Browsing by Subject "Mothers"
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Item Open Access Altered ultrasonic vocalization and impaired learning and memory in Angelman syndrome mouse model with a large maternal deletion from Ube3a to Gabrb3.(PLoS One, 2010-08-20) Jiang, Yong-Hui; Pan, Yanzhen; Zhu, Li; Landa, Luis; Yoo, Jong; Spencer, Corinne; Lorenzo, Isabel; Brilliant, Murray; Noebels, Jeffrey; Beaudet, Arthur LAngelman syndrome (AS) is a neurobehavioral disorder associated with mental retardation, absence of language development, characteristic electroencephalography (EEG) abnormalities and epilepsy, happy disposition, movement or balance disorders, and autistic behaviors. The molecular defects underlying AS are heterogeneous, including large maternal deletions of chromosome 15q11-q13 (70%), paternal uniparental disomy (UPD) of chromosome 15 (5%), imprinting mutations (rare), and mutations in the E6-AP ubiquitin ligase gene UBE3A (15%). Although patients with UBE3A mutations have a wide spectrum of neurological phenotypes, their features are usually milder than AS patients with deletions of 15q11-q13. Using a chromosomal engineering strategy, we generated mutant mice with a 1.6-Mb chromosomal deletion from Ube3a to Gabrb3, which inactivated the Ube3a and Gabrb3 genes and deleted the Atp10a gene. Homozygous deletion mutant mice died in the perinatal period due to a cleft palate resulting from the null mutation in Gabrb3 gene. Mice with a maternal deletion (m-/p+) were viable and did not have any obvious developmental defects. Expression analysis of the maternal and paternal deletion mice confirmed that the Ube3a gene is maternally expressed in brain, and showed that the Atp10a and Gabrb3 genes are biallelically expressed in all brain sub-regions studied. Maternal (m-/p+), but not paternal (m+/p-), deletion mice had increased spontaneous seizure activity and abnormal EEG. Extensive behavioral analyses revealed significant impairment in motor function, learning and memory tasks, and anxiety-related measures assayed in the light-dark box in maternal deletion but not paternal deletion mice. Ultrasonic vocalization (USV) recording in newborns revealed that maternal deletion pups emitted significantly more USVs than wild-type littermates. The increased USV in maternal deletion mice suggests abnormal signaling behavior between mothers and pups that may reflect abnormal communication behaviors in human AS patients. Thus, mutant mice with a maternal deletion from Ube3a to Gabrb3 provide an AS mouse model that is molecularly more similar to the contiguous gene deletion form of AS in humans than mice with Ube3a mutation alone. These mice will be valuable for future comparative studies to mice with maternal deficiency of Ube3a alone.Item Open Access Body image and body satisfaction differ by race in overweight postpartum mothers.(J Womens Health (Larchmt), 2010-02) Carter-Edwards, Lori; Bastian, Lori A; Revels, Jessica; Durham, Holiday; Lokhnygina, Yuliya; Amamoo, M Ahinee; Ostbye, TrulsBACKGROUND: Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women. METHODS: The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BD(Ideal) (current image minus the ideal image) and BD(Ideal Mother) (current image minus ideal mother image). RESULTS: Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BD(Ideal): 1.7 vs. 2.3, p = 0.005; BD(Ideal Mother): 1.1 vs. 1.8, p = 0.0002). CONCLUSIONS: Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers.Item Open Access Conformity behavior of schizophrenic subjects to maternal figures(1961) Clarke, Alan Rogers, 1932-Recent clinical studies of schizophrenia have been aimed at clarifying the nature of the relationship that has existed between the schizophrenic patient and other members of his family. The majority of these investigations have focused upon the mother-son relationship, and the experiment to be described represents an extension of this area of study. Specifically, the present investigation was an attempt to observe the extent to which schizophrenic patients would conform to the preferences expressed by mothers who possess some of the attributes reported to characterize mothers of Poor pre-morbid (Phillips, 1953) schizophrenic patients. These attributes, it was hoped, would serve as relevant cues foreliciting conformity responses in such patients.Item Open Access Extensive haplotype diversity in African American mothers and their cord blood units.(Tissue antigens, 2013-01) Tu, B; Leahy, N; Yang, R; Cha, N; Kariyawasam, K; Hou, L; Xiao, Y; Masaberg, C; Pulse-Earle, D; Maiers, M; Ng, J; Kurtzberg, J; Hurley, CKHLA-A, -B, -C, -DRB1, -DQB1 assignments were obtained for 374 pairs of African American mothers and their umbilical cord blood units (CBU) by DNA sequencing. An algorithm developed by the National Marrow Donor Program was used to assign 1122 haplotypes by segregation. Seventy percent of the haplotypes carried assignments at all five loci. In the remainder, alleles at various loci, most often DQB1 in 48% of the haplotypes with a missing assignment, could not be assigned due to sharing of both alleles by mother and CBU. There were 652 haplotypes carrying a unique combination of alleles at the five loci; the majority (74%) were singletons. Novel B∼C and DRB1~DQB1 associations were observed. The results show the genetic diversity in this population and provide validation for a publically available tool for pedigree analysis. Our observations underscore the need for procurement of increased numbers of units in the national cord blood inventory in order to identify matching donors for all patients requiring hematopoietic stem cell transplantation.Item Open Access HPV Vaccine Distribution: An Ethical Tug-of-War. Perceptions Among Latina Mothers Living in Durham, NC(2009-12) Remtulla, ZahraThis research project examined the views of Latina mothers living in Durham, North Carolina on four major ethical dilemmas surrounding HPV vaccine distribution: mandating the vaccine for school entry, vaccinating males as well as females, allowing adolescent access to the vaccine without parental permission and requiring the vaccine for new female immigrants to the United States. Forty-five self-identified Latina mothers living in Durham, NC participated in six focus groups conducted in Spanish between September – October 2009. Latina mothers showed high acceptance of the vaccine in general, but voiced low desire to vaccinate their own daughters. Participants also favored conservative approaches to its distribution. Mothers opposed a school mandate, believing parental and individual autonomy should be respected, but were in favor of vaccinating males to protect them from HPV and related diseases. Participants also believed parental consent should be required for adolescent vaccination, because parents have a right and responsibility to be involved in the decision. Lastly, Latina mothers disagreed with the immigrant requirement, calling it a form of discrimination and racism. Cultural factors did influence some of participants’ views; however, the majority of opinions expressed were similar to those encountered in the literature for other groups. The HPV vaccine has the potential to reduce cervical cancer incidence among Latinos; however, mothers must be better informed about the vaccine, which could increase their desire to vaccinate their own daughters. The vaccine’s affordability within the Latino community must also be considered.Item Open Access Maximizing the return on investment in Early Childhood Home Visiting through enhanced eligibility screening.(Child abuse & neglect, 2021-12) Dodge, Kenneth A; Benjamin Goodman, W; Bai, Yu; Murphy, Robert A; O'Donnell, KarenBackground
The MIECHV (Maternal, Infant, and Early Childhood Home Visiting) program invests substantial federal resources to prevent child maltreatment and emergency medical costs. Eligibility is based on screening of demographic or clinical risk factors, but because screening accuracy in predicting poor outcomes is unknown, assignment to home-visiting might miss high-risk families or waste resources on low-risk families.Objectives
To guide eligibility decisions, this study tested accuracy of demographic and clinical screening in predicting child maltreatment and emergency medical care.Participants and setting
A population-representative sample of 201 birthing mothers (39.8% Black, 33.8% Latina) in Durham, NC, was enrolled between July 2009, and December 2010, and followed through December 2015.Methods
Participants were screened demographically (i.e., Medicaid, first-born, teenage, no high school diploma) and clinically (i.e., health/health care, parenting readiness, home safety, and parent mental health) at birth and followed through age 60 months, when Child Protective Services and hospital records were reviewed. Cox hazard models tested accuracy of prediction from screening variables.Results
Demographic factors did not significantly predict outcomes, except having Medicaid/uninsured predicted more emergency medical care and being first-born was a (surprising) protective factor against a child maltreatment investigation. In contrast, clinical factors strongly predicted both maltreatment investigations (Hazard Ratio = 4.01 [95% CI = 1.97, 8.15], sensitivity = 0.70, specificity = 0.64, accuracy = 0.65) and emergency medical care (Hazard Ratio = 2.14 [95% CI = 1.03, 2.14], sensitivity = 0.50, specificity = 0.69, accuracy = 0.58).Conclusions
Even with added costs for clinical screening, selecting families for home visiting based on assessed clinical risk will improve accuracy and may yield a higher return on investment. The authors recommend a universal system of screening and care to support birthing families.Item Open Access Postnatal cytomegalovirus exposure in infants of antiretroviral-treated and untreated HIV-infected mothers.(Infect Dis Obstet Gynecol, 2014) Meyer, Sarah A; Westreich, Daniel J; Patel, Emily; Ehlinger, Elizabeth P; Kalilani, Linda; Lovingood, Rachel V; Denny, Thomas N; Swamy, Geeta K; Permar, Sallie RHIV-1 and CMV are important pathogens transmitted via breastfeeding. Furthermore, perinatal CMV transmission may impact growth and disease progression in HIV-exposed infants. Although maternal antiretroviral therapy reduces milk HIV-1 RNA load and postnatal transmission, its impact on milk CMV load is unclear. We examined the relationship between milk CMV and HIV-1 load (4-6 weeks postpartum) and the impact of antiretroviral treatment in 69 HIV-infected, lactating Malawian women and assessed the relationship between milk CMV load and postnatal growth in HIV-exposed, breastfed infants through six months of age. Despite an association between milk HIV-1 RNA and CMV DNA load (0.39 log(10) rise CMV load per log(10) rise HIV-1 RNA load, 95% CI 0.13-0.66), milk CMV load was similar in antiretroviral-treated and untreated women. Higher milk CMV load was associated with lower length-for-age (-0.53, 95% CI: -0.96, -0.10) and weight-for-age (-0.40, 95% CI: -0.67, -0.13) Z-score at six months in exposed, uninfected infants. As the impact of maternal antiretroviral therapy on the magnitude of postnatal CMV exposure may be limited, our findings of an inverse relationship between infant growth and milk CMV load highlight the importance of defining the role of perinatal CMV exposure on growth faltering of HIV-exposed infants.Item Open Access Postpartum substance use and depressive symptoms: a review.(Women & health, 2013-01) Chapman, Shawna L Carroll; Wu, Li-TzyNational survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression may be at high risk for substance use. Understanding postpartum substance use and its relationship to postpartum depression can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999-2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%-49%) and drug use (4.5%-8.5%) were lower than use among not pregnant, not postpartum women (41.5%-57.5%, 7.6%-10.6%, respectively) but higher than use among pregnant women (5.4%-11.6%, 3.7%-4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by blacks and Hispanics, but black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%-46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use.Item Open Access The acquisition of abstract words by young infants.(Cognition, 2013-06) Bergelson, Elika; Swingley, DanielYoung infants' learning of words for abstract concepts like 'all gone' and 'eat,' in contrast to their learning of more concrete words like 'apple' and 'shoe,' may follow a relatively protracted developmental course. We examined whether infants know such abstract words. Parents named one of two events shown in side-by-side videos while their 6-16-month-old infants (n=98) watched. On average, infants successfully looked at the named video by 10 months, but not earlier, and infants' looking at the named referent increased robustly at around 14 months. Six-month-olds already understand concrete words in this task (Bergelson & Swingley, 2012). A video-corpus analysis of unscripted mother-infant interaction showed that mothers used the tested abstract words less often in the presence of their referent events than they used concrete words in the presence of their referent objects. We suggest that referential uncertainty in abstract words' teaching conditions may explain the later acquisition of abstract than concrete words, and we discuss the possible role of changes in social-cognitive abilities over the 6-14 month period.Item Open Access The effect of the home environment on physical activity and dietary intake in preschool children.(Int J Obes (Lond), 2013-10) Østbye, T; Malhotra, R; Stroo, M; Lovelady, C; Brouwer, R; Zucker, N; Fuemmeler, BBACKGROUND: The effects of the home environment on child health behaviors related to obesity are unclear. PURPOSE: To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator. METHODS: Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011. RESULTS: Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supporting family meals increased 'junk' food intake scores. CONCLUSIONS: To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake.Item Open Access The effects of a universal short-term home visiting program: Two-year impact on parenting behavior and parent mental health.(Child abuse & neglect, 2023-06) Baziyants, Gayane A; Dodge, Kenneth A; Bai, Yu; Goodman, W Benjamin; O'Donnell, Karen; Murphy, Robert ABackground
At the time of childbirth, families face heightened levels of unmet need. These needs, if left unmet, can lead parents to engage in less positive parenting practices, which in turn, increase the risk of child maltreatment. Family Connects (FC) is a universal postnatal nurse home-visiting program designed to prevent child maltreatment by supporting all families in a community through one to three visits to improve parent mental health and parenting behaviors. A randomized controlled trial of FC demonstrated improving positive parenting and reducing postpartum depression through age 6 months.Objective
To determine sustained (2-year) impact of random assignment to FC on parenting behavior and parent mental health and identify heterogeneity of effects.Participants and setting
A representative subsample of 496 families that had been randomized to FC (255 treatment; 241 control) of infants born between July 1, 2009, and December 31, 2010, in Durham County, North Carolina.Methods
Demographic characteristics were collected through hospital discharge data. Treatment-blinded interviewers collected maternal reports of parenting behavior and mental health at infant age two years. Moderation and subgroup analyses were conducted to estimate heterogeneity in impact of FC.Results
Mothers assigned to FC engaged in more self-reported positive parenting relative to control mothers (B = 0.21; p < 0.05). Hispanic mothers assigned to FC reported greater sense of parenting competence (B = 1.28; p < 0.05). No significant main effect differences were identified for negative parenting, maternal depression, or father involvement.Conclusions
Assignment to FC was associated with improvements in population-level self-reported scores of positive parenting 2 years post-intervention.Item Open Access When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19.(Maternal & child nutrition, 2020-10) Tomori, Cecília; Gribble, Karleen; Palmquist, Aunchalee EL; Ververs, Mija-Tesse; Gross, Marielle SThe World Health Organization (WHO) has provided detailed guidance on the care of infants of women who are persons under investigation (PUI) or confirmed to have COVID-19. The guidance supports immediate post-partum mother-infant contact and breastfeeding with appropriate respiratory precautions. Although many countries have followed WHO guidance, others have implemented infection prevention and control (IPC) policies that impose varying levels of post-partum separation and discourage or prohibit breastfeeding or provision of expressed breast milk. These policies aim to protect infants from the potential harm of infection from their mothers, yet they may fail to fully account for the impact of separation. Global COVID-19 data are suggestive of potentially lower susceptibility and a typically milder course of disease among children, although the potential for severe disease in infancy remains. Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding-a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post-discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long-standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS-CoV-2-positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world. Health services must consider the short-andlong-term impacts of separating mothers and infants in their policies.