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PubMed1995

Excess maternal history of diabetes in Caucasian and Afro-origin non-insulin-dependent diabetic patients suggests dominant maternal factors in disease transmission.

We examined the records of 2576 patients with non-insulin-dependent diabetes mellitus (NIDDM) and categorised them according to race and family history of diabetes. Family history of diabetes is known to play an important role in the development of NIDDM, and a maternal history is thought to be most influential. We found that a maternal history of diabetes was present in 60% of Caucasian and West Indian patients with a parental history of diabetes, whereas in Asian patients the figure was only 34%. Asian men were also more likely to have a father with diabetes. This anomaly may be due to cultural differences in the reporting of the disease. Our data support the dominant maternal role in the development of NIDDM in their offspring and suggest an under-reporting of NIDDM in Asian females.

Africa↗
PubMed1996

Maternal and non-maternal time-allocation to infant care, and care during infant illness in rural Java, Indonesia.

An estimated 60% of women in Central Java are engaged in income-generating work. This study addresses the manner in which mothers allocate time to infant care as well as to household maintenance and employment. The study investigates the time-allocation to infant care by non-maternal carers, both among infants whose mother is involved in income-generating work and among infants whose mother is not employed. The longitudinal study followed 60 households, one infant per household, of the age range 3-25 months (mean infant age over the course of the study was 13.8 months). Each household was visited every 7 to 10 days from February 1991 through June 1991. One observation day and two separate recall-days were recorded per month. Daily time allocation (6 a.m. to 6 p.m.) to infant care by the mother and other individuals, frequency and minutes of breastfeeding, and infants' non-breastmilk kilocalorie intake were recorded. In addition, mothers recorded any infant symptom(s) on a daily calendar provided to them, and this symptom-data and information on any treatments and/or help-seeking for the infant was collected every 7-10 days. One or more non-maternal caretaker participated in infant care on 90% of the total sample days, for a median of 3 hr 15 min (mean 3 hr 50 min per day), and participated in infant feeding on one-third of all sample days. Grandmothers, sisters, and fathers of the infants were the most important in terms of time allocated to infant care. One or more sister cared for the infant on 30% of total sample days (mean 180 min, median 150 min, 5-645 min), the father on 55% of sample days (mean 90 min, median 65 min, 5-600 min), and grandmother(s) on 32% of sample days (mean 160 min, median 130 min, 5-670 min). Non-maternal care was also substantial during days of symptom-reporting; other carers participated in infant-care on 84% of days, and fed the infant on 28% of days. The study findings suggest that health education messages related to infant care and feeding could be usefully targeted to other persons in addition to mothers. Infant care on symptom-free days were compared to symptom-days using Wilcoxon matched-pair test within each data-collection month (round). While no significant differences were found for the time-allocation to infant care by the mother or others on symptom-days compared to symptom-free days, there was a mean 25% lower non-breastmilk kilocalorie intake on symptom-days (P = 0.00) in four of five data-collection rounds. Mothers reported that lack of appetite accompanied other symptom(s) on 46% of the days of help-seeking in the modern sector. This reflects the mothers' concern for infant appetite in association with illness.

Adult↗
PubMed1984

Acute effect of maternal smoking on the maternal and fetal cardiovascular system.

Maternal and fetal cardiovascular dynamics were studied in relation to maternal smoking in 18 healthy nulliparous subjects randomly divided into a smoking (n = 9) and a control group (n = 9) between 34 and 38 weeks of gestation. At the end of the study, data from 7 smokers and 7 controls were available for analysis. A significant rise in maternal heart rate and systolic blood pressure was observed during and following smoking one cigarette. A significant increase in fetal heart rate occurred following smoking, whereas mean blood flow velocity and vessel diameter in the fetal descending aorta as measured by pulsed Doppler and time motion techniques did not demonstrate any significant changes.

Aorta↗
PubMed1986

Maternal serum alpha-fetoprotein screening, maternal weight, and detection efficiency.

Various methods of adjusting maternal serum alpha-fetoprotein levels based on maternal weight have been recommended in order to more appropriately assign risk in maternal serum alpha-fetoprotein screening. These adjustments may, however, result in a larger proportion of pregnancies designated as having increased risk and reduction in detection accuracy.

Body Weight↗
PubMed1996

Maternal varicella during pregnancy: correlation of maternal history and fetal outcome with placental histopathology.

The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.

Chickenpox↗
PubMed2004

The effect of family physician timing of maternal admission on procedures in labour and maternal and infant morbidity.

OBJECTIVE: To determine if a family physician practice pattern of early admission is associated with increased rates of intervention in labour and delivery, and/or adverse maternal and newborn outcomes. METHOD: A retrospective cohort study compared women under the care of family physicians having 50% or more of their patients admitted to the labour and delivery unit "early" (defined as a cervical dilatation of < or =3 cm) to women under the care of family physicians having less than 50% of their patients admitted "early." Outcome measures included labour intervention rates and maternal and neonatal morbidity. RESULTS: After adjusting for maternal characteristics, care by family physicians with a practice of early admission was associated with increased rates of electronic fetal monitoring (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.27-1.89), epidural analgesia (OR, 1.34; 95% CI, 1.15-1.55), and Caesarean section (OR, 1.33; 95% CI, 1.00-1.65) compared to family physicians with a practice pattern of late admission. Malposition in labour was associated with more interventions in labour than was family physician practice pattern. CONCLUSION: Women under the care of family physicians with a practice pattern of early admission were more likely to receive electronic fetal monitoring, epidural analgesia, and Caesarean section than women under the care of family physicians with a practice pattern of late admission. Malposition in labour had a greater effect on procedure use than any other variable in our model.

Adult↗
PubMed1984

Antibody against viruses in maternal and cord sera: non-specific inhibitors are found to higher titre on the maternal side of the circulation.

Pregnancies were identified in which maternal IgG antibodies against rubella virus were not detectable by single radial haemolysis. Twenty paired maternal/cord sera were then tested for haemagglutination-inhibiting (HI) activity against rubella virus without kaolin pretreatment of the sera. In the absence of specific antibody, the HI activity observed could thus be ascribed to the effect of non-specific inhibitors. The HI activity in maternal sera was significantly (P less than 0.001) higher than that in cord sera. The 20 pairs of sera were similarly tested against a bunyavirus, an alphavirus and a flavivirus, both with and without kaolin pretreatment. The results showed non-specific inhibitors were found to higher titre in maternal sera, with the difference being statistically significant (P less than 0.001) for each of the three viruses.

Absorption↗
PubMed2006

Maternal request cesarean versus planned spontaneous vaginal delivery: maternal morbidity and short term outcomes.

Since no randomized trial evaluates maternal morbidity from planned cesarean versus planned vaginal delivery, the issue must be addressed indirectly from retrospective cohort studies of vertex fetuses by actual or planned delivery route, and retrospective or randomized studies of breech fetuses by planned delivery route. The available data, although limited, suggest that term planned cesarean and planned vaginal delivery have similarly low rates of absolute and relative short-term maternal morbidity. Endometritis and cystitis are more frequent with cesarean, whereas hemorrhage is more frequent with planned vaginal delivery. Much of the morbidity of planned vaginal delivery is the morbidity of unplanned cesarean in labor and operative vaginal delivery, particularly forceps. Thus, the relative risk of short-term maternal morbidity of planned cesarean versus planned vaginal delivery will depend on the proportion of women in each group ultimately delivering in the planned manner and the frequency with which delivery occurs by an alternative unplanned method.

Cesarean Section↗
PubMed2002

Maternal and umbilical fatty acid status in relation to maternal diet.

The aim of this study was to describe the dietary fat intake during pregnancy and to study the relationship between the intake of polyunsaturated fatty acids (PUFAs) and the fatty acid composition of maternal and umbilical plasma phospholipids (PLs) and cholesterol esters (CEs) at delivery. In addition, the contribution of food groups to the intake of total fat and fatty acids in the diet was quantified.Maternal and umbilical blood samples were collected at delivery from 30 healthy pregnant women. The women completed a food frequency questionnaire during the first and third trimesters. The total fat intake during pregnancy is 85 (SD 24) g/day. The mean intake of saturated fatty acids (SFAs) is 33.4 g/day, of monounsaturated fatty acids (MUFAs) 28.6 g/day and of PUFA 15.2 g/day. Major sources of fat, MUFA and PUFA are fats, oils and sauces. Major sources of SFA are meat and poultry followed by cheese and eggs. Meat and poultry contribute the most to the intake of 20:4n-6 whereas fish is the major source of 20:5n-3 (EPA) and 22:6n-3 (docosahexaenoic acid (DHA)) in the diet. Linoleic acid, EPA and DHA (w%) in PL of maternal plasma are positively related to the intake of these fatty acids during pregnancy. No association is found between the maternal intake of the two parent essential fatty acids (18:2n-6 and 18:3n-3) and their fraction in umbilical PL or CE. EPA and the sum of n-6 fatty acids (w%) in umbilical plasma PL are positively correlated with the dietary intake of these fatty acids.

Animals↗
PubMed2002

The Maternal Lifestyle Study: drug exposure during pregnancy and short-term maternal outcomes.

OBJECTIVE: Reports of maternal effects resulting from drug exposure during pregnancy are inconsistent. The Maternal Lifestyle Study (MLS) is a multicenter, prospective, observational study that was initiated to better define the effects of exposure to illicit drugs during pregnancy on the mother, fetus, and infant. METHODS: Between May 1993 and May 1995, of 19,079 mother-infant dyads that were screened after delivery for cocaine and opiate exposure at four clinical centers (Brown University, University of Miami, University of Tennessee, Memphis, and Wayne State University), 16,988 (89%) met eligibility criteria and 11,811 (70%) of those eligible agreed to participate in the study. Exposure was defined as an admission of use of cocaine or opiates or both or the presence of cocaine or opiate metabolites in meconium as determined by use of gas chromatography-mass spectroscopy assay. Nonexposure was defined as a negative drug use history by interview and a negative immunoassay screen. When exposure could not be confirmed, such as when meconium was not obtained or was inadequate for confirmatory analysis, the mother-infant dyad was excluded (n = 3184). RESULTS: Of the mothers who consented to participate, 50% were African American, 38% were married, 64% were Medicaid recipients, and 95% had at least one prenatal care visit (median, 10 visits). Significant differences (P <.01) between cocaine-opiate exposed (n = 1185) and nonexposed (n = 7442) mothers included race (African American: 74.6% and 47.0%, respectively), mean age (29.6 and 26.1 years, respectively), and polydrug use including any combination of alcohol, tobacco, and/or marijuana (93% and 42%, respectively). Odds ratios (99% CI) indicate that exposed mothers had a significantly higher risk(P <.001) of medical complications including syphilis 6.7 (4.8-9.6), gonorrhea 1.9 (1.3-3.0), and hepatitis 4.8 (2.6-8.91); psychiatric, nervous, and emotional disorders 4.0 (2.2-7.4); and abruptio placenta 2.3 (1.4-3.9). The odds of a positive test for human immunodeficiency virus were higher (available on 28% of the cohort) in the exposed group 8.2 (14.3-15.4). Seventeen cases of maternal acquired immunodeficiency syndrome (AIDS) were identified. Opiate exposure with its attendant needle use significantly increased the risk of hepatitis and AIDS. The number of hospitalizations during pregnancy did not differ between the exposure groups because 11% of patients in each group were hospitalized at least once. However, violence as a cause of hospitalization was more common in the cocaine-exposed group, 19.6 (2.7-144.7). CONCLUSION: This observational study confirmed many of the reported adverse social and serious medical perinatal complications of mothers exposed to cocaine or opiates during pregnancy. The overall prevalence of these risk outcomes was lower than has been reported previously.

Adult↗
PubMed2005

Predicting children's separation anxiety at age 6: the contributions of infant-mother attachment security, maternal sensitivity, and maternal separation anxiety.

The purpose of the present investigation was to examine the precursors and familial conditions which sustain school-aged children's separation anxiety. In a prospective, longitudinal study of 99 mother-child dyads, infancy measures of infant-mother attachment security, maternal separation anxiety, and maternal sensitivity were used to predict children's self-reported symptoms of separation anxiety at age 6. Insecurely attached children reported more separation anxiety than securely attached children. Insecure-ambivalent children reported marginally more separation anxiety than securely attached children, but not more than insecure-avoidant attached children. Regression analysis showed infant-mother attachment security and mother's sensitivity added uniquely to the prediction of children's separation anxiety, but mother's separation anxiety did not. Mediation tests show that the effect of mother's separation anxiety on children's separation anxiety may be mediated by maternal sensitivity. Research and clinical implications are discussed.

Adaptation, Psychological↗
PubMed2006

Maternal attachment script representations: longitudinal stability and associations with stylistic features of maternal narratives.

To evaluate the temporal stability of maternal attachment representations obtained using a word-prompt task, a sample of mothers (N = 55) was assessed on two occasions, 12 - 15 months apart. Each mother responded to six word-prompt sets on each assessment occasion (4 word-prompt sets were designed to prime secure base themes, 2 word-prompt sets were designed to prime different themes), and the resulting stories were scored in terms of the presence and quality of the secure base scripts evident in each story. The story scriptedness scores (average across four stories) were internally consistent at each assessment (alphas >.85) and the mean difference in scores was not significant across assessments. The cross-time correlation for the composites (aggregates of scores at each age) was positive and significant, r53 = .54. Other aspects of maternal stories were also stable (e.g., number of words used, number of sentences per story, use of words from the prompt list). Controlling for stable stylistic features of the stories did not reduce the magnitude of association for scriptedness scores across time. These results suggest that the presence and quality of secure base scripts is a stable aspect of maternal representations of attachment and that the word-prompt task is useful for prompting the script in narrative production.

Adult↗
PubMed1990

Antimicrobial proteins of maternal and cord sera and human milk in relation to maternal nutritional status.

Antimicrobial proteins in maternal and cord sera and sequential samples of human milk were studied in a group of 60 Chinese women to determine the degrees of passive immunity transferred from women of different nutritional status to their infants. Maternal malnutrition was characterized by low values for wt/ht2 and serum total protein and albumin. Maternal immunoglobulin (IgG) concentrations were not significantly different between well- and malnourished groups prepartum but were significantly different postpartum. Mean concentrations of cord IgG and lysozyme from well- and malnourished groups were not statistically different. During the first 7 d of lactation and most stages thereafter, mean concentrations of IgA; complements C3 and C4, and lysozyme in milk from the malnourished group were only half of those of the well-nourished group. Antimicrobial proteins transferred via milk to newborns may be influenced by the mother's nutritional status.

Blood Proteins↗
PubMed2000

alpha-fetoprotein levels in maternal serum during pregnancy and maternal breast cancer incidence.

BACKGROUND: A full-term pregnancy is associated with a reduced risk of breast cancer, but the underlying biologic mechanism has not been elucidated. During pregnancy, maternal serum levels of alpha-fetoprotein, an estradiol-binding protein, rise sharply. In culture, alpha-fetoprotein inhibits the growth of estrogen-sensitive cells, including estrogen-sensitive breast cancer cells. Thus, we investigated whether a high level of alpha-fetoprotein in maternal serum during pregnancy is associated with a reduced risk of breast cancer. METHODS: From a population-based cohort of 42057 pregnant women in Denmark, enrolled in an alpha-fetoprotein-screening program from 1978 through 1996, we obtained a complete reproductive history, vital status, and a possible diagnosis of breast cancer (in 117 women) to the end of follow-up on September 1, 1998. RESULTS: During pregnancy, women with an alpha-fetoprotein level greater than or equal to the median value had a 41% lower risk of breast cancer than women with an alpha-fetoprotein level below the median value (relative risk [RR] = 0.59; 95% confidence interval [CI] = 0.41-0. 85). RRs for breast cancer by mother's age at childbirth were as follows: 29 years or younger, RR = 0.21 (95% CI = 0.08-0.56); 30-34 years, RR = 0.61 (95% CI = 0.32-1.14); 35-37 years, RR = 0.96 (95% CI = 0.49-1.89); and 38 years or older, RR = 0.71 (95% CI = 0.29-1. 75) (P for trend =.02). Further analyses suggested that high levels of alpha-fetoprotein were associated with a reduced incidence of aggressive disease. The most striking finding was that women with high levels of serum alpha-fetoprotein, compared with women with low levels of serum alpha-fetoprotein, showed a particularly reduced incidence of large tumors (>2 cm; RR = 0.24 [95% CI = 0.11-0.50]). CONCLUSION: A high level of alpha-fetoprotein in maternal serum during any pregnancy is associated with a low overall incidence of breast cancer and, in particular, with a low incidence of advanced breast cancer at diagnosis. This association appears particularly strong for a pregnancy occurring at a young age.

Adult↗
PubMed2004

Maternal nutrient restriction reduces concentrations of amino acids and polyamines in ovine maternal and fetal plasma and fetal fluids.

Amino acids and polyamines are essential for placental and fetal growth, but little is known about their availability in the conceptus in response to maternal undernutrition. We hypothesized that maternal nutrient restriction reduces concentrations of amino acids and polyamines in the ovine conceptus. This hypothesis was tested in nutrient-restricted ewes between Days 28 and 78 (experiment 1) and between Days 28 and 135 (experiment 2) of gestation. In both experiments, ewes were assigned randomly on Day 28 of gestation to a control group fed 100% of National Research Council (NRC) nutrient requirements and to an nutrient-restricted group fed 50% of NRC requirements. Every 7 days beginning on Day 28 of gestation, ewes were weighed and rations adjusted for changes in body weight. On Day 78 of gestation, blood samples were obtained from the uterine artery and umbilical vein for analysis. In experiment 2, nutrient-restricted ewes on Day 78 of gestation either continued to be fed 50% of NRC requirements or were realimented to 100% of NRC requirements until Day 135. Fetal weight was reduced in nutrient-restricted ewes at both Day 78 (32%) and Day 135 (15%) compared with controls. Nutritional restriction markedly reduced (P < 0.05) concentrations of total alpha-amino acids (particularly serine, arginine-family amino acids, and branched-chain amino acids) and polyamines in maternal and fetal plasma and in fetal allantoic and amniotic fluids at both mid and late gestation. Realimentation of nutrient-restricted ewes increased (P < 0.05) concentrations of total alpha-amino acids and polyamines in all the measured compartments and prevented intrauterine growth retardation. These novel findings demonstrate that 50% global nutrient restriction decreases concentrations of amino acids and polyamines in the ovine conceptus that could adversely impact key fetal functions. The results have important implications for understanding the mechanisms responsible for both intrauterine growth retardation and developmental origins of adult disease.

Amino Acids↗
PubMed1991

Temporal structuring of delivery in the absence of a photoperiod: preparturient myometrial activity of the rhesus monkey is related to maternal body temperature and depends on the maternal circadian system.

No convincing evidence exists that the shift from myometrial contractures to contractions, which determines the synchronized 24-h rhythm in the dynamics of the primate uterus, may be attributed to an endogenous circadian rhythm. We therefore wished to ascertain whether a 24-h periodic shift would also occur in the myometrial activity of animals kept under constant conditions. We studied five pregnant rhesus monkeys, kept in continuous darkness from 56-77 days gestational age until delivery at 117-167 days gestational age. During the last week before delivery we determined the individual phase, level, and amplitude of circadian changes in maternal body temperature and 24-h myometrial activity patterns in the form of contractions. In all five monkeys, a rhythm with a period of 24-h characterized the temporal incidence of preparturient contraction activity. A consistent phase lag of 6-7 h from the temperature crest was observed in four out of the five animals. The circadian phase of all individual rhythms was idiosyncratic among animals. We conclude that endogenous rhythms in body temperature and preparturient myometrial activity are truly circadian. In addition, these rhythms are either interdependent or subject to the same maternal timekeeping mechanism, supporting the hypothesis that the exact time of the day at which birth occurs in the rhesus monkey depends on the maternal circadian system.

Animals↗
PubMed1983

Habitual abortion: parental sharing of HLA antigens, absence of maternal blocking antibody, and suppression of maternal lymphocytes.

The immunologic responsiveness of eight women who habitually abort has been investigated. All shared an HLA-A or B antigen with their husbands. Sharing of an HLA-DR antigen was found in seven couples, one of which also had a second DR antigen in common. The probability for this high frequency of HLA-DR sharing is negligible (p = 0.0004), as calculated from the antigen frequencies among Europeans. Cells from the woman with two shared DR antigens displayed a minor response to her husband's cells but reacted strongly to control cells, whereas the other women's cells reacted normally to cells from both their husbands and controls in one-way mixed lymphocyte culture (MLC). Only minor cytotoxicity was displayed by women's cells in a direct cell-mediated lympholysis (CML) assay, but they mounted normal cytotoxic responses against both husbands' cells and control cells in an amplified CML assay. The sera from six of the habitually aborting women displayed no blocking activity in one-way MLC, and seven of them had no cytotoxic antibodies. Cells from all habitual aborters were suppressed in two-way MLC by cells from husbands and most controls. We hypothesize that increases in HLA compatibility between mother and fetus and in maternal susceptibility to suppressive influences are in some way linked to a deficiency in the development of antifetal antibody during pregnancy. As a consequence, the fetus may be deprived of the protection by maternal blocking antibody, which may allow maternal cytotoxic reactions to cause abortion.

Abortion, Habitual↗
PubMed2005

Maternal hyperinsulinemia predisposes rat fetuses for hyperinsulinemia, and adult-onset obesity and maternal mild food restriction reverses this phenotype.

We have previously shown that artificial rearing of newborn female rat pups on a high-carbohydrate (HC) milk formula resulted in chronic hyperinsulinemia and adult-onset obesity (HC phenotype) and that the maternal HC phenotype was transmitted to their progeny (2-HC rats) because of fetal development in the HC female rat. The aims of this study were to investigate 1) the fetal adaptations that predisposed the progeny for the expression of the HC phenotype in adulthood and 2) whether the transfer of the HC phenotype to the progeny could be reversed by maternal food restriction. Fetal parameters such as plasma insulin and glucose levels, mRNA level of preproinsulin gene, pancreatic insulin content, and islet insulin secretory response in vitro were determined. On gestational day 21, 2-HC fetuses were hyperinsulinemic, had increased insulin content and mRNA level of the preproinsulin gene in their pancreata and demonstrated an altered glucose-stimulated insulin secretory response by isolated islets. Modification of the intrauterine environment in HC female rats was achieved by pair feeding them to the amount of diet consumed by age-matched control rats from the time of their weaning. This mild dietary restriction reversed their HC phenotype and also prevented the development of the HC phenotype in their progeny. These findings show that mal-programming of the progeny of the hyperinsulinemic-obese HC female for the expression of the HC phenotype is initiated in utero and that normalization of the maternal environment in HC female rats by mild food restriction resulted in the normal phenotype in their progeny.

Animals↗