Alcohol consumption during pregnancy may affect learning and memory function in offspring

Maternal alcohol consumption during pregnancy has detrimental effects on fetal central nervous system development. Maternal alcohol consumption prior to and during pregnancy significantly affects cognitive functions in offspring, which may be related to changes in cyclin-dependent kinase 5 because it is associated with modulation of synaptic plasticity and impaired learning and memory. Prof. Ruiling Zhang and team from Xinxiang Medical University explored the correlation between cyclin-dependent kinase 5 expression in the hippocampus and neurological impairments following prenatal ethanol exposure, and found that prenatal ethanol exposure could affect cyclin-dependent kinase 5 and its activator p35 in the hippocampus of offspring rats. These findings, which were reported in Neural Regeneration Research (Vol. 8, No. 18, 2013), propose new insights into the mechanisms underlying the role of ethanol exposure in central nervous system injuries, and provide a new strategy for treating the consequences of prenatal ethanol exposure.

Sleep disruption during pregnancy affects the immune system and can cause birth-related complications
Poor sleep quality and quantity during pregnancy can disrupt normal immune processes and lead to lower birth weights and other complications, finds a University of Pittsburgh School of Medicine study published today in the journal Psychosomatic Medicine. Women withdepression also are more likely than non-depressed women to suffer from disturbed sleep and to experience immune system disruption and adverse pregnancy outcomes. "Our results highlight the importance of identifying sleep problems in early pregnancy, especially in women experiencing depression, since sleep is a modifiable behavior," said Michele Okun, Ph.D., assistant professor of psychiatry at Pitt's School of Medicine and lead author of the report. "The earlier that sleep problems are identified, the sooner physicians can work with pregnant women to implement solutions." Adequate and high-quality sleep, both in pregnant and non-pregnant women as well as men, is essential for a healthy immune system. Pregnancy often is associated with changes in sleep patterns, including shortened sleep, insomnia symptoms and poor sleep quality. These disturbances can exacerbate the body's inflammatory responses and cause an overproduction of cytokines, which act as signal molecules that communicate among immune cells. "There is a dynamic relationship between sleep and immunity, and this study is the first to examine this relationship during pregnancy as opposed to postpartum," added Dr. Okun. While cytokines are important for numerous pregnancy-related processes, excess cytokines can attack and destroy healthy cells and cause destruction of tissue in pregnant women, thereby inhibiting the ability to ward off disease. For expectant mothers, excess cytokines also can disrupt spinal arteries leading to the placenta, cause vascular disease, lead to depression and cause preterm birth. Previous studies conducted postpartum have shown higher inflammatory cytokine concentrations among women who experienced adverse pregnancy outcomes such aspreeclampsia and pre-term birth. While infection accounts for half of these adverse outcomes, researchers discovered that behavioral processes such as disturbed sleep also may play a role, given the relationship between sleep disturbance and immune function. Furthermore, higher concentrations of inflammatory cytokines also are found in depressed individuals. The study is the first to evaluate all factors - inflammatory cytokines, depression and insomnia - and their possible combined effect on pregnant women. The study examined nearly 170 women, both depressed and not depressed, at 20 weeks of pregnancy and analyzed their sleep patterns and

cytokine production levels over the course of 10 weeks (pregnancy-related physiological adaptations are in flux prior to 20 weeks). The findings reveal:

Women with depression and poor sleep are at greatest risk for adverse birth-related outcomes. Cytokine levels may be one biological pathway through which this is accomplished, particularly with regard to preterm birth. Any shift in immunity, such as poor sleep and/or depression, could set the stage for increased risk for adverse outcomes. At 20 weeks, depressed pregnant women have higher levels of inflammatory cytokines compared to non-depressed women. At 30 weeks of pregnancy, differences in cytokines among depressed and non-depressed women were negligible, likely because as pregnancy progresses, levels of cytokines normally increase.

Delayed Cord Clamping After Birth Better For Baby's Health

In wealthier nations it is common practice to clamp the baby's umbilical cord less than a minute after birth. But a recent review of published studies suggests delaying cord clamping results in healthier blood and iron levels in babies, and this benefit outweighs the slightly higher risk of developing jaundice. The reviewers arrived at this conclusion after analyzing data on nearly 4,000 women and their babies. They report their findings online in a July 11th issue of the Cochrane Database of Systematic Reviews. One of the authors, Philippa Middleton of the Australian Research Centre for Health of Women and Babies at the University of Adelaide, says in a statement: "In light of growing evidence that delayed cord clamping increases early haemoglobin concentrations and iron stores in infants, a more liberal approach to delaying clamping of the umbilical cord in healthy babies appears to be warranted." In higher income countries, the standard practice is to clamp the umbilical cord within a minute of the baby being born. If cord clamping is delayed, the risk that the baby will develop jaundice rises. Newborns with jaundice are treated with light therapy.

However, stopping the blood from the placenta reaching the baby before the final few pulses stop, means there is a chance the baby will not receive enough blood from the mother and will have lower iron levels. Middleton says they did find that clamping the cord later was linked to higher numbers of babies needing treatment for jaundice, however, she urges that: "The benefits of delayed cord clamping need to be weighed against the small additional risk of jaundice in newborns. Later cord clamping to increase iron stores might be particularly beneficial in settings where severe anaemia is common" The researchers reviewed 15 trials comparing early and late cord clamping covering a total of 3,911 women and their infants. They examined results for mothers and babies separately, using haemoglobin measures as indicators of healthy blood and iron levels. Although another reason sometimes given for early cord clamping is that it reduces the mother's risk of bleeding after birth, the reviewers found no evidence of this.

Benefits of delayed cord clamping did not come with any increased risks
Delayed cord clamping did not change the mother's risk of haemorrhaging, losing blood or having reduced haemoglobin levels, they note. But delaying cord clamping did make a difference to the health of the babies. Between one and two days after birth, their haemoglobin levels were higher; between three and six months after birth, they were less likely to be deficient in iron. The reviewers also found that delayed cord clamping was linked to higher birth weight and made no difference to deaths in newborns. They also found delayed cord clamping appears to have no effect on longer-term brain development, although only one of the trials examined this. The reviewers conclude their findings suggest we need to adopt a "more liberal approach" to delaying cord clamping which is likely to benefit babies, "as long as access to treatment for jaundice requiring phototherapy is available". The World Health Organization recommends cord clamping between one and three minutes after birth.

This review only included babies born full term. However, another review published in the same journal in 2012 found that delayed cord clamping also benefits preterm babies. Two studies published in The Lancet suggest that cleansing the umbilical cord is also vital for newborn health and survival.