PTH-related protein is released into the mother's bloodstream during location: evidence for beneficial effects on maternal calcium-phosphate metabolism

Recent studies have indicated that parathyroid hormone-related protein (PTHrP) may have important actions in lactation, affecting the mammary gland, and also calcium metabolism in the newborn and the mother. However, there are as yet no longitudinal studies to support the notion of an endocrine role of this peptide during nursing. We studied a group of 12 nursing mothers, mean age 32 years, after they had been nursing for an average of 7 weeks (B) and also 4 months after stopping nursing (A). It was assumed that changes occurring between A and B correspond to the effect of lactation. Blood was assayed for prolactin (PRL), PTHrP (two-site immunoradiometric assay with sheep antibody against PTHrP(1-40), and goat antibody against PTHrP(60-72), detection limit 0.3 pmol/l), intact PTH (iPTH), ionized calcium (Ca2+), 25-hydroxyvitamin D3 (25(OH)D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), alkaline phosphatase (alkP), as well as for creatinine (Cr), protein, phosphorus (P), and total calcium (Ca). Fasting 2-h urine samples were analyzed for Ca excretion (CaE) and renal phosphate threshold (TmP/GFR). PRL was significantly higher during lactation than after weaning (39 +/- 10 vs. 13 +/- 9 micrograms/l; p = 0.018) and so was PTHrP (2.8 +/- 0.35 vs. 0.52 +/- 0.04 pmol/l; p = 0.002), values during lactation being above the normal limit (1.3 pmol/l) in all 12 mothers. There was a significant correlation between PRL and PTHrP during lactation (r = 0.8, p = 0.002). Whole blood Ca2+ did not significantly change from A (1.20 +/- 0.02 mmol/l) to B (1.22 +/- 0.02, mmol/l), whereas total Ca corrected for protein (2.18 +/- 0.02 mmol/l) or uncorrected (2.18 +/- 0.02 mmol/l) significantly rose during lactation (2.31 +/- 0.02 mmol/l, p = 0.003 and 2.37 +/- 0.03 mmol/l, p = 0.002, respectively). Conversely, iPTH decreased during lactation (3.47 +/- 0.38 vs. 2.11 +/- 0.35 pmol/l, A vs. B, p = 0.02). Serum-levels of 25(OH)D3 and 1,25(OH)2D3 did not significantly change from A to B (23 +/- 2.3 vs. 24 +/- 1.9 ng/ml and 29.5 +/- 6.0 vs. 21.9 +/- 1.8 pg/ml, respectively). Both TmP/GFR and P were higher during lactation than after weaning (1.15 +/- 0.03 vs. 0.86 +/- 0.05 mmol/l GF, p = 0.003 and 1.25 +/- 0.03 vs. 0.96 +/- 0.05 mmol/l, p = 0.002, respectively) as was alkP (74.0 +/- 7.1 vs. 52.6 +/- 6.9 U/l, p = 0.003). CaE did not differ between A and B (0.015 +/- 0.003 vs. 0.017 +/- 0.003 mmol/l GF, A vs. B, NS). We conclude that lactation is accompanied by an increase in serum PRL. This is associated with a release of PTHrP into the maternal blood circulation. A rise in total plasma Ca ensues, probably in part by increased bone turnover as suggested by the elevation of alkP. PTH secretion falls, with a subsequent rise of TmP/GFR and plasma P despite high plasma levels of PTHrP.

Certified nurse midwives effects on catecholamine levels and maternal anxiety during labor

Studies of nurse midwifery care in the last twenty one years have reported excellent birth outcomes (Levy, Wilkenson and Marine, 1971; Platt et al. 1985; Stone et al. 1976). These outcomes are frequently attributed to the special support offered during labor and delivery by nurse midwives. This supportive style is thought to decrease catecholamine levels by reducing maternal anxiety. This prospective observational study evaluated catecholamine levels, anxiety levels, in-hospital costs, obstetrical practices and outcomes between low risk, term, labor and delivery primigravida patients managed by obstetrical residents (n = 55) or by certified nurse-midwives CNM (n = 59). The two groups were similar with regard to obstetrical risk factors present at admission. Each group was selected over the same period of time between March 23, 1994 and November 2, 1994. Specific catecholamines evaluated were epinephrine and norepinephrine. Obstetrical and newborn characteristics were also compared. This study did not prove that there is a decreased level in stress as indicated by lower levels of epinephrine and norepinephrine in nurse-midwife patients compared to obstetrical resident patients after adjusting for the use of epidural anesthesia. There was also no difference found in the perceived anxiety levels between the two groups. This study did confirm that nurse-midwives and obstetrical residents have different practice styles. Nurse-midwife patients had fewer augmented deliveries, fewer operative deliveries, less blood loss, fewer episiotomies and fewer third and fourth degree lacerations. The physician's choice to utilize more interventions such as continuous fetal monitoring and epidural anesthesia did not improve outcomes. The hospital cost of the nurse-midwife patients in this study was 35 percent lower than the physician patients. ^

Caesarean Birth vs. Vaginal Delivery: Effects upon Maternal Satisfaction, Maternal Confidence and Maternal Perception of the Newborn Behaviour

In order to test the hypothesis that caesarean birth has negative consequences upon newly mothers’ satisfaction and perceptions, women delivering by caesarean birth (WCB) were compared with women delivering by vaginal birth (WVB). Subjects: 180 newly mothers; 93 WCB and 87 WVB. Instruments: A Socio-Demographic Questionnaire developed for this research, the Childbirth Perceptions Questionnaire and the Mother and Baby Scales. Results: WCB had significantly lower scores in perceptions of baby as alert/responsive and nearly significant lower scores for baby as alert during feeds. WVB showed a significantly higher level of satisfaction with delivery and conduct during labour, as also had significantly lower scores for perceptions of baby as irritable during feeds and for lack of confidence in feeds. After controlling for the kind of anesthesia received in labour, three conclusions must be taken into account: 1) between WCB with regional anaesthesia and WCB with general anaesthesia there is only one significant difference, with the former having higher scores for perception of baby as alert during feeds; 2) between WVB with regional anaesthesia and WVB with no anaesthesia there are only two significant differences, with the former having higher scores for lack of confidence in feeding and having lower scores for global confidence; 3) between WCB with regional anaesthesia and WVB with regional anaesthesia four significant differences emerge, with the former having a lower level of satisfaction with delivery and conduct in labour and having lower scores for perception of baby as alert responsive, and also having higher scores of perception of baby as irritable in feeds and higher scores for lack of confidence in feeding. Data seem compatible with the hypothesis that caesarean birth has some negative consequences upon mothers’ satisfaction and perceptions and, for this reason, psychological surveys should constitute a routine procedure in maternity hospitals, especially when newly mothers pertain to families affected by risks of psychological or social nature.

Transgenerational effects persist down the maternal line in marine sticklebacks: gene expression matches physiology in a warming ocean, supplementary material

Transgenerational effects can buffer populations against environmental change, yet little is known about underlying mechanisms, their persistence, or the influence of environmental cue timing. We investigated mitochondrial respiratory capacity (MRC) and gene expression of marine sticklebacks that experienced acute or developmental acclimation to simulated ocean warming (21°C) across three generations. Previous work showed that acute acclimation of grandmothers to 21°C led to lower (optimised) offspring MRCs. Here, developmental acclimation of mothers to 21°C led to higher, but more efficient offspring MRCs. Offspring with a 21°Cx17°C grandmother-mother environment mismatch showed metabolic compensation: their MRCs were as low as offspring with a 17°C thermal history across generations. Transcriptional analyses showed primarily maternal but also grandmaternal environment effects: genes involved in metabolism and mitochondrial protein biosynthesis were differentially expressed when mothers developed at 21°C, whereas 21°C grandmothers influenced genes involved in hemostasis and apoptosis. Genes involved in mitochondrial respiration all showed higher expression when mothers developed at 21° and lower expression in the 21°Cx17°C group, matching the phenotypic pattern for MRCs. Our study links transcriptomics to physiology under climate change, and demonstrates that mechanisms underlying transgenerational effects persist across multiple generations with specific outcomes depending on acclimation type and environmental mismatch between generations.

Maternal alcohol use disorder and offspring ADHD: disentangling genetic and environmental effects using a children-of-twins design

Background. Children of alcoholics are significantly more likely to experience high-risk environmental exposures, including prenatal substance exposure, and are more likely to exhibit externalizing problems [e.g. attention deficit hyperactivity disorder (ADHD)]. While there is evidence that genetic influences and prenatal nicotine and/or alcohol exposure play separate roles in determining risk of ADHD, little has been done on determining the joint roles that genetic risk associated with maternal alcohol use disorder (AUD) and prenatal risk factors play in determining risk of ADHD. Method. Using a children-of-twins design, diagnostic telephone interview data from high-risk families (female monozygotic and dizygotic twins concordant or discordant for AUD as parents) and control families targeted from a large Australian twin cohort were analyzed using logistic regression models. Results. Offspring of twins with a history of AUD, as well as offspring of non-AUD monozygotic twins whose co-twin had AUD, were significantly more likely to exhibit ADHD than offspring of controls. This pattern is consistent with a genetic explanation for the association between maternal AUD and increased offspring risk of ADHD. Adjustment for prenatal smoking, which remained significantly predictive, did not remove the significant genetic association between maternal AUD and offspring ADHD. Conclusions. While maternal smoking during pregnancy probably contributes to the association between maternal AUD and offspring ADHD risk, the evidence for a significant genetic correlation suggests: (i) pleiotropic genetic effects, with some genes that influence risk of AUD also influencing vulnerability to ADHD; or (ii) ADHD is a direct risk-factor for AUD.

The DVD animal model of schizophrenia: Effects of low maternal vitamin D on brain dopamine

Background: We have previously shown that the offspring of vitamin D3 depleted rats have enlarged ventricles and altered neurotrophin profiles (reduced NGF and GDNF). These findings enhance the biological plausibility that low prenatal vitamin D may be a risk factor for schizophrenia. Our recent behavioural studies have found that adult rats with developmental vitamin D deficiency (DVD) have a subtle increase in baseline locomotor activity and a heightened response to dopamine (DA) antagonists. The aim of this study was to investigate brain DA neurochemistry in the DVD model. Methods: We examined cerebrums and striatal tissue from neonates and a variety of brain tissues from the remaining littermates at adulthood. DA, DOPAC, HVA, serotonin and 5HIAA were analysed by HPLC. Single point comparisons for DA1, DA2 and NMDA receptors were also assessed in these tissues. Results: Significant increases in DA and HVA were found in brains from DVD deplete neonates (P=0.01). However, DA and its metabolites were not increased in either the neonate or adult striatum, however there was a trend towards increased DA and its metabolites in the accumbens (P=0.1). Receptor densities were unaffected by prenatal vitamin D levels. Conclusions: Although the effect of maternal diet appears to increase DA production and turnover in neonatal brain, this does not persist into adulthood. Thus other factors must underlie the increased locomotor activity noted in these animals. Future experiments will concentrate on monitoring accumbens and striatal DA release and turnover using microdialysis in pharmacologically challenged behavioural paradigms. References: Eyles D, Brown J; Mackay-Sim A, McGrath J, Feron F. (2003) Vitamin D3 and brain development. Neuroscience 118 (3) 641–653. Burne T, McGrath J, Eyles D, Mackay-Sim A. Behavioural characterization of vitamin D receptor knockout mice. (2005) Behavioural Brain Res: 157 299–308.

The v-MFG test: Investigating maternal, offspring and maternal-fetal genetic incompatibility effects on disease and viability

The MFG test is a family-based association test that detects genetic effects contributing to disease in offspring, including offspring allelic effects, maternal allelic effects and MFG incompatibility effects. Like many other family-based association tests, it assumes that the offspring survival and the offspring-parent genotypes are conditionally independent provided the offspring is affected. However, when the putative disease-increasing locus can affect another competing phenotype, for example, offspring viability, the conditional independence assumption fails and these tests could lead to incorrect conclusions regarding the role of the gene in disease. We propose the v-MFG test to adjust for the genetic effects on one phenotype, e.g., viability, when testing the effects of that locus on another phenotype, e.g., disease. Using genotype data from nuclear families containing parents and at least one affected offspring, the v-MFG test models the distribution of family genotypes conditional on offspring phenotypes. It simultaneously estimates genetic effects on two phenotypes, viability and disease. Simulations show that the v-MFG test produces accurate genetic effect estimates on disease as well as on viability under several different scenarios. It generates accurate type-I error rates and provides adequate power with moderate sample sizes to detect genetic effects on disease risk when viability is reduced. We demonstrate the v-MFG test with HLA-DRB1 data from study participants with rheumatoid arthritis (RA) and their parents, we show that the v-MFG test successfully detects an MFG incompatibility effect on RA while simultaneously adjusting for a possible viability loss.

Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

Effects of Contingent Maternal Imitation vs. Contingent Motherese Speech on Infant Canonical Babbling

Maternal vocal stimulation plays a vital role in infants’ language acquisition. Contingent maternal imitation and contingent motherese speech were used in an alternating sequence as reinforcers to a 12 month-old infant’s canonical babbling. Both vocal contingencies function as reinforcers; however, motherese speech produced the highest frequency of canonical babbling.

The effects of paternal and maternal nurturance and involvement on young adult academic outcomes

The present study examines how mothering and fathering impact child academic outcomes in divorced and intact families, and if there are unique influences of mothering and fathering variables for sons and daughters. An ethnically diverse sample of 1,714 university students from Florida International University (n=1371) and Florida State University (n=343) responded to measures on a questionnaire that included the Nurturant Fathering and Mothering Scales (Finley & Schwartz, 2004; Schwartz & Finley, 2005; Finley & Schwartz, 2006), the Mother and Father Involvement Scales (Finley, Mira, & Schwartz, 2008), demographic measures, and academic outcome measures. In intact families, mothering and fathering variables were significantly correlated with each other, and positively correlated with child academic outcomes including grades, GPA, academic satisfaction, and academic importance. In divorced families, mothering and fathering variables were not correlated with each other. Furthermore, when analyzing divorced families, significant effects were found for both parent and child gender. Mothering variables were found to have the greatest positive impact for sons' academic outcomes. Maternal nurturance and maternal involvement were correlated positively with academic outcomes for sons from divorced families and accounted for 3-4% of the unique variance explained. Consistently, desired mother involvement, how much involvement the child wished they had received, was negatively correlated with academic outcomes for sons from divorced families and accounted for 10-15% of the unique variance explained. This means that when the amount of maternal involvement that sons in divorced families received matched or exceeded their desired level of involvement, sons had more positive academic outcomes including grades, GPA, satisfaction with academics and academic importance. This suggests that in intact family forms, nurturant and involved mothering and fathering have a positive effect on academic outcomes for sons and daughters. In divorced family forms, the effects of fathering on child academic outcomes were not significant. Therefore, in divorced families, the positive effects fathering on academic outcomes of sons and daughters drop out, and mothers are uniquely important for sons' academic success.^

The Effects of Paternal and Maternal Nurturance and Involvement on Young Adult Academic Outcomes

The present study examines how mothering and fathering impact child academic outcomes in divorced and intact families, and if there are unique influences of mothering and fathering variables for sons and daughters. An ethnically diverse sample of 1,714 university students from Florida International University (n=1371) and Florida State University (n=343) responded to measures on a questionnaire that included the Nurturant Fathering and Mothering Scales (Finley & Schwartz, 2004; Schwartz & Finley, 2005; Finley & Schwartz, 2006), the Mother and Father Involvement Scales (Finley, Mira, & Schwartz, 2008), demographic measures, and academic outcome measures. In intact families, mothering and fathering variables were significantly correlated with each other, and positively correlated with child academic outcomes including grades, GPA, academic satisfaction, and academic importance. In divorced families, mothering and fathering variables were not correlated with each other. Furthermore, when analyzing divorced families, significant effects were found for both parent and child gender. Mothering variables were found to have the greatest positive impact for sons’ academic outcomes. Maternal nurturance and maternal involvement were correlated positively with academic outcomes for sons from divorced families and accounted for 3-4% of the unique variance explained. Consistently, desired mother involvement, how much involvement the child wished they had received, was negatively correlated with academic outcomes for sons from divorced families and accounted for 10-15% of the unique variance explained. This means that when the amount of maternal involvement that sons in divorced families received matched or exceeded their desired level of involvement, sons had more positive academic outcomes including grades, GPA, satisfaction with academics and academic importance. This suggests that in intact family forms, nurturant and involved mothering and fathering have a positive effect on academic outcomes for sons and daughters. In divorced family forms, the effects of fathering on child academic outcomes were not significant. Therefore, in divorced families, the positive effects fathering on academic outcomes of sons and daughters drop out, and mothers are uniquely important for sons’ academic success.