Search Results (345)

Down syndrome (DS), stemming from the triplication of human chromosome 21, results in intellectual disability, with early mid-life onset of Alzheimer’s disease (AD) pathology. Early interventions to reduce cognitive impairments and neuropathology are lacking. One modality, maternal choline supplementation (MCS), has shown beneficial effects on behavior and gene expression in neurodevelopmental and neurodegenerative disorders, including trisomic mice. Loss of basal forebrain cholinergic neurons (BFCNs) and other DS/AD relevant hallmarks were observed in a well-established trisomic model (Ts65Dn, Ts). MCS attenuates these endophenotypes with beneficial behavioral effects in trisomic offspring. We postulate MCS ameliorates dysregulated cellular mechanisms within vulnerable BFCNs, with attenuation driven by novel gene expression. Here, choline acetyltransferase immunohistochemical labeling identified BFCNs in the medial septal/ventral diagonal band nuclei of the basal forebrain in Ts and normal disomic (2N) offspring at ~11 months of age from dams exposed to MCS or normal choline during the perinatal period. BFCNs (~500 per mouse) were microisolated and processed for RNA-sequencing. Bioinformatic assessment elucidated differentially expressed genes (DEGs) and pathway alterations in the context of genotype (Ts, 2N) and maternal diet (MCS, normal choline). MCS attenuated select dysregulated DEGs and relevant pathways in aged BFCNs. Trisomic MCS-responsive improvements included pathways such as cognitive impairment and nicotinamide adenine dinucleotide signaling, among others, indicative of increased behavioral and bioenergetic fitness. Although MCS does not eliminate the DS/AD phenotype, early choline delivery provides long-lasting benefits to aged trisomic BFCNs, indicating that MCS prolongs neuronal health in the context of DS/AD. Full article

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

Childhood obesity is a growing global health concern, with established links to physical activity, nutrition, and, increasingly, to prenatal and perinatal factors. Emerging evidence highlights the significant role of maternal conditions such as obesity, comorbidities, nutrition, and environmental exposures in predisposing offspring to long-term metabolic and cardiovascular diseases. The “Developmental Origins of Health and Disease” (DOHaD) paradigm provides a framework for understanding how early life environmental exposures, particularly during the periconceptional, fetal, and neonatal periods, can program future health outcomes through epigenetic mechanisms. Epigenetic modifications alter gene expression without changing the DNA sequence and are increasingly recognized as key mediators in the development of obesity. This narrative review summarizes current findings on the early determinants of childhood obesity, emphasizing the molecular and epigenetic pathways involved. A comprehensive literature search was conducted across multiple databases and international sources, focusing on recent studies from the past decade. Both human and animal research were included to provide a broad perspective. This review aims to consolidate recent insights into early life influences on obesity, underscoring the need for preventive strategies starting as early as the preconception period. Full article

Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women’s autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women’s experiences and minimizing needless interventions require active decision-making participation, a positive provider–patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women’s experiences of consent can be more effectively understood through the use of instruments such as the Mothers’ Respect (MOR) Index and the Mothers’ Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice. Full article

Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article

Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress—up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of maternal mortality and are associated with adverse birth outcomes, including preterm birth and low birth weight. These risks are likely compounded in pregnancies involving fetal anomalies due to the intersecting psychological and social burdens that complicate maternal well-being and access to care. However, there is a critical gap in understanding how these mental health symptoms translate into diagnoses, treatments, and outcomes due to the absence of a validated screening tool tailored to this population’s unique psychosocial needs. This perspective article reviews evidence, highlights the urgent need for specialized screening, and introduces ongoing research aimed at developing and validating an instrument that integrates both mental health symptoms and broader psychosocial distress. By bridging this gap, structured psychosocial screening has the potential to improve care coordination, facilitate earlier intervention, and mitigate long-term distress for individuals navigating pregnancies affected by fetal anomalies. Full article

Background: Perinatal depression refers to a major depressive episode that begins during pregnancy or within four weeks after childbirth and persists through the first year postpartum. Perinatal depression is one of the most common complications of pregnancy, with significant adverse maternal and infant outcomes. Numerous reviews and policy guidelines have emerged from Canada; however, a bibliometric analysis that focuses not only on the international sources for perinatal depression research, but also on Canadian sources, has not been undertaken. Purpose: To provide insight on perinatal depression publications conducted by researchers affiliated with Canadian institutions, within an international context. Methods: A bibliometric analysis was performed using performance analysis and science mapping techniques, with data retrieved from Scopus until 31 December 2022. The analysis focused on original peer-reviewed publications, applying no language restrictions and ensuring at least one author was affiliated with a Canadian institution. VOSviewer version 1.6.20 was used to generate visual networks for analysis. Results: In total, there were 763 publications identified in 160 different journals. Among these publications, there were 123 institutions represented. At least one author was associated with a Canadian institution per publication. The University of Toronto had the highest frequency of affiliations (n = 313). Most publications (79.55%) occurred between 2011 and 2022, with 2021 as the year with the most publications (n = 80). The journal with the most publications was Archives of Women’s Mental Health (n = 57, 35.65%). Canadian institution-affiliated authors with the largest number of publications were Dennis (n = 57), Oberlander (n = 39), Meaney (n = 38), and Letourneau (n = 37). Conclusion: This is the first study mapping publications on perinatal depression research within a Canadian context. This bibliometric analysis provides a valuable reference for future research by identifying key authors, institutions, journals, and research areas that prioritize perinatal mental health. Full article

Background: Polysubstance use, particularly combining opioids with stimulants such as cocaine, is rising among individuals with substance use disorders. This practice aims to balance cocaine’s stimulant effects with opioids’ sedative effect, potentially decreasing adverse outcomes. We hypothesized that concurrent exposure to cocaine and opioids would reduce the risk of neonatal opioid withdrawal syndrome (NOWS) compared to opioid use alone. Methods: This analysis draws from an ongoing prospective study of maternal substance use (SUD) at Regional One Health’s perinatal center in Memphis, TN, and included mothers and their infants born between 2018 and 2022. Maternal SUD was identified via screening questionnaires, urine toxicology, or umbilical cord tissue analysis. Participants were grouped into using (a) opioids with cocaine (OwC) and (b) opioids without cocaine (OwoC). Univariate and regression analyses were conducted to assess the risk of NOWS. Results: A total of 353 infants were born to 342 mothers, with 31% (110/353) of the infants born to women who used cocaine along with opioids. While maternal demographics were similar, the OwC group had significantly lower rates of prenatal care, chronic pain history, and MOUD enrollment (p = 0.03). Infants in the OwC group had significantly higher rates of NOWS (p < 0.01), longer hospital stays (p < 0.01), and 6.5 times greater odds of developing NOWS (p < 0.001). NOWS was associated with an average 15-day increase in the length of stay for term infants (95% CI: 11.2, 18.8; p < 0.001). Conclusions: Contrary to our hypothesis, our study highlights the significant impact of maternal cocaine use on the increased likelihood of NOWS and extended hospital stays for affected infants. Full article

Maternal mortality and morbidity are critical health challenges in the U.S., and building the perinatal workforce is a key to providing high-quality maternal medical care and services. Texas Southern University (TSU), home to a Doctor of Pharmacy program, launched the first Maternal Health Education and Research Training (MHERT) program to educate a cohort of high school, pharmacy, and health sciences students. Aiming to raise awareness of maternal health issues, build research skills, and promote action-based solutions. MHERT integrated online self-paced interactive lessons with hands-on research or community projects. Topics included maternal health epidemiology, causes of morbidity and mortality, research methods, literature reviews, and the development of action plans addressing maternal health challenges. Assessment tools included quizzes, open-ended reflection responses, training surveys, and course evaluations. Running from 3 June to 26 July 2024, the program enrolled 22 students. All participants completed both course components. Course evaluations showed strong and consistent satisfaction with the program, with teaching effectiveness rated at 95% and 96% for mid-program and final evaluations, respectively. MHERT enhanced participants’ understanding of maternal health, improved research skills, and encouraged community engagement and interdisciplinary collaboration. It offers a scalable model to strengthen public health education among high school, pharmacy, and health sciences students. Full article

Background: Vitamin D is increasingly recognized not only for its role in skeletal development but also for its immunomodulatory and gastrointestinal effects. Maternal and neonatal vitamin D deficiency (VDD) has been associated with alterations in gut microbiota, impaired intestinal barrier integrity, and increased susceptibility to inflammatory conditions in neonates. However, the exact mechanisms linking perinatal vitamin D status to neonatal gastrointestinal morbidity remain incompletely understood. Methods: This review synthesizes current evidence (2015–2024) from clinical studies, animal models, and mechanistic research on the impact of VDD during pregnancy and the neonatal period on gastrointestinal health. Databases such as PubMed, Scopus, and Web of Science were systematically searched using keywords, including “vitamin D”, “neonate”, “gut microbiome”, “intestinal barrier”, and “necrotizing enterocolitis”. Results: Emerging data suggest that VDD in utero and postnatally correlates with dysbiosis, increased intestinal permeability, and elevated inflammatory responses in neonates. Notably, low 25(OH)D levels in mothers and newborns have been linked with a higher incidence of necrotizing enterocolitis (NEC), delayed gut maturation, and altered mucosal immunity. Vitamin D appears to modulate the expression of tight junction proteins, regulate antimicrobial peptides, and maintain microbial diversity through the vitamin D receptor (VDR). Conclusions: Understanding the gastrointestinal implications of early-life VDD opens a potential window for preventive strategies in neonatal care. Timely maternal supplementation and targeted neonatal interventions may mitigate gut-related morbidities and improve early-life health outcomes. Further longitudinal and interventional studies are warranted to clarify causality and optimal intervention timing. Full article

Background/Objectives: Postpartum depression (PPD) affects approximately 10–20% of women during and after pregnancy, posing significant risks to maternal health, infant development, and family dynamics. Identifying modifiable risk factors is essential for prevention. Emerging evidence suggests that vitamin D, a neuroactive steroid hormone involved in neurotransmitter synthesis, neuroinflammation regulation, and calcium homeostasis, may play a protective role against mood disorders, including PPD. Methods: The search was conducted through a comprehensive search of the PubMed, Scopus, and Web of Science databases using a combination of Medical Subject Headings (MeSH) and free-text terms including “vitamin D”, “25-hydroxyvitamin D”, “deficiency”, “pregnancy”, “postpartum”, “depression”, “antenatal depression”, “maternal mental health”, and “perinatal mood disorders”. Results: Numerous observational studies and systematic review reports around the world reinforce the potential global relevance of vitamin D insufficiency. This study advances personalized and precision medicine approaches by emphasizing the importance of individualized screening for vitamin D deficiency during pregnancy and postpartum, enabling tailored interventions that could mitigate the risk of postpartum depression. Conclusions: In conclusion, while a definitive causal relationship between vitamin D deficiency and perinatal depression remains unproven, screening for vitamin D levels during pregnancy could serve as a low-risk intervention to support maternal mental health. Future research should focus on well designed, large-scale randomized trials and standardization of diagnostic criteria to clarify vitamin D’s role in preventing perinatal depression. Recognizing vitamin D status as a modifiable biomarker allows for targeted nutritional and pharmacological strategies to optimize maternal mental health. Full article

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

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Objectives: The present study evaluated anthropometry Z-scores of exclusively breastfed infants aged 0~6 months and examined their associations with various parent–infant factors. Methods: This cross-sectional study included 383 mother–infant dyads from 10 Chinese cities in the final analyses, under strict inclusion and exclusion criteria. Data were collected by trained investigators using questionnaires covering demographic characteristics, perinatal health, maternal and infant factors during lactation. Nutrient intake was assessed and calculated by 24 h recall. Anthropometric measurements of parents and infants were taken using calibrated instruments, with infant growth assessed via Chinese growth standards. Statistical analyses included correlation and linear mixed-effect models accounting for regional clustering, with variable selection guided by backward elimination step regression. Nonlinear relationships were explored using spline and piecewise regression methods. Results: Over 60% of the mothers had inadequate energy and protein intake. Approximately two-thirds of the participants had fat intakes exceeding the upper limit. Inadequate or excessive gestational weight gain, poor maternal sleep quality, lactational mastitis, higher maternal fat intake and infant gastrointestinal symptoms were associated with lower infant anthropometry Z-scores. A threshold effect was detected between maternal fat intake and infant WAZ, BMI Z, and WLZ. Conclusions: This study found that anthropometry Z-scores of exclusively breastfed infants aged 0–6 months were significantly associated with certain maternal–infant factors and maternal fat intake, emphasizing the need for early intervention on adverse factors and balanced maternal diet nutrition during lactation. Full article

Background and Objectives: Evidence regarding how dispositional traits, antenatal anxiety, substance use, and obstetric events converge to shape post-partum depression (PPD) in South-East Europe is limited. We analysed 102 third-trimester women and followed them to six weeks post-partum, and 102 age-matched community controls were used to (i) compare baseline psychological profiles, (ii) chart antenatal-to-post-partum symptom trajectories, and (iii) build an integrated model of clinically relevant PPD (Edinburgh Post-natal Depression Scale, EPDS ≥ 12). Materials and Methods: All 96 raw variables were forward–backward translated from Romanian, reconciled, and harmonized. The principal instruments used were EPDS, State–Trait Anxiety Inventory form Y (STAI-Y), Revised Obsessive–Compulsive Inventory (OCI-R), NEO Five-Factor Inventory (NEO-FFI-60), and the four-item Maternal Worry and Satisfaction Scale (MWSS). Results: Groups were age-matched (31.1 ± 5.4 vs. 30.3 ± 5.1 years, p = 0.268) but differed in urban residence (39% vs. 17%, p = 0.001) and current substance use (smoking 21% vs. 34%, p = 0.041; alcohol 6% vs. 22%, p = 0.002). Of five personality domains, only openness scored lower in peripartum women (26.1 ± 4.6 vs. 29.3 ± 5.2, p < 0.001). State anxiety rose significantly from pregnancy to puerperium (+5.1 ± 8.4 points, p < 0.001). Post-partum EPDS correlated most strongly with state anxiety (r = 0.62) and neuroticism (r = 0.50). A final model (pseudo-R² = 0.30) identified post-partum state anxiety (OR 1.10 per point, 95% CI 1.05–1.15, p < 0.001) as the independent predictor; neuroticism showed a trend (OR 1.08, p = 0.081). Obstetric factors (prematurity, birth weight, caesarean section) were not significant. Conclusions: In this Romanian cohort, heightened state anxiety—in synergy with high neuroticism and lower openness—dominated the risk landscape of early onset PPD, whereas delivery mode and neonatal status were neutral. Routine perinatal mental health screening should therefore incorporate anxiety metrics alongside depression scales and brief trait inventories to refine preventive targeting. Full article