Knowledge Summary 22: Reaching Child Brides

Child marriage affects 10 million girls under the age of 18 every year. The negative health and social impact of child marriage include higher rates of maternal and infant mortality, sexually transmitted infection, social separation, and domestic abuse compared with older married women. The UN defines Child Marriage as a Human Rights violation and is working to end this practice globally, however many girls still fall victim each year. While the importance of ending the practice of child marriage cannot be overlooked, targeted interventions are also needed to mitigate the negative health and development impacts. Health services can serve as an entry point for health and social interventions to decrease the risks associated with pregnancy and improve reproductive and child health. Health services can also facilitate opportunities for multi-sectoral connections such as formal and informal education and income generation to mitigate the negative impact of child marriage

To Treat or Not To Treat? Bioethics and the Handicapped Newborn

Reviewed Book: Sparks, Richard C. To Treat or Not To Treat? Bioethics and the Handicapped Newborn. New York/Mahwah: Paulist Press, 198

Opportunity analysis of newborn screening programs

There exist congenital diseases that reduce newborns' potential opportunities. This reduction is sometimes alleviated if the congenital disease is early detected thanks to a newborn screening program. We propose an outcome measurement of newborn screening programs based on the opportunity gains they offer. We show that, under plausible assumptions, the ranking of the available screening programs for a particular disease, according to this new outcome measurement, do not depend on the metric of opportunity. We also apply our model to the current debate about choosing between a selective or a universal newborn hearing screening program to detect congenital hearing impairment.opportunities, potential success, screening programs

Community-based Approach to Intermittent Preventive Treatment for Malaria in Pregnancy in Kisumu, Kenya

Malaria in pregnancy (MiP) is a significant contributor to maternal and newborn morbidity and mortality. In malaria-endemic countries, especially those in tropical areas of Africa where there is intense transmission of Plasmodium falciparum (P. falciparum), malaria infection directly contributes to adverse outcomes in maternal and newborn health. An estimated 11% of neonatal deaths in malariaendemic African countries are due to low birth weight resulting from P. falciparum infections in pregnancy. According to the Roll Back Malaria (RBM) Initiative, malaria accounts for over 10,000 maternal and between 75,000 and 200,000 infant deaths per year in Africa. Prevention of MiP is thus a key public health intervention

Treatment algorithm for infants diagnosed with spinal muscular atrophy through newborn screening

Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by the degeneration of alpha motor neurons in the spinal cord, leading to muscular atrophy. SMA is caused by deletions or mutations in the survival motor neuron 1 gene (SMN1). In humans, a nearly identical copy gene, SMN2, is present. Because SMN2 has been shown to decrease disease severity in a dose-dependent manner, SMN2 copy number is predictive of disease severity. To develop a treatment algorithm for SMA-positive infants identified through newborn screening based upon SMN2 copy number. A working group comprised of 15 SMA experts participated in a modified Delphi process, moderated by a neutral third-party expert, to develop treatment guidelines. The overarching recommendation is that all infants with two or three copies of SMN2 should receive immediate treatment (n = 13). For those infants in which immediate treatment is not recommended, guidelines were developed that outline the timing and appropriate screens and tests to be used to determine the timing of treatment initiation. The identification SMA affected infants via newborn screening presents an unprecedented opportunity for achievement of maximal therapeutic benefit through the administration of treatment pre-symptomatically. The recommendations provided here are intended to help formulate treatment guidelines for infants who test positive during the newborn screening process

Nitric Oxide Regulates Neurogenesis in the Hippocampus following Seizures

Hippocampal neurogenesis is changed by brain injury. When neuroinflammation accompanies injury, activation of resident microglial cells promotes the release of inflammatory cytokines and reactive oxygen/nitrogen species like nitric oxide (NO). In these conditions, NO promotes proliferation of neural stem cells (NSC) in the hippocampus. However, little is known about the role of NO in the survival and differentiation of newborn cells in the injured dentate gyrus. Here we investigated the role of NO following seizures in the regulation of proliferation, migration, differentiation, and survival of NSC in the hippocampus using the kainic acid (KA) induced seizuremouse model. We show that NO increased the proliferation of NSC and the number of neuroblasts following seizures but was detrimental to the survival of newborn neurons. NO was also required for the maintenance of long-term neuroinflammation. Taken together, our data show that NO positively contributes to the initial stages of neurogenesis following seizures but compromises survival of newborn neurons.Foundation for Science and Technology (FCT, Portugal); COMPETE; FEDER [PTDC/SAU-NEU/102612/2008, PTDC/NEU-OSD/0473/2012, PEst-C/SAU/LA0001/2013-2014, PEst-OE/EQB/LA0023/2013-2014]; FCT, Portugal [SFRH/BPD/78901/2011, SFRH/BD/77903/2011

Pregnancy lipidomic profiles and DNA methylation in newborns from the CHAMACOS cohort.

Lipids play a role in many biological functions and the newly emerging field of lipidomics aims to characterize the varying classes of lipid molecules present in biological specimens. Animal models have shown associations between maternal dietary supplementation with fatty acids during pregnancy and epigenetic changes in their offspring, demonstrating a mechanism through which prenatal environment can affect outcomes in children; however, data on maternal lipid metabolite levels during pregnancy and newborn DNA methylation in humans are sparse. In this study, we assessed the relationship of maternal lipid metabolites measured in the blood from pregnant women with newborn DNA methylation profiles in the Center for the Health Assessment of Mothers and Children of Salinas cohort. Targeted metabolomics was performed by selected reaction monitoring liquid chromatography and triple quadrupole mass spectrometry to measure 92 metabolites in plasma samples of pregnant women at ∼26 weeks gestation. DNA methylation was assessed using the Infinium HumanMethylation 450K BeadChip adjusting for cord blood cell composition. We uncovered numerous false discovery rate significant associations between maternal metabolite levels, particularly phospholipid and lysolipid metabolites, and newborn methylation. The majority of the observed relationships were negative, suggesting that higher lipid metabolites during pregnancy are associated with lower methylation levels at genes related to fetal development. These results further elucidate the complex relationship between early life exposures, maternal lipid metabolites, and infant epigenetic status

Aetiologies after newborn hearing screening

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