Reproductive patterns and thalassaemia major

This study investigated the effect of the diagnosis of transfusion-dependent homozygous beta-thalassemia on subsequent parental reproductive patterns in 44 families in New South Wales. The results indicate a shift over time from parental risk-taking (either consciously or in ignorance of the implications of the diagnosis) to premature curtailment of reproduction to the likelihood of attaining birth expectations through antenatal diagnosis. 67% of families with both of their 1st 2 children affected by thalassemia major had additional children, compared with 38% of those where the 1st child was affected and the 2nd child was unaffected and 37% of families where the 1st child was unaffected and the 2nd child was affected. Overall, 48% of mothers of children with thalassemia major had as many children as they had expected at the time of marriage, 13% had more, and 39% had fewer children. The mothers of older children were less likely to have had the planned number of births than those of children born more recently. The value of antenatal diagnosis to couples at risk of thalassemia appears to have been to enable them to meet or almost meet their birth expectations.     

Rare Detection of Occult Hepatitis B Virus Infection in Children of Mothers with Positive Hepatitis B Surface Antigen

The prevalence of occult Hepatitis B virus (HBV) infection in children was considerably varied from 0.1–64% in different reports. In this study we aimed to investigate the prevalence of occult HBV infection among the children born to mothers with positive hepatitis B surface antigen (HBsAg) in Jiangsu, China. Serum samples were collected from 210 children of 207 mothers with positive HBsAg. HBV serological markers were detected by ELISA and HBV DNA was detected by nested PCR. Homology comparison of HBV sequences recovered from the child and mother was used to define the infection. Three children (1.43%) were positive for HBsAg, in whom the HBV pre S and S gene sequence in each child was identical to that in her mother. Of the 207 HBsAg-negative children, nine displayed HBV DNA positive by two nested PCR assays using primers derived from S and C genes. However, the sequence alignment showed that the sequences in each child were considerably different from those in his/her mother. Therefore, the sequences amplified from the children were very likely resultant from the cross-contaminations. Furthermore, the nine children with ‘positive HBV DNA’ were all negative for anti-HBc, and one had anti-HBs 3.42 mIU/ml and eight others had anti-HBs from 72 to >1000 mIU/ml, indicating that the nine children were less likely infected with HBV. Therefore, none of the 207 HBsAg-negative children of HBV-infected mothers was found to have occult HBV infection. We conclude that the prevalence of occult HBV infection in vaccinated children born to HBsAg positive mothers should be extremely low. We recommend that homology comparison of sequences recovered from the child and mother be used to define the occult HBV infection in children born to HBV infected mothers.     

Breast-feeding in Bangladesh

In this paper the duration of breastfeeding is examined in relation to demographic and socioeconomic characteristics of women and households. 98% of Bangladesh mothers breastfeed their children from birth. In data from the Bangladesh Fertility Survey conducted in 1975-1976 on 4998 live births, the mean duration of breastfeeding was 27.3 months. Duration of breastfeeding was positively related with the age of women. Female children were breastfed for periods about 5 months shorter than male children. Children born to urban mothers were breastfed for shorter durations than children born to rural mothers of all age groups. The duration of breastfeeding decreased with the increase of education of the mother. Promotion of breastfeeding should be a primary responsibility of family planning clinics. Further decline in the duration of breastfeeding would increase levels of fertility and infant and child mortality.     

On the incidence of diarrhoea among young Indian children

Diarrhoea, claiming over three million young lives in the world every year, is the second biggest killer of children in developing countries. Using data for over 13,000 children in rural India, under the age of 3 years, this paper examines the relative effects of the different factors--inter alia the quality of the water supply, mother's literacy, housing conditions, and the level of development of the villages in which the children lived--contributing to diarrhoea. The paper highlights the importance of two factors: that children born to undernourished mothers may be more susceptible to infection than children whose mothers are well nourished, and that good hygienic practices within the home, such as washing hands with soap before feeding a child, can reduce the incidence of diarrhoea. The paper also quantifies the relative strength of the factors that determine whether mothers do so. The results emphasize the importance of mothers being literate, of household affluence and of institutional support (through the availability of trained midwives and mother and child centres in villages) in promoting domestic hygiene.     

The Bacon Chow study: Genetic analysis of physical growth in assessment of energy–protein malnutrition

Estimates of the prevalence of energy–protein malnutrition almost universally employ physical growth measurements. In this study we focus on this disease and the role of body size of relatives as mediators of responses in individuals to one type of nutrition intervention: supplementation of pregnant and lactating women. In this study, initiated by Dr. Bacon Chow and others in 1967, during gestation of a first infant a mother was untreated, while during the lactation of the first infant and the gestation and lactation of a second infant she was treated with either a calorie supplement or a placebo. Supplement–placebo group differences were sought in sibling and mother–child correlations in growth from birth to 30 months, in order to assess the role of heredity as a mediator of supplement effects. There were 108 pairs of siblings whose mothers had received a high-calorie–high-protein supplement as described above and 105 pairs of siblings whose mothers had received a placebo. Among the latter, sibling correlations for most measurements are statistically significant at birth, and of the same magnitude seen in previous studies (～0.5), while among supplemented siblings, birth correlations are unusually low and often insignificant. The sibling correlations in Rohrer's index (wt/L³) differed the most between groups (p < 0.01). Group differences in the sibling correlation tended to disappear over the first 2.5 years of life. Correlations between mothers and their second children in subscapular skinfold tended to be higher in the supplemented than in the placebo group, birth to 30 months. In both supplement groups mother–second child correlations for body weight were higher than mother–first child correlations, suggesting the occurrence of secular changes in the environment unconnected with the treatment. The results suggest that: (1) genetic analysis of components of anthropometric variation may be a more sensitive method than the more conventional comparison of group means in detecting supplement effects; and (2) infant relative weight (Rohrer index), particularly the addition of subcutaneous fat, may be more affected by maternal supplementation than growth in weight or length alone.     

THE THORNY CHILD

Too many physicians—and parents—hide behind the overworked excuse that “Johnny is just going through a stage.” If the remark is inaccurate a great disservice can be done to both mother and child, and ultimately to society. The well oriented physician would no more permit a young mother to unwittingly feel “guilty” because her two-year-old “little stinker” behaves like a two-year-old little stinker than he would casually reassure when a ten-year-old behaves as though he were two.Actually much of the unpleasant behavior of children is quite normal. If physicians would help all young mothers to recognize this without dismissing abnormal behavior, it would do much to avert the overwhelming sense of inadequacy that so many modern young mothers feel—especially with their first baby. If they can be made comfortable with their first the others usually come easily. Many physicians who care for children are not trained in the rudiments of developmental behavior. By means of a simple outline and drawing of “the thorny child” even the least of the experts can better understand some of the chronologic variations in developmental behavior.     

Strongyloides stercoralis: a field-based survey of mothers and their preschool children using ELISA, Baermann and Koga plate methods reveals low endemicity in western Uganda

To ascertain the current status of strongyloidiasis in mothers and their preschool children, a field-based survey was conducted in western Uganda using a combination of diagnostic methods: ELISA, Baermann concentration and Koga agar plate. The prevalence of other soil-transmitted helminthiasis and intestinal schistosomiasis were also determined. In total, 158 mothers and 143 children were examined from five villages within Kabale, Hoima and Masindi districts. In mothers and children, the general prevalence of strongyloidiasis inferred by ELISA was approximately 4% and approximately 2%, respectively. Using the Baermann concentration method, two parasitologically proven cases were encountered in an unrelated mother and child, both of whom were sero-negative for strongyloidiasis. No infections were detected by Koga agar plate method. The general level of awareness of strongyloidiasis was very poor ( < 5%) in comparison to schistosomiasis (51%) and ascariasis (36%). Strongyloidiasis is presently at insufficient levels to justify inclusion within a community treatment programme targeting maternal and child health. Better epidemiological screening is needed, however, especially identifying infections in HIV-positive women of childbearing age. In the rural clinic setting, further use of the Baermann concentration method would appear to be the most immediate and pragmatic option for disease diagnosis.     

HIV-1 Autologous Antibody Neutralization Associates with Mother to Child Transmission

The HIV-1 characteristics associated with mother to child transmission (MTCT) are still poorly understood and if known would indicate where intervention strategies should be targeted. In contrast to horizontally infected individuals, exposed infants possess inherited antibodies (Abs) from their mother with the potential to protect against infection. We investigated the HIV-1 gp160 envelope proteins from seven transmitting mothers (TM) whose children were infected either during gestation or soon after delivery and from four non-transmitting mothers (NTM) with similar viral loads and CD4 counts. Using pseudo-typed viruses we tested gp160 envelope glycoproteins for TZM-bl infectivity, CD4 and CCR5 interactions, DC-SIGN capture and transfer and neutralization with an array of common neutralizing Abs (NAbs) (2F5, 2G12, 4E10 and b12) as well as mother and infant plasma. We found no viral correlates associated with HIV-1 MTCT nor did we find differences in neutralization with the panel of NAbs. We did, however, find that TM possessed significantly higher plasma neutralization capacities than NTM (P  = 0.002). Furthermore, we found that in utero (IU) TM had a higher neutralization capacity than mothers transmitting either peri - partum (PP) or via breastfeeding (BF) (P  = 0.002). Plasma from children infected IU neutralized viruses carrying autologous gp160 viral envelopes as well as those from their corresponding mothers whilst plasma from children infected PP and/or BF demonstrated poor neutralizing capacity. Our results demonstrate heightened autologous NAb responses against gp120/gp41 can associate with a greater risk of HIV-1 MTCT and more specifically in those infants infected IU. Although the number of HIV-1 transmitting pairs is low our results indicate that autologous NAb responses in mothers and infants do not protect against MTCT and may in fact be detrimental when considering IU HIV-1 transmissions.     

Individual human hair mitochondrial DNA control region heteroplasmy proportions in mothers and children

Due to maternal inheritance, lack of recombination and a high polymorphic density, the mtDNA control region hypervariable (HV) regions are well suited for forensic identification using a maternal relative as the known sample. This analysis can be performed in hair, however, heteroplasmy in this tissue is not rare and can result in an apparent sequence mismatch that complicates this application. There is little data comparing mother and child mtDNA-CR heteroplasmic proportions in hair. In this study, we assayed four hairs per individual in 26 mother-child pairs by TTGE for heteroplasmy across HV1. Single nucleotide heteroplasmy was detected in seven families, and in four families at least two hairs were heteroplasmic. In each of the latter families, sequencing and PCR-RFLP confirmed single nucleotide heteroplasmy in proportions of the variant ranging from < or =10 to > or =90% in the mothers, with far less variability in their children. Sequencing alone would have revealed apparent homoplasmic differences at one nucleotide in these families, possibly resulting in an 'inconclusive' verdict for relatedness of child and mother. However, mother-child heteroplasmic variability did not exceed intra-individual variability in the mothers alone.     

Teenage motherhood and infant mortality in Bangladesh: maternal age-dependent effect of parity one

Nuptiality norms in rural Bangladesh favour birth during the teenage years. An appreciable proportion of teenage births are, in fact, second births. This study examines the relationship between teenage fertility and high infant mortality. It is hypothesized that if physiological immaturity is responsible, then the younger the mother, the higher would be the mortality risk, and the effect of mother's 'teenage' on mortality in infancy, particularly in the neonatal period, would be higher for the second than the first births. Vital events recorded by the longitudinal demographic surveillance system in Matlab, Bangladesh, in 1990-92 were used. Logistic regression was used to estimate the effects on early and late neonatal (0-3 days and 4-28 days respectively) and post-neonatal mortality of the following variables: mother's age at birth, parity, education and religion, sex of the child, household economic status and exposure to a health intervention programme. The younger the mother, the higher were the odds of her child dying as a neonate, and the odds were higher for second children than first children of teenage mothers. First-born children were at higher odds of dying in infancy than second births if mothers were in their twenties. Unfavourable mother's socioeconomic conditions were weakly, but significantly, associated with higher odds of dying during late neonatal and post-neonatal periods. The results suggest that physical immaturity may be of major importance in determining the relationship between teenage fertility and high neonatal mortality.     

Fetal sex determination in infants in Punjab,India: correlations and implications.

OBJECTIVES--To determine the proportion of children whose sex was determined prenatally among those attending one Indian hospital and to identify factors which affect use of fetal sex determination. DESIGN--Cross sectional study using interviews with mothers. SETTING--Medical school hospital in Punjab, India. SUBJECTS--596 children delivered or seen for inpatient or outpatient care. MAIN OUTCOME MEASURES--Fetal sex determination, sex of child, number and sex of siblings, type of care received, socioeconomic status, and maternal education. RESULTS--Sex had been determined prenatally for fewer girls (5/236, 2%) than boys (49/360, 14%). Fetal sex determination had been done for only 2% (3/154) of first born boys compared with 18% (12/66) with one older sister and no older brother and 63% (30/48) with more than one older sister and no older brother. Only four boys whose sex had been determined prenatally had older brothers. The five girls whose sex had been determined prenatally either had a male twin or were incorrectly identified as male. Prenatal sex determination had been done for 21% (26/122) of boys admitted for inpatient care compared with 11% (19/173) seen as outpatients. Use of fetal sex determination increased with increasing monthly income (chi2 for trend = 6.384, P = 0.0115). None of the mothers who had had no education had used fetal sex determination, but among mothers with some education the frequency of use did not change with increasing education. The sex ratio of children born at the hospital rose from 107 boys/100 girls in 1982 to 132 boys/100 girls in 1993. CONCLUSIONS--Fetal sex determination was common, especially if the family already had daughters. Sex determination seems to be driven by a desire to have sons, with socioeconomic status and education having little effect. The lower prevalence of fetal sex determinations for girls is likely to be due to abortion of fetuses found to be female.     

Mother-child separation: a study in a remote health care setting.

The literature indicates that the birth of a sibling and the consequent temporary separation from the mother is usually a stressful experience for a child. It was hypothesized that this stress would result in an increased number of visits by the child to health care facilities because of new health problems. In a controlled study of 89 matched pairs of Indian families in a remote region of northwestern Ontario this hypothesis was not supported. During the intervals studied - the anticipatory period before delivery, the separation itself and the period immediately following the mother''s return home - the number of diagnoses of new medical problems was significantly less for the children who were separated from their mothers for the birth of a sibling. As well, the number of diagnoses of new medical problems in the children separated form their mothers decreased over the three intervals. The fathers'' reluctance to seek health care probably played a major role in this decrease.     

Interaction of PDGFRA promoter haplotypes and maternal environmental exposures in the risk of spina bifida

BACKGROUND: Neural tube defects are multifactorial malformations involving both environmental exposures, such as maternal nutrition, and genetic factors. Aberrant expression of the platelet‐derived growth factor alpha‐receptor (PDGFRA) gene has been implicated in neural‐tube‐defect etiology in both mice and humans. METHODS: We investigated possible interactions between the PDGFRA promoter haplotype of mother and child, as well as maternal glucose, myo‐inositol, and zinc levels, in relation to spina bifida offspring. Distributions were determined of the PDGFRA promoter haplotypes H1 and H2 in a Dutch cohort, consisting of 88 spina bifida children with 56 of their mothers, and 74 control children with 72 of their mothers, as well as maternal plasma glucose, myo‐inositol, and red blood cell zinc concentrations. RESULTS: A significantly higher frequency of H1 was observed in children with spina bifida than in controls (30.1 vs. 20.3%; OR = 1.69, 95% CI 1.02–2.83). High maternal body mass index (BMI) and glucose were significant risk factors for both H1 and H2 children, whereas low myo‐inositol and zinc were risk factors for H2 but not for H1 children. Stepwise multiple logistic regression analysis showed that high maternal glucose and low myo‐inositol are the main risk factors for H2 spina bifida children, whereas for H1 spina bifida children, maternal BMI was the main risk factor. Interestingly, H1 mothers (median 165.5 cm) showed a significantly lower body height than H2 mothers (median 169.1 cm; p = 0.003). CONCLUSIONS: These data suggest that the child's PDGFRA promoter haplotype is differentially sensitive for periconceptional exposure to glucose, myo‐inositol, and zinc in the risk of spina bifida. Birth Defects Research (Part A), 2009. © 2009 Wiley‐Liss, Inc.     

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders(ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother–child pairs of ASD children and 30 matched mother–child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother–child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.     

The application of autogenic training in counseling center for mother and child in order to promote breastfeeding

The aim of this study was to investigate whether mothers with newborn children, the usage of autogenic training with advice on breastfeeding effect on: the decision and the duration of breastfeeding, increase maternal confidence and support. It was assumed that the above result in a higher percentage of mothers who exclusively breastfed baby during the first six months of child's life. The survey was conducted in the Association "For a healthy and happy childhood"-Counseling center for mother and child, in Bjelovar in 2010. The Counseling center was attended by 100 nursing mothers with children aged up to two months. They randomly went to the study or control group. Mothers of both groups were advised to successful breastfeeding. Study group has practiced autogenic training until the child's age of six months. In parallel, by using psychotherapeutic interview and specific questionnaires we collected data on the somatic, psychological and social situation of the mother, discovered mother's mental changes (anxiety, depression) that were treated. The results at the end of the study confirm the initial expected benefits from the application of autogenic training. Mothers of the study group were significantly more emotionally balanced with a higher self-esteem. Autogenous training with the advices for successful breastfeeding conducted in this counseling center contributed in significantly higher rate of breastfeeding children up to six months of life, improved mental and physical health of mother and child and their peculiar relationship.     

Services d’éducation préscolaire et comportements agressifs : un rôle de prévention pour les familles vulnérables

Context

Physical violence is a significant problem in health terms and for society as a whole. Many studies have shown that socio-economic indicators such as poverty and poor parental educational attainment are associated with an increased risk of difficulties in social adjustment of the child. The hypothesis of this study was that the pre-school educational services (PES) could help to prevent the development of physical aggression (PA) in the children of vulnerable families, and that this would depend on the age at which the child first had access to the service.

Methods

Identification of children presenting with a pattern of increased PA between 17 and 60 months of age, taken from a representative sample of children born in Quebec (N = 1691). We took into consideration the educational level of the mother and the age at which the child started to receive PES. We examined the association of these factors with the PA group to which the child belonged, while controlling against several other family characteristics which are associated with PES and PA.

Results

The children of mothers with a low level of educational attainment (no secondary school qualification) were less likely to have received PES than the others. Those who had received such attention had a considerably reduced risk of displaying a behaviour pattern of increased PA. The results of multiple logistic regression analysis revealed that the PES reduced the risk of high PA, especially if the child was exposed to the service before the age of 9 months (d = ?0.62; SD = 0.24; 95% CI: ?1.09 to ?0.16; odds ratio = 0.20; 95% CI: 0.05–0.9). Children whose mothers had obtained a secondary school diploma were at reduced risk of high PA. For them, the PES did not represent an additional protective factor.

Interpretation

PES directed towards children of poorly educated mothers might reduce considerably the risk of chronic physical aggression, especially if initiated soon after birth. As those children who aremost likely to benefit from PES are the least likely to receive it, it is necessary to put special measures in place to direct this sort of service towards at risk families.     

Familial Accumulation of Social Anxiety Symptoms and Maladaptive Emotion Regulation

BackgroundSocial anxiety is thought to be strongly related to maladaptive emotion regulation (ER). As social anxiety symptoms accumulate in families, we hypothesize that maladaptive ER is also more prevalent in families with anxious children. Thus, we analyze differences in emotion regulation of both child and mother in relation to social anxiety, as well as both their ER strategies in dealing with anxiety. Further, a positive relation between child and maternal ER strategies is assumed.MethodChildren (aged 9 to 13 years) with social, anxiety disorder (SAD; n = 25) and healthy controls (HC, n = 26) as well as their mothers completed several measures of social anxiety and trait ER strategies towards anxiety. As ER of children is still in development, age is considered as covariate.ResultsSAD children and their mothers reported more maladaptive ER strategies than HC dyads. Maternal maladaptive ER was related negatively to child adaptive ER which was further moderated by the child’s age.DiscussionMaladaptive ER strategies seem to contribute to the exacerbation of social anxiety in both mother and child. Mothers reporting maladaptive ER may have difficulties supporting their child in coping with social anxiety while simultaneously also experiencing heightened levels of anxiety. Deeper understanding of interactional processes between mothers and children during development can assist the comprehension of factors maintaining SAD. Implications for future research and possible consequences for interventions are discussed.     

Efficiency of haplotype frequency estimation when nuclear family information is included

In genetic studies the haplotype structure of the regarded population is expected to carry important information. Experimental methods to derive haplotypes, however, are expensive and none of them has yet become standard methodology. On the other hand, maximum likelihood haplotype estimation from unphased individual genotypes may incur inaccuracies. We therefore investigated the relative efficiency of haplotype frequency estimation when nuclear family information is included compared to estimation from experimentally derived haplotypes. Efficiency was measured in terms of variance ratios of the estimates. The variances were derived from the binomial distribution for experimentally derived haplotypes, and from the Fisher information matrix corresponding to the general likelihood function of the haplotype frequency parameters, including family information. We subsequently compared these variance ratios to the variance ratios for the case of estimation from individual genotypes. We found that the information gained from a single child compensates missing phase information to a high degree, resulting in estimates almost as reliable as those derived from observed haplotypes. Thus, if children have already been genotyped for other reasons, it is highly recommendable to include them into the estimation. If child information is not already present, it depends on the number of loci and the haplotype diversity if it is useful to genotype a single child just to reduce phase ambiguity. In general, if the number of loci is less than or equal to three or if the number of haplotypes with a frequency >5% is less than or equal to four, haplotype estimation from individuals is quite good already and the improvement gained from a single child can not compensate the genotyping effort for it. On the other hand, under scenarios with many loci and high haplotype diversity, haplotype frequency estimation from trios can be more efficient than haplotype frequency estimation from individuals also on a per genotype base.     

Retrospective report revisited: Long-term recall in European American mothers moderated by developmental domain,child age,person, and metric of agreement

Abstract

Retrospective parental reports are common in the developmental science literature, but their validity has been questioned. We investigated the consistency of retrospective maternal recall by comparing original with retrospective maternal reports in three domains (maternal cognitions, mother-reported child and mother behaviors, and observed child and mother behaviors) at three retention intervals (12, 14, and 15 years) in two metrics (individual standing and group level). In a longitudinal study, European American mothers (N?=?46) provided data when their children were 5, 20, and 48 months of age and retrospective recall data for each age when their children were 16 years. Overall, mothers recalled similar average mean levels (49% of variables explored) or better mean levels (41% of variables) retrospectively; better levels indicating a positive recollection bias. At least moderate consistency in relative standing was evident for 52% of variables. However, the findings varied somewhat by domain, child age, and person. Retrospective parental reports can provide accurate accounts of the past, but should be used with caution, as their consistency varies and is specific to moderating factors.