The role of maternal attachment in children's attachment and cognitive executive functioning: A preliminary study

The influence of maternal attachment on children's attachment and executive functioning skills through maternal sensitivity and decentered tutoring were studied in 40 middle-class mother–child dyads. Infant attachment security in the Strange Situation Procedure was related to maternal attachment security, evaluated with the Adult Attachment Interview. When the children were six–seven months of age, maternal sensitivity was evaluated. When the child was six years old, maternal decentered tutoring and the children's executive functioning were evaluated. Regression analyses indicated that maternal tutoring accounted for the association between maternal attachment and child cognitive functioning, whereas maternal sensitivity accounted for the association between maternal and child attachment.     

Predictability of Macrosomic Birth based on Maternal Factors and Fetal Aneuploidy Screening Biochemical Markers in Hyperglycemic Mothers

Background: Macrosomic birth weight has been implicated as a significant risk factor for developing various adult metabolic diseases such as diabetes mellitus and coronary heart diseases; it has also been associated with higher incidences of complicated births. This study aimed to examine the predictability of macrosomic births in hyperglycemic pregnant women using maternal clinical characteristics and serum biomarkers of aneuploidy screening performed in the first half of pregnancy.Methods: A retrospective observational study was performed on a cohort of 1,668 pregnant women who 1) had positive outcomes after undergoing 50-g oral glucose challenge test (OGCT) at two university-based hospitals and 2) underwent any one of the following maternal biomarker screening tests for fetal aneuploidy: triple test, quadruple test, and integrated test. Logistic regression-based models for predicting macrosomic births using maternal characteristics and serum biomarkers were developed and evaluated for prediction power. A nomogram, which is a graphical display of the best predictable model, was then generated.Results: The study cohort included 157 macrosomic birth cases defined as birth weight ≥3,820 g, which was equivalent to the top 10 percentile of the modeling cohort. Three primary models solely based on serum biomarkers achieved area under curves (AUCs) of 0.55-0.62. Expanded models, including maternal demographic and clinical factors, demonstrated an improved performance by 25% (AUCs, 0.69-0.73).Conclusion: Our prediction models will help to identify pregnancies with an elevated risk of macrosomic births in hyperglycemic mothers using maternal clinical factors and serum markers from routine antenatal screening tests. Prediction of macrosomic birth at mid-pregnancy may allow customized antenatal care to reduce the risk of macrosomic births.     

Predictors of maternal mortality in institutional deliveries in Nigeria

Background

Maternal mortality in poor countries reflects the under-development in these societies. Global recognition of the burden of maternal mortality and the urgency for a reversal of the trend underpin the Millenium Development Goals (MDGs).

Objective

To determine risk factors for maternal mortality in institutional births in Nigeria.

Method

Twenty one health facilities in three states were selected using stratified multi-stage cluster sampling strategy. Information on all delivered mothers and their newborn infants within a three-month period was culled from medical records.

Results

A total of 9 208 deliveries were recorded. About one-fifth (20.5%) of women had no antenatal care while 79.5% had at least one antenatal visit during pregnancy. Four-fifths (80.5%) of all deliveries were normal deliveries. Elective and emergency caesarean section rates were 3.1% and 11.5% respectively. There were 79 maternal deaths and 8 526 live births, giving a maternal mortality ratio of 927 maternal deaths per 100 000 live births. No antenatal care, parity, level of education, and mode of delivery were significantly associated with maternal mortality. Low maternal education, high parity, emergency caesarean delivery, and high risk patients risk independently predicted maternal mortality.

Conclusion

Meeting goal five of the MDGs remains a major challenge in Nigeria. Multi-sectoral approaches and focused political will are needed to revert the high maternal mortality.     

Maternally separated rats show deficits in maternal care in adulthood

Although there is considerable research on the phenomenology, neuroendocrinology, neuroanatomy, and sensory control of maternal behavior, little is known about the influences of early postnatal and postweaning experiences on the development of maternal behavior. The purpose of this study was to assess how early life separation from the mother rat affects development of the offspring's juvenile and adult maternal behavior. From postnatal Days 1 to 17, 3 female rats within each litter were separated (SEP) from the mother and the rest of the litter for 5 hr daily while 3 of their sisters were not maternally separated (NSEP). On postnatal Day 21, all subjects were weaned and randomly assigned to one of three juvenile conditions. One female from both SEP and NSEP groups was either isolated (I), given a social conspecific (S), or given 1- to 4-day-old pups (P) for 5 consecutive days. Maternal behavior of SEP and NSEP animals was assessed and recorded on each of the 5 days. Once all animals reached adulthood, they were mated, gave birth, and were assessed for their maternal behavior. We found that the effects of maternal separation on juvenile maternal-like behaviors were minimal. On the other hand, maternal separation reduced adult maternal licking and crouching over pups. In addition, there was a significant interaction between postnatal and juvenile experience on maternal crouching in maternal animals. These results are discussed in terms of the variety of possible behavioral, endocrine, and neurochemical mechanisms that mediate the effects of early life experiences on adult maternal behavior.     

Children's Internalizing and Externalizing Behaviors and Maternal Health Problems

Examined the impact of a range of health related constructsreflecting maternal physical symptomatology, health servicesutilization, subjective health status, depressed mood, medical-psychologicalcomplaints, and marital adjustment on children's internalizingand externalizing behavior problems in a community sample (N= 145). Physical symptomatology predicted a general second-orderlatent factor of children's behavior problems. Depressed moodpredicted a primary latent factor of internalizing child behaviorproblems. Seizure symptoms, and more health problems in thelast 4 years specifically predicted child psychosomatic complaints/anxiety.Thus, general physical symptoms predicted a broad spectrum ofproblem behaviors, whereas specific mental or physical healthproblems predicted similar distinct problem behavior syndromes.Implications of these results for identifying children at riskfor psychopathology, and the relevance of social learning theoryand a broader based family systems approach are discussed.     

Maternal memory in adult, nulliparous rats: effects of testing interval on the retention of maternal behavior

The retention of maternal behavior (i.e., maternal memory) was measured in adult, nulliparous rats induced to respond maternally by continuous exposure to foster pups. Specifically, the effects of the interval duration between the initial induction and the reinduction of maternal behavior were determined. Intact virgin rats were first exposed to foster young to induce maternal behavior. During the initial induction phase, females were required to be fully maternal on 2 consecutive test days. Animals were then assigned to one of three interval groups (10, 20, or 40 days). After being isolated from rat pups for these designated periods, females in each group were tested again for their latencies to induce maternal behavior. Whereas the initial median latencies to display full maternal behavior ranged from 4.5 to 5 days for each group, upon retesting, median latencies for each group declined to 1 to 4 days. The greatest reduction in latency was present in the 10-day group (80%), and the smallest reduction was detected in the 40-day group (20%). A significant negative linear correlation was found between test interval and percentage reduction in behavioral latency. Based upon this relationship and under these test conditions, "maternal memory" in the adult, nulliparous rat would be expected to be nondetectable after about an interval of 50 days between tests. The pattern of maternal memory acquisition and loss appears similar to that reported in parous animals. The present study highlights similarities and possible differences underlying the establishment of the retention of maternal behavior (i.e., maternal memory).     

Maternal ornithine transcarbamylase deficiency,a genetic condition associated with high maternal and neonatal mortality every clinician should know: A systematic review

Ornithine transcarbamylase deficiency (OTCD) is a rare X‐linked urea cycle disorder. Maternal OTCD can lead to life‐threatening hyperammonemia if untreated. We aimed to compare the outcomes of maternal OTCD when diagnosis is known prior to pregnancy to when diagnosis is made during pregnancy. We performed a systematic literature review on maternal OTCD using the databases Ovid MEDLINE and PubMed from 1982 through 2018. Studies were included if addressed maternal OTCD signs, symptoms, and detailed pregnancy outcomes. We calculated the median or the mean for continuous variables and percentages for categorical variables. Of 36 cases of maternal OTCD, 20 (55%) were diagnosed prior to pregnancy while 16 (45%) were not. In the 20 patients diagnosed prior to pregnancy, 7 (35%) had either a neurologic or psychiatric presentation during pregnancy or postpartum. Two hyperammonemic patients (11%) experienced ICU admission, dialysis, and coma with no maternal deaths. All had a favorable outcome. In the 16 patients not known to have maternal OTCD prior to pregnancy, 13 (81%) had neurologic or psychiatric presentation during pregnancy or postpartum. Four presented with hyperemesis gravidarum. Eleven (69%) hyperammonemic patients had ICU admission and coma and 7 (47%) of them had dialysis. There were 5 (31%) maternal deaths. Three patients (19%) had prolonged hospitalization course. Overall, three male neonatal deaths were reported. Three other male children had liver transplant. Maternal OTCD is associated with high maternal and neonatal morbidity and mortality when diagnosis is made during pregnancy compared to when diagnosis is known prior to pregnancy.     

The role of sociodemographic risk and maternal behavior in the prediction of infant attachment disorganization

Predictors of infant attachment disorganization were examined among 203 primiparous mothers (52% European American, 48% African American) and their infants (104 female). The Strange Situation Procedure was administered at one year. Global maternal insensitivity and overtly negative maternal behavior were observed during distress-eliciting tasks when infants were six months and one year old. Mothers reported on their demographics to yield a measure of sociodemographic risk (i.e., age, education, income-to-needs). Overtly negative maternal behavior was positively associated with the infant attachment disorganization rating scale score, but did not predict being classified as disorganized. Global maternal insensitivity was associated with higher attachment disorganization, both the rating and the classification, when sociodemographic risk was high but not when sociodemographic risk was low. The pattern of results did not vary by maternal race. The results provide some support for the view that negative maternal behavior and the combination of sociodemographic risk and global maternal insensitivity play a role in the development of infant attachment disorganization.     

Maternal distress across the postnatal period is associated with infant secretory immunoglobulin A

Employing a longitudinal design, relationships between maternal distress (i.e., perceived stress, negative affect, depressive symptomology), and infant secretory immunoglobulin A (sIgA) across the peripartum period were examined in 51 mother–infant dyads. Indices of maternal distress were assessed at four time periods: third trimester of pregnancy and 1, 3, and 6 months postpartum. Infant saliva samples were collected at each of the three time points in the postpartum period to assess sIgA levels. No relationships were found between prenatal maternal distress and infant sIgA. Results indicated that during the postnatal period, higher concurrent maternal distress was associated with reduced infant sIgA. Maternal distress did not prospectively predict infant sIgA. These findings advance our understanding of the social-context of infant development, highlighting the significance of maternal regulation of infant immunity.     

Maternal attachment and mind-mindedness: the role of emotional specificity

We explored the relation between maternal mind-mindedness (i.e., a mother’s tendency to verbally refer to her infant’s mental world through use of infant-directed mental state terms) and maternal attachment. Mothers (N = 76), classified prenatally as Autonomous, Dismissing, Preoccupied, and Unresolved using the Adult Attachment Interview (AAI), simulated speaking to their 6-month-old infants in positive and negative emotion contexts. Mothers’ utterances were coded for frequency of use of emotion and cognition-related mind-minded terms. Results indicated a significant negative relation between coherence of mind scores on the AAI and emotion mind-mindedness in the positive emotion context. When differences between insecure attachment categories and mind-mindedness were explored, results indicated that mothers with Preoccupied attachments were significantly more likely to use emotion-related terms than mothers with Dismissing attachments and that these differences were most pronounced in the negative emotion context. A similar pattern was found for mothers with Unresolved attachments compared to those with organized (Autonomous, Dismissing, Preoccupied) attachment classifications, however use of emotion mind-minded terms did not differ by emotional context. Future research directions highlighting the importance of exploring the unique contribution of Preoccupied, Dismissing and Unresolved attachment and emotional context in the exploration of mind-mindedness are discussed.     

母亲行为与儿童行为问题的探讨

目的 :探讨母亲行为与儿童行为问题之间的关系。方法 :以山东省 765名 6-11岁儿童的母亲为被试 ,采用Achenbach’s儿童行为量表 (CBCL)和母亲行为问卷分别对儿童及其母亲进行评定。结果 :儿童行为问题的检出率为 12 0 % ,有行为问题儿童母亲的支持行为显著低于正常儿童 ,有行为问题儿童母亲的不支持行为显著高于正常儿童。结论 :母亲的不支持行为增加儿童的行为问题 ,母亲支持行为减少儿童的行为问题。母亲行为对儿童的行为问题有显著影响     

Maternal stress and behavior modulate relationships between neonatal stress, attention, and basal cortisol at 8 months in preterm infants

There is evidence that the developmental trajectory of cortisol secretion in preterm infants is altered, with elevated basal cortisol levels observed postnatally through at least 18 months corrected age (CA). This alteration is possibly due to neonatal pain-related stress. High cortisol levels might contribute to greater risk of impaired neurodevelopment. Since maternal factors are important for the regulation of infant stress responses, we investigated relationships between infant (neonatal pain-related stress, attention, cortisol) and maternal (stress, interactive behaviors) factors at age 8 months CA. We found that interactive maternal behaviors buffered the relationship between high neonatal pain-related stress exposure and poorer focused attention in mothers who self-reported low concurrent stress. Furthermore, in preterm infants exposed to high concurrent maternal stress and overwhelming interactive maternal behaviors, higher basal cortisol levels were associated with poor focused attention. Overall, these findings suggest that maternal factors can influence the cognitive resilience at 8 months of preterm infants exposed to early life stress.     

Color atlas of genetics, 2nd edition,by Eberhard Passarge

In 1997, Narchi and Kulaylat, studying the incidence of Down syndrome in infants of gestational diabetic mothers, concluded that maternal diabetes increases the risk for Down syndrome, but failed to control the maternal age in their analysis. Using data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), we analyzed the relationship between Down syndrome and maternal diabetes mellitus, and maternal gestational diabetes, controlling the maternal age through the pair‐matching analysis, stratifying by maternal age and logistic regression analysis. The analyses show that maternal age is related either to Down syndrome as well as to both types of maternal diabetes. Thus, the overall analysis could be confounded by maternal age. Once we controlled the maternal age, the risk of maternal diabetes mellitus for Down syndrome is: odds ratio (OR) = 0.92 (0.41–2.07); P = 0.83. Controlling maternal age in gestational diabetes, the risk is OR = 1.18 (0.61–2.35); P > 0.70. Based on our results, we conclude that Down syndrome is related to maternal age, but does not seem to be related to any type of maternal diabetes. © 2002 Wiley‐Liss, Inc.     

Maternal and littermate deprivation disrupts maternal behavior and social-learning of food preference in adulthood: tactile stimulation, nest odor, and social rearing prevent these effects

Maternal and littermate (social) separation, through artificial rearing (AR), disrupts the development of subsequent maternal behavior and social learning in rats. The addition of maternal-licking-like stimulation during AR, partially reverses some of these effects. However, little is know about the role of social stimuli from littermates and nest odors during the preweaning period, in the development of the adult maternal behavior and social learning. The purpose of this study was to examine the effects of peer- and peer-and-odor rearing on the development of maternal behavior and social learning in rats. Female pups were reared with mothers (mother reared-MR) or without mothers (AR) from postnatal day (PND) 3. AR rats received three different treatments: (1) AR-CONTROL group received minimal tactile stimulation, (2) AR-ODOR females received exposure to maternal nest material inside the AR-isolation-cup environment, (3) AR-SOCIAL group was reared in the cup with maternal nest material and a conspecific of the same-age and same-sex and received additional tactile stimulation. MR females were reared by their mothers in the nest and with conspecifics. In adulthood, rats were tested for maternal behavior towards their own pups and in a social learning task. Results confirm our previous report that AR impairs performance of maternal behavior and the development of a social food preference. Furthermore, social cues from a littermate, in combination with tactile stimulation and the nest odor, reversed the negative effects of complete isolation (AR-CONTROL) on some of the above behaviors. Exposure to the odor alone also had effects on some of these olfactory-mediated behaviors. These studies indicate that social stimulation from littermates during the preweaning period, in combination with odor from the nest and tactile stimulation, contributes to the development of affiliative behaviors.     

Prevalence and risk factors for Down syndrome: A hospital‐based single‐center study in Western Mexico

Although Hispanics of Mexican origin in the United States have been identified as a population with a particularly higher rate of Down syndrome (DS), there is a paucity of studies concerning this topic in Mexico. The aim of this study was to determine the prevalence and risk factors for DS in a population from Western Mexico. For prevalence, 230 liveborn infants with DS were included from a total of 89,332 births occurring during the period 2009–2017 at the Dr. Juan I. Menchaca Civil Hospital of Guadalajara (Mexico). In order to evaluate potential DS risks, a case‐control study was conducted among 633 newborns, including those 211 DS patients with full trisomy 21 (cases) and 422 infants without birth defects (controls). Data were analyzed using multivariable logistic regression analysis. The overall prevalence for DS was 25.7 per 10,000 (95% confidence interval [95% CI]: 22.4–29.1). Patients with DS had a significantly higher risk for family history of DS in distant relatives (adjusted odds ratio [aOR] = 4.4, 95% CI: 2.5–7.7), relatives with thyroid disease (aOR = 2.3, 95% CI: 1.2–4.0), maternal age ≤ 19 years (aOR = 5.1, 95% CI: 2.7–9.6) or ≥ 35 years (aOR = 3.3, 95% CI: 1.5–6.9), paternal age ≤ 19 years (aOR = 3.5, 95% CI: 1.7–7.4), pre‐pregnancy BMI ≥ 25 kg/m² (aOR = 1.6, 95% CI: 1.0–2.4), and pre‐pregnancy alcohol consumption (aOR = 1.8, 95% CI: 1.1–2.9). The identified risks in family history, and previously mentioned nutritional disadvantages were associated with DS in our sample and probably also to its increased prevalence in our population.     

Effects of preweaning exposure to novel maternal odors on maternal responsiveness and selectivity in adulthood

We examined the effects of odor exposure in the nest on the offspring's subsequent adult responsivity to pups scented with the same odor or a different odor. It was hypothesized that animals receiving exposure to the odor in the nest would be more maternally responsive to pups scented with the (same) exposed odor than to unscented (water-scented) pups. In the first part of the study (Part A), Sprague-Dawley female rat pups (days 1-18 of age) either received exposure to an artificial lemon odor or to the natural (water) odor in the nest. In the second part of the study (Part B), rat pups were exposed daily to lemon or neutral odorants in an incubator at a distance from the mother and the nest. On day 21, animals received odor preference tests for lemon versus neutral pine bedding. On day 60, animals were mated and their pups were removed at 15-min intervals at the time of parturition. Animals were then tested for maternal behavior to foster pups on day 1 or 7 after parturition. Foster pups were scented either with the lemon odor or with water (unscented). Early exposure to lemon in the nest context enhanced animals' attraction to the lemon odor in juvenile tests. In adult maternal tests, exposure to odor on the mother and in the nest had two effects. It increased the latency for animals to express maternal behavior; however, once mothers expressed maternal behavior, they spent more time licking and crouching over pups scented with the same odorant to which they had been exposed earlier on their own mothers. Simple exposure to the lemon odorant out of context of the nest had no effect on adult maternal latencies or behavior.     

Deletion of corticotropin-releasing factor binding protein selectively impairs maternal, but not intermale aggression

Corticotropin-releasing factor (CRF) binding protein (CRF-BP) is a secreted protein that acts to bind and limit the activity of the neuropeptides, CRF and urocortin (Ucn) 1. We previously selected for high maternal defense (protection of offspring) in mice and found CRF-BP to be elevated in the CNS of selected mice. We also previously determined that both CRF and Ucn 1 are potent inhibitors of offspring protection when administered centrally. Thus, elevated CRF-BP could promote defense by limiting endogenous actions of CRF or Ucn 1. To test this hypothesis, we crossed the deletion for CRF-BP into the mice selected for high maternal defense and evaluated offspring protection and other maternal behaviors. CRF-BP knockout (KO) mice exhibited significant deficits in maternal aggression relative to wild-type (WT) mice in three different measures. Other maternal features were almost identical between groups, including dam and pup weight, litter size, nursing time, and pup retrieval. Both groups performed similarly in a forced swim stress test and aggression in both groups was reduced following the swim test. Virgin KO female mice exhibited higher levels of anxiety-like behavior in terms of decreased time in the light portion of the light/dark box test. For males, no differences in light/dark box or swim test were found. However, increased anxiety-like behavior in male KO mice was identified in terms of contact and approach to a novel object both with and without previous exposure to the swim test. No differences in isolation induced resident intruder male aggression were found between groups. Together, these results indicate that loss of CRF-BP selectively impairs maternal, but not intermale aggression and that loss of the gene induces anxiety-like behavior in males and females, but there are sex differences in terms of how that anxiety is revealed.