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PubMed2001

Maternally separated rats show deficits in maternal care in adulthood.

Although there is considerable research on the phenomenology, neuroendocrinology, neuroanatomy, and sensory control of maternal behavior, little is known about the influences of early postnatal and postweaning experiences on the development of maternal behavior. The purpose of this study was to assess how early life separation from the mother rat affects development of the offspring's juvenile and adult maternal behavior. From postnatal Days 1 to 17, 3 female rats within each litter were separated (SEP) from the mother and the rest of the litter for 5 hr daily while 3 of their sisters were not maternally separated (NSEP). On postnatal Day 21, all subjects were weaned and randomly assigned to one of three juvenile conditions. One female from both SEP and NSEP groups was either isolated (I), given a social conspecific (S), or given 1- to 4-day-old pups (P) for 5 consecutive days. Maternal behavior of SEP and NSEP animals was assessed and recorded on each of the 5 days. Once all animals reached adulthood, they were mated, gave birth, and were assessed for their maternal behavior. We found that the effects of maternal separation on juvenile maternal-like behaviors were minimal. On the other hand, maternal separation reduced adult maternal licking and crouching over pups. In addition, there was a significant interaction between postnatal and juvenile experience on maternal crouching in maternal animals. These results are discussed in terms of the variety of possible behavioral, endocrine, and neurochemical mechanisms that mediate the effects of early life experiences on adult maternal behavior.

Affect↗
PubMed2006

Maternal intake of antioxidant vitamins in pregnancy in relation to maternal and fetal plasma levels at delivery.

The aim of the present study was to test the hypothesis that maternal intake of antioxidant vitamins is associated with maternal and cord plasma levels at delivery. Women were recruited in early pregnancy in Aberdeen Maternity Hospital and habitual diet during pregnancy was assessed by a food-frequency questionnaire mailed at 34 weeks gestation. Blood samples were taken at recruitment (n 1149) and maternal (n 1149) and cord blood samples (n 747) taken at delivery for analyses of vitamins A, C, E and beta-carotene. Maternal plasma levels of vitamin E and beta-carotene at delivery were significantly higher than levels in early pregnancy while levels of vitamins A and C were significantly lower. Positive correlations were observed for maternal levels of all the vitamins between early pregnancy and delivery. At delivery, maternal plasma concentrations of vitamins A, E and beta-carotene were significantly higher than cord levels, while maternal levels of vitamin C were significantly lower. There were significant correlations between maternal and cord plasma concentrations for beta-carotene and vitamin C but not for vitamins A or E. Maternal dietary intakes were positively correlated with maternal plasma levels of vitamins C, E and beta-carotene in early pregnancy, with maternal plasma levels of beta-carotene and vitamin C at delivery and with cord plasma levels of beta-carotene and vitamin C. The results from the present study show that, in this population, maternal diet influences cord plasma levels of beta-carotene and vitamin C, but not vitamins A and E.

Adolescent↗
PubMed2003

Association between second-trimester isolated high maternal serum maternal serum human chorionic gonadotropin levels and obstetric complications in singleton and twin pregnancies.

OBJECTIVE: The purpose of this study was to examine the clinical significance of high maternal serum human chorionic gonadotropin levels in the second trimester in singleton and twin pregnancies within the Ontario maternal serum screening program. STUDY DESIGN: The study group comprised 564 women with singleton pregnancies with total maternal serum human chorionic gonadotropin levels of > or =4.0 multiples of the median (MoM) and serum marker alpha-fetoprotein levels of <2.0 MoM. The cases were matched with 1692 control subjects who had both serum marker alpha-fetoprotein levels and maternal serum human chorionic gonadotropin levels of <2.0 MoM. The second part of the study comprised 93 twin pregnancies with maternal serum human chorionic gonadotropin levels of > or =5.0 MoM and serum marker alpha-fetoprotein levels of <4.0 MoM; the control group (n = 1496) had serum marker alpha-fetoprotein levels of <4.0 MoM and maternal serum human chorionic gonadotropin levels of <5.0 MoM. The final part of the study included 25 women with extremely high maternal serum human chorionic gonadotropin levels (> or = 14;10 MoM). RESULTS: Of the singleton pregnancies with maternal serum human chorionic gonadotropin levels of > or = 14;4.0 MoM, 22.5% had severe adverse obstetric outcomes, compared with only 10.9% of the matched control population (P =.001). Women with markedly elevated maternal serum human chorionic gonadotropin levels had significantly increased risks of having spontaneous miscarriage, small-for-gestational-age infants, pregnancy-associated hypertensive disorder, and preterm delivery. Of the women with twin pregnancies with high maternal serum human chorionic gonadotropin levels (> or =5.0 MoM), 71% had at least one complication (such as miscarriage and preterm delivery) compared with 55.3% in the control group. Finally, 23 of 25 women with extremely high maternal serum human chorionic gonadotropin levels (> or = 14;10 MoM) had serious adverse outcomes (such as fetal abnormalities, pregnancy-associated hypertensive disorder, premature separation of placenta, intrauterine growth restriction, neonatal respiratory distress syndrome, and neonatal jaundice). CONCLUSION: Pregnancies with an elevated maternal serum human chorionic gonadotropin level are associated with adverse obstetric outcomes. Increased maternal and fetal surveillance is warranted in these pregnancies.

Case-Control Studies↗
PubMed2002

The effects of pregnancy and maternal nutrition on the maternal renin-angiotensin system in sheep.

Physiological changes occurring in the mother during pregnancy can determine the outcome of pregnancy in terms of birthweight and neonatal viability. Maternal adaptations include plasma volume expansion linked to enhanced activity of the renin-angiotensin system (RAS). The present study was designed to determine whether these changes occur very early in gestation, and the extent to which maternal nutrient restriction may compromise the maternal RAS. Using sheep, we have investigated the effects of pregnancy per se, maternal nutrient restriction and later restoration of maternal diet on maternal body weight, plasma volume and plasma renin concentration (PRC), and angiotensinogen (Aogen) and arginine vasopressin (AVP) concentration. During the period of placental growth (i.e. 28-80 days gestation) ewes were fed either a nutrient-restricted (NR) diet or were well fed (WF). NR ewes consumed between 3.2 and 3.8 MJ day(-1) of metabolisable energy (ME) which is close to 60 % of requirements taking into account the ME required for both ewe maintenance and growth of the conceptus in order to produce a 4.5 kg lamb at term. WF ewes consumed 150 % of ME requirements. Restoration of maternal diet between 80 and 140 days gestation (i.e. fed to satiety and consuming between 8 and 10.9 MJ day(-1), which is close to 150 % of ME requirements) followed previous nutrient restriction. Between pre-conception and 28 days gestation, plasma volume increased in conjunction with a decline in PRC and Aogen concentration. During the period of nutrient restriction ewe body weight did not increase and plasma volume was lower in NR than WF ewes. During this time there was no effect of maternal nutrition on PRC; however, Aogen concentration was lower in the NR group. From 80 days gestation following the rise in food intake for previously NR ewes, greater increases in ewe body weight, plasma volume and PRC occurred up to term compared with ewes that were well fed throughout gestation. Plasma AVP concentration was not significantly affected by either maternal nutrition or gestational age. In conclusion, the stimulus of moderately severe maternal nutrient restriction evoked smaller rises in maternal weight, plasma volume and Aogen concentration than occurred in ewes that were well fed throughout gestation. Following the restoration of maternal diet after 80 days gestation, PRC gradually rose to peak at term. These adaptations in the maternal RAS during the critical period of placental growth may have long-term effects on fetal development.

Angiotensinogen↗
PubMed1985

[Effects of mother-infant interaction on maternal milk secretion and dynamics of maternal serum prolactin levels in puerperium].

Effects of maternal-infant interaction on maternal milk secretion and the dynamics of maternal serum prolactin levels in puerperium were examined in 183 normally delivered mothers without any complications. No significant change was observed in the amount of maternal milk secretion between the primiparas and the multiparas. However, there was a significant increase in the amount of maternal milk secretion in the breast feeding group compared to the supplementary feeding group from the second to the sixth day of the puerperium (p less than 0.005). Moreover, the amount of maternal milk secretion increased significantly in the group that adopted the rooming-in system compared to the non rooming-in group (p less than 0.005). And also the significant increase occurred in the encouragement of breast feeding following the adoption of the rooming-in system (x2 = 7.244, p less than 0.01). There was no significant correlation between the amount of maternal milk secretion and the puerperal maternal prolactin levels, but the maternal serum prolactin level at 24 hours after delivery was significantly higher in the breast feeding group than in the supplementary feeding group (p less than 0.01). Also, the maternal serum prolactin was increased by the stimulation of the baby crying the same as by suckling or manual expression. These facts suggest that the maternal-infant bonding plays the important role in the encouragement of the breast feeding and the maternal serum prolactin may have some actions on the mechanism of maternal milk secretion.

Animals↗
PubMed2005

Maternal memory in adult, nulliparous rats: effects of testing interval on the retention of maternal behavior.

The retention of maternal behavior (i.e., maternal memory) was measured in adult, nulliparous rats induced to respond maternally by continuous exposure to foster pups. Specifically, the effects of the interval duration between the initial induction and the reinduction of maternal behavior were determined. Intact virgin rats were first exposed to foster young to induce maternal behavior. During the initial induction phase, females were required to be fully maternal on 2 consecutive test days. Animals were then assigned to one of three interval groups (10, 20, or 40 days). After being isolated from rat pups for these designated periods, females in each group were tested again for their latencies to induce maternal behavior. Whereas the initial median latencies to display full maternal behavior ranged from 4.5 to 5 days for each group, upon retesting, median latencies for each group declined to 1 to 4 days. The greatest reduction in latency was present in the 10-day group (80%), and the smallest reduction was detected in the 40-day group (20%). A significant negative linear correlation was found between test interval and percentage reduction in behavioral latency. Based upon this relationship and under these test conditions, "maternal memory" in the adult, nulliparous rat would be expected to be nondetectable after about an interval of 50 days between tests. The pattern of maternal memory acquisition and loss appears similar to that reported in parous animals. The present study highlights similarities and possible differences underlying the establishment of the retention of maternal behavior (i.e., maternal memory).

Analysis of Variance↗
PubMed2002

Are maternal deaths on the ascent in Singapore? A review of maternal mortality as reflected by coronial casework from 1990 to 1999.

INTRODUCTION: In Singapore, published maternal mortality rates (MMR) over the last decade (1990 to 1999) have been so low (0.0 to 1.0 per 1000 live births and still births) as to imply that maternal deaths are rare to the point of being non-existent in some years. This inference is counterintuitive, and earlier studies on maternal mortality, amniotic fluid embolism (AFE) and pulmonary thromboembolism (PTE) have also suggested otherwise. Accordingly, local trends in maternal mortality warrant further examination. MATERIALS AND METHODS: A descriptive and comparative study, comprising a clinico-pathological review of maternal deaths, for which autopsies were conducted by the Centre for Forensic Medicine, during a 10-year period from 1990 to 1999. The annual necropsy-based, MMR (estimated MMR), as well as the prevalence of maternal deaths during this time, were estimated with the aid of the relevant, published demographic data on live births and still births. These were compared with the corresponding rates calculated (calculated MMR) from raw demographic data on maternal deaths classified as such in the published data. RESULTS: Coronial autopsies were conducted on a total of 51 cases of maternal death, of which 33, 17 and 1 were direct, indirect and fortuitous deaths, respectively. The annual, estimated MMR ranged from 0.4 to 1.8 per 10,000 live births and still births. The estimated MMR was twice as high as the calculated MMR and a statistically significant upward linear trend was demonstrated for the former (P = 0.046). AFE (16/51) and PTE (10/51) were the two most common causes of maternal death; their corresponding cause-specific, 10-year prevalence being 0.33 and 0.21 per 10,000 live births and still births, respectively. There was apparent clustering of the cases of PTE during the earlier part of the last decade (1990 to 1995), corresponding to a statistically significant, upward trend in its overall necropsy incidence during that time (P = 0.019). Cardiovascular and pulmonary disorders constituted the bulk of indirect deaths (13/17), while antenatal suicides accounted for 3 of these deaths (0.06 per 10,000 live births and still births). CONCLUSIONS: This was an upward trend in MMR, as reflected in coronial casework, over the last decade. It would appear that the local, estimated (direct and indirect) maternal mortality prevalence compares favourably with the MMR reported in developed countries. The apparent rate of AFE was no less than 4 times higher than that reported in the United Kingdom, while the maternal mortality rate from PTE was at least as high. Allowing for the possibility that such deaths were under-reported, the actual annual MMR and 10-year prevalence could be appreciably higher than the estimates presented here. There may well be a case for the establishment of a comprehensive database of maternal deaths, that is updated continually and contemporaneously, in Singapore.

Adult↗
PubMed1993

Persistent effects on maternal aggression of pregnancy but not of estrogen/progesterone treatment of nonpregnant ovariectomized rats revealed when initiation of maternal behavior is delayed.

Two experiments explored the effects on subsequent maternal aggression of interspersing 5-24 days between pregnancy termination and pup exposure to elicit maternal behavior. Pregnancy-terminated females displaying maternal behavior were compared to nonpregnant females also stimulated by pups to behave maternally and to pregnancy-terminated groups that were not exposed to pups. Pregnancies were terminated by hysterectomy-ovariectomy on Gestation Day 19 (G19), with pup exposure commencing after 6 days (Expt. 1), and by Cesarean section + ovariectomy (OVX), after delays of 5, 10, or 24 days (Expt. 2). In each study pregnancy-terminated, maternal groups were more aggressive than both nonpregnant, maternal groups and pregnancy-terminated, nonmaternal groups regardless of the imposed delays. In Expt. 2, postsurgical interval also was a significant factor, suggesting that surgical stress may elevate maternal aggression for several days. Prolonged treatment of nonpregnant OVX females (Expt. 3) with estrogen and progesterone elevated maternal aggression when pup exposure commenced 2 but not 7 days after termination of hormone treatment (Expt. 3). Therefore the physiological changes initiated during pregnancy that support maternal aggression persist for at least 4 weeks and may involve factors in addition to ovarian hormones that stimulate maternal behavior and maternal aggression. An additional unexpected finding was that nonpregnant (OVX) females had significantly higher Aggression scores after initiating maternal behavior.

Aggression↗
PubMed2005

The relations among maternal depression, maternal criticism, and adolescents' externalizing and internalizing symptoms.

This study examined the relations between maternal criticism and externalizing and internalizing symptoms in adolescents who varied in their risk for psychopathology. Both maternal-effects and child-effects models were examined. The sample consisted of 194 adolescents (mean age = 11.8 years) and their mothers; 146 mothers had a history of depressive disorders and 48 did not. When adolescents were in 6th and 8th grade, maternal criticism was measured with the five-minute speech sample and adolescents' symptoms were assessed with the Child Behavior Checklist. Maternal criticism was significantly associated with both adolescents' externalizing and internalizing symptoms, beyond the contribution of the chronicity/severity of mothers' depression history. Maternal criticism did not mediate the relation between maternal depression and adolescent symptoms. In contrast, adolescent externalizing behaviors mediated the relation between chronicity/severity of maternal depression history and maternal criticism in 6th grade. Prospective analyses showed that adolescents' externalizing symptoms in 6th grade significantly predicted maternal criticism in 8th grade, controlling for maternal depression history and prior maternal criticism. Results are discussed in terms of the importance of examining child-effects models in studies of maternal criticism.

Adolescent↗
PubMed2000

A review of maternal deaths in South Africa during 1998. National Committee on Confidential Enquiries into Maternal Deaths.

OBJECTIVE: To document the prevalence and causes of maternal mortality and to identify avoidable factors, missed opportunities and substandard care related to these deaths. METHOD: Maternal deaths are notifiable; when a maternal death occurs a maternal death notification form is filled in and sent to the provincial Maternal, Child and Women's Health (MCWH) units. Provincial assessors assess the death and submit a report. This report is forwarded to the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD), where the data are collated and the prevalence, pattern of disease, avoidable factors, missed opportunities and substandard care pertaining to maternal deaths are described. RESULTS: Data were collected on the maternal deaths occurring during 1998 in South Africa. Collection of data on maternal deaths was incomplete and a maternal mortality ratio could not be calculated. However, a clear pattern of disease and problems in patient care emerged. The 'big five' causes of death were complications of hypertensive conditions in pregnancy, AIDS, obstetric haemorrhage, pregnancy-related sepsis and pre-existing medical conditions. Women aged 30 years and older were at greater risk of dying than younger women. Women in their first pregnancy or who had had 5 or more pregnancies were also at greater risk. Obstetric haemorrhage was the most common cause of death at level 1 hospitals, AIDS at level 2 hospitals and hypertensive diseases at level 3 hospitals. The vast majority of anaesthetic-related deaths occurred at level 1 hospitals. Non-attendance and delayed attendance at the health institutions were the most common patient-orientated problems. Poor transport facilities and lack of intensive care facilities were the major administrative problems. Problems in the care of women occurred in more than half the cases of maternal death, the majority at the primary level of care. Poor initial assessment and diagnosis of cases, especially at secondary level of care, failure to follow standard protocols at primary and secondary levels, and poor monitoring of patients at all levels of care were the common health worker-related problems. CONCLUSION: Ten key recommendations based on this information have been made by the NCCEMD; if implemented these will result in a reduction of maternal deaths.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Can enquiries into severe acute maternal morbidity act as a surrogate for maternal death enquiries?

OBJECTIVE: To assess whether severe acute maternal morbidity (SAMM, 'near misses') can be used as a surrogate of an analysis of maternal deaths to describe the pattern of severe maternal disease and avoidable factors related to it. DESIGN: Prospective, descriptive study. SETTING: A SAMM and maternal mortality audit was conducted in three clearly defined geographical areas, consisting of rural and urban settings in South Africa. POPULATION: Indigent black African pregnant women. METHOD: Cases of SAMM and maternal deaths were collected in the areas and a comparison was made of the disease profiles and avoidable factors, missed opportunities and substandard care. MAIN OUTCOME MEASURES: The proportion of primary obstetric causes and avoidable factors in women with SAMM and maternal deaths, and the mortality indices of the primary obstetric causes of death and organ system dysfunction. RESULTS: A total of 423 women with SAMM and 128 maternal deaths were collected over two years. Demographic factors were similar between the groups except that significantly more maternal deaths had not attended any antenatal care. The primary obstetric causes of SAMM and maternal death did not correlate. The four most common causes of SAMM were complications of hypertension (27.2%), postpartum haemorrhage (18.0%), antepartum haemorrhage (12.8%) and abortion (11.3%), whereas the four most common causes of maternal death were non-pregnancy related sepsis (26.6%), complications of hypertension (23.4%), pre-existing medical disease (14.1%) and abortion (10.9%). The types of avoidable factors were similar between both groups although administrative factors occurred significantly more frequently in the maternal death group as did poor problem identification and monitoring. CONCLUSION: Review of SAMM gives a different disease pattern to that obtained from maternal death audits. However, in diagnosing inadequacies in the health system, similar information was obtained.

Adult↗
PubMed1996

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

A critical issue regarding the broader utilization of placental/ umbilical cord blood (PCB) in unrelated bone marrow restoration is the possibility of contamination with maternal lymphocytes capable of immunological reactivity against the eventual recipient. On transplantation, such maternal cells might lead to graft-versus-host disease (GVHD) even if the intended donor's neonatal lymphocytes were unresponsive. We measured the proportion of PCB samples that were contaminated with maternal cells. Placental-maternal sample pairs were selected so that the mother was heterozygous for the DR53 haplotype, whereas the placental sample was DR53-negative. The PCB samples were investigated for the presence of the noninherited maternal gene DRB4, exclusive to the DR53 haplotypes. Locus-specific polymerase chain reaction amplification with DRB4 sequence-specific primers was followed by either gel electrophoresis or blotting and hybridization to an internal sequence DRB4 probe. Polymerase chain reaction products from DNA mixtures containing as low as 0.5 ng of a DRB4-positive DNA control in 1.0 microgram of a DRB4-negative DNA sample (1:2 x 10(3) dilution) showed a visible DRB4 band in agarose gels stained with ethidium bromide. Locus-specific hybridization increased the detection sensitivity to 1:10(5) (0.01 ng of the DRB4-positive DNA control). Control mixtures of known amounts of DRB4-positive and -negative DNA were included in all experiments. Comparison of the thickness of DRB4 bands after electrophoresis and the intensity of the DRB4-specific hybridization signals to the concentration controls allowed a rough estimation of the amount of maternal DNA in the placental blood specimens. A total of 213 PCB samples were tested. By gel electrophoresis, DRB4-specific bands were observed to be as strong or stronger in 23 (10.8%) samples as those in the 1:2 x 10(3) control, and 153 (17.8%) samples were negative in this test. The remaining 37 (17.3%) samples disclosed weaker DRB4 bands, suggesting the presence of maternal genetic material. By hybridization, 81 (38%) samples were positive and 132 were negative for the noninherited maternal gene. Review of the clinical characteristics of the mothers (demographics and labor and delivery information), the newborns (birth weight, sex, and gestational age), and PCB collections (placental weight, white blood cell count, and collected volume) failed to show any significant differences between the units testing positive or negative for the noninherited maternal gene. Thus, transplantable PCB units carry a high probability of having maternal DNA in detectable amounts. Whether this DNA comes from potentially graft-versus-host disease-inducing maternal lymphocytes or whether the putatively transplacentally-acquired maternal cells are immunologically dysfunctional, as in most infants with severe combined immunodeficiency disease, remains to be shown.

Alleles↗
PubMed2000

Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume.

BACKGROUND: Oligohydramnios (reduced amniotic fluid) may be responsible for malpresentation problems, umbilical cord compression, concentration of meconium in the liquor, and difficult or failed external cephalic version. Simple maternal hydration has been suggested as a way of increasing amniotic fluid volume in order to reduce some of these problems. OBJECTIVES: The objective of this review was to assess the effects of maternal hydration on amniotic fluid volume and measures of pregnancy outcome. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: 1 February 1999. SELECTION CRITERIA: Randomised trials comparing maternal hydration with no hydration in pregnant women with reduced or normal amniotic fluid volume. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by both reviewers. MAIN RESULTS: Two studies of 77 women were included. The women were asked to drink two litres of water before having a repeat ultrasound examination. Maternal hydration in women with and without oligohydramnios was associated with an increase in amniotic volume (weighted mean difference for women with oligohydramnios 2.01, 95% confidence interval 1.43 to 2.56; and weighted mean difference for women with normal amniotic fluid volume 4.5, 95% confidence interval 2.92 to 6.08). Intravenous hypotonic hydration in women with oligohydramnios was associated with an increase in amniotic fluid volume (weighted mean difference 2.3, 95% confidence interval 1.36 to 3.24). Isotonic intravenous hydration had no measurable effect. No clinically important outcomes were assessed in any of the trials. REVIEWER'S CONCLUSIONS: Simple maternal hydration appears to increase amniotic fluid volume and may be beneficial in the management of oligohydramnios and prevention of oligohydramnios during labour or prior to external cephalic version. Controlled trials are needed to assess the clinical benefits and possible risks of maternal hydration for specific clinical purposes.

Amniotic Fluid↗
PubMed1992

Circadian timekeeping during pregnancy: endogenous phase relationships between maternal plasma hormones and the maternal body temperature rhythm in pregnant rhesus monkeys.

Nine pregnant rhesus monkeys maintained in constant low level lighting (5 Lux) from 56-80 days gestation (dGA) onward were studied to assess the presence or absence of circadian maternal body temperature and maternal plasma hormone variations. Maternal arterial blood samples were taken every 4 h in six monkeys (105-120 dGA) for 48-56 h and every 2 h in three monkeys (108-115 dGA) for 60 h. Maternal intraabdominal temperature was recorded continuously. Cosinor analysis was used to determine circadian rhythmicity. Individual endogenous timekeeping was demonstrated by 1) free-running circadian variations in maternal body temperature in all nine animals, 2) consistent internal acrophase relationships between the maternal body temperature and maternal plasma cortisol rhythm, and 3) idiosyncrasy of the temporal relationship of detectable rhythms to the external environment in individual animals. Only one animal had a significant maternal plasma ACTH rhythm, whereas the presence of 24-h variations in the other hormones varied in individual animals. The mean +/- SD acrophase profiles in hours from the temperature acrophase in those animals who showed significant rhythms were 19.7 +/- 0.6 (n = 8) for cortisol, 19.4 +/- 2.4 (n = 6) for dehydroepiandrosterone sulfate, 8.3 +/- 1.1 (n = 6) for progesterone, and 18.9 +/- 1.6 (n = 3) for estradiol. We conclude that 24-h variations in maternal plasma hormones are truly endogenously generated and not passively dependent on the light-dark cycle. The maternal circadian system regulates the 24 h temporal organization of endogenous plasma hormone variations. We hypothesize that rhythms in cortisol, dehydroepiandrosterone sulfate, progesterone, and estradiol during pregnancy are directly or indirectly governed by the maternal hypothalamus via the circadian oscillatory output of the maternal adrenal.

Adrenocorticotropic Hormone↗
PubMed2001

Maternal periodontitis and prematurity. Part II: Maternal infection and fetal exposure.

Clinical data from the first 812 deliveries from a cohort study of pregnant mothers entitled Oral Conditions and Pregnancy (OCAP) demonstrate that both antepartum maternal periodontal disease and incidence/progression of periodontal disease are associated with preterm birth and growth restriction after adjusting for traditional obstetric risk factors. In the current study we present measures of maternal periodontal infection using whole chromosomal DNA probes to identify 15 periodontal organisms within maternal periodontal plaque sampled at delivery. In addition, maternal postpartum IgG antibody and fetal exposure, as indexed by fetal cord blood IgM level to these 15 maternal oral pathogens, was measured by whole bacterial immunoblots. The potential role of maternal infection with specific organisms within 2 bacterial complexes most often associated with periodontitis, conventionally termed "Orange" (Campylobacter rectus, Fusobacterium nucleatum, Peptostreptococcus micros, Prevotella nigrescens, and Prevotella intermedia) and "Red" (Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola) complexes, respectively, to prematurity was investigated by relating the presence of oral infection, maternal IgG, and fetal cord IgM, comparing full-term to preterm (gestational age < 37 weeks). The prevalence of 8 periodontal pathogens was similar among term and preterm mothers at postpartum. There was a 2.9-fold higher prevalence of IgM seropositivity for one or more organisms of the Orange or Red complex among preterm babies, as compared to term babies (19.9% versus 6.9%, respectively, P = 0.0015, chi square). Specifically, the prevalence of positive fetal IgM to C. rectus was significantly higher for preterm as compared to full-term neonates (20.0% versus 6.3%, P = 0.0002, as well as P. intermedia (8.8% versus 1.1%, P = 0.0003). A lack of maternal IgG antibody to organisms of the Red complex was associated with an increased rate of prematurity with an odds ratio (OR) = 2.2; confidence interval (CI) 1.48 to 3.79), consistent with the concept that maternal antibody protects the fetus from exposure and resultant prematurity. The highest rate of prematurity (66.7%) was observed among those mothers without a protective Red complex IgG response coupled with a fetal IgM response to Orange complex microbes (combined OR 10.3; P < 0.0001). These data support the concept that maternal periodontal infection in the absence of a protective maternal antibody response is associated with systemic dissemination of oral organisms that translocate to the fetus resulting in prematurity. The high prevalence of elevated fetal IgM to C. rectus among premature infants raises the possibility that this specific maternal oral pathogen may serve as a primary fetal infectious agent eliciting prematurity.

Antibodies, Bacterial↗
PubMed1999

Maternal animal model with correlation between maternal environmental effects of related dams.

A procedure to take into account the nongenetic relationship between maternal effects in adjacent generations is presented. It considers a correlation between maternal environments provided by a dam and its daughters (lambda). The dispersion structure of the maternal animal model was modified to include a correlation matrix (E) that relates the maternal permanent environmental effects. The structures of the E matrix and its inverse (E(-1)) are described. Both matrices are completely defined by the correlation coefficient lambda. An algorithm to compute these matrices from pedigree information was also developed. Furthermore, a Bayesian analysis of this model including the lambda parameter was developed using Gibbs sampling, with Metropolis steps for the nonstandard conditional distributions. With simulated data, the proposed model reduced the bias in all estimates of dispersion parameters when an antagonism between the maternal effects received by a daughter and its future maternal environment existed. This model also provides an estimate of the environmental relationship between the maternal effects of dams and daughters by the lambda parameter. The same Bayesian analysis was also carried out with weaning weight data of the Bruna dels Pirineus breed. The posterior means (standard deviation) of (co)variance ratios were .214 (.081) for direct heritability (h2d), .107 (.033) for maternal heritability (h2m), .047 (.020) for the proportion of variance due to maternal environmental effects (c2m), and -.034 (.043) for the genetic correlation between direct and maternal effects (r(dm)). The posterior mean of lambda parameter was -.190, and 76% of its marginal posterior distribution took negative values. As occurred with simulated data, considering the maternal environmental correlation in the analysis implied higher h2m estimates, lower c2m and h2d estimates, and less negative values for the marginal posterior distribution of r(dm). These results were considered as evidence of the environmental antagonism between maternal effects provided by a dam and its daughters to weaning weight of their progeny in the Bruna dels Pirineus breed.

Animal Husbandry↗
PubMed1999

Assessment of maternal mortality and late maternal mortality among a cohort of pregnant women in Bamako, Mali.

OBJECTIVE: Few prospective studies have been undertaken of maternal mortality in sub-Saharan Africa. National statistics are inadequate, and data from hospitals are often the only source of information available. Reported maternal mortality ratios may therefore show large variations within the same country, as in Mali. This study was designed to produce an estimate of the maternal mortality ratio for the population of Bamako. DESIGN: Prospective cohort study. SETTING: Bankoni (population 59,000), a district of Bamako (population 700,000). POPULATION: 5782 pregnant women identified during quarterly household visits. METHODS: After enrolment, two follow up visits, at six weeks and one year after delivery, were performed to collect information on the pregnancy, its outcome, the method of delivery, the puerperium and the first year after birth. Detailed inquiries on deaths were undertaken in the community, the maternity units and the reference hospital. MAIN OUTCOME MEASURES: Maternal mortality ratio, late maternal mortality, likely cause of death. RESULTS: Complete data at follow up were available on 4717 women (82%) (4653 single and 64 twin pregnancies). Most of the women had antenatal care were and delivered in a district maternity hospital. There were 4580 live births (96%). Fifteen maternal deaths were recorded, yielding an overall maternal mortality ratio of 327 per 100,000 live births. Hypertensive disorders and haemorrhage were the main causes of death. Five more deaths occurred within 42 days or one year after delivery. CONCLUSIONS: This study gave an estimate of the maternal mortality ratio for the population of Bamako, and stressed the need of better emergency obstetric care and the importance of late maternal mortality.

Adolescent↗