Carbon Chemist

Tag: Childbirth

  • Public funding for single embryo transfer cuts multifetal pregnancy rates in IVF

    Public funding for single embryo transfer cuts multifetal pregnancy rates in IVF

    [ad_1]

    In the era after the introduction of publicly funded in vitro fertilization (IVF) mandating elective single embryo transfer, the multifetal pregnancy rate decreased significantly for IVF, but the contribution of ovulation induction and intrauterine insemination (OI/IUI) to multifetal pregnancy still needs attention, according to a new study from ICES and Queen’s University. 

    Twins, triplets, and higher multifetal pregnancies are associated with some adverse outcomes in pregnancy and childbirth. Fertility treatments such as IVF and ovulation induction and intrauterine insemination (OI/IUI) are more likely to result in a multifetal pregnancy. In Canada, Ontario’s publicly funded fertility program mandated the use of elective single embryo transfer (eSET) in 2015. 

    In a new study from the journal JAMA Network Open, researchers evaluated the association between fertility treatment and multifetal pregnancies in Ontario for over 1 million pregnancies between 2006 and 2021. This is one of the first studies to include all forms of fertility treatments and accounted for fetal reductions that may have been performed earlier in a pregnancy. 

    While we found a substantial decrease in multifetal pregnancy rates for IVF after the mandate was introduced, we didn’t see the same decrease after OI/IUI. It’s more difficult to regulate multifetal pregnancies with this type of fertility treatment, because the type of protocols used and adherence to specific cancellation criteria may differ across clinics.” 

    Maria Velez, lead author, adjunct scientist at ICES and associate professor in the department of Obstetrics and Gynaecology at Queen’s University

    Of the total number of pregnancies, 96.9% were from unassisted conception, 1.4% from OI/IUI and 1.7% from IVF. Compared to those who had unassisted conception, people who received fertility treatments tended to be older, lived in higher-income communities, and had more preexisting health conditions. 

    The overall rate of multifetal pregnancies declined from 2006 to 2021, but the decrease was greater for IVF pregnancies than for those conceived by OI/IUI. When comparing the time periods before and after the eSET mandate, the rate of multifetal pregnancies declined from 13% to 9% with OI/IUI, and from 29% to 7% with IVF. 

    Improvements in assisted reproductive technology (ART) have also influenced rates of multifetal pregnancies. Advances in technologies such as embryo culture media and elective freezing of all available embryos means higher success rates for pregnancy. 

    However, the authors say that “Future studies should address the cost-effectiveness of providing 1 vs multiple publicly funded IVF cycles, especially because some couples in Ontario still pursue privately paid IVF cycles, which can result in a higher rate of multifetal pregnancy and an inherently higher risk of maternal and neonatal morbidity.” 

    One limitation of the study was the lack of detail about those who underwent fetal reduction. The data also did not capture information about the type of medication used for OI/IUI, and IVF cycles would have included both private and publicly funded treatments. 

    Nevertheless, the findings show that changes to assisted reproductive technology and the introduction of a publicly funded IVF program in Ontario both contributed to a decrease in the risk of multifetal pregnancy. 

    “Future work should address the higher risk associated with OI/IUI, and changes may be needed to standardize protocols and cancellation policies,” says Velez. 

    Source:

    Institute for Clinical Evaluative Sciences

    Journal reference:

    Velez, M. P., et al. (2024). Multifetal Pregnancy After Implementation of a Publicly Funded Fertility Program. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2024.8496.

    [ad_2]

    Source link

  • Esketamine after childbirth cuts risk of postnatal depression by three-quarters

    Esketamine after childbirth cuts risk of postnatal depression by three-quarters

    [ad_1]

    In a recent study published in the British Medical Journal, researchers investigated whether low-dose esketamine delivered after labor improves post-delivery depression in women with prenatal depression.

    Study: Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. Image Credit: christinarosepix / ShutterstockStudy: Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. Image Credit: christinarosepix / Shutterstock

    Background

    Perinatal depression is common among women, particularly in low-income nations, and has negative consequences for both the mother and her child. Mothers with depression frequently feel anxiety, weaker connections, and lower attachment. Their kids are more likely to experience behavioral and emotional issues, as well as long-term psychological and developmental disorders. Poor physical health, a lack of social support, a low socioeconomic level, insufficient education, and a history of violent exposure are all risk factors for prenatal depression.

    Prenatal depression is a primary predictor of postnatal depression, and pharmacological therapies are occasionally required. Esketamine, a rapid-onset antidepressant, offers potential advantages for treatment-resistant depression, but its effect on women with perinatal depression is unknown. Previous studies have mainly focused on cesarean births, omitting moms who are depressed or at high risk of developing depression after delivery.

    About the study

    In the present randomized, placebo-controlled, double-blinded, controlled trial, researchers evaluated whether low-dose esketamine administered immediately after birth lowers depression in moms suffering from prenatal depression for 42 days.

    The researchers conducted the trial at five hospitals across China between June 19, 2020, and August 3, 2022. They included pregnant women aged 18 years and above with mild, moderate, or severe prenatal depression [defined as Edinburgh postnatal depression scale (EPDS] scores equal to or above 10) hospitalized for delivery. They excluded women with pre-pregnancy mood disorders, severe pregnancy complications, physical status III or higher, or contraindications to ketamine or esketamine use, such as severe cardiovascular disease, refractory hypertension, or hyperthyroidism. Exclusion criteria included American Society of Anesthesiologists (ASA) physical status III or higher.

    The researchers randomized the individuals in a 1:1 ratio to the esketamine group (0.20 mg per kg body weight) or placebo group, with drugs administered intravenously during the initial 40 minutes post-delivery while clipping the birth cord. The primary research outcomes were major depressive events after 42 days of delivery, identified using mini-international neuropsychiatric interviews.

    Secondary study outcomes included EPDS scores on days one and 42 after childbirth and the Hamilton Depression Rating Scale (HDRS) score 42 days after delivery. The researchers monitored adverse occurrences until 24 hours after delivery. They used logistic regression to determine the relative risk (RR) values. They used imputed missing primary outcome data in post-hoc sensitivity analyses.

    The researchers measured anxiety using the Zung self-rating anxiety scale, social assistance using the social support rating scale, marital satisfaction using the ENRICH (evaluation and nurturing relationship issues, communication, and happiness) scale, and agitation-sedation using the Richmond agitation-sedation scale. Maternal data included epidural analgesia acceptance, delivery style, fluid infusion, and blood loss, as well as the use of additional analgesics and sedatives. Bodyweight, sex, Apgar scores at one and five minutes after delivery, and initial destination were all recorded.

    Results

    The researchers screened 14,243 women and randomly assigned 364 to the study groups. The average participation age was 32 years. After 42 days, 12 (6.7%) esketamine recipients and 46 (25%) placebo recipients experienced a severe depressive episode (RR 0.3). After accounting for missing data, 14 (7.7%) of esketamine recipients and 46 (25%) of placebo recipients experienced severe depressive episodes (RR 0.3). The protocol analysis yielded comparable results.

    Esketamine-treated women had lower EPDS scores on day 7 and day 42 (median difference, -3). Individuals receiving esketamine also had reduced HDRS scores 42 days after delivery (mean difference, -4). Neuropsychiatric adverse event occurrence (including dizziness, diplopia, and hallucinations) was higher among individuals receiving esketamine (45%, n=82) compared to those receiving placebo 22% (n=40); however, the symptoms lasted <24 hours, with none requiring pharmacological therapy.

    Esketamine-treated women had lower EPDS scores on day seven and 42 (median difference, -3). Individuals receiving esketamine also had reduced HDRS scores 42 days after delivery (mean difference, -4). Neuropsychiatric adverse event occurrence (including dizziness, diplopia, and hallucinations) was higher among individuals receiving esketamine (45%, n=82) compared to those receiving placebo 22% (n=40); however, the symptoms lasted <24 hours, with none requiring pharmacological therapy.

    Overall, the study found that a single modest dosage of 0.2 mg/kg of esketamine administered soon after childbirth reduces major depressive events among women with prenatal depressive symptoms by almost three-quarters at 42 days postpartum. Esketamine increased the frequency of neuropsychiatric symptoms, but they were brief and lasted <24 hours, requiring no medication. The antidepressant effect of low-dose esketamine appears to continue longer in women with prenatal depression than in the overall population with depression. Further analysis is required to establish whether the reaction continues after 42 days.

    Journal reference:

    • Shuo Wang et al., Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial, BMJ 2024;385:e078218, DOI: 10.1136/bmj-2023-078218, https://www.bmj.com/content/385/bmj-2023-078218

    [ad_2]

    Source link

  • AI model can accurately screen for post-traumatic stress disorder after childbirth

    AI model can accurately screen for post-traumatic stress disorder after childbirth

    [ad_1]

    A generative artificial intelligence (AI) model that can analyze the narrative accounts of women who have undergone recent childbirth has shown the ability to accurately screen for post-traumatic stress disorder (CB-PTSD), a study by Massachusetts General Hospital (MGH), a founding member of the Mass General Brigham healthcare system has found.

    By exploring the capabilities and shortcomings of several models from OpenAI, including ChatGPT, the researchers identified a version that offers rich insights into maternal mental health following traumatic childbirth.

    The model can fit seamlessly into routine obstetric care and could potentially be harnessed to assess other mental health disorders. The results of the study were published in Scientific Reports.

    Evaluation of PTSD related to traumatic birth currently relies on extensive clinician evaluation, which fails to meet the urgent need for a rapid, low-cost assessment strategy.”


    Sharon Dekel, PhD, director of MGH’s Postpartum Traumatic Stress Disorders Research Program, and senior author of the study

    “The use of brief patient narratives of childbirth analyzed by AI’s text-based computational methods could become an efficient, low-cost, and patient-friendly strategy for detecting CB-PTSD after a traumatic birth and with more research this tool may potentially aid in identifying women at risk for CB-PTSD before the condition fully develops.”

    For an estimated eight million women a year globally, childbirth that is traumatic and/or medically complicated is expected to trigger post-traumatic stress disorder, a condition historically has been associated with military combat or severe sexual assault.

    In recent years, childbirth has become acknowledged as a significant PTSD trigger which, if left untreated, can impair the health of both the mother and child and result in significant societal costs.

    In previous studies, Dekel’s lab found evidence that brief psychological interventions delivered soon after traumatic childbirth can reduce maternal childbirth-related PTSD symptoms.

    In their latest study, Dekel in collaboration with first author Alon Bartal, PhD, of Bar-Ilan University in Israel, investigated the effectiveness of artificial intelligence and related machine learning (ML) analysis strategies to detect CB-PTSD.

    Specifically, they evaluated the performance of different large language models (LLMs) and variations of ChatGPT and their ability to extract novel insights from text-based data sets derived from the brief narrative descriptions by postpartum women of their childbirth experience.

    As part of their work, the team collected short narrative accounts from 1,295 women who had recently given birth.

    The study focused on an OpenAI model known as text-embeddings-ada-002, which converted narrative data from the personal accounts of women with and without probable CB-PTSD to a numerical format that was then analyzed by a trained machine learning algorithm developed by the team.

    Researchers showed this model had superior performance in identifying postpartum traumatic stress compared to other ChatGPT and large language models, which are typically trained on huge volumes of data allowing them to understand, analyze and interpret natural language.

    “The reliance of the ML model using childbirth narrative input from the Open AI model as its exclusive data source presents an efficient mechanism for data collection during the vulnerable postpartum period, demonstrating 85 percent sensitivity and 75 percent specificity in identifying CB-PTSD cases,” notes Dekel.

     “Moreover, the model we developed could potentially improve accessibility to CB-PTSD screening and diagnosis by fitting seamlessly into routine obstetric care and providing a foundation for commercial product development and mainstream adoption.”

    Dekel, whose research program is dedicated to exploring women’s mental health following traumatic childbirth, underscores the clinical benefits of using a pre-trained large language model to assess potential PTSD in new mothers.

    “Early intervention is essential to prevent the progression of this disorder to chronic stages, which can seriously complicate treatment,” the MGH investigator points out.

    “Our unique approach could introduce an innovative and cost-effective screening strategy for identifying high-risk women and facilitating timely treatment. It may also holds promise for assessing other mental health disorders, and consequently improving patient outcomes.”

    The emergence of artificial intelligence tools in health has been groundbreaking and has the potential to positively reshape the continuum of care. Mass General Brigham, as one of the nation’s top integrated academic health systems and largest innovation enterprises, is leading the way in conducting rigorous research on new and emerging technologies to inform the responsible incorporation of AI into care delivery, workforce support, and administrative processes. 

    Dekel is a psychologist at MGH, and assistant professor of Psychology at Harvard Medical School. Bartal is an assistant professor of Information Systems at Bar-Ilan University in Israel. Co-authors in the Dekel Laboratory include Kathleen Jagodnik, PhD, a Harvard research fellow, and Sabrina Chan, a clinical research coordinator.

    Dekel was supported by funds from the NIH (Eunice Kennedy Shriver National Institute of Child Health and Human Development, grants R01HD108619, R21HD109546, and R21HD100817).

    Source:

    Massachusetts General Hospital

    Journal reference:

    Bartal, A., et al. (2024). AI and narrative embeddings detect PTSD following childbirth via birth stories. Scientific Reports. doi.org/10.1038/s41598-024-54242-2.

    [ad_2]

    Source link

  • AI program can help identify signs of childbirth-related PTSD

    AI program can help identify signs of childbirth-related PTSD

    [ad_1]

    Researchers have adapted an artificial intelligence (AI) program to identify signs of childbirth-related post-traumatic stress disorder (CB-PTSD) by evaluating short narrative statements of patients who have given birth. The program successfully identified a large proportion of participants likely to have the disorder, and with further refinements-;such as details from medical records and birth experience data from diverse populations-;the model could potentially identify a large percentage of those at risk. The study, which was funded by the National Institutes of Health, appears in Scientific Reports.

    Worldwide, CB-PTSD affects about 8 million people who give birth each year, and current practice for diagnosing CB-PTSD requires a physician evaluation, which is time-consuming and costly. An effective screening method has the potential to rapidly and inexpensively identify large numbers of postpartum patients who could benefit from diagnosis and treatment. Untreated CB-PTSD may interfere with breastfeeding, bonding with the infant and the desire for a future pregnancy. It also may worsen maternal depression, which can lead to suicidal thoughts and behaviors.

    Investigators administered the CB-PTSD Checklist, which is a questionnaire designed to screen for the disorder, to 1,295 postpartum people. Participants also provided short narratives of approximately 30 words about their childbirth experience. Researchers then trained an AI model to analyze a subset of narratives from patients who also tested high for CB-PTSD symptoms on the questionnaire. Next, the model was used to analyze a different subset of narratives for evidence of CB-PTSD. Overall, the model correctly identified the narratives of participants who were likely to have CB-PTSD because they scored high on the questionnaire.

    The authors believe their work could eventually make the diagnosis of childbirth post-traumatic stress disorder more accessible, providing a means to compensate for past socioeconomic, racial, and ethnic disparities.

    The study was conducted by Alon Bartal, Ph.D., of Bar Ilan University in Israel, and led by senior author Sharon Dekel, Ph.D., of Massachusetts General Hospital and Harvard Medical School, Boston. Funding was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

    Source:

    NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development

    Journal reference:

    Bartal, A., et al. (2024). AI and narrative embeddings detect PTSD following childbirth via birth stories. Scientific Reports. doi.org/10.1038/s41598-024-54242-2.

    [ad_2]

    Source link

  • Low dose esketamine injection after childbirth reduces postpartum depression

    Low dose esketamine injection after childbirth reduces postpartum depression

    [ad_1]

    A single low dose injection of esketamine given immediately after childbirth reduces major depressive episodes in individuals with depressive symptoms during pregnancy (prenatal depression), finds a clinical trial published by The BMJ today.

    The results suggest that low dose esketamine should be considered in new mothers with prenatal depressive symptoms.

    Depression is common during pregnancy and shortly after giving birth and can have several adverse effects on new mothers and their infants.

    Esketamine is made from a drug called ketamine. It’s used as an anesthetic and to treat depression, yet the effect for mothers with perinatal depression is unclear.

    To examine this further, researchers based in China and the USA wanted to find out if a single low dose injection of esketamine given just after childbirth might reduce subsequent depression in mothers with pre-existing prenatal depression.

    Their findings are based on 361 mothers (average age 32 years) enrolled from five Chinese hospitals from June 2020 to August 2022 with no medical history of depression and no diagnosis of depression in pregnancy, but who had scores on a scale consistent with mild prenatal depression and were preparing for childbirth. 

    None of the participants had severe pregnancy complications, or any condition that meant they couldn’t be given esketamine.

    Information on factors including age, weight (BMI), education level, family income and existing health conditions was recorded at the start of the trial and participants were randomly assigned to either esketamine or placebo intravenously infused over 40 minutes after childbirth.

    Participants were interviewed 18 to 30 hours after giving birth and again at 7 and 42 days. 

    Major depressive episode was diagnosed with the Mini-International Neuropsychiatric Interview at 42 days. Depression was also assessed using the Edinburgh depression score at 7 and 42 days, and the Hamilton Depression Rating Scale score at 42 days. No participant took antidepressants or received psychotherapy during the follow-up period.

    At 42 days after giving birth, 12 of 180 (6.7%) of mothers given esketamine experienced a major depressive episode compared with 46 of 181 (25.4%) of those given placebo (a relative risk reduction of about three-quarters). 

    As expected, mothers given esketamine had lower Edinburgh depression scores at 7 and 42 days, and a lower Hamilton depression score at 42 days.

    Based on these figures, the researchers estimate that, for every five mothers given esketamine, one major depressive episode would be prevented.

    More neuropsychiatric adverse events such as dizziness and diplopia (double vision) occurred with esketamine (45% v 22%). However, symptoms lasted less than a day and none needed drug treatment. 

    The researchers acknowledge that excluding mothers with pre-pregnancy mood disorders may have affected the validity of their results, and the short follow-up period may have led to under-reporting of neuropsychiatric symptoms and other adverse events.

    What’s more, most participants had only mild prenatal depressive symptoms, so it’s unclear whether esketamine is equally effective in those with more severe depressive symptoms.

    Nevertheless, they conclude that for mothers with prenatal depressive symptoms, a single low dose of esketamine given shortly after childbirth decreases major depressive episodes at 42 days postpartum by about three quarters. 

    These results are generally consistent with previous work investigating the effects of low dose ketamine or esketamine on postpartum depression, mainly in mothers after cesarean delivery, and, importantly, the researchers say their trial “extends existing understanding by targeting women with pre-existing prenatal depression, who were therefore at high risk of postnatal depression.”

    As such, they conclude that low dose esketamine should be considered in mothers with symptoms of prenatal depression.

    Source:

    Journal reference:

    Wang, S., et al. (2024). Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. BMJ. doi.org/10.1136/bmj-2023-078218.

    [ad_2]

    Source link

  • Study reveals strong bidirectional relationship between perinatal depression and premenstrual disorders

    Study reveals strong bidirectional relationship between perinatal depression and premenstrual disorders

    [ad_1]

    Women affected by premenstrual disorders have a higher risk of perinatal depression compared with those who do not, according to research published March 28th in the open access journal PLOS Medicine. The relationship works both ways: those with perinatal depression are also more likely to develop premenstrual disorders after pregnancy and childbirth. This study suggests that a common mechanism might contribute to the two conditions.

    Menstruating women experience cyclical hormone fluctuations through puberty, menstrual cycle, pregnancy and menopause. Some women have difficult to manage symptoms of low mood and depression during these fluctuations. Between a fifth and a third of women are reportedly affected by premenstrual disorders and 11% of mothers suffer perinatal depression -; depressive symptoms during pregnancy and up to 12 months after delivery.

    Qian Yang and colleagues at the Karolinska Institutet, Sweden and University of Iceland used the Swedish nationwide registers from 2001 to 2018 and identified 84,949 women with perinatal depression and 849,482 unaffected women. The researchers matched the women on age and calendar year, and further controlled for demographic factors, smoking, BMI, parity and history of psychiatric disorders. Among women with perinatal depression, almost 3% had premenstrual disorders before pregnancy compared with 0.6% of matched unaffected women. Women with perinatal depression were also twice as likely to report premenstrual disorders when the menstruation resumed after childbirth, compared to those unaffected by perinatal depression.

    The research sheds light on the association between the two conditions and supports a theory that they may share underlying biological mechanisms and/or risk factors. Understanding this association could help healthcare providers to better target support to women most likely to be affected.

    The authors add, “This study reveals a strong bidirectional relationship between perinatal depression and premenstrual disorders, using data from over 900,000 pregnancies. The findings suggest that both disorders may exist on a continuum, and emphasize the importance of recognizing these susceptibilities in clinical practice.“

    Source:

    Journal reference:

    Yang, Q., et al. (2024) The bidirectional association between premenstrual disorders and perinatal depression: A nationwide register-based study from Sweden. PLOS Medicine. doi.org/10.1371/journal.pmed.1004363.

    [ad_2]

    Source link

  • Objective risk information motivates preeclampsia prevention among pregnant patients

    Objective risk information motivates preeclampsia prevention among pregnant patients

    [ad_1]

    A new study in BMC Pregnancy and Childbirth finds that objective information about risk of preeclampsia could be key to driving patient behavior change and creates motivation among pregnant patients to follow provider recommendations on prevention, even among those who are medication-hesitant.

    Key findings include:

    • 91% of the study participants desired predictive testing for preeclampsia

    • 94% reported they would want blood pressure monitoring at home if found to be at high risk 

    • 88% reported they would be more motivated to follow their provider’s medication recommendations if at high risk. This finding was consistent even for individuals who were hesitant to take medication at baseline

    Preeclampsia – a condition that manifests as high blood pressure which impacts 8% of pregnancies – is often silent until symptoms develop and requires emergency intervention, including the need for preterm delivery. Currently, there is no way to predict who is most at-risk for developing complications like preeclampsia early in pregnancy. Women who experience preeclampsia during pregnancy are atincreased risk for heart disease, stroke, and premature death, and children who are born preterm are at increased risk for numerous challenges across their lifespan. While there are medications like baby aspirin that have been shown to lower the risk of preeclampsia for high-risk individuals, reluctance to take aspirin remains a barrier.

    Evidence from other medical fields suggests that when patients know their personalized risk, they act on that information. This study translates insights from cardiology and personalized information on risk of heart disease to obstetrics for the first time. Patients are telling us that if they had objective testing to predict their risk of preeclampsia, it would meaningfully change the way they manage their pregnancies.” 


    Dr. Alison Cowan, FACOG, Head of Medical Affairs at Mirvie and lead author of the study

    While the present study focuses on the hypothetical availability of an objective test to predict preeclampsia, such testing for preeclampsia and other pregnancy complications could soon be available. 

    “Mirvie’s RNA platform focuses on the prediction of pregnancy complications, which is at the leading edge of what’s possible – addressing a huge unmet need in maternal health. Being able to predict who is at highest risk of pregnancy complications presents a massive opportunity for patients to do everything possible to prevent preeclampsia. And for physicians, it’s an important reminder that the toolbox isn’t empty when working with patients on prevention – especially if we can objectively identify who is at highest risk early in the pregnancy,” said Cowan. 

    Mirvie enabled leading researchers and patient advocates to publish the first-ever actionable, evidence-based care plan for preeclampsia, which will translate prediction of risk into prevention of disease. Recommendations include daily aspirin, blood pressure monitoring at home, and lifestyle shifts focused on diet, exercise, and sleep. 

    Methodology

    The study gleaned insights from a digital survey of 1,022 pregnant and recently delivered individuals on sentiments surrounding pregnancy care, knowledge about pregnancy complications, and their anticipated behavior change resulting from predictive testing for complications. 

    Source:

    Journal reference:

    Cowan, A., et al. (2024) Impact of early preeclampsia prediction on medication adherence and behavior change: a survey of pregnant and recently-delivered individuals. BMC Pregnancy Childbirth. doi.org/10.1186/s12884-024-06397-z.

    [ad_2]

    Source link

  • Maternal antibiotic use during childbirth tied to higher risk of autoimmune diseases in children

    Maternal antibiotic use during childbirth tied to higher risk of autoimmune diseases in children

    [ad_1]

    Children whose mothers have received antibiotic treatment during childbirth are more likely to develop autoimmune diseases compared to their counterparts, according to a recent registry-based study conducted at the University of Oulu, Finland, involving nearly 46,000 children. The most common autoimmune diseases in children include type 1 diabetes, celiac disease, and rheumatic diseases. However, the study found that administration of antibiotics during childbirth showed no association with allergic diseases or asthma in the child.

    Antibiotic treatment given to mothers during delivery effectively prevents rare serious infections caused by Group B streptococcus in newborns, thereby reducing associated mortality. In Finland, antibiotics are administered to mothers during childbirth if Group B streptococcus is detected in the birth canal before delivery, and almost one in four women delivering vaginally receives antibiotic treatment.

    The research findings play a crucial role in assessing the potential drawbacks of perinatal antibiotic use and investigating the underlying mechanisms of immune-related diseases. Previous knowledge indicated that antibiotics given to mothers during childbirth affect the development of the child’s intestinal microbiota. The study supports the idea that a normal gut microbiota may have implications for a child’s long-term health.

    This is an observational study that does not directly establish a cause-and-effect relationship between the antibiotics given to mothers during childbirth and the child’s later health. The result is a statistical association possibly influenced by other factors as well.”


    Sofia Ainonen, lead author of the article and doctoral researcher at the University of Oulu

    According to Professor Terhi Ruuska, who led the study, the findings encourage the development of precise prevention methods for Group B streptococcus infections. One potential method could be a vaccine administered to mothers that does not impact the child’s normal microbiota.

    The study followed children born vaginally in Oulu University Hospital (OYS) and Oulaskangas hospital in Northern Ostrobothnia, Finland, between 2007 and 2018. The study utilised national registers from the National Institute for Health and Welfare, the Social Insurance Institution of Finland (Kela) and Statistics Finland, as well as high-quality electronic patient records from the hospitals in the OYS region, which provided comprehensive information on maternal antibiotic exposure.

    The pre-approved version of the study was published in the American Journal of Obstetrics and Gynecology on February 16th.

    Source:

    Journal reference:

    Ainonen, S., et al. (2024) Risk of Immune-related Diseases in Childhood after Intrapartum Antibiotic Exposure. ​​American Journal of Obstetrics and Gynecology. doi.org/10.1016/j.ajog.2024.02.020.

    [ad_2]

    Source link

  • Study reveals lower birth rates on weekends and holidays in Japan

    Study reveals lower birth rates on weekends and holidays in Japan

    [ad_1]

    Significantly more babies were born on a weekday instead of weekend day or holiday, reveals a large-scale analysis of 21 million births in Japan over almost four decades published February 14, 2024 in the open-access journal PLOS ONE by Miho Sassa from the University of Tokyo, Japan, and colleagues.

    Medical resources are generally stretched during holidays (including weekends) due to factors like staffing and hospital policies. This may amplify holiday effects: disparities and variations of health outcomes between holidays and weekdays. Dr. Sassa and colleagues studied this holiday effect with a focus on birth, especially high-risk births as measured by babies born preterm and/or with a low birthweight.

    The authors used birth certificate data from over 21 million individuals born from 1979-2018 (which included birthday, birthweight, and gestational age) to categorize individuals into five groups: low birthweight (<2,500g), preterm birth (<37 weeks), low birthweight and preterm birth, and full-term birth. For this analysis, the authors compared weekdays (Monday-Friday) with weekend days (Saturday and Sunday), national holidays, substitute holidays, Golden Week (four consecutive spring festival days in Japan April 29-;May 5), and the new year period (December 29-;January 3). Leap days and multiple births were excluded. 

    They found that all births were significantly less common on weekend or holiday periods versus weekends (p < 0.01). High-risk births became more frequent over the four decades studied, and the trend of non-weekend or holiday births was especially evident for high-risk births, which were found to take place particularly frequently on Thursday and Friday. Though this study doesn’t include data on medical interventions or pregnancies that didn’t end in a live birth, which could potentially impact the findings, its broad scale suggests medical staff may often control births so that they take place before a weekend or holiday, especially for high-risk births. The authors note that this may be prudent since there are often fewer staff or resources available on weekend/holiday days, but since some holiday births are inevitable, it’s critical for hospitals to plan to minimize risks to those mothers who do give birth on non-weekdays.

    The authors add: “Delving into decades of birth data in Japan, our research illuminates a fascinating trend-;deliveries on holidays, especially those deemed high-risk, show a distinct decline. This discovery prompts a call for innovative solutions and systemic strategies to safeguard maternal and neonatal well-being anytime, demonstrating the need for creative thinking in optimizing medical resources for everyone.”

    Source:

    Journal reference:

    Sassa, M., et al. (2024). Holiday effect on childbirth: A population-based analysis of 21,869,652 birth records, 1979–2018. PLOS ONE. doi.org/10.1371/journal.pone.0296403.

    [ad_2]

    Source link

  • Genetic link found to emotional sensitivity in stressful situations

    Genetic link found to emotional sensitivity in stressful situations

    [ad_1]

    In a recent study published in Scientific Reports, researchers assess how genetic variation in a cluster of differentiation 38 (CD38) is associated with increased personal distress in an emotionally evocative situation. 

    Study: CD38 genetic variation is associated with increased personal distress to an emotional stimulus. Image Credit: Dragana Gordic / Shutterstock.com Study: CD38 genetic variation is associated with increased personal distress to an emotional stimulus. Image Credit: Dragana Gordic / Shutterstock.com

    CD38 and oxytocin

    Oxytocin is a peptide neurohormone that is actively involved in social behavior, including parent-infant bonding, particularly in the immediate period following childbirth, romantic relationships, and group dynamics. Oxytocin-related genetic variants have been associated with various effects on empathy, brain activation during emotion recognition tasks, responses to trauma, and the risk of autism.

    Recently, researchers have identified that A allele carriers of the CD38 single nucleotide polymorphism (SNP) rs3796863 had higher plasma oxytocin levels, a more sensitive approach to parenting, and stronger empathic responses. However, other studies have reported that students with the AA genotype of the CD38 SNP reported higher levels of suicide ideation, depressive symptoms, and greater alienation from parents and peers.

    These conflicting findings have led some researchers to theorize that A carriers may be more socially sensitive, which, as a result, could lead to a stronger negative emotional response during stressful situations. Despite this concept, no study to date has assessed the impact of the CD38 genotype on negative reactivity to an emotionally stressful situation.

    About the study

    For the present study, researchers recruited Canadian university students 18 years of age and older with no health issues expected to influence hormone levels. All study participants were shown a three-minute video depicting a father narrating the story of his child’s terminal cancer.

    After the video, study participants completed a questionnaire seeking to assess their emotional response to 12 emotions, six of which involved feelings of empathic concern, whereas the remaining six included feelings of personal distress. These responses were rated on a scale from one to five, with higher scores indicating higher endorsement of the emotional response. 

    Two Interpersonal Reactivity Index (IRI) subscales, including the personal distress and empathic concern subscales, were used to explore whether the CD38 genotype related to dispositional measures of emotional responses. Participants completed the IRI approximately 10 minutes after watching the emotional video, during which they rated their responses on a five-point Likert scale, with a higher score indicating increased empathy.

    Study findings

    A total of 171 students participated in the current study, 24, 77, and 70 of whom had the AA, AC, and CC genotypes of the CD38 SNP, respectively. 

    The average distress-related response ratings were higher for females than males and AA/AC than CC genotypes, thus suggesting that sex and CD38 genotype affected these responses but not their interaction. Females also scored higher than males on empathy-related responses; however, these scores were not significantly different among the different genotypes.

    On both IRI subscales, sex had a significant effect, with females scoring higher than males. However, the IRI subscale results were not significantly different between the CD38 genotypes.

    When seeing someone in distress, people with the A allele reported insignificant levels of empathy, a well-recognized response of care, but markedly higher levels of personal distress, a self-focused emotional reaction. 

    An empathy-inducing situation may elicit these two responses simultaneously; however, they can have different consequences. For example, while empathy promotes helping behavior to relieve the distress of the individual in need, a person in distress may have the urge to alleviate their own distress rather than offer help to the other person in need of help.

    Conclusions

    The current study provides preliminary evidence that genetic variation in CD38 influences social-emotional sensitivity. To this end, A allele carriers were more vulnerable to distress-related emotions in response to a negative social stressor. 

    The study findings may reconcile paradoxical findings that CD38 A allele carriers are more empathetic despite exhibiting worse interpersonal outcomes. Despite having greater empathy, their high levels of personal distress may prevent appropriate social support from being provided when involved in social conflict. 

    This data on oxytocin-related genetic variants could be used to predict individuals for whom the buffer against stress and anxiety in response to challenging interpersonal situations is weaker. Given their inability to regulate their negative emotions, these individuals should receive adequate and timely support.

    Future studies, especially in interpersonal contexts, need to use more natural empathy paradigms to assess the role of CD38 in emotional regulation.

    Journal reference:

    • Procyshyn, T. L., Leclerc Bédard, L., Crespi, B. J., & Bartz, J. A. (2024). CD38 genetic variation is associated with increased personal distress to an emotional stimulus. Scientific Reports 14(1); 1-7. doi:10.1038/s41598-024-53081-5

    [ad_2]

    Source link