The Relationship of Preterm, Term, and Post-Term Births to Maternal Stress and Human Milk Cortisol Levels.

Introduction: Maternal stress can lead to changes in the composition of human breast milk. The present study evaluates cortisol levels in the breast milk of mothers after giving birth preterm, term, or post-term, and ascertains whether the levels are associated with maternal stress. Materials and Methods: Included in the study were mothers who gave birth vaginally after 32 weeks of gestation between January and April 2022. The breast milk was expressed with an electronic pump under the supervision of a nurse on day 7 following birth, and 2 mL samples of the milk were transferred into microtubes and stored at -80°C. Stress in the mothers was measured using the perceived stress scale developed by Cohen et al. The human breast milk cortisol levels were determined using an enzyme-linked immunoassay in a single session. Results: A total of 90 mothers, including 30 with preterm births, 38 with term births, and 22 with post-term births, were included in the study. The median stress scale score was 28 (17-50) and the median breast milk cortisol level was 0.49 ng/mL (0.1-1.96 ng/mL). A significant positive correlation was noted between the stress scale scores and breast milk cortisol levels (r = 0.56, p < 0.01). The breast milk cortisol levels and maternal stress scale scores were significantly higher in the preterm birth group than in the term birth group (p = 0.011 and p = 0.013, respectively). Conclusion: Although there is an association between maternal stress and preterm labor and milk cortisol levels, we believe that more studies are needed to establish a causal link.

Factors that affect placental retinol transfer in preterm infants and mothers with retinol deficiency.

BACKGROUND: The retinol level and retinol delivery to the placenta may vary depending on various factors involving the mother and newborn. The present study evaluates the factors affecting retinol levels in newborns and the transplacental retinol passage in preterm newborns. METHODS: In this prospective cohort study, the retinol and retinol binding protein (RBP) in the umbilical cord blood of 44 preterm infants with a gestation age of <30 weeks were studied. Serum retinol and RBP levels were determined using an enzyme-linked immunosorbent assay, and the rate of transplacental retinol passage was calculated. The demographic data of mothers and newborns, the use of vitamins by the mother, the application of antenatal corticosteroids, and any diseases diagnosed during pregnancy were recorded. An evaluation was made of the retinol, RBP, and other factors of the mother and newborn affecting transplacental retinol passage. RESULTS: A retinol deficiency was identified in 68.2% of the study population. Retinol and RBP levels in umbilical cord blood (273.7 ± 150.03 ng/mL, 7.88 ± 5.6 ng/mL, respectively) were significantly higher than the corresponding levels in the mother (206.4 ± 86.26 ng/ mL, 1.04 ± 0.97 ng/mL, respectively). Umbilical cord blood retinol deficiency was more common in the male participants, while the transplacental retinol passage rate was higher in females. The umbilical cord blood RBP was found to be lower in those administered antenatal corticosteroids than in those who did not receive antenatal corticosteroids, and median maternal RBP levels were lower in patients with anemia and pregnancy-induced hypertension than in those with no disease. DISCUSSION: Placental adaptation and contributing factors may vary in populations with severe retinol deficiency. The finding of significantly increased cord blood retinol levels when compared to maternal retinol levels in the present study suggests that some compensatory mechanisms, such as increased placental RBP levels, support the presentation of retinol to the fetus, even if the mother has a retinol deficiency.

Hypobaric birth room may prevent intraventricular hemorrhage in extremely low birth weights infants.

In the early postnatal period, intraventricular hemorrhage may develop in infants with extremely low birth weights due to hemodynamic instability. One of the most significant factors in intraventricular hemorrhage development is fluctuations in the cerebral blood flow due to left-to-right shunting as a result of patent ductus arteriosus, and such cases most frequently develop intraventricular hemorrhage within the first 72 h. The frequency of intraventricular hemorrhage may be reduced through the prevention of fluctuations in the cerebral blood flow in this time frame. Based on our hypothesis, we recommend that extremely low birth weight infants should be delivered and monitored in hypobaric rooms for the first three days after birth, as this may reduce left-to-right shunting as a result of patent ductus arteriosus by preventing the rapid drops seen in pulmonary pressure after birth. A more stable hemodynamic status may be achieved by increasing the cerebral blood flow during an acute term in a hypobaric environment. Gradual transition to the normobaric status at the end of the third day may prevent the long-term negative effects of hypobaric conditions.