Essential fatty acids and their long-chain polyunsaturated metabolites in maternal and cord plasma triglycerides during late gestation

The fatty acid composition of plasma lipids was determined in 41 pairs of mothers and their term infants at time of birth (38-42 postmenstrual weeks) by high-resolution capillary gas-liquid chromatography. Linoleic and alpha-linolenic acids were found at smaller concentrations in cord than in maternal triglycerides, in contrast to strikingly higher proportions of their long-chain polyunsaturated metabolites (LC-PUFA), which indicates a preferential maternofetal transport for certain physiologically important LC-PUFA. While no significant gestational age-dependent changes occurred in maternal plasma triglycerides, the values for most of the fetal long-chain n-3 metabolites increased with the duration of gestation, possibly reflecting an increased transplacental fatty acid passage during late pregnancy or a maturation of desaturation in the fetal liver.     

Hepatic taurine, glycine and individual bile acids in early human fetus

OBJECTIVE: To examine 3alpha-hydroxy individual bile acid and the association between taurine and taurine-conjugated bile acid in human fetal liver. METHODS: Taurine, glycine and the individual bile acids in liver samples taken from 17 human fetuses whose abortion was induced from 12 to 23 weeks' gestation were determined by high-performance liquid chromatography. RESULTS: The concentrations of taurine, glycine and bile acids in early fetal life were not related to gestational age. Hepatic taurine was statistically correlated with total taurine-conjugates (r = 0.798; P < 0.0001), but hepatic glycine was not correlated with glycine-conjugates (r = -0.103; P > 0.05). Lithocholic acid was conjugated exclusively with taurine. CONCLUSIONS: Our results supported that in human fetal life there is a considerable bile acid pool in liver, and that taurine works effectively on the bile acid metabolism depending on the hepatic taurine concentration.     

Effect of guanidinoethyl sulfonate on taurine concentrations and fetal growth in pregnant rats

Guanidinoethyl sulfonate (GES), a transport antagonist of taurine, was given to pregnant rats from day 11 to 21 of gestation as a 1% solution in drinking water. On day 21 of gestation in GES-treated pregnant rats, the concentration of taurine markedly decreased in the fetal whole body (54% of the control), the fetal liver (37%), the fetal whole brain (87%), the placenta (32%), the maternal liver (33%), the maternal whole brain (32%), and the maternal plasma (46%). The wet weight of fetal whole body, liver and brain of fetus, and placenta also showed a significant drop. But there were no differences of weight gain, in the liver and brain weights of the mother of the control and GES-treated pregnant rats. The urinary excretion of taurine in pregnant rats treated with GES was much higher than that of the controls. These results suggest that the administration of GES to pregnant rats induces much urinary taurine excretion with a resulting decrease in the tissue taurine content and readily produces taurine-deficient fetal rats.     

Erythropoietin and hypoxia inducible factor-1 expression in the mid-trimester human fetus

AIM: Infants born prematurely lack a normal response to anemia and fail to increase erythropoietin (Epo) production despite an apparent need for improved tissue oxygenation. This anemia may involve a deficiency in the fetal and premature kidney to produce Epo. To evaluate fetal Epo production, Epo and hypoxia inducible factor-1 (HIF) mRNA expression was measured in the mid-trimester human fetus. METHODS: Fetal liver and kidney samples were obtained at 11-22 wk of gestation. RNA was isolated and reverse transcribed from snap-frozen specimens. Epo and HIF cDNA concentrations were determined using real-time polymerase chain reaction (PRISM). Epo cDNA concentrations were standardized to HIF concentrations present in each sample. RESULTS: HIF concentrations remained constant during gestation in kidney and liver samples. Epo cDNA concentrations in kidney did not change from 12 to 22 wk (8.4 +/- 3.4 fg Epo pg(-1) HIF cDNA, 4.8 +/- 1.4, 2.6 +/- 0.4, and 4.2 +/- 1.8 at 11-14, 15-16, 17-19, and 20-22 wk of gestation, respectively), while Epo cDNA concentrations in liver increased with gestation (74.5 +/- 31.9 fg pg(-1) HIF, 23.8 +/- 6.5, 96.4 +/- 19.2 and 276.1 +/- 28.5 at 12-14, 15-16, 17-19 and 20-22 wk of gestation, respectively, p < 0.05, 20-22 wk of gestation liver samples vs all other gestations). Concentrations were 5-20-fold higher in liver than in kidney in each gestational group (p < 0.01, liver vs kidney). CONCLUSION: HIF concentrations did not change with gestation in liver or kidney. The human fetal kidney produced approximately 5% of the total Epo mRNA measured during the second trimester. It remains to be determined how Epo production by these tissues is affected by premature birth.     

Placental taurine and low birth weight infants

In order to determine whether the decrease in taurine concentration in the placenta during pregnancy could affect fetal development, as has been observed in animals, we measured the concentration of taurine in placentas obtained after vaginal expulsion. 31 placentas from women with normal pregnancies of over 37 weeks who have given birth to infants of normal weight (3,200 +/- 310 g) were included in the study. In addition, 26 placentas of infants considered to be hypotrophic were also included (gestation over 37 weeks, birth weight: 2,260 +/- 230 g). The taurine was assayed using gaz-liquid chromatography. The concentration of taurine in the placenta was 2.80 +/- 0.56 mumol/g for the placentas of normal birth weight infants and 2.40 +/- 0.64 mumol/g for the placentas of hypotrophic infants (p less than 0.02). There is no significant correlation in normal and hypotrophic newborns between the gestation period, the weight and height at birth, the weight of the placenta, and the taurine concentration in the placenta. The taurine concentration in placentas of hypotrophic born infants is significantly reduced compared to the placentas from normal infants.     

Clinical significance of glycolysis indicators in the evaluation of the condition of the fetus and newborn infant

A total of 40 full-term newborns, 41 miscarried fetuses and 196 pregnant women were examined. Of these, 85 women had an uncomplicated pregnancy, 70 were with threatened abortion and 41 with miscarriage within the gestation period of 24-27 weeks. Blood was examined for the glycolysis parameters (glucose, lactate, activity of LDH and its isozymes) and hormonal concentrations: ACTH, cortisol, insulin, C-peptide estriol; urine was examined for excretion of estrogens, pregnanediol++, total neutral 17-CS. It has been established that newborn infants assessed by the Apgar score as having 8-10 points and developing in conditions of threatened abortion are born in a state of hypoxia of different degrees, with dysfunction of the endocrine organs.     

Free amino acid distribution inside the first trimester human gestational sac

The trophoblast functions of nutrient transport and protein synthesis generate high concentrations of amino acids in the placenta and in fetal blood during the second half of pregnancy, but little is known about these metabolic processes in embryonic and early fetal periods. The aim of this study is to compare the distribution of amino acids inside the first trimester gestational sac. Free amino acid concentrations were measured in homogenates of placental villi, in samples of coelomic and amniotic fluid, and in the maternal serum from 17 normal pregnancies between 7 and 11 weeks of gestation. Significant positive relationships between maternal serum and placental tissue were found for 10 amino acids, indicating that active amino acid transport and accumulation by the human syncytiotrophoblast occurs as early as 7 weeks of gestation. The transplacental flux of most amino acid transport from maternal blood to the exocoelomic cavity was against a concentration gradient. The highest placental amino acid concentrations were found for taurine, glutamic acid, glycine and alanine. The amniotic fluid contained lower mean concentration of all amino acids than coelomic fluid and maternal serum. The concentration distribution of individual amino acids in coelomic and amniotic fluid were related indicating a passive transfer through the amniotic membrane. A coelomic-maternal gradient was observed in 19 out of 24 amino acids measured and positive correlations were found between maternal serum and coelomic fluid for concentrations of α-aminobutyric acid, tyrosine and histidine, suggesting that these amino acids are only partially retained and/or transferred more rapidly by the early placenta.     

Bile salt-stimulated lipase of human milk: characteristics of the enzyme in the milk of mothers of premature and full-term infants

Human milk contains a lipase (bile salt-stimulated lipase) that is considered to have an important role in infant fat digestion. In this study we compared the characteristics of bile salt-stimulated lipase activity in milk samples from mothers delivering prematurely (26-30 and 31-37 weeks of gestation) and in milk from mothers delivering at term (38-42 weeks of gestation). Preterm milks were collected at day 1-5 and during week 6 of lactation. Term milks were collected during week 6 of lactation. The characteristics of the enzyme (kinetics, enzyme concentration, pH optimum, and pH stability, effects of bile salt structure and concentration, eserine inhibition) were identical regardless of length of pregnancy or duration of lactation. Bile salt-stimulated lipase had a neutral to alkaline pH optimum (pH 7.3-8.6), was stable for 1 h at a wide pH range (pH 3.1-8.6), was active only in the presence of primary bile salts, and was inhibited by eserine. The data indicate that, following parturition at as early as 26 weeks of gestation, the mammary glands synthesizes bile salt-stimulated lipase with identical characteristics as does the mammary gland after a full-term pregnancy.     

Erythropoietin and hypoxia inducible factor-1 expression in the mid-trimester human fetus

Aim : Infants born prematurely lack a normal response to anemia and fail to increase erythropoietin (Epo) production despite an apparent need for improved tissue oxygenation. This anemia may involve a deficiency in the fetal and premature kidney to produce Epo. To evaluate fetal Epo production, Epo and hypoxia inducible factor-1 (HIF) mRNA expression was measured in the mid-trimester human fetus. Methods : Fetal liver and kidney samples were obtained at 11–22 wk of gestation. RNA was isolated and reverse transcribed from snap-frozen specimens. Epo and HIF cDNA concentrations were determined using real-time polymerase chain reaction (PRISM). Epo cDNA concentrations were standardized to HIF concentrations present in each sample. Results : HIF concentrations remained constant during gestation in kidney and liver samples. Epo cDNA concentrations in kidney did not change from 12 to 22 wk (8.4 ± 3.4 fg Epo pg⁻¹ HIF cDNA, 4.8 ± 1.4, 2.6 ± 0.4, and 4.2 ± 1.8 at 11–14, 15–16, 17–19, and 20–22 wk of gestation, respectively), while Epo cDNA concentrations in liver increased with gestation (74.5 ± 31.9 fg pg⁻¹ HIF, 23.8 ± 6.5, 96.4 ± 19.2 and 276.1 ± 28.5 at 12–14, 15–16, 17–19 and 20–22 wk of gestation, respectively, p ± 0.05, 20–22 wk of gestation liver samples vs all other gestations). Concentrations were 5–20-fold higher in liver than in kidney in each gestational group ( p ± 0.01, liver vs kidney).
Conclusion : HIF concentrations did not change with gestation in liver or kidney. The human fetal kidney produced approximately 5% of the total Epo mRNA measured during the second trimester. It remains to be determined how Epo production by these tissues is affected by premature birth.     

Xanthine oxidase during human fetal development

Through oxygen free-radical production, xanthine oxidase (XOD, E.C.1.2.3.2) has been implicated in the pathogenesis of postischemic and hyperoxic tissue injuries among newborn. We measured the activity and evaluated the kinetic characteristics of XOD in human fetal liver, intestine, brain, and myocardium. Both the fetal liver and intestine contain a high XOD activity through gestation. The activity increases in the liver and decreases in the intestine with advancing gestation. The apparent Km for hypoxanthine is 4.8-5.5 microM in the intestine throughout gestation and in the liver at term but higher than 30 microM in the liver during the first half of pregnancy. The activity is undetectable both in the fetal brain and myocardium throughout gestation. Thus, XOD activity is present at least in the liver and intestine to account for the oxidation of hypoxanthine and xanthine. However, direct evidence for adenine nucleotide catabolism, followed by oxidation of the accumulated hypoxanthine during tissue reoxygenation in the human liver or intestine is not available.     

Longitudinal study of fetal body movements: nomograms,intrafetal consistency,and relationship with episodes of heart rate patterns a and B

Our objective was to investigate the longitudinal development of incidence parameters of fetal body movements to define normal reference ranges, to relate them to episodes of fetal heart rate patterns A and B, and to determine the intrafetal consistency for these parameters. Twenty-nine fetuses were studied longitudinally from 24 wk of gestation. Fetal body movements and heart rate were recorded at fortnightly intervals between 24 and 36 wk of gestation and weekly from 36 wk of gestation. Data were analyzed using multilevel analysis. Reference ranges were constructed for the percentage of observation time that movements were present, the number of movement bursts per hour, the mean burst duration, and the median onset-onset interval. The median percentage incidence of fetal body movements decreased from 17% at 24 wk to about 7% near term. The developmental course was the same during active episodes. Body movements also decreased during episodes of relative quiescence, in the course of pregnancy. Intrafetal variance was on average 40-80% of the total range of the four movement parameters. Normal reference ranges were developed for incidence parameters of fetal body movements from 24 wk of gestation onward. The overall decline in the incidence of movements during pregnancy appeared to be a developmental phenomenon and not due to progressively increasing episodes of fetal quiescence. Individual fetuses showed a degree of consistency in the percentage incidence of body movements, but intra- and interfetal variances were generally high, resulting in wide ranges.     

Longitudinal study of umbilical and portal venous blood flow to the fetal liver: low pregnancy weight gain is associated with preferential supply to the fetal left liver lobe

Recent data suggest that umbilical venous perfusion of the fetal liver has an important influence on fetal growth and postnatal liver function, and that maternal factors in late pregnancy modify this circulation. In a longitudinal study of 160 low-risk pregnancies, we determined how umbilical and portal venous blood flows to the fetal liver changed during gestation, and examined the hypothesis that maternal body mass index and pregnancy weight gain influenced fetal liver blood flows. We measured blood flows in the umbilical and portal veins, left portal branch, and ductus venosus using ultrasound. Normalizing for estimated fetal weight, fetal liver total venous blood flow fell from 84 to 57 mL. min(-1). kg(-1) during 21-39 wk of gestation; toward term the portal contribution increased (from 14 to 20%) and the umbilical contribution fell, whereas distribution between the left and right liver lobes was stable, 60%/40%. Greater flow of nutrient-rich umbilical venous blood to the liver was associated with higher birth weight and neonatal ponderal index. Maternal body mass index was not related to fetal liver blood flows, but low pregnancy weight gain strongly influenced flow distribution between the right and left liver lobes, sparing the left lobe and increasing the difference between lobes by 16%.     

Human placental lactogen administration in the pregnant rat: acceleration of fetal growth

To determine whether administration of human placental lactogen (hPL) to pregnant rats during late gestation might enhance fetal growth, we implanted osmotically driven minipumps to provide 75 micrograms h PL/24 h on day 14 of the rat's 21.5-day gestation. This substantially increased maternal and fetal plasma hPL concentrations. By day 18, hPL fetuses were significantly heavier and had larger placentas than controls. From this point until term, their rate of growth (1.20 g/24 h) significantly exceeded that of controls (0.95 g/24 h). Birth weights differed significantly (hPL 5.86 +/- 0.08 g; controls 5.20 +/- 0.08 g, p less than 0.001). This increase was due primarily to significant increases in the growth of the liver and carcass. Enhanced glucose availability was in part responsible for this phenomenon inasmuch as plasma glucose concentrations were significantly increased in hPL maternal rats from days 15 to 19. This resulted on days 18 and 19 in significantly increased plasma glucose and insulin concentrations in hPL fetuses. Fetal/maternal glucose ratios did not differ between hPL and control fetuses. Fetal heptic glycogen concentrations were significantly increased on day 18 and 19 but were similar to controls from day 20 until birth. These observations suggest that increased maternal glucose availability with consequent stimulation of fetal insulin secretion accelerated the growth of hPL fetuses. However, maternal and fetal plasma glucose concentrations and fetal plasma insulin and hepatic glycogen concentrations on days 20 and 21 were normal, suggesting that other factors also were responsible for sustaining the accelerated fetal growth on these days.(ABSTRACT TRUNCATED AT 250 WORDS)     

Protein turnover in tissues of the fetal rat after prolonged maternal malnutrition

Protein turnover in fetal diaphragm, heart, liver, and brain was determined at 21 days gestation in fetal rats whose mothers had received a protein-restricted diet (6% protein) throughout gestation. This diet resulted in severe combined protein-calorie malnutrition. Fetal body weight was significantly decreased at days 19-22 gestation versus controls (27% protein diet) when pregnant animals were protein-restricted (e.g. 40% decrease in body weight at day 22 gestation versus controls). Protein synthesis was determined by intravenous injection of "massive" amounts of [3H]phenylalanine to pregnant animals and measuring free and protein-bound specific radioactivities in fetal tissues. Rate constants for protein degradation were calculated by subtracting fractional growth rate from protein synthesis. Fractional protein synthesis was reduced in diaphragm (0.26 versus 0.41 days-1), heart (0.41 versus 0.52 days-1), and liver (0.35 versus 0.89 days-1) in fetuses from malnourished mothers relative to controls. Similarly, fractional protein degradation was decreased in these fetal tissues-diaphragm (0.03 versus 0.06 days-1), heart (0.14 versus 0.18 days-1), and liver (0.25 versus 0.80 days-1). Reduced protein accretion during maternal malnutrition in these fetal tissues is secondary to decreased protein synthesis out of proportion to the concurrent reduction in protein degradation. Protein synthesis and degradation in fetal brain from malnourished mothers were not altered versus controls. These effects of malnutrition on protein turnover in fetal tissues throughout pregnancy in the rat correspond closely with the effect of protein restriction in young adult rats and the effect of protein-calorie malnutrition on whole body protein turnover in human infants.     

Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana

Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high‐income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort (n = 320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol, and triglyceride concentrations were analyzed in plasma at ≤20and 36 weeks gestation as continuous variables and also categorized into low, referent, or high (<10th, 10th–90th, >90th percentile). At ≤20 weeks, plasma lipid concentrations were not associated with pregnancy duration. At 36 weeks, total cholesterol and triglyceride concentrations were not associated with pregnancy duration. Higher HDL‐C at 36 weeks was associated with a longer pregnancy duration (adjusted β‐coefficient ± standard error: 0.05 ± 0.02 days mg^?1/dL, p = .02); pregnancy duration was 5.9 ± 2.0 (mean ± standard error) days shorter among women with low HDL‐C compared with the referent group (10th–90th percentile) (p = .02) and 8.6 ± 2.6 days shorter when compared with the high HDL‐C group (p = .003). Pregnancy duration was 4.9 ± 2.1 days longer among women with low low‐density lipoprotein cholesterol at 36 weeks gestation when compared with the referent group (p = .051). Our data suggest that low HDL‐C in the third trimester of pregnancy is associated with a shorter duration of pregnancy in this study population but do not support the hypothesis that low total cholesterol is associated with a shorter pregnancy duration.     

Pituitary changes of desacetyl-alpha-melanocyte-stimulating hormone throughout development

Adrenocorticotropin (ACTH), alpha-melanocyte-stimulating hormone (alpha-MSH) and desacetyl-alpha-MSH (des-alpha-MSH) concentrations were evaluated in 4 embryos and 18 fetal pituitaries collected after spontaneous (n = 9) and prostaglandin-induced abortion (n = 9) at 13-25 weeks of gestation. The peptides were measured by radioimmunoassays after a high-performance liquid chromatographic separation of the homogenates. In both embryonic and fetal pituitaries, des-alpha-MSH concentrations were 2-4 times higher than those of alpha-MSH and 1- to 50-fold increased in comparison to those of ACTH. Either melanotropin showed the highest pituitary content in the first part of the second trimester, while the ACTH content remained constant. In the oldest fetuses (over 20th week), the pituitaries collected after prostaglandin-induced abortion showed markedly increased values of both des-alpha-MSH and alpha-MSH in comparison to samples collected after spontaneous abortion. In conclusion, des-alpha-MSH, the typical melanotropic hormone of fetal pituitary, undergoes important changes during development. Des-alpha-MSH seems to be the end product of proopiomelanocortin cleavage and its pituitary content increases in concomitance with the fetal adrenal sprout. Moreover, these data indicate that the intermediate pituitary lobe could be activated by the stress of labor after the 20th week of pregnancy.     

Cord haemoglobin in low birthweight infants

Cord haemoglobin was measured in 349 low birthweight infants born after a pregnancy lasting 28 to 41 weeks inclusive. 82 babies were small-for-dates and were born after 36 weeks'' gestation; their Hb was not related to sex or duration of pregnancy, but there was a negative correlation with placental weight and placental weight/birthweight ratios. The mean Hb of small-for-dates babies (17·09±2·11 g/100 ml) was higher than for comparable normal babies (16·24±2·26 g/100 ml).In normal-for-dates females there was a linear relation between Hb and duration of pregnancy approximately expressed by: cord Hb (g/100 ml) = 7 + gestational age in lunar months. In males a plateau Hb of 16·22 g/100 ml was reached at 32 weeks.     

Effects of ursodeoxycholic acid therapy for liver disease associated with cystic fibrosis

The hydrophilic bile acid ursodeoxycholic acid (UDCA) has recently been shown to improve indexes of liver function in adult patients with various liver diseases. The clinical and biochemical responses to UDCA administration (10 to 15 mg/kg body weight per day) were therefore investigated in nine patients with cystic fibrosis and evidence of liver disease. All patients were receiving pancreatic enzymes and taurine supplementation. Liver function tests were done and serum bile acid concentrations and biliary bile acid composition were determined before and during UDCA therapy; fat balance studies and fecal bile acid excretion were carried out before and 6 months after UDCA treatment. After 2 months of bile acid therapy, biliary bile acid composition was enriched in UDCA from approximately 5% before treatment to 25%, at the expense of cholic and chenodeoxycholic acids, thus making the pool more hydrophilic. This enrichment is lower than that reported for adults with chronic liver diseases. Serum concentrations of UDCA increased significantly but variably. UDCA became the predominant fecal bile acid excreted (12% to 67%), indicating a variable absorption of the administered bile acid. Liver function improved in all patients after 2 to 6 months of therapy, although the degree of improvement (aspartate aminotransferase, -34%; alanine aminotransferase, -41%; gamma-glutamyltranspeptidase, -41% alkaline phosphatase, -19%) was lower than that observed in adults with chronic liver diseases. Mean coefficient of fat absorption and growth rate were, on average, unaffected by UDCA therapy, although an improvement was noted for three patients with greater severity of steatorrhea. The study indicates that UDCA can be used safely in this patient population but that higher doses of UDCA may be of greater benefit in the treatment of the liver disease associated with cystic fibrosis.     

Taurine and osmoregulation. III. Taurine deficiency protects against cerebral edema during acute hyponatremia

Taurine is a cerebral osmoprotective molecule during chronic hypernatremic dehydration. In these experiments, we investigated the role of taurine in osmoregulation during acute hyponatremia. Taurine deficiency was induced in experimental cats (n = 6) by feeding a taurine-free diet for 8-10 wk, whereas control counterparts (n = 6) consumed a regular diet. Hyponatremia was provoked in all cats over 54 h by daily injections of 5% dextrose in water (7.5% body wt) and vasopressin (20 U/d). The serum Na+ concentration was abruptly lowered to 110 +/- 3 and 117 +/- 2 mmol/L, in experimental and control animals, respectively. The cerebral total and intracellular water compartment sizes were reduced from 486 +/- 11 to 441 +/- 11 ml/100 g dry wt and from 357 +/- 7 to 309 +/- 12 mL/100 g dry wt, respectively, in control versus experimental cats, p less than 0.05. There was a significant linear relationship between cerebral taurine content and the intracellular water compartment size in all animals, p less than 0.02. Taurine displayed a similar osmoprotective capacity in muscle tissue in these studies. We conclude that taurine is an osmoregulatory molecule in cerebral and extracerebral tissues during severe hyponatremia. Reductions in tissue taurine content may complement decreases in cytosolic electrolyte levels during adaptation to more prolonged hyponatremia.     

Maternal psychosocial well-being in pregnancy and breastfeeding duration

AIM: An increased duration of breastfeeding has many advantages for the child and mother. However, little research to date has investigated the influence of maternal psychosocial well-being during pregnancy on the duration of breastfeeding. This study aimed to examine whether experience of life stress events, social contact/support in pregnancy and postpartum emotional disturbance had an effect on breastfeeding duration. METHODS: Using data from the Western Australian Pregnancy Cohort Study for 2420 women followed from 18 weeks gestation, we analyzed prevalent breastfeeding for 4 months or longer and its association with maternal psychosocial and socio-demographic factors in pregnancy, using multivariable logistic regressions. RESULTS: Experience of stressful life events during pregnancy increased the odds for the early cessation of prevalent breastfeeding (OR 1.34, p < 0.05, 95% CI 1.04-1.71) independent of maternal socio-demographic characteristics and biomedical factors. Stress events associated with separation or divorce, financial problems and residential moves in pregnancy were important predictors for a shorter duration of prevalent breastfeeding. CONCLUSION: Experience of stressful life events during pregnancy increased the odds for the early cessation of prevalent breastfeeding. Interventions that move beyond hospital-based antenatal care to address the causes of maternal stress in pregnancy and socioeconomic disparities between women are required to increase breastfeeding duration.