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PloS One 2024Bisphenols (BP), including BPA and "BPA-free" structural analogs, are commonly used plasticizers that are present in many plastics and are known endocrine disrupting...
Bisphenols (BP), including BPA and "BPA-free" structural analogs, are commonly used plasticizers that are present in many plastics and are known endocrine disrupting chemicals. Prenatal exposure to BPA has been associated with negative neurodevelopmental and behavioral outcomes in children and in rodent models. Prenatal BPA exposure has also been shown to impair postnatal maternal care provisioning, which can also affect offspring neurodevelopment and behavior. However, there is limited knowledge regarding the biological effects of prenatal exposure to bisphenols other than BPA and the interplay between prenatal bisphenol exposure and postnatal maternal care on adult behavior. The purpose of the current study was to determine the interactive impact of prenatal bisphenol exposure and postnatal maternal care on neurodevelopment and behavior in rats. Our findings suggest that the effects of prenatal bisphenol exposure on eye-opening, adult attentional set shifting and anxiety-like behavior in the open field are dependent on maternal care in the first five days of life. Interestingly, maternal care might also attenuate the effects of prenatal bisphenol exposure on eye opening and adult attentional set shifting. Finally, transcriptomic profiles in male and female medial prefrontal cortex and amygdala suggest that the interactive effects of prenatal bisphenol exposure and postnatal maternal care converge on estrogen receptor signaling and are involved in biological processes related to gene expression and protein translation and synthesis. Overall, these findings indicate that postnatal maternal care plays a critical role in the expression of the effects of prenatal bisphenol exposure on neurodevelopment and adult behavior. Understanding the underlying biological mechanisms involved might allow us to identify potential avenues to mitigate the adverse effects of prenatal bisphenol exposure and improve health and well-being in human populations.
Topics: Animals; Female; Pregnancy; Phenols; Benzhydryl Compounds; Prenatal Exposure Delayed Effects; Male; Rats; Behavior, Animal; Transcriptome; Maternal Behavior; Endocrine Disruptors; Postnatal Care; Maternal Exposure
PubMed: 38861567
DOI: 10.1371/journal.pone.0305256 -
PloS One 2024Despite the advantages of vaccination in preventing maternal and fetal problems, there were many concerns in the medical community regarding vaccine safety for pregnant...
BACKGROUND
Despite the advantages of vaccination in preventing maternal and fetal problems, there were many concerns in the medical community regarding vaccine safety for pregnant women, and this has put obstetricians in a challenging situation when it comes to advising their pregnant patients on whether to obtain the vaccine.
AIM
This study was performed to define the level of acceptance of COVID-19 vaccination and assess the impact of COVID-19 attitudes and knowledge on vaccine acceptance between pregnant and lactating Syrian women who are seeking prenatal care services at the clinics in Azraq refugee camp in Jordan.
METHOD
A quantitative, cross-sectional study utilizing a non-probability convenience sample. A validated and reliable self-administered questionnaire consisting of four sections was used.
RESULTS
A total of 412 pregnant/lactating women was recruited The acceptance rate of the COVID-19 vaccine among participants was 86.5%. There was a significant positive moderate association between respondents' attitudes and knowledge around the COVID-19 vaccine and their acceptance of the vaccine (r = .468, p < .001, r = .357, p < .001), respectively.
CONCLUSION
To effectively mitigate the COVID-19 pandemic and achieve collective protection, decision-makers must intensify the efforts in promoting the importance of maternal vaccination, especially in vulnerable communities that suffer the most from pandemic outcomes.
Topics: Humans; Female; COVID-19 Vaccines; Adult; Jordan; Pregnancy; COVID-19; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Refugee Camps; Patient Acceptance of Health Care; Surveys and Questionnaires; Young Adult; SARS-CoV-2; Lactation; Vaccination; Refugees; Prenatal Care; Pregnant Women; Maternal Health Services; Adolescent
PubMed: 38861556
DOI: 10.1371/journal.pone.0305314 -
Molecular Genetics & Genomic Medicine Jun 2024Hearing loss (HL) is the most frequent sensory deficit in humans, with strong genetic heterogeneity. The genetic diagnosis of HL is very important to aid treatment...
BACKGROUND
Hearing loss (HL) is the most frequent sensory deficit in humans, with strong genetic heterogeneity. The genetic diagnosis of HL is very important to aid treatment decisions and to provide prognostic information and genetic counselling for the patient's family.
METHODS
We detected and analysed 362 Chinese non-syndromic HL patients by screening of variants in 15 hot spot mutations. Subsequently, 40 patients underwent further whole-exome sequencing (WES) to determine genetic aetiology. The candidate variants were verified using Sanger sequencing. Twenty-three carrier couples with pathogenic variants or likely pathogenic variants chose to proceed with prenatal diagnosis using Sanger sequencing.
RESULTS
Among the 362 HL patients, 102 were assigned a molecular diagnosis with 52 different variants in 22 deafness genes. A total of 41 (11.33%) cases with the biallelic GJB2 (OMIM # 220290) gene mutations were detected, and 21 (5.80%) had biallelic SLC26A4 (OMIM # 605646) mutations. Mitochondrial gene (OMIM # 561000) mutations were detected in seven (1.93%) patients. Twenty of the variants in 15 deafness genes were novel. SOX10 (OMIM # 602229), MYO15A (OMIM # 602666) and WFS1 (OMIM # 606201) were each detected in two patients. Meanwhile, OSBPL2 (OMIM # 606731), RRM2B (OMIM # 604712), OTOG (OMIM # 604487), STRC (OMIM # 606440), PCDH15 (OMIM # 605514), LOXHD1 (OMIM # 613072), CDH23 (OMIM # 605516), TMC1 (OMIM # 606706), CHD7 (OMIM # 608892), DIAPH3 (OMIM # 614567), TBC1D24 (OMIM # 613577), TIMM8A (OMIM # 300356), PTPRQ (OMIM # 603317), SALL1 (OMIM # 602218), and GSDME (OMIM # 608798) were each detected in one patient. In addition, as regards one couple with a heterozygous variant of CDH23 and PCDH15, respectively, prenatal diagnosis results suggest that the foetus had double heterozygous (DH) variants of CDH23 and PCDH15, which has a high risk to cause ID/F type Usher syndrome.
CONCLUSION
Our study expanded the spectrum of deafness gene variation, which will contribute to the genetic diagnosis, prenatal diagnosis and the procreation guidance of deaf couple. In addition, the deafness caused by two genes should be paid attention to in the prenatal diagnosis of families with both deaf patients.
Topics: Humans; Female; Male; China; Mutation; Child; Hearing Loss; Adult; Child, Preschool; Sulfate Transporters; Adolescent; Cadherin Related Proteins
PubMed: 38860500
DOI: 10.1002/mgg3.2434 -
BMC Pregnancy and Childbirth Jun 2024Frontonasal dysplasia (FND) is a rare congenital anomaly resulting from the underdevelopment of the frontonasal process, and it can be syndromic or nonsyndromic. The... (Review)
Review
Prenatal diagnosis of a severe form of frontonasal dysplasia with severe limb anomalies, hydrocephaly, a hypoplastic corpus callosum, and a ventricular septal defect using 3D ultrasound: a case report and literature review.
BACKGROUND
Frontonasal dysplasia (FND) is a rare congenital anomaly resulting from the underdevelopment of the frontonasal process, and it can be syndromic or nonsyndromic. The typical features of FND include a deformed nose and ocular hypertelorism, which are sometimes associated with cleft lip and/or palate. Only approximately 10 cases of prenatally diagnosed nonsyndromic FND have been reported in the past 30 years.
CASE PRESENTATION
A 33-year-old woman (G2P1) was referred to our center at 20 gestational weeks for bilateral hydrocephaly. We detected typical features of FND, including severe hypertelorism, median nasal bifidity, a minor cleft lip, and multiple limb anomalies using three-dimensional (3D) ultrasound. A hypoplastic corpus callosum, unilateral microtia, and a ventricular septal defect were also detected. Genetic testing, including karyotype analysis, copy number variation (CNV) analysis, trio-whole exome sequencing (trio-WES), and trio-whole-gene sequencing (trio-WGS), was performed; however, we did not find any de novo gene variants in the fetus as compared to the parents. Postmortem examination confirmed the prenatal diagnosis of FND.
CONCLUSION
The present case expands the wide phenotypic spectrum of prenatal FND patients. 3D ultrasound is a useful tool for detecting facial and limb deformities.
Topics: Humans; Female; Adult; Pregnancy; Ultrasonography, Prenatal; Craniofacial Abnormalities; Agenesis of Corpus Callosum; Limb Deformities, Congenital; Face; Hydrocephalus; Imaging, Three-Dimensional; Heart Septal Defects, Ventricular; Abnormalities, Multiple
PubMed: 38858685
DOI: 10.1186/s12884-024-06619-4 -
BMJ Open Jun 2024To assess the efficacy of a sustained educational intervention to affect diverse outcomes across the pregnancy and infancy timeline. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To assess the efficacy of a sustained educational intervention to affect diverse outcomes across the pregnancy and infancy timeline.
SETTING
A multi-arm cluster-randomised controlled trial in 99 villages in Honduras' Copán region, involving 16 301 people in 5633 households from October 2015 to December 2019.
PARTICIPANTS
Residents aged 12 and older were eligible. A photographic census involved 93% of the population, with 13 881 and 10 263 individuals completing baseline and endline surveys, respectively.
INTERVENTION
22-month household-based counselling intervention aiming to improve practices, knowledge and attitudes related to maternal, neonatal and child health.
PRIMARY AND SECONDARY OUTCOME MEASURES
Primary outcomes were prenatal/postnatal care behaviours, facility births, exclusive breast feeding, parental involvement, treatment of diarrhoea and respiratory illness, reproductive health, and gender/reproductive norms. Secondary outcomes were knowledge and attitudes related to the primary outcomes.
RESULTS
Parents targeted for the intervention were 16.4% (95% CI 3.1%-29.8%, p=0.016) more likely to have their newborn's health checked in a health facility within 3 days of birth; 19.6% (95% CI 4.2%-35.1%, p=0.013) more likely to not wrap a fajero around the umbilical cord in the first week after birth; and 8.9% (95% CI 0.3%-17.5%, p=0.043) more likely to report that the mother breast fed immediately after birth. Changes in knowledge and attitudes related to these primary outcomes were also observed. We found no significant effect on various other practices.
CONCLUSION
A sustained counselling intervention delivered in the home setting by community health workers can meaningfully change practices, knowledge and attitudes related to proper newborn care following birth, including professional care-seeking, umbilical cord care and breast feeding.
TRIAL REGISTRATION NUMBER
NCT02694679.
Topics: Humans; Honduras; Female; Health Knowledge, Attitudes, Practice; Adult; Pregnancy; Infant, Newborn; Male; Health Promotion; Child; Breast Feeding; Counseling; Infant; Adolescent; Child Health; Young Adult; Prenatal Care; Postnatal Care
PubMed: 38858139
DOI: 10.1136/bmjopen-2022-060784 -
BMJ Open Jun 2024National-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study...
BACKGROUND
National-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study is to estimate grid-level coverage of essential MCH services in Nigeria using machine learning techniques.
METHODS
Essential MCH services in this study included antenatal care, facility-based delivery, childhood vaccinations and treatments of childhood illnesses. We estimated generalised additive models (GAMs) and gradient boosting regressions (GB) for each essential MCH service using data from five national representative cross-sectional surveys in Nigeria from 2003 to 2018 and geospatial socioeconomic, environmental and physical characteristics. Using the best-performed model for each service, we map predicted coverage at 1 km and 5 km spatial resolutions in urban and rural areas, respectively.
RESULTS
GAMs consistently outperformed GB models across a range of essential MCH services, demonstrating low systematic prediction errors. High-resolution maps revealed stark geographic disparities in MCH service coverage, especially between rural and urban areas and among different states and service types. Temporal trends indicated an overall increase in MCH service coverage from 2003 to 2018, although with variations by service type and location. Priority areas with lower coverage of both maternal and vaccination services were identified, mostly located in the northern parts of Nigeria.
CONCLUSION
High-resolution spatial estimates can guide geographic prioritisation and help develop better strategies for implementation plans, allowing limited resources to be targeted to areas with lower coverage of essential MCH services.
Topics: Humans; Nigeria; Machine Learning; Female; Cross-Sectional Studies; Maternal-Child Health Services; Pregnancy; Child; Rural Population; Prenatal Care; Health Services Accessibility
PubMed: 38858137
DOI: 10.1136/bmjopen-2023-080135 -
BMJ Open Quality Jun 2024Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness.
OBJECTIVE
Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness.
DESIGN
There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement.
SETTING
The study was set in a single maternity unit with approximately 5500 births annually.
PARTICIPANTS
Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback.
OUTCOME MEASURES
We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers.
RESULTS
The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention.
CONCLUSIONS
Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.
Topics: Humans; Female; Pregnancy; Focus Groups; Adult; Surveys and Questionnaires; Prenatal Education; Prenatal Care; Labor, Obstetric
PubMed: 38858078
DOI: 10.1136/bmjoq-2023-002731 -
ELife Jun 2024Abnormal lung development can cause congenital pulmonary cysts, the mechanisms of which remain largely unknown. Although the cystic lesions are believed to result...
Abnormal lung development can cause congenital pulmonary cysts, the mechanisms of which remain largely unknown. Although the cystic lesions are believed to result directly from disrupted airway epithelial cell growth, the extent to which developmental defects in lung mesenchymal cells contribute to abnormal airway epithelial cell growth and subsequent cystic lesions has not been thoroughly examined. In the present study using genetic mouse models, we dissected the roles of bone morphogenetic protein (BMP) receptor 1a (Bmpr1a)-mediated BMP signaling in lung mesenchyme during prenatal lung development and discovered that abrogation of mesenchymal disrupted normal lung branching morphogenesis, leading to the formation of prenatal pulmonary cystic lesions. Severe deficiency of airway smooth muscle cells and subepithelial elastin fibers were found in the cystic airways of the mesenchymal knockout lungs. In addition, ectopic mesenchymal expression of BMP ligands and airway epithelial perturbation of the Sox2-Sox9 proximal-distal axis were detected in the mesenchymal knockout lungs. However, deletion of Smad1/5, two major BMP signaling downstream effectors, from the lung mesenchyme did not phenocopy the cystic abnormalities observed in the mesenchymal knockout lungs, suggesting that a Smad-independent mechanism contributes to prenatal pulmonary cystic lesions. These findings reveal for the first time the role of mesenchymal BMP signaling in lung development and a potential pathogenic mechanism underlying congenital pulmonary cysts.
Topics: Animals; Bone Morphogenetic Protein Receptors, Type I; Signal Transduction; Mice; Mice, Knockout; Lung; Mesoderm; Cysts; Bone Morphogenetic Proteins; Lung Diseases; Disease Models, Animal
PubMed: 38856718
DOI: 10.7554/eLife.91876 -
Journal of Multidisciplinary Healthcare 2024This study aimed to evaluate racial disparities in medication use and associated factors among pregnant women receiving prenatal care at Brazilian Unified Health System...
PURPOSE
This study aimed to evaluate racial disparities in medication use and associated factors among pregnant women receiving prenatal care at Brazilian Unified Health System primary care health units in the northeast region.
PATIENTS AND METHODS
A total of 1058 pregnant women in the NISAMI Cohort were interviewed between June 2012 and February 2014. Medicines used during pregnancy were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and ANVISA pregnancy risk categories. Prevalence ratios (crude and adjusted) and 95% confidence intervals (CIs) were estimated using Poisson regression with robust error variance. All analyses were stratified by race (Asian, black, brown/mixed, Brazilian indigenous, and white).
RESULTS
Approximately 84% of the pregnant women used at least one medication, with a lower proportion among white women. The most reported medications were antianemic preparations (71.08%; 95% CI 68.27-73.72%), analgesics (21.74%; 95% CI 19.36-24.32%), and drugs for functional gastrointestinal disorders (18.81%; 95% CI 16.57-21.28%). Approximately 29% of women took potentially risky medications during pregnancy, with a higher prevalence among Asian and white women. Factors associated with medication use during pregnancy include a greater number of prenatal consultations, higher education levels, health problems, and smoking. In addition, maternal age above 25 years, smoking status, and two or more previous pregnancies were associated with potentially risky medication use during pregnancy.
CONCLUSION
A high prevalence of medication use during pregnancy was found; however, this prevalence was lower among white women. Nonetheless, black and brown women used antianemic preparations less frequently. This finding suggests that race is a factor of inequity in prenatal care, demanding public policies to mitigate it.
PubMed: 38855020
DOI: 10.2147/JMDH.S455378 -
The Pan African Medical Journal 2024syphilis and its outcomes remain a healthcare system burden with adverse consequences such as stillbirths, neonatal deaths and spontaneous abortions among others. The...
Sero-prevalence of syphilis and associated risk factors among pregnant women attending antenatal care at an urban-poor health centre in Kampala, Uganda: a cross-sectional study.
INTRODUCTION
syphilis and its outcomes remain a healthcare system burden with adverse consequences such as stillbirths, neonatal deaths and spontaneous abortions among others. The situation might have worsened because the COVID-19 pandemic has caused a major attention drift from other diseases. Additionally, much as testing for syphilis is a routine practice among pregnant mothers, its proportion is not known in urban health care setting. A study to determine the prevalence of syphilis among pregnant mothers in an urban poor setting is warranted.
METHODS
a cross-sectional study was conducted among pregnant women who attended antenatal care at Kawaala Health Centre IV in Kampala Capital City between December 2019 to March 2020. Informed consent was sought from study participants prior to data collection using structured questionnaires. Whole blood was collected and tested using SD Bioline HIV/syphilis duo rapid test kit (SD Standard Diagnostics, INC, Korea). Data analysis was done using STATA 14.2.
RESULTS
one thousand one hundred and sixty-nine pregnant women participated in the study, with a mean age of 25 years. About 27% of them had completed only primary-level education. Approximately 6% of the participants were HIV seropositive. The prevalence of syphilis was 5.9% (69/1169). HIV positivity (aOR: 4.13, 95%CI: 2.05-8.34), elevated blood pressure (aOR: 2.84, 95%CI: 1.42-5.69), and status of previous pregnancy (aOR: 0.21, 95%CI: 0.05-0.89) were significant predictors of the risk of syphilis among pregnant women in this setting.
CONCLUSION
the prevalence of syphilis among pregnant women in urban poor settings is not low and so must not be underestimated. The potential drivers of syphilis among pregnant women are HIV, elevated blood pressure, and status of previous pregnancy. There should be increased awareness about routine syphilis testing among pregnant mothers attending antenatal care.
Topics: Humans; Female; Syphilis; Pregnancy; Cross-Sectional Studies; Adult; Prenatal Care; Uganda; Pregnancy Complications, Infectious; Risk Factors; Young Adult; Prevalence; Seroepidemiologic Studies; Urban Population; Adolescent; HIV Infections
PubMed: 38854863
DOI: 10.11604/pamj.2024.47.129.31622