Journal of mother and child最新文献

Various aspects concerning the quality of mother-infant early interactions have been identified as developmentally supportive, promoting child socio-emotional and cognitive skills or related to less favourable outcomes. This review aims to: 1) an overview of observation-based measures assessing the quality of earliest mother-infant interactions, 2) systematically categorize associated behavioural and developmental outcomes, 3) identify potential gaps, together with promising new directions in research. We conducted systematic searches of SCOPUS, Web of Science, PubMed, Cochrane Library, EBSCO, and Google Scholar, in which 30 articles met the eligibility criteria and were selected. Only empirical papers were included, if the quality of mother-infant interactions was measured by direct observation within the first 8 months of the infant's life. The interaction quality measures were divided into unidirectional ones, focused on maternal contribution to the interaction, and bidirectional ones, describing mutual dynamics during interaction. We found that within the selected literature, unilateral methods were prevalent over the bilateral approach. What is more, we identified a research gap concerning the relationship between bidirectional indices of interaction quality and child physiological and neurodevelopmental outcomes. Further studies are needed to comprehend the cascading relationships, through which interactional experience modulates a baby's physiological response, resulting in specific developmental outcomes.

Netherton syndrome (NS) is a rare, autosomal recessive genodermatosis resulting from mutations in the SPINK5 gene, which encodes the LEKTI (Lympho-Epithelial Kazal-type-related inhibitor) protein. This deficiency leads to dysregulated epidermal protease activity, primarily of kallikrein-related peptidases (KLKs), causing severe skin barrier defects, abnormal desquamation, and a complex immune dysregulation involving the T_H2 and T_H17 pathways. Clinically, NS is characterised by a triad of ichthyosiform erythroderma (often evolving from congenital ichthyosiform erythroderma to ichthyosis linearis circumflexa); pathognomonic hair shaft abnormalities, such as trichorrhexis invaginata ("bamboo hair"); and atopic manifestations with elevated serum IgE. Diagnosis can be challenging due to symptomatic overlap with other inflammatory dermatoses, congenital ichthyosis, and primary immunodeficiencies. Confirmation relies on clinical findings, trichoscopic hair examination, and SPINK5 genetic testing. Management is currently largely supportive, focusing on emollients, antiseptics, and cautious use of topical anti-inflammatory agents. While traditional systemic treatments have limitations, emerging targeted therapies, including biologics and gene therapy, show promise, but require further investigation through robust clinical trials to establish their efficacy and safety. This review highlights the diagnostic intricacies and evolving therapeutic landscape of this complex disorder.

Respiratory Syncytial Virus (RSV) causes over 50,000 hospitalizations annually among children under five years of age, leading to long-term consequences, such as asthma. Monoclonal antibodies (mAb) have been recommended for prevention, but their limitations have prompted the search for alternative preventive measures. The recent Food and Drug Administration (FDA) approval of a maternal RSV vaccine with 80% efficacy in protecting infants up to 90 days post-birth marks a significant advancement. Our narrative review investigates the differences in RSV immunization in pregnant mothers versus infants and children, with the goal of identifying factors that influence parental decisions. This study provides insights for optimising preventive strategies, and the results highlight the importance of maternal vaccination in combating RSV in children.

Background: Breastfeeding is the ideal nutrition for the first half of an infant's life. It contains the right nutrients for the physical and mental development of the infant. In general, however, fewer than 50% of infants under six months are exclusively breastfed globally. This study aims to determine if Greece's exclusive breastfeeding rates comply with WHO and UNICEF recommendations and to explore the variables that affect the lengthening of exclusive breastfeeding.

Material and methods: This cross-sectional study was conducted in four municipalities of South Athens, Greece from July 2018 to June 2019 in day care centers. The sample of study consisted of 674 mother-child couples. The study was approved by the Department of Nursing at the University of the Peloponnese, as well as the municipal day care centers. The mothers were informed about the purpose of the study.

Results: 236 (35.01%) women in the sample breastfed exclusively for six months or more, of which 106 (44.91%) women continued breastfeeding for one year, and 22 (9.32%) women until two years. Exclusive breastfeeding, satisfaction with the process, gestational diabetes, excess and normal maternal weight at the time of the study are statistically significant factors for increasing the duration of exclusive breastfeeding.

Conclusions: Exclusive breastfeeding rates in Greece fall short of WHO and UNICEF targets, with only 35.01% of mothers breastfeeding exclusively for six months.

Background: Placenta Accreta Spectrum (PAS) is a life-threatening obstetric condition with increasing incidence due to rising caesarean deliveries and assisted reproductive technologies. Our objective was to determine PAS incidence, identify risk factors, and develop a clinically relevant risk stratification model.

Material and methods: A retrospective study of 85 PAS cases from 9,088 deliveries (September 2023 to September 2024, SMS Medical College, Jaipur) analysed clinical and histopathological data, including placenta praevia, multiparity, prior caesarean sections, uterine surgeries, and IVF. Cases with spontaneous placental separation were excluded.

Results: PAS incidence was 0.94%. Placenta accreta, increta, and percreta were found in 35.3%, 34.1%, and 30.6% of cases, respectively. Significant risk factors included multiparity (82.4%, p < 0.001), prior caesarean sections (88.2%, p < 0.05), placenta praevia (70.6%, p = 0.002), uterine surgeries (21.17%, p < 0.05), and IVF (7.1%, p < 0.05). A PAS risk model integrating clinical predictors and region-specific weighted scoring was developed for early identification.

Conclusion: PAS is a significant obstetric challenge. Identified risk factors include multiparity, prior caesarean sections, placenta praevia, uterine surgeries, and IVF. Early detection and structured referral pathways are critical for reducing maternal morbidity. This study bridges the gap between region-specific data and global PAS trends, offering a tailored, evidence-based risk stratification model for improved maternal care in resource-limited settings.

Peripartum cardiomyopathy (PPCM) and HELLP syndrome are rare, life-threatening pregnancy-associated conditions. PPCM, a dilated cardiomyopathy, presents with heart failure during the peripartum period. In comparison, HELLP syndrome involves hemolysis, elevated liver enzymes, and low platelet count. Symptoms of these conditions often mimic normal physiological discomforts and can be confused with typical peripartum issues. We report a unique case of a 24-year-old primigravida presenting with PPCM and HELLP syndrome. Timely diagnosis and multidisciplinary management resulted in her recovery, owing to a high level of clinical suspicion for her symptoms. Six-month follow-up showed normalisation of her cardiac function and complete clinical resolution.

A Transient Ischemic Attack (TIA) in children results from a temporary interruption of blood flow to the brain, leading to brief neurological symptoms. The most common causes of pediatric TIA include congenital heart defects and vascular anomalies. We present a 10-year-old girl with neurological symptoms due to subclavian steal syndrome. Physical examination revealed an asymmetry in blood pressure measurements between the upper limbs, exceeding 30 mmHg. Echocardiography revealed a right-sided aortic arch (RAA) with an atypical configuration of the cephalic vessels. Ultrasound of the vertebral arteries demonstrated reversed flow direction in the left vertebral artery. CT angiography confirmed RAA and an atypical branching pattern. The left subclavian artery was narrower with critical stenosis in its proximal segment, adjacent to the origin of the ductus arteriosus. The girl was qualified to surgical intervention to correct the incomplete vascular ring associated with a RAA and an aberrant left subclavian artery.

Introduction: The appearance of depressive symptoms is a prevalent mental health issue among women, with inflammatory cytokines being explored as potential biomarkers. This systematic review evaluates the relationship between inflammatory cytokines and depressive symptoms in postpartum women.

Material and methods: Following PRISMA 2020 guidelines, a search was conducted across five electronic databases (PubMed, ScienceDirect, CINAHL, Web of Science, and Tripdatabase) up to September 2024. Studies examining the relationship between inflammatory cytokines and postpartum depressive symptoms that were published in English were included. The risk of bias was assessed using the Revised Risk of Bias Assessment Tool for Non-Randomised Studies of Interventions 2.

Results: Nine studies were included in this review. A total of 888 postpartum women were analysed across nine studies. IL-1β was significantly elevated in postpartum women with depressive symptoms in two studies. IL-6 showed mixed findings, with three studies supporting an association, while three others did not. IL-10 and TNF-α generally showed no significant relationship with depressive symptoms. The overall quality of the studies included varied, with three studies at high risk of bias and five at low risk.

Conclusion: Evidence on the relationship between inflammatory cytokines and postpartum depressive symptoms is inconsistent. IL-1β may be linked to depressive symptoms. TNF-α and CRP may have no relationship with depressive symptoms in postpartum women, but the roles of IL-6 and IL-10 remain unclear. More high-quality research is necessary to determine the clinical significance of cytokine levels in predicting or managing postpartum depression.

Background: Telehealth was an alternative in many countries during the COVID-19 pandemic for infants at risk of developmental delays. However, some barriers still challenge the adoption of telehealth as a care option, particularly once face-to-face interventions recommenced. This study aimed to identify the barriers and facilitators of a telehealth program to support infants at risk for developmental delays.

Materials and methods: A prospective longitudinal study was conducted with 30 infants born at risk of developmental delay (preterm or term, with mean age of 3.1 months). Infants were enrolled between 2-12 months of corrected age. The program consisted of weekly telehealth sessions with a physical therapist focusing on supporting children's cognitive, motor, speech, and language development. After 6 months, the caregivers answered a questionnaire on perceived barriers and facilitators of the telehealth program.

Results: A mean of 9.5 (range 2-12) sessions were carried out. Most caregivers (80%) felt comfortable and satisfied with the program, found the application for video calls easy to use, got help with their questions, and perceived improvements in the development of their infants. The main barrier was most caregivers rated the concern regarding their child as low (53.3%).

Conclusion: Caregivers considered the telehealth program satisfactory and viable for complementary care and monitoring of infants' development.

Background: This study investigates genetic markers, such as polymorphisms in the vitamin D receptor (VDR) and receptor activator of nuclear factor-kappa B ligand (RANKL) genes, to determine if they can serve as prognostic indicators for the development of bone-tissue pathologies in childhood.

Material and methods: The study included 104 healthy children aged from birth to 12 months. Genetic testing was conducted to identify polymorphisms in the VDR and RANKL genes.

Results: 78% of the 104 children from the Kazakh population showed a decrease in the level of vitamin D, with particularly promising results in infants seven to 12 months old. Indicators of total calcium and phosphorus in children were uninformative for bone-metabolism analysis. The homozygous C/C type according to RANKL rs9594759 was detected in 17% of children; the homozygous T/T variant according to RANKL rs9594738 was detected in 28%; the homozygous T/T according to VDR rs2228570 was detected in 17%; and the homozygous A/A according to VDR rs2228570 was detected in 4%. These variant polymorphisms are associated with reduced bone density. RANKL rs9594738 and RANKL rs9594759 have shown a moderate connection with vitamin D serum concentration.

Conclusion: A relatively strong relationship was found between the T/T and C/T genotypes of the VDR gene and the concentration of vitamin D falling below the norm, and there is a direct relationship between vitamin D levels and bone pathology risk in children.