindi from January 2004 to December 2005 that fulfilled the required criteria were included. Out of the 860 patients, 402 were anemic (<11gm/dl) and 458 were non anemic. Perinatal outcome included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low apgr scores and intrauterine fetal deaths. Risk of preterm and Low birth weight among anemic women was 3.4 and 1.8 times more than non anaemic women. The neonates of anemic woman also had 1.7 times increased risk of having low apgr scores at 1 min. Among anemic women there was 2.2 times greater risk of intrauterine fetal death than the non-anemic women. Regular antenatal care from first trimester has a vital role in assessing and managing maternal anemia timely and it directly affects the perinatal outcome. The patients with anemia have also higher risk of having low birth weight, preterm births and intra uterine fetal death. (author)

Maternal hypothyroidism in the perinatal period and childhood asthma in the offspring

DEFF Research Database (Denmark)

Liu, Xiaoqin; Andersen, Stine Linding; Olsen, Jørn

2017-01-01

BACKGROUND: There is increasing interest in the possible link between maternal hypothyroidism in the perinatal period and childhood asthma risk. We explored this in the present study while accounting for the timing of hypothyroidism diagnosis. Further, we evaluated whether the risk was moderated...... that maternal hypothyroidism, especially when it is untreated, increases childhood asthma risk. Early detection and appropriate treatment of hypothyroidism in pregnant women may be an area for possible prevention of childhood asthma. This article is protected by copyright. All rights reserved....... by thyroid hormone treatment during pregnancy. METHODS: We conducted a population-based cohort study using Danish national registers. All liveborn singletons in Denmark from 1998 to 2007 were identified. Maternal hypothyroidism and asthma in the children were defined by data from the Patient Register...

Mother's education and offspring asthma risk in 10 European cohort studies

NARCIS (Netherlands)

Lewis, Kate Marie; Ruiz, Milagros; Goldblatt, Peter; Morrison, Joana; Porta, Daniela; Forastiere, Francesco; Hryhorczuk, Daniel; Zvinchuk, Oleksandr; Saurel-Cubizolles, Marie-Josephe; Lioret, Sandrine; Annesi-Maesano, Isabella; Vrijheid, Martine; Torrent, Maties; Iniguez, Carmen; Larranaga, Isabel; Harskamp-van Ginkel, Margreet W.; Vrijkotte, Tanja G. M.; Klanova, Jana; Svancara, Jan; Barross, Henrique; Correia, Sofia; Jarvelin, Marjo-Riitta; Taanila, Anja; Ludvigsson, Johnny; Faresjo, Tomas; Marmot, Michael; Pikhart, Hynek

2017-01-01

Highly prevalent and typically beginning in childhood, asthma is a burdensome disease, yet the risk factors for this condition are not clarified. To enhance understanding, this study assessed the cohort-specific and pooled risk of maternal education on asthma in children aged 3-8 across 10 European

An international contrast of rates of placental abruption: an age-period-cohort analysis.

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Cande V Ananth

Full Text Available Although rare, placental abruption is implicated in disproportionately high rates of perinatal morbidity and mortality. Understanding geographic and temporal variations may provide insights into possible amenable factors of abruption. We examined abruption frequencies by maternal age, delivery year, and maternal birth cohorts over three decades across seven countries.Women that delivered in the US (n = 863,879; 1979-10, Canada (4 provinces, n = 5,407,463; 1982-11, Sweden (n = 3,266,742; 1978-10, Denmark (n = 1,773,895; 1978-08, Norway (n = 1,780,271, 1978-09, Finland (n = 1,411,867; 1987-10, and Spain (n = 6,151,508; 1999-12 were analyzed. Abruption diagnosis was based on ICD coding. Rates were modeled using Poisson regression within the framework of an age-period-cohort analysis, and multi-level models to examine the contribution of smoking in four countries.Abruption rates varied across the seven countries (3-10 per 1000, Maternal age showed a consistent J-shaped pattern with increased rates at the extremes of the age distribution. In comparison to births in 2000, births after 2000 in European countries had lower abruption rates; in the US there was an increase in rate up to 2000 and a plateau thereafter. No birth cohort effects were evident. Changes in smoking prevalence partially explained the period effect in the US (P = 0.01 and Sweden (P<0.01.There is a strong maternal age effect on abruption. While the abruption rate has plateaued since 2000 in the US, all other countries show declining rates. These findings suggest considerable variation in abruption frequencies across countries; differences in the distribution of risk factors, especially smoking, may help guide policy to reduce abruption rates.

Serum Lycopene Concentrations and Associations with Clinical Outcomes in a Cohort of Maternal-Infant Dyads.

Science.gov (United States)

Hanson, Corrine; Lyden, Elizabeth; Furtado, Jeremy; Van Ormer, Matthew; White, Kimberly; Overby, Nina; Anderson-Berry, Ann

2018-02-13

Oxidative stress has been associated with adverse neonatal outcomes, and many carotenoids, including lycopene, potentially have antioxidant properties. The objective of this analysis was to explore the associations between serum lycopene concentrations, including lycopene isomers, and maternal-newborn outcomes. Maternal and cord blood samples were collected in 180 mother-infant pairs. Serum of total lycopene as well as the cis - and trans -isomers concentrations were measured using HPLC (High Performance Liquid Chromatography). Descriptive statistics were calculated; Spearman coefficients were used to assess correlations between maternal and cord concentrations. The relationship between lycopene concentration and outcomes were evaluated with linear and logistic regression models, with adjustment for relevant confounders. A p ≤ 0.05 was considered statistically significant. Maternal and cord serum lycopene concentrations were positively correlated for total lycopene ( r = 0.30, p lycopene ( r = 0.29, p = 0.0002); and trans -lycopene ( r = 0.32, p lycopene were significantly lower in mothers whose infants developed respiratory distress syndrome compared to those who did not (0.336 ± 0.171 vs. 0.445 ± 0.238 µmol/L, p = 0.04) and also in mothers whose babies were admitted to the newborn intensive care unit compared to those who were not (0.380 ± 0.202 vs. 0.458 ± 0.244 µmol/L, p = 0.04). Conversely, cord concentrations of trans -lycopene were significantly higher in infants who developed RDS (Respiratory Distress Syndrome) (0.023 ± 0.012 vs. 0.016 ± 0.012, p = 0.007 for RDS vs. no RDS), and a similar pattern was seen NICU admission (0.023 ± 0.016 vs. 0.015 ± 0.009 µmol/L for NICU (Newborn Intensive Care Unit) admission vs. no NICU admission, p = 0.007). Maternal concentrations of total and cis -lycopene were positively associated with infant birth weight, length and head circumference after adjustment for relevant confounders. As serum carotenoids

Possibilities and considerations when merging dietary data from the world's two largest pregnancy cohorts: the Danish National Birth Cohort and the Norwegian Mother and Child Cohort Study.

Science.gov (United States)

Olsen, Sjurdur F; Birgisdottir, Bryndis Eva; Halldorsson, Thorhallur I; Brantsaeter, Anne Lise; Haugen, Margaretha; Torjusen, Hanne; Petersen, Sesilje B; Strøm, Marin; Meltzer, Helle Margrete

2014-11-01

To elucidate the research possibilities when merging data on maternal diet from the Danish National Birth Cohort (DNBC) and the Norwegian Mother and Child Cohort Study (MoBa), through comparison of (i) the methodology used for dietary assessment and (ii) the estimated intake of selected food groups in the two cohorts. Qualitative and quantitative comparison of the two dietary databases. Two national prospective pregnancy cohorts. Denmark, Norway. Comparison of food intake using food frequency questionnaires (FFQs). The FFQs had overlapping time windows and a majority of the questions in the two FFQs were comparable. Calculation principles shared similar features, including the software used and use of global questions to calibrate intakes of different food groups. A total of 63 food groups were defined that could be compared across the two cohorts; these were further aggregated down to 31 broader groups. A comparison of food intakes (grams/d) showed 39, 74 and 141% lower daily intakes of fish, potatoes and rice, respectively, in DNBC vs. MoBa and 39, 54 and 65% higher daily intakes of milk, butter and potatoes in DNBC vs. MoBa. For most other food groups, differences in consumption data were below 20%. The two FFQs are to a large extent compatible and substantial differences in dietary habits were observed between the two cohorts. This may strengthen studies using pooled analysis to examine diet-disease relations. This is a conclusion of great importance given the colossal and costly task involved to establish each of these two cohorts. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Maternal antibiotic use and risk of asthma in offspring--Authors' reply

DEFF Research Database (Denmark)

Bisgaard, Hans; Stokholm, Jakob; Sevelsted, Astrid

2014-01-01

registries.2,3 We interpreted this association between use of antibiotics in pregnancy and the child's risk of asthma as one that was mediated through changes in the microbiome. In our study we aimed to test this hypothesis by investigating the temporal associations between maternal antibiotics and childhood......We thank Martin J Blaser and Maria Bello for their interest in our study.1 Our original discovery of an association between use of antibiotics in pregnancy and an offspring's risk of asthma was replicated in the COPSAC2000 birth cohort and another Danish birth cohort, as well as in national...... asthma....

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

Adherence to the New Nordic Diet during pregnancy and subsequent maternal weight development: a study conducted in the Norwegian Mother and Child Cohort Study (MoBa).

Science.gov (United States)

Skreden, Marianne; Hillesund, Elisabet R; Wills, Andrew K; Brantsæter, Anne Lise; Bere, Elling; Øverby, Nina C

2018-06-01

The rising prevalence of overweight and obesity is a worldwide public health challenge. Pregnancy and beyond is a potentially important window for future weight gain in women. We investigated associations between maternal adherence to the New Nordic diet (NND) during pregnancy and maternal BMI trajectories from delivery to 8 years post delivery. Data are from the Norwegian Mother and Child Cohort. Pregnant women from all of Norway were recruited between 1999 and 2008, and 55 056 are included in the present analysis. A previously constructed diet score, NND, was used to assess adherence to the diet. The score favours intake of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water. Linear spline multi-level models were used to estimate the association. We found that women with higher adherence to the NND pattern during pregnancy had on average lower post-partum BMI trajectories and slightly less weight gain up to 8 years post delivery compared with the lower NND adherers. These associations remained after adjustment for physical activity, education, maternal age, smoking and parity (mean diff at delivery (high v. low adherers): -0·3 kg/m2; 95 % CI -0·4, -0·2; mean diff at 8 years: -0·5 kg/m2; 95 % CI -0·6, -0·4), and were not explained by differences in energy intake or by exclusive breast-feeding duration. Similar patterns of associations were seen with trajectories of overweight/obesity as the outcome. In conclusion, our findings suggest that the NND may have beneficial properties to long-term weight regulation among women post-partum.

Does microchimerism mediate kin conflicts?

Science.gov (United States)

Haig, David

2014-01-01

Fetal microchimerism (FMc) is predicted to promote the fitness of the fetus and maternal microchimerism (MMc) to promote the fitness of the mother. Offspring and mothers benefit from each other's health. Therefore, microchimeric cells should usually not be harmful to their host. However, the evolutionary interests of mothers and offspring diverge when there is competition among siblings for maternal investment. Fetal cells in mothers' bodies could benefit their own offspring at the expense of its sibs by promoting lactogenesis or by extending the interbirth interval. Maternal cells in fetal bodies could benefit from the suppression of sibling rivalry. Non-inherited haplotypes in MMc or sibling microchimerism (SMc) gain no direct benefit from their hosts' health and could be associated with substantial detrimental effects.

Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis.

Science.gov (United States)

Rahman, M M; Abe, S K; Kanda, M; Narita, S; Rahman, M S; Bilano, V; Ota, E; Gilmour, S; Shibuya, K

2015-09-01

We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index (BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. PubMed, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27), low birthweight (OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age (OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk (PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries. © 2015 World Obesity.

Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children.

Science.gov (United States)

Rodriguez, Alina

2010-02-01

This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714). Mothers and kindergarten teachers rated children's ADHD symptoms, presence and duration of problems, and emotionality. Dichotomized outcomes examined difficulties of clinical relevance (top 15% of the distribution). Analyses adjusted for pregnancy (maternal smoking, depressive symptoms, life events, education, age, family structure), birth outcomes (birth weight, gestational age, infant sex) and concurrent variables (family structure, maternal depressive symptoms, parental ADHD symptoms, and child overweight) in an attempt to rule out confounding. Maternal pre-pregnancy overweight and obesity predicted high inattention symptom scores and obesity was associated with a two-fold increase in risk of difficulties with emotion intensity and emotion regulation according to teacher reports. Means of maternal ratings were unrelated to pre-pregnancy body mass index (BMI). Presence and duration of problems were associated with both maternal over and underweight according to teachers. Despite discrepancies between maternal and teacher reports, these results provide further evidence that maternal pre-pregnancy overweight and obesity are associated with child inattention symptoms and extend previous work by establishing a link between obesity and emotional difficulties. Maternal adiposity at the time of conception may be instrumental in programming child mental health, as prenatal brain development depends on maternal energy supply. Possible mechanisms include disturbed maternal metabolic function. If maternal pre-pregnancy obesity is a causal risk factor, the potential for prevention is great.

Planned Home VBAC in the United States, 2004-2009: Outcomes, Maternity Care Practices, and Implications for Shared Decision Making.

Science.gov (United States)

Cox, Kim J; Bovbjerg, Marit L; Cheyney, Melissa; Leeman, Lawrence M

2015-12-01

In the United States, the number of planned home vaginal births after cesarean (VBACs) has increased. This study describes the maternal and neonatal outcomes for women who planned a VBAC at home with midwives who were contributing data to the Midwives Alliance of North America Statistics Project 2.0 cohort during the years 2004-2009. Two subsamples were created from the parent cohort: 12,092 multiparous women without a prior cesarean and 1,052 women with a prior cesarean. Descriptive statistics were calculated for maternal and neonatal outcomes for both groups. Sensitivity analyses comparing women with a prior vaginal birth and those who were at the lowest risk with various subgroups in the parent cohort were also conducted. Women with a prior cesarean had a VBAC rate of 87 percent, although transfer rates were higher compared with women without a prior cesarean (18% vs 7%, p history of cesarean (p = 0.015). Although there is a high likelihood of a vaginal birth at home, women planning a home VBAC should be counseled regarding maternal transfer rates and potential for increased risk to the newborn, particularly if uterine rupture occurs in the home setting. © 2015 Wiley Periodicals, Inc.

First trimester prediction of maternal glycemic status.

Science.gov (United States)

Gabbay-Benziv, Rinat; Doyle, Lauren E; Blitzer, Miriam; Baschat, Ahmet A

2015-05-01

To predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics. We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state. Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC - area under the curve 0.819, CI - confidence interval 0.769-0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668-0.746). GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

Antenatal risk factors for symptomatic congenital CMV disease following primary maternal CMV infection.

Science.gov (United States)

Hadar, Eran; Salzer, Liat; Dorfman, Elizabeta; Amir, Jacob; Pardo, Joseph

2016-04-01

This study aimed to evaluate antenatal risk factors associated with symptomatic congenital cytomegalovirus (CMV) disease, following in utero vertical infection. This study included a retrospective cohort of 155 neonates with congenital CMV infection, following primary maternal CMV infection during pregnancy, and were divided to symptomatic (n=95) and asymptomatic (n=60) newborns. Young maternal age (29.1±5.12 vs. 31.6±5.36 years, P=0.005), high risk occupation for viral exposure (20.0% vs. 11.7%, P=0.04), CMV IgG seroconversion at diagnosis (83.1% vs. 63.3%, P=0.005) and abnormal fetal MRI (11.6% vs. 0%, P=0.003) were found to be prognostic risk factors associated with symptomatic CMV disease of the newborn. Maternal febrile illness at diagnosis, IgG avidity, US findings and the timing of maternal infection were not associated with the occurrence of neonatal symptoms. Knowledge of the reported risk factors may assist in counseling parents with intra uterine CMV infection.

Timing of umbilical cord-clamping and infant anaemia: the role of maternal anaemia.

Science.gov (United States)

Blouin, Brittany; Penny, Mary E; Maheu-Giroux, Mathieu; Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Creed-Kanashiro, Hilary M; Joseph, Serene A; Gagnon, Anita; Rahme, Elham; Gyorkos, Theresa W

2013-05-01

Evidence from randomized controlled trials has shown that delayed cord-clamping is beneficial to infant iron status. The role of maternal anaemia in this relationship, however, has not been established. To determine the effect of maternal anaemia at delivery on the association between timing of umbilical cord-clamping and infant anaemia at 4 and 8 months of age. A cohort of pregnant women admitted to the labour room of Hospital Iquitos (Iquitos, Peru) and their newborns were recruited into the study during two time periods (18 May to 3 June and 6-20 July 2009). Between the two recruitment periods, the hospital's policy changed from early to delayed umbilical cord-clamping. Maternal haemoglobin levels were measured before delivery, and the time between delivery and cord-clamping was recorded at delivery for the entire cohort. Mother-infant pairs were followed-up at 4 (n = 207) and 8 months (n = 184) post partum. Infant haemoglobin levels were measured at follow-up visits. Data were analysed using logistic regression models. The prevalence of maternal anaemia (Hb anaemia was modified by the mother's anaemia status. Significant benefits of delayed cord-clamping in preventing anaemia were found in infants born to anaemic mothers at both 4 months (aOR = 0.59, 95% CI 0.36-0.99) and 8 months (aOR = 0.38, 95% CI 0.19-0.76) of age. The study contributes additional evidence in support of delayed cord-clamping. This intervention is likely to have most public health impact in areas with a high prevalence of anaemia during pregnancy.

Associations between maternal helminth and malaria infections in pregnancy, and clinical malaria in the offspring

DEFF Research Database (Denmark)

Ndibazza, Juliet; Webb, Emily L; Lule, Swaib

2013-01-01

Background. Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis that prenatal exposure to these parasites might influence susceptibility to infections such as malaria in childhood.Methods. In a birth cohort of 2,345 mother-child pairs in Uganda, maternal...... helminth and malaria infection status was determined during pregnancy, and childhood malaria episodes recorded from birth to age five years. We examined associations between maternal infections and malaria in the offspring.Results. Common maternal infections were hookworm (45%), Mansonella perstans (21......%), Schistosoma mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up. The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at annual visits was 5.4%. Maternal hookworm and M. perstans infections were...

Maternal and Paternal Height and the Risk of Preeclampsia.

Science.gov (United States)

Lee, Yunsung; Magnus, Per

2018-04-01

The etiology of preeclampsia is unknown. Tall women have been found to have lower incidence of preeclampsia. This points to a possible biological causal effect but may be because of socioeconomic confounding. We used paternal height as an unexposed control to examine confounding. The MoBa (Norwegian Mother and Child Cohort Study) was used to extract data on parental heights, maternal prepregnancy weight, other background factors, and pregnancy outcomes for 99 968 singleton births. Multiple logistic regression was used to estimate odds ratios for preeclampsia according to parental height. The adjusted odds ratio for preeclampsia was 0.74 (95% CI, 0.66-0.82) for women >172 cm as compared with women 186 cm was 1.03 (95% CI, 0.93-1.15) compared with men <178 cm. The association between maternal height and preeclampsia is unlikely to be because of confounding by familial, socioeconomic factors or by fetal genes related to height. The observed association between maternal height and preeclampsia merits further investigation. © 2018 American Heart Association, Inc.

The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

Science.gov (United States)

2013-01-01

Background Previous studies have reported on adverse neonatal outcomes associated with parity and maternal age. Many of these studies have relied on cross-sectional data, from which drawing causal inference is complex. We explore the associations between parity/maternal age and adverse neonatal outcomes using data from cohort studies conducted in low- and middle-income countries (LMIC). Methods Data from 14 cohort studies were included. Parity (nulliparous, parity 1-2, parity ≥3) and maternal age (gestational-age (SGA), preterm, neonatal and infant mortality. Adjusted odds ratios (aOR) were calculated per study and meta-analyzed. Results Nulliparous, age mothers, suggesting that reproductive health interventions need to address the entirety of a woman’s reproductive period. Funding Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the Child Health Epidemiology Reference Group. PMID:24564800

Effect of hemoglobin adjustment on the precision of mercury concentrations in maternal and cord blood

DEFF Research Database (Denmark)

Kim, Byung Mi; Choi, Anna L.; Ha, Eun Hee

2014-01-01

to be less precise than suggested by laboratory quality data, we studied the interrelationships of mercury concentrations with hemoglobin in paired maternal and cord blood samples from a Faroese birth cohort (N=514) and the Mothers and Children[U+05F3]s Environmental Health study in Korea (n=797). Linear...... and cord blood for hemoglobin improved their precision, while no significant effect of the selenium concentration in maternal blood was found. Adjustment of blood-mercury concentrations for hemoglobin is therefore recommended. © 2014 Elsevier Inc....

A study of association of obesity with maternal complications

International Nuclear Information System (INIS)

Iqbal, N.; Rahim, S.; Azhar, I.A.

2013-01-01

To determine the association of obesity with maternal complications. Methodology: A prospective cohort study was conducted at Gynae Unit lll Jinnah Hospital Lahore, from 21st May 2011 to 20th Nov.2011 All women fulfilling the inclusion were included in this study. Two groups were made, Group l was allotted to obese pregnant women and Group ll was allotted to non-obese pregnant women. Demographic data included age, parity, duration of pregnancy and maternal complications i-e urinary tract infection , instrumental vaginal delivery and post-partum haemorrhage were recorded and analyzed by SPSS -version 13. Results: The results of this study revealed that demographics like age parity and duration of pregnancy were almost similar in both groups , common age was 25.21 +- 2.73 in group-A and 26.34 +- 3.56 years in group -B . Comparison of maternal complications revealed that 22.23 % in group-A and 10.70% in group -B had urinary tract infection, relative risk was 2.087, instrumental delivery in group -A was 14.42% and in group-B was 4.19% relative risk was 3.44 while post-partum haemorrhage was 9.77% in group -A and 3.26% in group -B , relative risk was 3.00. Conclusion: The frequency of maternal complications is higher among obese pregnant women so it is recommended that every pregnant woman who presents with increased BMI should be sort out for maternal complications. (author)

The role of birth cohorts in studies of adult health: the New York women's birth cohort.

Science.gov (United States)

Terry, Mary Beth; Flom, Julie; Tehranifar, Parisa; Susser, Ezra

2009-09-01

Epidemiological studies investigating associations between early life factors and adult health are often limited to studying exposures that can be reliably recalled in adulthood or obtained from existing medical records. There are few US studies with detailed data on the pre- and postnatal environment whose study populations are now in adulthood; one exception is the Collaborative Perinatal Project (CPP). We contacted former female participants of the New York site of the CPP who were born from 1959 to 1963 and were prospectively followed for 7 years to examine whether the pre- and postnatal environment is associated with adult health in women 40 years after birth. The New York CPP cohort is particularly diverse; at enrolment, the race/ethnicity distribution of mothers was approximately 30% White, 40% Black and 30% Puerto Rican. Of the 841 eligible women, we successfully traced 375 women (45%) and enrolled 262 women (70% of those traced). Baseline data were available for all eligible women, and we compared those who participated with the remaining cohort (n = 579). Higher family socio-economic status at age 7, availability of maternal social security number, and White race/ethnicity were statistically significantly associated with a higher probability of tracing. Of those traced, race/ethnicity was associated with participation, with Blacks and Puerto Ricans less likely to participate than Whites (OR = 0.5, 95% CI 0.3, 0.8, and OR = 0.5, 95% CI 0.3, 1.0, respectively). In addition, higher weight at 7 years was associated with lower participation (OR = 0.95, 95% CI 0.92, 0.99), but this association was observed only among the non-White participants. None of the other maternal characteristics, infant or early childhood growth measures was associated with participation or with tracing, either overall or within each racial/ethnic subgroup. Daughters' recall of early life factors such as pre-eclampsia (sensitivity = 24%) and birthweight were generally poor, with the

Maternal Pre-Pregnancy Obesity and Risk for Inattention and Negative Emotionality in Children

Science.gov (United States)

Rodriguez, Alina

2010-01-01

Objective: This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. Methods: A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714).…

Maternal Age at Child Birth, Birth Order, and Suicide at a Young Age: A Sibling Comparison

OpenAIRE

Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Vatten, Lars Johan; Janszky, Imre; Gunnell, David; Romundstad, Pål Richard

2013-01-01

Previous studies have reported strong associations between birth order, maternal age, and suicide, but these results might have been confounded by socioeconomic and other factors. To control for such factors, we compared suicide risk between siblings and studied how maternal age at child birth and birth order influenced risk in a cohort study of 1,690,306 Norwegians born in 1967–1996 who were followed up until 2008. Using stratified Cox regression, we compared suicide risk within families wit...

Maternal characteristics and hospital policies as risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery.

Science.gov (United States)

O'Leary, Sean T; Nelson, Christina; Duran, Julie

2012-01-01

A birth dose of hepatitis B vaccine (HBV) is a primary focus of the Advisory Committee on Immunization Practices' strategy to eliminate transmission of hepatitis B virus in the United States. We sought to assess the impact of maternal characteristics and hospital policy on the receipt of a birth dose of HBV. A retrospective cohort study was performed using data from the 2008 Colorado birth registry. Hospital policy was assessed by state health department personnel. Univariate and multivariate logistic regression analyses were used to examine the association of maternal characteristics and hospital policy with nonreceipt of HBV. A total of 64,425 infants were identified in the birth cohort, of whom 61.6% received a birth dose of HBV. Higher maternal education and income were associated with nonreceipt of HBV (master's degree vs. eighth grade or less: adjusted odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.49-1.85; >$75,000 vs. risk of perinatal hepatitis B transmission, hospitals should stipulate that all infants are offered HBV and ensure that these policies are implemented and followed.

Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies.

Science.gov (United States)

Bianchi, Diana W; Chudova, Darya; Sehnert, Amy J; Bhatt, Sucheta; Murray, Kathryn; Prosen, Tracy L; Garber, Judy E; Wilkins-Haug, Louise; Vora, Neeta L; Warsof, Stephen; Goldberg, James; Ziainia, Tina; Halks-Miller, Meredith

2015-07-14

Understanding the relationship between aneuploidy detection on noninvasive prenatal testing (NIPT) and occult maternal malignancies may explain results that are discordant with the fetal karyotype and improve maternal clinical care. To evaluate massively parallel sequencing data for patterns of copy-number variations that might prospectively identify occult maternal malignancies. Case series identified from 125,426 samples submitted between February 15, 2012, and September 30, 2014, from asymptomatic pregnant women who underwent plasma cell-free DNA sequencing for clinical prenatal aneuploidy screening. Analyses were conducted in a clinical laboratory that performs DNA sequencing. Among the clinical samples, abnormal results were detected in 3757 (3%); these were reported to the ordering physician with recommendations for further evaluation. NIPT for fetal aneuploidy screening (chromosomes 13, 18, 21, X, and Y). Detailed genome-wide bioinformatics analysis was performed on available sequencing data from 8 of 10 women with known cancers. Genome-wide copy-number changes in the original NIPT samples and in subsequent serial samples from individual patients when available are reported. Copy-number changes detected in NIPT sequencing data in the known cancer cases were compared with the types of aneuploidies detected in the overall cohort. From a cohort of 125,426 NIPT results, 3757 (3%) were positive for 1 or more aneuploidies involving chromosomes 13, 18, 21, X, or Y. From this set of 3757 samples, 10 cases of maternal cancer were identified. Detailed clinical and sequencing data were obtained in 8. Maternal cancers most frequently occurred with the rare NIPT finding of more than 1 aneuploidy detected (7 known cancers among 39 cases of multiple aneuploidies by NIPT, 18% [95% CI, 7.5%-33.5%]). All 8 cases that underwent further bioinformatics analysis showed unique patterns of nonspecific copy-number gains and losses across multiple chromosomes. In 1 case, blood was

Effects of maternal smoking and exposure to methylmercury on brain-derived neurotrophic factor concentrations in umbilical cord serum

DEFF Research Database (Denmark)

Spulber, Stefan; Rantamäki, Tomi; Nikkilä, Outi

2010-01-01

. The cohort consisted of 395 singleton births (206 boys and 189 girls), gestational age ranging from 38 to 42 weeks. Serum BDNF was measured by sandwich ELISA. Maternal smoking habits and other relevant factors were obtained by interviewing the mothers. The exposure to MeHg was estimated from Hg...... concentrations in cord blood, whereas exposure to PCB was estimated based on maternal serum concentrations. Only MeHg exposure affected the serum BDNF, which decreased in a concentration-dependent manner in girls born to nonsmoking mothers. Maternal smoking significantly increased BNDF in girls but not in boys....... For further statistical analyses, we used the serum BDNF concentration as a continuous outcome variable in supervised regression models. Serum BDNF concentration increased with gestational age, increased by maternal smoking, decreased slightly with MeHg exposure, and maternal smoking enhanced the decrease...

Maternal depressive symptoms in childhood and risky behaviours in early adolescence.

Science.gov (United States)

Flouri, Eirini; Ioakeimidi, Sofia

2018-03-01

Longitudinal patterns of maternal depressive symptoms have yet to be linked to risky behaviours, such as substance use or violence, in early adolescence, when such behaviours may be particularly detrimental. This study was carried out to do this. Using data from the UK's Millennium Cohort Study, it modelled the effect of trajectories of maternal depressive symptoms at child ages 3, 5, 7 and 11 years on antisocial behaviour and delinquency at age 11 years (N = 12,494). It also explored their role in predicting moral judgement and attitudes to alcohol at age 11, important predictors of delinquent or antisocial behaviour and alcohol use, respectively. Latent class analysis showed four longitudinal types of maternal depressive symptoms (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal symptom typology predicted antisocial behaviour in males and attitudes to alcohol in females, even after adjusting for youth's age and pubertal status and after correcting for confounding. Specifically, compared to males growing up with never-depressed mothers, those exposed to chronically high or accelerating maternal depressive symptoms were more likely to report engaging in loud and rowdy behaviour, alcohol use and bullying. Females exposed to chronically high maternal depressive symptoms were more likely than those growing up with never-depressed mothers to support the view that alcohol use is harmless. While causal conclusions cannot be drawn, these findings suggest that preventing or treating maternal depressive symptoms in childhood may be a useful approach to reducing future externalising and health-risk behaviours in offspring.

Maternal labor force participation and differences by education in an urban birth cohort study - 1998-2010

Directory of Open Access Journals (Sweden)

Natasha Pilkauskas

2016-03-01

Full Text Available Background: Maternal labor force participation has increased dramatically over the last 40 years, yet surprisingly little is known about longitudinal patterns of maternal labor force participation in the years after a birth, or how these patterns vary by education. Objective: We document variation by maternal education in mothers' labor force participation (timing, intensity, non-standard work, multiple job-holding over the first nine years after the birth of a child. Methods: We use the Fragile Families and Child Wellbeing Study (N~3000 to predict longitudinal labor force participation in a recent longitudinal sample of mothers who gave birth in large US cities between 1998 and 2000. Families were followed until children were age 9, through 2010. Results: Labor force participation gradually increases in the years after birth for mothers with high school or less education, whereas for mothers with some college or more, participation increases between ages 1 and 3 and then remains mostly stable thereafter. Mothers with less than high school education have the highest rates of unemployment (actively seeking work, which remain high compared with all other education groups, whose unemployment declines over time. Compared with all other education groups, mothers with some college have the highest rates of labor force participation, but Contribution: Simple conceptualizations of labor force participation do not fully capture the dynamics of labor force attachment for mothers in terms of intensity, timing of entry, and type of work hours, as well as differences by maternal education.

Development and validation of a predictive model for excessive postpartum blood loss: A retrospective, cohort study.

Science.gov (United States)

Rubio-Álvarez, Ana; Molina-Alarcón, Milagros; Arias-Arias, Ángel; Hernández-Martínez, Antonio

2018-03-01

postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. Despite the use of uterotonics agents as preventive measure, it remains a challenge to identify those women who are at increased risk of postpartum bleeding. to develop and to validate a predictive model to assess the risk of excessive bleeding in women with vaginal birth. retrospective cohorts study. "Mancha-Centro Hospital" (Spain). the elaboration of the predictive model was based on a derivation cohort consisting of 2336 women between 2009 and 2011. For validation purposes, a prospective cohort of 953 women between 2013 and 2014 were employed. Women with antenatal fetal demise, multiple pregnancies and gestations under 35 weeks were excluded METHODS: we used a multivariate analysis with binary logistic regression, Ridge Regression and areas under the Receiver Operating Characteristic curves to determine the predictive ability of the proposed model. there was 197 (8.43%) women with excessive bleeding in the derivation cohort and 63 (6.61%) women in the validation cohort. Predictive factors in the final model were: maternal age, primiparity, duration of the first and second stages of labour, neonatal birth weight and antepartum haemoglobin levels. Accordingly, the predictive ability of this model in the derivation cohort was 0.90 (95% CI: 0.85-0.93), while it remained 0.83 (95% CI: 0.74-0.92) in the validation cohort. this predictive model is proved to have an excellent predictive ability in the derivation cohort, and its validation in a latter population equally shows a good ability for prediction. This model can be employed to identify women with a higher risk of postpartum haemorrhage. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physical health after childbirth and maternal depression in the first 12 months post partum: results of an Australian nulliparous pregnancy cohort study.

Science.gov (United States)

Woolhouse, Hannah; Gartland, Deirdre; Perlen, Susan; Donath, Susan; Brown, Stephanie J

2014-03-01

to investigate the relationship between maternal physical health problems and depressive symptoms in the first year after childbirth. prospective pregnancy cohort study. Melbourne, Victoria, Australia. 1507 nulliparous women. women were recruited from six public hospitals between six and 24 weeks gestation. Written questionnaires were completed at recruitment and at three, six and 12 months post partum. Edinburgh Postnatal Depression Scale (EPDS); standardised measures of urinary and faecal incontinence, a checklist of symptoms for other physical health problems. overall, 16.1% of women reported depressive symptoms during the first 12 months post partum, with point prevalence at three, six and 12 months post partum of 6.9%, 8.8% and 7.8% respectively. The most commonly reported physical health problems in the first three months were tiredness (67%), back pain (47%), breast problems (37%), painful perineum (30%), and urinary incontinence (29%). Compared with women reporting 0-2 health problems in the first three months post partum, women reporting 5 or more health problems had a six-fold increase in likelihood of reporting concurrent depressive symptoms at three months post partum (Adjusted OR=6.69, 95% CI=3.0-15.0) and a three-fold increase in likelihood of reporting subsequent depressive symptoms at 6-12 months post partum (Adjusted OR=3.43, 95% CI 2.1-5.5). poor physical health in the early postnatal period is associated with poorer mental health throughout the first 12 months post partum. Early intervention to promote maternal mental health should incorporate assessment and intervention to address common postnatal physical health problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa).

Science.gov (United States)

Torgersen, Leila; Ystrom, Eivind; Siega-Riz, Anna Maria; Berg, Cecilie Knoph; Zerwas, Stephanie C; Reichborn-Kjennerud, Ted; Bulik, Cynthia M

2015-01-01

Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified-purging subtype, to the diet of children of mothers with no eating disorders (reference group). The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort Study (MoBa). Latent class analysis (LCA) was used to identify discrete latent classes of infant diet based on the mothers' responses to questions about 16 food items. LCA identified five classes, characterized by primarily homemade vegetarian food (4% of infants), homemade traditional food (8%), commercial cereals (35%), commercial jarred baby food (39%), and a mix of all food groups (11%). The association between latent dietary classes and maternal eating disorders were estimated by multinomial logistic regression. Infants of mothers with bulimia nervosa had a lower probability of being in the homemade traditional food class compared to the commercial jarred baby food class, than the referent (O.R. 0.59; 95% CI 0.36-0.99). Infants of mothers with binge eating disorder had a lower probability of being in the homemade vegetarian class compared to the commercial jarred baby food class (O.R. 0.77; 95% CI 0.60-0.99), but only before adjusting for relevant confounders. Anorexia nervosa and eating disorder not otherwise specified-purging subtype were not statistically significantly associated with any of the dietary classes. These results suggest that maternal eating disorders may to some extent influence the child's diet at 6 months; however, the extent to which these differences influence child health and development remains an area for further inquiry. Copyright © 2014 Elsevier Ltd. All rights reserved.

Military milk: breastfeeding rates among Australian Defence Force women who return to military service following maternity leave.

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Stewart, Kelley

2015-02-01

The breastfeeding behaviors among Australian Defence Force women have not previously been examined. Studies have shown that breastfeeding prevalence and duration are affected by maternity leave entitlements and returning to work. This study aimed to benchmark breastfeeding initiation, prevalence, and duration among a cohort of Australian Defence Force women and to compare these findings against Australian population norms. A cross-sectional survey was conducted via email in 2008 for Australian Defence Force women who had taken maternity leave in the Australian financial year of 2006/2007. Analysis of breastfeeding indicators was undertaken. Ninety-eight percent of Australian Defence Force women in this cohort initiated breastfeeding and breastfed for a median duration of 8 months, returning to work when the mean age of the child was 8.4 months. Breastfeeding prevalence did not meet 2003 Australian National Health and Medical Research Council targets by 6 months postpartum but compared favorably to the Australian population norms. Sixty-six percent of the respondents returned to work full-time, with a median breastfeeding duration of 7 months. Women who returned to work part-time had a longer median duration of 10 months. Breastfeeding rates among this cohort of Australian Defence Force women compare favorably with the general Australian population until 9 months, coinciding with returning to work after a period of maternity leave. The results support recent Australian population studies on breastfeeding and employment. © The Author(s) 2014.

Does acute maternal stress in pregnancy affect infant health outcomes? Examination of a large cohort of infants born after the terrorist attacks of September 11, 2001

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Conlin Ava Marie S

2009-07-01

Full Text Available Abstract Background Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results. Methods Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty military families. Infants were considered exposed if they were in utero on September 11, 2001, while the referent group included infants gestating in the same period in the preceding and following year (2000 and 2002. We investigated the association of this acute stress during pregnancy with the infant health outcomes of male:female sex ratio, birth defects, preterm birth, and growth deficiencies in utero and in infancy. Results No difference in sex ratio was observed between infants in utero in the first trimester of pregnancy on September 11, 2001 and infants in the referent population. Examination of the relationship between first-trimester exposure and birth defects also revealed no significant associations. In adjusted multivariable models, neither preterm birth nor growth deficiencies were significantly associated with the maternal exposure to the stress of September 11 during pregnancy. Conclusion The findings from this large population-based study suggest that women who were pregnant during the terrorist attacks of September 11, 2001 had no increased risk of adverse infant health outcomes.

Parental death and bipolar disorder: a robust association was found in early maternal suicide

DEFF Research Database (Denmark)

Tsuchiya, Kenji; Agerbo, Esben; Mortensen, Preben Bo

2005-01-01

of a conditional logistic regression analysis. RESULTS: Among 947 subjects with bipolar disorder and 47,350 controls, those having experienced the parental suicide were significantly associated with an increased risk for BPD (incidence rate ratios: 1.83 [95% confidence interval: 1.07 to 3.12] for paternal suicide......, 3.44 [1.97 to 6.00] for maternal suicide), whereas the non-suicidal death of parents showed no such association. Those having experienced maternal suicide at some point before reaching 10 years of age were seven times as likely to develop bipolar disorder. LIMITATIONS: The cohort members were...

Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses.

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Bianchi-Jassir, Fiorella; Seale, Anna C; Kohli-Lynch, Maya; Lawn, Joy E; Baker, Carol J; Bartlett, Linda; Cutland, Clare; Gravett, Michael G; Heath, Paul T; Ip, Margaret; Le Doare, Kirsty; Madhi, Shabir A; Saha, Samir K; Schrag, Stephanie; Sobanjo-Ter Meulen, Ajoke; Vekemans, Johan; Rubens, Craig E

2017-11-06

Preterm birth complications are the leading cause of deaths among children birth in order to inform estimates of the burden of GBS. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups on the association of preterm birth (birth with maternal GBS colonization to be 1.21 (95% confidence interval [CI], .99-1.48; P = .061) in cohort and cross-sectional studies, and the odds ratio to be 1.85 (95% CI, 1.24-2.77; P = .003) in case-control studies. Preterm birth was associated with GBS bacteriuria in cohort studies (RR, 1.98 [95% CI, 1.45-2.69]; P birth is associated with maternal GBS colonization, especially where there is evidence of ascending infection (bacteriuria). Several biases reduce the chance of detecting an effect. Equally, however, results, including evidence for the association, may be due to confounding, which is rarely addressed in studies. Assessment of any effect on preterm delivery should be included in future maternal GBS vaccine trials. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Maternal veterinary occupation and adverse birth outcomes in Washington State, 1992-2014: a population-based retrospective cohort study.

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Meisner, Julianne; Vora, Manali V; Fuller, Mackenzie S; Phipps, Amanda I; Rabinowitz, Peter M

2018-05-01

Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (veterinary support staff separately. While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. These results support the need for further study of the association between veterinary occupation and adverse birth outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Association between maternal depressive symptoms with child malnutrition or child excess weight

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Thais Feres Moreira Lima

Full Text Available Abstract Objectives: to verify associations between maternal depressive symptoms with child malnutrition or child excess weight. Methods: prospective study with data from the BRISA prenatal cohort in São Luís, Brazil, obtained from the 22nd to the 25th week of gestation (in 2009 and 2010 and, later, when children were aged 12 to 32 months (in 2010 and 2012. Maternal depressive symptoms were identified using the Center for Epidemiologic Studies Depression Scale (CES-D and the Edinburgh Postnatal Depression Scale (EPDS. For the excess weight evaluation, BMI z-score for age > +2 was used. For measuring child malnutrition, height z-score for age < -2 was used. The confounding factors were identified using a directed acyclic graph in DAGitty software. Results: we did not find associations between maternal depressive symptoms with child malnutrition or child excess weight. The prevalence of maternal depressive symptoms was 27.6% during gestation and 19.8% in the second or third year of the child's life. The malnutrition rate was 6% and the excess weight rate was 10.9%. Conclusions: no associations between maternal depressive symptoms in prenatal or in the second or third year of the child's life and child malnutrition or excess weight were detected.

Father Involvement and Maternal Depressive Symptoms in Families of Children with Disabilities or Delays

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Laxman, Daniel J.; McBride, Brent A.; Jeans, Laurie M.; Dyer, William J.; Santos, Rosa M.; Kern, Justin L.; Sugimura, Niwako; Curtiss, Sarah L.; Weglarz-Ward, Jenna M.

2015-01-01

This study examined the longitudinal association between fathers' early involvement in routine caregiving, literacy, play, and responsive caregiving activities at 9 months and maternal depressive symptoms at 4 years. Data for 3,550 children and their biological parents were drawn from the Early Childhood Longitudinal Study-Birth Cohort data set.…

Maternal hemoglobin and hematocrit levels during pregnancy and childhood lung function and asthma. The Generation R Study

NARCIS (Netherlands)

Pereira de Jesus, S.M.C.B. (Sabrina M. C. B.); H.T. den Dekker (Herman); J.C. de Jongste (Johan); I.K.M. Reiss (Irwin); E.A.P. Steegers (Eric); V.W.V. Jaddoe (Vincent); L. Duijts (Liesbeth)

2018-01-01

textabstractObjective: To examine the associations of maternal hemoglobin and hematocrit levels during pregnancy with childhood lung function and asthma, and whether adverse pregnancy outcomes and atopic predisposition modify the associations. Methods: In a population-based prospective cohort study

Maternal use of mild analgesics during pregnancy associated with reduced anogenital distance in sons: a cohort study of 1027 mother-child pairs.

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Lind, Dorte Vesterholm; Main, Katharina M; Kyhl, Henriette Boye; Kristensen, David Møbjerg; Toppari, Jorma; Andersen, Helle Raun; Andersen, Marianne Skovsager; Skakkebæk, Niels E; Jensen, Tina Kold

2017-01-01

Is maternal use of mild analgesics in pregnancy associated with anogenital distance (AGD)-the distance from the anus to the genitals-in the offspring? Maternal use of mild analgesics [especially simultaneous use of paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)] during pregnancy was associated with a shorter AGD in boys whereas no effect was found in girls. Mild analgesics including paracetamol (acetaminophen) and NSAIDs (e.g. ibuprofen and acetyl salicylic acid) have endocrine disrupting properties and in utero exposure reduces AGD in male rats. In humans, maternal exposure has been associated with cryptorchidism and hypospadias in male offspring but no studies have examined AGD. A prospective birth cohort study. Between 2010 and 2012, 2500 pregnant women were recruited from the Odense Child Cohort. Children were examined 3 months after the expected date of birth. Pregnant women were asked about use of medication including mild analgesics (paracetamol and NSAID) during pregnancy at recruitment (gestational age (GA) week 10-27) and at GA week 28. AGD and penile width were measured 3 months after expected date of birth by trained personnel. A total of 1027 women answered both questionnaires and their children were examined. Associations between prenatal exposure to mild analgesics and AGD and penile width were estimated using multivariable linear regression adjusting for age and weight-for-age SD score. A total of 40% of the women reported use of paracetamol and/or NSAIDs (4.4%) during the first 28 weeks of pregnancy. Exposure to analgesics during pregnancy was associated with a reduced AGD in boys, although statistically significant only for NSAIDs. The association was significant among 20 boys exposed to both paracetamol and NSAIDs (AGD -4.1 mm; CI 95%: -6.4; -1.7). Maternal intake of analgesics did not show any clear association with AGD in female offspring. No effect on penile width was found. Only 27 boys and 18 girls were exposed to NSAIDs and

Influence of maternal and socioeconomic factors on breast milk fatty acid composition in urban, low‐income families

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Nayak, Uma; Kanungo, Suman; Zhang, Dadong; Ross Colgate, E.; Carmolli, Marya P.; Dey, Ayan; Alam, Masud; Manna, Byomkesh; Nandy, Ranjan Kumar; Kim, Deok Ryun; Paul, Dilip Kumar; Choudhury, Saugato; Sahoo, Sushama; Harris, William S.; Wierzba, Thomas F.; Ahmed, Tahmeed; Kirkpatrick, Beth D.; Haque, Rashidul; Petri, William A.

2017-01-01

Abstract The lipid composition of breast milk may have a significant impact on early infant growth and cognitive development. Comprehensive breast milk data is lacking from low‐income populations in the Indian subcontinent impeding assessment of deficiencies and limiting development of maternal nutritional interventions. A single breast milk specimen was collected within 6 weeks postpartum from two low‐income maternal cohorts of exclusively breastfed infants, from Dhaka, Bangladesh (n = 683) and Kolkata, India (n = 372) and assayed for percentage composition of 26 fatty acids. Mature milk (>15 days) in Dhaka (n = 99) compared to Kolkata (n = 372) was higher in total saturated fatty acid (SFA; mean 48% vs. 44%) and disproportionately lower in ω3‐polyunsaturated fatty acid (PUFA), hence the ω6‐ and ω3‐PUFA ratio in Dhaka were almost double the value in Kolkata. In both sites, after adjusting for days of lactation, increased maternal education was associated with decreased SFA and PUFA, and increasing birth order or total pregnancies was associated with decreasing ω6‐PUFA or ω3‐PUFA by a factor of 0.95 for each birth and pregnancy. In Dhaka, household prosperity was associated with decreased SFA and PUFA and increased ω6‐ and ω3‐PUFA. Maternal height was associated with increased SFA and PUFA in Kolkata (1% increase per 1 cm), but body mass index showed no independent association with either ratio in either cohort. In summary, the socioeconomic factors of maternal education and household prosperity were associated with breast milk composition, although prosperity may only be important in higher cost of living communities. Associated maternal biological factors were height and infant birth order, but not adiposity. Further study is needed to elucidate the underlying mechanisms of these effects. PMID:28198164

Impact of Maternal Death on Household Economy in Rural China: A Prospective Path Analysis.

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Ye, Fang; Ao, Deng; Feng, Yao; Wang, Lin; Chen, Jie; Huntington, Dale; Wang, Haijun; Wang, Yan

2015-01-01

The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors. We conducted a prospective cohort study of households that had experienced maternal death (n = 195) and those that experienced childbirth without maternal death (n = 384) in rural China. All the households were interviewed after the event occurred and were followed up 12 months later. Structural equation modeling was used to test the relationship model, utilizing income and expenditure per capita in the following year after the event as the main outcome variables, maternal death as the predictor, and direct costs, the amount of money offset by positive and negative coping strategies, whether the husband remarried, and whether the newborn was alive as the mediators. In the following year after the event, the path analysis revealed a direct effect from maternal death to lower income per capita (standardized coefficient = -0.43, p = 0.041) and to lower expenditure per capita (standardized coefficient = -0.51, peconomy. The results provided evidence for better understanding the mechanism of how this event affects a household economy and provided a reference for social welfare policies to target the most vulnerable households that have suffered from maternal deaths.

Maternal impulse control disability and developmental disorder traits are risk factors for child maltreatment.

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Tachibana, Yoshiyuki; Takehara, Kenji; Kakee, Naoko; Mikami, Masashi; Inoue, Eisuke; Mori, Rintaro; Ota, Erika; Koizumi, Tomoe; Okuyama, Makiko; Kubo, Takahiko

2017-11-14

Previous work has suggested that maternal developmental disorder traits related to autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are significantly associated with child maltreatment. However, there may be other important maternal characteristics that contribute to child maltreatment. We hypothesized that maternal impulse control disability may also affect child maltreatment in addition to maternal developmental disorder traits. We aimed to test this hypothesis via a cohort study performed in Tokyo (n = 1,260). Linear regression analyses using the Behavioural Inhibition/Behavioural Activation Scales, the self-administered short version of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the short form of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and the Child Maltreatment Scale, revealed that excessive inhibition of behaviour and affect, which is impulse control disability, is significantly associated with child maltreatment (b = 0.031, p = 0.018) in addition to maternal developmental disorder traits (ASD: b = 0.052, p = 0.004; ADHD: b = 0.178, p child maltreatment, while ADHD was associated (AOR = 1.034, p = 0.022) with severe child maltreatment. These maternal characteristics may inform the best means for prevention and management of child maltreatment cases.

The Impact of Parental Personality on Birth Outcomes: A Prospective Cohort Study.

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Naho Morisaki

Full Text Available To investigate the effect of parental personality on birth outcomes.Prospective cohort study.727 pregnant women and 579 spouses receiving antenatal care at a single-center in rural Tokyo, Japan during 2010-2013.We measured the association between maternal effect of parental personality traits assessed by the Cloninger's Temperament and Character Inventory on birth outcomes, using multiple regression and adjusting for demographics.Maternal self-transcendence personality was inversely associated with gestational age [-0.26 (95% confidence interval (CI: -0.51 to -0.01 weeks per unit] and positively associated with preterm birth [odds ratio (OR 2.60 (95% CI: 1.00 to 6.75 per unit], while paternal self-transcendence personality was positively associated with gestational age [0.31 (95% CI: 0.07 to 0.55 weeks per unit]. Maternal reward dependence was positively associated with fetal growth [0.30 (95% CI: 0.02 to 0.59 per unit]. Other maternal and paternal personality traits associated with adverse maternal behavior, such as novelty seeking, harm avoidance and self-directedness, were not associated with birth outcomes.We found that specific parental personality traits can be associated with birth outcomes.

Maternal employment in child-care institutions and the risk of infant wheeze and atopic dermatitis in the offspring

DEFF Research Database (Denmark)

Hersoug, L.G.; Benn, C.S.; Simonsen, J.B.

2008-01-01

in the Danish National Birth Cohort were followed prospectively. Information on wheezing episodes, AD, maternal employment, and other variables were collected by interview at 12 and 30 wk of gestation, and 6 and 18 months of age, and by linkage to the Danish Medical Birth Register and the Child-care Database......% CI: 1.05-1.77), and 1.03 (95% CI: 0.81-1.31), respectively, for first-born infants of mothers employed in child-care institutions compared with infants of mothers not so employed. There was no effect of maternal employment in child-care institutions among infants with older siblings. In conclusion......, the results did not support the hypothesis that maternal microbial exposure before or during pregnancy as reflected by maternal employment in child-care institutions protects the offspring against infant wheeze and AD....

Maternal Prenatal Stress and Other Developmental Risk Factors for Adolescent Depression: Spotlight on Sex Differences.

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Maxwell, Seth D; Fineberg, Anna M; Drabick, Deborah A; Murphy, Shannon K; Ellman, Lauren M

2018-02-01

Maternal stress during pregnancy has been linked to premorbid abnormalities associated with depression (e.g., difficult temperament, cognitive deficits) in offspring. However, few studies have looked across developmental periods to examine maternal stress during pregnancy and offspring depression during adolescence and whether these associations differ by sex. The current study used data from 1711 mother-offspring dyads (offspring sex: 49.8% male) in a longitudinal birth cohort study. Maternal narratives collected during pregnancy were qualitatively coded for stress-related themes by independent raters. Latent class analysis (LCA) identified distinct subgroups of offspring based on exposure to maternal prenatal stress and other developmental factors from the prenatal, childhood, and adolescent periods that have been associated with depression and/or maternal prenatal stress. LCA identified subgroups that were compared to determine whether and to what extent they differed on adolescent depressive symptoms. LCA revealed a subgroup of "high-risk" individuals, characterized by maternal factors during pregnancy (higher ambivalence/negativity and lower positivity towards the pregnancy, higher levels of hassles, lower maternal education and higher maternal age at birth, higher pre-pregnancy BMI) and offspring developmental factors (decreased cognitive functioning during childhood and adolescence, lower perceived parental support during adolescence, and higher levels of maternal depression during adolescence). High-risk females exhibited elevated conduct symptoms and higher birth order, while high-risk males exhibited decreased internalizing symptoms and lower birth order. Both high-risk males and females reported elevated depressive symptoms during adolescence relative to their "low-risk" counterparts.

Maternal first-trimester dietary intake and childhood blood pressure: the Generation R Study.

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van den Hil, Leontine C L; Rob Taal, H; de Jonge, Layla L; Heppe, Denise H M; Steegers, Eric A P; Hofman, Albert; van der Heijden, Albert J; Jaddoe, Vincent W V

2013-10-01

Suboptimal maternal dietary intake during pregnancy might lead to fetal cardiovascular adaptations and higher blood pressure in the offspring. The aim of the present study was to investigate the associations of maternal first-trimester dietary intake with blood pressure in children at the age of 6 years. We assessed first-trimester maternal daily dietary intake by a FFQ and measured folate, homocysteine and vitamin B₁₂ concentrations in the blood, in a population-based prospective cohort study among 2863 mothers and children. Childhood systolic and diastolic blood pressure was measured using a validated automatic sphygmomanometer. First-trimester maternal daily intake of energy, fat, protein and carbohydrate was not associated with childhood blood pressure. Furthermore, maternal intake of micronutrients was not associated with childhood blood pressure. Also, higher maternal vitamin B₁₂ concentrations were associated with a higher diastolic blood pressure (0·31 mmHg per standard deviation increase in vitamin B₁₂ (95% CI 0·06, 0·56)). After taking into account multiple testing, none of the associations was statistically significant. Maternal first-trimester folate and homocysteine concentrations were not associated with childhood blood pressure. The results from the present study suggest that maternal Fe intake and vitamin B₁₂ concentrations during the first trimester of pregnancy might affect childhood blood pressure, although the effect estimates were small and were not significant after correction for multiple testing. Further studies are needed to replicate these findings, to elucidate the underlying mechanisms and to assess whether these differences in blood pressure persist in later life.

An international contrast of rates of placental abruption: an age-period-cohort analysis.

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Ananth, Cande V; Keyes, Katherine M; Hamilton, Ava; Gissler, Mika; Wu, Chunsen; Liu, Shiliang; Luque-Fernandez, Miguel Angel; Skjærven, Rolv; Williams, Michelle A; Tikkanen, Minna; Cnattingius, Sven

2015-01-01

Although rare, placental abruption is implicated in disproportionately high rates of perinatal morbidity and mortality. Understanding geographic and temporal variations may provide insights into possible amenable factors of abruption. We examined abruption frequencies by maternal age, delivery year, and maternal birth cohorts over three decades across seven countries. Women that delivered in the US (n = 863,879; 1979-10), Canada (4 provinces, n = 5,407,463; 1982-11), Sweden (n = 3,266,742; 1978-10), Denmark (n = 1,773,895; 1978-08), Norway (n = 1,780,271, 1978-09), Finland (n = 1,411,867; 1987-10), and Spain (n = 6,151,508; 1999-12) were analyzed. Abruption diagnosis was based on ICD coding. Rates were modeled using Poisson regression within the framework of an age-period-cohort analysis, and multi-level models to examine the contribution of smoking in four countries. Abruption rates varied across the seven countries (3-10 per 1000), Maternal age showed a consistent J-shaped pattern with increased rates at the extremes of the age distribution. In comparison to births in 2000, births after 2000 in European countries had lower abruption rates; in the US there was an increase in rate up to 2000 and a plateau thereafter. No birth cohort effects were evident. Changes in smoking prevalence partially explained the period effect in the US (P = 0.01) and Sweden (Prate has plateaued since 2000 in the US, all other countries show declining rates. These findings suggest considerable variation in abruption frequencies across countries; differences in the distribution of risk factors, especially smoking, may help guide policy to reduce abruption rates.

Maternal Vitamin D Status in the Late Second Trimester and the Risk of Severe Preeclampsia in Southeastern China

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Xin Zhao

2017-02-01

Full Text Available The association between maternal vitamin D deficiency and the risk of severe preeclampsia is still debated. In the present study, we aimed to evaluate vitamin D status in Chinese pregnant women and investigate its correlation with the odds of developing severe preeclampsia. A cohort study was performed on 13,806 pregnant women who routinely visited the antenatal care clinics and subsequently delivered at the Wuxi Maternity and Child Health Hospital. All the subjects in the cohort had their serum 25-hydroxyvitamin D (25(OHD concentrations measured during pregnancy. A high prevalence of maternal vitamin D deficiency (25(OHD < 50 nmol/L was found. Pregnant women who had different BMIs before pregnancy had significantly different serum concentrations of 25(OHD. There was also a significant difference in the serum 25(OHD concentration among pregnant women of different ages. The serum 25(OHD concentration was significantly lower in pregnant women who subsequently developed severe preeclampsia compared with those who did not. Maternal vitamin D deficiency at 23–28 weeks of gestation was strongly associated with increased odds for severe preeclampsia after adjusting for relevant confounders (adjusted OR, 3.16; 95% CI, 1.77–5.65. Further studies are required to investigate whether vitamin D supplementation would reduce the risk of severe preeclampsia and improve pregnancy outcomes.

The Comparison and Interdependence of Maternal and Paternal Influences on Young Children's Behavior and Resilience

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Malmberg, Lars-Erik; Flouri, Eirini

2011-01-01

We investigated how mothers' and fathers' depressed mood and father-child and mother-child relationship predicted preschool children's problem behavior. The sample was 11,286 continuously intact, two-parent biological families of the United Kingdom's Millennium Cohort Study. We found that mother-child relationship and maternal depressed mood had…

Maternal pre-pregnancy obesity and child ADHD symptoms, executive function and cortical thickness

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Claudia Buss

2012-09-01

Full Text Available Rationale/statement of the problem : Increasing evidence suggests exposure to adverse conditions in intrauterine life may increase the risk of developing attention-deficit/hyperactivity disorder (ADHD in childhood. High maternal pre-pregnancy body mass index (BMI has been shown to predict child ADHD symptoms; however, the neurocognitive processes underlying this relationship are not known. The aim of the present study was to test the hypothesis that this association is mediated by alterations in child executive function and cortical development. Methods : A population-based cohort of 174 children (mean age = 7.3±0.9 (SD years, 55% girls was evaluated for ADHD symptoms, using the Child Behavior Checklist, and for neurocognitive function, using the Go/No-go Task. This cohort had been followed prospectively from early gestation and birth through infancy and childhood with serial measures of maternal and child prenatal and postnatal factors. In 108 children, a structural MRI scan was acquired and the association between maternal obesity and child cortical thickness was investigated using Freesurfer software. Results : Maternal pre-pregnancy BMI was a significant predictor of child ADHD symptoms (F (1,158=4.80, p = 0.03 and of child performance on the Go/No-go Task (F (1,157=8.37, p=0.004 after controlling for key potential confounding variables. A test of the mediation model revealed that the association between higher maternal pre-pregnancy BMI and child ADHD symptoms was mediated by impaired executive function (inefficient/less attentive processing; Sobel test: t=2.39 (±0.002, SEM; p=0.02. Interestingly, after controlling for key potential confounding variables pre-pregnancy obesity was furthermore associated with region-specific thinner cortices, including regions previously reported to be thinner in children with ADHD, like the prefrontal cortex. Conclusion : To the best of our knowledge, this is the first study to report the

Maternal hepatitis B infection and gestational diabetes mellitus.

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Lao, Terence T; Chan, Ben C P; Leung, Wing-Cheong; Ho, Lai-Fong; Tse, Ka-Yu

2007-07-01

This retrospective cohort study was performed to examine the relationship between maternal hepatitis B virus infection, as indicated by the surface antigen status, with the development of gestational diabetes mellitus in a normal-risk Chinese obstetric population. Maternal demographics, risk factors, and pregnancy outcome of 13,683 singleton pregnancies delivering in 1998-2001 were analysed according to maternal hepatitis B surface antigen status, which was routinely screened. Multiple logistic regression analysis was performed to examine the role of hepatitis B infection in the development of gestational diabetes mellitus. The 1138 women (8.3%) with hepatitis B infection had lower mean weight and body mass index, similar prevalence of chronic medical diseases and smokers, but increased prevalence of gestational diabetes mellitus, which remained significant (odds ratio 1.24, 95% confidence interval 1.01-1.51) after adjustment for confounding variables. However, there was no difference in pregnancy outcome. Our results confirmed the independent association between hepatitis B infection with gestational diabetes mellitus. The magnitude of chronic hepatitis B infection in the developing world and certain ethnic groups could have contributed to the high prevalence of gestational and possibly type 2 diabetes in these populations. Further studies on the long-term implications of our finding are warranted.

Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.

Science.gov (United States)

Prado, Elizabeth L; Abbeddou, Souheila; Adu-Afarwuah, Seth; Arimond, Mary; Ashorn, Per; Ashorn, Ulla; Bendabenda, Jaden; Brown, Kenneth H; Hess, Sonja Y; Kortekangas, Emma; Lartey, Anna; Maleta, Kenneth; Oaks, Brietta M; Ocansey, Eugenia; Okronipa, Harriet; Ouédraogo, Jean Bosco; Pulakka, Anna; Somé, Jérôme W; Stewart, Christine P; Stewart, Robert C; Vosti, Stephen A; Yakes Jimenez, Elizabeth; Dewey, Kathryn G

2017-11-01

Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD. We conducted path analyses of factors associated with 18-month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD. Out of 42 indicators of the 34 factors examined, 6 were associated with 18-month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts. Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child

Maternal and infant vitamin D status during the first 9 months of infant life-a cohort study

DEFF Research Database (Denmark)

Við Streym, S; Kristine Moller, U; Rejnmark, Lars

2013-01-01

/l), with increasing levels (P3.08 (2.67-3.92  pmol/l) at the last visit. Vitamin D levels were not associated with anthropometric indices of the newborn infant or their growth during follow-up. CONCLUSIONS: Vitamin D deficiency is widespread in newborn. Maternal 25OHD levels above 50  nmol......BACKGROUND/OBJECTIVES: The objective of this study was to assess vitamin D status and possible consequences of low plasma 25-hydroxyvitamin D (25OHD) levels in a population of healthy mothers and their infants.Subjects/methods:A total of 107 women aged 24-41 years gave birth to 108 infants....... They were followed up three times during 9 months. RESULTS: Cord blood 25OHD level (43.3 ± 20.4  nmol/l) on average was 62 ± 16% of maternal levels (73.3 ± 30.7  nmol/l), measured 1-2 weeks postpartum. Cord blood 25OHD correlated positively with maternal 25OHD levels (r=0.83, P

Parental investments in child health - maternal health behaviours and birth outcomes

DEFF Research Database (Denmark)

Wüst, Miriam

consumption, exercise and diet during pregnancy on birth outcomes and considers the problem of identifying the causal effect of these endogenous maternal health behaviours. The analysis controls for a wide range of covariates and exploits sibling variation in the Danish National Birth Cohort. The paper...... the ways in which child health is generated, and - for children of higher birth order - earlier children's outcomes will shape parental investments in child health....

Maternal diet quality in pregnancy and neonatal adiposity: the Healthy Start Study.

Science.gov (United States)

Shapiro, A L B; Kaar, J L; Crume, T L; Starling, A P; Siega-Riz, A M; Ringham, B M; Glueck, D H; Norris, J M; Barbour, L A; Friedman, J E; Dabelea, D

2016-07-01

Poor maternal diet in pregnancy can influence fetal growth and development. We tested the hypothesis that poor maternal diet quality during pregnancy would increase neonatal adiposity (percent fat mass (%FM)) at birth by increasing the fat mass (FM) component of neonatal body composition. Our analysis was conducted using a prebirth observational cohort of 1079 mother-offspring pairs. Pregnancy diet was assessed via repeated Automated Self-Administered 24-h dietary recalls, from which Healthy Eating Index-2010 (HEI-2010) scores were calculated for each mother. HEI-2010 was dichotomized into scores of ⩽57 and >57, with low scores representing poorer diet quality. Neonatal %FM was assessed within 72 h after birth with air displacement plethysmography. Using univariate and multivariate linear models, we analyzed the relationship between maternal diet quality and neonatal %FM, FM, and fat-free mass (FFM) while adjusting for prepregnancy body mass index (BMI), physical activity, maternal age, smoking, energy intake, preeclampsia, hypertension, infant sex and gestational age. Total HEI-2010 score ranged between 18.2 and 89.5 (mean: 54.2, s.d.: 13.6). An HEI-2010 score of ⩽57 was significantly associated with higher neonatal %FM (β=0.58, 95% confidence interval (CI) 0.07-1.1, Pdiet quality during pregnancy increases neonatal adiposity independent of maternal prepregnancy BMI and total caloric intake. This further implicates maternal diet as a potentially important exposure for fetal adiposity.

Is maternal obesity related to semen quality in the male offspring? A pilot study

DEFF Research Database (Denmark)

Ramlau-Hansen, Cecilia Høst; Nøhr, Ellen Aagaard; Thulstrup, A M

2007-01-01

BACKGROUND: Obesity is a strong predictor of fecundity and maternal obesity may well program semen quality during pregnancy, but to our knowledge, no published studies have evaluated this hypothesis. METHODS: From a Danish pregnancy cohort established in 1984-87, 347 out of 5109 sons were selected...... for a follow-up study conducted from February 2005 to January 2006. Semen and blood samples were analyzed for conventional semen characteristics and reproductive hormones and related to information on maternal pre-pregnant body mass index (BMI) that was available for 328 men. Of these, 34 were sons...... of underweight, and 25 sons of overweight, mothers. RESULTS: Inhibin B decreased with increasing maternal BMI (P = 0.04) and the point estimates for sperm concentration, semen volume, percent motile sperm, testosterone and FSH suggested an impaired reproductive status among sons of overweight mothers, but none...

Oral clefts and life style factors - a case-cohort study based on prospective Danish data

DEFF Research Database (Denmark)

Bille, Camilla; Olsen, Jørn; Vach, Werner

2007-01-01

supplementation with > or =400 mcg folic acid daily during the entire first trimester (OR: 0.75; CIs: 0.46, 1.22) suggested an inverse associated with oral clefts, similar to our results on coffee drinking. No effects were found for smaller doses of folic acid, vitamin A, B6 or B12 in this study. The present......This study examines the association between oral clefts and first trimester maternal lifestyle factors based on prospective data from the Danish National Birth Cohort. The cohort includes approximately 100,000 pregnancies. In total 192 mothers gave birth to child with an oral cleft during 1997......-2003. Information on risk factors such as smoking, alcohol consumption, tea, coffee, cola, and food supplements was obtained during pregnancy for these and 828 randomly selected controls. We found that first trimester maternal smoking was associated with an increased risk of oral clefts (odds ratio (OR): 1.50; 95...

Maternal serum laeverin (aminopeptidase Q) measured in the first trimester of pregnancy does not predict preeclampsia

DEFF Research Database (Denmark)

Pihl, Kasper; Sørensen, Steen; Nystad, Mona

2018-01-01

OBJECTIVE: The aim of this study was to compare the laeverin level in maternal serum from first trimester (11-14 weeks) of pregnancy between normal pregnancies and pregnancies that later developed preeclampsia (PE). MATERIAL AND METHODS: This was a case-cohort study. The laeverin concentration wa...

Prenatal influences on size, velocity and tempo of infant growth: findings from three contemporary cohorts.

Directory of Open Access Journals (Sweden)

Costanza Pizzi

Full Text Available Studying prenatal influences of early life growth is relevant to life-course epidemiology as some of its features have been linked to the onset of later diseases.We studied the association between prenatal maternal characteristics (height, age, parity, education, pre-pregnancy body mass index (BMI, smoking, gestational diabetes and hypertension and offspring weight trajectories in infancy using SuperImposition by Translation And Rotation (SITAR models, which parameterize growth in terms of three biologically interpretable parameters: size, velocity and tempo. We used data from three contemporary cohorts based in Portugal (GXXI, n=738, Italy (NINFEA, n=2,925, and Chile (GOCS, n=959.Estimates were generally consistent across the cohorts for maternal height, age, parity and pre-pregnancy overweight/obesity. Some exposures only affected one growth parameter (e.g. maternal height (per cm: 0.4% increase in size (95% confidence interval (CI:0.3; 0.5, others were either found to affect size and velocity (e.g. pre-pregnancy underweight vs normal weight: smaller size (-4.9%, 95% CI:-6.5; -3.3, greater velocity (5.9%, 95% CI:1.9;10.0, or to additionally influence tempo (e.g. pre-pregnancy overweight/obesity vs normal weight: increased size (7.9%, 95% CI:4.9;10.8, delayed tempo (0.26 months, 95% CI:0.11;0.41, decreased velocity (-4.9%, 95% CI: -10.8;0.9.By disentangling the growth parameters of size, velocity and tempo, we found that prenatal maternal characteristics, especially maternal smoking, pre-pregnancy overweight and underweight, parity and gestational hypertension, are associated with different aspects of infant weight growth. These results may offer insights into the mechanisms governing infant growth.

Offspring preterm birth and birth size are related to long-term risk of maternal diabetes

DEFF Research Database (Denmark)

Naver, Klara Vinsand; Secher, Niels Jørgen; Ovesen, Per Glud

2013-01-01

The aim of the study is to investigate the association between gestational age, birth size, and the long-term risk of maternal diabetes. We conducted a nation-wide prospective follow-up study of the cohort of all Danish women with a singleton delivery in 1982/1983 (index delivery) and no history...

Maternal age during pregnancy is associated with third trimester blood pressure level: the generation R study.

Science.gov (United States)

Gaillard, Romy; Bakker, Rachel; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V

2011-09-01

We hypothesized that hemodynamic adaptations related to pregnancy and ageing might be associated with differences in blood pressure levels during pregnancy between younger and older women. This might partly explain the increased risk of gestational hypertensive disorders with advanced maternal age. We examined the associations of maternal age with systolic and diastolic blood pressure in each trimester of pregnancy and the risks of gestational hypertensive disorders. The study was conducted among 8,623 women participating in a population-based prospective cohort study from early pregnancy onwards. Age was assessed at enrolment. Blood pressure was measured in each trimester. Information about gestational hypertensive disorders was available from medical records. In second and third trimester, older maternal age was associated with lower systolic blood pressure (-0.9 mm Hg (95% confidence interval: -1.4, -0.3) and -0.6 mm Hg (95% confidence interval: -1.1, -0.02) per additional 10 maternal years, respectively). Older maternal age was associated with higher third trimester diastolic blood pressure (0.5 mm Hg (95% confidence interval: 0.04, 0.9) per additional 10 maternal years). Maternal age was associated with pregnancy-induced hypertension among overweight and obese women. Older maternal age is associated with lower second and third trimester systolic blood pressure, but higher third trimester diastolic blood pressure. These blood pressure differences seem to be small and within the physiological range. Maternal age is not consistently associated with the risks of gestational hypertensive disorders. Maternal body mass index might influence the association between maternal age and the risk of pregnancy-induced hypertension.

Maternal serum lead level during pregnancy is positively correlated with risk of preterm birth in a Chinese population

International Nuclear Information System (INIS)

Li, Jun; Wang, Hua; Hao, Jia-Hu; Chen, Yuan-Hua; Liu, Lu; Yu, Zhen; Fu, Lin; Tao, Fang-Biao; Xu, De-Xiang

2017-01-01

Lead (Pb) is a well-known developmental toxicant. The aim of the present study was to analyze the association between maternal serum Pb level and risk of preterm birth in a population-based birth cohort study. The present study analyzed a sub-study of the China-Anhui Birth Cohort that recruited 3125 eligible mother-and-singleton-offspring pairs. Maternal serum Pb level was measured by graphite furnace atomic absorption spectrometry. All subjects were classified into three groups by tertile division according to serum Pb level: Low-Pb (L-Pb, <1.18 μg/dl), Medium-Pb (M-Pb, 1.18–1.70 μg/dl), and High-Pb (H-Pb, ≥1.71 μg/dl). The rate of preterm birth was 2.8% among subjects with L-Pb, 6.1% among subjects with M-Pb, and 8.1% among subjects with H-Pb, respectively. After controlling confounding factors, the adjusted OR for preterm birth was 2.33 (95%CI: 1.49, 3.65) among subjects with M-Pb and 3.09 (95%CI: 2.01, 4.76) among subjects with H-Pb. Of interest, maternal Pb exposure in early gestational stage than in middle gestational stage was more susceptible to preterm birth. Moreover, maternal serum Pb level was only associated with increased risk of late preterm birth. The present study provides evidence that maternal serum Pb level during pregnancy is positively associated with risk of preterm birth in a Chinese population. - Highlights: • Environmental Pb exposure during pregnancy elevates risk of preterm birth. • Environmental Pb exposure during pregnancy elevates risk of moderate and late preterm birth. • Environmental Pb exposure at early or middle gestational stage elevates risk of preterm birth. - Maternal serum Pb level during pregnancy is positively associated with risk of preterm birth in a Chinese population.

Impact of Maternal Body Mass Index on Intrapartum and Neonatal Outcomes in Brisbane, Australia, 2007 to 2013.

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Foo, Xin Y; Greer, Ristan M; Kumar, Sailesh

2016-12-01

The aim of this study was to evaluate the influence of maternal body mass index on intrapartum and neonatal outcomes at one of the largest maternity hospitals in Australia. A retrospective cross-sectional study of 55,352 term singleton deliveries at the Mater Mothers' Hospital in Brisbane, Australia, was conducted. The study cohort was stratified into six groups based on the World Health Organization's body mass index classification. The normal body mass index category was the reference group for all comparisons. Multivariate logistic regression was used to examine the effect of maternal body mass index, adjusted for maternal age, ethnicity, parity, and preexisting conditions (e.g., diabetes mellitus and hypertension), on selected intrapartum and neonatal outcomes. Women in the overweight and Obese I, II, and III categories were more likely to have chronic or gestational hypertension/preeclampsia, and preexisting or gestational diabetes mellitus. They also had an increased risk for induction of labor, elective and emergency cesarean, and postpartum hemorrhage. Underweight women were less likely to require induction of labor and emergency cesarean. Infants born to women with increased body mass index were more likely to require neonatal resuscitation, neonatal intensive care unit admission, and have lower Apgar scores at 5 minutes. There is an increased risk of adverse intrapartum and neonatal outcomes for women who are overweight and obese, with the risks increasing with rising body mass index. Appropriately targeted weight management strategies and health education may yield improved maternal and perinatal outcomes if effectively implemented before pregnancy. These may particularly be of benefit in the teenage cohort that has yet to embark on pregnancy. © 2016 Wiley Periodicals, Inc.

Effects of maternal characteristics and climatic variation on birth masses of Alaskan caribou

Science.gov (United States)

Adams, Layne G.

2005-01-01

Understanding factors that influence birth mass of mammals provides insights to nutritional trade-offs made by females to optimize their reproduction, growth, and survival. I evaluated variation in birth mass of caribou (Rangifer tarandus) in central Alaska relative to maternal characteristics (age, body mass, cohort, and nutritional condition as influenced by winter severity) during 11 years with substantial variation in winter snowfall. Snowfall during gestation was the predominant factor explaining variation in birth masses, influencing birth mass inversely and through interactions with maternal age and lactation status. Maternal age effects were noted for females ≤ 5 years old, declining in magnitude with each successive age class. Birth mass as a proportion of autumn maternal mass was inversely related to winter snowfall, even though there was no decrease in masses of adult females in late winter associated with severe winters. I found no evidence of a hypothesized intergenerational effect of lower birth masses for offspring of females born after severe winters. Caribou produce relatively small offspring but provide exceptional lactation support for those that survive. Conservative maternal investment before parturition may represent an optimal reproductive strategy given that caribou experience stochastic variation in winter severity during gestation, uncertainty of environmental conditions surrounding the birth season, and intense predation on neonates.

Maternal life course socio-economic position and offspring body composition at birth in a multi-ethnic population.

Science.gov (United States)

Sletner, Line; Jenum, Anne Karen; Mørkrid, Kjersti; Vangen, Siri; Holme, Ingar M; Birkeland, Kåre I; Nakstad, Britt

2014-09-01

Size and body composition at birth may affect long-term health. Mean birthweight and body composition differ between ethnic groups living in Europe. We wanted to explore if this relates to differences in socio-economic conditions in country of origin and over the maternal life course. This is a population-based cohort study of healthy pregnant women living in Oslo, Norway. Data on maternal early life and present socio-economic position (SEP) were collected in early gestation, and SEP scores were extracted through two separate principal components analyses. The associations between maternal present SEP and four different offspring anthropometric measures at birth were assessed separately, stratified by maternal early life SEP (dichotomised score) and Human Development Index (HDI, a country-level socio-economic indicator) in the country of origin [high HDI (Reference), n = 287 and low HDI, n = 250]. A strong positive association between maternal present SEP and offspring birthweight was observed if maternal early life SEP was high, but not if maternal early life SEP was low (P countries had smaller abdominal circumference, possibly indicating less fat-free mass, regardless of maternal life course SEP. Our results suggest that there are transgenerational effects of maternal past socio-economic conditions on offspring size and body composition at birth that modify the associations with present socio-economic factors. © 2014 John Wiley & Sons Ltd.

Maternal or neonatal infection: association with neonatal encephalopathy outcomes.

Science.gov (United States)

Jenster, Meike; Bonifacio, Sonia L; Ruel, Theodore; Rogers, Elizabeth E; Tam, Emily W; Partridge, John Colin; Barkovich, Anthony James; Ferriero, Donna M; Glass, Hannah C

2014-07-01

Perinatal infection may potentiate brain injury among children born preterm. The objective of this study was to examine whether maternal and/or neonatal infection are associated with adverse outcomes among term neonates with encephalopathy. This study is a cohort study of 258 term newborns with encephalopathy whose clinical records were examined for signs of maternal infection (chorioamnionitis) and infant infection (sepsis). Multivariate regression was used to assess associations between infection, pattern, and severity of injury on neonatal magnetic resonance imaging, as well as neurodevelopment at 30 mo (neuromotor examination, or Bayley Scales of Infant Development, second edition mental development index encephalopathy, chorioamnionitis was associated with a lower risk of brain injury and adverse outcomes, whereas signs of neonatal sepsis carried an elevated risk. The etiology of encephalopathy and timing of infection and its associated inflammatory response may influence whether infection potentiates or mitigates injury in term newborns.

Severe acute maternal morbidity and maternal death audit - a rapid ...

African Journals Online (AJOL)

Severe acute maternal morbidity and maternal death audit - a rapid diagnostic tool for evaluating maternal care. L Cochet, R.C. Pattinson, A.P. Macdonald. Abstract. Objective. To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000 - 2001). Setting.

Transfer of perfluoroalkyl substances from mother to fetus in a Spanish birth cohort.

Science.gov (United States)

Manzano-Salgado, Cyntia B; Casas, Maribel; Lopez-Espinosa, Maria-Jose; Ballester, Ferran; Basterrechea, Mikel; Grimalt, Joan O; Jiménez, Ana-María; Kraus, Thomas; Schettgen, Thomas; Sunyer, Jordi; Vrijheid, Martine

2015-10-01

Prenatal exposure to perfluoroalkyl substances (PFAS) might affect child health; thus estimating PFAS fetal burden is relevant. PFAS fetal burden is best estimated in cord samples; previous studies have used either maternal plasma or serum during pregnancy as proxy, but their validity is not clear. We aimed to evaluate PFAS transfer between mother and fetus and determine its predictors in a Spanish birth cohort. We measured perfluorobutane sulfonate (PFBS), perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorononanoate (PFNA) in maternal blood and cord serum from 66 mother-child pairs. We used Spearman's rank coefficients to correlate PFAS concentrations in first trimester maternal plasma and serum, with cord serum samples. We assessed PFAS placental transfer by calculating maternal to cord ratios and examined their association with maternal socio-demographic characteristics and child sex using linear regression models. Median concentrations of PFAS (ng/mL) of PFHxS, PFOS, PFOA, and PFNA in maternal plasma (0.79, 6.18, 2.85 and 0.84, respectively) and serum (0.84, 6.99, 2.97 and 0.85) were higher than in cord serum (0.40, 1.86, 1.90 and 0.32). PFBS was not detected. Positive Spearman's correlations (p-valuesPFAS fetal body burden can be assessed using as proxy maternal plasma or serum collected early in pregnancy. Maternal age might influence PFAS placental transfer. Copyright © 2015 Elsevier Inc. All rights reserved.

Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan

Directory of Open Access Journals (Sweden)

Elbashir Hagir M

2010-07-01

Full Text Available Abstract Aim To investigate maternal and perinatal outcomes (maternal death, preterm delivery, low birth weight and perinatal mortality of dengue at PortSudan and Elmawani hospitals in the eastern Sudan. Method This was a retrospective Cohort study where medical files of women with dengue were reviewed. Results There were 10820 deliveries and 78 (0.7% pregnant women with confirmed dengue IgM serology at the mean (SD gestational age of 29.4(8.2 weeks. While the majority of these women had dengue fever (46, 58.9%, hemorrhagic fever and dengue shock syndrome were the presentations in 18 (23.0% and 12, (15.3% of these women, respectively. There were 17(21.7% maternal deaths. Fourteen (17.9% of these 78 women had preterm deliveries and 19 (24.3% neonates were admitted to neonatal intensive care unit. Nineteen (24.3% women gave birth to low birth weight babies. There were seven (8.9% perinatal deaths. Eight (10.2% patients delivered by caesarean section due to various obstetrical indications. Conclusion Thus dengue has poor maternal and perinatal outcomes in this setting. Preventive measures against dengue should be employed in the region, and more research on dengue during pregnancy is needed.

External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study.

Science.gov (United States)

Lamain-de Ruiter, Marije; Kwee, Anneke; Naaktgeboren, Christiana A; de Groot, Inge; Evers, Inge M; Groenendaal, Floris; Hering, Yolanda R; Huisjes, Anjoke J M; Kirpestein, Cornel; Monincx, Wilma M; Siljee, Jacqueline E; Van 't Zelfde, Annewil; van Oirschot, Charlotte M; Vankan-Buitelaar, Simone A; Vonk, Mariska A A W; Wiegers, Therese A; Zwart, Joost J; Franx, Arie; Moons, Karel G M; Koster, Maria P H

2016-08-30

 To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.  External validation of all published prognostic models in large scale, prospective, multicentre cohort study.  31 independent midwifery practices and six hospitals in the Netherlands.  Women recruited in their first trimester (diabetes mellitus of any type were excluded.  Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots.  3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.  In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Hyperemesis gravidarum and pregnancy outcomes in the Norwegian Mother and Child Cohort - a cohort study.

Science.gov (United States)

Vikanes, Åse V; Støer, Nathalie C; Magnus, Per; Grjibovski, Andrej M

2013-09-03

Hyperemesis gravidarum (HG) characterized by excessive nausea and vomiting in early pregnancy, is reported to be associated with increased risks for low birthweight (LBW), preterm birth (PTB), small-for-gestational-age (SGA) and perinatal death. Conflicting results in previous studies underline the necessity to study HG's potential effect on pregnancy outcomes using large cohorts with valid data on exposure and outcome measures, as well as potential confounders. This study aims to investigate associations between HG and adverse pregnancy outcomes using the Norwegian Mother and Child Cohort Study (MoBa). All singleton pregnancies in MoBa from 1998 to 2008 were included. Multivariable regression was used to estimate relative risks, approximated by odds ratios, for PTB, LBW, SGA and perinatal death. Linear regression was applied to assess differences in birthweight and gestational age for children born to women with and without HG. Potential confounders were adjusted for. Altogether, 814 out of 71,468 women (or 1.1%) had HG. In MoBa HG was not associated with PTB, LBW or SGA. Babies born to women with HG were born on average 1 day earlier than those born to women without HG; (-0.97 day (95% confidence intervals (CI): -1.80 - -0.15). There was no difference in birthweight when maternal weight gain was adjusted for; (23.42 grams (95% CI: -56.71 - 9.86). Babies born by women with HG had lower risk for having Apgar score < 7 after 1 minute (crude odds ratio was 0.64 (95% CI: 0.43 - 0.95)). No differences between the groups for Apgar score < 7 after 5 minutes were observed. Time-point for hospitalisation slightly increased differences in gestational age according to maternal HG status. HG was not associated with adverse pregnancy outcomes. Pregnancies complicated with HG had a slightly shorter gestational length. There was no difference in birth weight according to maternal HG-status. HG was associated with an almost 40% reduced risk for having Apgar score�

Associations Between the KIAA0319 Dyslexia Susceptibility Gene Variants, Antenatal Maternal Stress, and Reading Ability in a Longitudinal Birth Cohort.

Science.gov (United States)

D'Souza, Stephanie; Backhouse-Smith, Amelia; Thompson, John M D; Slykerman, Rebecca; Marlow, Gareth; Wall, Clare; Murphy, Rinki; Ferguson, Lynnette R; Mitchell, Edwin A; Waldie, Karen E

2016-11-01

Maternal stress during pregnancy has been associated with detrimental cognitive developmental outcomes in offspring. This study investigated whether antenatal maternal perceived stress and variants of the rs12193738 and rs2179515 polymorphisms on the KIAA0319 gene interact to affect reading ability and full-scale IQ (FSIQ) in members of the longitudinal Auckland Birthweight Collaborative study. Antenatal maternal stress was measured at birth, and reading ability was assessed at ages 7 and 16. Reading data were available for 500 participants at age 7 and 479 participants at age 16. FSIQ was measured at ages 7 and 11. At age 11, DNA samples were collected. Analyses of covariance revealed that individuals with the TT genotype of the rs12193738 polymorphism exposed to high maternal stress during pregnancy possessed significantly poorer reading ability (as measured by Woodcock-Johnson Word Identification standard scores) during adolescence compared with TT carriers exposed to low maternal stress. TT carriers of the rs12193738 SNP also obtained lower IQ scores at age 7 than C allele carriers. These findings suggest that the KIAA0319 gene is associated with both reading ability and general cognition, but in different ways. The effect on IQ appears to occur earlier in development and is transient, whereas the effect of reading ability occurs later and is moderated by antenatal maternal stress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Prenatal exposure to escitalopram and/or stress in rats: a prenatal stress model of maternal depression and its treatment

Science.gov (United States)

Bourke, Chase H.; Capello, Catherine F.; Rogers, Swati M.; Yu, Megan L.; Boss-Williams, Katherine A.; Weiss, Jay M.; Stowe, Zachary N.; Owens, Michael J.

2014-01-01

Rationale A rigorously investigated model of stress and antidepressant administration during pregnancy is needed to evaluate possible effects on the mother. Objective The objective of this study was to develop a model of clinically relevant prenatal exposure to an antidepressant and stress during pregnancy to evaluate the effects on maternal care behavior. Results Female rats implanted with 28 day osmotic minipumps delivering the SSRI escitalopram throughout pregnancy had serum escitalopram concentrations in a clinically observed range (17-65 ng/mL). A separate cohort of pregnant females exposed to a chronic unpredictable mild stress paradigm on gestational days 10-20 showed elevated baseline (305 ng/mL), and acute stress-induced (463 ng/mL), plasma corticosterone concentrations compared to unstressed controls (109 ng/mL). A final cohort of pregnant dams were exposed to saline (control), escitalopram, stress, or stress and escitalopram to determine the effects on maternal care. Maternal behavior was continuously monitored over the first 10 days post parturition. A reduction of 35% in maternal contact and 11% in nursing behavior was observed due to stress during the light cycle. Licking and grooming behavior was unaffected by stress or drug exposure in either the light or dark cycle. Conclusions These data indicate that: 1) clinically relevant antidepressant treatment during human pregnancy can be modeled in rats using escitalopram; 2) chronic mild stress can be delivered in a manner that does not compromise fetal viability; and 3) neither of these prenatal treatments substantially altered maternal care post parturition. PMID:23436130

Infant mortality in Pelotas, Brazil: a comparison of risk factors in two birth cohorts.

Science.gov (United States)

Menezes, Ana Maria Baptista; Hallal, Pedro Curi; Santos, Iná Silva dos; Victora, Cesar Gomes; Barros, Fernando Celso

2005-12-01

To compare two population-based birth cohorts to assess trends in infant mortality rates and the distribution of relevant risk factors, and how these changed after an 11-year period. Data from two population-based prospective birth cohorts (1982 and 1993) were analyzed. Both studies included all children born in a hospital (> 99% of all births) in the city of Pelotas, Southern Brazil. Infant mortality was monitored through surveillance of all maternity hospitals, mortality registries and cemeteries. There were 5,914 live-born children in 1982 and 5,249 in 1993. The infant mortality rate decreased by 41%, from 36.0 per 1,000 live births in 1982 to 21.1 per 1,000 in 1993. Socioeconomic and maternal factors tended to become more favorable during the study period, but there were unfavorable changes in birthweight and gestational age. Poverty, high parity, low birthweight, preterm delivery, and intrauterine growth restriction were the main risk factors for infant mortality in both cohorts. The 41% reduction in infant mortality between 1982 and 1993 would have been even greater had the prevalence of risk factors remained constant during the period studied here. There were impressive declines in infant mortality which were not due to changes in the risk factors we studied. Because no reduction was seen in the large social inequalities documented in the 1982 cohort, it is likely that the reduction in infant mortality resulted largely from improvements in health care.

An inventory of Canadian pregnancy and birth cohort studies: research in progress

Directory of Open Access Journals (Sweden)

Joly Marie-Pier

2012-10-01

Full Text Available Abstract Background A web-based inventory was developed as a voluntary registry of Canadian pregnancy and birth cohort studies, with the objective to foster collaboration and sharing of research tools among cohort study groups as a means to enrich research in maternal and child health across Canada. Description Information on existing birth cohort studies conducted in Canada exclusively or as part of broader international initiatives was accessed by searching the literature in PubMed and PsychInfo databases. Additional studies were identified by enquiring about the research activities of researchers at Canadian universities or working in affiliated hospitals or research centres or institutes. Of the fifty-eight birth cohort studies initially identified, forty-six were incorporated into the inventory if they were of a retrospective and/or prospective longitudinal design and with a minimum of two phases of data collection, with the first period having occurred before, during, or shortly after pregnancy and had an initial study sample size of a minimum of 200 participants. Information collected from each study was organized into four main categories: basic information, data source and period of collection, exposures, and outcome measures and was coded and entered into an Excel spreadsheet. The information incorporated into the Excel spreadsheet was double checked, completed when necessary, and verified for completeness and accuracy by contacting the principal investigator or research coordinator. All data collected were then uploaded onto the website of the Institute of Human Development Child and Youth Health of the Canadian Institutes of Health Research. Subsequently, the database was updated and developed as an online searchable inventory on the website of the Maternal, Infant, Child and Youth Research Network. Conclusions This inventory is unique, as it represents detailed information assembled for the first time on a large number of Canadian

Maternal vitamin D deficiency increases the risk of adverse neonatal outcomes in the Chinese population: A prospective cohort study.

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Yuanliu Wang

Full Text Available Although vitamin D (vitD deficiency is a common problem in pregnant women, in China, few studies have focused on the relationship between maternal vitD deficiency throughout the three trimesters and subsequent neonatal outcomes in China.Between 2015 and 2016, maternal serum and neonate cord blood samples were collected from 1978 mother-neonate pairs from Liuzhou city.The mean concentrations of 25-hydroxy vitD (25(OHD were 16.17±6.27 and 15.23±5.43 ng/ml in the mother and neonate groups, respectively, and the prevalence values of vitD deficiency in the two groups were 78.18% and 83.27%, respectively. Logistic regression showed that maternal vitD deficiency independently increased the risk of gestational diabetes mellitus (GDM (adjust OR, aOR 1.08; P = 0.026. A relatively lower risk of vitD deficiency was observed in the third trimester than in the first and second trimester (aOR 0.80; P = 0.004. VitD-calcium cosupplementation during pregnancy improves the vitD deficiency in both the maternal and neonatal groups (aOR 0.56, 0.66; P<0.001 and 0.021, respectively. Maternal vitD deficiency significantly increased the risk of neonatal low birth weight (LBW (aOR 2.83; P = 0.005 and small-for-gestational-age (SGA (aOR 1.17; P = 0.015. There was a positive correlation between maternal and neonatal vitD deficiency (r = 0.879, P<0.001. VitD supplementation during pregnancy significantly reduced the risk of giving birth to LBW infants (OR = 0.47, 95%CI = 0.33-0.68, P<0.001.Further research focusing on the consumption of vitD with calcium during pregnancy and the consequential clinical outcomes in Chinese pregnant women is warranted.

Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis. A nationwide cohort study

DEFF Research Database (Denmark)

Rom, Ane L; Wu, Chunsen; Olsen, Jørn

2014-01-01

OBJECTIVE: To assess indicators of fetal growth and risk of preterm birth in children of parents with rheumatoid arthritis (RA). METHODS: Through linkage of Danish national registries, we identified all children born in Denmark between 1977 and 2008. We used general linear regression models...... to estimate mean differences in indicators of fetal growth among children with a parent with RA compared to unexposed children. Odds ratios (ORs) and 95% confidence intervals (95% CIs) of preterm birth were calculated using a logistic regression model. RESULTS: Of the 1,917,723 children included, a total...... of 13,556 children were exposed to maternal RA or maternal preclinical RA. Children exposed to maternal RA (n = 2,101) had approximately similar length, head circumference, and abdominal circumference at birth compared with children of mothers without RA. Birth weight was 87 gm lower (mean difference...

Type of Labour in the First Pregnancy and Cumulative Maternal Morbidity.

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Allen, Victoria M; Baskett, Thomas F; O'Connell, Colleen M

2015-08-01

To estimate cumulative maternal morbidity among women who delivered at term in their first pregnancy on the basis of type of labour in the first pregnancy. Using a 25-year population-based cohort (1988 to 2012) derived from the Nova Scotia Atlee Perinatal Database, we determined the type of labour in successive pregnancies in low-risk, nulliparous women at term in their first pregnancy (who had at least one subsequent pregnancy), and the maternal outcomes in subsequent deliveries based on the type of labour in the first pregnancy. A total of 36 871 pregnancies satisfied inclusion and exclusion criteria, 1346 of which were delivered by Caesarean section without labour in the first pregnancy. Rates of most adverse maternal outcomes were low (≤1%). The type of labour in the first pregnancy influenced the subsequent risk of postpartum hemorrhage and blood transfusion, and the risks increased with successive deliveries when labours were spontaneous in onset or were induced. The risks for abnormal placentation were low with subsequent deliveries, including following CS without labour in the first pregnancy, and risks for overall severe maternal morbidity were less than 10% for all subsequent deliveries. The absolute risks for severe maternal morbidity outcomes in a population of women without a high number of subsequent pregnancies were small (regardless of type of labour in the first pregnancy); this provides important information for women, families, and caregivers when considering pregnancy outcomes related to type of labour.

Fewer self-reported depressive symptoms in young adults exposed to maternal depressed mood during pregnancy.

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Zohsel, Katrin; Holz, Nathalie E; Hohm, Erika; Schmidt, Martin H; Esser, Günter; Brandeis, Daniel; Banaschewski, Tobias; Laucht, Manfred

2017-02-01

Depressed mood is prevalent during pregnancy, with accumulating evidence suggesting an impact on developmental outcome in the offspring. However, the long-term effects of prenatal maternal depression regarding internalizing psychopathology in the offspring are as yet unclear. As part of an ongoing epidemiological cohort study, prenatal maternal depressed mood was assessed at the child's age of 3 months. In a sample of n=307 offspring, depressive symptoms were obtained via questionnaire at the ages of 19, 22, 23 and 25 years. At age 25 years, diagnoses of depressive disorder were obtained using a diagnostic interview. In a subsample of currently healthy participants, voxel-based morphometry was conducted and amygdala volume was assessed. In n=85 young adults exposed to prenatal maternal depressed mood, no significantly higher risk for a diagnosis of depressive disorder was observed. However, they reported significantly lower levels of depressive symptoms. This association was especially pronounced when prenatal maternal depressed mood was present during the first trimester of pregnancy and when maternal mood was depressed pre- as well as postnatally. At an uncorrected level only, prenatal maternal depressed mood was associated with decreased amygdala volume. Prenatal maternal depressed mood was not assessed during pregnancy, but shortly after childbirth. No diagnoses of maternal clinical depression during pregnancy were available. Self-reported depressive symptoms do not imply increased, but rather decreased symptom levels in young adults who were exposed to prenatal maternal depressed mood. A long-term perspective may be important when considering consequences of prenatal risk factors. Copyright © 2016. Published by Elsevier B.V.

Postnatal Growth Patterns in a Chilean Cohort: The Role of SES and Family Environment

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Kang Sim, D. E.; Cappiello, M.; Castillo, M.; Lozoff, B.; Martinez, S.; Blanco, E.; Gahagan, S.

2012-01-01

Objective. This study examined how family environmental characteristics served as mediators in the relationship between socioeconomic conditions and infant growth in a cohort of Chilean infants. Methods. We studied 999 infants, born between 1991 and 1996, from a longitudinal cohort which began as an iron deficiency anemia preventive trial. SES (Graffar Index), the Life Experiences Survey, and the Home Observation for Measurement of the Environment (HOME) were assessed in infancy. Using path analysis, we assessed the relationships between the social factors, home environment, and infant growth. Results. During the first year, weight and length gain averaged 540 grams/month and 6.5 cm/month, respectively. In the path analysis model for weight gain, higher SES and a better physical environment were positively related to higher maternal warmth, which in turn was associated with higher average weight gain. Higher SES was directly related to higher average length gain. Conclusions. In our cohort, a direct relationship between SES and length gain developed during infancy. Higher SES was indirectly related to infant weight gain through the home environment and maternal warmth. As the fastest growing infants are at risk for later obesity, new strategies are needed to encourage optimal rather than maximal growth. PMID:22666275

Postnatal Growth Patterns in a Chilean Cohort: The Role of SES and Family Environment

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D. E. Kang Sim

2012-01-01

Full Text Available Objective. This study examined how family environmental characteristics served as mediators in the relationship between socioeconomic conditions and infant growth in a cohort of Chilean infants. Methods. We studied 999 infants, born between 1991 and 1996, from a longitudinal cohort which began as an iron deficiency anemia preventive trial. SES (Graffar Index, the Life Experiences Survey, and the Home Observation for Measurement of the Environment (HOME were assessed in infancy. Using path analysis, we assessed the relationships between the social factors, home environment, and infant growth. Results. During the first year, weight and length gain averaged 540 grams/month and 6.5 cm/month, respectively. In the path analysis model for weight gain, higher SES and a better physical environment were positively related to higher maternal warmth, which in turn was associated with higher average weight gain. Higher SES was directly related to higher average length gain. Conclusions. In our cohort, a direct relationship between SES and length gain developed during infancy. Higher SES was indirectly related to infant weight gain through the home environment and maternal warmth. As the fastest growing infants are at risk for later obesity, new strategies are needed to encourage optimal rather than maximal growth.

Obstacles in the Utilisation of Maternal Health Care Services in Murarai-II C.D. Block, Birbhum District, West Bengal, India

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Alokananda Ghosh; Dr.Biswaranjan Mistri

2017-01-01

Improving maternal health was one of the eight Millennium Development Goals (MDGs) and now it is one of the targets of 17 point Sustainable Development Goals (SDGs). The utilisation of Maternal Health Care Services (MHCSs) is a complex phenomenon and it is influenced by several factors, like-health care seeking behaviour of the cohorts belonging to different socio-economic and cultural background, distance of the facility centres, type and conditions of the roads including undulating surface,...

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

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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

Disruption to the development of maternal responsiveness? The impact of prenatal depression on mother-infant interactions.

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Pearson, R M; Melotti, R; Heron, J; Joinson, C; Stein, A; Ramchandani, P G; Evans, J

2012-12-01

Both prenatal and postnatal maternal depression are independently associated with an increased risk of adverse infant development. The impact of postnatal depression on infants may be mediated through the effect of depression in reducing maternal responsiveness. However, the mechanisms underlying the effect of prenatal depression are unclear. Using longitudinal data from over 900 mother-infant pairs in a UK birth cohort (ALSPAC), we found that women with high depressive symptom scores during mid pregnancy, but NOT when their infants were 8 months, had a 30% increased risk of low maternal responsiveness when the infant was 12 months compared to women with consistently low depression. This may provide a mechanism to explain the independent association between prenatal depression and poorer infant development. Copyright © 2012 Elsevier Inc. All rights reserved.

The early infant gut microbiome varies in association with a maternal high-fat diet.

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Chu, Derrick M; Antony, Kathleen M; Ma, Jun; Prince, Amanda L; Showalter, Lori; Moller, Michelle; Aagaard, Kjersti M

2016-08-09

Emerging evidence suggests that the in utero environment is not sterile as once presumed. Work in the mouse demonstrated transmission of commensal bacteria from mother to fetus during gestation, though it is unclear what modulates this process. We have previously shown in the nonhuman primate that, independent of obesity, a maternal high-fat diet during gestation and lactation persistently shapes the juvenile gut microbiome. We therefore sought to interrogate in a population-based human longitudinal cohort whether a maternal high-fat diet similarly alters the neonatal and infant gut microbiome in early life. A representative cohort was prospectively enrolled either in the early third trimester or intrapartum (n = 163), with a subset consented to longitudinal sampling through the postpartum interval (n = 81). Multiple body site samples, including stool and meconium, were collected from neonates at delivery and by 6 weeks of age. A rapid dietary questionnaire was administered to estimate intake of fat, added sugars, and fiber over the past month (National Health and Examination Survey). DNA was extracted from each infant meconium/stool sample (MoBio) and subjected to 16S rRNA gene sequencing and analysis. On average, the maternal dietary intake of fat ranged from 14.0 to 55.2 %, with an average intake of 33.1 % (σ = 6.1 %). Mothers whose diets significantly differed from the mean (±1 standard deviation) were separated into two distinct groups, a control group (n = 13, μ = 24.4 %) and a high-fat group (n = 13, μ = 43.1 %). Principal coordinate analysis revealed that the microbiome of the neonatal stool at birth (meconium) clustered differently by virtue of maternal gestational diet (PERMANOVA p = 0.001). LEfSe feature selection identified several taxa that discriminated the groups, with a notable relative depletion of Bacteroides in the neonates exposed to a maternal high-fat gestational diet (Student's t-test, p < 0

A nationwide study on the risk of autism after prenatal stress exposure to maternal bereavement

DEFF Research Database (Denmark)

Li, Jiong; Vestergaard, Mogens; Obel, Carsten

2009-01-01

OBJECTIVE: Prenatal stress has been linked to several adverse neurobehavioral outcomes, which may share a common pathophysiology with autism. We aimed to examine whether prenatal stress exposure after maternal bereavement is associated with an increased risk of autism later in life. METHODS: We...... compared with those in the unexposed group. RESULTS: Maternal bereavement during the prenatal period was not associated with an increased risk of autism in the offspring. The hazard ratios did not differ by the nature of the exposure (maternal relationship to the deceased or cause of death). The hazard...... ratios were comparable between the 5 prenatal exposure periods under study (7-12 months before pregnancy, 0-6 months before pregnancy, first trimester, second trimester, and third trimester). CONCLUSIONS: This is the first population-based cohort study to examine the effect of prenatal stress on autism...

Familial confounding of the association between maternal smoking during pregnancy and internalizing disorders in offspring

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Meier, S M; Plessen, K J; Verhulst, F

2017-01-01

Background Maternal smoking has consistently been associated with multiple adverse childhood outcomes including externalizing disorders. In contrast the association between maternal smoking during pregnancy (MSDP) and internalizing (anxiety and depressive) disorders in offspring has received less...... investigation. Method We conducted a nationwide cohort study including 957635 individuals born in Denmark between 1991 and 2007. Data on MSDP and diagnoses of depression or anxiety disorders were derived from national registers and patients were followed up from the age of 5 years to the end of 2012. Hazard...... severe depression [HRR 1.29, 95% confidence interval (CI) 1.22-1.36] and severe anxiety disorders (HRR 1.26, 95% CI 1.20-1.32) even when controlling for maternal and paternal traits. However, there was no association between MSDP and internalizing disorders when controlling for the mother's propensity...

Maternal reproductive history and the risk of isolated congenital malformations.

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Materna-Kiryluk, A; Więckowska, B; Wiśniewska, K; Borszewska-Kornacka, M K; Godula-Stuglik, U; Limon, J; Rusin, J; Sawulicka-Oleszczuk, H; Szwałkiewicz-Warowicka, E; Walczak, M

2011-03-01

We examined the relationship between maternal reproductive history and the newborn's risk of isolated congenital malformations in a large case-control cohort from the Polish Registry of Congenital Malformations. Congenital malformations were classified into four categories: isolated congenital heart defects (n=1673), isolated cleft palate (n=255), cleft lip with or without cleft palate (n=448) and renal agenesis (n=103). The case groups were compared with a shared group of 2068 controls recruited in the same time period and geographic area. Multivariable logistic regression was used to assess the risk associated with maternal gravidity and of previous miscarriages after accounting for maternal age and other potential risk factors. In unadjusted analyses, maternal gravidity was significantly associated with increased risk of all four classes of congenital malformations. After adjustment, a significant association persisted for congenital heart defects [odds ratio (OR)=1.22, [95% confidence interval (CI) 1.09, 1.36], P=0.0007] and cleft lip with or without cleft palate (OR=1.21, [95% CI 1.09, 1.36], P=0.0005). A similar trend existed for isolated cleft palate (OR=1.18, [95% CI 1.02, 1.37], P=0.03). There was no appreciable increase in the risk of congenital malformations associated with a maternal history of miscarriages, but a trend for a protective effect on the occurrence of cleft lip with or without cleft palate was observed (OR=0.72, [95% CI 0.52, 0.99], P=0.045). Based on our data, maternal gravidity represents a significant risk factor for congenital heart defects and cleft lip with or without cleft palate in the newborn infant. Our data do not support an increase in risk because of past history of miscarriages. © 2011 Blackwell Publishing Ltd.

Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort

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Surkan, Pamela J; Ettinger, Anna K; Hock, Rebecca S; Ahmed, Saifuddin; Strobino, Donna M; Minkovitz, Cynthia S

2014-01-01

Background: Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the child’s life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods: Using data from 6,550 singleton births from the E...

Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State.

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Nicolaidis, Christina; Ko, Cynthia W; Saha, Somnath; Koepsell, Thomas D

2004-06-17

BACKGROUND: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups. METHODS: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. RESULTS: Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. CONCLUSIONS: The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories.

Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State

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Ko Cynthia W

2004-06-01

Full Text Available Abstract Background The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW across different racial groups. Methods We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789. We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. Results Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. Conclusions The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories.

Impact of maternal antibodies and infant gut microbiota on the immunogenicity of rotavirus vaccines in African, Indian and European infants: protocol for a prospective cohort study.

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Sindhu, Kuladaipalayam Natarajan C; Cunliffe, Nigel; Peak, Matthew; Turner, Mark; Darby, Alistair; Grassly, Nicholas; Gordon, Melita; Dube, Queen; Babji, Sudhir; Praharaj, Ira; Verghese, Valsan; Iturriza-Gómara, Miren; Kang, Gagandeep

2017-03-29

Gastroenteritis is the leading cause of morbidity and mortality among young children living in resource-poor settings, majority of which is attributed to rotavirus. Rotavirus vaccination can therefore have a significant impact on infant mortality. However, rotavirus vaccine efficacy in Sub-Saharan Africa and Southeast Asia is significantly lower than in high-income countries. Maternally derived antibodies, infant gut microbiota and concomitant oral polio vaccination have been proposed as potential reasons for poor vaccine performance in low-income settings. The overall aim of this study is to compare the role of maternally derived antibodies and infant gut microbiota in determining immune response to rotavirus vaccine in high-income and low-income settings, using the same vaccine and a similar study protocol. The study is an observational cohort in three countries-Malawi, India and UK. Mothers will be enrolled in third trimester of pregnancy and followed up, along with infants after delivery, until the infant completes two doses of oral rotavirus vaccine (along with routine immunisation). The levels of prevaccination maternally derived rotavirus-specific antibodies (IgG) will be correlated with infant seroconversion and antibody titres, 4 weeks after the second dose of rotavirus vaccine. Both within-country and between-country comparisons of gut microbiome will be carried out between children who seroconvert and those who do not. The impact of oral polio vaccine coadministration on rotavirus vaccine response will be studied in Indian infants. Ethical approvals have been obtained from Integrated Research Application System (IRAS, NHS ethics) in UK, College of Medicine Research and Ethics Committee (COMREC) in Malawi and Institutional Review Board (IRB), Christian Medical College, Vellore in India. Participant recruitment and follow-up is ongoing at all three sites. Analysis of data, followed by publication of the results, is expected in 2018. Published by the BMJ

Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit.

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Herich, Lena Carolin; Cuttini, Marina; Croci, Ileana; Franco, Francesco; Di Lallo, Domenico; Baronciani, Dante; Fares, Katia; Gargano, Giancarlo; Raponi, Massimiliano; Zeitlin, Jennifer

2017-03-01

To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education. Copyright © 2016 Elsevier Inc. All rights reserved.

Maternal first-trimester diet and childhood bone mass: the Generation R Study.

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Heppe, Denise H M; Medina-Gomez, Carolina; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V

2013-07-01

Maternal diet during pregnancy has been suggested to influence bone health in later life. We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. In a prospective cohort study in 2819 mothers and their children, we measured first-trimester daily energy, protein, fat, carbohydrate, calcium, phosphorus, and magnesium intakes by using a food-frequency questionnaire and homocysteine, folate, and vitamin B-12 concentrations in venous blood. We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y. Higher first-trimester maternal protein, calcium, and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass, whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass (all P-trend childhood bone mass. In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass, maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content (BMC) [β = 2.8 (95% CI: 1.1, 4.5) and β = -1.8 (95% CI: -3.6, 0.1) g per SD increase, respectively], whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [β = 2.1 (95% CI: 0.7, 3.5) and β = 1.8 (95% CI: 0.4, 3.2) g per SD increase, respectively]. Maternal first-trimester dietary factors are associated with childhood bone mass, suggesting that fetal nutritional exposures may permanently influence bone development.

Maternal correlates of maternal child feeding practices: a systematic review.

Science.gov (United States)

McPhie, Skye; Skouteris, Helen; Daniels, Lynne; Jansen, Elena

2014-01-01

Establishing healthy eating habits early in life is one important strategy to combat childhood obesity. Given that early maternal child feeding practices have been linked to child food intake and weight, identifying the maternal correlates of maternal child feeding practices is important in order to understand the determinants of childhood obesity; this was the overall aim of the current review. Academic databases were searched for studies examining the relationship between maternal child feeding practices and parenting, personal characteristics and psychopathology of mothers with preschoolers. Papers were limited to those published in English, between January 2000 and June 2012. Only studies with mothers of normally developing children between the ages of 2 and 6 years were included. There were no restrictions regarding the inclusion of maternal nationality or socioeconomic status (SES). Seventeen eligible studies were sourced. Information on the aim, sample, measures and findings of these was summarised into tables. The findings of this review support a relationship between maternal controlling parenting, general and eating psychopathology, and SES and maternal child feeding practices. The main methodological issues of the studies reviewed included inconsistency in measures of maternal variables across studies and cross-sectional designs. We conclude that the maternal correlates associated with maternal child feeding practices are complex, and the pathways by which maternal correlates impact these feeding practices require further investigation. © 2012 John Wiley & Sons Ltd.

The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts.

Science.gov (United States)

Lewis, Gemma; Neary, Martha; Polek, Ela; Flouri, Eirini; Lewis, Glyn

2017-12-01

Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies. We used data for two-parent families from two representative prospective cohorts in Ireland (Growing up in Ireland [GUI]) and the UK (Millennium Cohort Study [MCS]). Parental depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale in the GUI cohort when children were 9 years old, and the Kessler six-item psychological distress scale in the MCS cohort when children were 7 years old. Adolescent depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 13 years in the GUI cohort and age 14 years in the MCS cohort. We analysed data using linear regression models, before and after adjustment for confounders, in both multiply imputed and complete case samples. There were 6070 families in GUI and 7768 in MCS. After all adjustments, a 1 SD (three-point) increase in paternal depressive symptoms was associated with an increase of 0·24 SMFQ points (95% CI 0·03-0·45; p=0·023) in the GUI cohort and 0·18 SMFQ points (0·01-0·36; p=0·041) in the MCS cohort. This association was independent of, and not different in magnitude to, the association between maternal and adolescent depressive symptoms (Wald test p=0·435 in the GUI cohort and 0·470 in the MCS cohort). Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the

Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries

DEFF Research Database (Denmark)

Kozuki, Naoko; Katz, Joanne; Lee, Anne Cc

2015-01-01

BACKGROUND: Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. OBJECTIVES: The specific aims of this study were to estimate the association between...... short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. METHODS: We conducted an individual participant data meta-analysis with the use of data sets from 12...... population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each...

Novel myelin penta- and hexa-acetyl-galactosyl-ceramides: structural characterization and immunoreactivity in cerebrospinal fluid

DEFF Research Database (Denmark)

Podbielska, Maria; Dasgupta, Somsankar; Levery, Steven B

2010-01-01

Fast migrating cerebrosides (FMC) are derivatives of galactosylceramide (GalCer). The structures of the most hydrophobic FMC-5, FMC-6, and FMC-7 were determined by electrospray ionization linear ion-trap mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy complementing previous...... NMR spectroscopy and gas chromatography-mass spectrometry to be 3-O-acetyl-sphingosine-GalCer derivatives with galactose O-acetyl modifications. FMC-5 and FMC-6 are 3-O-acetyl-sphingosine-2,3,4,6-tetra-O-acetyl-GalCer with nonhydroxy and hydroxy-N-fatty-acids, while FMC-7 has an additional O...... Mycoplasma fermentans. The cross-reactivity of highly acetylated GalCer with microbial acyl-glycolipid raises the possibility that myelin-O-acetyl-cerebrosides, bacterial infection, and neurological disease are linked....

Management strategy in pregnancies with elevated second-trimester maternal serum alpha-fetoprotein based on a second assay.

Science.gov (United States)

Spaggiari, Emmanuel; Ruas, Marie; Dreux, Sophie; Valat, Anne-Sylvie; Czerkiewicz, Isabelle; Guimiot, Fabien; Schmitz, Thomas; Delezoide, Anne-Lise; Muller, Françoise

2013-04-01

To assess maternal-fetal outcomes in pregnancies associated with persistently elevated second-trimester maternal serum alpha-fetoprotein. A retrospective cohort study in 658 patients with maternal serum alpha-fetoprotein ≥2.5 multiple of median, performed at routine Down syndrome screening. Maternal serum alpha-fetoprotein was assayed a second time in 341 of them. Outcomes were recorded in all cases. The group with unexplained maternal serum alpha-fetoprotein persistently ≥2.5 multiple of median was associated with more pregnancy complications 37 of 92 (40.2%) as fetal death, preeclampsia, intrauterine growth restriction, and congenital nephrotic syndrome, compared with the group with maternal serum alpha-fetoprotein that returned to a normal level 37 of 226 (16.4%) (P alpha-fetoprotein returns to a normal level on a second assay, the risk of adverse outcome significantly decreases, but these pregnancies are still at risk of complications and therefore need close surveillance. Repeat maternal serum alpha-fetoprotein assay allows identification of patients who should be offered amniocentesis to evaluate the risk of nephrotic syndrome and epidermolysis bullosa. Alpha-fetoprotein should be monitored in pregnancies associated with unexplained high maternal serum alpha-fetoprotein. A management strategy based on ultrasound examination, second maternal serum alpha-fetoprotein assay and amniocentesis is proposed to improve prenatal counseling and management of such pregnancies. However, a prospective study remains necessary to evaluate it. Copyright © 2013 Mosby, Inc. All rights reserved.