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Background: Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective: We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods: This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results: Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators' guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions: This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users' perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth. Trial Registration: ClinicalTrials.gov NCT04693585 (Registration date: 05/01/21). [ABSTRACT FROM AUTHOR]

Becoming a father is a critical period of life transition. Evidence suggests that a lifetime history of mental health disorder/s and elevated depressive symptoms prior to conception increase risk for men's post-natal depression. Less is understood about the role of positive mental health, or wellbeing, as a protective factor for future depressive outcomes during the transition to fatherhood. The present study investigated whether men's post-natal depressive outcomes were associated with pre-conception levels of wellbeing and whether wellbeing during the post-natal period predicted depressive outcomes post-infancy. Secondary analysis of data from a national, longitudinal cohort study of men's health, namely, The Ten to Men (TTM) Study, was conducted. Participants in the pre-conception sample were n = 350 men for whom data were available at both a pre-conception baseline and post-natal follow-up period. The post-natal sample were n = 427 men with post-natal baseline data and post-infancy follow-up data. Multivariate negative binomial regressions and logistic regression models were used to determine pre-conception and post-natal predictors of future depressive outcomes. Men's pre-conception depressive symptoms were the best predictor of post-natal depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) the latter of which was also predicted by a previous mental health diagnosis (IRR = 3.079, p = 0.029). Similarly, post-natal depressive symptoms were the best predictor of post-infancy depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) alongside lifetime prevalence of a mental health disorder (symptoms: IRR = 1.317, p = 0.011; moderate-severe depression: IRR = 2.606, p = 0.023). Pre-conception levels of wellbeing predicted lower post-natal depressive symptoms (IRR = 0.988, p < 0.001) and reduced risk of moderate-severe depression (IRR = 0.940, p = 0.002) after controlling for baseline symptoms and socio-demographic and behavioural confounds; however, wellbeing during the post-natal period did not predict either of the depressive outcomes post-infancy. Fatherhood-specific risk factors for mental health outcomes (e.g., conception difficulties, maternal post-natal mental health) were not assessed in the present study, and only one aspect of wellbeing was captured. Screening for history of common mental health disorders and current symptoms is recommended to inform preventative approaches to paternal mental health care during early fatherhood. Inclusion of wellbeing in such screening procedures may be beneficial; however, further research is required to elucidate the prospective associations between wellbeing and depressive symptoms during the transition to fatherhood. • Approximately 1 in 10 men screen positive for depression in the postnatal period. • Future depressive outcomes are best predicted by prior mental ill-health. • Preconception wellbeing protective against postnatal depressive outcomes • Postnatal wellbeing not associated with depressive outcomes post-infancy [ABSTRACT FROM AUTHOR]

Background: Globally, alarmingly high rates of maternal and infant mortality and morbidity persist. A constellation of health system and social factors contribute to this, including poor quality and barriers to accessing health care, including preventive services. As such, there have been calls for a redesign of maternal and child health (MCH) services. Although group care has primarily been tested in antenatal settings, it offers a promising redesign that optimizes maternal and child health care, survival, and well-being. The purpose of this study was to produce a blueprint of an adapted group care model that integrates postnatal maternal care, well-child care, and family engagement to be adapted to realities of different settings. Methods: Using a human-centered design approach and the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME), we employed qualitative methods to adapt CenteringParenting® (retaining its three core pillars of health assessment, interactive learning, and community building), and co-create the blueprint for group care beyond birth that can be used across settings. We initiated the process through face-to-face workshops during a global meeting on group care, followed by six online incubator sessions with key stakeholders from 13 countries during which we used qualitative methods of free listing, pile sorting, and ranking. We conducted a rapid qualitative analysis to produce a blueprint. Results: Participants collaboratively modified the content, format, and evaluation of CenteringParenting® with the goal of creating a blueprint that integrates postnatal and pediatric care into group care that can be further adapted and implemented across diverse settings and contexts. The blueprint consists of suggested timing of visits over two years after birth, suggested visit content, and evaluation metrics for research and practice. Conclusions: The resulting group care beyond birth blueprint offers a strategy to redesign maternal and infant/child health services that can positively transform postnatal care and provide essential services to postpartum people. Adaptation of the blueprint to local realities is expected. Future research is recommended to test the model's acceptability, feasibility, and effectiveness across settings. Using this blueprint, we can build the evidence base to support this model aiming to improve maternal and infant/child health outcomes. [ABSTRACT FROM AUTHOR]

AbstractWe previously developed a quantitative weight-of-evidence (QWoE) framework using prespecified scoring criteria for preclinical acetaminophen data to characterize potential developmental neurotoxicity outcomes with considerations for biological relevance of the response to adverse outcomes and the strength of methods and study design. The current analysis uses this framework to characterize potential developmental and reproductive toxicity (DART) outcomes following exposure to acetaminophen. Two-hundred forty-two QWoE entries were documented from in vivo rodent studies identified in 110 publications across five categories: DART endpoints in the context of (1) periadolescent/adulthood (nonpregnancy) exposures; (2) pregnant female exposures; and, for in utero or other developmental exposures, (3) anatomical abnormalities, (4) reproductive development, and (5) other physical development. A mean outcome score and methods score were calculated for 242 QWoE entries. Data analyzed in our framework were of moderate quality showing no consistent evidence of DART in male and female rodents following exposure to acetaminophen at therapeutic and/or non-systemically toxic doses. Similar results were found for the individual context- and outcome-related endpoint analyses and as segregated by sex. Overall, this QWoE analysis on the in vivo rodent data demonstrated no consistent evidence of adverse effects following exposure to therapeutic and/or non-systemically toxic acetaminophen on development or on the structure and function of the reproductive system. [ABSTRACT FROM AUTHOR]

AbstractAcetaminophen [paracetamol; N-acetyl-para-aminophenol (APAP)] is an antipyretic/analgesic commonly used in the treatment of fever and mild to moderate pain, headache, myalgia, and dysmenorrhea. Recent literature has questioned the safety of acetaminophen use during pregnancy, with an emphasis on whether exposure to the developing nervous system results in behavioral changes consistent with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and/or other cognitive deficits in the offspring. No previous review has used a fully detailed, quantitative weight-of-evidence (QWoE) approach to critically examine the preclinical acetaminophen data with regards to potential developmental neurotoxicity (DNT). Following regulatory guidance, a QWoE framework using prespecified scoring criteria was developed consistent with previous approaches to characterize potential adverse DNT outcomes with considerations for biological relevance of the response to adverse outcomes (outcome score) and the strength of methods and study design (methods score). Considerations for the methods score included (1) experimental design, (2) details/reliability of measurement(s), (3) data transparency, and (4) translational/methodological relevance. Considerations for the outcome score included response-related (1) statistical significance, (2) dose-response, (3) relevance/reliability/magnitude, (4) plausibility, and (5) translational relevance, including consideration of systemic toxicity/hepatotoxicity and therapeutic and/or non-systemically toxic doses and durations of use. Application of this QWoE framework to the 34 in vivo studies identified that assess the potential DNT of acetaminophen resulted in 188 QWoE entries documented across 11 DNT endpoints: social behavior, stereotypic behavior, behavioral rigidity, attention/impulsivity, hyperactivity, anxiety-like behavior, sensorimotor function, spatial learning/memory, nonspatial learning/memory, neuroanatomy, and neurotransmission. For each endpoint, the mean outcome score and methods score were calculated for total entries and for entries segregated by sex to assist in determining data quality and potential adversity. Informed by all 188 entries, the QWoE analysis demonstrated data of moderate quality showing no consistent evidence of DNT in male and female rodents following exposure to acetaminophen at therapeutic and/or nonsystemically toxic doses. Although some of the DNT endpoints (behavioral rigidity, attention/impulsivity, spatial learning/memory, neuroanatomy, and neurotransmission) generally displayed a more limited dataset and/or relatively lower data quality, similar conclusions were drawn based on results indicating a lack of biological relevance and reliability of reported adverse effects. Overall, this QWoE analysis on the preclinical in vivo data demonstrates no consistent evidence of adverse effects following developmental exposure to acetaminophen at therapeutic and/or non-systemically toxic doses on the structure and function of the nervous system, including neuroanatomical, neurotransmission, and behavioral endpoints. [ABSTRACT FROM AUTHOR]

Regarding treasures, babies emerge as divine gifts, exuding beauty that transcends words. Their delicate features and tender innocence evoke an indescribable admiration. However, understanding the physiological and biological processes that go into giving birth makes it clear that childbirth is traumatic. But why do women make childbirth and motherhood strolls in the park? Is there a fear, perhaps, that being honest diminishes the beauty of being a mother? Can the two things not be true—that it is traumatic to give birth and beautiful to bring a human being into the world? In romanticizing this process, is society not setting parameters for the shunning and shaming of women who experience problems like post-partum depression or even post-traumatic stress disorder resulting from childbirth? Is the romanticized narrative around childbirth and even motherhood, not a foundation on which shaming women who dare to say "I wanted to die rather than go through the birth" or "I want a break from my child" is built? This qualitative study investigated 64 mothers and would-be mothers in Lagos State about their pregnancy expectations. Mothers, drawn from a mix of socioeconomic ethnic and backgrounds agreed that truths and realities about pregnancy, childbirth, and motherhood are often masked or infrequently discussed in the motherhood narrative. It is also common to hear mothers speak about how great their children are, and rarely can one ever hear women talk about traumas of childbirth that are dangerous and have significant effects or impact on women's quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Chronic fetal hypoxia is commonly associated with fetal growth restriction and can predispose to respiratory disease at birth and in later life. Antenatal antioxidant treatment has been investigated to overcome the effects of oxidative stress in utero to improve respiratory outcomes. We aimed to determine if the effects of chronic fetal hypoxia and antenatal antioxidant administration persist in the lung in early adulthood. Methods: Chronically catheterised pregnant sheep were exposed to normoxia (N; n = 20) or hypoxia (H; n = 18; 10% O2) ± maternal daily i. v. saline (N = 11; H = 8) or Vitamin C (VC; NVC = 9; HVC = 10) from 105 to 138 days (term, ∼145 days). Lungs were collected from female lambs 9 months after birth (early adulthood). Lung tissue expression of genes and proteins regulating oxidative stress, mitochondrial function, hypoxia signalling, glucocorticoid signalling, surfactant maturation, inflammation and airway remodelling were measured. Results: Chronic fetal hypoxia upregulated lung expression of markers of prooxidant, surfactant lipid transport and airway remodelling pathways in early adulthood. Antenatal Vitamin C normalized prooxidant and airway remodelling markers, increased endogenous antioxidant, vasodilator and inflammatory markers, and altered regulation of hypoxia signalling and glucocorticoid availability. Conclusion: There are differential effects of antenatal Vitamin C on molecular markers in the lungs of female lambs from normoxic and hypoxic pregnancy in early adulthood. [ABSTRACT FROM AUTHOR]

Objective: To determine the change in English emergency postnatal maternal readmissions 2007–2017 (pre‐COVID‐19) and the association with maternal demographics, obstetric risk factors and postnatal length of stay (LOS). Design: National cohort study. Setting: All English National Health Service hospitals. Population: A total of 6 192 140 women who gave birth in English NHS hospitals from April 2007 to March 2017. Methods: Statistical analysis using birth and readmission data from routinely collected National Hospital Episode Statistics (HES) database. Main Outcome Measures: Rate of emergency postnatal maternal hospital readmissions related to pregnancy or giving birth within 42 days postpartum, readmission diagnoses and association with maternal demographic factors, obstetric risk factors and postnatal LOS. Results: A significant increase in the rate of emergency postnatal maternal readmissions from 15 128 (2.5%) in 2008 to 20 734 (3.4%) in 2016 (aOR 1.32, 95% CI 1.28–1.37) was found. Risk factors for readmission included minoritised ethnicity (particularly Black or Black British ethnicity: aOR 1.35, 95% CI 1.31–1.39); age < 20 years (aOR 1.09, 95% CI 1.05–1.12); 40+ years (aOR 1.07, 95% CI 1.03–1.10); primiparity (multiparity: aOR 0.92, 95% CI 0.91–0.93); nonspontaneous vaginal birth modes (emergency caesarean: aOR 1.86, 95% CI 1.82–1.90); longer LOS (4+ vs. 0 days: aOR 1.58, 95% CI 1.53–1.64); and obstetric risk factors including urinary retention (aOR 2.34, 95% CI 2.06–2.53) and postnatal wound breakdown (aOR 2.01, 95% CI 1.83–2.21). Conclusions: The concerning rise in emergency maternal readmissions should be addressed from a health inequalities perspective focusing on women from minoritised ethnic groups; those < 20 and ≥ 40 years old; primiparous women; and those with specified obstetric risk factors. [ABSTRACT FROM AUTHOR]

Midwives are in an optimum position to address the mental health of new fathers and paternal perinatal mental health is a recognised concern. However, the mechanisms that exist to recognise, escalate and intervene appropriately are limited in scope and effectiveness. Screening tools may have the potential to identify fathers at risk of postpartum depression, but they are limited in sensitivity and specificity, meaning that when there may be deterioration in a partner's mental health, diagnosis may not follow. This has implications for the health and wellbeing of the family, especially if male partners are relied upon as the mainstay of emotional and social support for women in the early postnatal period. To actualise strategies to address these issues, changes in policy, education and practice are required. Recommendations for research, education and patient engagement are made to assure early intervention and to ensure that emotional and social support in the family is optimised. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to evaluate the effects of mindfulness interventions on women's mental health in the perinatal and postpartum period. In the study, randomized controlled studies published in the last five years, from January 2018 to September 2023, were searched in CINAHL, PubMed, Cochrane Library, Science Direct, and Springer Link databases. The keywords "Pregnancy", "Pregnant", "Prenatal", "Perinatal", "Postpartum", "Mindfulness", "Meditation", "Self-compassion" and "Randomized controlled trial" were used while searching the databases. The assessed articles were subjected to quality assessment using the PRISMA checklist and the Joanna Briggs Institute's Critical Appraisal Checklist for Randomized Controlled Trials. As a result of the search, 26 studies were found. The studies revealed that the most commonly applied mindfulness intervention among intervention groups was self-help programs in an online setting. Mindfulness-based practices significantly impacted women's mental health, reducing fear of childbirth, depression, anxiety, and stress levels, while enhancing psychological well-being, self-efficacy, self-compassion, and mindfulness. Furthermore, these practices also benefited women's physical health, contributing to higher rates of normal vaginal births and increased maternal-fetal attachment. They were found to lessen birth pain, reduce the need for medication or anesthesia, and support the adoption of healthy lifestyle behaviors. These findings suggest that mindfulness interventions, which positively influence the mental health of both mothers and infants, should be widely applied to women, and the results of this study should be disseminated. [ABSTRACT FROM AUTHOR]

There is growing international evidence of the benefits of early perinatal palliative care for babies and their families. Despite this, inconsistency remains in ways care is provided by services including fetal medicine, maternity and neonatal services, and children's hospices. The aim of this study was to answer the question " What are the benefits and barriers to family-centered perinatal advance care planning from the perspective of professionals involved in the care of neonates and infants with life-limiting conditions? " Three focus groups comprising hospice practitioners were held across the UK. A lack of awareness of the role of hospices was described as the biggest barrier to referral to hospice services. Practitioners unanimously described having a physical presence alongside teams, as being the biggest contributor to improved multiagency working, facilitated through joint working and education provision. Early referral to hospice services, in parallel with curative services led to better outcomes and experiences of families, according to participants. [ABSTRACT FROM AUTHOR]

Focused Clinical Question: In individuals reporting low back pain postpartum, is exercise an effective intervention to reduce symptoms? Clinical Bottom Line: There is moderate evidence to support the use of an exercise intervention to reduce pain and improve functional disability in postpartum females with low back pain. [ABSTRACT FROM AUTHOR]

Background: Service gaps continue in hospital and community-based postnatal care despite a high prevalence of physical and mental health concerns reported by women following birth. The aim of this study was to describe the postnatal journey and the care provided to women and their babies who were at low risk for health complications from birth to discharge from the maternity service. Methods: A mixed methods design was used to map the postnatal journey, for the woman and baby, from birth to discharge from the maternity service. Data were collected through activity diaries completed by 15 women and telephone interviews with the women two weeks after birth. Results: The average hospital postnatal stay was 70 h and, in this time, the women received on average, a total of 3 h of direct care from a health professional. That is, 4.3% of the in-hospital postnatal stay was spent interacting with a health professional. Approximately 53 min of care in the postnatal unit was directed at the mother's health, 50 min on the baby's health needs, 43 min supporting breastfeeding and 20 min on discharge information. Most reported that hospital based postnatal care was helpful, although they reported that staff on the postnatal unit were rushed and mostly the midwife caring for them was unfamiliar to them. Breastfeeding support in the first 12–24 h was limited, with women wanting more one-on-one access to midwives. Some women received home-based midwifery care, and on average each home visit by a midwife was 29 min. Women who received home-based midwifery care reported that this care was very helpful. Women reported that home-based midwives were more likely to engage women in conversations about their social and emotional needs than hospital-based midwives. All mothers were offered a home visit from a child and family health nurse and most visited a general practitioner in the first week. Conclusions: Women often experience limited time in direct interaction with midwives in the postnatal unit in hospital. Those who received midwifery care at home were more satisfied with this care, Women are requesting more support from professionals in the early postnatal period. [ABSTRACT FROM AUTHOR]

Pregnancy and childbirth involve substantial physical, physiological and psychological changes. As such, postpartum rugby players should be supported and appropriately prepared to return to the demands of rugby alongside the additional demands of motherhood. This review aims to discuss specific perinatal considerations that inform a rugby player's readiness to return‐to‐sport postpartum and present an approach to rehabilitation. Before engaging in full rugby training and matchplay, postpartum players should have progressed through the initial phases of rehabilitation and graded sports‐specific training to prepare them for the loads they will be exposed to. Additional rehabilitation considerations include minimising deconditioning during pregnancy; medical concerns; the abdominal wall; the pelvic floor; perinatal breast changes, breastfeeding and risk of contact breast injury; body mass; nutritional requirements; hormonal considerations; athlete identity and psychological considerations; joining team training; return to contact and tackle training; evaluating player load tolerance and future research, policy and surveillance needs. A whole‐systems, biopsychosocial approach following an evidence informed return‐to‐sport framework is recommended when rehabilitating postpartum rugby players. Health and exercise professionals are encouraged to use the perinatal‐specific recommendations in this review to guide the development of postpartum rehabilitation protocols and resources. Highlights: Unlike an injury, the postpartum period is a transitional time with unique biopsychosocial considerations, many of which can be anticipated and prepared for during pregnancy.Player education should commence early before they likely transition into motherhood.Before engaging in rugby postpartum, players should progress through the initial phases of a postpartum return‐to‐sport framework to respect tissue healing and prepare for the progressive loads they may be exposed to.Welfare and long‐term player health should focus across the player lifespan and playing level (from girls and community to the elite women's game). It also serves to educate others involved in the women's game (match officials, coaches, fans and family members) regarding key aspects of women's physical and mental well‐being (e.g., pregnancy and postpartum). [ABSTRACT FROM AUTHOR]

Objective: This integrative literature review aims to discuss the benefits and limitations of postnatal surgery to correct myelomeningocele using the placenta as an autologous graft used on the lesion; in addition, it seeks to highlight the placental properties and the benefits and indications of surgery. Methods: For this production, the PRISMA criteria were used. PubMed was used as a database on October 19, 2023, and three searches were made, all using the words "myelomeningocele" and "surgery" varying only between "amnion," "placenta," and "chorion" as the third word. A total of 91 articles were found, and after analysis of duplicates and inclusion and exclusion criteria, only 11 articles were used in this systematic review. Results: Properties of the amniotic membrane were observed, such as anti-inflammatory, stimulation of native tissue growth, regenerating action by the secretion of neutrophil factors, promotion of epithelialization, inhibition of fibrosis and healing, and antibacterial effect. It is observed that there are benefits in using the placenta as an autograft and there are contradictions between the periods of surgery. Conclusion: Due to its properties that accelerate healing, the absence of the possibility of rejection, and its easy access make this choice more frequently adopted. We are confident in saying that the effectiveness of the amniotic membrane is widely reliable. [ABSTRACT FROM AUTHOR]

Objective: Suicide is a leading cause of death in males aged 25–44 years, an age which often coincides with becoming a father. This review aims to synthesise the evidence of the prevalence of suicidal and self-harm ideation in fathers during the perinatal, postnatal and early parenting period. Methods: Five databases were searched (PsycINFO, Medline, Web of Science, PubMed and the Cochrane Database of Systematic Reviews) to identify papers published between 1 January 2000 and 9 March 2023. A meta-analysis was conducted to estimate the prevalence of suicidality and self-harm ideation across the included studies. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity. Results: A total of 4215 articles were identified, with 14 studies included in the review. The combined pooled prevalence of suicidal and self-harm ideation was 4.2% (95% CI [2.6%, 6.2%]). Prevalence estimates were higher for self-harm ideation at 5.1% (95% CI [2.6%, 6.2%]) than for suicidality at 3% (95% CI [0.9%, 6.1%]). Conclusions: This review found that a considerable proportion of fathers experience suicidal and self-harm ideation during the early years of parenting. However, the paucity of rigorous prevalence studies indicates that further research in this area is needed urgently. [ABSTRACT FROM AUTHOR]

The study was conducted at the Department of Veterinary Anatomy, College of Veterinary Science and Animal Husbandry, Nanaji Deshmukh Veterinary Science University, Jabalpur, Madhya Pradesh, India, from January to June, 2020. It involved the hearts of 18 prenatal and 12 postnatal normal, healthy goats (Capra hircus). The heart was located in the ventral part of the thoracic cavity, within the middle mediastinal space, enclosed by the pericardium. In groups I and II, the heart appeared oval, while in groups III, IV and V, it assumed a flattened cone shape, reflecting progressive maturation. The heart weight relative to body weight was highest in group I and lowest in group V, indicating a gradual reduction in relative heart mass with age. A significant positive correlation was found between body weight and both heart weight and volume, with heart volume increasing consistently across all groups. The cranial border of the heart was longer than the caudal, while the coronary fat increased progressively from group I to group V, contributing to the functional efficiency of the heart. The heart's transverse diameter exceeded the sagittal in all groups, reflecting lateral growth, while the left ventricular wall was significantly thicker than the right ventricular wall and the interventricular septum, a structural adaptation to higher pressure loads in systemic circulation. These findings provide valuable insight into the anatomical development and physiological adaptations of the heart across prenatal and postnatal stages in goats, contributing to a better understanding of cardiovascular growth patterns in this species. [ABSTRACT FROM AUTHOR]

Congenital hand and upper limb differences may be detected during antenatal ultrasonography or visually at birth. We investigated the experience of parents when they first learned that their child had an upper limb difference. This national retrospective cross-sectional quantitative and qualitative survey within the UK and Ireland received 261 responses from parents of children. Differences were first suspected antenatally among 41% of respondents and in 57% postnatally, with 2% unsure. Of the children, 54% were seen in a clinic by a specialist congenital hand surgeon within 3 months and 88% within 12 months, with 73% of respondents feeling unsupported after a diagnosis that was unexpected. Qualitative analysis outlined a broad spectrum of parental concerns about the quality of information received, especially regarding the child's future biopsychosocial needs. This study showed the need for more support for parents from frontline healthcare professionals and the need for a streamlined referral pathway. Level of evidence: IV [ABSTRACT FROM AUTHOR]

Aim: Parents' postnatal sense of security is often mentioned in recent publications, but there is no consensus on its definitions and measurement. A concept analysis was conducted to clarify the definition, the attributes, antecedents and the consequences of parents' postnatal sense of security and to promote consistency in its usage. Design: Walker and Avant's eight‐step concept analysis model was adopted to define the concept of parents' postnatal sense of security. Methods: A comprehensive search of multiple databases (Sinomed, CNKI, Wanfang database, CINAHL, PubMed, Embase, Web of Science, ProQuest, PsyInfo and Cochrane Library) was conducted to identify relevant articles from the inception of the databases until December 2022. In addition, a manual search was performed to gather any additional papers related to the topic. Ultimately, a total of 48 articles were included in the concept analysis. Results: Three attributes were identified: perceive one's physical well‐being not being threatened, feel confident and in control of the parenting role, feel confident in one's available relationships. The identified antecedents were: being prepared for child rearing, being in familiar or safe environment, general well‐being of the baby and parents, support from medical staff and family members, being empowered by medical staff. Consequences of parents' postnatal sense of security included successful adaptation to the parental role, decreased postpartum depression symptoms in mothers, successful infant care and the development of parent‐infant relationship. [ABSTRACT FROM AUTHOR]

Achondroplasia is the most common form of human dwarfism caused by mutations in the FGFR3 receptor tyrosine kinase. Current therapy begins at 2 years of age and improves longitudinal growth but does not address the cranial malformations including midface hypoplasia and foramen magnum stenosis, which lead to significant otolaryngeal and neurologic compromise. A recent clinical trial found partial restoration of cranial defects with therapy starting at 3 months of age, but results are still inconclusive. The benefits of achondroplasia therapy are therefore controversial, increasing skepticism among the medical community and patients. We used a mouse model of achondroplasia to test treatment protocols aligned with human studies. Early postnatal treatment (from day 1) was compared with late postnatal treatment (from day 4, equivalent to ~5 months in humans). Animals were treated with the FGFR3 inhibitor infigratinib and the effect on skeleton was thoroughly examined. We show that premature fusion of the skull base synchondroses occurs immediately after birth and leads to defective cranial development and foramen magnum stenosis in the mouse model to achondroplasia. This phenotype appears significantly restored by early infigratinib administration when compared with late treatment, which provides weak to no rescue. In contrast, the long bone growth is similarly improved by both early and late protocols. We provide clear evidence that immediate postnatal therapy is critical for normalization of skeletal growth in both the cranial base and long bones and the prevention of sequelae associated with achondroplasia. We also describe the limitations of early postnatal therapy, providing a paradigm-shifting argument for the development of prenatal therapy for achondroplasia. [ABSTRACT FROM AUTHOR]

Abstract Background Globally, alarmingly high rates of maternal and infant mortality and morbidity persist. A constellation of health system and social factors contribute to this, including poor quality and barriers to accessing health care, including preventive services. As such, there have been calls for a redesign of maternal and child health (MCH) services. Although group care has primarily been tested in antenatal settings, it offers a promising redesign that optimizes maternal and child health care, survival, and well-being. The purpose of this study was to produce a blueprint of an adapted group care model that integrates postnatal maternal care, well-child care, and family engagement to be adapted to realities of different settings. Methods Using a human-centered design approach and the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME), we employed qualitative methods to adapt CenteringParenting® (retaining its three core pillars of health assessment, interactive learning, and community building), and co-create the blueprint for group care beyond birth that can be used across settings. We initiated the process through face-to-face workshops during a global meeting on group care, followed by six online incubator sessions with key stakeholders from 13 countries during which we used qualitative methods of free listing, pile sorting, and ranking. We conducted a rapid qualitative analysis to produce a blueprint. Results Participants collaboratively modified the content, format, and evaluation of CenteringParenting® with the goal of creating a blueprint that integrates postnatal and pediatric care into group care that can be further adapted and implemented across diverse settings and contexts. The blueprint consists of suggested timing of visits over two years after birth, suggested visit content, and evaluation metrics for research and practice. Conclusions The resulting group care beyond birth blueprint offers a strategy to redesign maternal and infant/child health services that can positively transform postnatal care and provide essential services to postpartum people. Adaptation of the blueprint to local realities is expected. Future research is recommended to test the model’s acceptability, feasibility, and effectiveness across settings. Using this blueprint, we can build the evidence base to support this model aiming to improve maternal and infant/child health outcomes.

Abstract Background Pregnancy resulting from Medicalised Conception (MAC) is increasingly prevalent. In-Vitro Fertilisation (IVF) is the most common type of treatment which has been linked to increased pregnancy-specific anxiety and different approaches to parenting. This study explored the experiences of pregnancy and the transition to parenthood in individuals who conceived via IVF, identifying how they coped with any psychological difficulties. Method Participants who successfully achieved pregnancy via IVF and had given birth to an infant aged 12 weeks to two years old, were interviewed. Interviews were audio-recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Results Based on data from 12 British participants, three superordinate themes were identified: (1) The lasting imprint of IVF: unidentified and unmet psychological needs. The resultant loss, grief and powerlessness associated with the IVF treatment left individuals emotionally vulnerable entering pregnancy. The lasting impact of IVF was evident, influencing birth preferences and feeding choices. (2) The fragility of pregnancy: helpless and existing in a world of uncertainty. Pregnancy was often approached with caution and trepidation, leading to methods of self-protection, such as difficulties in believing the existence of the pregnancy. (3) The parental function of healthcare systems: needing an anchor and a sense of safety highlighted the pivotal role of health systems and their ability to perpetuate or alleviate distress. Conclusions The psychological vulnerability of parents after IVF needs to be considered throughout the perinatal period. Monitoring of psychological well-being and the implementation of specialist services and peer support for individuals who conceive via IVF are recommended.

INTRODUCTION: The role of social support in antiretroviral therapy (ART) uptake and retention among pregnant and postpartum women in Ghanas capital, Accra, has received limited attention in the literature. This cross-sectional study extends existing knowledge by investigating the role of social support in ART adherence and retention among pregnant and postpartum women in Accra. METHODS: We implemented a cross-sectional study in eleven (11) public health facilities. Convenience sampling approach was used to recruit 180 participants, out of which 176 with completed data were included in the study. ART adherence in the three months preceding the survey (termed consistent uptake), and ART retention were the outcomes of interest. Initial analysis included descriptive statistics characterized by frequencies and percentages to describe the study population. In model building, we included all variables that had p-values of 0.2 or lesser in the bivariate analysis to minimize negative confounding. Overall, a two-sided p-value of

Background: The prevalence of gestational diabetes mellitus (GDM) is rapidly increasing. It is associated with adverse physical and mental health outcomes for women and their babies. Mother-infant bonding is important for maternal health and infant development, but the effect of GDM on mother-infant bonding has not been examined. Objective: To explore and describe the impact of GDM on perceived mother infant-bonding in the antenatal and postnatal period. Methods: Qualitative, individual, semi-structured interviews were conducted with 33 women from diverse backgrounds with current or previous GDM. Data were analysed using reflexive inductive thematic analysis. Results: Three main themes were generated from the analysis: 1) Concern for baby's health and its impact on bonding; 2) GDM management, the pregnancy experience, and bonding; 3) Continuity and discontinuity of the impact on bonding between the antenatal and postnatal periods. Conclusion: It was found that GDM can have both positive and negative impacts on perceived mother-infant bonding, which appear to change over the course of the perinatal period. Further observational research is needed to assist in understanding the impact of GDM on mother-infant bonding and the potential mediating effect of mental disorders, including depression. [ABSTRACT FROM AUTHOR]

Abstract Prematurity has physical consequences, such as lower birth weight, decreased muscle mass and increased risk of adult‐onset metabolic disease. Insulin‐like growth factor 1 (IGF‐1) has therapeutic potential to improve the growth and quality of muscle and tendon in premature births, and thus attenuate some of these sequalae. We investigated the effect of IGF‐1 on extensor carpi radialis muscle and biceps brachii tendon of preterm piglets. The preterm group consisted of 19‐day‐old preterm (10 days early) piglets, treated with either IGF‐1 or vehicle. Term controls consisted of groups of 9‐day‐old piglets (D9) and 19‐day‐old piglets (D19). Muscle samples were analysed by immunofluorescence to determine the cross‐sectional area (CSA) of muscle fibres, fibre type composition, satellite cell content and central nuclei‐containing fibres in the muscle. Tendon samples were analysed for CSA, collagen content and maturation, and vascularization. Gene expression of the tendon was measured by RT‐qPCR. Across all endpoints, we found no significant effect of IGF‐1 treatment on preterm piglets. Preterm piglets had smaller muscle fibre CSA compared to D9 and D19 control group. Satellite cell content was similar across all groups. For tendon, we found an effect of age on tendon CSA, and mRNA levels of COL1A1, tenomodulin and scleraxis. Immunoreactivity for elastin and CD31, and several markers of tendon maturation, were increased in D9 compared to the preterm piglets. Collagen content was similar across groups. IGF‐1 treatment of preterm‐born piglets does not influence the growth and maturation of skeletal muscle and tendon.

Simple Summary: We investigated the health and growth of dairy calves in southern Brazil. Over the course of a year, we tracked 547 calves from 70 farms across 27 municipalities, focusing on factors such as farming practices, nutrition, and health care. The average pre-weaning mortality rate was 6.8%. The main disease affecting calves was diarrhoea; additionally, weight gain (570 ± 212 g/d) was insufficient for calves to double their weight by the time they were weaned. Despite differences in farm size and management, the calf morbidity and mortality rates were similar to international studies. Our findings suggest that colostrum and milk feeding, as well as the quality of the rearing environment are major challenges to be overcome in the studied region and may help explain the relatively poor productive performance and economic viability of dairy activity in many farms in the region. They can be useful for future comparisons between farms, as well as to support extensionists, consultants, and dairy farmers and to guide official programs. This study investigates morbidity, mortality, and weight gain in pre-weaned female dairy calves, which pose economic and animal welfare challenges for farms, particularly in family-run operations in southern Brazil. We aimed to identify the rates and factors associated with these outcomes in Alto Uruguai, Rio Grande do Sul, Brazil, tracking 547 calves from 70 farms across 27 municipalities from July 2015 to September 2016. We assessed calf-rearing practices, nutrition, health, and the environment using farmer questionnaires, direct observations, and systematic weight and health monitoring of female calves from birth to weaning. The association between predictors and perinatal mortality (stillbirths and deaths within 24 h), postnatal mortality (deaths from 25 h after birth to weaning), calf morbidity, and weight gain was analysed through regression models. The participating farms had 25 (9–70) (median and range) lactating cows and produced 411 (96–1631) L/d of milk (median and range). Total mortality rate was 6.8% (median 0, range 0–50%/range), of which 2.4% (median 0, range 0–50%/range) was perinatal and 4.5% (median 0, range 0–40%/range) postnatal. Average morbidity was one case for every five calves born alive (106/538), 83% of which were reported as diarrhoea cases. Weight gain was 570 ± 212 g/d (mean and standard deviation). The postnatal mortality rate was highest in the first few weeks of life and among calves with at least one case of diarrhoea. Younger and winter/spring-born calves became sick more frequently. The calves of purebred bulls, fed with cow's milk, which received at least 4 L of milk and 0.5 kg of feed daily, had greater weight gain. The calf mortality rate was at the lower end of the range reported in international research. The main disease affecting calves was diarrhoea, and weight gain was insufficient for calves to double their weight by the time they were weaned. The results of the present study suggest that the quality of the management adopted in calf rearing in many of the family-run dairy farms of southern Brazil may be compromising the welfare, health, performance, and survival of the calves and possibly the productivity of dairy herds. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Quality maternity care is known to improve a range of maternal and neonatal outcomes. The Lancet Series on Midwifery's Quality Maternal and Newborn Care (QMNC) Framework is a high‐level synthesis of the global evidence on quality maternity care. Initial qualitative work demonstrated the Framework's adaptability in evaluating service user and provider perceptions of the quality of maternity care. However, evaluating services at scale requires a survey instrument. This paper reports the validation of the QMNC Framework index (QMNCFi), a five‐part survey for the evaluation of maternity care across diverse settings.International online English language survey of women who had given birth in the previous year in Australia, Ghana, India and the United Kingdom (UK). It was distributed through service user networks (UK and Australia) and at postnatal clinics (Ghana and India). All forms were completed online. Test–retest was conducted to assess reliability.Five hundred and forty mothers completed the survey (Australia 136; Ghana 131; India 153; UK 120). Construct validity: Cronbach's α in 12 of the survey's 13 sections ranged from 0.795 to 0.986; for the remaining section the alpha was 0.594. Reliability: 55 participants completed the QMNCFi a second time. Intraclass correlation coefficient results ranged from 0.657 to 0.939 across the 13 sections. Field researchers in Ghana and India reported that the survey was easily understood and completed.This survey has shown that, across diverse contexts, the QMNCFi is a valid, reliable, and comprehensive tool for measuring service user perceptions of the quality of care over time. [ABSTRACT FROM AUTHOR]

Background: Screening for perinatal depression can lower its prevalence and ensure that mothers receive adequate treatment and support. Yet, few practitioners screen for it. The present article is a brief review of barriers to screening, and two screening scales are validated for perinatal women. Findings: Even though health organizations recommend screening, most new mothers are not screened. Providers cite a lack of time, opening "Pandora's box," and a lack of resources for mothers who screen positive as the reasons why they do not screen for this condition. The Edinburgh Postnatal Depression Scale and the Patient Health Questionnaires are brief screening scales validated for new mothers and widely available. Conclusions: Screening is necessary to identify depression in pregnant and postpartum women. Practitioners who screen for this condition need a clear plan and knowledge of how to access available community resources so that they know what to do when a mother screens positive. [ABSTRACT FROM AUTHOR]

Background: Anxiety in pregnancy and postnatally is highly prevalent but under‐recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal. Methods: A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi‐structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes. Results: Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) Raising awareness; (2) Improving support; (3) Surveillance and stigma; (4) Gatekeeping; (5) Personalized care and (6) Trust. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative 'tick box' exercise that depersonalizes care and does not provide a space to discuss mental health problems. Conclusion: Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care. [ABSTRACT FROM AUTHOR]

Aim: To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND). Design: The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work. Data Sources: A systematic search of PubMed, CINAHL, Embase, MEDLINE, PsycINFO and Scopus databases was conducted in January and February 2023. Review Methods: Peer‐reviewed primary research articles published in English between 2012 and 2023 that involved nurses or midwives managing PPND were included. Rayyan was used to screen titles, abstracts and full‐text articles. A spreadsheet was used to organize extracted data and synthesize results. Results: Twenty‐nine articles met the inclusion criteria. Most study samples were of mothers, and few were from middle‐ and lower‐income countries. Nurses and midwives lacked knowledge about PPND, yet they felt responsible for its management. Nurses and midwives faced significant organizational and systems‐level challenges in managing PPND. However, nurses and midwives facilitated PPND care in collaboration with other healthcare providers. Conclusion: The review highlights significant gaps in the nurses' and midwives' care of PPND. Educational programmes are necessary to increase nurse and midwife knowledge of PPND and strategies for its management, including facilitating collaboration across the healthcare system and eliminating organizational and systemic‐related barriers. Additional focused research is needed on nurses' and midwives' knowledge, perception of and experience with PPND beyond mothers, such as with fathers, sexually and gender‐minoritized parents and surrogate mothers. Finally, additional research is needed in middle‐ and lower‐income countries where nurses and midwives may face a higher burden of and unique cultural considerations in managing PPND. Impact: PPND can affect the parent's mental and physical health and relationship with their child. If left untreated, PPND can lead to long‐term consequences, including child developmental delays, behavioural problems and difficulties with parental–child attachment. Reporting Method: This scoping review adheres to PRISMA Extension for Scoping Review guidelines and the Joanna Briggs Institute scoping review method. Patient or Public Contribution: This research is a scoping review of published peer‐reviewed studies. [ABSTRACT FROM AUTHOR]

Introduction: Early parenting services in Australia offer brief structured residential programs to address moderate to severe non‐psychotic mental health problems among women and unsettled infant/toddler behaviours. The aims were to (1) estimate the immediate and medium‐term impact of a five‐night psychoeducational residential early parenting program on postpartum depressive symptoms and (2) identify the factors associated with improvement or worsening of postpartum depressive symptoms after completing the program and six weeks post‐discharge. Methods: Audit of routinely collected medical record data from pre‐admission, pre‐discharge and post‐discharge assessments of a consecutive cohort of women admitted, with their infants/toddlers in a 15‐month period to Masada Private Hospital Early Parenting Centre. Data included structured questions assessing: demographic characteristics, access to family and social support, past and current mental health problems, reproductive and obstetric health, chronic health conditions, breastfeeding problems, coincidental major life events, health risk behaviours and infant/toddler feeding, sleeping and crying behaviours. Standardised instruments included the Partner Interaction after Birth Scale (PIBS), the MacLean Screening Instrument for Borderline Personality Disorder (MSI‐BPD), Modified Fatigue Assessment Scale (FAS) and selected items from the Karitane Parenting Confidence Scale. The primary outcomes were Edinburgh Postnatal Depression Scale scores at pre‐discharge and follow up assessments. Data were analysed using multinomial logistic regression models in which individual and psychosocial characteristics at pre‐admission were included as predictors of the likelihood of the changes of the outcomes from pre‐admission to pre‐discharge and follow up. Results: Complete data from 1220 of 1290 (95%) eligible women were available to assess pre‐admission to pre‐discharge and from 559 (45.8%) to assess pre‐discharge to six‐week follow‐up changes. The mean pre‐admission EPDS score was 11.7 (95% CI: 11.5; 12.0), pre‐discharge it was 7.1 (95% CI: 6.9; 7.4) and at six‐week follow up it was 5.7 (95% CI: 5.3; 6.1). We found that almost all women experienced a clinically meaningful and rapid improvement in depressive symptoms of at least this magnitude (reduction in mean EPDS scores of 4.6 points from pre‐admission to pre‐discharge (five nights) and a further reduction of 1.2 points pre‐discharge to follow up) (six weeks) and we identified an interpretable set of risk factors for symptoms that did not improve or worsened. The adverse outcomes were associated with having symptoms of borderline personality disorder, a partner experienced as lacking kindness and care, coincidental adverse events and having a child younger than six months. Conclusion: Residential early parenting programs, which take a psycho‐educational approach to strengthening caregiving skills, maximising agency, and reducing helplessness, have a rapid beneficial effect on women's postpartum depressive symptoms. These programs provide a valuable and effective component of comprehensive mental health services. Long‐term dialectical behaviour therapy is indicated for women with borderline personality disorder traits for whom early parenting programs alone are insufficient to improve depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high rates of unemployment, reduced access to education, and poorer health, with significantly increased risk of poverty compared with the general population. In pregnancy, there appears to be a gap in the literature surrounding the experiences and outcomes of pregnant people within these ethnic groups. Objectives: The aim of this study was therefore to scope published research, specifically questioning "What is the experience of Roma Gypsy and Traveller pregnant people who access maternity care?" and "What are the obstetric outcomes within these groups?" Search Strategy: This review followed frameworks proposed by Arksey and O'Malley, Levac, and the Joanna Brigg's Institute. The PRISMA extension for Scoping Reviews (PRISMA‐ScR) tool was used. The search strategy and specific terms were chosen using the population–concepts–context framework. Selection Criteria: Titles and abstracts were reviewed independently by two reviewers. Inclusion and exclusion criteria were defined to set clear guidance for reviewers to identify appropriate studies. Data Collection and Analysis: Five electronic databases were searched (CINAHL, EMBASE, MEDLINE [OVID] Web of Science and SCOPUS). A charting form was developed to record key characteristics systematically and uniformly from the studies. Main Results: Five themes were identified: systemic issues, antenatal care, complications of pregnancy, birth experience, and postnatal care. Systemic issues included racism, barriers to care, and adapted antenatal care. Antenatal issues included teenage pregnancy, smoking, risk of venous thrombus embolism, dietary issues, risk of communicable diseases, domestic violence, and mental health concerns. Increased risks of congenital abnormalities, growth restriction, premature labor, and perinatal and early childhood mortality were identified. For Roma women, negative birth experiences were reported, whereas the experiences of Traveller women varied. Conclusions: The findings identified in this study serve to create a framework upon which healthcare providers can tailor the way in which pregnant people from a Roma, Gypsy, or Irish Traveller background are cared for. Using such a framework would hopefully begin to reduce the systematic marginalization and discrimination of these minorities. Synopsis: Gypsy, Roma, and Traveller pregnant people suffer poor outcomes in pregnancy. The true extent of this is not known as they are underrepresented in research. [ABSTRACT FROM AUTHOR]

Introduction: Fatherhood is a significant transition in a man's life, introducing new challenges. Yet men's experiences of this period remain poorly understood. Occupational therapists possess skills and knowledge to support individuals during transition. This study explored the experiences of men during the transition to fatherhood over the first postnatal year. Method: Underpinned by an occupational therapy theoretical perspective, a systematic review was conducted. Following searches of databases: AMED, CINAHL, Medline and PsycINFO, qualitative studies meeting selection criteria were retrieved and quality assessed. Data was extracted and synthesised using an established meta-ethnographic approach. Findings: Seven articles were included in the review. Four interconnected themes: (1) A New Occupational Identity, (2) Relationship Changes, (3) Challenges and Impact, (4) Unmet Occupational Needs, and four subthemes: Roles and Responsibilities, and Adjusting Priorities (theme 1); An Emotional Journey and Exhaustion (theme 3) were identified. Discussion: Fathers' postnatal transitional experiences were reflective of a journey of adjustment and growth. Experiences indicated the requirement for greater support of fathers throughout the antenatal and postnatal transition. Occupational therapists have the skills to work with fathers to balance occupations, manage fatigue and adjust to new roles. Further research should focus on understanding experiences of men in under-represented groups. [ABSTRACT FROM AUTHOR]

Development is a continuous process, but few studies have assessed the simultaneous impact of prenatal and postnatal phthalate exposure on children's behavioral and emotional development. A total of 491 mother–child pairs from the general population in southern Taiwan were studied from 2021 to 2022. Urinary concentrations of bisphenol A (BPA) and phthalate metabolites—mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), and mono-2-ethylhexyl phthalate (MEHP)—were measured in pregnant mothers during the second trimester and in their corresponding children aged 1.5 to 3 years. Behavioral symptoms in children were evaluated using the Child Behavior Checklist (CBCL). Odds ratios (ORs) represent a 1-unit increase in log10-transformed creatinine-corrected maternal urine concentrations. Prenatal maternal urinary MnBP levels were associated with total problems (OR = 19.32, 95% CI: 1.80–43.13, p = 0.04), anxiety (OR = 33.58, 95% CI: 2.16–521.18, p = 0.01), and sleep problems (OR = 41.34, 95% CI: 1.04–1632.84, p = 0.04) in children. Additionally, urinary MnBP levels in children correlated with total problems (OR = 7.06, 95% CI: 1.01–49.05, p = 0.04) and internalizing problems (OR = 11.04, 95% CI: 1.27–95.72, p = 0.01). These findings suggest that prenatal and postnatal exposure to dibutyl phthalate (DBP), metabolized as MnBP, distinctly affects children's behavioral development. [ABSTRACT FROM AUTHOR]

In Oman, the risk of maternal depression is not routinely screened for during pregnancy or after childbirth. This study aimed therefore to explore the prevalence of and the association between the risk of antenatal and postnatal depression among Omani mothers, as well as the sociodemographic characteristics of women with increased risk of antenatal depression. A longitudinal study was conducted among 263 Omani pregnant women who were screened for risk of antenatal and postnatal depression, using the Edinburg Postnatal Depression Scale (EPDS). A considerable rate of women had an increased risk of antenatal depression (22.4%), which slightly increased after childbirth. The majority of mothers who had increased risk of depression were housewives (61.0%), had low monthly income (62.7%), had higher education (54.2%), were living in simple family construction (55.9%), were physically inactive (86.4%), and were not using contraception before the current pregnancy (55.9%). Increased risk of antenatal depression was significantly and positively associated with risk of postnatal depression (P < 0.001). The findings of this study highlight the urgent need for standardization of depression screening of all pregnant women in the Sultanate. It also calls for a population-based study to investigate the prevalence of depression in pregnant women and the first year following childbirth. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the development of the kidneys and adrenal glands in rabbits using histological, histochemical, and biochemical techniques. The experiment was conducted on 28 kidney and adrenal gland samples at different ages (one day, seven days, fourteen days, and ninety days). Histological findings revealed that the kidney was covered by a small amount of collagen and reticular fibers and had a thin capsule that thickened with age. The renal corpuscle increased in diameter as the age progressed. The proximal convoluted tubules were the longest, surrounded by cuboidal epithelial tissue, and had a brush border. The adrenal glands were encased in a well-developed capsule, and the cortex was divided into the glomerular, fasciculate, and reticular zones. The medulla was composed of large, pale-staining hexagonal cells arranged in small anastomosing strands held together by reticular fibers and separated by sinusoids. Norepinephrine cells were smaller. Histochemical studies showed that the brush border in the kidney responded positively to PAS, AB, and PAS-AB stains. PAS staining revealed that the basement membranes of the glomerulus and renal tubules were fully developed. Biochemical tests showed significant age-related differences in uric acid levels and each enzyme. As the urea burden increased, more urine was needed because the kidneys' ability to filter urea was limited. The kidneys underwent postnatal developmental changes, reaching maturity three months after birth when the normal adult nephron structure was observed. This indicated that the structure of the kidney and adrenal glands developed after birth with age progression. [ABSTRACT FROM AUTHOR]

Background/Objectives: Molar Incisor Hypomineralization (MIH) is a prevalent multifactorial developmental dental defect with unclear etiology. This study aimed to identify potential risk factors for MIH among primary school children in Jeddah, Saudi Arabia. Methods: A cross-sectional study including children aged 7 to 10 years old, recruited from twelve randomly selected schools located in three regions of Jeddah city, was carried out. The children were examined for MIH and dental caries using the European Academy of Pediatric Dentistry Criteria (2003) and the DMFT/dmft WHO index. Parents were asked to provide medical and socio-demographic information on their children from their first two years of life. Results: A total of 2010 children were examined, with 888 parents responding to the survey (a 44.2% response rate). Lower maternal education was found to be significantly associated with a decreased adjusted odds ratio (AOR) of MIH (Model 1: p = 0.014, AOR = 0.646, and 95% CI = 0.456 to 0.915; Model 2: p = 0.019, AOR = 0.658, and 95% CI = 0.465 to 0.933). Being an only child, a child's birth order, type of delivery, breastfeeding, and medical conditions were not associated with MIH. Conclusions: The significant association between MIH and maternal education suggests that further research is needed to explore the underlying mechanisms and identify other potential confounding variables. [ABSTRACT FROM AUTHOR]