Valuing mother and child health: The intrauterine environment

The paper estimates the value a mother assigns to own health relative to child health. Estimation of relative health valuation requires the decomposition of a child health improvement into its direct effect on the child's health and its indirect effect, through improvements in maternal health. Failure to distinguish the impact of the direct and indirect effects can lead to biased estimates. We consider the intrauterine environment of a pregnant mother and her unborn child, where maternal health inputs are choice variables and her health affects child health. The empirical estimates suggest that mothers value child health up to six times higher than own health, and that the relative value depends on maternal consumption patterns and household characteristics.     

Antidepressants and pregnancy: risks and benefits for the mother and child

Depression, anxiety disorders, anorexia nervosa and bulimia, all indications for antidepressant use, are common disorders in women of childbearing age. Nevertheless, antidepressant use during the gestational period remains a controversial topic. Given that 50 % of pregnancies are unplanned, the safety of antidepressants during the first trimester of pregnancy, a critical period for foetal development, has become a major public health concern. Until now, most studies suggest that physicians may often under-prescribe or discontinue antidepressants at the time of conception and during pregnancy. This may be a consequence of the concern over the safety of these agents in pregnant women and the risks they may pose to the foetus. In fact, recent studies and warnings from Health Canada and the US Food and Drug Administration have reinforced this uncertainty regarding the adverse effects of antidepressant use on the foetus. On the other hand, discontinuation of antidepressant use during pregnancy was also recently associated with maternal relapse of depression and withdrawal symptoms, which is not optimal for the mother and her foetus. Consequently, women who wish to become pregnant and who suffer from psychiatric disorders are faced with the difficult task of deciding whether to continue or discontinue their antidepressant during pregnancy. At this time, it appears important to take into account all evidence-based data to evaluate the risks/benefits of using antidepressants during the gestational period in order to help mothers make the best choice for themselves, and their infants.     

Report of two cases with Van der Woude syndrome: a child and her mother

Report of two cases with Van der Woude syndrome: a child and her mother: Congenital pits of the lower lip are rare malformations. They are closely associated with cleft lip (CL), cleft lip/palate (CL/CP) or isolated cleft palate (CP) and if so this condition is known as Van der Woude syndrome, which is inherited in an autosomal dominant fashion with high penetrance. Two individuals, one with lower lip pits and cleft palate and the other with isolated lower lip pit from the same family are described. Autosomal dominant pattern of inheritance was observed in this family and treatment consisted of complete removal of sinus tracts in one patient. Pathological features of sinus tracts consisted of stratified nonkeratinized squamous epithelium and a lamina propria of dense connective tissue. Importance of genetic counseling is emphasized as at least half of gene carriers have some kind of clefting.     

The iron trap: iron,malaria and anemia at the mother–child interface

Iron deficiency causes anemia, but prevents malaria for unknown reasons, thus hindering iron supplementation programs for mothers and children. Iron homeostasis is tightly regulated, including at the mother–fetus interface where iron–malaria relationships are complex. Improved iron status assays, and understanding of malaria protection mechanisms, are needed to manage these disorders.