Analysis of Mother-child Interaction and Regulation of Candidate Genes of Stress Signaling Pathways in Mature Infants
Condition: Mother-Child Interaction
Study type: Observational

Summary: 
      The planned study will investigate the quality of mother-child interaction at the age of 6
      months as well as the expression and methylation of candidate genes of stress signaling
      pathway in mature infants.

      At best, mother and the healthy, term newborn are undisturbed after birth. This creates
      optimal conditions for the development of a good mother-child interaction. The results of the
      mother-child interaction and the molecular genetic investigations will be compared to the
      results of the randomized controlled delivery room skin-to-skin study (deisy,
      clinicaltrial.gov identifier: NCT 01959737). This study showed a significant difference in
      the mother-child interaction and expression of candidate genes in preterm infants with or
      without skin-to-skin contact after birth.

      The investigators hypothesize that the quality of mother-child interaction at the age of six
      months will be better in term newborns without postpartal separation of mother and child than
      in preterm infants with or without skin contact after birth. The second hypothesis is that
      there will be a difference in the expression and methylation of candidate genes of stress
      signaling pathway in these infants.
    

Detailed description: 
      A separation of mother and child after birth can influence the quality of mother-child
      interaction and the regulation of stress signaling pathways. Maternal depression, parental
      stress and socioeconomic status can also affect the quality of mother-child interaction.

      A former controlled randomized delivery room skin-to-skin study (deisy) showed, that skin
      contact of preterm infants and their mothers after birth improves the mother-child
      interaction. It also leads to a differential expression of candidate genes of the stress
      signaling pathways, which suggests a long term effect on mechanisms in stress response. The
      study group should now be compared to a group of mature infants with a normal, uninterrupted
      postnatal course.

      The hypothesis is that the intervention in the deisy study (early skin-to-skin contact of
      preterm infants and their mothers) improves the mother-child interaction so that it is nearly
      comparable to mature infants with uninterrupted mother-child contact after birth. Furthermore
      it is assumed that the expression and methylation of candidate genes of the stress signaling
      pathways will be influenced by the intervention in the same way.

      The mother-child interaction will be evaluated at the age of six months with a standardized
      method (Mannheim Rating Scales). Questionnaires about maternal depression, social support,
      socio-economic status, parental stress and mother-child relationship disorders as well as
      samples for the molecular genetic testing will be collected on the third day of life and at
      the age of six months. For the molecular genetic testing one blood sample and buccal swabs
      will be taken. The blood sample will not be done additionally but with a routine blood
      sampling on the third day of life (screening of inborn errors of metabolism).
    

Intervention name(s): no intervention
Intervention type(s): Other
Intervention description(s): There will be no intervention. The blood sample is taken while a routine blood sampling.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study population consits of healthy mature newborns who are not seperated from the
        mothers for three hours after birth. The recruitment will take place in three obstetric
        hospitals in Cologne (University Hospital of Cologne, Krankenhaus der Augustinnerinnen,
        evangelisches Krankenhaus Köln-Weyertal).
      
Biospecimen description: 
      -  500µl whole blood sample for RNA extraction in peripheral white blood cells

        -  2 buccal swabs with mucosal epithelial cells for RNA and DNA extraction
    
Keywords: stress response; neurodevelopment; newborn