Search Results (340)

Perinatal depression is one of the most common mental illnesses in women. The aim of this study was to assess the association of life stressors, perceived stress, obstetric and neonatal complications, and depressive symptoms in the early postpartum period and to compare these variables in two groups of women (preterm and term deliveries). Methods: A case–control study was conducted among 300 women who gave birth in 2019 at the University of Szeged. Cases included women with preterm deliveries (<37 weeks, n = 100), and the controls included women with term deliveries (≥37 weeks, n = 200). Data were collected during postpartum hospital stays through a self-administered questionnaire (containing validated questionnaires: the Holmes–Rahe Life Stress Inventory, the Perceived Stress Scale (PSS-14), and the Edinburgh Postnatal Depression Scale (EPDS)) and the medical records of women and newborns. A descriptive statistical analysis and logistic regression were used to identify predictors of high EPDS scores (≥10). Results: Perceived stress levels were significantly higher among cases than controls (p < 0.001). Higher perceived stress was associated with a higher risk of depression in cases (OR: 1.31, 95% CI: 1.17–1.48, p < 0.001) and controls (OR: 1.33, 95% CI: 1.21–1.45, p < 0.001), too. Newborn complications were associated with an increased perinatal depression risk in the controls (OR: 2.48, 95% CI: 1.05–5.91; p = 0.039) but not in the cases (OR: 2.79, 95% CI: 0.79–9.85; p = 0.111). It is supposed that premature birth was stressful itself, and women with preterm babies were less sensitive to any complications occurring in their newborns compared to women with term newborns. Neither maternal age, education, nor obstetric complications predicted depressive symptoms. Conclusions: Our findings highlight the impact of maternal perceived stress and newborns’ health status on the risk of developing depression during the early postpartum period. These results emphasize the need for ongoing screening and follow-up measures, especially for women with higher EPDS scores. Full article

Neonatal jaundice (NNJ) is a leading cause of death in the early neonatal period, disproportionately affecting newborns in sub-Saharan Africa. In a setting without access to rapid assessment via transcutaneous bilirubin meter, we sought to determine how closely the diagnosis and treatment of neonatal jaundice at an urban district hospital aligned with retrospective assessment and treatment recommendations using the BiliApp (based on the UK NICE Guideline CG98). This retrospective chart review study aimed to identify: (1) What percent of admissions within 8 days of birth to the Mother and Baby Unit (MBU) at our study site were admitted for a primary diagnosis of neonatal jaundice, and what characterized those admissions? (2) How did treatment provided compare to the recommendations of the United Kingdom NICE Guideline CG98 via the “BiliApp”? and (3) Among those with jaundice, what factors were associated with an increased likelihood of severity indicative of the need for blood exchange therapy? The charts of all neonates admitted to the MBU at Suntreso Government Hospital (SGH), in Kumasi, Ghana, in 2020 were reviewed by trained research assistants. Data were collected regarding demographics, reason for admission, diagnostic markers (e.g., serum bilirubin level), treatments performed in the hospital, and outcome. Data were analyzed using Stata 18.0. There were 1059 newborns admitted to the MBU in 2020 at less than 8 days of age. A total of 179 (16.9%) were admitted with a primary diagnosis of neonatal jaundice. According to the BiliApp, 29.4% (n = 50) of newborns admitted for jaundice had bilirubin levels that were normal or below the phototherapy threshold for their gestational age on admission; 25.3% (n = 43) were at or near the threshold for phototherapy; 21.2% (n = 36) were above the phototherapy threshold; and 24.1% (n = 41) were above the blood exchange therapy threshold. The BiliApp recommended no treatment for 21.2% (n = 36) of newborns, repeated assessment for 33.6% (n = 57), phototherapy for 21.2% (n = 36), and exchange therapy for 24.1% (n = 41). By comparison, 8.2% (n = 14) of neonates admitted for jaundice received no treatment, 77.8% (n = 133) received phototherapy only, and 14.0% (n = 24) received both phototherapy and exchange therapy. Without sufficient data on G6PD status and parent/newborn blood type to include in the analysis, the biggest risk factors for a BiliApp recommendation of exchange therapy included serum bilirubin level (OR 1.01, p < 0.001) and gestational age (OR 0.51, p < 0.001), even after controlling for breastfeeding and male sex of the newborn. Without access to rapid assessment tools, many providers in low-resource settings are put in a position to presumptively treat newborns suspected of having jaundice, rather than waiting for serum lab tests to return. Given the cost of transcutaneous bilirubin meters, additional options for rapid diagnostic testing are warranted. Full article

Objectives: This study analyzed correlations of colostrum fatty acids (FAs), newborns’ and mothers’ thyroid hormones (THs), and birth weight, all crucially important in neonatal health. Methods: LC-MS/MS was used to measure 22 FAs in the colostrum of 78 healthy mothers who delivered term babies. FT3, FT4, and TSH levels were determined in the mothers’ serum, and newborns’ TSH was measured in heel-pricked specimens. Correlations were defined in the whole cohort and the subsets, which were separated according to ranges of birth weight, thyroid hormones, and mothers’ body mass index. Phyton Software was used for statistics. Results: The colostrum’s total FA content was highly variable and correlated positively with the percentage values of arachidic, gondoic, and nervonic acids. Five FAs all positively correlated with birth weight for the entire cohort—including ω9 gondoic, erucic, and nervonic acids as well as saturated behenic and lignoceric acids—all produced with the same elongases. These correlations were relevant to gondoic, nervonic, behenic, and lignoceric acids when mothers with low FT4 levels were evaluated separately and to erucic acid in the subset comprising mothers with high TSH values. Conclusions: The priming of breast epithelia to adjust the colostrum quality starts prenatally, whose regulatory mechanisms partially overlap with fetal fat accretion. Thus, colostrum content may undergo modifications to compensate for the harm of subtle TH deficiencies on neonates’ thermoregulation and development. Considering the previous findings showing that milk ω9 FAs are highest in colostrum, and even higher when mothers deliver preterm, our current results indicate their possible protective functions. Full article

Background: Newborns’ plasticity allows the brain to adapt and reorganize in response to external stimuli; therefore, tactile stimuli could generate brain changes. The objective of this study was to verify the feasibility of using fNIRS to measure the degree of brain oxygenation with tactile techniques in babies. Methods: Oxygenation was recorded continuously and bilaterally before, during, and after the interventions (massage protocol and Reflex Locomotion Therapy) with functional near-infrared spectroscopy in 11-week-old babies. Results: Preliminary data suggested that the massage intervention decreased the activity bilaterally (first minute of the intervention) and then increased it bilaterally (second minute), where it continued to increase in the left hemisphere (third minute) before decreasing bilaterally (fourth minute). Finally, the activity continued to decrease in the right hemisphere but increased in the most dorsal area of the left hemisphere (fifth minute). For the Reflex Locomotion intervention, the activity substantially increased bilaterally (first minute of the intervention) and then decreased bilaterally, but more pronouncedly in the left hemisphere (second minute). Then, the activity decreased to pre-intervention values (third minute) and increased bilaterally again, but pronouncedly in the right hemisphere (fourth minute). In the fifth minute, the activity in the right hemisphere drastically decreased, but it increased in the left hemisphere. During the post-intervention resting period, in the massage intervention, the activity increased in the right hemisphere and in the most ventral part of the left hemisphere; in Reflex Locomotion Therapy, the activity decreased only in the left hemisphere. Conclusions: Both techniques achieve a potential increase in oxyhemoglobin concentration bilaterally during stimulation, but while the effects decrease with Reflex Locomotion Therapy, the effects are maintained with massage. More studies are needed to establish the neurophysiological basis of these therapies in pediatrics. Full article

Objective: The aim of our study was to develop current local anthropometric measurement percentiles for newborns and to compare these values with national and international growth chart percentiles. Methods: This retrospective cross-sectional study evaluated the birth records of 17,693 infants born between 24 and 42 weeks of gestation at the Health Sciences University Istanbul Training and Research Hospital between January 2018 and December 2023. The following data were collected from the birth records: type of delivery, gender, gestational week, birth weight, birth length, head circumference, and the nationality of the infants. Percentile charts for weight, length, and head circumference were generated according to gender and gestational week. The 10th, 50th, and 90th percentiles of the local anthropometric measurement percentiles were compared with the national and the international growth charts. Results: The anthropometric measurements of 17,693 newborns were evaluated in this study. Of the included infants, 9589 (54.2%) were born by normal spontaneous delivery and 8104 (45.8%) by cesarean section. A total of 4955 (28%) of the infants were preterm and 12,738 (72%) were term; 8700 (49.2%) were female and 8993 (50.8%) male. When compared by gender, it was observed that the birth weights of boys were higher than girls at all gestational weeks, but the lengths and head circumferences of both genders were similar. When our weight, length, and head circumference percentiles by gestational week were compared with the Fenton growth charts, we found that our babies had higher average values in all percentiles. When compared with national growth charts, the weight, length, and head circumference measurements of our girls and boys were higher, especially under 38 weeks, and they had similar anthropometric measurements from 38 weeks onwards. When compared with the Fenton growth chart, the ranges of difference from the current values used in each week of pregnancy for the SGA cut-off values for girls and boys were found to be 30–290 g and 30–230 g, respectively, and those for the LGA cut-off values for girls and boys were 80–300 g and 95–230 g, respectively. Conclusions: Our study reveals the current birth weight, length, and head circumference percentile values in infants, including a large number of infants in our region. Notably, the generated regional growth curves differ from existing international standards, which may have significant implications for the accurate diagnosis and follow-up of SGA and LGA infants. We suppose that our current national data can serve as a valuable reference for future multicenter studies involving larger populations and contribute to the optimal assessment of growth parameters in pediatric health surveillance. Full article

Background/Objectives: Congenital cytomegalovirus (cCMV) infection is a significant cause of pediatric hearing loss. However, the prevalence and characteristics of cCMV-related hearing loss remain unclear. Methods: A comprehensive search of major databases (PubMed, Scopus, and Web of Science) was conducted to identify studies and reviews published between 2000 and 2024 that investigated cCMV infection, testing for cCMV, and pediatric hearing loss. Studies were included if they reported on the prevalence, characteristics, current policies, and recommendations for universal cCMV testing in newborns. Results: This review highlights key issues: cCMV is a significant and treatable cause of pediatric hearing loss; most cCMV-related hearing loss cases presented with bilateral and profound hearing impairment; and cCMV testing is performed only for babies who fail newborn hearing screening. Conclusions: This narrative review highlights the significant association between cCMV infection and pediatric hearing loss. Currently, targeted cCMV testing is recommended for newborns who fail newborn hearing screening. Universal cCMV testing may facilitate early diagnosis and directed intervention and could be cost-effective in the long run. Full article

Background: The analysis of posture in the early stages of motor development has always been a subject of research and study. With the evolution of new technologies, the need arises to implement evaluation tools that allow an objective and effective assessment of postural control, which is intrinsically linked to motor development. Objectives: The objective was to analyze posture in babies from 0 to 6 months in ventral and dorsal decubitus using artificial intelligence to determine objective parameters of postural assessment. Methods: The study is an observational and cross-sectional study. The babies will be studied following a systematic kinesiological assessment, and the images of the babies will be taken, both in ventral and dorsal decubitus, on a glass platform, to analyze their posture by means of deep learning techniques. Results: Many authors have investigated posture in newborns. However, there is no method for assessing motor and postural development to determine the support area of typically developing babies. Artificial intelligence is postulated as an effective tool to objectively analyze the posture of babies and detect possible delays. Using deep learning techniques as a predictive tool, the support areas of each baby will be defined according to their age. Conclusions: Early detection of motor or postural developmental delays in babies to optimize effective treatment is of great importance. Artificial intelligence can help manage the complexity and growing volume of data in healthcare by knowing the correct postural control at each stage of a baby’s early months, while reducing the workload of healthcare professionals by facilitating decision-making. Full article

Newborn Bloodspot Screening (NBS) can detect severe treatable health conditions with onset during infancy. The parents of a newborn baby are vulnerable in the days after birth, and the optimal way to deliver the shocking and distressing news of a potential serious diagnosis is yet to be defined. More data are needed to determine whether access to a genetic counsellor (GC) improves families’ experiences with genetic conditions identified by NBS. This study aimed to explore the similarities and differences for parents who received a positive NBS result for Spinal Muscular Atrophy (SMA) and received access to a GC (GC cohort), to a cohort of parents who received a diagnosis for inborn errors of metabolism (IEM) and did not have access to a GC (non-GC cohort). Semi-structured interviews explored the retrospective experiences of receiving the NBS result, including diagnosis implications and subsequent adaptation to respective genetic diagnoses. Inductive thematic analysis was used from group comparison. 7 SMA families and 5 IEM families were included in the study. Four themes were identified: 1. minimal pre-test counselling; 2. perceived lack of local healthcare team knowledge; 3. enabling factors for adaptation; 4. implications for both individuals and their families. Both the GC and non-GC cohorts reported insufficient counselling in the pre-test period and described feeling traumatised at the time of the diagnosis delivery. Families without subsequent GC input described limited understanding of the disease due to the use of medicalized terms, as well as a decreased understanding of reproductive options, familial communication and subsequent cascade screening. GCs can support information needs and adaptation following a NBS diagnosis. Full article

Background: Gestational trophoblastic diseases comprise the hydatiform moles (HMs), complete or partial, an abnormal development of trophoblastic tissue. HMs derive from a gametogenesis error during conception leading to an anomalous chromosomal asset. In the complete hydatiform mole (CHM), when one or two spermatozoa enter an empty oocyte, the karyotype, paternally derived, is diploid 46,XX or 46,XY. CHM is characterized by massive hydropic degeneration of the villi, with no fetal structures, easily detected by ultrasound (US) in early gestation, confirmed by elevated maternal beta-hCG levels. CHM with coexistent fetus (CHMCF) is an exceptional event with a high risk of malignant progression, and severe complications such as massive vaginal bleeding, preeclampsia, and fetal death. Methods/Results: We present a case of CHMCF in a 29-year-old woman, which resulted in a liveborn and healthy baby at 38 weeks of gestation. The patient was prenatally carefully monitored with biweekly US and periodic beta-hCG levels. Post-partum follow-up consisted of transvaginal US and beta-hCG levels at 1, 3, and 6 months. After 1 year post-delivery, both the mother and the newborn were healthy. Conclusions: CHMCF management can be challenging as shared guidelines are currently lacking and the case described may be helpful in adding more data. Full article

Newborns cry intensely, and most parents struggle to understand the reason behind their crying, as the baby cannot verbally express their needs. This makes it challenging for parents to know if their child has a need or a health issue. An embedded solution based on a Raspberry Pi is presented to address this problem. The module analyzes audio techniques to capture, analyze, classify, and remotely monitor a baby’s cries. These techniques rely on prosodic and cepstral features, such as MFCC coefficients. They can differentiate the reason behind a baby’s cry, such as hunger, stomach pain, or discomfort. A machine learning model was trained to anticipate the reason based on audio features. The embedded system includes a microphone to capture real-time cries and a display screen to show the anticipated reason. In addition, the system sends the collected data to a web server for storage, enabling remote monitoring and more detailed data analysis. A cell phone application has also been developed to notify parents in real time of why their baby is crying. This application enables parents to adapt quickly and efficiently to their infant’s needs, even when they are not around. Full article

Phthalates are widely used plasticizers that can leach from consumer products and pose potential health risks, particularly to infants whose developing systems are vulnerable to environmental toxicants. While various exposure pathways have been identified, the contribution of dermal absorption from disposable diapers remains inadequately characterized. This study recruited 66 infants from Guangzhou, a representative city in southern China. Paired disposable diaper and urine samples were collected from each participant. Six phthalates in the diapers and nine metabolites in the urine were quantitatively analyzed. The predominant phthalate detected in the diapers was bis-2-ethylhexyl phthalate (DEHP, with a median concentration of 1670 ng/g, range: 678–5200 ng/g), followed by di-n-butyl phthalate (DnBP, 948 ng/g, range: 189–5980 ng/g), di-iso-butyl phthalate (DiBP, 333 ng/g, range: 16.1–4910 ng/g), and diethyl phthalate (DEP, 252 ng/g, range: 116–3350 ng/g). In urine, metabolites of DEHP (mEHP, mEHHP, and mEOHP) were the most abundant (87.1 ng/mL), followed by mnBP (metabolites of DnBP, 44.6 ng/mL), mEP (metabolites of DEP, 33.7 ng/mL), and miBP (metabolites of DiBP, 13.9 ng/mL). A positive correlation was observed between DnBP levels in diapers and mnBP levels in urine (r = 0.259, p = 0.035). Additionally, several urinary metabolites (miBP, mnBP, and mEP) were positively associated with a biomarker of DNA oxidative damage, 8-hydroxydeoxyguanosine (r = 0.265–0.316, p < 0.01). The estimated daily uptake of DEP, DiBP, DnBP, and DEHP through dermal absorption from diapers accounted for 44.9%, 19.5%, 15.1%, and 7.76% of total exposure to these phthalates, respectively. These findings suggest that dermal absorption from diapers is a significant exposure pathway for infants. Given that both the amount of exposure and the contribution of dermal uptake are higher in younger infants, further attention is warranted to understand the potential effects of transdermal phthalate exposure on infant growth and development. Full article

Background: Sickle cell disease (SCD) is consequently associated with increased rates of infant and childhood morbidity and mortality. Therefore, early detection is a crucial aspect of managing SCD to mitigate complications and improve health outcomes for SCD children. Neonatal screening is the primary method for identifying newborns with SCD, enabling early diagnosis, family screening, and comprehensive medical care. The protocol presented in this paper describes a study aimed at screening newborns for SCD in high-prevalence SCD states of India to understand the magnitude of the problem and the benefits of early comprehensive care along with the genotypic and phenotypic correlation. Methods: A prospective cohort study will be conducted across seven sites in six states of India (Rajasthan, Odisha, Tamil Nadu, Maharashtra, Madhya Pradesh, and Gujarat), having a high prevalence of SCD. The cord blood or heel prick samples of all the live-born babies delivered within the facilities of selected regions will be collected for screening SCD by HPLC (High-Performance Liquid Chromatography). All the sickle cell homozygous (SS) babies will be confirmed at 6 weeks for Sickle genotype along with cascade screening. Further, SS babies will be followed up from six weeks up to five years of life with initiation of folic acid, antibiotic prophylaxis, and hydroxyurea treatment at appropriate times. Results: The protocol aims to lay the groundwork for the smooth implementation of newborn screening programs and effective follow-up strategies. Conclusions: It will pave the way for developing a strategic framework for implementing newborn screening programs for haemoglobinopathies in India. Full article

Invasive infection by Streptococcus agalactiae (GBS) is a significant cause of death in newborn babies. In Thailand, data on strain distribution in GBS, specific virulence genes, and susceptibility patterns are limited. Therefore, our study aimed to establish the sequence type (ST) distribution and to use a specific virulence gene in combination with a susceptibility profile for strain identification. Non-duplicate 277 isolates of GBS were tested for ST, virulence genes, and antimicrobial susceptibility profiles. Twenty-five STs were detected. The ST283 (29.24%) and ST1 (27.07%) were the most common STs. The absence of the bca gene was an excellent marker to rule out ST283. All isolates were susceptible to nearly all tested antibiotics; however, only ST283 revealed 100% susceptibility to tetracycline, while ST1 and other non-ST283 showed 21.33 and 4.96%, respectively. Therefore, combining the alpha-C protein (bca) positive and tetracycline susceptible revealed 100% sensitivity for ST283. However, to identify the ST283, this combination revealed 78.9% specificity, which increased to 80.2% when erythromycin or azithromycin-susceptible was added. The bca positive combined with tetracycline and erythromycin susceptibility results were a simple tool for predicting ST283. The bca negative profile with tetracycline and macrolides resistance was commonly non-ST283. The information gained by this tool would benefit patient management. Full article

ZIKA fever (ZIKAF) is an emerging mosquito-borne flavivirus illness in humans. Regarding the etiological agent, ZIKA virus (ZIKAV), though it is known to be distributed in the tropics, causing sporadic cases, its rapid global expansion with pandemic potential has raised global concern. Due to its abrupt emergence in South American countries, the Caribbean, and the Americas, the WHO declared ZIKA a public health emergency of international concern in 2016. ZIKAV usually causes mild infections; however, its recent unusual presentations of Guillen–Barré syndrome in adults and microcephaly in newborn babies of ZIKAV-infected mothers in Brazil has caused concern among global public health authorities. Certain mutations on virus genomes have been found to be correlated with clinical severity, and its unusual transmission routes through sexual and blood transfusions emphasize the necessity for understanding its virological determinants and impact. Its abrupt re-emergence in India (2018–2019), particularly in Gujarat (2016), Tamil Nadu (2017), Uttar Pradesh (2021), Maharashtra, Kerala (2021), and Karnataka (2023), has indicated the need for urgent measures to strengthen surveillance systems and design effective prevention and control measures in this country. Given the global concern around ZIKAV, here, we reviewed current knowledge about global ZIKAV genetic lineages vis à vis the situation in India and discussed future priorities for ZIKAV research in India for effectively designing control strategies. Full article

Background: In recent years, there has been an increase in the incidence of gestational diabetes (GDM) with serious risks for both mother and child. Pre-pregnancy BMI and physical activity significantly influence GDM development. Promoting a healthy lifestyle is essential to prevent GDM and improve health outcomes for mother and baby. Objective: The aim of this study was to evaluate the relationship between pre-pregnancy physical activity and pre-pregnancy BMI and the occurrence of gestational diabetes, as well as to assess their impact on the development of complications associated with gestational diabetes. Methods: A retrospective-prospective study was conducted from October 2024 to December 2024 at a tertiary referral hospital in Poland. The study included 205 pregnant women (42 with gestational diabetes, 163 without gestational diabetes) who met the inclusion criteria. Data were collected using a self-administered questionnaire and the Polish version of the Get Active Questionnaire for Pregnancy (GAQ-P). The impact of pre-pregnancy physical activity and pre-pregnancy BMI on the occurrence of gestational diabetes was assessed based on data collected from both surveys and medical records analysis. Statistical analyses included Pearson’s chi-square tests, logistic regression, and Cramér’s V coefficient to determine the relationship between pre-pregnancy physical activity and ppBMI and the occurrence of gestational diabetes. Results: The study revealed that pre-pregnancy BMI and gestational weight gain were significant predictors, with a higher BMI increasing the risk of gestational diabetes. In contrast, physical activity before pregnancy—including its frequency, intensity, and duration—was not a significant predictor. Additionally, no significant associations were found between physical activity and birth weight, mode of delivery, or preterm birth. These findings highlight the role of pre-pregnancy BMI in gestational diabetes risk while suggesting that physical activity before conception may have a limited impact. Conclusions: These results highlight the significant role of pre-pregnancy body mass index (BMI) in the development of gestational diabetes, emphasizing the need for targeted interventions aimed at maintaining a healthy weight before conception. They suggest that weight management strategies should be an important component of gestational diabetes prevention. Future research should further investigate the complex interaction between lifestyle factors and metabolic health to refine preventive recommendations and improve health outcomes for mothers and newborns. Full article