Sylvia Ley

Rationale: Respiratory viral infections can be transmitted from pregnant women to their offspring, but frequency, mechanisms, and postnatal outcomes remain unclear. Objectives: The aims of this prospective cohort study were to compare the frequencies of transplacental transmission of respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), analyze the concentrations of inflammatory mediators in maternal and fetal blood, and assess clinical consequences. Methods: We recruited pregnant women who developed upper respiratory infections or tested positive for SARS-CoV-2. Maternal and cord blood samples were collected at delivery. Study questionnaires and electronic medical records were used to document demographic and medical information. Measurements and Main Results: From October 2020 to June 2022, droplet digital PCR was used to test blood …

OBJECTIVE Breastfeeding duration is inversely associated with risks of cardiovascular disease (CVD) and type 2 diabetes in parous women. However, the association among women at high risk, including women with type 2 diabetes or gestational diabetes (GDM) is unclear. RESEARCH DESIGN AND METHODS We included 15,146 parous women with type 2 diabetes from the Nurses’ Health Study I and II (NHS, NHS II) and 4,537 women with a history of GDM from NHS II. Participants reported history of breastfeeding via follow-up questionnaires. Incident CVD by 2017 comprised stroke or coronary heart disease (CHD: myocardial infarction, coronary revascularization). Adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox models. RESULTS We documented 1,159 incident CVD cases among women with type 2 diabetes in both cohorts during …

BackgroundPregnancy is associated with a higher risk of adverse symptoms and outcomes for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for both mother and neonate. Antibodies can provide protection against SARS-CoV-2 infection and are induced in pregnant women after vaccination or infection. Passive transfer of these antibodies from mother to fetus in utero may provide protection to the neonate against infection. However, it is unclear whether the magnitude or quality and kinetics of maternally derived fetal antibodies differs in the context of maternal infection or vaccination.ObjectiveWe aimed to determine whether antibodies transferred from maternal to fetus differed in quality or quantity between infection- or vaccination-induced humoral immune responses.MethodsWe evaluated 93 paired maternal and neonatal umbilical cord blood plasma samples collected between October …

Background The metabolic changes that ultimately lead to gestational diabetes mellitus (GDM) likely begin before pregnancy. Cannabis use might increase the risk of GDM by increasing appetite or promoting fat deposition and adipogenesis. Objectives We aimed to assess the association between preconception cannabis use and GDM incidence. Methods We analysed individual‐level data from eight prospective cohort studies. We identified the first, or index, pregnancy (lasting ≥20 weeks of gestation with GDM status) after cannabis use. In analyses of pooled individual‐level data, we used logistic regression to estimate study‐type‐specific odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential confounders using random effect meta‐analysis to combine study‐type‐specific ORs and 95% CIs. Stratified analyses assessed potential effect modification by preconception tobacco use and pre …

Background There is a paucity of data on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces of lactating women with coronavirus disease 2019 (COVID-19) and their breastfed infants as well as associations between fecal shedding and symptomatology. Objective We examined whether and to what extent SARS-CoV-2 is detectable in the feces of lactating women and their breastfed infants following maternal COVID-19 diagnosis. Methods This was a longitudinal study carried out from April 2020 to December 2021 involving 57 breastfeeding maternal-infant dyads: 33 dyads were enrolled within 7 d of maternal COVID-19 diagnosis, and 24 healthy dyads served as controls. Maternal/infant fecal samples were collected by participants, and surveys were administered via telephone over an 8-wk period. Feces were analyzed for SARS-CoV-2 RNA. Results Signs/symptoms related to ears, eyes, nose, and throat (EENT); general fatigue/malaise; and cardiopulmonary signs/symptoms were commonly reported among mothers with COVID-19. In infants of mothers with COVID-19, EENT, immunologic, and cardiopulmonary signs/symptoms were most common, but prevalence did not differ from that of infants of control mothers. SARS-CoV-2 RNA was detected in feces of 7 (25%) women with COVID-19 and 10 (30%) of their infants. Duration of fecal shedding ranged from 1-4 wk for both mothers and infants. SARS-CoV-2 RNA was sparsely detected in feces of healthy dyads, with only one mother’s and two infants’ fecal samples testing positive. There was no relationship between frequencies of maternal and infant …

Background Sleep and diet contribute to cardiometabolic disease, but evidence is sparse for the association between these behaviors. This study analyzed the cross-sectional relationship between diet quality and multiple sleep outcomes in the Bogalusa Heart Study (BHS). Methods Diet and sleep characteristics, including insomnia and sleep apnea symptoms, were measured with validated questionnaires. Poisson regression using generalized estimating equations with a log link estimated prevalence rate ratios (PRR) of sleep outcomes by dietary pattern scores (quintile (Q) and per SD). Models were adjusted for body mass index (BMI), multi-level socioeconomic factors, physical activity, depressive symptoms, and other potential confounders. Results In 824 participants, higher diet quality, measured by the Alternate Healthy Eating Index-2010, was associated with lower sleep apnea risk score after adjustment (PRR [95% confidence interval (CI)] Q5 vs. Q1: 0.59 [0.44, 0.79], per SD increase: 0.88 [0.81, 0.95], p-trend < 0.0001). There were no statistically significant associations with the Healthy Eating Index 2015 or the Alternate Mediterranean dietary patterns, or for insomnia symptoms or a healthy sleep score. Conclusions Higher diet quality, after adjustment for BMI, was associated with a lower sleep apnea risk score in a cohort with substantial minority representation from a semi-rural, lower-income community.

BackgroundDiabetes and diabetes complications are on the rise in US adults aged< 65 years, while onset of menarche at a younger age is also increasing. We examined the associations of age at menarche with type 2 diabetes among women aged< 65 years and with cardiovascular disease (CVD) complications among women with diabetes.MethodsUsing the nationally representative cross-sectional National Health and Nutrition Examination Survey 1999–2018, women aged 20–65 years free of cancer were included in the current analysis. Diabetes was defined as a self-reported diabetes diagnosis. CVD was defined as coronary heart disease or stroke. Age at menarche was self-reported age of first menstruation and categorised into≤ 10, 11, 12, 13, 14 and≥ 15 years.ResultsOf 17 377 women included in the analysis, 1773 (10.2%) reported having type 2 diabetes. Earlier age at menarche was associated with …

Introduction: The link between gestational diabetes mellitus (GDM) and long-term risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is well established; however, risk factors underlying the progression of disease remain uncertain. Hypothesis: Female reproductive factors including ages at menarche, menopause, and first birth, number of live births, and surgically-induced menopause (uni- or bilateral oophorectomy or hysterectomy) are associated with higher risk of progression, while breastfeeding is associated with lower risk of progression from GDM to T2D/CVD. Methods: Participants in the Nurses’ Health Study II reported reproductive history at cohort baseline and over follow-up, including 5346 women with a history of GDM. Self-reported incident T2D or CVD (myocardial infarction, coronary revascularization or stroke) were confirmed via questionnaire or medical records. We estimated the hazard …

The Preconception Period Analysis of Risks and Exposures Influencing Health and Development (PrePARED) Consortium creates a novel resource for addressing preconception health by merging data from numerous cohort studies. In this paper, we describe our data harmonization methods and results. Individual-level data from 12 prospective studies were pooled. The crosswalk-cataloging-harmonization procedure was used. The index pregnancy was defined as the first postbaseline pregnancy lasting more than 20 weeks. We assessed heterogeneity across studies by comparing preconception characteristics in different types of studies. The pooled data set included 114,762 women, and 25,531 (22%) reported at least 1 pregnancy of more than 20 weeks’ gestation during the study period. Babies from the index pregnancies were delivered between 1976 and 2021 (median, 2008), at a mean maternal age of …

Purpose of Study Health policy regarding possible mother-to-child transmission of SARS-CoV-2 via breastfeeding was highly debated during the first months of the COVID-19 pandemic. However, subsequent research revealed that mother-to-infant transmission of SARS-COV-2 through breastmilk is highly unlikely, and the World Health Organization continues to recommend breastfeeding for all mothers, including those with confirmed COVID-19. Another mode of viral transmission and diagnostic testing that garnered scientific interest is the fecal route. The purpose of this study was to determine the detection rate of SARS-CoV-2 RNA in fecal samples collected from breastfeeding mothers with and without confirmed COVID-19. Methods Used From April 2020 to March 2021, fecal samples were collected repeatedly over an 8-wk period from 28 nursing mothers with confirmed COVID-19 (162 total fecal samples) and from 24 healthy nursing mothers with no known exposure to COVID-19 (93 total fecal samples). For mothers enrolled within 7 d of a positive COVID-19 test, up to 7 repeated samples were collected 3 in the first wk and 1 each at wk 2, 3, 4, and 8. For self-reported healthy mothers, up to 4 samples were collected d 1, d 7, wk 3, and wk 8. RNA was isolated, and the presence of SARS-CoV-2 RNA was determined using RT-qPCR following a modified version of the CDC's SARS-CoV-2 assay. Summary ofResults:Among COVID-19-positive mothers, 7/28 (25%) had SARS-CoV-2 in at least one fecal sample. Among these mothers, mean duration of presence of SARS-CoV-2 in feces was 1.6+/-1.4 wk. One mother had SARS-CoV-2 in feces in five …

Pregnancy diet to prevent gestational diabetes: study design and dietary assessments. - Abstract - Europe PMC Sign in | Create an account https://orcid.org Europe PMC Menu About Tools Developers Help Contact us Helpdesk Feedback Twitter Blog Tech blog Developer Forum Europe PMC plus Search life-sciences literature (43,144,622 articles, preprints and more) Search Advanced search Feedback This website requires cookies, and the limited processing of your personal data in order to function. By using the site you are agreeing to this as outlined in our privacy notice and cookie policy. Abstract Full text Pregnancy diet to prevent gestational diabetes: study design and dietary assessments. Ley SH 1 Author information Affiliations 1. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States. (1 author) The American Journal of Clinical Nutrition, …

Objectives: We sought to identify plasma proteins reflecting habitual sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) intake.Methods: We quantified 754 proteins using Olink aptamerbased high-throughput proteomics profiling in stored plasma from 570 men in the Health Professionals Follow-up Study and 118 women in the Nurses’ Health Study II US cohorts. SSB and ASB intake were estimated from food frequency questionnaires closest to the time of blood draw. In a protein-wide association study, we used linear regression models to examine associations of SSBs and ASBs with individual proteins, adjusting for potential confounders and correcting for multiple testing with a false discovery rate (FDR). Among proteins with a nominal p< 0.05, elastic net regression with 10-fold-cross-validation in a random training set (n= 482) was used to derive weighted proteomic profiles separately associated with higher SSB and ASB intake. We examined Pearson correlation coefficients [r] between proteomic scores and self-reported intake in the training and internal testing (n= 206) sets.Results: In models adjusted for blood draw, demographic, lifestyle, and dietary factors, 39 and 79 proteins were nominally associated (p< 0.05) with SSB and ASB intake, respectively, and 48 and 14 with additional adjustment for BMI. No proteins were significantly associated with SSB intake after correcting for multiple testing. Participants with higher ASB intake had higher plasma leptin (FDR= 0.002), fatty acid-binding protein (FDR= 0.01), small heat shock protein (FDR= 0.02), and reticulon-4 receptor (FDR= 0.04) concentrations, and these were …

Background: Early age at menarche (AAM) is a risk factor for type 2 diabetes later in life, but the pathways involved remain unknown. We examined the associations of AAM with C-reactive protein, fasting glucose, and fasting insulin among US adult women free of diabetes in adulthood.Methods: Using the National Health and Nutrition Examination Survey (NHANES) 1999-2018, 19,228 women over 20 years old, free of cancer and diabetes were included in our cross-sectional analysis. AAM was self-reported age of first menstruation. Multiple linear regression was performed on biomarkers measured in adulthood.Results: The median age was 44 years (IQR, 33-62). Age-adjusted least-square means for AAM categories≤ 10, 11, 12, 13, 14, and≥ 15 years were 1.42, 1.08, 1.05, 0.80, 0.84, and 0.91 mg/L for C-reactive protein (P-trend= 0.006); 84.85, 69.19, 68.11, 67.27, 64.42, and 60.69 pmol/L for fasting glucose (P …

BackgroundDiet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though evidence for how they associate with each is scarce. This study aimed to determine the association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS).MethodsThis prospective study included 593 BHS subjects with dietary assessment at the 2001–2002 visit and sleep questionnaire responses from the 2013–2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested.ResultsHigher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower risk of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower risk of insomnia symptoms at follow-up (RR [95 …

Complications and side effects Demographic aspects Development and progression Diabetes in pregnancy Risk factors Type 2 diabetes

Lactogenesis II is the onset of copious milk production following parturition. Delayed onset of lactogenesis II (DLII) often contributes to poorer lactation performance, which may adversely affect maternal and child health. The present study aims to identify the metabolic and obstetric risk factors for DLII in a secondary analysis of a prospective cohort study following pregnant women through postpartum. We defined the onset of lactogenesis II as delayed if it occurred ≥72 h postpartum. Multiple logistic regression analyses were conducted to evaluate the associations of metabolic and obstetric variables with DLII. Median onset of lactogenesis II was 72.4 h (IQR 60.4–91.6) postpartum, and 55.4% (98 of 177) of women experienced DLII. Time to first breast contact ≥ 2 h postpartum compared to ≤1 h postpartum was associated with DLII (OR 2.71 95% CI 1.12–6.53) with adjustment for age, race, pregravid BMI, primiparity, and mode of delivery, while metabolic variables were not significantly associated with DLII. In this comprehensive examination of potential metabolic and obstetric parameters, earlier timing of putting the infant to the breast remained significantly associated with earlier onset of milk coming in after consideration of the other potential risk factors. Obstetrical practices, including putting the baby to the breast later, may have an important impact on the timing of lactation, and interventions are needed to address this concern.

About a decade ago, healthy eating guidelines for chronic disease prevention primarily focused on communicating nutrient-specific recommendations. Although these recommendations were supported by ample scientific evidence, they were challenging for the public to interpret what to eat. Therefore, when the 2015 Dietary Guidelines for Americans (DGA) committee recommended consuming healthy eating patterns (1), which included a variety of food items and groups, many members of the nutrition research and practice communities welcomed the changes. The latest 2020–2025 DGA continues to highlight healthy dietary patterns and further emphasizes the importance of meeting life stage–specific dietary needs (2). Although this introduction of life stage–specific recommendations has been celebrated, the adults aged 60 years and older have received less coverage compared to the younger life stages, such …

Lactation is associated with a lower risk of subsequent cardiometabolic disease among parous women; however, the underlying mechanisms are unknown. Further, the potential protective effects of lactation on cardiometabolic risk markers at mid-life among high-risk women with past gestational diabetes (GDM) are not established. Using data from the Diabetes & Women’s Health Study (2012–2014; n = 577), a longitudinal cohort of women with past GDM from the Danish National Birth Cohort (1996–2002), we assessed associations of cumulative lactation duration (none, <6 months, 6–12 months, ≥12–24 months, and ≥24 months) with clinical metabolic outcomes (including type 2 diabetes [T2D], prediabetes, and obesity) and cardiometabolic biomarkers (including biomarkers of glucose/insulin metabolism, fasting lipids, inflammation, and anthropometrics) 9–16 years after enrollment when women were at mid-life. At follow-up, women were 43.9 years old (SD 4.6) with a BMI of 28.7 kg/m2 (IQR 24.6, 33.0); 28.6% of participants had T2D, 39.7% had prediabetes, and 41.2% had obesity. Relative risks (95% CI) of T2D for 0–6, 6–12, 12–24, and ≥24 months of cumulative lactation duration compared to none were 0.94 (0.62,1.44), 0.88 (0.59,1.32), 0.73 (0.46,1.17), and 0.71 (0.40,1.27), respectively. Cumulative lactation duration was not significantly associated with any other clinical outcome or continuous biomarker. In this high-risk cohort of middle-aged women with past GDM, T2D, prediabetes, and obesity were common at follow-up, but not associated with history of cumulative lactation duration 9–16 years after the index pregnancy. Further …

Rationale There is growing evidence supporting the possibility of vertical transmission of respiratory RNA viruses like RSV and SARS-CoV-2 from pregnant women to their offspring. Here, we sought to determine the frequency of RSV and SARS-CoV-2 maternal-fetal transmission in humans and whether prenatal exposure to these viruses can affect respiratory outcomes during the neonatal period. Methods Recruitment of this prospective cohort began in October 2020. Participants include women≥ 18 years, who during pregnancy reported≥ 2 respiratory symptoms, or tested COVID-19 positive, or both. Multiple gestation, HIV positivity, and delivery at< 34 weeks of gestation were exclusion criteria. Demographic and medical information was obtained through standardized questionnaires. Maternal blood (MB) samples were collected at prenatal clinic visits, or at delivery together with fetal cord blood (CB), and were …

Rationale While it is known that viral infections can be vertically transmitted, the frequency and mechanisms of maternal-fetal transmission of RSV and SARS-CoV-2 and the postnatal clinical consequences of this transmission are currently unclear. We aim to evaluate the frequency of transplacental transmission of RSV and SARS-CoV-2 and document whether there is a correlation to respiratory outcomes and growth trajectory of the offspring through a new prospective cohort study. Methods This is an ongoing prospective cohort study recruiting women exposed to RSV or SARS-CoV-2 during pregnancy and following the mother-baby dyad after delivery and through infancy and early childhood. Pregnant women attending hospitals and clinics affiliated with Tulane and Ochsner in Greater New Orleans, Louisiana are being recruited since October 2020. At delivery, maternal blood and cord blood samples are collected …