Incidence of Autism Spectrum Disorder (ASD) is increasing across the globe and no data is available from India regarding the risk factors of ASD. In this regard a questionnaire based epidemiological assessment was carried out on prenatal, perinatal and neonatal risk factors of ASD across 8 cities in India. A retrospective cohort of 942 children was enrolled for the study. 471 children with ASD, under age of 10, were analyzed for pre-, peri-, and neonatal factors and were compared with the observations from equal number of controls. The quality control of the questionnaire and data collection was done thoroughly and the observations were computed statistically. A total of 25 factors were evaluated by unadjusted and adjusted analysis in this study. Among the prenatal factors considered, advanced maternal age, fetal distress and gestational respiratory infections were found to be associated with ASD and had an odds ratio of 1.8. Evaluation of perinatal and neonatal risk factors showed labor complications, pre-term birth, neonatal jaundice, delayed birth cry and birth asphyxia to be associated with ASD with an odds ratio greater than 1.5. This important study, first of its kind in Indian population gives a firsthand account of the relation of pre-, peri- and neonatal risk factors on ASD from an ethnically and socially diverse country like India, the impact of which was unknown earlier. This advocates additional focused investigations on physiological and genetic changes contributed by these risk factor inducing environments. 相似文献
Objective: The present study explored differences in mental health between women who experienced a trauma which involved a loss of fetal or infant life compared to women whose trauma did not involve a loss (difficult childbirth). Method: The sample consisted of 144 women (mean age = 31.13) from the UK, USA/Canada, Europe, Australia/New Zealand, who had experienced either stillbirth, neonatal loss, ectopic pregnancy, or traumatic birth with a living infant in the last 4 years. Results: The trauma without loss group reported significantly higher mental health problems than the trauma with loss group (F (1,117) = 4.807, p = .03). This difference was observed in the subtypes of OCD, panic, PTSD and GAD but not for major depression, agoraphobia and social phobia. However, once previous mental health diagnoses were taken into account, differences between trauma groups in terms of mental health scores disappeared, with the exception of PTSD symptoms. Trauma groups also differed in terms of perceived emotional support from significant others. Conclusion: The findings illustrate the need for a change in the focus of support for women’s birth experiences and highlighted previous mental health problems as a risk factor for mental health problems during the perinatal period. 相似文献
The potential neuroprotection of nicotinamide on the consequences of perinatal asphyxia was investigated with triple organotypic
cultures. Perinatal asphyxia was induced in vivo by immersing foetuses-containing uterine horns removed from ready-to-deliver
rats into a water bath for 20 min. Sibling caesarean-delivered pups were used as controls. Three days later tissue from substantia
nigra, neostriatum and neocortex was dissected and placed on a coverslip. After a month, the cultures were processed for immunocytochemistry
and phenotyped with markers against the NMDA receptor subunit NR1, tyrosine hydroxylase (TH), or neuronal nitric oxide synthase
(nNOS). Some cultures were analysed for cell viability. Nicotinamide (0.8 mmol/kg, i.p.) or saline was administered to asphyxia-exposed
and caesarean-delivered control pups 24, 48 and 72 h after birth. Perinatal asphyxia produced a decrease of cell viability
in substantia nigra, but not in neostriatum or neocortex. Immunocytochemistry confirmed the vulnerability of the substantia
nigra, demonstrating that there was a significant decrease in the number of NR1 and TH-positive (+) cells/mm2, as well as a decrease in the length of TH+ processes, suggesting neurite atrophy. In control cultures, many nNOS+ cells were seen, with different features, regional distribution and cell body sizes. Following perinatal asphyxia, there
was an increase in the number of nNOS+ cells/mm2 in substantia nigra, versus a decrease in neostriatum including reduced neurite length, and no apparent changes in neocortex.
The main effect of nicotinamide was seen in the neostriatum, preventing the asphyxia-induced decrease in the number of nNOS+ cells and neurite length. Nicotinamide also prevented the effect of perinatal asphyxia on TH-positive neurite length. The
present results support the idea that nicotinamide can prevent the effects produced by a sustained energy-failure condition,
as occurring during perinatal asphyxia.
The contribution of VK and PM has been equally relevant. 相似文献
As estimated from the number of published studies, in Poland the research into the perinatal care experiences of women with low vision or total blindness remains limited.
Objectives
The purpose of the study was to fill this gap by investigating satisfaction with perinatal care received by women with visual impairment in four city hospitals in Warsaw, Poland, and to recommend, if required, modifications in midwives' education and care standards based on the women's perceptions and expectations.
Methods
Hour-long interviews were conducted between 30 August 2014 and 2 September 2015 with 16 blind or low vision women in perinatal care, audio-recorded and transcribed verbatim. The accounts were subsequently evaluated using the Interpretative Phenomenological Analysis (IPA) approach. Five major themes were pre-selected: perceived stigma and lack of affirmation for the interviewee's motherhood, accessibility of childbirth preparation, accessibility of perinatal care and hospital facilities, midwives' attitudes and the interviewees' expectations for care improvements.
Results
Overall, the accounts demonstrated the lack of satisfaction with the quality of perinatal care, including the childbirth preparation classes, hospital facilities and hospital staff approach as not actually meeting specific functional needs. They also suggested how the quality of care could be improved.
Conclusions
Specific standards and procedures for perinatal care for women who are blind or have low vision should be developed and introduced in clinical practice in Poland based on research into the experiences of these women. Also, the training of health care professionals should be modified and their attitudes changed to meet maternal needs. 相似文献
Objective: To evaluate whether early folic acid or multivitamin supplementation during pregnancy prevents diagnosis of hyperkinetic disorders (HKD), treatment for attention deficit hyperactivity disorder (ADHD), and ADHD-like behaviors reported by parents participating in the DNBC for children at age 7.
Methods: HKD diagnosis and ADHD medication use data were obtained from the Danish National Hospital, Central Psychiatric and Pharmaceutical registers. We estimated hazard ratios (HRs) for HKD diagnosis and ADHD medication use and risk ratios (RRs) for parent-reported ADHD behavior collected with the Strength and Difficulties Questionnaire (SDQ), comparing children whose mothers took folic acid or multivitamin supplements early in pregnancy defined as starting periconceptionally (4 weeks prior to their last menstrual period (LMP)) through 8 weeks after their LMP (4–8 weeks), to children whose mothers indicated no supplement use for the same entire period.
Results: We identified 384 children (1.1%) with a hospital diagnosis for HKD and 642 children (1.8%) treated with ADHD medication. We found no association between risk of HKD diagnosis or intake of ADHD medication and early maternal folic acid use. However, early multivitamin use was associated with an approximately 30% reduction in risk for HKD diagnosis (aHR: 0.70, 95% CI: 0.52–0.96) and 21% reduction in treatment with ADHD medication (aHR: 0.79, 95% CI: 0.62–0.98). We observed a reduced risk in parent-reported ADHD behaviors, but these results were attenuated after adjustment.
Conclusion: Our data suggest that multivitamin use in early pregnancy may reduce risk for HKD diagnosis and treatment for ADHD in the offspring. 相似文献
ABSTRACTThis article makes a review and reflection on parenting practices and child development in the perinatal period; the theoretical foundations and recent data in the field are exposed. Spanish and international research in this emerging area indicates that pregnancy, postpartum and early parenting are opportunities and unique spaces to develop competencies to create family contexts that promote healthy development. An exhaustive positive parenting proposal of early promotion of child development in the perinatal period is presented. This includes the promotion of: prenatal bond, couple's relationship, social support networks, the physical and mental health of the mother alongside with the support to make informed decisions about parenting and the development of parental knowledge of the intergenerational transmission of parenting patterns and of early childhood development. It is expected, that the proposal could be a tool in the future design of public intervention programmes with families. 相似文献