[This Day] A social and developmental organisation, HACEY, has partnered with Access Corporation to improve maternal health outcomes for mothers at Meiran Primary Healthcare Center, Lagos.

[Nigeria Health Watch] Maternal mortality continues to critically impact women of reproductive age across Africa. In Nigeria, research shows that maternal and infant mortality rates are highest in the northeast and northwest zones and lowest in the southeast and southwest. Kano State has the highest maternal mortality rate, with 377.8 per 100,000 live births, which exceeds the national target of 288 per 100,000 national target.

Aim/Purpose: The aim of the study is to explore factors that affect how healthcare clients in rural areas use infomediaries in maternal mHealth interventions. The study focuses on maternal healthcare clients who do not own mobile phones but use the mHealth intervention. Background: Maternal mHealth interventions in poor-resource settings are bedevilled by inequalities in mobile phone ownership. Clients who do not own mobile phones risk being excluded from benefiting from the interventions. Some maternal mHealth providers facilitate the access of mobile phones for those who do not own them using “infomediaries”. Infomediaries, in this case, refer to individuals who have custody of mobile phones that other potential beneficiaries may use. However, the use of infomediaries to offer access to the “have nots” may be influenced by a number of factors. Methodology: The study uses a case of a maternal mHealth intervention project in Malawi, as well as a qualitative research method and interpretive paradigm. Data was collected using secondary data from the implementing agency, semi-structured interviews, and focus group discussions. Empirical data was collected from maternal healthcare clients who do not own mobile phones and infomediaries. Data were analysed inductively using thematic analysis. Contribution: The study proposed a theoretical framework for studying infomediaries in ICT4D. The study may inform mHealth designers, implementers, and policymakers on how infomediaries could be implemented in a rural setting. Consequently, understanding the factors that affect the use of infomediaries may inform mHealth intervention implementers on how they could overcome the challenges by implementing mHealth interventions that reduce the challenges on the mHealth infomediaries side, and the maternal healthcare clients’ side. Findings: Characteristics of the maternal healthcare client, characteristics of the mHealth infomediary, perceived value of mHealth intervention, and socio-environmental factors affect maternal healthcare clients’ use of mHealth infomediaries. Recommendations for Practitioners: Implementers of interventions ought to manage the use of infomediaries to avoid volunteer fatigue and infomediaries who may not be compatible with the potential users of the intervention. Implementers could leverage traditional systems of identifying and using infomediaries instead of reinventing the wheel. Recommendation for Researchers: This research adopted a single case study to develop the theoretical framework for mHealth infomediary use. We recommend future studies are conducted in order to test and develop this framework further, not only in ICT4D, but also in other areas of application. Impact on Society: People still lack access. The lack of ownership of technology may still exclude them from participating in an information society. The use of infomediaries may help to provide access to technologies to those who do not have them thereby bridging the digital divide gap. Future Research: We propose herein that traditional systems may offer a good starting point for designing a system that would work for communities. We, therefore, recommend that future research may explore these possibilities.

Aim/Purpose: This paper illustrates the potential of health recommender systems (HRS) to support and enhance maternal care. The study aims to explore the recent implementations of maternal HRS and to discover the challenges of the implementations. Background: The sustainable development goals (SDG) aim to reduce maternal mortality to less than 70 per 100,000 live births by 2030. However, progress is uneven between countries, with primary causes being severe bleeding, infections, high blood pressure, and failed abortions. Regular antenatal care (ANC) visits are crucial for detecting and managing complications, such as hypertensive illnesses, anemia, and gestational diabetes mellitus. Utilizing maternal evaluations during ANC visits can help identify and treat problems early, lowering morbidity and death rates for both mothers and fetuses. Technology-enabled daily health recording can help monitor pregnancy by providing actionable guides to patients and health workers based on patient status. Methodology: A systematic literature review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify maternal HRS reported in studies between November 2022 and December 2022. Information was subsequently extracted to understand the potential benefits of maternal HRS. Titles and abstracts of 1,851 studies were screened for the full-text screening, in which two reviewers independently selected articles and systematically extracted data using a predefined extraction form. Contribution: This study adds to the explorations of the challenges of implementing HRS for maternal care. This study also emphasizes the significance of explainability, data-driven methodologies, automation, and the necessity for integration and interoperability in the creation and deployment of health recommendation systems for maternity care. Findings: The majority of maternal HRS use a knowledge-based (constraint-based) ap-proach with more than half of the studies generating recommendations based on rules defined by experts or available guidelines. We also derived four types of interfaces that can be used for delivering recommendations. Moreover, patient health records as data sources can hold data from patients’ or health workers’ input or directly from the measurement devices. Finally, the number of studies in the pilot or demonstration stage is twice that in the sustained stages. We also discovered crucial challenges where the explainability of the methods was needed to ensure trustworthiness, comprehensibility, and effective enhancement of the decision-making process. Automatic data collection was also required to avoid complexity and reduce workload. Other obstacles were also identified where data integration between systems should be established and decent connectivity must be provided so that complete services can be admin-istered. Lastly, sustainable operations would depend on the availability of standards for integration and interoperability as well as sufficient financial sup-port. Recommendations for Practitioners: Developers of maternal HRS should consider including the system in the main healthcare system, providing connectivity, and automation to deliver better service and prevent maternal risks. Regulations should also be established to support the scale-up. Recommendation for Researchers: Further research is needed to do a thorough comparison of the recommendation techniques used in maternal HRS. Researchers are also recommended to explore more on this topic by adding more research questions. Impact on Society: This study highlights the lack of sustainability studies, the potential for scaling up, and the necessity for a comprehensive strategy to integrate the maternal recommender system into the larger maternal healthcare system. Researchers can enhance and improve health recommendation systems for maternity care by focusing on these areas, which will ultimately increase their efficacy and facilitate clinical practice integration. Future Research: Additional research can concentrate on creating and assessing methods to increase the explainability and interpretability of data-driven health recommender systems and integrating automatic measurement into the traditional health recommender system to enhance the anticipated outcome of antenatal care. Comparative research can also be done to assess how well various models or algorithms utilized in these systems function. Future research can also examine creative solutions to address resource, infrastructure, and technological constraints, such as connectivity and automation to help address the shortage of medical personnel in remote areas, as well as define tactics for long-term sustainability and integration into current healthcare systems.

The post Considering Maternal Health Disparities: Proceedings of a Workshop Series—in Brief was curated by information for practice.

This Mother’s Day and beyond, as cardiologists we care for the fate of all women. The death of a woman during pregnancy, at delivery, or soon after childbirth is an immeasurable tragedy for her family as well as society at large. Urgent action is ...

We continue our series on Maternal & Early Childhood Issues with a look at Morning Star Pregnancy Services. They do an outstanding job working with women facing unplanned pregnancies. https://fb.watch/bEB-FxMfAj/ The Harrisburg location for Morning Star Pregnancy Services at 2509 Front Street is relatively new, but the service itself is celebrating its 50th year in existence in 2022. The mission remains the same—helping women with unplanned pregnancies and with their sexual health. It offers a number of free health services, including pregnancy testing and ultrasound exams, along with education and support after the pregnancy. Morningstar does not provide or refer for abortion services but they help you to consider all options, including abortion, parenting and adoption. Bottom line, they are there for support. “We know that all mothers would like to feel loved and supported in their pregnancy and beyond. We are also able to reach out to the fathers of their children and offer them support and education as well,” said Morningstar Executive Director Linda Plummer. She says they see a range of women and men who have just had a positive pregnancy test and just can’t see beyond the immediate challenge. “The majority of women don’t want an abortion. They just feel like they don’t have another solution.” Morningstar will schedule regular visits for clients and will monitor the changing circumstances as the weeks progress. As the circumstances change, so do the perspectives. 6:12   “the first time they come to Morningstar and feel that they have no alternative but abortion, they change on their second visit when we invite them back in a decision-making process on a weekly basis. They may come the second time and say, well now my boyfriend says maybe we can have this baby or now my parents are saying they will support me.” Plummer also points out that 25 to 30% of pregnancies end in miscarriage. Morningstar will help to determine the viability of the fetus through ultrasound testing. “Because a lot of those pregnancies end in miscarriage, what we see here is that women grieve that loss of the baby so in the process, they recognize the idea that if I had gone through with an abortion, I would have been carrying this burden and I would have been mourning the loss of that child.” They’ve been around for 50 years and must be doing something right for folks to keep coming back. The commitment to providing care and support without judgement has translated into a very impressive statistic. “80% of the time that women who come here who are at risk for an abortion will decide to have their child.” Plummer says many of the 20% who choose otherwise later return in a subsequent pregnancy.

Our series on Maternal & Early Childhood Issues continues today with a look at the Heart of Tioga Pregnancy Center in Tioga County, PA and the support it gets from parishioners at Holy Child Catholic Church in the Diocese of Scranton. https://fb.watch/bHgvkXjO3Z/

Our series on Maternal & Early Childhood Issues continues today with a look at the Tri-State Pregnancy Center in northeastern PA. The facility gets help from local Catholics and on-the-spot advice from above! https://fb.watch/bHh3c7Z-Hu/

Our series on Maternal & Early Childhood Issues continues today with a look at the extensive work being done by the Community Based Services segment of Catholic Social Services of the Archdiocese of Philadelphia. https://fb.watch/bHhrh-1oe7/

We continue our series on Maternal & Early Childhood Issues with more on the subject of breastfeeding. For the next several days we will look at the important work being done by the Mid-Atlantic Mothers’ Milk Bank and how the PCC is looking to help them. https://fb.watch/dv4YBuc3qS/ https://twitter.com/PAcatholic/status/1532416678121857025?s=20&t=6XAnUbQUJooExYYWxkr1WQ  

6-10-22 Our focus on breastfeeding continues with a look at the increase in public accommodations for breastfeeding moms. https://fb.watch/dz7s3mmxy1/ https://twitter.com/PAcatholic/status/1535283771251085313?s=20&t=d8Pb52gE3vOjcBIAujH0rQ   6-9-22 Our series on Maternal & Early Childhood Issues continues with a look back at the passage of the PA law to permit breastfeeding in public. https://fb.watch/dz7zQTeSHv/ https://twitter.com/PAcatholic/status/1534961334323904512?s=20&t=d8Pb52gE3vOjcBIAujH0rQ  

6-16-22 Interesting story here on one person’s belief that the COVID lockdowns are to blame for many moms turning away from breastfeeding and, in turn, contributing to the current shortage in baby formula. pic.twitter.com/1iU3XYFbZF — PAcatholic (@PAcatholic) June 16, 2022 https://fb.watch/dHdtLvKsVG/ 6-14-22 Sharing an article that came out Tuesday for our series on breastfeeding about trying to still do it while returning to work. Sharing an article that came out Tuesday for our series on breastfeeding about trying to still do it while returning to work. pic.twitter.com/Fb43upYGpy — PAcatholic (@PAcatholic) June 15, 2022 https://fb.watch/dHdp5IzKNN/   6-13-22 Continuing our series on breastfeeding for June. Women of color are less likely to breastfeed than those of other races and that has made them more vulnerable to the baby formula shortage. We look at some of the societal factors involved. https://fb.watch/dHdd4Kl8j6/ https://twitter.com/PAcatholic/status/1536404428735094788?s=20&t=K3d74k2cioFdzcdNNHbHTg

6-30-22 We finish up our stories on breastfeeding by talking again with Colette Acker of the Breastfeeding Resource Center about the culture that exists towards BF in the U.S. https://twitter.com/PAcatholic/status/1542502773232631808?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZztlqwT-k/ 6-29-22 As we’ve focused this month on issues involved in breastfeeding, we’ve talked with our advocates and moms about the challenges involved in doing so while going back to work full time. Colette Acker of the Breastfeeding Resource Center shares her views on what’s involved. https://twitter.com/PAcatholic/status/1542181083462221833?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZzB2MlLo-/ 6-28-22 Colette Acker of the Breastfeeding Resource Center talks with us about why many new moms give up on breastfeeding within the first several weeks after the birth of their child. https://twitter.com/PAcatholic/status/1541812970275180546?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZzHsbhiOH/ 6-27-22 We begin today a series of stories with Colette Acker of the Breastfeeding Resource Center in Montgomery County. They’ve been providing vital support for new moms for nearly 20 years. https://twitter.com/PAcatholic/status/1541447488065966082?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZA4NAhnvc/ 6-24-22 We wrap up our conversation on breastfeeding with Amy Wilt by talking about two potential problems that may affect moms during breastfeeding. https://twitter.com/PAcatholic/status/1540366512262975488?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZAjWQcR-8/ 6-23-22 We continue our June focus on breastfeeding by talking with doula Amy Wilt about the challenges involved in breastfeeding while returning to work. https://twitter.com/PAcatholic/status/1540060616722989056?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZApmYqCFR/ 6-22-22 We continue our chat with Amy Wilt about breastfeeding. Today’s focus is on relactation. A total education for many of us. https://twitter.com/PAcatholic/status/1539653795398836224?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZAyeP5WNk/ 6-21-22 We continue the conversation with our doula consultant, Amy Wilt, about the influence and pressure that moms get from those closest to them when trying to decide whether or not to breastfeed their newborns. https://twitter.com/PAcatholic/status/1539255591914328065?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZAFgKarE-/ 6-20-22 We continue our series on breastfeeding by talking again with Amy Wilt of Dauphin County Doulas. She has provided a ton of information for us in our nine-month long focus on Maternal & Early Childhood Issues. Today Amy talks about ”the latch.” https://twitter.com/PAcatholic/status/1538962868414169094?s=20&t=y-vWAw8jWy_JOJQb9YkGAw https://fb.watch/dZAMmSazHv/  

July 18th We continue our look at Early Childhood Screenings by talking with Kris Bowman of Ramsey Educational and Development Institute, or REDI. They administer the PA Early Intervention Program in Montgomery County. https://twitter.com/PAcatholic/status/1549094658478903299?s=20&t=bfxurJPODSGTJUaDird-pg https://fb.watch/elp1XOaQ3p/   July 15th As part of look at Early Childhood Screenings, we are looking to find out about screenings in PA for newborns suffering from their mothers’ drug addiction. We’d love to talk with the state task force created to help those children but haven’t had much help from the Wolf Admin. https://twitter.com/PAcatholic/status/1548004337758060544?s=20&t=bfxurJPODSGTJUaDird-pg https://fb.watch/elp7An1dbk/   July 14th Continuing our series for July on Early Childhood Screenings with a quick look at the first big test for the newborn, the blood test. https://twitter.com/PAcatholic/status/1547690893766930437?s=20&t=bfxurJPODSGTJUaDird-pg https://fb.watch/elpe8tHA1I/   July 13th Continuing our series on Early Childhood Screenings… it was a crisis in Michigan that sparked lawmakers here in Pennsylvania to put an emphasis on testing children for the presence of lead. https://twitter.com/PAcatholic/status/1547429183864840192?s=20&t=bfxurJPODSGTJUaDird-pg https://fb.watch/elpkHkI4mB/   July 12th  We wrap up the conversation with our friend Victoria about the tests, screenings and milestones designed for children after they come home from the hospital. It’s part of our July focus on Early Childhood Screenings. https://twitter.com/PAcatholic/status/1546897353843539968?s=20&t=bfxurJPODSGTJUaDird-pg https://fb.watch/elpDdGWIN8/ July 11th As part of our continuing look at Early Childhood Screenings for July, we talk with a young mother about all the tests that we went through. https://twitter.com/PAcatholic/status/1546491903083945984?s=20&t=bfxurJPODSGTJUaDird-pg    

The 4th installment of our series on Maternal and Early Childhood Issues looks at the role the Wolf Administration has played in curtailing Catholic adoption efforts in Pennsylvania. https://fb.watch/bBXX1F6m97/ A woman we’ll call Kelly talked with me about her adoption a number of years ago through Catholic charities. She learned details of what happened as she got older. Kelly says it could have worked out any better. Kelly’s story was a familiar one for decades, but one that is happening less and less in many states across the country, as officials have placed restrictions on adoption agencies that contradict their long-held beliefs. Pennsylvania governor Tom Wolf several years ago joined Democratic governors in other states to require adoption agencies to place children with same-sex parents in order to get funding. That requirement by Governor Wolf would be in direct contrast with the long-standing Catholic belief that a marriage is between a man and a woman. It is that parental combination, Catholics believe, that is the best way to raise a child. The Pennsylvania Catholic Conference appealed to the Wolf Administration for a religious exemption. It was denied in 2018, basically causing most adoption efforts by Catholic organizations in PA to grind to a halt. Similar regulations have been shutting down Catholic adoption agencies across the U.S. ever since Boston Catholic Charities did so in 2006. The efforts by the PCC to remove this burden continued on both the state and federal level. We sent an appeal to the Department of Health and Human Services in Washington to grant us a religious exemption. We worked closely with U.S. Congressman Mike Kelly on getting federal relief. A number of state senators sent a letter to President Trump asking him to provide relief for our efforts. We’re hoping that a recent Supreme Court ruling involving foster care services by Catholic Charities in Philadelphia. Fulton vs. the City of Philadelphia started when the city said it would no longer contract with Catholic Social Services because CSS would not certify same-sex couples to be foster parents In response, two foster mothers—Sharonell Fulton and Toni Simms-Busch—and the CSS sued the city, arguing that severing the contract violated their religious freedom. Fulton and Simms-Busch, the mothers who are plaintiffs, claim it was their Catholic faith that inspired them to be foster mothers.After losing in two lower courts, they petitioned the Supreme Court, which first agreed to hear the case in February 2020. Over a year later  the Court ruled that the city’s refusal due to the agency’s same-sex couple policy violated the Free Exercise Clause. Great news and a big win for religious liberty. The PCC is hoping the principal will carry over into adoptions, but the damage may have already been done. In 2019 the Diocese of Greensburg closed its adoption and foster care program after 65 years because of the decision by the Wolf Administration. Adoptions were halted by Catholic agencies in other parts of the state.  Will the adoption work done by these organizations ever return to what it once was? We can only hope and pray.

Our series on Maternal & Early Childhood Issues continues today with a look the work being done by Morning Star Pregnancy Services in Harrisburg to help kids build a foundation for strong relationships and avoid problems down the road. https://fb.watch/bECfSEse06/ We’ve all had our fair share of relationships that have not gone well over the years, whether they were romantic or just friendly in nature. Wouldn’t it be nice to have gotten some advice before sailing on those waters and crashing into the rocks? The folks at Morning Star Pregnancy Services in Harrisburg are offering just such advice to teenagers and also actually to moms and dads through a program called Unfiltered Truth. Leslie Moyer is the Director of Educational Programs at Morning Star. She works with Ann Deegan from an established curriculum called “Real Essentials” to present different lessons to try to teach kids to build a foundation for strong relationships. Leslie Moyer : “So what are people expecting and what are your boundaries and do you have boundaries and how do you make sure the person knows?” The program is –not- lecture based. Moyer says that would never work. They have discussions so the kids will take ownership of the concepts they are presented and make them their own.  They are getting a lot of positive feedback. Moyer :  “I believe it was woman, she said I wish I’d had this when I was younger. I needed to know about those relationship red flags, the break up skills, which is two lessons that we do. I needed that two years ago when I was in a really bad relationship.” One of the lessons is on living together, which is something that many young people see as the go-to route for couples in love. Ann Deegan : “So many people are living together and so we talk about what are the benefits and what it really looks like and what are some of the myths surrounding living together and why it isn’t a good thing to do. Most of the classes have been with high school students. Moyer says they’re hoping to get more time with middle school kids to help them build their skills by the time they get to high school. There are also classes for adults. Deegan  : “The focus isn’t just on mothering skills, like taking care of a baby. The focus is on what do your relationships look like? And what do you want to pass on to your children? What is the legacy? What do you want to pass on to your children and have your children receive from you?” There is also the goal of having kids take a more deliberate and thoughtful approach to having sex. It may prevent many problems down the road, not the least of which being an unwanted pregnancy. Moyer shares a recurring sentiment that she hears from returning clients. Moyer  : “Over and over again I will hear ‘I would not change the fact that I had my child. But I wish I had waited. I wish I had waited just a little bit longer. I wish I was married. I can’t tell you how many times I hear that.”

California's surgeon general unveiled a new initiative Tuesday aimed at reducing maternal mortality, setting a goal of halving the statewide rate of deaths related to pregnancy and birth by December 2026.

Maternal health organizations and advocates are urging the California surgeon general to suspend the rollout of a plan aimed at reducing maternal mortality.

DOVER, DE (Nov. 17, 2022) — The Maternal Child Health Bureau of the Delaware Division of Public Health (DPH), Delaware 2-1-1 and other state and community organizations proudly recognized Help Me Grow Delaware during an event celebrating Help Me Grow’s 10th anniversary on Nov. 9 at the Route 9 Library & Innovation Center in New […]

ABSTRACTPolitics is one of the critical factors that influence health policy agendas. However, scholarly efforts, especially in low- and middle-income countries, rarely focus on how politics influence health policy agenda-setting. We conducted a qualitative document review to examine the factors that led to developing the free primary health care policy for maternal health in Papua New Guinea. We also discuss mechanisms through which national politics, as an overriding factor, influenced the development of the policy. The review draws on Kingdon’s multiple-stream model for agenda-setting and incorporates theoretical insights from Fox and Reich’s framework for analyzing the politics of health reform for universal health coverage in low- and middle-income countries.

During a recent panel, experts discussed the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms and how it achieved scale.

The post How One Massachusetts Maternal Mental Health Program Scaled Across the Country appeared first on MedCity News.

The United Nations Population Fund (UNFPA) commended India for its significant achievements in maternal health and family planning. Recognizing the country's

New research published in iBrain Medicine/i has found that the placenta can influence maternal mental health (!--ref1--). The placenta has 13

New research study from the University of Surrey and the University of Birmingham reveals "compelling evidence" that maternal dengue fever, including

According to research led by the Barcelona Institute for Global Health (ISGlobal) in partnership with seven African centers, maternal antibodies transferred

Maternal medlinkZika virus/medlink infections can alter fetal immune development, resulting in long-term effects on children's immunity (!--ref1--).

National Bureau of Economic Research

Guaranteed maternal nutrition can break the cycle of malnutrition passed from one generation to the next

[Wellbeing Foundation] CHICAGO, Illinois and LAGOS, NIGERIA -Partnership combines private sector ingenuity with local know-how and leadership to save the lives of millions of women and children suffering from iron deficiency

Hidden in the thick foliage of tropical forests a subfamily of colorful beetles–the Chrysomelidae–may be hiding the secrets to the earliest stages of social behavior. […]

The post Beetle moms show clear signs of maternal instincts and care appeared first on Smithsonian Insider.

Maternal-fetal telemedicine allows high-risk patients with complex care needs to receive safe, high-quality care in their own communities

Research Highlights: Hypertensive pregnancy disorders, especially preeclampsia – may increase the risk of psychological development disorders and behavioral and emotional disorders in children. This is the first study to show that preeclampsia...

To ensure fetal lipid supply, maternal blood triglyceride (TG) concentrations are robustly elevated during pregnancy. Interestingly, a lower increase in maternal blood TG concentrations has been observed in some obese mothers. We have shown that high-fat (HF) feeding during pregnancy significantly reduces maternal blood TG levels. Therefore, we performed this study to investigate if and how obesity alters maternal blood TG levels. Maternal obesity was established by prepregnant HF feeding (ppHF), which avoided the dietary effect during pregnancy. We found that maternal blood TG concentrations in ppHF dams were not only remarkably lower than control dams, but the TG peak occurred earlier during gestation. Hepatic TG production and intestinal TG absorption were unchanged in ppHF dams, but systemic lipoprotein lipase (LPL) activity was increased, suggesting that increased blood TG clearance contributes to the decreased blood TG concentrations in ppHF dams. Although significantly higher levels of UCP1 protein were observed in iBAT of ppHF dams, Ucp1 gene deletion did not restore blood TG concentrations in ppHF dams. Expression of the angiopoietin-like protein 4 (ANGPTL4), a potent endogenous LPL inhibitor, was significantly increased during pregnancy. However, the pregnancy-induced elevation of blood TG was almost abolished in Angptl4^-/- dams. Compared with control dams, Angptl4 mRNA levels were significantly lower in iBAT, gWAT and livers of ppHF dams. Importantly, ectopic overexpression of ANGPTL4 restored maternal blood TG concentrations in ppHF dams. Together, these results indicate that ANGPTL4 plays a vital role in increasing maternal blood TG concentrations during pregnancy. Obesity impairs the rise of maternal blood TG concentrations by reducing ANGPTL4 expression in mice.

Chronic low-grade inflammation plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). In order to investigate the ability of different inflammatory blood cell parameters in predicting the development of GDM and pregnancy outcomes, 258 women with GDM and 1154 women without were included in this retrospective study. First-trimester neutrophil count outperformed white blood cell (WBC) count, and neutrophil-to-lymphocyte ratio (NLR) in the predictability for GDM. Subjects were grouped based on tertiles of neutrophil count during their first-trimester pregnancy. The results showed that as the neutrophil count increased, there was a step-wise increase in GDM incidence, as well as glucose and glycosylated hemoglobin (HbA1c) level, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), macrosomia incidence and newborn weight. Neutrophil count was positively associated with pre-pregnancy Body Mass Index (BMI), HOMA-IR and newborn weight. Additionally, neutrophil count was an independent risk factor for the development of GDM, regardless of the history of GDM. Spline regression showed that there was a significant linear association between GDM incidence and continuous neutrophil count when it exceeded 5.0 x 10⁹/L. This work suggested that first-trimester neutrophil count is closely associated with the development of GDM and adverse pregnancy outcomes.

Infants born to mothers with obesity have a greater risk for childhood obesity and metabolic diseases; however, the underlying biological mechanisms remain poorly understood. We used a Japanese macaque model to investigate whether maternal obesity combined with a western-style diet (WSD) impairs offspring muscle insulin action. Adult females were fed a control or WSD prior to and during pregnancy through lactation, and offspring subsequently weaned to a control or WSD. Muscle glucose uptake and signaling were measured ex vivo in fetal (n=5-8/group) and juvenile offspring (n=8/group). In vivo signaling was evaluated after an insulin bolus just prior to weaning (n=4-5/group). Maternal WSD reduced insulin-stimulated glucose uptake and impaired insulin signaling at the level of Akt phosphorylation in fetal muscle. In juvenile offspring, insulin-stimulated glucose uptake was similarly reduced by both maternal and post-weaning WSD and corresponded to modest reductions in insulin-stimulated Akt phosphorylation relative to controls. We conclude that maternal WSD leads to a persistent decrease in offspring muscle insulin-stimulated glucose uptake even in the absence of increased offspring adiposity or markers of systemic insulin resistance. Switching offspring to a healthy diet did not reverse the effects of maternal WSD on muscle insulin action suggesting earlier interventions may be warranted.

The placenta participates in maternal insulin sensitivity changes during pregnancy; however, mechanisms remain unclear. We investigated associations between maternal insulin sensitivity and placental DNA methylation markers across the genome. We analyzed data from 430 mother-offspring dyads in the Gen3G cohort. All women underwent 75-g oral glucose tolerance tests at ~26 weeks of gestation; we used glucose and insulin measures to estimate insulin sensitivity (Matsuda index). At delivery, we collected samples from placenta (fetal side) and measured DNA methylation using Illumina EPIC arrays. Using linear regression models to quantify associations at 720,077 cytosine-guanine dinucleotides (CpGs), with adjustment for maternal age, gravidity, smoking, BMI, child sex, and gestational age at delivery, we identified 188 CpG sites where placental DNA methylation was associated with Matsuda index (P < 6.94 x 10^–8). Among genes annotated to these 188 CpGs, we found enrichment in targets for miRNAs, in histone modifications, and in parent-of-origin DNA methylation including the H19/MIR675 locus (paternally imprinted). We identified 12 known placenta imprinted genes, including KCNQ1. Mendelian randomization analyses revealed five loci where placenta DNA methylation may causally influence maternal insulin sensitivity, including the maternally imprinted gene DLGAP2. Our results suggest that placental DNA methylation is fundamentally linked to the regulation of maternal insulin sensitivity in pregnancy.

Autoimmunity against pancreatic β-cell autoantigens is a characteristic of childhood type 1 diabetes (T1D). Autoimmunity usually appears in genetically susceptible children with the development of autoantibodies against (pro)insulin in early childhood. The offspring of mothers with T1D are protected from this process. The aim of this study was to determine whether the protection conferred by maternal T1D is associated with improved neonatal tolerance against (pro)insulin. Consistent with improved neonatal tolerance, the offspring of mothers with T1D had reduced cord blood CD4⁺ T-cell responses to proinsulin and insulin, a reduction in the inflammatory profile of their proinsulin-responsive CD4⁺ T cells, and improved regulation of CD4⁺ T cell responses to proinsulin at 9 months of age, as compared with offspring with a father or sibling with T1D. Maternal T1D was also associated with a modest reduction in CpG methylation of the INS gene in cord blood mononuclear cells from offspring with a susceptible INS genotype. Our findings support the concept that a maternal T1D environment improves neonatal immune tolerance against the autoantigen (pro)insulin.

Jennifer M. Yamamoto
Jul 1, 2018; 41:1346-1361
Reconsidering Pregnancy With Diabetes

The role of motherhood is complex and profound. Psychology and development experts agree — the role of the mother is critical to child development, for better or worse. This role...

England : National Association for Maternal and Child Welfare, 1961.

Parents-to-be who will have their new child delivered at the Thunder Bay Regional Health Sciences Centre have to follow a different set of guidelines than found at many other hospitals across Ontario.

OBJECTIVES:

To provide an overview and quantitatively demonstrate the reach of the Health Resources and Services Administration’s Maternal and Child Health Bureau autism research program.

For mothers of children with chronic medical conditions or disabilities, such as epilepsy or cerebral palsy, a history of maternal unresolved grief regarding the child's diagnosis has been associated with insecure infant-mother attachment.

Unresolved grief related to a preterm birth is associated with the development of insecure infantmother attachment. Mothers with resolved grief after preterm birth are 2.9 times as likely to have securely attached infants, compared with mothers with unresolved grief. (Read the full article)