Introduction: Obsessive-compulsive disorder (OCD) is a complex disorder that is associated with significantly impaired functioning. The current prevailing model of OCD implicates dysfunction of the serotonergic neurotransmitter system and fronto-striatal neural networks, but challenges in replicating findings within OCD samples are often attributed to clinical heterogeneity. OCD symptoms that develop or worsen within the perinatal period appears to reflect a distinct subtype of the disorder, but the genetic and neurobiological factors that contributes to its presentation in women is poorly understood. In this dissertation, we aimed to review the literature on the genetic architecture of OCD, identify potential gene candidates for perinatal OCD and analyze one serotonin system gene according to OCD and possible subtypes using meta-analytic techniques. Based on these findings, we then tested the association of serotonergic candidate gene polymorphisms with the presence of infant-related obsessive-compulsive symptoms (OCS). Lastly, we investigated the cortical morphological features associated with perinatal OCD and OCS symptom severity in postpartum mothers. Results: From prior reports in the literature and our own meta-analytic investigation, polymorphic variants in genes coding for the serotonergic transporter and serotonin 2A receptor subtype (SLC6A4 and HTR2A, respectively) appear to be candidates for perinatal OCD due to their association in female samples. However, upon investigation in our perinatal sample (n=107), we found no evidence to support the association of the 5-HTTLPR polymorphism of SLC6A4 with perinatal-related OCS, but larger samples are needed to confirm this finding. Due to technical challenges, the HTR2A polymorphism remains to be tested. Our novel whole-brain explorations revealed distinct cortical morphology associated with symptom worsening across the perinatal period, irrespective of diagnosis. Cortical parameters were not able to differentiate mothers with and without OCD; however, OCD mothers displayed positive correlations between cortical surface area and symptom severity in widespread regions, including the frontal, parietal, temporal and occipital cortex. Conclusions: Overall, this body of work aimed to fill the gap in the literature by exploring the possible genetic and cortical correlates of perinatal-related OCS and OCD. While 5-HTTLPR or HTR2A are candidates for perinatal OCD, it is not yet clear whether they increase susceptibility for the development of infant-related OCS in the perinatal period. Distinct cortical alterations in surface area appeared alongside OCS exacerbation in the postpartum period in regions that extend beyond the frontoparietal network. This suggests that additional neural networks may be contributing to symptom severity and that the cortical plasticity that occurs across the perinatal period may predispose women for risk of OCD. Future studies should continue to use a multiple perspective approach, that utilizes genetic and neurobiological techniques, in order to provide greater insight into the etiology of perinatal OCD. / Dissertation / Doctor of Philosophy (PhD) / Women are at greater risk for the development of mental illness in the time surrounding pregnancy and postpartum, known as the perinatal period. In the case of perinatal obsessive-compulsive disorder (OCD), mothers may experience unique worries in regard to their parenting or fears that their baby may be harmed. While these worries are common, they can become disruptive when persistent and impact the mother’s mood and ability to bond with the infant. Our current understanding of OCD includes the influence of genetic factors and brain changes, but little is understood about what factors may increase risk for OCD in the perinatal period. In this thesis, we aimed to review whether certain alterations within DNA segments, known as gene variants, may be linked to the development of OCD in females and if these gene changes, as well as differences in brain structures in postpartum mothers, are associated with OCD symptoms during the perinatal period. The genes we examined are important for regulating a chemical signaling substance in the brain known as serotonin. Based on our results, we did not find a relationship between serotonin gene variants and OCD symptoms in perinatal women. We also found no differences when comparing the cortical brain structures between mothers with OCD and healthy mothers; however, we observed that measures of surface area across several cortical brain regions were related to symptom worsening from pregnancy to postpartum, and also with symptom severity in postpartum mothers with OCD. These results suggest that there are widespread brain changes during the postpartum period that may increase a mother’s risk for developing OCD. Overall, the work in this thesis provides the first glimpse into potential risk factors for perinatal OCD.

La période périnatale est particulièrement propice pour que les futures et nouvelles mères consommatrices de substances psychoactives et leur partenaire entrent en relation d’aide avec des intervenants médicaux et psychosociaux. Pour ces mères et ces pères, l’arrivée d’un poupon dans leur vie est une source de motivation pour entreprendre une démarche d’aide basée sur la confiance. Pourtant, plusieurs études soulignent différentes contraintes qui rendent difficile l’entrée en relation d’aide de ces parents avec des intervenants. Ce mémoire à donc pour objectif d’explorer, à partir du point de vue de mères consommatrices et de leur partenaire, la façon dont se vivent leurs expériences relationnelles avec des intervenants médicaux et psychosociaux au cours de la période périnatale, tout en identifiant des éléments qui ont influencé leurs rapports. Nous avons fait une analyse secondaire du discours de vingt mères consommatrices et de leur partenaire, recrutés au moment de la naissance dans le cadre d’une recherche de Morissette, Devault et Rondeau (2006-2010). Les résultats obtenus indiquent que les parents semblent généralement satisfaits de leurs relations avec les intervenants médicaux et psychosociaux qu’ils ont rencontrés à cette période, même s’ils rapportent vivre des peurs importantes qui nuisent à la relation d’aide. Nos résultats révèlent également plusieurs éléments qui influencent les relations relevant autant des contextes d’intervention que des intervenants eux-mêmes et de leurs rôles. Nous constatons d’après les résultats qu’en dépit de certains aspects qui nuisent aux relations avec des intervenants, le cumul des éléments qui les favorisent semble susciter une satisfaction des mères consommatrices et de leur partenaire. Dans les situations où plusieurs éléments nuisent à la relation d’aide, il se créer une dynamique de méfiance réciproque entre ces parents et les intervenants. Néanmoins, comme les relations ne sont pas immuables, il est possible de transformer les relations difficiles pour les rendre plus satisfaisantes pour les mères consommatrices, leur partenaire et les intervenants médicaux et psychosociaux. / The perinatal period is especially prone for future and new mothers who use or abuse of psychoactives substances and their partners to enter helping relationships with medical and psychosocial workers. For these mothers and their partner, the birth of a child is a source of motivation to begin a helping process based on trust. However, studies underline multiple obstacles that restrain those parents to enter helping relationships with workers. This research aims to explore, from the substance-using mothers and their partners’ point of view, the ways in which they have experienced their relationships with the medical and psychosocial workers during the perinatal period, while pointing to elements that have influenced those relationships. Twenty substances-using mothers and their partner were recruited at the time of birth and interviewed as part of a research conducted by Morissette, Devault and Rondeau (2006-2010). We have made a secondary analysis of the interviews. The results indicate that, despite their fears to establish helping interactions with workers, parents seem generally satisfied of the relationships they have had with the medical and psychosocial workers met. Our results also point to many elements that have an influence on the helping relationships pertaining to the context in which the interactions took place, to the workers themselves and their roles. We notice from the results that the combination of elements favorably influencing their relationships with the worker conveys a sense of satisfaction to the substance-using mothers and their partners about the helping relationships experienced, despite some aspects that hinder these relationships. A mutual mistrust dynamic is created between the parents and the workers in situations where many elements hinder the helping relations. However, as the relationships are not static, it is possible to transform difficult relations to make them more satisfying for substance-using mothers, their partners and the medical and psychosocial workers.

La période périnatale est particulièrement propice pour que les futures et nouvelles mères consommatrices de substances psychoactives et leur partenaire entrent en relation d’aide avec des intervenants médicaux et psychosociaux. Pour ces mères et ces pères, l’arrivée d’un poupon dans leur vie est une source de motivation pour entreprendre une démarche d’aide basée sur la confiance. Pourtant, plusieurs études soulignent différentes contraintes qui rendent difficile l’entrée en relation d’aide de ces parents avec des intervenants. Ce mémoire à donc pour objectif d’explorer, à partir du point de vue de mères consommatrices et de leur partenaire, la façon dont se vivent leurs expériences relationnelles avec des intervenants médicaux et psychosociaux au cours de la période périnatale, tout en identifiant des éléments qui ont influencé leurs rapports. Nous avons fait une analyse secondaire du discours de vingt mères consommatrices et de leur partenaire, recrutés au moment de la naissance dans le cadre d’une recherche de Morissette, Devault et Rondeau (2006-2010). Les résultats obtenus indiquent que les parents semblent généralement satisfaits de leurs relations avec les intervenants médicaux et psychosociaux qu’ils ont rencontrés à cette période, même s’ils rapportent vivre des peurs importantes qui nuisent à la relation d’aide. Nos résultats révèlent également plusieurs éléments qui influencent les relations relevant autant des contextes d’intervention que des intervenants eux-mêmes et de leurs rôles. Nous constatons d’après les résultats qu’en dépit de certains aspects qui nuisent aux relations avec des intervenants, le cumul des éléments qui les favorisent semble susciter une satisfaction des mères consommatrices et de leur partenaire. Dans les situations où plusieurs éléments nuisent à la relation d’aide, il se créer une dynamique de méfiance réciproque entre ces parents et les intervenants. Néanmoins, comme les relations ne sont pas immuables, il est possible de transformer les relations difficiles pour les rendre plus satisfaisantes pour les mères consommatrices, leur partenaire et les intervenants médicaux et psychosociaux. / The perinatal period is especially prone for future and new mothers who use or abuse of psychoactives substances and their partners to enter helping relationships with medical and psychosocial workers. For these mothers and their partner, the birth of a child is a source of motivation to begin a helping process based on trust. However, studies underline multiple obstacles that restrain those parents to enter helping relationships with workers. This research aims to explore, from the substance-using mothers and their partners’ point of view, the ways in which they have experienced their relationships with the medical and psychosocial workers during the perinatal period, while pointing to elements that have influenced those relationships. Twenty substances-using mothers and their partner were recruited at the time of birth and interviewed as part of a research conducted by Morissette, Devault and Rondeau (2006-2010). We have made a secondary analysis of the interviews. The results indicate that, despite their fears to establish helping interactions with workers, parents seem generally satisfied of the relationships they have had with the medical and psychosocial workers met. Our results also point to many elements that have an influence on the helping relationships pertaining to the context in which the interactions took place, to the workers themselves and their roles. We notice from the results that the combination of elements favorably influencing their relationships with the worker conveys a sense of satisfaction to the substance-using mothers and their partners about the helping relationships experienced, despite some aspects that hinder these relationships. A mutual mistrust dynamic is created between the parents and the workers in situations where many elements hinder the helping relations. However, as the relationships are not static, it is possible to transform difficult relations to make them more satisfying for substance-using mothers, their partners and the medical and psychosocial workers.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2002. / Härtill 6 uppsatser.

Les ovins D’man sont élevés dans les oasis tunisiennes selon un rythme accéléré permettant d’avoir trois agnelages en deux ans. En plus des effets directs du mode d’élevage et d’environnement exercés sur les brebis D’man, la prolificité élevée pose question quant à la survie, la croissance et le bien-être des agneaux. L’objectif de ce travail est de déterminer les facteurs de risque qui affectent la survie et la croissance chez les agneaux D’man élevés dans les oasis de Gabès. Dans une première étape, le travail a traité les facteurs de risque d’ordre zootechnique et environnemental sur la base des données concernant 1189 agneaux élevés à la ferme de l’OEP de Gabès. En moyenne, un taux de mortalité égal à 13,4% a été observé de la naissance au sevrage dont 41% pendant les 10 premiers jours de vie, 29% entre 10 et 30 jours et 30% entre 30 et 70 jours. Le taux de mortalité est plus élevé chez les agneaux nés en hiver (23,5%) par comparaison au printemps (12,3%), l’automne (10,2%) et l’été (9,5%). A cause de leur poids léger, les agneaux issus des portées multiples (triples et quadruples) ont un taux de mortalité plus élevé (52,2%) comparés à ceux issus des portées simples et doubles ayant un poids de naissance medium (24,4%) ou lourd (1,8%). Les agneaux nés en printemps sont plus lourds à la naissance, à 30 et 70 jours et par conséquent ont des vitesses de croissance plus importantes par comparaison aux agneaux nés en hiver, en automne et en été. Le poids à la naissance et les vitesses de croissance sont également influencés par la taille de portée et l’âge de la brebis. Le faible poids à la naissance (≤ 1,5 kg), les portées multiples (quadruples et quintuples) et les agnelages d’hiver sont les principaux facteurs de risque pour la survie et la croissance des agneaux D’man. / D’man ewes are reared in Tunisian oases under an accelerated management system allowing breeders to have three lambing periods every two years. High prolificacy may accentuate the detrimental effects of an accelerated lambing system through problems which affect growth, welfare and survival. Therefore, the aim of the present study was to determine the risk factors of lamb mortality in this prolific breed maintained under intensive management in Tunisian oases. In a first step, growth and mortality rates are reported using records of 1189 lambs collected between 2004 and 2009 from an accelerated lambing system to determine risk factors according to characteristics of the animals and the environment. Results showed that overall mortality from birth to 70 days of age was 13.4%. Of all the total losses, 41% of the lambs died within 10 days of birth, 29% died between 10 and 30 days of age and 30% between 30 and 70 days. Mortality rate was significantly higher in winter (23.5%) than in spring (12.3%), autumn (10.2%) and summer (9.5%). Lambs in the low-weight category died more frequently (52.2%) than lambs from medium-weight (24.4%) to high-weight (1.8%) categories. Lambs born in spring were consistently the heaviest at birth, at 30 and 70 days of age with the greatest average daily gains compared to those born in winter, autumn and summer. Birth weights were affected by litter size and ewe age, and lambs from older ewes (2-10 years) grew faster than lambs born from young ewes (1 year). The principal risk factors identified were season (winter), birth type (multiple) and weight class (≤ 1.5 kg).

Bakgrund: Fadern kan vara ett stort stöd till kvinnan under såväl graviditet som förlossning. Under pågående covid-19-pandemi togs beslutet att fadern inte fick närvara fysiskt i samma utsträckning som tidigare. Att själv inte kunna välja nivå av involvering under denna period i livet kan påverka känslan av delaktighet hos fadern. Syfte: Att beskriva fäders upplevelser av delaktighet under den perinatala perioden under covid-19-pandemin. Metod: En kvalitativ studie med induktiv ansats gjordes med hjälp av intervjuer med åtta fäder. En kvalitativ innehållsanalys användes för att genomföra dataanalysen. Resultat: Resultatet omfattar tre huvudkategorier och sex underkategorier: Ej bemött ur ett familjeperspektiv; Ensamhet och oro och Bristfällig information; Fäders syn på sin roll; Prioriteringar och Ta eget ansvar; Acceptans av situationen; Förståelse och Andra former av delaktighet. Resultatet visar att flera fäder upplevde ensamhet, oro och bristande information från vårdpersonalens sida. Samtliga fäder hade en förståelse för de restriktioner som vidtagits till följd av pandemin men hade gärna blivit erbjudna att få delta vid de antenatala besöken via videolänk. De upplevde att de behövde ta eget ansvar och söka information själva för att kunna involvera sig. Fäderna graderade helhetskänslan av delaktighet under den perinatala perioden som god. Detta var till följd av att de fått närvara under förlossningen, vilket var viktigast för dem.  Slutsats: Barnmorskan bör ha i åtanke att arbeta för att involvera fäderna, främst i besöken på mödrahälsovården. Genom att involvera och stödja kan barnmorskan hjälpa fäderna att förbereda sig inför föräldraskapet Om fäderna känner sig förberedda kan de vara ett bra stöd för sin partner under den perinatala perioden. / Background: The father can be a great support to the woman during both pregnancy and childbirth. During the covid-19 pandemic the decision was made that the father was not allowed to be as physically present as before. Not being able to choose the level of involvement during this period of life can affect the fathers feeling of participation. Purpose: Describe fathers experiences of participation during the perinatal period during the covid-19 pandemic. Method: A qualitative study with inductive approach based on interviews with 8 different fathers. The data analysis was performed using a qualitative content analysis. Result: The result can be subdivided into three main categories and six subcategories: Not treated from a family perspective; Loneliness and Anxiety and Inadequate information; Fathers views on their role; Priorities and Take own responsibility; Acceptance of the situation; Understanding and Other forms of participation. The result shows that several fathers experienced loneliness, anxiety, and inadequate information from the care staff. All fathers showed understanding of the restrictions due to the pandemic but had wished to be offered participation via video link. They felt that they needed to take responsibility and seek information themselves to be involved. The fathers rated the overall feeling of participation during the perinatal period as good. This was because they were allowed to attend during the childbirth, which was the most important to them. Conclusion: The midwife must keep in mind to work to involve the fathers, especially at the visits to the maternal health care. By involving and supporting, the midwife can help the fathers prepare for parenthood. If the fathers feel prepared, they could be a good support for their partner during the perinatal period.

Background: Intimate partner violence (IPV) is not only considered a serious public health issue and a cause of human suffering (National Center for Injury Prevention of the Centers for Disease Control and Prevention, 2015), IPV can be a barrier to utilization of care in vital life phases (Bonomi et al, 2009; Snow Jones, Dienemann, & Schollenberger, 2006), and a determinant of many serious negative health outcomes for affected individuals and their families (Silverman et al, 2020). As a significant contributor to health, social, and economic disparities, violence jeopardizes the fabric of families and transcends all levels of socioeconomic status (Rhodes, 2012). Among those who suffer serious to fatal consequences as a direct result of IPV, the perinatal period has only recently received special attention in research and is extremely scarce (WHO, 2011). This is particularly the case as the exposure/context of IPV may be further complicated by societal crises such as natural disasters and pandemics, where the threat of violence and its health consequences may be heightened (Yehuda et al, 2008). Objectives: The objectives of this dissertation were to address the knowledge gaps pertaining to perinatal IPV and violence experiences during the COVID-19 pandemic. It had three specialist articles, two of which were reviews of the literature, and one was a population-based empirical study. The objectives of the dissertation were as follows: 1) To explore uni- and bi-directional IPV prevalence estimates and associated factors during the perinatal period (Paper I) (Mojahed et al, 2021a); 2) To investigate a broader range of pre- pandemic contexts of social and geographical isolation and their associations with IPV, as well as to provide reliable, preliminary knowledge of their potential impact during the COVID- 19 pandemic (Paper II) (Mojahed et al, 2021b; 3) To explore the 12-month prevalence of psychological, physical, and sexual IPV within an existing cohort, which consists of women and men, as well as to detect any possible changes during the COVID-19 pandemic in the experienced IPV behaviors as opposed to pre-pandemic times (Paper III) (Mojahed et al, 2023); 4) To explore factors that could prospectively predict IPV victimization (Paper III). Materials and Methods: Paper I involved a qualitative synthesis of the literature. Due to the heterogeneity of prevalence studies and varying violence definitions, quantitative analyses were not feasible for this review. The paper investigated prevalence estimates of perinatal IPV among intimate partners and explored associated factors. Information such as author, year of publication, recruitment setting, study design, sample size, directionality of IPV, prevalence estimates, and types of violence were extracted and tabulated. The integrative ecological model was used to consider population characteristics and (gender-based) associated factors relevant to IPV prevalence. Paper II was a rapid review conducted following Cochrane guidelines to address the urgency of studying IPV in the context of the COVID-19 pandemic. The review focused on the correlation between social and geographical isolation and IPV. Paper III utilized data from the population-based longitudinal study DREAMCORONA. Descriptive analyses were performed to determine the prevalence of IPV victimization among women and men, examining changes during the pandemic. Pearson correlation analyses and multiple logistic regression analysis were conducted to identify associations and potential predictors of IPV. The results were presented as odds ratios with confidence intervals. Results: In Paper I, several key findings were reported. Psychological uni-directional IPV against female partners was most prevalent during pregnancy. Studies comparing IPV prevalence before and after childbirth showed mixed results, with some reporting a decrease and others reporting an increase in IPV after birth. Risk factors at the individual, family, community, and societal levels were identified, including socioeconomic status, substance use, insufficient prenatal care utilization, low self-esteem, unplanned pregnancy, lack of support, and certain social and ethnic identities. Paper II found that lack of social support increased the risk of IPV victimization, and the compounding effect of social and geographical isolation heightened this risk. It also revealed that social isolation correlated with physical and sexual IPV among female drug users and predicted various forms of IPV among immigrant women. In Paper III, it was found that around 50% of women and 40% of men experienced some form of IPV in the last 12 months. Psychological aggression was the most prevalent form of violence reported. The majority of women and men reported no change in victimization by psychological and physical violence during the pandemic. On the other hand, about a quarter of (expectant) mothers (27%) and fathers (22-24%) reported an increase in psychological and physical IPV. With regard to sexual violence, neither mothers nor fathers reported any changes during the pandemic. Higher partnership satisfaction reduced the likelihood of IPV victimization, while symptoms of anger-hostility increased this probability. Conclusions: Considering the burden of perinatal IPV and the impact of the COVID-19 pandemic on IPV, this dissertation highlights the urgent need for effective preventive interventions. The findings suggest the importance of initiating antenatal care and delivering in clinical settings, as these factors were associated with a lower risk of perinatal IPV. Routine screening for IPV in obstetric care is crucial, and healthcare providers should be aware of the elevated risk for mental health distress among perinatal partners exposed to IPV. As experiences of IPV remained largely unchanged during the pandemic, there is a strong recommendation to strengthen and improve access to support services. Alternative support measures such as messenger services and telemedicine should be accessible and reliable for victims of severe IPV who may face increased isolation. Raising awareness about IPV is essential for individuals in informal and formal sectors, as well as family and friends within the immediate social network of those at risk. The findings also support the use of programs targeting adverse interaction patterns, particularly psychological aggression. Future research should focus on associated factors of IPV during the peripartum period and other critical life phases or societal events. It is crucial to adopt ecological and intersectional perspectives to gain a comprehensive understanding of IPV. Furthermore, including the perspective of the other partner in IPV research can provide valuable context for better prevention and intervention strategies.

En dépit des taux élevés de mortalité infantile dans les populations du passé, les sujets décédés en période périnatale ont longtemps été délaissés dans les travaux anthropologiques et paléoanthropologiques. Alors que les analyses biologiques portant sur les individus adultes intègrent l’étude de la variabilité comme une composante majeure, rares sont celles permettant de replacer un individu décédé en période périnatale dans le cadre de la variabilité individuelle ou populationnelle de cette classe d’âge. Le présent travail se propose ainsi d’investir le sujet de la diversité métrique et non-métrique des sujets décédés entre 22 et 48 semaines d’aménorrhée à partir de l’étude biologique de 116 sujets de trois collections archéologiques (une kerma et deux médiévales et modernes) et d’une collection actuelle virtuelle comportant 364 individus. Un premier axe de recherche caractérise la variabilité des corpus dans ses composantes intra-individuelles, inter-individuelles, populationnelles, ainsi que du point de vue des corrélations à l’âge au décès. Un second axe de recherche vise à identifier des caractères permettant d’estimer l’état de morbidité et de vitalité à la naissance de l’individu, donnée déterminante pour le statut du sujet dans la société. Pour le premier axe, l’étude révèle des différences de conformation selon l’âge au décès et les groupes populationnels, de même que l’existence d’asymétries directionnelles et fluctuantes. Les résultats vont ensuite dans le sens d’une forte proximité biologique pour le groupe kerma, traduisant potentiellement une certaine endogamie, au contraire du groupe médiéval et moderne dont la diversité plus importante pourrait refléter des facteurs socio-géographiques ou séculaires. Le second axe de recherche a permis de souligner que la mécano-sensibilité des régions d’insertion musculaire apparaît comme un nouveau paramètre à considérer pour discerner les sujets ayant survécu à la naissance. L’étude de la collection kerma livre également la première identification en contexte archéologique d’un critère de morbidité spécifique, la côte surnuméraire cervicale. Enfin, le croisement des analyses biologiques et des données archéologiques de la nécropole 8B-51 de l’île de Saï, permet d’appréhender et de discuter les traitements funéraires dévolus à la classe d’âge périnatale au Kerma classique. / Despite the high rates of child mortality in past populations, subjects deceased in perinatal period were often neglected in bioarchaeological and paleoanthropology studies. Unlike biological analysis on adults, investigations on newborns rarely include individual or populational variability comparisons as a major component. In the present work, we will focus on metrical and non-metrical diversity of subject deceased between 22 and 48 amenorrhea weeks, based on the biological study of 116 subjects from three archaeological collections (one kerma and two medieval and modern) and one current virtual collection with 364 individuals. The first research axis characterizes the intra-individual, inter-individual and populational variability, and differences by age at death in both samples. The second line of research aims to identify criteria making it possible to estimate individual morbidity and live birth on dry bones, informations that are needed to understand the child’s position in society. Biological studies reveal for the first research axis shape differences by age at death and populations, as well as the existence of directional and fluctuating asymmetries. Results provide evidences of strong biological proximity in the kerma group, potentially indicating of endogamy. On the contrary, the diversity of the medieval and modern group appears broader and could reflect socio-geographical factors or secular trends. The second line of research reveals the mechanical sensitivity of muscular insertions as a key parameter for tracking of live-born subjects. The study of the kerma collection provides the first archaeological identification of the supernumerary cervical rib, detected as a morbidity criterion in perinatal period. Lastly, crossing of biological and archaeological data on the 8B-51 necropolis provides an interpretative framework for funerary treatments dedicated to the perinatal age group in Classic Kerma.