Role of sexually dimorphic oxytocin receptor-expressing neurons in the anteroventral periventricular nucleus on maternal behavior.

Oxytocin is a neuropeptide produced by magnocellular neurosecretory neurons located primarily in the supraoptic nucleus and paraventricular nucleus of the hypothalamus. The long axons of these neurons project to the neurohypophysis where oxytocin is released into the general circulation in response to the physiological demands. Oxytocin plays critical roles in female reproductive physiology, specifically in uterine contraction during labor and milk ejection while nursing. Oxytocin is also called "the love hormone" due to its modulatory roles in prosocial behaviors, including social recognition, maternal behavior, and pair bonding. Oxytocin influences behaviors by binding to oxytocin receptors (OXTR) located in various parts of the brain. Previously, we discovered a group of estrogen-dependent OXTR neurons that is exclusively present in the anteroventral periventricular nucleus (AVPV) of females but not of males. The female-specific expression of OXTR in the AVPV is a rare case of neurochemically-demonstrated, all-or-none sexual dimorphism in the brain. In this review, the cellular characterization and functional significance of the sexually dimorphic OXTR neurons in the AVPV as well as the clinical implications of the research will be discussed.

Percepção materna do cuidado à recém-nascidos com baixo peso: revisão sistemática qualitativa

Introdução: O peso ao nascer tem grande influência sobre o desenvolvimento global da criança, que por sua vez sofre influência direta dos cuidados maternos. Objetivo: Identificar na literatura científica a percepção materna sobre o cuidado de recém-nascidos com baixo peso. Métodos: Trata-se de uma revisão sistemática de estudos qualitativos conduzida em conformidade com as diretrizes metodológicas do Instituto Joanna Briggs. A pesquisa foi realizada entre abril de 2021 e março de 2023 nas bases de dados PubMed, MedLine, BVS, Scielo, EMBASE e Web of Science, com os descritores: "percepção materna", "baixo peso ao nascer" e "cuidado da criança", em diferentes combinações. Incluíram-se estudos em português, inglês e espanhol, publicados entre 2013 e 2023, que tratassem do cuidado materno de recém-nascidos com baixo peso no contexto hospitalar ou domiciliar. Os resultados foram categorizados de acordo com a análise de conteúdo. Resultados: Foram identificados 1129 estudos, dos quais apenas 11 foram incluídos nesta revisão, nas seguintes categorias: sentimentos maternos, necessidades e desafios do cuidado, aleitamento materno, vínculo mãe-bebê e apoio social. Considerações finais: Mães de recém-nascidos com baixo peso experimentam insegurança e problemas gerais de adaptação que afetam os cuidados para suprimento das necessidades essenciais da criança. Apoio familiar e de profissionais de saúde podem reforçar a segurança materna e contribuir para o cuidado integral de recém-nascidos com baixo peso.

Introducción: El peso al nacer tiene una gran influencia en el desarrollo global del niño, el cual a su vez está directamente influido por los cuidados maternos. Objetivo: Identificar en la literatura científica la percepción de la madre sobre el cuidado del niño nacido con bajo peso. Métodos: Esta es una revisión sistemática de estudios cualitativos realizados de acuerdo con las pautas metodológicas del Instituto Joanna Briggs. La investigación fue realizada entre abril de 2021 y marzo de 2023 en las bases de datos PubMed, MedLine, BVS, Scielo, EMBASE y Web of Science, con los descriptores: "percepción materna", "bajo peso al nacer" y "cuidado del niño", en diferentes combinaciones. Se incluyeron estudios en portugués, inglés y español, publicados entre 2013 y 2023, que abordaran el cuidado materno de niños nacidos con bajo peso en el contexto hospitalario o domiciliario. Los resultados se clasificaron según el análisis de contenido. Resultados: Se identificaron 1129 estudios, de los cuales solo 11 fueron incluidos en esta revisión, en las siguientes categorías: sentimientos maternos, necesidades y desafíos de cuidado, lactancia materna, vínculo madre-hijo y apoyo social. Consideraciones finales: Las madres de niños nacidos con bajo peso experimentan inseguridad y problemas generales de adaptación que afectan los cuidados para satisfacer las necesidades esenciales del niño. El apoyo familiar y el apoyo de los profesionales de la salud pueden reforzar la seguridad materna y contribuir a la atención integral en salud de los niños nacidos con bajo peso.

Introduction: Birth weight has a great influence on the child's global development, which in turn is directly influenced by maternal care. Objective: To identify in the scientific literature the mother's perception about the care of children born with low birth weight. Methods: This is a systematic review of qualitative studies conducted in accordance with the methodological guidelines of the Joanna Briggs Institute. The research was carried out between April/2021 and March/2023 in the databases: PubMed, Medline, VHL, SciELO, EMBASE and Web of Science, with the descriptors: maternal perception, low birth weight and child care, in different combinations. Studies in Portuguese, English and Spanish, published between 2013 and 2023, that addressed the maternal care of children born with low birth weight in the hospital or home context were included. Results were categorized according to content analysis. Results: 1129 studies were identified, of which only 11 were included in this review, in the following categories: maternal feelings, care needs and challenges, breastfeeding, mother-infant bonding and social support. Final considerations: Mothers of children born with low birth weight experience insecurity and general adaptation problems that affect care to meet the child's essential needs. Family support and support from health professionals can reinforce maternal security and contribute to the comprehensive health care of low birth weight children.

Conhecimento materno sobre os cuidados bucais das crianças na primeira infância / Maternal knowledge about children's oral care in early childhood / Conocimiento materno sobre elcuidado bucal de los niños en la primera infância

Introdução:Os pais exercem um importante papel no estabelecimento dos hábitos saudáveis durante a infância.Aoprestarem cuidados bucais necessários às suas crianças, observa-se um significativo resultado na prevenção dos agravos.Objetivo:Identificaroconhecimento materno sobre os cuidados bucais das crianças na primeira infância. Metodologia:Trata-se de um estudo de natureza quantitativa do tipo exploratório e observacional. A coleta ocorreu através da aplicação de um questionário semiestruturado, com questões sobre o conhecimento materno em relação à higiene bucal, hábitos alimentares, acometimento de cárie e perfil socioeconômico. Realizou-se uma análise descritiva dos dados, seguida de análise bivariada pelo teste do Qui-quadrado de Pearson, considerando-se um nível de significância de 5%. Resultados:Sobre o conhecimento dos cuidados bucais dos filhos, o mesmo encontrou-se insatisfatório em relação à idade em que as crianças devem começar a escovar seus dentes sozinhas,quanto ao uso de escova e docreme dental fluoretado como método de higiene após a erupção do primeiro dente e quanto à inexistência do dente decíduo antes do nascimento dos molares permanentes. Observou-se conhecimento satisfatório em relação à importância de se realizar restauraçãoem dente decíduo acometido por cárie,à idade em que a criança troca os dentes decíduos pelos permanentes e, à realização de algum cuidado bucal (fralda e gaze) antes do nascimento do primeiro dente.Conclusões:Há uma lacuna quanto às orientações de saúde bucal providas pelos dentistasdirecionadas às mães. As mães/gestantes têm o conhecimento adequado sobre os cuidados bucais do bebê, porém, quanto aos cuidados após o nascimento do primeiro dente, os resultados foram desfavoráveis. Faz-se necessário a maior participação do cirurgião-dentista nas consultas de pré-natal e de crescimento e desenvolvimento praticando educaçãoem saúde (AU).

Introduction:Parents play an important role in establishing healthy habits during childhood. Providing necessary oral care to their children significantly contributes to preventing oral health issues.Objective: To verify maternal knowledge about children's oral care in early childhood.Methodology:Thisis a quantitative, exploratoryandobservationalstudy. Data werecollectedthroughtheapplicationof a semistructuredquestionnaire, withquestionsabout maternal knowledgeregarding oral hygiene, eatinghabits, caries involvementandsocioeconomic profile. A descriptivedata analysiswasperformed, followedby a bivariate analysis, usingPearson's chi-square test, considering a 5% significance level. Results:Regardingmothers' knowledge about their children's oral care, it was unsatisfactory in relation to the age at which children should start brushing their teeth by themselves; regarding the use of a toothbrush and fluoride toothpaste as hygiene methods, after the first tooth's eruption, and regarding the absence of the deciduous tooth before the permanent molars eruption. Satisfactory knowledge was observed regarding the importance of carrying out restoration in decayed deciduous teeth; the age at which children begin to change deciduous teeth for permanent ones and, carrying out some oral care (fabric and gauze) before the first tooth's eruption. Conclusions:There is a gap in the oral health guidelines provided by dentists, aimed to mothers. The mothers/pregnant women have sufficient knowledge about their baby's oral care, but considering the oral care after the first tooth eruption, the results were critical. It is necessary a greater participation of the dentist in prenatal and growth and development consultations, practicing Health Education (AU).

Introducción: Los padres ejercen un papel importante en el establecimiento de hábitos saludables durante la infancia. Al proporcionar el cuidado bucal necesario a sus hijos, se obtienen resultados importantes en la prevención de enfermedades. Objetivo: Identificar el conocimiento materno sobre el cuidado bucal de los niños en la primera infancia. Metodología:Se trata de un estudio cuantitativo de carácter exploratorio yobservacional. La colecta ocurrió mediante la aplicación de un cuestionario semiestructurado, con preguntas sobre conocimientos maternos sobre higiene bucal, hábitos alimentarios, caries y perfil socioeconómico. Se realizó un análisis descriptivo de los datos, seguido de un análisis bivariado mediante la prueba Chi-cuadrado de Pearson, considerando un nivel de significancia del 5%. Resultados:En cuanto al conocimiento sobre el cuidado bucal de los niños, se encontró insatisfactorio en relación a la edad en la que los niños deben comenzar a cepillarse los dientes solos, en cuanto al uso de cepillos dentales y pasta dental fluorada como método de higiene después de la erupción del primer diente y la ausencia de un diente temporal antes del nacimiento de los molares permanentes. Se observó conocimiento satisfactorio sobre la importancia de restaurar un diente temporal afectado por caries, la edad en que el niño cambia los dientes temporales por permanentes y la provisión de algunos cuidados bucales (pañal y gasa) antes del nacimiento del primer diente. Conclusiones:Existe un vacío en la orientación sobre salud bucal proporcionada por los odontólogos dirigida a las madres. Las madres/gestantes tienen conocimientos adecuados sobre el cuidado bucal de su bebé, sin embargo, en relación a los cuidados después del nacimiento del primer diente los resultados fueron desfavorables. Es necesaria una mayor participación del odontólogo en las consultas prenatales y de crecimiento y desarrollo, practicando la educación para la salud (AU).

Percepções das mães que são profissionais de saúde sobre as relações na unidade neonatal / Health professionals mothers' perceptions about relationships in the neonatal unit / Percepciones de las madres profesionales de la salud sobre las relaciones en la unidad neonatal

Objetivo: discutir as percepções das mães que são profissionais de saúde sobre as relações na unidade neonatal. Método: estudo qualitativo, apoiado no Interacionismo Simbólico, com 11 mães de recém-nascidos pré-termo que são profissionais da saúde. Após aprovação pelo Comitê de Ética em Pesquisa, os dados foram coletados de maio a outubro de 2021, por meio de entrevistas individuais, e submetidos à análise de conteúdo temática. Resultados: apesar de as mães serem profissionais da saúde, as relações na unidade neonatal foram difíceis, sofridas, desconfortantes e restritivas ao processo de 'ser e tornar-se mãe'. Estas desvelaram sentimentos de não pertencimento ao cuidado e de afastamento de suas crianças. Conclusão: as relações entre mães e profissionais da saúde atuantes na unidade neonatal estiveram marcadas por sofrimentos, limitações e desconfortos, sendo lacunares em processos colaborativos, na contramão do Cuidado Centrado na Família(AU)

Objective: to discuss the perceptions of mothers who are health professionals about relationships in the neonatal unit. Method: a qualitative study, based on Symbolic Interactionism, with 11 mothers of preterm newborns who are health professionals. After approval by the Research Ethics Committee, data was collected from May yo October 2021, through individual interviews, and subjected to thematic content analysis. Results: despite the mothers being health professionals, relationships in the neonatal unit were difficult, painful, uncomfortable, and restrictive to the process of 'being and becoming a mother'. They revealed feelings of not belonging to care and of being away from their children. Conclusion: the relationships between mothers and health professionals working in the neonatal unit were marked by suffering, limitations, and discomfort, and were lacking in collaborative process, going against Family-Centered Care(AU)

Objetivo: discutir las percepciones de las madres profesionales de salud sobre las relaciones en la unidad neonatal. Método: estudio cualitativo, basado en el Interaccionismo Simbólico, con 11 madres de recién nacidos prematuros que son profesionales de la salud. Previa aprobación del Comité de Ética en Investigación, se recolectaron los datos de mayo a octubre de 2021, mediante entrevistas individuales y los sometieron a análisis temático de contenido. Resultados: aunque las madres eran profesionales de salud, las relaciones en la unidad neonatal fueron difíciles, dolorosas, incómodas y restrictivas al proceso de 'ser y volverse madre'. Revelaron sentimientos de no pertenencia a los cuidados y de alejamiento de sus hijos. Conclusión: las relaciones entre las madres y los profesionales sanitarios que trabajan en la unidad neonatal estaban marcadas por el sufrimiento, las limitaciones y la incomodidad, y carecían de procesos de colaboración, lo que iba en contra de la Atención Centrada en la Familia(AU)

Research progress on the interference effects of plasticizers on maternal behavior and its potential mechanisms.

Environmental endocrine disrupting chemicals (EDCs), known as environmental hormones, are exogenous chemicals that can disrupt hormone levels and cause dysfunction of the secretory system in humans and animals. Plasticizers, which are widely used EDCs, are commonly used to enhance the flexibility of plastic products. As plastics age and wear, however, they can leach into the environment and enter the bodies of animals through various pathways such as the digestive tract and skin. They can lead to estrogen-like effects and have substantial reproductive toxicity. Residual plasticizer concentrations in the environment are typically low. Unlike high doses that induce acute damage to the reproductive system, low doses of plasticizers do not cause macroscopic harm and thus its reproductive toxicity is often overlooked for extended periods. An increasing number of studies conducted on humans and mice in recent years have demonstrated that low doses of plasticizers can induce reproductive toxicity by interfering with maternal behavior. Prenatal exposure to plasticizers can result in abnormal postnatal maternal behavior. Female offspring also exhibit significantly low maternal care, lactation, and other behaviors in adulthood, which may persist for multiple generations, significantly disrupting the animal breeding process and impacting the health and well-being of newborn pups. The underlying mechanisms have not been systematically summarized. The risk of continuous exposure to low-dose plasticizers in humans and animals has increased due to the extensive utilization of plastic and rubber products in modern production and lifestyle patterns. It is thus crucial to conduct a systematic review on the effects of low-dose plasticizers on maternal behavior. We reviewed the research progress on the disruptive effects of plasticizers on animals' maternal behavior and concluded that these effects are primarily caused by inducing oxidative stress damage and DNA methylation reprogramming in the hypothalamic-pituitary-ovarian axis, as well as disrupting the balance of the thyroid system and causing intestinal microbial disorders. It would offer a novel perspective for future studies about the influence of plasticizers and other environmental hormones on maternal behavior in domesticated animals.

Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment.

BACKGROUND: Despite limited clinical consensus regarding surgery for tethered oral tissues ("tongue-tie") for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. RESEARCH AIM: To explore experiences of breastfeeding mothers with infants having undergone "tongue-tie" surgery. METHOD: This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. RESULTS: The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%).Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt "very confident" in their ability to correctly identify it and 97% (n = 87) felt "very involved" and "strongly agreed" with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%). CONCLUSIONS: Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.

The increase in the number of amylin neurons in the medial preoptic area throughout the lactational period and its relationship with melanin-concentrating hormone.

The amylin and the melanin-concentrating hormone [MCH] are two peptides related to energetic homeostasis. During lactation, it is possible to locate neurons expressing these peptides in the preoptic area of rat dams. In addition, it was demonstrated that the number of MCH neurons in this region is modulated by litter size. Taken together, the aims of this work were (1) to verify the time course of amylin immunoreactivity during lactation; (2) to verify whether litter size modulates the number of amylin-ir neurons (3) to verify whether there is colocalization between the amylin-ir and MCH-ir neurons. Our results show that (1) there is an increase in the number of amylin-ir neurons during lactation, which reaches a peak at postpartum day 19 and drastically reduces after weaning; (2) there is no correlation between litter size and the number of amylin-ir neurons; and (3) there is minimal overlap between amylin-ir and MCH-ir neurons.

The influence of perception of care and maternal protection on breastfeeding practices on the infants' third month of life / Influência da percepção do cuidado e da proteção materna sobre as práticas de aleitamento materno em lactentes no terceiro mês de vida

Abstract Objectives: to evaluate the influence of perception of care and maternal protection on breastfeeding practices on the infants' third month of life. Methods: longitudinal study with mother-infant pairs distributed in five groupsof gestational clinical conditions. The recruitment occurred in the period 2011 to 2016 at three hospitals in the public health systems in Porto Alegre, Brazil. The Parental Bonding Instrument and the Edinburgh Postpartum Depression Scale were assessed. Exclusive and prolonged breastfeeding were analyzed by questionnaires. Data were analyzed by one-way ANOVA with Tukey's post-hoc test, Kruskal-Wallis with Dunn's post-hoc test, or Pearson's chi-squared test. The significance was set at 5%. Results: 209 mother-infant pairs were investigated. Among those who did not practice breastfeeding, a lower perception of care, a higher perception of maternal protection, and a higher score of postpartum depression were observed (p=0.022, p=0.038, and p<0.001, respectively), when compared to peers who practiced. The control group had a significantly higher perception of care when compared to thediabetes mellitus group (p=0.006), and the perception of maternal protection and postpartum depression had no differences between the intrauterine groups (p>0.05). Conclusions: the perception of care and maternalprotection and the postpartum depressive symptomatology influenced breastfeeding at three months. It is possible to assume a transgenerational effect on breastfeeding, suggesting the existence of a complex model related to mental health in a sample of women who had different backgrounds of gestational clinical conditions

Resumo Objetivos: avaliar a influência da percepção do cuidado e da proteção materna sobre as práticas de aleitamento materno em lactentes no terceiro mês de vida. Métodos: estudo longitudinal, com pares mães-lactentes distribuídos em cinco grupos de diferentes condições clínicas gestacionais. O recrutamento ocorreu no período de 2011 a 2016 em três hospitais da rede pública de saúde de Porto Alegre, Brasil. Foram utilizados o Parental Bonding Instrument e o Edinburgh Postpartun Depression Scale. O aleitamento materno exclusivo e continuado foi analisado por questionários. Na análise de dados foram utilizados os testes de ANOVA com post-hoc de Tukey, Kruskal-Wallis com post-hoc de Dunn e Qui-quadrado. Resultados: foram investigados 209 pares mães-lactentes. Entre aqueles que não praticaram o aleitamento materno foi observadouma menor percepção de cuidado materno, uma maior percepção de proteção materna e ummaior escore de depressão pós-parto (p=0,022, p=0,038 e p<0,001, respectivamente) quandocomparados aos pares mães-lactentes que praticaram. O grupo controle teve significativamente maior percepção do cuidado materno quando comparado ao grupo com diabetes mellitus (p=0,006) enquanto a percepção de proteção materna e a depressão pós-parto não apresentaram diferenças entre os cinco grupos intrauterinos (p>0,05). Conclusões: a percepção de cuidado e proteção materna e asintomatologia depressiva pós-parto influenciaram o aleitamento materno aos três meses. É possível assumir um efeito transgeracional no aleitamento materno, sugerindo a existência de um modelo complexo relacionado à saúde mental numa amostra de mulheres que tinham diferentes antecedentes de condições clínicas gestacionais.

Convertirse en madre y preparación para la maternidad. Un estudio cualitativo exploratorio / Becoming a Mother and Preparation for Motherhood. An Exploratory Qualitative Study / Preparando-se para a maternidade. Um estudo qualitativo exploratório

Introducción: la preparación para la maternidad contribuye al fenómeno de convertirse en madre. Objetivo: describir los significados que las mujeres que se vuelven madres por primera vez le atribuyen a la preparación para la maternidad. Método: estudio cualitativo, descriptivo y exploratorio que utilizó la entrevista abierta con mujeres que estaban experimentando por primera vez el proceso de convertirse en madre. Se utilizó un muestreo por conveniencia y el tamaño de la muestra estuvo determinado por la saturación teórica. Las entrevistas se grabaron y se transcribieron. Se aplicó la técnica de análisis de contenido a los relatos y todas las mujeres firmaron consentimiento informado autorizando su participación. Resultados: se entrevistaron diez mujeres y de sus relatos emergieron cinco categorías: 1) aprender, la tarea de ser madre; 2) apoyo durante el proceso de convertirse en madre; 3) atributos de la preparación; 4) relación con la pareja; y 5) relación con la madre. La preparación para la maternidad se ve permeada y configurada por una serie de encuentros y desencuentros en una red de interacciones con el compañero, la madre de la mujer, el bebé y la sí misma. Conclusiones: la preparación para la maternidad requiere del apoyo de otras personas significativas en varios momentos del proceso; es un fenómeno en el que se logran aprendizajes, se transita por aspectos emocionales y modifica la relación con la pareja y con la madre.

Introduction: The preparation for motherhood contributes to the phenomenon of becoming a mother. Objective: To describe the meanings that women who are mothers for the first-time attribute to the preparation for motherhood. Method: Qualitative descriptive and exploratory study that used open interviews with women who were experiencing the process of becoming a mother for the first time. A convenience sample was used, and the sample size was determined by theoretical saturation. The interviews were recorded and transcribed. The content analysis technique was applied to the stories and all women signed and informed consent authorizing their participation. Results: Ten women were interviewed, and five categories emerged from their reports: 1) Learning the task of being a mother; 2) Support; 3) Attributes of preparation; 4) Relationship with partner; and 5) Relationship with the mother. The preparation for motherhood is permeated and shaped by a series of encounters and disagreements in a network of interactions with the partner, the woman's mother, the baby, and herself. Conclusions: Preparation for motherhood requires the support of other significant people at various moments of the process; it is a phenomenon in which learning is achieved. It goes through emotional aspects and modifies the relationship with the couple and with the mother.

Introdução: a preparação para a maternidade contribui para o fenômeno de tornar-se mãe. Objetivo: descrever os significados que as mulheres que são mães pela primeira vez atribuem a preparação para a maternidade. Método: estudo qualitativo, descritivo e exploratório que utilizou entrevistas abertas com mulheres que vivenciavam o processo de tornar-se mãe pela primeira vez; foi utilizada a amostragem de conveniência e o tamanho da amostra foi determinado pela saturação teórica. As entrevistas foram gravadas e transcritas. A técnica de análise de conteúdo foi aplicada as histórias e todas as mulheres assinaram o Termo de Consentimento Livre e Esclarecido autorizando sua participação. Resultados: foram entrevistadas dez mulheres e em seus relatos emergiram cinco categorias: 1) aprendizado tarefa de ser mãe; 2) apoio; 3) atributos do preparo; 4) relação com o parceiro; 5) relação com o a mãe. A preparação para a maternidade e permeada e moldada por uma série de encontros e desencontros em uma rede de interações com o parceiro, a mãe da mulher, o bebê e a própria mãe. Conclusões: a preparação para a maternidade requer o apoio de outras pessoas significativas em vários momentos do processo; é um fenômeno em que a aprendizagem é alcançada, passa por aspectos emocionais e modifica a relação com o casal e com a mãe.

Parental educational practices, emotional health and maternal sociodemographic variables: Nuclear and non-nuclear families / Práticas educativas parentais, saúde emocional e variáveis sociodemográficas maternas: famílias nucleares e não nucleares

Objective We compared parental educational practices and emotional health of 62 mothers of students from nuclear (G1) and non-nuclear families (G2). Method We used an inventory of parenting practices and scales for assessment of anxiety, stress and depression. Results G1 showed significantly higher means for Moral Behavior. Positive correlations between negative parenting educational practices and clinical indicators for maternal emotional health were perceived in both groups and more significantly for G2. Younger mothers in G1 indicated more signs of state anxiety and for G2 the lower socioeconomic level indicated more signs of stress and trait anxiety and less depression. Conclusion The data can contribute to the planning of interventions.

Objetivo Comparar e relacionar práticas educativas parentais e saúde emocional de 62 mães de escolares de famílias nucleares (G1) e não nucleares (G2). Método Utilizou-se um inventário de práticas parentais e escalas para avaliação da ansiedade, estresse e depressão. Resultados O G1 apresentou significativamente médias superiores para Comportamento Moral. Correlações positivas entre as práticas educativas parentais negativas e indicadores clínicos para saúde emocional materna foram percebidos em ambos os grupos e de forma mais expressiva para G2. Mães mais jovens em G1 indicaram mais sinais de ansiedade-estado. Já para G2, o nível socioeconômico inferior indicou mais sinais de estresse e ansiedade-traço e menos depressão. Conclusão Os dados podem contribuir para o planejamento de intervenções.

Exposure to environmentally relevant doses of plasticizers alters maternal behavior and related neuroendocrine processes in primiparous and multiparous female mice.

Phthalates are organic pollutants frequently detected in the environment. The effects of these substances on male reproduction have been extensively studied but their potential impact on female reproductive behaviors in particular at environmental doses still remains to be documented. In the present study, we examined the effects of chronic exposure to di (2-ethylhexyl) phthalate (DEHP) alone at 5 or 50 µg/kg/d, or in an environmental phthalate mixture on maternal behavior of lactating female mice after a first (primiparous) and a second gestation (multiparous). Exposure of DEHP alone or in a phthalate mixture reduced pup-directed behaviors, increased self-care and forced nursing behaviors and altered nest quality for both primiparous and multiparous dams. In pup-retrieval test, primiparous and multiparous dams exposed to DEHP alone or in a phthalate mixture retrieved their pups more rapidly, probably due to a higher emission of ultrasonic vocalizations by the pups. At lactational day 2 following the third and last gestational period, the neural circuitry of maternal behavior was analyzed. A lower number of oxytocin-immunoreactive neurons in the paraventricular and anterior commissural nuclei was found in dams exposed to DEHP alone or in a phthalate mixture, while no changes were observed in the number of arginine-vasopressin immunoreactive cells. In the medial preoptic area, exposure to DEHP alone or in a phthalate mixture reduced ERα-immunoreactive cell number. Dendritic spine density assessed for DEHP at 5 µg/kg/d was also reduced. Thus, exposure to DEHP alone or in a phthalate mixture altered maternal behavior probably through a neuroendocrine mode of action involving oxytocin and estrogen through ERα, key pathways necessary for neuroplasticity and behavioral processing.

Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities.

BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

Determinantes sociales de la salud relacionados con la morbilidad materna extrema departamento de Sucre 2018-2019

Objetivo: Describir los determinantes sociales de la salud relacionados con la aparición de morbilidad materna extrema en gestantes de una institución de salud del departamento de Sucre durante 2018 - 2019. Materiales y métodos: Estudio mixto con fuentes secundarias (Sistema de vigilancia epidemiológica), observación directa en los sitios de residencia y la aplicación de una entrevista semiestructurada al grupo de sobrevivientes. Resultados: La incidencia del evento fue de 1.4 % de gestantes atendidas. El promedio de edad fue de 24 años, pertenece a una etnia el 37.5 %, proceden de área rural el 69.7 %, con niveles educativos bajos (38 %), conviviendo en unión libre (68.7 %), primigestantes (56.2 %), ingreso tardío a los controles prenatales (68.7 %), promedio de asistencias de 3.5 controles. Los determinantes que guardan relación estadística para la aparición del evento fueron: nivel educativo, la pertenencia étnica, tenencia de compañero sentimental y número de controles a los que asiste. La calidad de los servicios de salud, la pobreza, inaccesibilidad geográfica y barreras administrativas de las aseguradoras fueron las más destacadas para las gestantes. Conclusión: El evento se presenta principalmente en gestantes jóvenes, con bajo nivel educativo y de zonas rurales, los determinantes que se asociaron fueron: la etnia, el número de controles prenatales a los que asiste, el nivel educativo y el estado conyugal; para las gestantes con Morbilidad materna los bajos ingresos económicos, la inaccesibilidad a los servicios de salud y la mala calidad en la prestación de estos fueron los más importantes.

Objective: To describe the social determinants of health related to the appearance of extreme maternal morbidity in pregnant women from a health institution in the department of Sucre, for the 2018 - 2019 period. Materials and methods: Mixed study with secondary sources (Epidemiological surveillance system), direct observation at the places of residence, and the application of a semi-structured interview to the group of survivors. Results: The incidence of the event was 1.4% of pregnant women attending. The average age was 24 years old, 37.5% belong to an ethnic group, 69.7% from rural areas, with low educational levels (38%), living together in a free union (68.7%), first pregnancy (56.2%), late admission to prenatal controls (68.7%), average attendance of 3.5 controls. The determinants that are statistically related to the occurrence of the event were: educational level, ethnicity, possession of a romantic partner, and number of controls attended. The quality of health services, poverty, geographic inaccessibility, and administrative barriers of insurance companies were the most prominent for pregnant women. Conclusion: The event occurs mainly in young pregnant women, with a low educational level, and in rural areas. The determinants that were associated were: ethnicity, the number of prenatal check-ups attended, educational level, and marital status; for pregnant women with maternal morbidity, low income, inaccessibility to health services, and the presence of previous illnesses were the most important.

Association between sociodemographic, obstetric, and lifestyle factors among Hungarian pregnant women-A cross-sectional study.

AIM: To learn the association between sociodemographic and obstetric factors and lifestyle characteristics of pregnant women, and to identify factors that can influence pregnant women's health consciousness. METHODS: A cross-sectional, questionnaire-based study was performed among women who gave birth in Szeged in 2014-2015. Data collection was based on a self-administered questionnaire and health documentations. Overall maternal health promoting behavior (MHPB) index was defined by summarizing the scores obtained from diet, physical activity, smoking status, and alcohol consumption. RESULTS: The final analysis included 1548 mothers; 41.3% (n = 602) of the sample had healthy diet, 9.0% (n = 134) were physically active and attended special pregnancy exercise classes, 84.4% (n = 1279) did not drink alcohol, and 93.5% (n = 1447) were nonsmokers. Regarding the MHPB index, 0.8% (n = 11) of the women reached the maximum score (20), while the average was 14.8 (SD = 2.58). Advanced maternal age (p < 0.001), having a spouse or partner (p < 0.001), higher educational level (p < 0.001), planned pregnancy (p < 0.001), and early visit at pregnancy care (p = 0.046) were significantly associated with higher MHPB index. CONCLUSION: The lifestyle of pregnant women can have a great impact on the developing fetus, either in a positive or negative way. In order to evaluate maternal lifestyle, overall health behavior should be considered. Lifestyle of the included women was not satisfactory, an improvement in health consciousness is needed at every social level; however, the differences between the various social classes may suggest the importance of further promotion and improvement of pregnancy planning and pregnancy care among younger and lower educated women.

Expectativas de mães de crianças com síndrome congênita do vírus zika: atribuições dos gestores / Expectativas de madres de niños con síndrome de zika congénito: atribuciones de los gestores / Expectations of children's mothers with Congenital Zika Syndrome: attributions of governors

Objetivo: compreender as expectativas de mães de crianças com síndrome congênita do vírus zika sobre as atribuições dos gestores direcionadas à assistência integral à criança. Materiais e métodos: estudo qualitativo realizado a partir das entrevistas em profundidade e do desenho estória-tema com 10 mães em Feira de Santana, Bahia, Brasil, entre setembro e novembro de 2017. Resultados: as expectativas das mães residem em elevar o número de sessões de estimulação precoce e reabilitação; incluir novos métodos de tratamento, como a ecoterapia, a hidroginástica e a fisioterapia avançada; construir centros de reabilitação; qualificar os profissionais da rede de atenção à saúde; inserir, minimamente, os serviços de terapia ocupacional, fisioterapia e fonoaudiologia na rede de saúde do município de residência; assegurar o acesso a órteses, próteses, cadeira de rodas e de banho, além de outros aparelhos de reabilitação, como fraldas e medicamentos; desburocratizar o percurso para a concessão do benefício de prestação continuada; definir um modelo de ensino-aprendizagem específico para as crianças. Conclusões: desconsiderar as expectativas das mães significa sobrecarregá-las de serviços que seriam de responsabilidade legal doEstado, o que repercute no seu adoecimento, além de restringir o desenvolvimento da criança e elevar os casos de judicialização da saúde.

Objetivo: comprender las expectativas de las madres de niños con síndrome de virus del zika congénito acerca de las atribuciones de los gestores encaminadas al cuidado infantil integral. Materiales y métodos: estudio cualitativo basado en entrevistas en profundidad y dibujo historia-tema con 10 madres en Feira de Santana, Bahia, Brasil, entre septiembre y noviembre de 2017. Resultados: las expectativas de las madres son aumentar el número de sesiones de estimulación precoz y rehabilitación; incluir nuevos métodos de tratamiento como ecoterapia, hidrogimnasia y fisioterapia avanzada; construir centros de rehabilitación; calificar los profesionales de la red de atención de salud; integrar, de forma básica, los servicios de terapia ocupacional, fisioterapia y fonoaudiología en la red de salud del municipio de residencia; garantizar el acceso a las ortesis, prótesis, sillas de ruedas y de baño, además de otros dispositivos de rehabilitación, así como pañales y medicamentos; reducir la burocracia para otorgar el beneficio de servicio continuo; definir un modelo de enseñanza-aprendizaje específico para niños. Conclusiones: ignorar las expectativas de las madres significa sobrecargarlas de servicios que serían responsabilidad legal del Estado, afectando su enfermedad, además de restringir el desarrollo del niño y aumentar los casos de judicialización de la salud.

Objective: understand the expectations of the mothers of children with Congenital Zika virus Syndrome on the attributions of the managers directed to integral care to the child. Materials and method: qualitative study based on in-depth interviews and Story-Theme Design with 10 mothers in Feira de Santana, Bahia, Brazil, between September and November 2017. Results: The expectations of the mothers reside in increasing the number of sessions of early stimulation and rehabilitation; include new treatment methods such as eco-therapy, hydrogymnastics and advanced physiotherapy; building rehabilitation centers; qualify the professionals of the health care network; insert, minimally, the services of Occupational Therapy, Physiotherapy and Speech Therapy in the health network of the municipality of residence; ensure access to orthosis, prosthesis, wheelchairs and bath chairs, and other rehabilitation appliances, as well as materials such as diapers and medicines; to debureaucratize the course for the granting of the continuous benefit; to define a specific teaching-learning model for children. Conclusions: Disregarding the expectations of mothers means overloading them with services that would be the legal responsibility of the State, affecting their illness, in addition to restricting the child's development and increasing cases of judicialization of health.

Deficient maternal behavior in multiparous Pou3f2⊿ mice is associated with an impaired exploratory activity.

Mammalian adult females develop specialized body parts, namely mammary glands and uterus, and exhibit specialized maternal behavior, lactation/nursing and care for their offspring. As the brain plays an essential role in regulating related physiological functions in the body, the morphology or function of the mammalian brain has been modified to manage newly equipped structures and functions. However, this evolutionary process is largely unknown. Pou3f2/Brn2 is an evolutionarily remarkable gene as it contains mammal-specific base sequences encoding three stretches of homopolymeric amino acids (polyAAs): poly-glycine (polyG), poly-glutamine (polyQ), and poly-proline (polyP). Previously, we demonstrated that POU3F2 acquisition of mammal-specific polyAAs contributed to the establishment of behaviors characteristic of mammals. Here, we demonstrated that Pou3f2⊿ mice displayed basic features required for maternal care. However, Pou3f2⊿ mice exhibited deficits in the reproductive performance and maternal behavior, which were not fully improved by multiparas. Therefore, we extensively investigated pup retrieval behavior and discovered that the retrieval and the exploratory behaviors were impaired in Pou3f2⊿ female mice, but not in males. Altogether, our data suggest that POU3F2 acquisition of mammal-specific polyAAs contributes to the continuous awareness and curiosity needed for maternal interaction.

A functional cellular framework for sex and estrous cycle-dependent gene expression and behavior.

Sex hormones exert a profound influence on gendered behaviors. How individual sex hormone-responsive neuronal populations regulate diverse sex-typical behaviors is unclear. We performed orthogonal, genetically targeted sequencing of four estrogen receptor 1-expressing (Esr1+) populations and identified 1,415 genes expressed differentially between sexes or estrous states. Unique subsets of these genes were distributed across all 137 transcriptomically defined Esr1+ cell types, including estrous stage-specific ones, that comprise the four populations. We used differentially expressed genes labeling single Esr1+ cell types as entry points to functionally characterize two such cell types, BNSTprTac1/Esr1 and VMHvlCckar/Esr1. We observed that these two cell types, but not the other Esr1+ cell types in these populations, are essential for sex recognition in males and mating in females, respectively. Furthermore, VMHvlCckar/Esr1 cell type projections are distinct from those of other VMHvlEsr1 cell types. Together, projection and functional specialization of dimorphic cell types enables sex hormone-responsive populations to regulate diverse social behaviors.

O apego está na relação? Revisão sobre a sensibilidade materna no Brasil / Is the attachment in the relationship? Review on maternal sensitivity in Brazil

Esta revisão integrativa de literatura visa mapear artigos brasileiros a partir do referencial da sensibilidade materna, por meio de busca nas bases de dados do Portal CAPES, de modo mais específico, na BVS Brasil e SciELO, realizada em 2019, e atualizada no primeiro semestre de 2020, utilizando os descritores "sensibilidade materna", "maternal sensitivity and brazil" e "sensibilidade materna and vulnerabilidade". Os critérios de inclusão foram artigos empíricos realizados no Brasil, publicados nos últimos 10 anos (2010-2020) em português, com acesso irrestrito em texto completo. Encontrou-se 685 referências e somente 14 estudos foram analisados na íntegra por atenderem aos critérios estabelecidos nesta pesquisa. Percebe-se que alguns fatores impactam negativamente na sensibilidade materna, como a vivência em situação de vulnerabilidade socioeconômica; a saúde mental da mãe e a fragilidade da rede de suporte. Evidencia-se escassez de produções brasileiras sobre essa temática e de pesquisas interventivas com a díade mãe-bebê, demonstrando a relevância deste trabalho.

This integrative literature review aims to map Brazilian articles from the maternal sensitivity perspective, based on a search in the CAPES Portal databases, more specifically in BVS Brasil and SciELO, carried out in 2019, and updated in the first half of 2020, using the descriptors "maternal sensitivity", "maternal sensitivity and brazil" and "maternal sensitivity and vulnerability". The inclusion criteria were empirical articles carried out in Brazil, published in the last 10 years (2010-2020) in Portuguese, with unrestricted access in full text. 685 references were found and only 14 studies were analyzed in full because they met the criteria established in this research. It is noticed that some factors have a negative impact on maternal sensitivity, such as living in a situation of socioeconomic vulnerability; the mother's mental health and the fragility of her support network. There is a shortage of Brazilian productions on this theme and of interventional research with the mother-baby dyad, demonstrating the relevance of this article.

Exposure to environmental chemicals and perinatal psychopathology.

Women are nearly twice as likely to develop mood disorders compared with men, and incidence is greatest during reproductive transitions, including pregnancy and postpartum. Because these periods are characterized by dramatic hormonal and physiologic changes, there is heightened susceptibility to external factors, such as exposure to environmental toxicants, which may play a role in maternal psychopathology. The purpose of this scoping review was to provide an overview of studies conducted in humans and animal models on the effects of nonoccupational exposure to environmental chemicals on maternal psychopathology during the perinatal period. The largest number of studies examined exposure to environmental tobacco smoke and antenatal depression and showed consistently positive findings, although more prospective studies using biomarkers for exposure assessment are needed. The few studies examining persistent organic pollutants such as polybrominated diphenyl ethers and perinatal depression were consistent in showing associations with increased depressive symptoms. Results were mixed for exposure to heavy metals and non-persistent chemicals, but a strong literature in animal models supported an association between bisphenols and phthalates and reduced maternal behavior and care of pups after parturition. Biological mechanisms may include endocrine disruption, neurotransmitter system impairment, alterations in gene expression, and immune activation and inflammation. Additional longitudinal studies that include biospecimen collection are essential to furthering the understanding of how environmental toxicants during pregnancy may affect perinatal psychopathology and the underlying mechanisms of action. Future work should also leverage the parallels between animal and human maternal behavior, thereby highlighting the opportunity for multidisciplinary work in this avenue.

Suicidal ideation in mothers of asthmatic children and adolescents in a subspecialty outpatient practice / Ideação suicida em mães de crianças e adolescentes asmáticos em ambulatório especializado / Ideación suicida en madres de niños y adolescentes asmáticos en consulta externa de subespecialidad

We aimed to investigate prevalence and factors associated with Suicide ideation (SI) in mothers of asthmatic children. This cross-sectional study included 362 dyads of mothers and children with asthma aged 2 to 14 years who attended two pediatric outpatient clinics in Brazil. We assessed the presence of SI (Self-Report Questionnaire-20), the occurrence of stressful events and maternal social support. The prevalence of SI was 8.6%. Low maternal education, exposure to serious illness, and low perception of social support in its affective-social interaction dimension remained significantly associated with SI in the final model. Thus, life stressors, social support and low maternal education accounted for most of the variation in prevalence of maternal SI. There were no effects of child asthma severity on maternal SI in this study.

Nosso objetivo foi investigar a prevalência e os fatores associados à ideação suicida (IS) em mães de crianças asmáticas. Este estudo transversal incluiu 362 díades de mães e crianças com asma de 2 a 14 anos em dois ambulatórios pediátricos no Brasil. Avaliamos a presença de IS (Self-Report Questionnaire-20), a ocorrência de eventos estressantes e o suporte social materno. A prevalência de IS materna foi de 8,6%. Escolaridade materna inferior a oito anos, doença materna grave e a baixa percepção de suporte social em sua dimensão afetivo-social permaneceram significativamente associadas à IS no modelo final. Portanto, eventos estressores maternos, suporte social e baixa escolaridade materna foram os responsáveis pela maior parte da variação na prevalência de IS materna. Não houve efeitos da gravidade da asma infantil na IS materna neste estudo.

Este estudio investigo la prevalencia y los factores asociados com ideación suicida (IS) en madres de niños asmáticos. Participaron 362 díadas de madres y niños con asma de 2 a 14 años en dos clínicas pediátricas ambulatorias en Brasil. Evaluamos la presencia de IS (Self-Report Questionnaire-20), la ocurrencia de eventos estresantes y el apoyo social materno. La prevalencia de IS materno fue del 8,6%. La educación materna de menos de ocho años, la enfermedad materna grave y la baja percepción de apoyo social en su dimensión afectivo-social se mantuvieron significativamente asociadas con el SI en el modelo final. Entonces, los eventos de estrés materno, el apoyo social y la baja educación materna explicaron la mayor parte de la variación en la prevalencia materna de IS. No hubo efectos de la gravedad del asma infantil en el IS materno en este estudio.