Chinese Meishan pigs exhibit exceptional prolificacy compared with common domestic breeds and therefore provide a model for investigating the mechanisms involved in a successful reproductive outcome. Previous studies have shown that the Meishan gains its reproductive advantage through reduced conceptus mortality at the time of conceptus attachment to the uterine endometrium and the establishment of pregnancy. The purpose of this thesis was to consider factors that might affect conceptus viability in the Meishan and a control breed (the Large White x Landrace), to determine where differences arise. Meishan and Large White x Landrace function was compared, in the period leading up to the establishment of pregnancy (days eight to 12 after the onset of oestrus, inclusive). Many factors that might impinge on conceptus survival were investigated, including maternal nutrition, metabolism, endocrinology and conceptus and endometrial morphology and biochemistry. Conceptus oestradiol-17β secretion, believed to be the signal for the establishment of pregnancy in the pig, was delayed and more synchronised in the Meishan than in Large White x Landrace. Also, Meishan plasma progesterone concentrations were elevated compared with the Large White x Landrace gilts. Other studies have positively correlated conceptus survival with raised plasma progesterone concentrations, which can be manipulated by altering the nutritional intake of the dam. The role of conceptus oestradiol-17β in the establishment of pregnancy in the Meishan was also investigated. A lack of aromatase enzyme activity, before day 12 after the onset of oestrus, prevents the conversion of testosterone to oestradiol-17β. Thereafter, substrate availability limits the reaction. Exogenous oestradiol benzoate extended the interoestrous interval of treated Meishan gilts, although differences in the physiology of pregnant and pseudopregnant gilts suggested that other conceptus-specific activity influences the establishment of pregnancy in this breed. These studies have highlighted specific aspects of pig reproduction, manipulation of which might improve the prolificacy of domestic breeds. Further investigations are required to establish the whether such techniques would be practical in the commercial setting.

Some previous work has suggested that fetal rejection may be a cause of spontaneous abortion in humans. The aim of the work presented, therefore, was to determine the influence of maternal alloantibody formation against paternal B lymphocytes, detected by the erythrocyte antibody rosette inhibition (EAI) assay, on the outcome of semi-allogeneic pregnancies. Preliminary studies indicated that EA rosette inhibition was a suitable assay for these investigations, because it detected alloantibodies directed to any major histocompatibility complex (MHC) antigen, irrespective of the ability of the antibody to fix complement; this was an important consideration because alloantibodies induced by pregnancy are often only weakly lytic. In humans it was found that antibodies to paternal B lymphocytes occurred significantly more commonly in normal primigravid and multigravid pregnancies when compared with pregnancies of similar gestation which aborted. These antibodies were shown to be directed to MHC encoded antigens by family studies, but were not removed by platelet absorption, strongly suggesting that they were not class I MHC antigens. Studies in inbred rats demonstrated that these paternal antigens were encoded by the RT1A region of the rat MHC alone. Maternal alloantibody responses to RT1A antigens appeared to be suppressive because studies using the rat kidney allograft model showed that multiparous rats with EAI antibodies to paternal strain cells enjoyed prolonged graft survival. It was also found that pregnancies in which the paternal strain differed only by RT1A antigens induced a suppressive immune response in the mother. These results suggest that immune responses to MHC encoded antigens, possibly unique, may prevent fetal rejection in some instances.

Background Air pollution exposure has been shown to have adverse effects on several health outcomes, and numerous studies have reported associations with cardiovascular morbidity, respiratory disease, and mortality. Over the last decade, an increasing number of studies have investigated possible associations with pregnancy outcomes, including preterm delivery. High levels of vehicle exhaust in residential neighborhoods have been associated with respiratory effects, including childhood asthma, and preterm birth is also associated with childhood asthma. The first aim of this thesis was to investigate possible associations between air pollution exposure and pregnancy outcomes – primarily preterm delivery but also small for gestational age (SGA) and pre-eclampsia – in a large Swedish population (Papers I–III). The second aim was to study any association between exposure to high levels of vehicle exhaust during pregnancy and infancy and prescribed asthma medication in childhood (Paper IV). Methods The study cohorts were constructed by matching other individual data to the Swedish Medical Birth Register. In the first two studies, air pollution data from monitoring stations were used, and in the third and fourth studies traffic intensity and dispersion model data were used.Preterm delivery was defined as giving birth before 37 weeks of gestation. SGA was defined as having a birth weight below the 10th percentile for a given duration of gestation. Pre-eclampsia was defined as having any of the ICD-10 diagnosis codes O11 (pre-existing hypertension with pre-eclampsia), O13 (gestational hypertension without significant proteinuria), O14 (gestational hypertension with significant proteinuria), or O15 (eclampsia). Childhood asthma medication was defined as having been prescribed asthma medication between the ages of five and six years. Results We observed an association between ozone exposure during the first trimester and preterm delivery. First trimester ozone exposure was also associated with pre-eclampsia. The modeled concentration of nitrogen oxides at the home address was associated with pre-eclampsia, but critical time windows were not possible to investigate due to high correlations between time windows. We did not observe any association between air pollution exposure and SGA. High levels of vehicle exhaust at the home address, estimated by nitrogen oxides and traffic intensity, were associated with a lower risk of asthma medication. Conclusion Air pollution exposure during pregnancy was associated with preterm delivery and pre-eclampsia. We did not observe any association between air pollution levels and intrauterine growth measured as SGA. No harmful effect of air pollution exposure during pregnancy or infancy on the risk of being prescribed asthma medication between five and six years of age was observed.

The nutritional status of 78 women was assessed during the third trimester of pregnancy. The study was conducted in military barracks in Sierra Leone with 39 adolescent women (<20 years) and 39 adult women (>20 years).Twenty-four hour dietary recall interviews and anthropometric measures were collected. Laboratory, clinical and physiological data were obtained from the subjects' medical records. The dietary analysis of the diets consumed by adolescent and adult women showed differences in the intakes of only calcium, phosphorous, potassium, selenium and sodium. The average diet consumed by the women was <2/3 the recommended guidelines for carbohydrate and <2/3 the Recommended Dietary Allowances for persons in the U.S. for kilocalories, protein, riboflavin, pyridoxine, folacin, pantothenic acid, cholesterol, calcium, iron, magnesium, phosphorous, sodium and zinc. The women consumed diets that were >100 percent of the RDA for vitamins A, C, E, niacin and selenium. Differences occurred in the infant birthweights and Apgar scores at 1, 5 and 10 minutes between women who had abnormal measures for hemoglobin, hematocrit, ketonuria, albuminuria, glycosuria and/or malaria parasites and the women who were healthy.Maternal weight gain, age and infant health status did not correlate. The average weight gain for all the women was 17.85 kg which is within the acceptable range recommended for pregnancy. Maternal weight-at-term, gestational age, triceps skinfolds, arm circumference, hemoglobin, hematocrit were correlated with infant birthweight, length and head circumference. Maternal hemoglobin and hematocrit further correlated with infant Apgar scores at 1, 5 and 10 minutes.Hemoglobin and hematocrit levels were very low for the average women in the study (X 9.7 g/dl and 29.7 percent respectively). The malaria reduced the infant birthweight by 431 g. Albuminuria and ketonuria were associated with reduced infant birthweight while modest glycosuria was associated with increased birthweight. / Department of Home Economics

The relationship between perinatal complications and sensory-motor functions was examined. Information from the Maternal Perinatal Scale (MPS) was used to predict factor scores of the Dean Sensory-Motor Battery (DSMB). Participants were 187 normal nonreferred children who were administered the DSMB while their mothers completed the MPS. Using MPS items as predictors, separate stepwise regression analyses for each DSMB factor found that 11 - 16% of variance could be accounted for in sensory-motor performance. At least three MPS items significantly contributed to the prediction of each DSMB factor. Predictors of Sensory and Simple Motor functions (DSMB Factor I) included maternal bleeding during pregnancy, delay between membrane rupture (water break) and onset of labor, and evidence of hypoxia. Evidence of hypoxia, maternal bleeding during pregnancy, and delay between water break and labor onset were predictive of Motor and Complex Sensory functions (DSMB Factor II). In addition, gender of the child joined maternal bleeding during pregnancy, amount of swelling during pregnancy, and mother's height in predicting Subcortical Motor functions (DSMB Factor III). Additional analyses using a canonical correlation confirmed the results of the regression analyses. A linear composite of sensory and motor variables was primarily defined by DSMB factors I and II. The linear composite of perinatal information was defined primarily by the same items that emerged as significant predictors of sensorymotor functions in the regression analyses. Most notably, a redundancy analysis indicated that about 20% of variance in DSMB factor scores could be accounted for by a linear composite of perinatal information. In general, sensory-motor performance decreased as severity of perinatal complications increased. Results were discussed in terms of the implications of using a normal non-referred population. More importantly, the present data suggested the possibility that 1) the relationship between perinatal complications and sensory-motor functions may exist on a continuum rather than the dichotomous diagnosis/no diagnosis, and 2) the synergistic influence of multiple perinatal complications may contribute to the manifestation of clinically significant behaviors. The role of sensory-motor functions as a foundation for more complex behaviors is also discussed. / Department of Educational Psychology

More North American Aboriginal women are being diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the association of a number of health problems with GDM, there have been few evaluations of GDM prevention projects. Nor have investigators looked at Aboriginal women’s understandings of GDM in an effort to develop appropriate and effective health strategies. A qualitative investigation was therefore proposed to describe the experiences of Aboriginal women with GDM. The study began with unstructured interviews and focus groups with 25 advisors such as maternal care providers and community representatives working with Aboriginal women. Semi-structured explanatory model interviews were then conducted with 29 Aboriginal women in Winnipeg, the capital city of Manitoba, Canada. Fixed-response interviews were also administered and analyzed using cultural consensus analysis to determine whether or not shared cultural understandings existed among the Aboriginal women participants. Results of the consensus analysis revealed biomedical understandings were the most commonly shared. A more variable response was associated with women’s personal interpretations of GDM, leading to weak consensus overall. Thematic analysis of the semi-structured interviews illustrated the fear, anxiety and frustration many participants experienced with GDM. Women discussed their emotional reactions alongside negative relationships with food and other prescribed lifestyle treatments. These perspectives, combined with results from the group of advisors, pointed to communication and cultural barriers which may limit the quality of prenatal care received. Collectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy and emotional security towards effective management practices. Research contributing to a more comprehensive understanding of Aboriginal women’s experiences with GDM is also required, to provide further perspective for diabetes prevention and positive change.

The purpose of this mixed methods study was to identify demographic and psychosocial correlates of illicit drug use among pregnant women and to explore the life experiences and circumstances that contribute to women’s use of illicit drugs during pregnancy. A sequential explanatory mixed-methods design consisting of quantitative and qualitative components was used. The results of the quantitative component found that women who are depressed, of First Nations ethnicity, drink alcohol during pregnancy, smoke during pregnancy, and have low self-esteem are more likely to use illicit drugs during pregnancy. The qualitative component of the study identified four themes that impacted women’s use of illicit drugs during pregnancy. These included: (1) living a chaotic life as a child, (2) complicated life circumstances, (3) social support system, and (4) the road to recovery. The information gathered during this study will inform practice and policy and may guide future research in this area.

Adolescent pregnancy is an important public health issue. The purpose of this mixed-methods study was to examine factors related to inadequate use of prenatal care (PNC) among adolescents living in inner-city Winnipeg. The quantitative component consisted of a secondary analysis of data from 92 adolescents (<20 years of age) who participated in a larger case-control study. Adolescents who were of First Nations ethnicity, single, multiparous, and who had low interpersonal support were more likely to receive inadequate PNC. Barriers, facilitators and motivators to PNC utilization were also identified. The qualitative component consisted of open-ended interviews with ten inner-city pregnant adolescents to examine how social support affected their use of PNC. Results showed that material, emotional and informational support were important factors affecting use of PNC. The most important source of material and emotional support was the adolescent’s mother, and the main source of informational support was the PNC provider.

Although the risk of malformations in the offspring of diabetic mothers remains the leading cause of perinatal mortality, the pathogenesis has not been elucidated. The hypothesis of this study was that protein glycation and oxygen free radicals play a role in hyperglycemia-induced malformations. CD-1 mouse embryos (0-2 somites) were cultured under hyperglycemic conditions for 48 hours with the exogenous addition of anti-glycating agents and oxygen free radical scavengers. The exogenous addition of aspirin (ASA) and D-lysine reduced significantly the malformations and embryonic glycated protein levels. Salicylate, arachidonic acid (AA), and to a lesser extent, indomethacin also exerted protective effects, but with no effect on glycated protein levels. We hypothesize that ASA, salicylate and indomethacin are protective by exerting free radical scavenging action; and ASA and D-lysine are acting as potent anti-glycating agents. Moreover, we suggest that AA may have inhibited hyperglycemia-induced malformations through the protective action of prostaglandins against free radical damage. Serum media lipid peroxidation (LPO) was reduced in the ASA and indomethacin groups possibly due to either a direct free radical scavenging action and/or the inhibitory effects of these agents on cyclooxygenase activity thereby decreasing the oxygen free radicals produced by this enzyme system. On the other hand, AA was associated with an increased level of LPO in the serum media. As the evidence has shown, the cause of hyperglycemia-induced malformations appears to be multifactorial and no one agent can completely eliminate the problem, although protective action can be exerted at different levels of the glycation-free radical cascade of tissue damage.

Our objectives were to measure concentrations of glucose, insulin, insulin-like-growth-factor-binding-protein-1 (IGF BP1) and beta-hydroxybutyrate (BOHB) in amniotic fluid (AF), and establish if these concentrations were associated with emergence of maternal gestational diabetes mellitus (GDM). AF samples (n=408) were collected following routine amniocentesis (12-22 weeks gestation). Glucose and insulin concentrations were elevated in our GDM mother-infant pairs, where GDM was associated with a 176g increase in birth weight. Logistic regression showed that AF glucose but not insulin was associated with developing GDM. Non-linear Bayesian probability plots showed that when 2nd trimester glucose was plotted against insulin increases in both were predictive of the subsequent emergence of GDM. In conclusion, our findings show that: (1) AF glucose but not insulin predicts subsequent emergence of GDM and (2) these observed elevations provide evidence that the fetus of GDM mothers is being exposed early in-utero to metabolic perturbations (i.e. elevated glucose) that may have important long-term metabolic consequences for their future development.