Human Milk Metabolic Hormones: Analytical Methods and Current Understanding

Human milk (HM) contains a wide array of peptide hormones including leptin and adiponectin, which are involved in the regulation of infant growth and development. These essential hormones might play an important role in the regulation of metabolic reprogramming of the new-born infant. However, HM hormone studies are sparse and heterogeneous in regard to the study design, sample collection, preparation and analysis methods. This review discussed the limitations of HM hormone analysis highlighting the gaps in pre-analytical and analytical stages. The methods used to quantify HM metabolic hormones (leptin, adiponectin, ghrelin, insulin, obestatin, resistin and apelin) can be classified as immunoassay, immunosensor and chromatography. Immunoassay methods (ELISA and RIA) have been predominantly used in the measurement of these HM hormones. The relative validity parameters of HM hormones analysis are often overlooked in publications, despite the complexity and differences of HM matrix when compared to that of plasma and urine. Therefore, appropriate reports of validation parameters of methodology and instrumentation are crucial for accurate measurements and therefore better understanding of the HM metabolic hormones and their influences on infant outcomes.

Retinal findings similar to retinopathy of prematurity in a term-infant with congenital cytomegalovirus infection

Purpose: To present a term-born infant with congenital cytomegalovirus (C-CMV) infection with an atypical retinal finding mimicking retinopathy of prematurity (ROP). Case description: A term-born infant was referred to our clinic due to a C-CMV infection. Fundoscopic examination of both eyes revealed a demarcation line at zone II level and peripheral avascular retina along the temporal retina. There was no chorioretinitis, no vitritis, and no retinal vasculitis. There was no history of oxygen supplementation. The demarcation lines in both eyes regressed spontaneously within 3 weeks without any sequelae. Conclusions: It has been known for many years that C-CMV infection may affect the eye, and chorioretinitis is the most common finding. In this case report, we presented an atypical ROP-like retinal finding in an infant with C-CMV infection. We think that the development of retinal vascularization may be affected by C-CMV infection. We hope that this finding may provide a clue for future investigations to understand the relationship between the pathogenesis of ROP and infection-induced inflammatory processes in prenatal and perinatal life.

Acquired Zinc Deficiency Mimicking Acrodermatitis Enteropathica in a Breast-Fed Premature Infant

We present a case of a transient acquired zinc deficiency in a breast-fed, 4-month-old-male prematurely born infant, with acrodermatitis enteropathica-like symptoms such as crusted, eroded, erythemato-squamous eruption in periorificial and acral patterns. The laboratory investigations showed low zinc levels in the infant’s and the mother’s serum and in the mother’s milk; genetic analysis did not show any mutation in the SLC39A4 gene, involved in acrodermatitis enteropathica. Acquired zinc deficiency is often found in premature infants because of their increased requirement, the low serum and milk zinc levels in breastfeeding women being also an important risk factor, as in this case. A prompt zinc supplementation is essential for the good prognosis of the disease.

Hostile environments? Down’s syndrome and genetic screening in contemporary culture

This essay explores the complex entanglement of new reproductive technologies, genetics, health economics, rights-based discourses and ethical considerations of the value of human life with particular reference to representations of Down’s syndrome and the identification of trisomy 21. Prompted by the debates that have occurred in the wake of the adoption of non-invasive prenatal testing (NIPT), the essay considers the representation of Down’s syndrome and prenatal testing in bioethical discourse, feminist writings on reproductive autonomy and disability studies and in a work of popular fiction, Yrsa Sigurdardóttir’s Someone To Look Over Me (2013), a novel set in Iceland during the post-2008 financial crisis. It argues that the conjunction of neo-utilitarian and neoliberal and biomedical models produce a hostile environment in which the concrete particularities of disabled people’s lives and experiences are placed under erasure for a ‘genetic fiction’ that imagines the life of the ‘not yet born’ infant with Down’s syndrome as depleted, diminished and burdensome. With close reference to the depiction of Down’s syndrome and learning disability in the novel, my reading explores the ways in which the generic conventions of crime fiction intersect with ideas about economics, politics and learning disability, to mediate an exploration of human value and social justice that troubles dominant deficit-led constructions of disability.

Twin pregnancy and perinatal outcomes: Data from ‘Birth in Brazil Study’

Background Twin pregnancies account for 0.5–2.0% of all gestations worldwide. They have a negative impact on perinatal health indicators, mainly owing to the increased risk for preterm birth. However, population-based data from low/middle income countries are limited. The current paper aims to understand the health risks of twins, compared to singletons, amongst late preterms and early terms. Methods Data is from “Birth in Brazil”, a national inquiry into childbirth care conducted in 2011/2012 in 266 maternity hospitals. We included women with a live birth or a stillborn, and excluded births of triplets or more, totalling 23,746 singletons and 554 twins. We used multiple logistic regressions and adjusted for potential confounders. Results Twins accounted for 1.2% of gestations and 2.3% of newborns. They had higher prevalence of low birth weight and intrauterine growth restriction, when compared to singletons, in all gestational age groups, except in the very premature ones (<34 weeks). Amongst late preterm’s, twins had higher odds of jaundice (OR 2.7, 95% CI 1.8–4.2) and antibiotic use (OR 1.8, 95% CI 1.1–3.2). Amongst early-terms, twins had higher odds of oxygen therapy (OR 2.7, 95% CI 1.3–5.9), admission to neonatal intensive care unit (OR 3.1, 95% CI 1.5–6.5), transient tachypnoea (OR 3.7, 95% CI 1.5–9.2), jaundice (OR 2.8, 95% CI 1.3–5.9) and antibiotic use (OR 2.2, 95% CI 1.14.9). In relation to birth order, the second-born infant had an elevated likelihood of jaundice, antibiotic use and oxygen therapy, than the first-born infant. Conclusion Although strongly mediated by gestational age, an independent risk remains for twins for most neonatal morbidities, when compared to singletons. These disadvantages seem to be more prominent in early-term newborns than in the late preterm ones.

A case report of a pregnant woman with coronavirus disease 2019 (COVID-19) and her live-born infant

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The disease, which is now a global pandemic, is reportedly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we report a case of COVID-19 in a 31-year-old pregnant woman who showed symptoms that included fever, a four-day history of dry cough, and myalgia. Real-time reverse transcriptase-polymerase chain reaction analysis of naso- and oropharyngeal samples was positive for the SARS-CoV-2. A cesarean section was performed during the acute phase of COVID-19; the full-term infant was isolated from his mother and underwent formula feeding. He was healthy and negative for the SARS-CoV-2. This report describes the clinical features, diagnosis, and treatment of the mother’s illness and its effects on her live-born infant.