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Background: This study investigates the effects of administering intravenous esketamine at a dose of 0.25 mg/kg to pregnant patients receiving epidural anesthesia for emergency cesarean section on both maternal and neonatal outcomes. Methods: Medical records of pregnant patients transitioning from labor analgesia to epidural anesthesia for emergency cesarean sections between January 2020 and December 2022 were analyzed. The patients were categorized based on whether they received esketamine infusions during the incision-to-delivery interval. The variables compared between the groups included hemodynamic parameters, perioperative and postoperative adverse reactions, and neonatal outcomes (gender, weight, Apgar scores at 1 and 5 min, need for neonatal intensive care, and umbilical artery/vein blood gas analysis). Results: For maternal outcomes, the systolic blood pressure (SBP) in the esketamine group showed a significant increase at 5 and 10 min' post-administration, and the diastolic blood pressure (DBP) significantly increased at 5 min, compared to the control group (p < 0.01). No significant differences were observed in heart rate (HR) and oxygen saturation (SpO2) at any time point (p > 0.05). The esketamine group experienced a significant rise in the incidence of arrhythmias, dizziness, and nystagmus during the perioperative period, a notable decrease in hypotension incidence, and an increase in postoperative nausea and dizziness. Regarding neonatal outcomes, there were no significant differences in gender, weight, Apgar scores ≤7 at 1 and 5 min, and the need for neonatal intensive care. However, the pH level in the umbilical artery blood of the esketamine group was significantly higher. The levels of PCO2 and PO2 in umbilical artery and venous blood did not show significant differences between the groups. Conclusions: In pregnant women undergoing emergency cesarean section, intravenous administration of 0.25 mg/kg esketamine is correlated with favorable maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: Epidural analgesia could increase the risk of maternal fever during labor, and the potential mechanisms involved inflammation. Neutrophil-to-lymphocyte ratio (NLR) was a sensitive inflammatory composite indicator and related to adverse outcomes in parturients. This study aimed to investigate the association between NLR levels and epidural related maternal fever (ERMF). Methods: This prospective cohort study included 614 parturients who underwent epidural analgesia at the Women's Hospital School of Medicine Zhejiang University from November 2021 to May 2023. NLR level was calculated before epidural analgesia for women. The outcome was ERMF. Univariate and multivariate logistic regression models were utilized to explore the association between NLR level and ERMF. And the association was further investigated in subgroups of age, body mass index (BMI) before pregnancy, and parity of delivery. The results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results: Totally, 614 parturients, of whom 171 (27.85%) had ERMF. High NLR level was associated with higher incidence of ERMF (OR = 2.70, 95% CI: 1.58-4.69). Parturients with ERMF had higher proportion of postpartum hemorrhage, longer labor times, and other adverse outcomes in parturients. The association also observed in subgroups of age <35 years old (OR = 2.74, 95% CI: 1.55-4.29), BMI <24 kg/m2 before pregnancy (OR = 2.32, 95% CI: 1.32-4.13), BMI ≥24 kg/m2 before pregnancy (OR = 38.28, 95%CI: 3.67-854.66), primipara (OR = 2.26, 95% CI:1.27-4.04), and multipara (OR = 30.60, 95% CI: 3.73-734.03). Conclusion: High NLR levels were associated with ERMF in women. It indicated that physicians may measure NLR levels as a regular measurement, which may beneficial for pregnancy outcomes. [ABSTRACT FROM AUTHOR]

AbstractDiminished/decreased ovarian reserve (DOR), which refers to a decline in oocyte number or quality, has a profound impact on women’s quality of life and fertility. In recent years, the incidence of DOR has been increasing, and more cases of this complication have been reported at younger ages. Therefore, finding the reasons for its occurrence is of great importance. Despite the great inter-individual differences in women’s ovarian reserves, environmental and epigenetic effects cannot be ignored in this regard. Since women’s ovarian reserves are developed in the prenatal period, the present evidence-based review study has addressed the effects of maternal nutrition, specifically undernutrition and overnutrition, during pre-conception, pregnancy, and lactation on the ovarian reserve of offspring. [ABSTRACT FROM AUTHOR]

In recent decades, global rates of overweight and obesity have surged, posing significant health challenges, Maternal obesity is particularly concerning because of its potential adverse effects on women, foetuses, and children. The intrauterine environment plays a crucial role in shaping long-term health outcomes, with maternal factors significantly influencing childhood obesity and related health markers. This review synthesises current evidence on the associations between macrosomia, maternal weight, pregnancy weight gain, and offspring obesity risk. It explores how maternal weight status during pregnancy may impact a child’s susceptibility to obesity later in life, examining potential underlying mechanisms. By consolidating these findings, the review aims to deepen our understanding of the complex relationships between maternal health, prenatal factors, and childhood obesity. This knowledge can inform future research and public health strategies aimed at addressing this global health issue effectively. [ABSTRACT FROM AUTHOR]

Background: Maternal opioid use (MOU) remains a public health concern. Studies have demonstrated significant increases in MOU, but estimates using ICD-10-CM or stratified by sociodemographic variables are limited. Objectives: Using a statewide, population-based dataset of Florida resident deliveries from 2000 to 2019, we examined the trend of MOU by age, race/ethnicity, education level, and insurance. Methods: Florida administrative data was used to conduct a retrospective cohort study. MOU was identified using opioid-related hospital discharge diagnoses documented prenatally or at delivery. Maternal sociodemographic variables were obtained from Florida vital statistics. Joinpoint regression was used to identify statistically significant changes in the trends overall and stratified by sociodemographic variables. Results are presented as annual percentage changes (APC) and 95% confidence intervals. Results: Our sample included over 3.6 million Florida resident mothers; of which, MOU was identified in 1% (n = 22,828) of the sample. From 2000 to 2019, MOU increased over ten-fold from 8.7 to 94.7 per 10,000 live birth deliveries. MOU increased significantly from 2000 to 2011 (APC: 32.8; 95% CI: 29.4, 36.2), remained stable from 2011 to 2016, and decreased significantly from 2016 to 2019 (APC: 3.9; 95% CI: −6.6, −1.0). However, from 2016 to 2019, MOU increased among non-Hispanic Black mothers (APC: 9.2; 95% CI: 7.5, 11.0), and those ages 30–34 (APC: 2.9; 95% CI: 1.2, 4.6) and 35–39 (APC: 6.4; 95% CI: 4.3, 8.4). Conclusions: Accurate prevalence estimates of MOU by sociodemographic factors are necessary to fully understand prevalence trends, describe the burden among sub-populations, and develop targeted interventions. [ABSTRACT FROM AUTHOR]

This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16–19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother–infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample – 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers. [ABSTRACT FROM AUTHOR]

Parental executive functioning (EF) is considered one key contributing source, via direct and indirect routes, of inter-individual variation in offspring EF. The current study investigated the unexplored associations between maternal EF and infant EF as well as its precursor, sustained attention. Ninety-seven mother-infant-dyads from the FinnBrain Birth Cohort Study participated. Maternal EF was assessed using selected measures from the Cogstate test battery. At 8 months, infants completed Lab-TAB Blocks and modified A-not-B tasks. A modest but robust link between maternal EF and infant attention was revealed in girls. There was no association between mother and infant EF in either sex at 8 months. Notable directions for future research, and potential underlying mechanisms of sex differences are discussed. [ABSTRACT FROM AUTHOR]

This study was designed to investigate patterns and risk factors for substance use among obstetrical patients who gave birth during the early period of the pandemic, and their partners. Cross-sectional survey of obstetrical patients between March 17th and June 16th, 2020, at The Ottawa Hospital, Ottawa, Canada. Substance use was a composite measure of any alcohol, tobacco, or cannabis use since COVID-19 began. Four outcomes included: any participant substance use or increase in substance use, any partner substance use or increase in substance use. Adjusted risk ratios (ARR) and 95% confidence intervals (CI) are presented. Of 216 participants, 113 (52.3%) and 15 (6.9%) obstetrical patients reported substance use and increased use, respectively. Those born in Canada (ARR: 2.03; 95% CI: 1.27–3.23) and those with lower household income (ARR: 1.38; 95% CI: 1.04–1.85) had higher risk of substance use. Those with postpartum depression (ARR: 5.78; 95%CI: 2.22–15.05) had the highest risk of increased substance use. Families affected by school/daycare closure reported a higher risk of increased partner substance use (ARR: 2.46; 95% CI:1.38–4.39). This study found that risk factors for substance use included demographics (i.e., being born in Canada, income), mental health (postpartum depression), and school/childcare closures. [ABSTRACT FROM AUTHOR]

Low-income women of color are disproportionately more likely to contract HIV, struggle with treatment adherence, and have compromised health as a result of HIV infections in comparison to White and more affluent women. The current study is a secondary analysis aimed at examining the association between stress, symptoms of depression, trauma exposure, healthcare engagement, and adherence self-efficacy, among low-income women of color with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Structural equation modeling is used to identify latent mental health symptoms that may influence one another, as well as outcomes involving treatment engagement. Participants contributing to this dataset (n = 134) were low income, women of color (primarily African American) living with HIV or AIDS, receiving care at a major medical center in the northeastern United States. Findings indicate significant indirect associations between perceived stress and the outcome of medical appointment attendance. Significant mediators of this indirect relationship include depressive symptoms, parenting stress, and adherence self-efficacy. Implications for health and behavioral health practice and policy interventions are drawn. Areas in need of future research are identified. [ABSTRACT FROM AUTHOR]

The focus on perinatal mental health has expanded recently, though there is less research on post-traumatic stress disorder (PTSD). Therefore, a review of the literature was undertaken and coupled with expert clinical insights to discuss current clinical practice recommendations for PTSD in the perinatal period. This review covers considerations for the assessment, prevention, and treatment of PTSD during the perinatal period. Within these sections, evidence-based and promising practices are outlined. Extra attention is afforded to treatment, which includes considerations from both psychotherapeutic and psychopharmacological perspectives. This review closes with coverage of three important and related areas of consideration, including bereavement, intimate partner violence, and childhood sexual abuse. Psychotherapeutic interventions for PTSD during pregnancy are limited, and no strong recommendations can be supported at this time while evidence points toward the effectiveness of cognitive behavioral therapies and eye movement desensitization therapy as first-line treatments postpartum though research evidence is also limited. Research on psychopharmacological interventions is similarly scarce, though selective serotonin reuptake inhibitors may be beneficial. Clinicians should also be mindful of additional considerations that may be needed for the treatment of PTSD in the context of bereavement, intimate partner violence, and history of sexual violence. [ABSTRACT FROM AUTHOR]

Who is afraid of passivity? Historically, women and minoritized people have had good reason to be, given that passivity has been a way to keep them out of the world of "reason." Freud's move from the activity/passivity binary as the principle of all instinct, to its gendering as femininity/passivity and masculinity/activity, leads him to assert the "repudiation of femininity" as the bedrock of psychic life (Freud, S. 1937. "Analysis Terminable and Interminable." In The Standard Edition of the Complete Psychological Works of Sigmund Freud, 23, 209–254. London: Hogarth Press). This has led to a generative history of feminist, queer and Black psychoanalytic scholarship that constantly re-opens the question of female subjectivity and sexuality, and what we mean by psychic femininity and masculinity. However, what does remains as "bedrock," even in this theorizing, is the figure of the mother in the internal world of the infant – supposedly castrated yet all-powerful, and requiring that the infant defend itself against what is stirred up as a result of dependency on her. After reviewing some of the psychoanalytic debates about femininity, I turn to "stillness" rather than passivity to suggest that we can identify a maternal element that is on the side of development, a figuration of psychical inertia that holds the capacity for waiting, stopping, ceasing and withdrawing in a world in which these mental functions are sorely missing. [ABSTRACT FROM AUTHOR]

The aim of this paper is to demonstrate how the Prayer Warriors of Rumuekpe, Rivers State, Nigeria, a women human rights defenders group demonstrated their ability to contribute to the peace process despite the patriarchal structures that impede them and conditions of extreme violence. The women saw the need to adopt methods that were in their feminine domain and therefore framed their collective action as maternal. Motherhood is a cultural role already assigned to them, and they decided to utilise it to prevent backlash and victimisation from men in the community. Primary and secondary data sources have been used in this study. Primary data included field notes and 30 interviews with men and women in Rumuekpe. Secondary data included books/book chapters, essays, journal articles, and research reports relevant to the theme of this paper. Findings show that women played an important role in the peace process. The paper demonstrates that amid gendered limitations and obstacles arising from conditions of extreme violence, women find their voices even if it is through processes like collectivising within a maternal framework, which aligns with the stereotypical idea that women are primarily mothers. [ABSTRACT FROM AUTHOR]

Prior results on the association between serum uric acid (UA) levels in the early trimester and the risk of small for gestational age (SGA) remain unclear. This study evaluated the association of maternal first-, second-, and third-trimester UA levels with the risk of SGA infants. A total of 23, 194 singleton mothers from the International Peace Maternity and Child Health Hospital between January 2014 and January 2017 were included. Maternal UA levels were measured at 12.1 ± 1.08th (UA1) and 32.2 ± 1.03th (UA2) gestational weeks. △UA was calculated as the difference between UA2 and UA1. Logistic regression and restricted cubic spline (RCS) were performed to evaluate the association between maternal UA and △UA during pregnancy and SGA. Receiver operating characteristic (ROC) analysis was employed to assess the serum uric acid prediction value. Women in the higher quartiles of UA1 had a significantly higher risk of SGA. A clear increased risk for SGA was observed with higher quartiles for UA2 (p for trend <0.05). An approximately "J-shaped" relationship was observed between UA2 and △UA, and the risk of SGA was observed. When compared with those with a lower level of UA in the first trimester, those with a higher level of UA1, the more increase in the later UA levels were associated with a higher risk of SGA [adjusted odds ratio (aOR) = 1.67, 95% CI:1.37–2.05]. The ROC curve areas were 0.525 for UA1, 0.582 for UA2 and 0.576 for △UA. The findings suggested that non-preeclamptic and non-hypertensive women who experienced early pregnancy with high UA levels had an elevated risk of SGA. Moreover, a high maternal UA level in the earlier trimester may be an early predictor of SGA. [ABSTRACT FROM AUTHOR]

Even through the fact that pregnant women are more and more severely infected with COVID-19 disease, there are still doubts about vaccinating these people due to the lack of sufficient evidence base information. So in this systematic review, we decided to study vaccinated and unvaccinated pregnant women regarding maternal, fetal and neonatal complications and outcomes. Between 30 December 2019 and 15 October 2021, electronic searches were performed on the databases of PubMed, Scopus, Google Scholar, and Cochrane library by searching in English and free full text. Keywords searched included these: maternal outcome, neonatal outcome, pregnancy, and COVID-19 vaccination. Among 451 articles, finally, seven studies were included to study pregnancy outcomes in vaccinated women compared to unvaccinated for systematic review purposes In this study 30257 vaccinated women in their third trimester compared to 132339 unvaccinated women in terms of age, the root of delivery, neonatal adverse outcomes. There were no significant differences between two groups in terms of: IUFD, and 1 min Apgar score, C/S rate, and NICU admission between the two groups, however, the rate of SGA, IUFD, and also neonatal jaundice, asphyxia, and hypoglycemia was more significant in the unvaccinated group comparing to the vaccinated group as a result. Among them, the chance of preterm labor pain was reported more among vaccinated patients. Emphasizing that, except 7.3% of the case population, everyone in the second and third trimesters had been vaccinated with mRNA COVID-19 vaccines COVID-19 vaccination during the second and third trimesters appears to be the right choice due to the immediate impact of COVID-19 antibodies on the developing fetus and formation of neonatal prophylaxis, as well as the absence of adverse outcomes for both the fetus and mothers. [ABSTRACT FROM AUTHOR]

To compare pregnancy risks between different congenital uterine anomalies utilizing other congenital anomalies as a control group in a large population database. A retrospective population-based cohort study from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) included 3,846,342 births (2010–2014). Of them, 6195 deliveries were to women with bicornuate uteri, 798 with arcuate uteri, 2255 with didelphys uteri, 802 with unicornuate uteri and 1404 with septate uteri. After adjustment for confounders, women with bicornuate uteri were more likely to deliver vaginally (aOR 1.4, 95%CI: 1.1–1.9), p =.01), less likely to deliver by cesarean (CD) and had lower risk of small for gestational age (SGA) (aOR 0.8, 95%CI: 0.7–0.9, p =.03) when compared to the other anomalies (aOR 0.6, 95%CI: 0.5–0.6, p =.0001). Pregnant women with arcuate uterus had lower risks of preterm delivery (PTD) (aOR 0.6, 95%CI: 0.5–0.8, p =.0001), less chance of operative vaginal delivery (aOR 0.5, 95%CI: 0.2–0.9, p =.04), and higher risk for CD (aOR 1.6, 95%CI: 1.4–2, p =.0001). Pregnant women with didelphys uteri had higher risk of preterm premature rupture of membranes (PPROM) (aOR 1.6, 95%CI: 1.3–1.9, p =.0001), PTD (aOR 1.5, 95%CI: 1.3–1.6, p =.0001), CD (aOR 1.4, 95%CI: 1.2–1.5, p =.0001) and wound complications (aOR 1.6, 95%CI: 1.1–2.4, p =.02). Pregnant unicornuate uteri had increased risks of PTD (aOR 1.4, 95%CI: 1.1–1.6, p =.0001), CD (aOR 2, 95%CI: 1.6–2.5, p =.0001) and of SGA (aOR 1.8, 95%CI: 1.4–2.3, p =.0001). Pregnant septate uteri had higher risk of chorioamnionitis (aOR 1.5, 95%CI: 1.1–2.1, p =.048) and CD (aOR 1.4, 95%CI: 1.2–1.6, p =.0001). We demonstrated that there are different risks for certain adverse pregnancy and neonatal outcomes in diverse uterine anomalies as compared to the other anomalies. [ABSTRACT FROM AUTHOR]

Background Retinopathy of prematurity is the abnormal development of retinal arteries in preterm neonates less than 32 weeks and weighing 1500 g, and less, which can lead to visual impairment during life and blindness. This study aims to investigate the relationship between some clinical characteristics of neonates and mothers with Retinopathy of prematurity in the world via a systematic review and meta-analysis. Materials and methods The present study is a systematic review and meta-analysis on the relationship between maternal and neonatal clinical variables with Retinopathy of prematurity in the world from the beginning of 2000 to the end of 2020. Accordingly, all English articles published on the topic were searched in scientific databases of Web of Science, PubMed, Google Scholar, Science Direct, and Scopus. The articles were searched independently by two researchers. Statistical analysis of data was performed using fixed and random effects model statistical tests in the meta-analysis, Cochran, meta-regression, I² index, Funnel plot, and Begg’s by STATA software program, version 14. Result A total of 191 studies with a sample size of 140,921 persons were including in the meta-analysis. Accordingly, Preterm delivery ≤28 weeks (OR:6.3, 95% CI:4.9–8.1), Birth Weight ≤1000 g (OR:5.8, 95% CI:4.8–6.8), Birth Weight ≤1500 g (OR:4.8, 95% CI:3.8–6.1), PROM (OR:1.2, 95% CI:1.0–1.4), induced fertility (OR:1.9, 95% CI:1.1–3.0) and Chorioamnionitis (OR:1.5, 95% CI:1.0–2.2) There was a statistically significant association with retinopathy. Conclusion Based on the results of the present meta-analysis, the risk of retinopathy of prematurity in neonates born at 28 weeks and less, LBW (weight 1500 g and less), neonatal hypotension, chorioamnionitis, and induced fertility increases. [ABSTRACT FROM AUTHOR]

Objective To compare the composite neonatal and maternal adverse outcomes among low-risk pregnancies with versus without chorioamnionitis. Methods We conducted a retrospective cohort study using U.S. Vital Statistics Data. The study population was restricted to full term, low-risk, singleton pregnancies. Pregnancies were categorized into those affected and unaffected by chorioamnionitis. The primary outcome was composite neonatal adverse outcome and the secondary outcome was composite maternal adverse outcome. Multivariable Poisson regression models with robust error variance were used to examine the factors associated with chorioamnionitis and to evaluate the association between chorioamnionitis and adverse outcomes [using adjusted relative risk (aRR) and 95% confidence interval (CI)]. Results Of 19.7 million live births, 59.4% met inclusion criteria; among them, 1.7% were complicated by chorioamnionitis. The risk of composite neonatal adverse outcome was higher in newborns delivered by women with chorioamnionitis (aRR = 3.40; 95% CI = 3.30–3.49). Compared to women without chorioamnionitis, those with chorioamnionitis had a higher risk of composite maternal adverse outcome (aRR = 2.42; 95% CI = 2.31–2.55). Infant mortality was also higher in affected pregnancies (aRR = 1.23; 95% CI = 1.09–1.38). Conclusion Among low-risk pregnancies, chorioamnionitis is associated with a higher risk of composite neonatal and maternal adverse outcomes. Infant death is also increased. [ABSTRACT FROM AUTHOR]

Objective The objectice of this study was to reveal difficulties, coping and expectations of overweight/obese women during pregnancy. Methods A descriptive, phenomenological approach was used. Fourteen pregnant women having a body mass index of 25 or over 25. Results The findings were presented under three themes: difficulties experienced, coping and expectations. The women had physical difficulties and their daily life was affected negatively. They experienced stigmatization, humiliation and uncertainty about how much they had to eat during pregnancy. Therefore, they were upset and unhappy. Some women denied that they were overweight and some women considered being overweight as normal due to pregnancy. Social support plays an important part in coping with difficulties; however, some women could not get sufficient social support. The women also expected to be treated tolerantly. Conclusion Overweight/obese women try to overcome many physical and psychological problems due to their weight during pregnancy, but they do not receive adequate support. [ABSTRACT FROM AUTHOR]

Keywords: Correlation; heritability; maternal; model; trait; variance; ; ; ; ; ; EN Correlation heritability maternal model trait variance ZH 7948 7955 8 11/21/22 20221220 NES 221220 Introduction Livestock rearing plays a major part in ensuring nutritional security of masses in developing countries (Randolph et al. [14]). Similarly, Wang et al. ([21]) reported moderate heritability (0.40) for fiber diameter and low heritability estimate (0.19) for staple length at yearling stage in Inner Mongolia White Cashmere goats. In concurrence to our study, Di et al. ([4]) reported moderate direct additive heritability estimate of 0.22 for yearling fiber diameter in Chinese superfine Merino sheep on fitting multi-trait animal model. Higher heritability estimates, when compared to the present study, have been reported by Hanford, Van Vleck, and Snowder ([9]) in Rambouillet sheep and Jafari and Hashemi ([10]) in Makuie sheep. [Extracted from the article]

Mirror syndrome is a rare disease associated with high fetal mortality of up to 67.2%. It is thought to be underdiagnosed and is often associated with preeclampsia. Mirror syndrome is characterized by "triple edema": generalized maternal, placental, and fetal edema. This comprehensive review aims to thoroughly summarize the existing data and provide a broad update on the topic to help accurate diagnosis and encourage further research. A comprehensive search of several databases (Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus) was conducted. The last systematic review of mirror syndrome cases was conducted in 2016 and included 113 patients. Much is still unknown about the pathophysiology of the disease and it remains underdiagnosed. Mirror syndrome is likely more prevalent than current data suggests for it is often misdiagnosed as pre-eclampsia. The differential of Mirror syndrome should be considered in anomalous presentations of pre-eclampsia as intervention may save the fetus and improve maternal symptoms. It is important to further the study on the pathophysiology of the disease to better understand, diagnose and potentially treat it, to avoid its high morbidity and mortality. [ABSTRACT FROM AUTHOR]

Pathological examination of placenta is vital to understand the pathophysiology of adverse perinatal outcomes, prevention of recurring conditions in subsequent pregnancies and medico-legal risk assessment. The College of American Pathologists (CAP) has published a set of guidelines to help guide the submission of placentas to pathology. However, awareness and conformity to these guidelines are not well established and vary from one institution to the other. We aimed to examine the appropriateness of placental pathologic examination at our institution and their conformity to guidelines in this audit type study to help improve our practices. Detailed retrospective review of obstetrical records was performed including history and delivery reports for a total of 500 consecutive live births noting whether the placenta was sent for pathologic evaluation according to CAP guidelines. Sensitivity and specificity of placental examination were calculated based on the 2 × 2 contingency table. The sensitivity and specificity of pathologic examination of placenta in conformity to CAP guidelines were 63.4% and 91.6%, respectively. The most common indications for submission were maternal followed by fetal and placental indications. Concordant clinico-pathologic correlation was found in 87/135 placentas submitted. Placenta has long been ignored with limited understanding of the value of its examination. More awareness of CAP guidelines is needed to appropriately submit placentas for pathologic examination. Each institution needs to develop their own set of guidelines taking guidance from CAP guidelines and tailored to its population. Meaningful communication between obstetricians, neonatologists, and pathologists is key to improving the utility of pathologic examination of placenta and the application of results for better patient care. [ABSTRACT FROM AUTHOR]

This study describes how three highly regarded instructors enact care in and out of the classroom. We first outline multiple theories of care in education-related literature. Then, using a multiple case study approach, we provide three vignettes of highly regarded instructors and their beliefs and practices regarding care in the college classroom. We term these three different enactments of care as critical maternal care, calculated care and neoliberal care. We make the case that these differing conceptions of care can serve as potential frameworks of care in higher education and are influenced by various factors including but not limited to instructors' teaching experience, disciplinary focus, gender, racial identity and approach to teaching. [ABSTRACT FROM AUTHOR]

Background: Maternal genetic variations, including variations in mitochondrial biogenesis (MB) and oxidative phosphorylation (OP), are associated with placental abruption (PA). However, the role of maternal-fetal genetic interactions (MFGI) and parent-of-origin (imprinting) effects in PA remain unknown. Objective: To investigate MFGI in MB-OP, and imprinting effects in relation to risk of PA. Methods: Among Peruvian mother-infant pairs (503 PA cases and 1052 controls), independent single nucleotide polymorphisms (SNPs), with linkage-disequilibrium coefficient <0.80, were selected to characterize genetic variations in MB-OP (78 SNPs in 24 genes) and imprinted genes (2713 SNPs in 73 genes). For each MB-OP SNP, four multinomial models corresponding to fetal allele effect, maternal allele effect, maternal and fetal allele additive effect, and maternal-fetal allele interaction effect were fit under Hardy-Weinberg equilibrium, random mating, and rare disease assumptions. The Bayesian information criterion (BIC) was used for model selection. For each SNP in imprinted genes, imprinting effect was tested using a likelihood ratio test. Bonferroni corrections were used to determine statistical significance (p-value < 6.4e-4 for MFGI and p-value < 1.8e-5 for imprinting). Abruption cases were more likely to experience preeclampsia, have shorter gestational age, and deliver infants with lower birthweight compared with controls. Models with MFGI effects provided improved fit than models with only maternal and fetal genotype main effects for SNP rs12530904 (p-value = 1.2e-04) in calcium/calmodulin-dependent protein kinase [CaM kinase] II beta (CAMK2B), and, SNP rs73136795 (p-value = 1.9e-04) in peroxisome proliferator-activated receptor-gamma (PPARG), both MB genes. We identified 320 SNPs in 45 maternally-imprinted genes (including potassium voltage-gated channel subfamily Q member 1 [KCNQ1], neurotrimin [NTM], and, ATPase phospholipid transporting 10 A [ATP10A]) associated with abruption. Top hits included rs2012323 (p-value = 1.6E-16) and rs12221520 (p-value1.3e-13) in KCNQ1, rs8036892 (p-value = 9.3E-17) and rs188497582 in ATP10A, rs12589854 (p-value = 2.9E-11) and rs80203467 (p-value = 4.6e-11) in maternally expressed 8, small nucleolar RNA host (MEG8), and rs138281088 in solute carrier family 22 member 2 (SLC22A2) (p-value = 6.8e-9). We identified novel PA-related maternal-fetal MB gene interactions and imprinting effects that highlight the role of the fetus in PA risk development. Findings can inform mechanistic investigations to understand the pathogenesis of PA. [ABSTRACT FROM AUTHOR]

Epigenetics links perinatal influences with later obesity. We identifed differentially methylated CpG (dmCpG) loci measured at 17 years associated with concurrent adiposity measures and examined whether these were associated with hsCRP, adipokines, and early life environmental factors. Genome-wide DNA methylation from 1192 Raine Study participants at 17 years, identified 29 dmCpGs (Bonferroni corrected p < 1.06E-07) associated with body mass index (BMI), 10 with waist circumference (WC) and 9 with subcutaneous fat thickness. DmCpGs within Ras Association (RalGDS/AF-6), Pleckstrin Homology Domains 1 (RAPH1), Musashi RNA-Binding Protein 2 (MSI2), and solute carrier family 25 member 10 (SLC25A10) are associated with both BMI and WC. Validation by pyrosequencing confirmed these associations and showed that MSI2 , SLC25A10 , and RAPH1 methylation was positively associated with serum leptin. These were also associated with the early environment; MSI2 methylation (β = 0.81, p = 0.0004) was associated with pregnancy maternal smoking, SLC25A10 (CpG2 β = 0.12, p = 0.002) with pre- and early pregnancy BMI, and RAPH1 (β = −1.49, p = 0.036) with gestational weight gain. Adjusting for perinatal factors, methylation of the dmCpGs within MSI2, RAPH1, and SLC25A10 independently predicted BMI, accounting for 24% of variance. MSI2 methylation was additionally associated with BMI over time (17 years old β = 0.026, p = 0.0025; 20 years old β = 0.027, p = 0.0029) and between generations (mother β = 0.044, p = 7.5e-04). Overall findings suggest that DNA methylation in MSI2, RAPH1, and SLC25A10 in blood may be robust markers, mediating through early life factors. [ABSTRACT FROM AUTHOR]

The current research was designed in order to investigate the differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. This is hypothesised that there is likely to be significant differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. The sample for the current research comprised of n = 300 (n = 150 mothers of children with hearing impairment who were compared with mothers of hearing children (n = 150, after matching them on core subject variables); children within age ranges of 12–18 years were selected through non-probability purposive sampling. The scales included Hope Trait Scale, Psychological Well-Being Scale and Gratitude Questionnaire. Independent Sample t-test revealed significant differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. Pearson Product Moment correlation revealed significant positive relationship among hope, gratitude and psychological well-being in mothers of children. Regression analyses revealed that hope and gratitude are significant predictors of psychological well-being. The findings are promising for counsellors, teachers and mothers to change the perception and views regarding disability to seek better results in their children's functioning. [ABSTRACT FROM AUTHOR]

Studies on COVID-19 infection in pregnancy thus far have largely focused on characterizing maternal and neonatal clinical characteristics. However, another evolving focus is assessing and mitigating the risk of vertical transmission amongst COVID-19-positive mothers. The objective of this review was to summarize the current evidence on the vertical transmission potential of COVID-19 infection in the third trimester and its effects on the neonate. OVID MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trial (CENTRAL) were searched from January 2020 to May 2020, with continuous surveillance. 18 studies met the inclusion criteria, consisting of 157 mothers and 160 neonates. The mean age of the pregnant patients was 30.8 years and the mean gestational period was 37 weeks and 1 d. Currently, there is currently no conclusive evidence to suggest that vertical transmission of SARS-CoV-2 occurs. Amongst 81 (69%) neonates who were tested for SARS-CoV-2, 5 (6%) had a positive result. However, amongst these 5 neonates, the earliest test was performed at 16 h after birth, and only 1 neonate was positive when they were later re-tested. However, this neonate initially tested negative at birth, suggesting that the SARS-CoV-2 infection was likely hospital-acquired rather than vertically transmitted. 13 (8%) neonates had complications or symptoms. The findings of this rapid descriptive review based on early clinical evidence suggest that vertical transmission of SARS-CoV-2 from mother to neonate/newborn did not occur. Future studies are needed to determine the optimal management of neonates born to COVID-19-positive mothers. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are two increasing important problems among children. This study aims to explore the link between maternal polycystic ovary syndrome (PCOS) and the risk of ASD and ADHD in the offspring. The MOOSE guidelines were followed in the conduct of this meta-analysis. A literature search was done in PubMed/MEDLINE, Scopus, and Web of Science from inception until January 2021. The DerSimonian and Laird random-effects model was used to estimate the combined risk ratios (RR) and 95% confidence intervals (CI). Sensitivity analysis was also used to investigate the effect of each study on the combined results. Seven studies, with 1,358,696 participants, comprising 7,334 ADHD cases and 3,920 ASD cases, were included in this study. Children born to mothers with maternal PCOS had higher risks of developing ASD (RR = 1.46, 95% CI: 1.26–1.69, I2 = 64%) and ADHD (RR = 1.43, 95% CI: 1.35–1.41, I2 = 0%) when compared with children born to mothers without maternal PCOS. This study showed that there might be a link between maternal PCOS and the risk of developing ASD and ADHD in the offspring. This important issue must be considered in PCOS women during and after pregnancy. [ABSTRACT FROM AUTHOR]

Neonatal abstinence syndrome (NAS) is a combination of symptoms in infants exposed to any variety of substances in utero. Information systems and registries help to collect information about these patients; however, there is always a deep gap between complete and accurate information to be collected, understood, and applied in the health care system; thus, defining a minimum data sets (MDS) as one of the primarily steps of designing a registry system is essential. The aim of this study was to develop an MDS of the registry for infants with NAS in Iran. This research is a descriptive cross-sectional study. In this study, three steps were carried out to develop the MDS including systematic review, Delphi technique, and focus group discussion. A systematic review was conducted in relevant databases to identify appropriate related data. In the second phase, a focus group discussion was used to classify the extracted data elements by contributing neonatologists. Finally, data elements were chosen through the decision Delphi technique in two distinct rounds. Collected data were analyzed using SPSS 22 (SPSS Inc., Chicago, IL). By reviewing related papers and available NAS registries in other countries, 145 essential data elements were identified. They were classified into two main categories based on the eight experts' opinions including maternal with two sections and infant with two sections. After applying two rounds of Delphi technique, the final data elements for maternal and infant categories were 42 and 31, respectively. Thus, on completion of the survey, 73 data elements were approved. The proposed MDS for NAS can help to store an accurate and comprehensive data, document medical records, integrate them with other information systems and registries, and communicate with other healthcare providers and healthcare centers. This MDS can contribute to the provision of high-quality care and better clinical decisions. [ABSTRACT FROM AUTHOR]

A full understanding of the pathways from efficacious interventions to population impact requires rigorous effectiveness evaluations conducted under realistic scale-up conditions at country level. In this paper, we introduce a deductive framework that underpins effectiveness evaluations. This framework forms the theoretical and conceptual basis for the 'Real Accountability: Data Analysis for Results' (RADAR) project, intended to address gaps in guidance and tools for the evaluation of projects being implemented at scale to reduce mortality among women and children. These gaps include needs for a framework to guide decisions about evaluations and practical measurement tools, as well as increased capacity in evaluation practice among donors and program planners at global, national and project levels. RADAR aimed to improve the evidence base for program and policy decisions in reproductive, maternal, newborn and child health and nutrition (RMNCH&N). We focus on five linked methodological steps – presented as core evaluation questions – for designing and implementing effectiveness evaluation of large-scale programs that support both the needs of program managers to improve their programs and the needs of donors to meet their accountability responsibilities. RADAR has operationalized each step with a tool to facilitate its application. We also describe cross-cutting methodological issues and broader contextual factors that affect the planning and implementation of such evaluations. We conclude with proposals for how the global RMNCH&N community can support rigorous program evaluations and make better use of the resulting evidence. [ABSTRACT FROM AUTHOR]

Even though previous systematic reviews have reported on the role of prenatal vitamin D on birth outcomes, its effect on child growth is poorly understood. To synthesize a systematic summary of the literature on the effect of maternal vitamin D supplementation on the linear growth of under-five children. This study includes studies (both observational and interventional with a control group) that evaluated the effects of prenatal vitamin D status on child linear growth. The mean child length/length for age with 95% confidence interval (CI) was pooled as the weighted mean difference using a random-effects model. A funnel plot was used to assess potential publication bias. A total of 45 studies and 66 reports covering a total population of 44,992 (19,683 intervention or high vitamin D group, and 25,309 control or low vitamin D group) were analyzed. Studies spanned from 1977 to 2022. The pooled weighted mean difference was 0.4 cm (95% CI: 0.15–0.65). A subgroup analysis, based on vitamin D supplementation frequency, showed that mothers who supplemented monthly or less frequently had a 0.7 cm (95% CI: 0.2–1.16 cm) longer child. Supplementation with a dose of >2000 international units increased child length at birth. The weighted mean difference was 0.35 cm (95% CI: 0.11–0.58). The evidence from this review shows that maternal supplementation of vitamin D is associated with increased birth length. This is apparent at higher doses, low frequency (monthly or less frequent), and during the second/third trimester. It appears that vitamin D supplementation during pregnancy is protective of future growth in under-five children. Clinical trials are needed to establish evidence of effectiveness for the frequency and dose of supplementation. [ABSTRACT FROM AUTHOR]

In this short essay, I offer an alternative ontology and epistemology of the term "lesbian" vis-à-vis my relationship with my brown Pakistani mother. I bring into this reading a number of variables ranging from the geographic, historical, biopolitical, and economic to the embodied, affective, esthetic, and immaterial. In recounting formative moments of my childhood – Quranic pedagogy alongside classical voice, singing and dance lessons – I re-read the spaces that produce homosociality and homoerotics as sites of brown maternal knowledges and feminist transgressions. This essay uses memory to examine the different ways that lesbian, both as a term and a mode of being, is not necessarily attached to sexual identity and practices. Analyzing how desire and secrecy are mediated by global capital, postcolonial respectability, nation, and compulsory heterosexuality, brown erotics and sacred notes offers a close look into the nuanced relationality between a brown mother and brown daughter, and takes seriously questions of what constitutes living a feminist life, and being and becoming a lesbian. [ABSTRACT FROM AUTHOR]

Measures to control the COVID-19 pandemic have disrupted social networks and employment security worldwide. Longitudinal data in representative samples are required to understand the corresponding mental health impacts. We aimed to estimate the prevalence of depressive symptoms in Australian women raising young families during the first Victorian lockdown and to identify risk factors. Participants comprise 347 mothers of children aged 7 (mean age: 32·11 years [4·27]), from the Barwon Infant Study (BIS). Mothers had previously completed Edinburgh Postnatal Depression Scale (EPDS) at child ages zero, two, four. Following the lock down, mothers again completed EPDS along with questions regarding current household and employment demographics. Depressive symptoms were substantially more prevalent in the lockdown sample than at any prior assessment (EPDS10+; 30·6%); and were particularly high in women with previous poor mental health. Anticipated and actual job loss were twice as common relative to previous assessment (5% to 13%, p = 0 006) and (4% to 10%, p = 0 001) and were associated with depressive symptoms. While further studies are required to confirm causal associations, these findings highlight the need to support mental health during the COVID-19 pandemic, particularly in the context of employment insecurity and previous mental illness. KEY POINTS What is already known about this topic: Emerging reports from convenience samples demonstrate elevated depressive symptoms during the COVID-19 pandemic. Maternal mental health is important for child mental health. Representative, longitudinal data are needed to further improve targeting of policy and health service delivery to prevent a post-COVID-19 mental health crisis. What this topic adds: This early report from a population-derived cohort demonstrates high rates of depression symptomatology in mothers of school aged children following the first COVID-19 lockdown. A past history of depression and current threats to employment are identified as key risk factors for adverse mental health. Our findings are consistent with concerns regarding an increase in mental health burden in the wake of the COVID-19 pandemic but further studies are required to assess causality. Interventions and broader community resources to support the mental health of women of school aged children are required, and should target those with a history of depression and current threats to employment. [ABSTRACT FROM AUTHOR]

Despite the fact that Levinas has often been accused of having little or no room for the maternal in his writing, his rhetoric nonetheless applies maternal tendencies that complicate his ethical stance and its relation to the experience of vulnerability. Haunting Levinas's oeuvre as the locus classicus for the un-substitutable, which in turn breaks with ontologies of sacrifice, the maternal inflects Levinas's thought in crucial junctures, whether this be the responsibility for the Other, or his thoughts on ipseity, as well as his articulation of the relation to the Same. Through a close reading of the two versions of "Substitution" as well as select passages from Otherwise than Being, the article demonstrates how Levinas's ethical inflection and grid of utterance simultaneously depend on and disavow the maternal as an ontological occurrence. [ABSTRACT FROM AUTHOR]

Maternal hypothyroidism has been reported to have concerns over neonatal outcomes, not only in the context of neurocognitive development but also in the short term as birth weight and neonatal jaundice. We conducted a cross-sectional retrospective study on 638 cases who delivered live births in the Aga Khan University Hospital after ethical approval. Data were collected on hypothyroid pregnant females who were diagnosed before conception or during their antenatal visits during the year 2008–2016. Neonatal outcomes were noted for birth weight, maturity, and neonatal jaundice, neonatal hypothyroidism, neonatal respiratory distress syndrome, sepsis, hypocalcaemia, congenital anomalies, need for intensive care admission, and neonatal death. Subgroup analysis was performed on the timing of diagnosis of maternal hypothyroidism. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Neonatal jaundice was the most common neonatal outcome (37.6%) in our cohort of 662 live births. Nearly 15% required intensive care unit admission, however, neonatal death was very rare. The most common clinically significant congenital anomalies were cardiovascular defects, whereas Mongolian spots were the commonest congenital condition to report. There is a statistically significant association between low birth weight (OR 1.86, 95% CI 1.0–3.2, p ≤ 0.05) and congenital anomalies (OR 2.39, 95% CI 1.4–4.0, p ≤ 0.05) with women diagnosed with hypothyroidism before pregnancy. We report the neonatal outcomes and spectrum of congenital anomalies of hypothyroid pregnancies diagnosed before and during conception for the first time from the region of Pakistan. Overall, none of the neonates of hypothyroid pregnancies developed congenital hypothyroidism. Cardiovascular defects in these neonates imply extensive screening and monitoring during pregnancy. Low birth weight and congenital anomalies are associated with the timings of diagnosis of hypothyroidism in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Infections during pregnancy are a preventable public health concern globally, with the highest burden occurring in low- and middle-income countries. Despite clear interventions to reduce these infections, their impact on preventing stillbirths is unclear, with conflicting evidence.Areas covered: The purpose of this review is to discuss data regarding infectious causes of stillbirths, and interventions for the prevention and/or treatment of these infections. We discuss the limitations in evaluating the true effect of the interventions on stillbirths, and highlight the importance of preventing infections in the grand scheme of improving maternal and infant pregnancy outcomes. We used PubMed to identify relevant studies, reviews, and meta-analysis until January 2021.Expert opinion: Maternal infections during pregnancy, especially malaria and syphilis, are notable causes of stillbirth in low- and middle-income countries. Despite considerable global advocacy, there is scant recognition of the potential to reduce the burden of antepartum stillbirths related to infections. Reducing stillbirths overall must become an important indicator for quality of care and accountability, and progress must also be assessed by coverage of key interventions that impact stillbirths, which includes population-based screening, prevention and timely treatment of infections during pregnancy. [ABSTRACT FROM AUTHOR]

An estimated 38 million and 50 million individuals will have cataract in the U.S. alone by 2030 and 2050, respectively. Breastfeeding is known to improve a number of health outcomes in both breastfed children and breastfeeding mothers. However, little is known about the relationship between breastfeeding and cataract, the leading cause of blindness worldwide, in breastfeeding mothers. This study was conducted to investigate the relationship between breastfeeding and maternal cataract extraction history in a nationally representative sample of the U.S. population. A 10-year multistage, probability-sampling survey data was used to identify parous women aged ≥50 years who provided breastfeeding history and cataract extraction history (n = 4897). Breastfeeding history was considered positive if a participant reported breastfeeding at least one child for ≥1 month. The main outcome was cataract extraction history. Estimates are presented in odds ratios (OR) and 95% confidence intervals (95%CI). Approximately half of the studied women breastfed at least one child ≥1 month, and about 18% reported cataract extraction history. Participants with a positive breastfeeding history were less likely to have a positive cataract extraction history in both age-adjusted (OR = 0.814, 95%CI = 0.670–0.989) and multivariable logistic regression (OR = 0.794, 95%CI = 0.639–0.988). Higher number of breastfed children was also associated with a lower risk of cataract extraction history (OR = 0.934, 95%CI = 0.883–0.988). The findings suggest that breastfeeding may be associated with a decrease in the likelihood of age-related cataract extraction in parous women from the U.S. population. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the relation between CD34+ cells count in maternal blood and potential development of fetal congenital renal abnormalities.Materials and Methods: We enrolled 16 women that gave birth to newborns carrying congenital renal malformations over a 3-year period and 48 women with uncomplicated pregnancies (controls) in a 1:3 ratio (three controls per case).Results: CD34+ cells in the maternal peripheral blood were significantly lower in the group of women who gave birth to newborns carrying congenital renal malformations compared to the controls (p < .0001).Conclusions: CD34+ cells in maternal blood could be validated as a potential marker to predict the development of possible kidney malformations. [ABSTRACT FROM AUTHOR]

This paper considers the evolution of the teaching assistant (TA) role in English primary schools, from the once pejorative description of them as paint pot washers to current conceptualisations of them as pedagogues. How the TA role has evolved and the issues associated with the changes to their deployment in mainstream primary schools will be discussed. Questions will be raised in relation to the type of research undertaken on TAs and whether the overwhelmingly female population of English TAs has influenced the studies conducted. The paper will conclude by sharing the methodology and findings from a recently conducted feminist research project investigating TAs' perceptions of their role. [ABSTRACT FROM AUTHOR]

A telomere is a nucleoprotein structure that is located at the end of a chromosome. Reduced telomere length manifests as physical ailments such as the increased risk of age-related illnesses. These age-related illnesses include heart disease and failure. Telomere length has been studied extensively in adults; however, limited information exists regarding maternal dietary influences on fetal telomere length. The objective of this study is to investigate the relationship between maternal vitamin C intake and fetal telomere length. Data for this analysis were collected as part of a prospective cohort study that recruited pregnant women upon admission into labor and delivery. Umbilical cord serum was collected for 96 maternal–fetal dyads, and DNA analysis was performed using a quantitative polymerase chain reaction. The telomere to single copy gene ratio method was used to determine telomere length, and maternal vitamin C intake was measured using the Dietary History Questionnaire (DHQ). Statistical analysis was conducted using generalized linear modeling-based analyses. The linear model indicates that maternal vitamin C intake (OR = 1.0032, 95%CI: 1.0014–1.0052, p ≤.05) was positively associated with fetal telomere length. BMI (OR = 1.1096, 95%CI: 1.0619–1.1660, p ≤.05) had a significant positive association with fetal telomere length while sodium intake was negatively associated with this outcome (OR = 0.9997, 95%CI: 0.9995–0.9998, p ≤.05). Black ethnicity had a significant negative association with fetal telomere length (OR = 0.0186, 95%CI: 0.0031–0.0824, p ≤.05). Our study shows a positive association between maternal vitamin C intake and fetal telomere length. These findings may provide a method of understanding and preventing adult-onset disease and mortality through intrauterine reprograming. [ABSTRACT FROM AUTHOR]

The chloroplast genomic information was obtained from three wild Solanum and four hybrids by chloroplast genome sequencing. The chloroplast genomes of the seven samples comprise of a circular structure and sizes from 155,581 to 155,612 bp and composed of 130 genes. The genome structures of the two hybrids were identical, while the other two hybrids showed 2 bp differences in the LSC when compared with their maternal parent. The total sites of SNP and InDel were 39–344 and 54–90, respectively. With the exception of one hybrid with two additional sites, the other hybrids were identical to their maternal. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of early versus delayed cord clamping of term births on maternal and neonatal outcomes. Method: A quasi-experimental study was conducted at the Jordan University Hospital in Amman. One hundred twenty-eight mothers expecting a full-term singleton baby were assigned to delayed cord clamping (90 seconds) or early cord clamping (<30 seconds). Results: Delayed cord clamping was associated with higher hemoglobin levels among newborns after 12 hours. On the other hand, early cord clamping was associated with an increased need for oxygen therapy among newborns and occurrence of postpartum hemorrhage among mothers. There were no differences between the groups on any other variable (Apgar score at 1 and 5 minutes, admission to NICU, baby bilirubin levels after 12 hours and day 3 of birth, and mothers' Hb levels after 12 hours of childbirth). Conclusion: Term babies receiving delayed cord clamping had improved hemoglobin levels with no adverse effect on other maternal and neonatal variables. Creating evidence-based practice guidelines for umbilical cord clamping in Jordanian hospitals is essential to improve neonatal and maternal health. [ABSTRACT FROM AUTHOR]

Background: The pursuit of health equity is a priority in Ethiopia, especially with regards to maternal, newborn, and child health (MNCH). To date, there has been little characterization of the 'problem' of health inequity, and the normative assumptions implicit in the representation of the problem. Yet, such insights have implications for shaping the framing, incentivization, and implementation of health policies and their wider impact. Objective: In this article, we characterize how health (in)equity is represented as a policy issue, how this representation came about, and the underlying assumptions. Methods: We draw from Bacchi's 'what is the problem represented to be' approach to explore how national-level actors in the health sector constitute the problem. The data for our analysis encompass 23 key informant interviews with national health sector actors working in leadership positions on MNCH in Ethiopia, and six policy documents. Findings were derived from thematic and content analysis. Results: Health inequity is a normalized and inevitable concern that is regarded as actionable (can be altered) but not fully resolvable (can never be fully achieved). Operationally, health equity is viewed as a technocratic matter, reflected in the widespread use of metrics to motivate and measure progress. These representations are shaped by Ethiopia's rapid expansion of health services into rural areas during the 2000s leading to the positive international attention and funding the country received for improved MNCH indicators. Expanding the coverage and efficiency of health service provision, especially in rural areas, is associated with economic productivity. Conclusion: The metrication of health equity may detract from the fairness, justice, and morality underpinnings of the concept. The findings of this study point to the implications of global pressures in terms of maximizing health investments, and call into question how social, political, and economic determinants of health are addressed through broader development agendas. [ABSTRACT FROM AUTHOR]

Abstract: Verbal abuse during childbirth constitutes a violation of women's human rights and indicates poor maternal health care. The aim of the study was to investigate experiences and drivers of verbal abuse among women in Ndola and Kitwe health facilities. The study adopted a cross-sectional survey. Qualitative and quantitative data using questionnaires and focus group interviews were employed. The study was done in the Ndola and Kitwe districts of Zambia. The target population were women attending postnatal services who had a live birth within 28 days of delivery. Twenty clinics were randomly selected and a total of 306 women were recruited using convenient sampling. Eleven percent of the study population experienced verbal abuse during intrapartum care. A 1-year increase in age reduced the odds of experiencing verbal abuse (Adjusted Odds Ratio [AOR] 0.89, 95% CI: 0.80–0.99). Women who consumed alcohol more frequently experienced verbal abuse than women who never consumed alcohol (adjusted odds ratio [AOR] 5.91, 99% CI 2.12–16.51), and women with bleached skin color more often experienced verbal abuse than women with natural skin tone (AOR = 3.95, 95% CI 1.13–13.83). Further, women with a medium skin tone were less likely (AOR = 0.17, 95% CI = 0.03–0.84) to experience verbal abuse. Other key drivers of verbal abuse include language barriers, laziness, vomiting, lack of seriousness, crying, lack of cooperation, and moving around during labour. We conclude that women experience various forms of verbal abuse. Therefore, there is a need to implement interventions that tackle the multiplicity of factors that drive verbal abuse at the individual, structural, and policy level. Further, there is a need to enhance training in respectful maternity care among service providers. [ABSTRACT FROM AUTHOR]

Infant-cue processing facilitates sensitive maternal care, which is necessary in the formation of healthy mother-infant attachment. Mothers may be particularly focused on cue processing early postpartum, contributing to intense preoccupation with their infant's well-being. Prior reproductive experience, or parity, may also impact the intensity of infant-cue processing and has been found to influence P300 neural responses to infant faces during pregnancy and at 2 months postpartum. However, we do not know whether this parity effect persists. Thus, we examined the P300 to infant faces in 59 mothers at 2 and 7 months postpartum. Our main finding was that primiparous, as compared to multiparous, women showed a significantly higher P300 to infant faces across the postpartum period. Findings further emphasize the importance of studying parity and its impact on the neural processing of infant faces. [ABSTRACT FROM AUTHOR]

Background: Given the increasing rate of cesarean delivery and request without maternal or fetal indication among pregnant women, this systematic review was conducted to obtain the reasons for maternal request for elective cesarean section.Methods: We searched published studies from the first year of records through August 2018 in PubMed, Scopus, and Web of Science. The quality assessment of the studies was performed by the improved Newcastle-Ottawa Scale. Due to data heterogeneity; no meta-analysis was performed.Results: Twenty-eight studies met the inclusion criteria and were included in the review. The results of studies on the reasons of maternal request for elective cesarean section were fear of labor pain, anxiety for fetal injury/death, fear of childbirth, urinary incontinence, pelvic floor and vaginal trauma, doctors suggestion, time of birth, experience of prior bad delivery, previous infertility, infertility, anxiety for gynecologic examination, anxiety for loss of control, avoid long labor, anxiety for lack of support from the staff, fear of fecal, emotional aspects, body weight of the infant at birth and abnormal prenatal examination. The results of studies on the demographic reasons of maternal request for elective cesarean section were advanced maternal age, parity, occupation, education, maternal obesity, family status, decreasing level of religiosity, household income, number of living children and age at marriage.Conclusions: Our study proposed that the comprehensive programs and the interventions of health promotion should be designed to reduce unnecessary cesarean section and improve the performance of vaginal delivery. [ABSTRACT FROM AUTHOR]

Aim: To compare the pregnancy outcome of immigrant women who became pregnant to the same ethnicity partner versus a partner from a different ethnicity.Methods: A retrospective cohort study on all singleton pregnancies of immigrant women who delivered between the years 2011-2015 in a single tertiary University Affiliated Hospital. Demographic and obstetrical data were collected. Same ethnicity couples and mixed couples were compared using the Pearson chi-square test for dichotomous variables, and Student's T-test for normally distributed continuous variables.Results: Overall, 443 immigrant women delivered during the study period, of them, 294 (66.37%) had the same ethnicity spouse and 149 (33.63%) were part of a mixed couple. Women of same ethnicity couples were significantly younger (32.7 versus 35.05 years, p < .0001) and more likely to be nulliparous (48 versus 32%, p = .001), compared to women of mixed couples. The rate of episiotomy was significantly higher among women with the same ethnicity spouse in comparison to women of mixed couples (37.22 versus 23.85%, p = .01). There was no significant difference in all other obstetrical or perinatal outcomes tested.Conclusions: Maternal component is the main factor for perinatal outcomes among immigrant mothers. [ABSTRACT FROM AUTHOR]

Background: The voices of those who have grown up in a family with maternal intellectual or developmental disability (IDD) are valuable for gaining an understanding of their situation, which is essential in order to be able to support these families and avoid potentially detrimental situations. Aim: The study aim was to describe the experience of having grown up in a family where the mother has an IDD, with a focus on everyday life and perceived health consequences in adult life. Method: A qualitative method with retrospective narrative interviews and narrative content analysis was chosen. In-depth interviews were performed with four women who had experiences of a childhood with maternal IDD. Findings: Four themes emerged: Living under adverse circumstances; Dealing with one's everyday life situation; Receiving insufficient support and wishing for more; and The echo from childhood into adult life. The findings revealed a distressing childhood, characterized by neglect, abuse, anxiety, and overburdening responsibilities, and also endeavors to keep the family situation a secret, while at the same time wanting the adult world to react. Discussion: The findings can hopefully stimulate occupational therapists and other professionals to more effectively identify the situation of these children and provide support to prevent adverse future health conditions and poor well-being. [ABSTRACT FROM AUTHOR]

Objective: Iron deficiency anemia is the most common cause of anemia during pregnancy. Other causes of anemia include parasitic diseases, micronutrient deficiencies, and genetic hemoglobin apathies. Maternal anemia during pregnancy is the most important public health problem. Since the relationship between maternal anemia by the months of pregnancy and premature birth has been reported differently in various studies; thus, this study aims to determine the relationship between maternal anemia during pregnancy and premature birth.Methods: This systematic review and meta-analysis article was designed based on the recommendations of PRISMA. This study was performed from 1990 to 2018. Articles extracted using related keywords such as maternal, anemia, premature birth, and pregnancy in databases, including Cochrane, Medline, Medlib, Web of Science, PubMed, Scopus, Springer, Science Direct, Embase, Google Scholar, Sid, Irandoc, Iranmedex, and Magiran. Relative risk and its confidence interval were extracted from each of the studies. The random effects model was used to combine study results and heterogeneity among the studies measured using I2 index and the data were analyzed based by using STATA software version 3.2.Results: Overall 18 studies with sample sizes of 932 090 were entered into the meta-analysis. The overall relationship between maternal anemia during pregnancy and premature birth was significant (1.56 [95% CI: 1.25-1.95]). Maternal anemia in the first trimester increases the risk of premature birth (relative risk, 1.65 [95% CI: 1.31-2.08]). But, this relationship was not significant in the second (relative risk, 1.45 [95% CI: 0.79-2.65]) and third trimester (relative risk, 1.43 [95% CI: 0.82-2.51]).Conclusion: Maternal anemia during pregnancy can be considered as a risk factor for premature birth. [ABSTRACT FROM AUTHOR]

Objective: The studies especially on the postpartum effects of passive exposure to cigarette smoke are limited, although there are studies investigating early and late postpartum effects of active smoking during pregnancy. This study aimed to investigate the relationship between gestational active and passive smoking and early postpartum complications.Methods: This study was conducted with 217 women in the early postpartum period (first 7 days after birth) in a research hospital, gynecology and obstetrics clinic. Data were collected using the questionnaire form prepared in accordance with the literature by the face-to-face interview method. They were evaluated in the SPSS 23.0 program, and descriptive statistics, logistic regression analysis in multivariate analyses and multiple linear regression analysis were in the analysis of data.Results: In the study, it was found that active smoking was associated with cardiac anomalies (OR = 0.18, 95% = CI 0.03-0.91; p = .039), developmental retardation (OR = 0.11, 95% CI = 0.02-0.56; p = .008), respiratory distress (OR = 0.12, 95% CI = 0.02-0.58; p = .008), low birth weight (OR = 0.22, 95% CI = 0.08-0.57; p = .003) and premature labor (OR = 0.30, 95% CI = 0.16-0.59; p = .000) while passive smoking was associated with premature labor (OR = 0.47, 95% CI = 0.25-0.89; p = .021). It was determined that passive smoking was associated with gestational hypertension (OR 0.30, 95% CI = 0.09-0.85; p = .025). Nevertheless, it was found that active smoking negatively affected the infant's birth weight (p = .000), length (p = .040), head circumference (p = .000) and breastfeeding (p = .005).Conclusion: Gestational active and passive smoking has significant negative effects on maternal and infant health in the early postpartum period. [ABSTRACT FROM AUTHOR]

This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12–16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters' step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers' step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p =.009) and daughters (1,393 increase, p =.007). Positive feasibility metrics demonstrated the program's appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial. [ABSTRACT FROM AUTHOR]