Search Results (138)

Background/Objectives: Appetite-regulating hormones are bioactive components of human milk. We tested the associations of leptin and adiponectin with infant growth and eating behaviors to age 6 months. Methods: In a cohort of 70 healthy, full-term infants and their mothers, human milk adiponectin and leptin were assayed at age 2 months (m). At infant ages 2, 4, and 6 m, infant anthropometry was obtained, mothers reported feeding frequency, duration, and breastfeeding intensity and completed the Baby Eating Behavior Questionnaire (Enjoyment of Food, Food Responsiveness, and General Appetite), and infant sucking vigor using an artificial nipple (burst duration and sucking frequency) was measured. Mothers reported demographics, gestational diabetes and pre-pregnancy body mass index (BMI), gestational age, and infant birthweight. Multivariate models evaluated predictors of leptin and adiponectin, and associations of leptin and adiponectin with infant growth and eating behaviors. Results: Human milk leptin was predicted by maternal BMI (β = 0.02) and breastfeeding intensity (β = −0.32). Regarding infant growth, infant weight-for-age and weight-for-length z-scores at 6 m were predicted by leptin (β = 0.91 and β = 1.22, respectively) and adiponectin (β = 0.01 and β = 0.01, respectively). Regarding infant eating behaviors, feeding duration at 2 m and feeding frequency at 4 m were predicted by adiponectin (β = 0.03 and β = −0.02, respectively). Conclusions: Human milk leptin and adiponectin may contribute to weight gain in early infancy, but the effect does not appear to be mediated substantially by infant eating behaviors. Further investigation into the metabolic programming of early infant weight gain is warranted. Full article

Over the years, the impact of music on the prenatal and neonatal stages of human life has gained significant scientific attention. This study provides a comprehensive bibliometric review of research investigating how music influences fetal and newborn development. Using the Scopus and Web of Science databases, a search of relevant studies published in English between January 2006 and July 2025 was conducted, whose basic criterion was the use of the following keywords: “music” and “fetus” or “fetal”. Additional terms such as “fetus development”, “fetus heart rate”, “fetus movement”, “mother–fetus relationship”, “newborn”, etc., were also utilized. In result, 75 publications were selected, and their bibliographic data and full sources were retrieved. The included studies were grouped according to two perspectives that consider the impact of music (1) on the development of the fetus and the newborn, and (2) on maternal health and mother–fetus bonding. Using VOSviewer, bibliometric mapping was performed, which allowed to obtain keyword co-occurrence network and co-authorship network. The chosen literature was then quantitatively and qualitatively analyzed. The analysis revealed a sharp upward trend in publications starting in 2015, with a temporary decline in 2020 due to the COVID-19 pandemic. The highest number of publications were from Iran. The most investigated topics were related to the fetus heart and maternal health. The most common publication type and research methodology were, respectively, article and experiment. While the key authors Lordier, L., Filippa, M., Grandjean, D., and Monaci, M.G. lead the field, the co-authorship network remains fragmented into isolated and relatively small research groups. The Journal of Maternal–Fetal and Neonatal Medicine emerged as the leading publication outlet, while the study by Graven et al. entitled “Auditory Development in the Fetus and Infant” remains the most cited work. The keyword co-occurrence network allowed the identification of three main thematic clusters indicating the physiological, clinical, and therapeutic aspects of the impact of music on fetal and neonatal development. A qualitative analysis revealed that music plays a vital role in early human development and maternal well-being, demonstrating positive effects of auditory stimuli on fetal and newborn physiology, as well as on the mother–fetus relationship, while being a non-invasive and non-pharmacological method of intervention. However, the lack of a fully connected global research community and standardized protocols for, e.g., choosing the musical repertoire, sound administration, and the duration of exposure suggests the need for increased international collaboration to further integrate music therapy into standard clinical practices for prenatal and neonatal care. Full article

Background/Objectives: Early-life gut colonization is crucial for immune system development and metabolic programming. Lactobacillus reuteri has been investigated for its capacity to modulate neonatal gut microbiota, but evidence regarding maternal supplementation during lactation remains limited. This study aimed to evaluate the effect of maternal supplementation with L. reuteri SGL 01 on the microbial composition of breast milk and neonatal feces over the first month of life. Methods: This is an exploratory, prospective, open-label randomized clinical trial. Lactating mothers of full-term and exclusively breastfed infants were randomized to receive either daily L. reuteri SGL 01 (1 × 10⁹ CFU) for 30 days or no supplementation. Quantitative real-time PCR was used to assess Bifidobacterium spp., Lactobacillus spp., Clostridium spp., and the Bacteroides fragilis group in maternal milk and neonatal feces at baseline (T0) and after 30 days (T1). Results: Twenty-seven mother–infant dyads completed the study (15 supplemented, 12 controls). No significant changes in breast milk microbiota composition were observed across any of the bacterial taxa following maternal supplementation. In contrast, neonatal fecal samples from the supplemented group showed significant increases in Bifidobacterium spp. (p < 0.001), Lactobacillus spp. (p = 0.029), and Clostridium spp. (p = 0.003) at T1. No significant microbial changes were observed in the control group, except for a slight reduction in Clostridium spp. (p = 0.046). Conclusions: Maternal supplementation with L. reuteri SGL 01 did not modify breast milk microbiota but was associated with a modulation of neonatal gut colonization, including an increased abundance of beneficial taxa such as Bifidobacterium, suggesting potential indirect maternal-to-infant microbial effects. Full article

Human cytomegalovirus (HCMV) and Human Immunodeficiency Virus (HIV) are two pathogens known to have dramatic consequences when contracted early in life. In addition to having a significant impact when acquired individually, these two viruses are known to frequently cause coinfections. Indeed, also in the modern era, HCMV remains one of the most prevalent coinfections in newborns of mothers living with HIV, including both HIV-positive children regardless of their immune status, and those exposed to HIV but uninfected (HEU). In children with HIV infection, HCMV coinfection has historically been associated with AIDS-defining disease, high mortality, and prolonged, elevated HCMV viral load. Although timely administration of antiretroviral therapy prevents immunodeficiency in people living with HIV and thus reduces the incidence of full-blown HCMV disease in cases of coinfection, emerging data suggest that HCMV-induced immune activation and aging persist, potentially contributing to long-term, non-AIDS-related comorbidities. Growing evidence indicates that also HCMV amplifies HIV susceptibility, disease progression, and immune dysregulation through multiple synergistic mechanisms. Moreover, congenital and early postnatal HCMV infections occur at significantly higher rates in HEU newborns than in HIV-unexposed children and are associated with worse clinical outcomes, particularly when HCMV viral loads are high. This review summarizes current knowledge on the epidemiology, clinical impact, and immunopathogenetic interactions of early HCMV–HIV coinfection in pediatric populations. By integrating recent findings with historical evidence, it highlights critical mechanistic and epidemiological gaps that warrant further investigation. Full article

The transplacental transfer of maternal immunoglobulin G from the mother to the foetus is central for providing immunity in early life, resulting in full-term newborns having IgG repertoires and levels similar to those of their mothers. The neonatal Fc receptor is recognised as the primary transporter of IgGs across the placental epithelium. Understanding the mechanisms of transplacental antibody transfer and factors that affect them is essential in optimising maternal vaccination strategies, ultimately protecting infants from various environmental pathogens. This review first outlines the biological mechanisms governing transplacental IgG transfer, followed by a discussion of how this process may be disrupted by physiological and pathological conditions during pregnancy, including preterm birth, hypergammaglobulinemia, maternal pathogenic IgG, maternal infections, hyperglycaemia, and exposure to biological therapies. We also summarise currently available models used to study transplacental IgG transfer, highlighting existing knowledge gaps and future directions for research in this field. Full article

Background: Childhood immunization is one of the most effective public health strategies for reducing morbidity and mortality from vaccine-preventable diseases. Although overall vaccination coverage in the United States remains high, disparities persist across socioeconomic and healthcare access groups. Understanding these disparities is particularly important in the post-COVID-19 era, when increased vaccine hesitancy may threaten progress in maintaining equitable coverage. Materials and Methods: We analyzed data from the National Immunization Survey–Child (NIS-Child), focusing on U.S. children aged 19–35 months in 2023, corresponding to cohorts reaching this age during or after the COVID-19 pandemic. The primary outcome was receipt of the up-to-date combined 7-vaccine series (4:3:1:3:3:1:3: ≥4 doses of DTaP, ≥3 doses of polio, ≥1 dose of measles-containing vaccine, full Hib series, ≥3 doses of hepatitis B, ≥1 dose of varicella, and ≥3 doses of PCV). Logistic regression models were used to estimate associations between vaccination coverage and key explanatory variables: household income-to-poverty ratio, maternal education, health insurance type, and provider facility type, controlling for demographic and regional covariates. Disparities were quantified using concentration indices (CIs). Results: Among children in the analytic sample, overall coverage for the 7-vaccine series was only 78.5%. Nonetheless, disparities were evident. Children from households with lower income-to-poverty ratios (<1 × FPL: OR = 0.44, 95% CI = 0.37–0.53; 100–200%: OR = 0.66, 95% CI = 0.56–0.79), those covered by Medicaid (OR = 0.54, 95% CI = 0.45–0.64), other insurance (OR = 0.48, 95% CI = 0.37–0.61), or uninsured (OR = 0.27, 95% CI = 0.18–0.42), and those whose mothers had lower educational attainment (<12 years: OR = 0.35, 95% CI = 0.28–0.44) had significantly lower odds of being up-to-date. Similar associations were observed across specific vaccines. Unadjusted CIs for income-to-poverty ratio (0.04, p < 0.01), maternal education (0.04, p < 0.01), health insurance (0.03, p < 0.01), and provider type (0.03, p < 0.01) decreased but remained statistically significant after adjustment (0.02, 0.02, 0.01, and 0.02, respectively; all p < 0.01). No significant disparities were found by census region or race/ethnicity. Discussion: Despite relatively high overall vaccination coverage among U.S. children born during and after the COVID-19 pandemic, disparities by socioeconomic and healthcare access factors persisted. However, the absolute magnitude of these disparities was very small (concentration indices ≤ 0.04). These findings suggest that while inequities remain statistically measurable, their scale is limited in absolute terms. Targeted efforts to address income, insurance, maternal education, and provider-related barriers will be important to sustain equitable immunization coverage in the post-pandemic era. Full article

Several factors have been associated with delayed eruption of primary teeth. Thus, the objective of the study was to test a path model of the direct and indirect birth-related risk factors influencing the age of first primary tooth eruption in infants. Cohort study with 43 preterm and 48 full-term infants aged at least four months. Infants were monitored monthly to verify the chronology of eruption of the first primary tooth. Mothers responded to sociodemographic and health behavior questionnaire. Principal Component Analysis and path analysis were performed. Two models were constructed: chronological and corrected age of tooth eruption. Model using chronological age of tooth eruption demonstrated that preterm infants had an increased risk of having later tooth eruption compared to those born at term ([β] = 0.888; p < 0.001). Indirect associations were found between socioeconomic and health conditions with the age of tooth eruption, mediated by gestational age. The same direct and indirect associations were also found for corrected age, with differences only in β values. It is concluded that preterm infants exhibited higher risk of delayed tooth eruption compared to full-term infants, considering both chronological and corrected age. Gestational age mediated the association between socioeconomic and health conditions with the age of tooth eruption. Full article

Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and structural needs among mothers of healthy, full-term infants. This formative mixed-methods study sought to identify and prioritize maternal needs across multiple socioecological levels to guide the development of a comprehensive Maternal Needs Assessment Tool (MNAT). Methods: Guided by the socioecological model, six virtual focus groups were conducted with U.S. mothers of healthy infants < 2 years (analytic sample = 28). Thematic analysis in ATLAS.ti (Version 25) identified key needs, which informed the creation of a 10-domain Maternal Needs Assessment Ranking Questionnaire (MNARQ). Participants (n = 22) rated each domain’s importance on a five-point scale; weighted mean ranks were calculated in SPSS (Version 30). Results: Seven overarching themes across ten domains emerged: infant and young child feeding and care, maternal psychosocial wellbeing, parenting knowledge and skills, interpersonal and community support, institutional assistance, and work-policy environments. The highest-ranked domains of need were complementary feeding, child development, care and health, social norms, networking and support, maternal mental health, and breastfeeding guidance. Mothers described pervasive informational confusion, inadequate professional and peer support, and institutional barriers such as limited postpartum follow-up, inflexible daycare policies, and WIC hurdles in formula substitution for infants with allergies. Conclusions: Maternal needs encompass intersecting personal, social, and structural factors. Findings will inform the development and validation of a national Maternal Needs Assessment Tool to guide integrated maternal and child health programs. Full article

Background: Human milk (HM) is the optimal nutrition for preterm infants, but supplementation is often required to meet their unique nutritional needs. Donor human milk (DHM) and preterm formula are commonly used alternatives, yet their impacts on bone metabolism and clinical outcomes remain incompletely defined. Objective: To compare the effects of exclusive mother’s own milk (MOM), MOM supplemented with DHM, and MOM supplemented with preterm formula on bone metabolism markers, growth milestones, and clinical outcomes in very preterm and very low birth weight (VLBW) infants. Methods: We conducted a retrospective review of medical records for infants born at <32 weeks’ gestation or <1500 g birth weight between January 2018 and June 2023. Feeding groups included exclusive MOM (N = 135), MOM + DHM (N = 74), and MOM + Formula (N = 54). Biochemical markers were assessed at baseline and on days 7, 14, and 28. Multivariate regression analyses evaluated predictors of growth and clinical outcomes. Results: Infants in the MOM group had significantly lower gestational age and birth weight, with higher rates of respiratory morbidity. Time to full enteral feeding and duration of parenteral nutrition were longer in the MOM group, but feeding regimen was not an independent predictor of these outcomes. By day 14, the MOM group had higher alkaline phosphatase levels and lower phosphorus levels compared to mix feeding groups, but these differences resolved by day 28. Calcium levels varied between groups but remained within normal ranges. Necrotizing Enterocolitis (NEC) incidence did not differ significantly across feeding regimens and was primarily associated with longer parenteral nutrition duration. Conclusions: Supplementation of MOM with either DHM or preterm formula supported adequate growth and bone metabolism without increasing NEC risk. Feeding regimen did not independently influence time to full enteral feeding or length of hospitalization, which were driven primarily by infant maturity and clinical status. Both DHM and preterm formula are viable supplements to MOM, ensuring nutritional adequacy without adverse bone health effects. Prospective studies are needed to evaluate long-term outcomes of these feeding strategies. Full article

Introduction: Little is known about the effects of intrauterine exposure to SARS-CoV-2, especially on growth and neurodevelopment in children. Objective: We wished to verify the effect of intrauterine exposure to SARS-CoV-2 on neurological development in children. Methods: Infants born to mothers presenting with SARS-CoV-2 infection during pregnancy were enrolled in a prospective descriptive–analytical study involving outpatient appointments performed 6 and 12 months after birth. Their neurological development was assessed using the Bayley-III Scale, using a score of >85 as the cutoff threshold for identifying developmental delay. Differences between groups were assessed through an ANOVA, using Bonferroni correction for multiple comparisons. Regression models were employed to examine the associations between the Bayley-III scores and maternal features. Results: Two hundred and sixty-nine infants were evaluated, most of whom were born full-term and with birth weights appropriate for gestational age at delivery. Developmental delays were observed in 26% of the infants in at least one of the Bayley-III domains. The language domain was particularly affected, with impairments observed in children exposed to SARS-CoV-2 closer to the time of delivery. These findings were statistically significant (p < 0.05). Conclusions: Infants born to mothers presenting with SARS-CoV-2 infection during pregnancy presented developmental delays at 6 and 12 months, particularly in the language domain. These findings reinforce the relevance of long-term clinical follow-ups of newborns exposed to SARS-CoV-2 infection during pregnancy. Full article

Background: Neonatal influenza is a rare condition. Young infants have immature immune defenses and are unable to receive direct vaccination; this can result in significant illness. Maternal anti-influenza immunization during pregnancy provides passive antibodies to the newborn via transplacental transfer, significantly decreasing the incidence and severity of influenza in early infancy. Nevertheless, the vaccination coverage during pregnancy remains low in many regions, leaving certain neonates without adequate protection. Methods: We present three cases of laboratory-confirmed influenza infection in neonates admitted to the “Sf. Ioan” Clinical Emergency Pediatric Hospital in Galați and conduct a literature review. The clinical presentation, co-infections, timing of antiviral therapy, laboratory findings, maternal vaccination status, and outcomes (including the hospitalization duration and recovery) were systematically analyzed for each case. Results: All three neonates were full-term and previously healthy, born to mothers who had not received influenza vaccinations during their pregnancies. They presented at ages ranging from 2 to 4 weeks with fever, respiratory symptoms including a cough, nasal congestion, and respiratory distress, as well as feeding difficulties. One case involved a co-infection with Bordetella pertussis, which manifested as a severe paroxysmal cough, cyanosis, and apnea. Laboratory findings in the cases with influenza alone indicated leukopenia accompanied by normal C-reactive protein levels. In the co-infection case, leukocytosis, lymphocytosis, and thrombocytosis were observed. All the infants received oseltamivir treatment within 48 h of the symptom onset; the case with pertussis co-infection also received azithromycin. Each infant required supplemental oxygen, but none necessitated mechanical ventilation. Clinical improvement was observed in all cases, with hospitalization ranging from 6 to 7 days and complete recovery without complications. Conclusions: Neonatal influenza may result in considerable morbidity, particularly in infants born to unvaccinated mothers. Positive outcomes, however, have been correlated with early diagnosis and antiviral treatment. Pertussis co-infection may exacerbate clinical progression, underscoring the importance of maternal immunization against both influenza and pertussis. In this case series, we aim to present three cases of laboratory-confirmed influenza in neonates born to mothers who were not immunized against influenza during pregnancy. These cases highlight the clinical presentations of neonatal influenza, underscore the risks associated with pertussis co-infection, and reinforce the importance of maternal influenza and Tdap vaccination for preventing severe outcomes in newborns. Full article

Background/Objectives: Despite ongoing national interventions, pockets of acute malnutrition persist in rural settings of South Africa, contributing to disproportionate rates of child morbidity and mortality. This study aimed to identify risk factors associated with acute malnutrition among under-five children attending primary healthcare facilities in Msinga, KwaZulu-Natal Province, with a specific focus on dietary diversity and selected infant and young child feeding indicators. Methods: A cross-sectional, facility-based study was conducted among 415 mother–child pairs attending five randomly selected PHC facilities in the Msinga sub-district. Participants were selected using a multistage sampling design from a sampling frame of 18,797 under-five children. Of the 551 mother–child pairs approached; the final analytic sample comprised 415 observations. Data were collected through structured interviews, anthropometric assessments, and dietary diversity scores (DDS). Data were analyzed using Stata 18, and Poisson regression was applied to identify risk factors. Results: The prevalence of acute malnutrition was 29% based on weight-for-height/length z-scores (WHZ/WLZ) and 27% based on mid–upper-arm circumference z-scores (MUACZ). Children aged ≥36 months had significantly higher prevalence of acute malnutrition (aPR = 1.62; 95% CI: 1.15–2.10). Children from households with five or more members had reduced risk (aPR = 0.66; 95% CI: 0.45–0.74), and those born full-term showed a strong protective association (aPR = 0.39; 95% CI: 0.23–0.64). Maternal age was associated with reduced risk, with children of mothers aged 25–34 years (aPR = 0.67; 95% CI: 0.48–0.93) and ≥35 years (aPR = 0.58; 95% CI: 0.35–0.84) experiencing significantly lower prevalence. Mixed feeding was significantly associated with reduced risk (aPR = 0.86; 95% CI: 0.55–1.17), while a DDS ≥4 was protective (aPR = 0.41; 95% CI: 0.04–0.84). Consumption of protein-rich foods was notably low, with only 21% consuming flesh foods and 10% consuming eggs. Conclusions: Acute malnutrition in under-five children was significantly associated with poor diet quality, older age, low household income, and mixed feeding practices. Protective factors included full-term pregnancy, larger households, older maternal age, and adequate dietary diversity, highlighting the importance of targeted, multisectoral interventions. Full article

Background/Objectives: Research shows that mothers of premature infants can experience increased symptoms of anxiety, depression, and even a post-traumatic stress in comparison to mothers of healthy, full-term infants. The aim of this study was to analyze and compare anxiety, coping, and self-efficacy in mothers who have and have not experienced a preterm birth, providing a basis for developing a targeted, mother-oriented support program that supports their adjustment to difficult situations. Methods: The study included 251 women, 112 of whom delivered infants prematurely (PTB group) and 139 who delivered infants at term (T-B group). Data were collected by using (1) The State-Trait Anxiety Inventory (STAI) Questionnaire, (2) the Generalized Self-Efficacy Scale (GSES), and (3) the Coping Inventory for Stressful Situations Questionnaire (CISS). Results: PTB women had higher results in anxiety in comparison to T-B women. Also, they were characterized by statistically significantly lower generalized self-efficacy and ability to cope with stress. PTB women more often presented the emotion-oriented coping style. Conclusions: A mother-oriented support program based on personal resources is a solution which could help mothers better adjust to difficult situations related to preterm birth child treatment and care. Full article

Neonicotinoids (NEOs) are widely used neuroactive insecticides with several adverse effects on human health. This study examined 186 colostrum samples collected at three time points between 2007 and 2019 from Shanghai, China to investigate the distribution and temporal variations of NEOs. The median total concentration (ΣNEOs) was 136 ng/L, with the imidacloprid equivalent concentration (IMIeq) of 249 ng/L. N-desmethyl-acetamiprid (DM-ACE) had the highest median level at 49.6 ng/L, accounting for 43.9% of ΣNEOs, followed by imidacloprid (IMI) (20.1 ng/L and 22.1%). Thiamethoxam (THM), clothianidin, and acetamiprid were also identified as important parent compounds (p-NEOs). Temporal variations suggested a decrease in ΣNEOs, IMIeq, and DM-ACE concentrations from 2013 to 2019; however, the total concentrations of p-NEOs remained comparable. Distinct trends were also observed in the concentrations of dinotefuran and IMI. Maternal body mass index and weight changes, which reflect the dietary habits of mothers, appeared to influence IMI and THM levels. No statistically significant relationships were found between colostrum concentrations and birth parameters using full-term birth data in 2019. The estimated hazard quotients (≤0.003), which were far below the risk threshold of 1, generally indicated negligible health risks for breastfeeding neonates. Nevertheless, the substantial contribution from several p-NEOs warrants further investigation. Full article

One out of every hundred live births present with congenital heart abnormalities caused by the aberrant development of the embryonic cardiovascular system. The conserved zinc finger transcription factor proteins, which include GATA binding protein 5 (GATA5) and GATA binding protein (GATA6) play important roles in embryonic development and their inactivation may result in congenital heart defects (CHDs). In this study, we performed genotypic–phenotypic analyses in two families affected by right-sided CHD diagnosed by echocardiography imaging. Proband A presented with pulmonary valve stenosis, and proband B presented with complex CHD involving the right heart structures. For variant detection, we employed whole-genome single-nucleotide polymorphism (SNP) microarray and family-based whole-exome sequencing (WES) studies. Proband A is a full-term infant who was admitted to the neonatal intensive care unit (NICU) at five days of life for pulmonary valve stenosis (PVS). Genomic studies revealed a normal SNP microarray; however, quad WES analysis identified a novel heterozygous [Chr20:g.61041597C>G (p.Arg237Pro)] variant in the GATA5 gene. Further analysis confirmed that the novel variant was inherited from the mother but was absent in the father and the maternal uncle with a history of heart murmur. Proband B was born prematurely at 35 weeks gestation with a prenatally diagnosed complex CHD. A postnatal evaluation revealed right-sided heart defects including pulmonary atresia with intact ventricular septum (PA/IVS), right ventricular hypoplasia, tricuspid valve hypoplasia, hypoplastic main and bilateral branch pulmonary arteries, and possible coronary sinusoids. Cardiac catheterization yielded anatomy and hemodynamics unfavorable to repair. Hence, heart transplantation was indicated. Upon genomic testing, a normal SNP microarray was observed, while trio WES analysis identified a novel heterozygous [Chr18:c.1757C>T (p.Pro586Leu)] variant in the GATA6 gene. This variant was inherited from the father, who carries a clinical diagnosis of tetralogy of Fallot. These findings provide new insights into novel GATA5/6 variants, elaborate on the genotypic and phenotypic association, and highlight the critical role of GATA5 and GATA6 transcription factors in a wide spectrum of right-sided CHDs. Full article