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At least 19 recordsLinked to original sources
PubMedDate not supplied

When is a maternal death a maternal death? A review of maternal deaths at the Mercy Maternity Hospital, Melbourne.

The limiting of the reporting of maternal deaths to those that are included in the criteria of the World Health Organization excludes deaths which yield useful information for further improvements in clinical performance. In this series of 22 maternal deaths, six deaths would have been excluded from reporting: one "direct" obstetric death of pre-eclampsia; one "indirect" death as a result of renal and cardiac failure; two deaths as a result of postnatal depression which led to suicide three and four months postpartum, respectively; and two deaths of cancers, where diagnostic delay may have been a result of the coexistent pregnancy. The importance of primary pulmonary hypertension, cardiomyopathy and psychiatric illness is emphasized. We endorse the recent recommendation of the International Federation of Gynaecology and Obstetrics (FIGO) that all maternal deaths that occur more than 42 days after the end of a pregnancy should be assessed for possible relationships with childbirth, and suggest that a time limit of one year would include all deaths that are worthy of scrutiny.

Adult↗
PubMed1999

Seed Dispersal as a Maternally Influenced Character: Mechanistic Basis of Maternal Effects and Selection on Maternal Characters in an Annual Plant.

Maternal influences on progeny characters affect phenotypic correlations between characters expressed in maternal and progeny generations and consequently influence evolutionary responses to selection. Net selection on maternally influenced characters depends on selection both on the progeny character and on the maternal characters that influence it. I used seed dispersal in Cakile edentula as a system in which to identify the mechanisms of environmentally mediated maternal effects and to determine how selection on maternal characters alters the adaptive value of dispersal. In C. edentula, maternal morphology responds to conspecific density experienced by the mother. Maternal morphology in turn affects offspring (seed) dispersal and density and thereby offspring morphology and fitness. I estimated the magnitude of density-mediated maternal effects on dispersal and identified their mechanism by characterizing the plasticity of maternal morphology to density. I also measured density-dependent selection on maternal characters that influence dispersal. Maternal plasticity to density was caused by both allometric and nonallometric variation in morphology, and this plasticity resulted in a negative correlation between maternal and progeny density. Such negative maternal effects are expected to retard responses to selection. Maternal morphology influenced maternal fitness, in part through the relationship of fitness to maternal plant size and in part through size-independent fitness effects. Maternal phenotypes that promote dispersal, and thereby increase progeny fitness, were associated with decreased maternal fitness. Selection on dispersal at the level of progeny favors increased dispersal; maternal influences on dispersal, however, not only cause a greatly reduced adaptive value of dispersal but lead to the prediction of a slower response to selection.

dispersal↗
PubMed2000

Maternal representation of the self as parent: connections with maternal sensitivity and maternal structuring.

Maternal representations of the self as parent were assessed via the Parent Attachment and Peer Relationship Interviews (Bretherton, Biringen, Ridgeway, Maslin-Cole, & Sherman, 1989; Biringen & Bretherton, 1988) when children were 39 months of age. Maternal sensitivity and maternal structuring during mother-child interactions were assessed at 18, 24 and 39 months. The central question of this study was whether maternal representations were related to aspects of observed maternal sensitivity and maternal structuring. We found that maternal sensitivity at 18 months predicted later maternal representations of the self as parent. But beginning at 24 months and continuing to 39 months maternal structuring proved to be a more important predictor of maternal representations of the self, in particular maternal self-esteem, even after controlling for maternal sensitivity.

Child, Preschool↗
PubMed1982

Maternal mortality. A review of maternal deaths over twenty years at the National Maternity Hospital, Dublin.

A retrospective study of the causes of maternal mortality over the past 20 years in the National Maternity Hospital, Dublin, was undertaken. Anaesthesia contributed to 4.4% of all maternal deaths and to 5.7% of 'true' maternal deaths. In the last 10 years studied it did not contribute to maternal mortality. It was concluded that anesthesia was not a major cause of maternal mortality in this hospital.

Adult↗
PubMed1989

Maternal transfer of photoperiodic information in Siberian hamsters. II. The nature of the maternal signal, time of signal transfer, and the effect of the maternal signal on peripubertal reproductive development in the absence of photoperiodic input.

Peripubertal reproductive development of Siberian hamsters is controlled by maternally derived photoperiodic information and the ambient photoperiod present after weaning. Previous experiments suggested that the maternally derived information is transferred during gestation, not during lactation. Development was examined in several photoperiods following manipulation of gestational and lactational photoperiods; development was influenced by the gestational, but not lactational, photoperiod. Second, effects of the gestational photoperiod were observed in young reared in constant light (LL) from Day 15. Depriving the young of ambient photoperiodic information after Day 15 allows a more direct assessment of the signal received from their dams. Finally, melatonin injections to long-day dams, at certain times of day, caused transmission of a short-day signal to young, as evidenced by their development in LL and light-dark cycles. Thus, a maternally derived signal that is dependent on melatonin influences reproductive development of the young during gestation; the maternally directed pattern of development can subsequently be modified by the youngs' own response to ambient photoperiods after weaning.

Aging↗
PubMed1976

Maternal deaths in Texas, 1969 to 1973. A report of 501 consecutive maternal deaths from the Texas Medical Association's Committee on Maternal Health.

The Texas Medical Association's Committee on Maternal Health reports its experience with 501 consecutive maternal deaths. The committee structure and procedures are explained. Demographic and pathologic data are presented and discussed. The defects which allowed complications to proceed to death are analyzed and recommendations are made to reduce the number of these deaths.

Maternal Mortality↗
PubMed2002

MPOA cytotoxic lesions and maternal behavior in the rat: effects of midpubertal lesions on maternal behavior and the role of ovarian hormones in maturation of MPOA control of maternal behavior.

Small neurotoxin lesions in the medial preoptic area (MPOA) block maternal behavior (MB) in adults but large lesions are required to produce the same effect in juvenile rats (23-27 days of age). To study the maturation of MPOA control of MB, in Experiment I, we compared the effects of small versus large neurotoxin MPOA lesions at midpuberty (38 days of age) on MB. Midpubertal females with large MPOA lesions showed severe impairment in MB affecting retrieving, crouching, and nest building, but 85% of females with small MPOA lesions exhibited all components of MB and performed like control females without MPOA lesions. To study the role of ovarian hormones during puberty on the maturation of MPOA mediation of MB (Experiment IIA), females were ovariectomized either before or after puberty and small MPOA cytotoxic lesions were made at 53 days of age. At 60 days of age both groups showed similar deficits in MB which indicated that the maturation of the MPOA mediation of MB is not dependent on pubertal ovarian hormones. In Experiment IIB, we administered estradiol benzoate (sc) and this overcame the deficit in MB after small MPOA lesions in females that had been deprived of estrogen for shorter periods (30 days) but had not been deprived for longer periods (60 days). In addition, ovary-intact females with circulating estrogen and small lesions in the MPOA at 53 days of age did not show deficits in MB.

Animals↗
PubMed1993

The effect of maternal depression on maternal ratings of child behavior.

There have been continuing concerns about the extent to which maternal depression may influence maternal reports of child behavior. To examine this issue, a series of structural equation models of the relationships between maternal depression and errors in maternal reports of child behavior was proposed and tested. These models assumed that (a) maternal depression was unrelated to maternal reporting behavior; (b) maternal depression causally influenced maternal reporting accuracy; (c) maternal depression was correlated with reporting accuracy. These models were fitted to data on maternal depression and multiple-informant (mother, teacher, child) reports of conduct disorder and attention deficit behaviors for a birth cohort of 12- and 13-year-old New Zealand children. The results of model fitting suggested the presence of small to moderate correlations (r = +.13 to +.40) between maternal depression and maternal reporting errors, indicating the presence of a tendency for increasing maternal depression to be associated with a tendency for mothers to over-report child behavior problems. However, independently of any effects of maternal depression on maternal reporting errors there was evidence of small but significant associations (r = .10 to .17; p < .05) between maternal depression and child conduct disorder and attention deficit behaviors.

Adolescent↗
PubMed1996

Maternal behavior in male rats: effects of medial preoptic area lesions and presence of maternal aggression.

Male rats exhibit maternal behavior prepuberally and in adulthood, but the neural mechanisms and the ability of males to respond to hormones that stimulate maternal aggression (following arousal of maternal behavior) in females have not been studies. In Experiment 1, males were exposed to pups to stimulate maternal behavior (sensitization) after either radiofrequency lesions of the MPOA or sham lesions with nonactivated electrodes that penetrated the MPOA. Nonsurgical males served as a CONTROL group. The LESION male group showed severe deficits in all components of maternal behavior compared to the latter two groups that showed no behavioral deficits. Females in the LESION group and those given SHAM 1 lesions (produced by electrodes without current introduced into the MPOA) also showed severe deficits in maternal behavior compared to SHAM 2 females (electrode lowered to above the MPOA without current) and nonsurgical CONTROL females. In Experiment 2, prolonged estradiol (E2), progesterone (P) treatment followed by an injection of either 20 micrograms or 100 micrograms/ kg estradiol benzoate (EB) or oil in castrated males was effective in stimulating short-latency maternal behavior, mainly in the 100 micrograms/kg EB group. Males of this group also showed a high level of maternal aggression that was inversely correlated with their latencies for maternal behavior. All groups showed maternal aggression when maternal behavior was established. The results indicate the MPOA mediates maternal behavior in males as it does in females; maternal aggression in males accompanies the stimulation of maternal behavior and may be stimulated by the same hormones.

Aggression↗
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↗
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↗
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↗