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PubMed2004

The association between maternal ratings of child health interviews and maternal and child characteristics.

BACKGROUND: Doctors develop the skills needed to interview parents and children in paediatric settings by practice and by receiving feedback during their medical training. Interviewed parents are ideally placed to provide evaluations of these skills. If parents, as consumers of health care services, are to be consulted, it is important to determine whether factors other than interview skills affect their evaluations. OBJECTIVES: Our aim was to examine the relationship between maternal satisfaction ratings of student doctor interviews, and maternal and child characteristics. METHODS: Sixty mothers of children attending the paediatric medical out-patient clinic at the Women's and Children's Hospital, South Australia were allocated randomly to rate one of four video-taped final year student doctor interviews (15 mothers per interview). The level of skills displayed by the student doctor differed in each interview. Maternal satisfaction was measured using the Medical Interview Satisfaction Scale (MISS) and the Interpersonal Skills Rating Scale (IPS), and interview ratings were compared for a number of maternal and child characteristics. RESULTS: No significant associations were observed between maternal satisfaction ratings and any maternal or child characteristics other than lower satisfaction associated with previous experience of a real student doctor interview (P <0.01). The interview seen by mothers predicted 53% (MISS) and 65% (IPS) of the variance in maternal satisfaction ratings. After controlling for the interview type, the maternal and child characteristics studied predicted 17% additional variance in MISS scores and 7% in IPS scores. CONCLUSION: The quality of the interview skills demonstrated was the principle determinant of maternal satisfaction ratings.

Adolescent↗
PubMed2004

Maternally administered dexamethasone at 0.7 of gestation suppresses maternal and fetal pituitary and adrenal responses to hypoxemia in sheep.

Women who are at risk of preterm delivery are treated with antenatal steroids to facilitate fetal lung maturation. During this period, there is a potential for fetal or maternal hypoxemia to occur. Fetal responses to hypoxemia in sheep are well documented. However, less is known regarding maternal responses to hypoxemia. Therefore, we determined the effects of dexamethasone (DM) on maternal and fetal responses to hypoxemia in sheep. Ewes received four i.m. injections of DM or saline at 12-h intervals beginning at 103 d of gestation. Samples for ACTH, cortisol, and glucose were collected at 0900 h. At 105 d of gestation, hypoxemia was induced for 1 h by maternal nitrogen gas inhalation. Samples for ACTH, cortisol, and glucose were collected at 15-min intervals before, during, and after the hypoxemia challenge. Fluorescent microspheres were administered to the mother and the fetus before and during hypoxemia to measure organ perfusion. DM suppressed basal fetal and maternal cortisol and ACTH concentrations but increased glucose levels. DM also increased fetal but not maternal blood pressure. In control subjects, hypoxemia elevated fetal and maternal cortisol and ACTH concentrations. These responses were obliterated by DM. Hypoxemia increased blood pressure in DM-exposed fetuses but not in control subjects. In addition, hypoxemia decreased fetal adrenal vascular resistance in saline but not DM fetuses or ewes from either treatment group. In summary, maternal administration of a low dose of DM at 0.7 of gestation suppresses maternal and fetal adrenal function and changes fetal responses to hypoxemic stress to resemble those observed later in gestation.

Adrenal Glands↗
PubMed2004

Association of maternal histocompatibility at class II HLA loci with maternal microchimerism in the fetus.

For investigating the possible influence of maternal-fetal HLA compatibility on maternal microchimerism, DNA samples from blood of 120 maternal-fetal pairs were genotyped at two polymorphic loci: glutathione-S-transferase M1 (GSTM1) and angiotensin-converting enzyme (ACE). Informative pairs (mother heterozygous/fetus homozygous at one of the two loci) were then tested by quantitative real-time PCR for the noninherited maternal allele(s) and genotyped at the HLA-A, B, and C class I loci and/or at the DRB1 and/or DQB1 class II loci. Small numbers of maternal cells were detected in the circulation of 16 of the 30 informative second- and third-trimester fetuses. Comparison with HLA data suggested an association between microchimerism and maternal compatibility at the class II DRB1 and/or DQB1 HLA loci and with the maternal HLA-DQB1*0301 allele. There was no relationship between maternal microchimerism and maternal-fetal HLA compatibility at other HLA loci or with gestational age, fetal anomalies, or red cell or platelet isoimmunity.

Adult↗
PubMed1987

Maternal cell contamination in cultured chorionic villi: comparison of chromosome Q-polymorphisms derived from villi, fetal skin, and maternal lymphocytes.

Maternal cell contamination of chorionic villi (CV) samples used for first trimester prenatal diagnosis can cause obvious and/or unrecognized diagnostic dilemmas. The purpose of this investigation is to assess the frequency of maternal cell contamination (MCC) in chorionic villus samples and to evaluate selected parameters which might predict where contamination is more likely to have occurred. Maternal lymphocytes, chorionic villi from ultrasonically directed transcervical catheter aspiration, and fetal tissue were obtained at 8-11 weeks gestation from 45 patients undergoing elective termination. Quinacrine (Q) banded metaphases were compared from duplicate direct preparations of chorionic villi; cultured chorionic villi, fetal fibroblast tissue cultures, and maternal lymphocyte cultures. Q-polymorphisms in metaphase chromosomes were 100 per cent concordant between fetal tissue and direct CV preparation. However, evidence for maternal cell contamination occurred in 13.1 per cent of cultured chorionic villi preparations where polymorphisms were found to be identical between maternal and cultured CV and both distinct from fetal tissue preparations. Where MCC was identified, it was noted that CV cell cultivation interval was prolonged (24.2 +/- 6.8 days) compared with non-contaminated cultures (14.1 +/- 4.4 days) (p less than 0.05). We conclude that maternal cell contamination is a significant problem with chorionic villus sampling. Where direct preparations are not employed or when cultures are 'slow growing', MCC may be a significant and unrecognized complication re: fetal diagnosis. Direct preparations, multiple cultures, quinacrine banding, and maternal Q-polymorphism comparisons can minimize diagnostic dilemmas secondary to maternal cell contamination.(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗
PubMed1977

Fetal and maternal blood glucose, insulin and acid base observations following maternal glucose infusion.

The aim of the present investigation was to examine the fetal and maternal blood glucose and insulin response following glucose infusion to the mother. The studies were performed on 11 primigravid patients with a gestational age of 38-40 weeks during the first stage of labor. Glucose was given intravenously by a bolus injection of 330 mg/kg body weight, followed by a glucose infusion of 27.5 mg/kg/min for 60 min. Glucose concentration, immuno-reactive insulin (IRI), pH and base excess of the maternal and fetal blood were measured before and during maternal glucose load. Maternal blood glucose rose within 10 min. up to 280.0 mg% (SD 25.9). This level could be fairly maintained throughout the experiment. The maternal glucose was after 60 min. infusion 326.5 mg% (SD 46.9). Fetal glucose concentration rose continuously from 65.8 mg% (SD 5.8) at control to 249.2 mg% (SD 23.3) after 60 min. The increase of maternal and fetal glucose was associated with an elevation of immuno-reactive insulin (IRI). The maternal insulin was 24.0 micronU/ml (SD 8.0). It was scattered over a wide range (55.4 micronU/ml-217.1 micronU/ml) after 60 min. glucose infusion. The fetal insulin was 17.0 micronU/ml (SD 5.2) at control and rose by 86.5% (SD 80.5) after 60 min. glucose load. One case of a mother with a subclinical diabetes mellitus deviated where the fetal insulin rose from 26.0 micronU/ml at control to 215.6 micronU/ml after 60 min. infusion. The increase of insulin per glucose rise was correlated to fetal body weight. During glucose infusion to the mother of both, fetal and maternal, acid base parameters remained unchanged. From these observations it may be concluded that in the human fetus insulin secretion following a single glucose load is generally low, however, it increases in cases where the maternal insulin response to glucose load is abnormal. This might be related to a chronic stimulation by glucose of the fetal pancreatic islet cells in poorly controlled diabetic and possibly prediabetic patients.

Acid-Base Equilibrium↗
PubMed1988

Dietary assessment of maternal vitamin D intake and correlation with maternal and neonatal serum vitamin D concentrations at delivery.

Maternal and cord blood 25-hydroxy vitamin D concentrations are positively and significantly correlated. If an easily obtainable maternal dietary history could be used to predict maternal and secondarily cord blood vitamin D status, it would be a useful means of assessing the vitamin D adequacy of the newborn. Therefore, a single assessment of maternal dietary vitamin D intake during the last trimester of pregnancy was correlated with maternal and newborn serum vitamin D concentration. Neither the correlation between maternal dietary history of vitamin D intake and maternal serum 25-hydroxy vitamin D level nor between maternal dietary history and cord blood 25-hydroxy vitamin D level was significant. These data indicate that a single maternal dietary history is an inadequate method of predicting neonatal vitamin status at delivery.

25-Hydroxyvitamin D 2↗
PubMed2005

Early weaning deprives mouse pups of maternal care and decreases their maternal behavior in adulthood.

Weaning is one of the most important events in the early stage of life, and recently we have found that precocious weaning augments anxiety and aggressiveness in mice. Maternal behavior has been reported to be transmitted from one generation to the next; that is, female pups that received intensive maternal care showed higher maternal behavior in their adulthood. In the present study, the following three experiments were conducted to understand maternal behavior transmission in early-weaned mice that were separated from the dam on postnatal day 14. First, the maternal behavior observed from the postpartum day 15 to 21, which was deprived in the early-weaned mice, were analyzed. Mothers spent 3% of their time on licking/grooming and arched-back nursing of their pups on postpartum day 15, and the time spent on these behaviors was gradually decreased until postpartum day 21; however, they spent 50% of their time attending to their pups through postpartum days 15-21. Simultaneously, the behavior of the pups was monitored, and it was found that the early-weaned mice had higher activity and lower resting behavior over the period from postnatal day 15 to 21. Secondly, the early- and normally weaned female mice were subjected to an elevated plus maze test at the age of 8 weeks to assess their anxiety level. The early-weaned mice showed a lower frequency of entering the open arms, and a shorter duration of time spent within them, as compared to the normally weaned mice, suggesting that early-weaned females had a higher anxiety level. In the third experiment, the two groups of female mice were paired with adult male mice for 2 weeks, and the mother's maternal behavior was analyzed. The early-weaned female mice showed lower frequency of licking/grooming and arched-back nursing of their pups as compared to the normally weaned mice, whereas the time of mother-off pups and attending to pups were not different between groups. These results suggest that early-weaning manipulation deprives offspring of a certain level of maternal care, and as a consequence, the offspring show higher anxiety levels and lower maternal behavior in their own adulthood.

Analysis of Variance↗
PubMed2005

Maternal exposure to bisphenol a during late pregnancy resulted in an increase of Calbindin-D9k mRNA and protein in maternal and postnatal rat uteri.

It has been reported that Calbindin-D9k (CaBP-9k) is rapidly and strongly induced by environmental estrogenic compounds, possibly through estrogen receptors (ERalpha) in the uterus of mammals. CaBP-9k can be evaluated as an early gene marker for assaying estrogenic effects of putative environmental chemicals in the rat uterus. This study was undertaken to investigate CaBP-9k mRNA and protein expression in the postnatal rat uterus following maternal exposure to 17beta-estradiol (E2) and bisphenol A (BPA) during the neonatal period. Treatment with a high dose of BPA (600 mg/kg body weight (BW) per day) resulted in a 3-fold increase in CaBP-9k mRNA expression for 3 days, while a single dose of E2 (40 microg/kg BW per day) induced 2-fold increase of this gene in the maternal uterus. In an agreement with maternal CaBP-9k mRNA, postnatal CaBP-9k mRNA in the uterus increased 4-fold when treated with BPA (600 mg/kg BW per day). In addition, treatment with increasing concentrations of BPA resulted in significant increases in CaBP-9k protein in the maternal rat uterus. It is of interest that increasing doses of BPA induced a significant ERalpha mRNA increase in the postnatal uterus. Furthermore, immunohistochemistry revealed that treatment with BPA induced CaBP-9k protein in the maternal uterus. We demonstrated that maternal exposure to BPA during late pregnancy induced CaBP-9k mRNA and protein in maternal and postnatal rat uteri. These results suggest that rapid absorption and distribution of environmental estrogenic compounds occurs in maternal and neonatal rat uteri and these chemicals can easily pass though the placenta during pregnancy to affect postnatal reproductive functions.

Animals↗
PubMed2000

Maternal smoking and birthweight: effect modification of period, maternal age and paternal smoking.

OBJECTIVE: To study the effect on birthweight of maternal smoking, and its modification by study period, maternal age and paternal smoking. DESIGN: A retrospective questionnaire based national survey comprising a random sample (n=34,799) of all mothers giving birth in Norway 1970-91. Variables studied were parental smoking during pregnancy, birthweight, maternal age and infant's year of birth. RESULTS: The overall difference in mean birthweight between non-smoking and smoking mothers was 197 g. The difference in birthweight between non-smoking and smoking mothers increased with maternal age from 182 g (<20 years of age) to 232 g (35+ years of age). There was no significant effect of paternal smoking on birthweight when the mother was a non-smoker. When the mother was a smoker and the father was a non-smoker, the birthweight, adjusted for maternal age, was reduced by 153 g (p<0.005). However, when both parents smoked, the birthweight, adjusted for maternal age, was reduced by 201 g (p<0.0005). Even though the prevalence of paternal smoking decreased by 38% during the study period, there was no significant increase in overall mean birthweight. IMPLICATION AND RELEVANCE OF RESULTS: The negative effect of maternal smoking on birthweight appears to increase with maternal age. For a non-smoking pregnant woman to live with a smoking partner has little, if any, effect on birthweight. The negative effect of paternal smoking was only observed when the mother was smoking and might reflect two possible mechanisms: (1) that a smoking mother has a greater cigarette consumption when the partner also smokes, and (2) that a smoking mother is less concerned about passive smoking than a non-smoking mother.

Adult↗
PubMed2006

Adoption, ART, and a re-conception of the maternal body: toward embodied maternity.

We criticize a view of maternity that equates the natural with the genetic and biological and show how such a practice overdetermines the maternal body and the maternal experience for women who are mothers through adoption and ART (Assisted Reproductive Technologies). As an alternative, we propose a new framework designed to rethink maternal bodies through the lens of feminist embodiment. Feminist embodied maternity, as we call it, stresses the particularity of experience through subjective embodiment. A feminist embodied maternity emphasizes the physical relations of the subjective lived-body rather than the genetic or biological connections. Instead of universalizing claims about the maternal body, embodied maternity looks to communicable experiences and empathetic understanding.

Adoption↗
PubMed1990

Prolonged estrogen-progesterone treatment of nonpregnant ovariectomized rats: factors stimulating home-cage and maternal aggression and short-latency maternal behavior.

A 16-day treatment of nonpregnant, ovariectomized rats using 5-mm Silastic implants of estradiol (E), daily injections of 4 mg of progesterone (P), and terminal injections of 5 micrograms/kg of estradiol benzoate (EB) to provide a pregnancy-like pattern of hormone exposure, stimulates (a) home-cage aggression toward unfamiliar intruder rats, (b) short-latency maternal behavior when the females are exposed continuously to pups, and (c) maternal aggression after maternal care has been initiated. Preliminary experiments examined the persistence of stimulation of aggression by the 16-day treatment in the absence of exposure to pups eliciting maternal care, and whether an abbreviated, 1-week treatment stimulates aggression equally. Subsequent experiments examined the importance of the elements of the treatment (E implants, P injections, EB injection), and whether prolonging exposure to P or E would alter its behavioral effects. The full 16-day E/P/EB treatment stimulated higher levels of home-cage and maternal aggression, and shorter maternal behavior latencies than abbreviated and partial treatments. E in combination with P or EB significantly raised home-cage aggression, whereas P alone was without effect. Administering P for 2 additional days attenuated reductions in maternal behavior latencies by E/P/EB, but did not reduce home-cage or maternal aggressiveness. Continuous exposure to E throughout testing did not affect any dependent variable. Comparing these findings to earlier data and reports suggests that hormone exposure for 2 weeks or more, and provision of P levels approaching those of pregnancy are important to the effects of the E/P/EB treatment on aggression.

Aggression↗
PubMed1991

Importance of progesterone and estrogen priming for the induction of maternal behavior by vaginocervical stimulation in sheep: effects of maternal experience.

The effects of treating ovariectomised nulliparous and multiparous ewes with progesterone and estrogen on maternal behavior with or without vagino-cervical stimulation were investigated. Following 48 h of estrogen treatment there was neither evidence for stimulation of maternal behavior, nor a reduction in aggressive behavior, towards lambs by either multiparous or nulliparous ewes compared with control treatment (injections of the oil vehicle). Following 5 min of mechanical vaginocervical stimulation, the multiparous estrogen-treated ewes showed both positive maternal responses (low pitch bleats, licking, sniffing and approaching the lamb) and a reduction in aggression (butts) and negative behavior (withdrawal from the lamb) towards the lambs, whereas the nulliparous ewes showed only a reduction in aggression and negative behavior. Neither group showed positive maternal responses following vaginocervical stimulation without steroid priming. When the ewes received two weeks of progesterone priming prior to estrogen treatment, both multiparous and nulliparous ewes showed reduced aggression towards, and withdrawal from, the lambs compared to the control condition, but no positive maternal responses apart from an increased sniffing of the lamb. After vaginocervical stimulation positive maternal responses showed by multiparous ewes were significantly potentiated compared to those shown following estrogen treatment alone. Nulliparous ewes remained unresponsive on positive maternal behaviors. These studies show that hormonal priming has little effect in inducing the onset of maternal behavior in multiparous or nulliparous sheep but is an essential prerequisite for vaginocervical stimulation to do so in multiparous animals.

Animals↗
PubMed2005

'Maternity clinic on the net service' and its introduction into practice: experiences of maternity-care professionals.

OBJECTIVE: To describe the experiences of maternity-care professionals using an Internet-based network service, called Net Clinic, and the opportunities and obstacles they encountered in Net Clinic while organising their work and developing their know-how. DESIGN: Qualitative information gathered from semi-structured thematic interviews. SETTING: Four maternity care units in Eastern Finland (one antenatal ward in a university hospital, one antenatal ward in a central hospital, two maternity clinics in the community). PARTICIPANTS: Five midwives, two public health nurses and three doctors. FINDINGS: All participants considered adequate privacy protection a prerequisite for development. They anticipated that because of their computer skills, young people would be able to use information and communication technology (ICT) as part of maternity-care services naturally. Managerial support, such as allocation of time and equipment, was extremely important during the introductory phase. The participants were divided into three groups based on their experiences of implementing Net Clinic: (1) 'doubters' did not believe in their own ICT competence and were afraid of using Net Clinic. They also showed resistance to Net Clinic. Doubters wanted versatile and personal guidance in ICT skills; (2) 'accepters' agreed that progress in ICT would inevitably affect their work. Development was considered difficult without awareness of the benefits of ICT, and Net Clinic was expected to increase their workload. Accepters preferred to have one-to-one ICT training; (3) 'future confidents' saw ICT as a useful tool for developing maternity care. They recognised the opportunities implicit in network collaboration and wanted versatile user training in ICT. They wanted successful network service models and were eager to develop them. IMPLICATIONS FOR THE FUTURE: Families will increase their knowledge levels, as those who will be future parents are learning to use public network services at school. The increasing diversity of family structure will be a challenge to maternity care. Changes in maternity services can be accomplished with new e-Working models developed through diversified co-operation and with managerial support. The crucial question will be the attitude of maternity-care professionals towards Internet-based network service in their work.

Adult↗
PubMed2003

Associations of maternal and umbilical cord hormone concentrations with maternal, gestational and neonatal factors (United States).

OBJECTIVE: Risks of some cancers in adults have been associated with several pregnancy factors, including greater maternal age and birth weight. For hormone-related cancers, these effects are hypothesized to be mediated through higher in utero estrogen concentrations. In addition, racial differences in pregnancy hormone levels have been suggested as being responsible for differences in testicular and prostate cancer risk by race. However, data on hormonal levels related to these characteristics of pregnancy are sparse, particularly those from studies of the fetal circulation. METHODS: Estrogen and androgen concentrations were measured in maternal and umbilical cord sera from 86 normal, singleton pregnancies. RESULTS: Birth size measures (weight, length and head circumference) were positively correlated with maternal estriol (r = 0.25-0.36) and with cord DHEAS concentrations (r = 0.24-0.41), but not with estrogens in cord sera. Maternal age was inversely correlated with maternal DHEAS, androstenedione and testosterone concentrations (r = -0.30, -0.25 and -0.30, respectively), but uncorrelated with estrogens in either the maternal or cord circulation. Black mothers had higher androstenedione and testosterone concentrations than white mothers, however, there were no racial differences in any of the androgens in cord sera. Cord testosterone concentrations were higher in mothers of male fetuses, while both maternal and cord concentrations of estriol were lower in these pregnancies. CONCLUSIONS: These data demonstrate associations between hormone concentrations and pregnancy factors associated with offspring's cancer risk, however, the hormones involved and their patterns of association differ by whether the maternal or fetal circulation was sampled. Hormone concentrations in the fetal circulation in this study are not consistent with the hypothesis that greater estrogen concentrations in high birth weight babies mediate the positive association with breast cancer risk observed in epidemiologic studies, or with the hypothesis that higher testosterone exposure in the in utero environment of black males explains their higher subsequent prostate cancer risk.

Adolescent↗