Analysis of Mother-child Interaction and Regulation of Candidate Genes of Stress Signaling Pathways in Mature Infants
Analysis of Mother-child Interaction and Regulation of Candidate Genes of Stress Signaling Pathways in Mature Infants
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.
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).
Inclusion Criteria:

 -  mature newborn (38 to 41 weeks of gestational age)

 -  first child

 -  no separation of mother and child for three hours after birth

 -  informed consent

 Exclusion Criteria:

 -  multiples

 -  malformations or syndromes in the infant

 -  maternal psychological or severe physical illness