Fetal Alcohol Spectrum Disorder Primary Prevention through FASD Diagnosis: Identification of High-Risk Birth Mothers through the Diagnosis of their Children. Follow-up Study

Thesis (Master's)--University of Washington, 2016-08

Adiponectin and insulin in grey seals during suckling and fasting: relationship with nutritional state and body mass during nursing in mothers and pups

Animals that fast during breeding and/or development, such as phocids, must regulate energy balance carefully to maximize reproductive fitness and survival probability. Adiponectin, produced by adipose tissue, contributes to metabolic regulation by modulating sensitivity to insulin, increasing fatty acid oxidation by liver and muscle, and promoting adipogenesis and lipid storage in fat tissue. We tested the hypotheses that (1) circulating adiponectin, insulin, or relative adiponectin gene expression is related to nutritional state, body mass, and mass gain in wild gray seal pups; (2) plasma adiponectin or insulin is related to maternal lactation duration, body mass, percentage milk fat, or free fatty acid (FFA) concentration; and (3) plasma adiponectin and insulin are correlated with circulating FFA in females and pups. In pups, plasma adiponectin decreased during suckling (linear mixed-effects model [LME]: T = 4.49; P < 0.001) and the early postweaning fast (LME: T = 3.39; P = 0.004). In contrast, their blubber adiponectin gene expression was higher during the early postweaning fast than early in suckling (LME: T = 2.11; P = 0.046). Insulin levels were significantly higher in early (LME: T = 3.52; P = 0.004) and late (LME: T = 6.99; P < 0.001) suckling than in fasting and, given the effect of nutritional state, were also positively related to body mass (LME: T = 3.58; P = 0.004). Adiponectin and insulin levels did not change during lactation and were unrelated to milk FFA or percentage milk fat in adult females. Our data suggest that adiponectin, in conjunction with insulin, may facilitate fat storage in seals and is likely to be particularly important in the development of blubber reserves in pups.

The millennial mum: technology use by new mothers

Becoming a mother presents a woman with new challenges and a need to access new sources of information. This work considers the increase in the use of online parenting support as the first group of millennials become parents. Initial results from a survey comparing the use of technology pre and post the experience of childbirth is presented. The survey reveals that mothers are likely to increase the time they spend online and are strongly motivated by seeking social contact. The paper concludes by considering the implications of this survey for healthcare professionals wishing to give information and support through online media and suggests how HCI professionals can become involved in this work.

Parental influences and mothers’ experiences on infant and young child feeding practices

The objective of this thesis was to better understand how parental factors influence feeding practices, how mothers experience feeding and what factors mothers perceive influencing feeding in different contexts. This study is largely based on STEPS Study (Steps to Healthy Development of Children), which is a longitudinal cohort of 1797 families. In addition, qualitative data was collected among mothers in Finland and Solomon Islands. The results of this study show that different parental determinants associate with infant and young child feeding behavior and practices. Mothers with high cognitive restraint of eating introduced complementary foods earlier and neophobic mothers’ breastfed exclusively for a shorter time than mothers who ranked lower in these behaviors. Fathers’ poor diet quality associated with shorter total breastfeeding duration. Mothers’ postnatal depressive symptoms associated with shorter duration of exclusive breastfeeding, earlier introduction of complementary foods and lower compliance of feeding recommendations. The higher amount of marital distress associated with longer duration of exclusive breastfeeding and better compliance with feeding recommendations. Mothers, who participated in qualitative interviews, described how complex interplay of individual perceptions, significant others and socio-cultural environment influenced feeding practices and behavior. This study showed that several parental factors influence infant and young child feeding practices as well as compliance with the feeding recommendations. Maternal experiences and perceptions on child feeding relate to the context where mother-infant pair lives in. These results highlight the importance of targeting feeding support and, if needed, specific interventions to mothers and families who are in risk of poor feeding practices.

Increased frequency of the autism broader phenotype in mothers transmitting etiological CNVs to sons affected by Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a frequent and complex neurodevelopmental disorder, characterized by impairments in social communication and repetitive behaviors and with a high male to female ratio: ~4:1. Genetic factors, including rare Copy Number Variants (CNVs), have a substantial impact in ASD risk1, and are associated with specific phenotypic manifestations2. Recent studies reported that rare inherited CNVs are enriched in mothers of ASD children compared with mothers of controls and are preferentially transmitted from mothers to ASD children suggesting a sex bias in CNV transmission; further, the imbalanced transmission of small pathogenic CNVs from unaffected mothers to their sons with ASD has been described3,4. An increased prevalence of autism-like personality traits is found in unaffected relatives of ASD children, suggesting a genetic liability of a broader autism phenotype (BAP)5. The BAP in parents of autistic children can be assessed by the Social Responsiveness Scale (SRS)6 and Broad Autism Phenotype Questionnaire (BAPQ)7 reports. The SRS is 65-item questionnaire to identify sub-clinical social impairments and interpersonal behaviour in individuals. The BAPQ is a 36-item questionnaire measures social aloofness, rigid personality, and pragmatic language deficits in both parents and children.

“Enjoy your baby” Internet-based CBT for mothers with babies: a feasibility randomised control trial

Background: Postnatal depression is a global health problem with lasting effects on the family. Government policy is focussed on early intervention and increasing access to psychological therapies. There is a growing evidence base for the use of computerised CBT packages and this study investigated the feasibility of a CBT-based self-help internet intervention for new mothers. Objective: To assess the ability to recruit mothers, deliver an internet course, obtain follow-up data and evaluate what mothers think of the course. Design: A feasibility randomised control design was used to compare a waiting list control group (delayed access= DA) to the Enjoy Your Baby course (immediate access= IA). Measures were administered at baseline and 8 week follow-up. Methods: Adverts were placed in the Metro freesheet, on charity web pages, on social media, posters were put up in the community, and leaflets were handed out at mother and baby groups. Participants had to be 18 years old or over with a child less than 18 months old. The IA arm was given access to the course straight away. After 8 weeks all participants were asked to recomplete the original measures and those in the IA arm also gave feedback on the course. Participants in the DA arm were given access after recompleting the questionnaires. Due to a lack of follow-up data a small discussion group was conducted. Intervention: The course contains 4 core modules including helping mothers understand why they feel the way they do and helping them build closeness to their babies. Additional modules, worksheets and homework tasks were available. The DA group were given a list of additional support resources and services, and encouraged to seek additional help if required. All participants received weekly automated emails for 12 weeks as they worked through the course. It was not possible to deliver individualised support. 34 Results: Despite using a number of recruitment strategies, recruitment was lower and slower than anticipated, and attrition was high. 41 women, primarily recruited via the internet, were randomised (IA n=21, DA n=20). No significant differences were observed between participants in either arm at baseline and no statistically significant differences were identified when the demographics and baseline measures of participants who logged-on to the course were compared to those who did not, or when participants who completed follow-up measures were compared to those who did not. Pre and post intervention scores on the EPDS approached statistical significance (P=.059, r=.444) favouring the intervention arm. The discussion group suggested strengths of the course and recommended areas for improvement, including making the course more mobile friendly. Conclusion: Internet interventions show promise; however it is difficult to recruit mothers, engagement is low and attrition high. A number of recommendations are made and a further pilot or an internal pilot of a larger substantive study should be conducted to confirm recruitment and retention. Trial ID: ISRCTN90927910.

Images of Childhood in Mothers' Accounts of Contemporary Childrearing

This article examines how a sample of first-time mothers in the UK constitute childhood in general, and their own children in particular, in and through their talk about the mundane practices of child-care. The data analysed are drawn from a longitudinal qualitative interview study which followed a sample of mothers from late pregnancy until their babies were two years old. The analysis explores links between mothers’ representations of childhood and the actualities of their child-rearing practices. The extent to which both the representations of childhood and the practices of individual mothers are consistent or contradictory, and change or remain constant over time, is also examined.

A Feminist Affective Turn for Public Relations: Mothers, Passionate Publics, and the Childhood Vaccine Debate

This project proposes a feminist intervention in how affect and publics are theorized in public relations research. Drawing from extant literature, I argue that public relations theories of affect and publics have been apolitical and lack depth and context (Leitch & Motion, 2010a). Using the context of the online childhood vaccine debate, I illustrate several theories and concepts of the new feminist affective turn, as well as postmodern theories of affect, relevant to public relations research: (a) Public Feelings, “ugly” feelings, agency, and community (Cvetkovich, 2012; Ngai, 2007); (b) passionate politics (Mouffe, 2014); (c) postmodern assemblages, biopower, and body politics (Deleuze & Guattari, 1988; Foucault, 1984); (d) affective facts and logics of future threats (Massumi, 2010); and (e) affective ethics (Bertleson & Murphie, 2010). Scholarship in the areas of public relations, risk, feminist and postmodern affect theory, and the vaccine debate provided theoretical grounding for this project. My research questions asked: How is feminist affect theory embodied by mothers in the vaccine debate? How do mothers understand risks as affective facts in the vaccine debate (if at all)? What affective logics are used by mothers in the vaccine debate (if any)? And, What are sources of knowledge for mothers in the vaccine debate? Multi-sited online ethnographic methods were used to explore how feminist affect theory contributes to public relations research, including 29 one-on-one in-depth interviews with mothers of young children and participant observation of 15 online discussions about vaccines on parenting websites BabyCenter.com, TheBump.com, and WhatToExpect.com. I used snowball sampling to recruit interview participants and grounded theory (Glaser & Strauss, 1967) to analyze interview and online data. Results show that feminist affect theory contributes to theoretical and practical knowledge in public relations by politicizing and contextualizing understandings of publics and elucidating how affective facts and logics inform publics’ knowledge and choices, specifically in the context of risk. I also found evidence of suppression of dissent (Martin, 2015) and academic bias in vaccine debate research, which resulted in cultures of silence. Further areas of study included how specific contexts such as motherhood and issues of privilege and access affect publics’ experiences, knowledges, and choices.

Gestation and breastfeeding in schistosomotic mothers differently modulate the immune response of adult offspring to postnatal Schistosoma mansoni infection

Schistosoma mansoni antigens in the early life alter homologous and heterologous immunity during postnatal infections. We evaluate the immunity to parasite antigens and ovalbumin (OA) in adult mice born/suckled by schistosomotic mothers. Newborns were divided into: born (BIM), suckled (SIM) or born/suckled (BSIM) in schistosomotic mothers, and animals from noninfected mothers (control). When adults, the mice were infected and compared the hepatic granuloma size and cellularity. Some animals were OA + adjuvant immunised. We evaluated hypersensitivity reactions (HR), antibodies levels (IgG1/IgG2a) anti-soluble egg antigen and anti-soluble worm antigen preparation, and anti-OA, cytokine production, and CD4+FoxP3+T-cells by splenocytes. Compared to control group, BIM mice showed a greater quantity of granulomas and collagen deposition, whereas SIM and BSIM presented smaller granulomas. BSIM group exhibited the lowest levels of anti-parasite antibodies. For anti-OA immunity, immediate HR was suppressed in all groups, with greater intensity in SIM mice accompanied of the remarkable level of basal CD4+FoxP3+T-cells. BIM and SIM groups produced less interleukin (IL)-4 and interferon (IFN)-g. In BSIM, there was higher production of IL-10 and IFN-γ, but lower levels of IL-4 and CD4+FoxP3+T-cells. Thus, pregnancy in schistosomotic mothers intensified hepatic fibrosis, whereas breastfeeding diminished granulomas in descendants. Separately, pregnancy and breastfeeding could suppress heterologous immunity; however, when combined, the responses could be partially restored in infected descendants.

Maternal Age and Infant Mortality for White, Black, and Mexican Mothers in the United States

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.

Cortisol Reactivity and Observed Parenting among Mothers of Children with and without ADHD

Parenting is a robust predictor of developmental outcomes among children with ADHD. Early parenting predicts the persistence and course of ADHD and comorbid problems above and beyond risk associated with shared genetic effects. Yet, on average, mothers of children with ADHD are less positive and more negative in their parent-child interactions compared to mothers of non-disordered children. Little is known about psychobiological markers which may be associated with individual variations in maternal parenting in families of children with ADHD. Neurobiological models of parenting suggest that maternal cortisol levels following a stressor may be positively associated with hostile and intrusive parenting; however, to date no studies have examined maternal cortisol reactivity and parenting in school-age, or clinical samples of, children. Mothers’ regulation of physiological stress responses may be particularly important for families of children with ADHD, as parenting a child with chronically challenging behaviors represents a persistent environmental stressor. The current study sought to extend the existing literature by providing an empirical examination of the relationship between maternal cortisol reactivity following two laboratory stressors and parenting among mothers of children with and without ADHD. It was hypothesized that child ADHD group would moderate the relationship between cortisol reactivity and self-reported and observed parenting. Greater total cortisol output and greater increase in cortisol during the TSST were associated with decreased positive parenting and increased negative and directive parenting, with the exception of parental involvement, which was associated with increased cortisol output during the TSST. Conversely, cortisol output during the PCI was associated with increased positive parenting, increased parental involvement, and decreased negative parenting. In contrast to the TSST, a greater decrease in cortisol during the PCI indicated more positive parenting and parental involvement. These associations were specific to mothers of children with ADHD, with the exception of maternal directiveness, which was specific to comparison mothers. Findings add to our understanding of physiological processes associated with maternal parenting and contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

An Evaluation of Oxidative Status in Serum and Breast Milk of Mothers Giving Birth Prematurely and at Full-Term

Background: Burning fat and carbohydrates to provide energy in biological systems causes the formation of free oxygen species. Objectives: This study aimed to evaluate the oxidative status of serum and breast milk of mothers giving birth prematurely and at full-term. Materials and Methods: The study comprised 50 mothers who gave birth at full-term at more than 38 weeks and 43 mothers who gave birth pre-term at below 32 weeks. On the postnatal 5th day, samples of the mother’s milk and serum were taken and stored at -80°C until the study day. On the study day, the total oxidant and total antioxidant levels were measured using the Erel method and the oxidative stress index (OSI) was calculated. Results: While the total oxidant level and total antioxidant level values of the milk of the premature birth mothers were found to be significantly high compared to those of the full-term birth mothers (P = 0.001), no statistically significant difference was found in the oxidative stress index values (P > 0.05). No statistically significant difference was found in the total oxidant level and oxidative stress index values of the serum of the premature birth mothers compared to those of the full-term birth mothers, while the total antioxidant level was found to be significantly low (P = 0.04). Conclusions: The oxidants and antioxidants in the milk of mothers giving birth prematurely were found to be significantly higher than those of full-term birth mothers. This can be evaluated as the milk of the premature birth mothers providing increased antioxidant defense to protect the infant.

Exploring barriers to breastfeeding among chinese mothers living in Madrid, Spain

In Spain, immigrant women have high rates for initiating breastfeeding. In contrast, the case of immigrant Chinese mothers stands out, due to the low rate. In China, breastfeeding has historically been the cultural norm. An ethnographic study was conducted to explore aspects related to the low rate of breastfeeding. Field observations and informal interviews were conducted in two hospitals and a primary care center. Semi-structured interviews were performed with Chinese mothers and health workers. Among Spanish health workers, there is a belief that Chinese women do not breastfeed due to cultural reasons. The rapid return to work and the popular phenomenon of sending babies back to China for grandparents to raise constitute barriers for breastfeeding. Although in China breastfeeding is common practice, in Madrid the prioritization of productivity over reproduction and the existence of the so-called “satellite babies” and transnational maternity make the establishment and maintenance of breastfeeding difficult.

Exposure To Bisphenol-a During Pregnancy Partially Mimics The Effects Of A High-fat Diet Altering Glucose Homeostasis And Gene Expression In Adult Male Mice.

Bisphenol-A (BPA) is one of the most widespread EDCs used as a base compound in the manufacture of polycarbonate plastics. The aim of our research has been to study how the exposure to BPA during pregnancy affects weight, glucose homeostasis, pancreatic β-cell function and gene expression in the major peripheral organs that control energy flux: white adipose tissue (WAT), the liver and skeletal muscle, in male offspring 17 and 28 weeks old. Pregnant mice were treated with a subcutaneous injection of 10 µg/kg/day of BPA or a vehicle from day 9 to 16 of pregnancy. One month old offspring were divided into four different groups: vehicle treated mice that ate a normal chow diet (Control group); BPA treated mice that also ate a normal chow diet (BPA); vehicle treated animals that had a high fat diet (HFD) and BPA treated animals that were fed HFD (HFD-BPA). The BPA group started to gain weight at 18 weeks old and caught up to the HFD group before week 28. The BPA group as well as the HFD and HFD-BPA ones presented fasting hyperglycemia, glucose intolerance and high levels of non-esterified fatty acids (NEFA) in plasma compared with the Control one. Glucose stimulated insulin release was disrupted, particularly in the HFD-BPA group. In WAT, the mRNA expression of the genes involved in fatty acid metabolism, Srebpc1, Pparα and Cpt1β was decreased by BPA to the same extent as with the HFD treatment. BPA treatment upregulated Pparγ and Prkaa1 genes in the liver; yet it diminished the expression of Cd36. Hepatic triglyceride levels were increased in all groups compared to control. In conclusion, male offspring from BPA-treated mothers presented symptoms of diabesity. This term refers to a form of diabetes which typically develops in later life and is associated with obesity.