Thread by @JNRutherford

Monster thread (with links and gifs!) hyping our new paper “#Womb2Womb: Maternal litter size and birth weight but not adult characteristics predict early neonatal death of offspring in the common marmoset monkey” out today in @PLOS: journals.plos.org/plosone/articl… 1/

“We” includes @CorinnaRoss, Suzette Tardif, Toni Ziegler, Laren Narapareddy, Tory deMartelly, Donna Layne Colon, Aubrey Sills, and also from @UICnursing Tori deMartelly, Alana Steffen, and Larisa Burke. And of course, the marmosets from @TxBiomed and @UTHealthSAResearch. 2/

Marmosets are cool because they produce multiples and fetuses experience more challenging intrauterine environments as litter size increases, as shown in different placental morphology (ncbi.nlm.nih.gov/pmc/articles/P…) and perinatal outcomes. 3/

What happens when triplet-born females grow up and start reproducing? That’s the #womb2womb question! Our 2014 work in @PLoS showed reproductive deficits for triplet born females (journals.plos.org/plosone/articl…) so we wrote an @NICHD grant to find out more. 4/

We explored whether 1) pregnancy outcomes were predicted independently by maternal adult weight vs. maternal litter size and birth weight, and 2) stillbirth and early neonatal death were differentially predicted by maternal variables, in 26 directly observed births. 5/

No maternal characteristics predicted stillbirth and no maternal adult characteristics predicted early neonatal death. Read that last part again: no maternal ADULT characteristics predicted early neonatal death, i.e., death of an infant in the first week of life. 6/

Here’s the #Womb2womb part: being born a triplet or at a lower birth weight was associated with losing more babies early, while current age or weight or weight gain has unrelated. Note that those last ones are the kinds of things we obsess over in human pregnancy management. 7/

In multivariate Poisson models, maternal litter size remained an independent predictor, explaining 13% of the variance in early neonatal death. That’s huge! Something far beyond the locus of the current pregnancy plays a huge role in the outcome of that pregnancy! 8/

We found that the later in the first week neonates died, the more weight they lost suggesting they were not eating/being fed in the same way as surviving infants, who did not lose weight. Maybe triplet-born moms have a harder time keeping up with their babies? 9/

Together these findings suggest that triplet-born and low birth weight females have distinct developmental trajectories underlying greater rates of infant loss, losses that we suggest may be attributable to developmental disruption of infant feeding and carrying. 10/

We suggest that conflating stillbirth and early neonatal death under a single umbrella of “perinatal loss” may obscure the particular fragility of early neonatal dependence and attendant needs for parental support. 11/

Now, here’s the thing I really want you to hear: Our findings of early life contributions to adult pregnancy outcomes in the common marmoset disrupt mother-blaming narratives of pregnancy outcomes in humans. 12/

How? Well, these narratives hold that the pregnant person is solely responsible for pregnancy outcomes and the health of their children, independent of socioecological factors, a moralistic framing that has shaped clinical pregnancy management. 13/

Mother-blaming narratives are written in racist ink, where erroneous biological notions of “race” abstracted from the structural forces of racism in action across generations are identified as deterministic risk factor. @RJEpiOBWarrior and @mclemoremr, cited in the paper. 14/

Even when a pregnant person does everything “right” losses may be suffered as a consequence of bodily or historical inertia that individual choices cannot fully bring to a halt. The marmoset mothers are not engaging in “risky” behavior and there are still patterns of loss. 15/

But see, we don’t blame the marmosets for adverse pregnancy outcomes because we recognize those outcomes are outside their locus of control and responsibility. This is why I ask, “What does monkey biology tell us about justice?” 16/

“I see an opportunity in this work to think about reimagining the way we approach human health and health care that is just and biologically sound.” today.uic.edu/new-research-i… 17/

Understanding that pregnancy is not a time-bound event but instead embedded in endless temporal, spatial, relational, and social complexity will move us past narratives of blame and help parents and communities better cope with loss. 18/

We need better screening and diagnostic (and pedagogical & epistemological!) tools for pregnancy outcomes that take into account the full arc of a mother’s lived experience, from #womb2womb and beyond. journals.plos.org/plosone/articl… 19/

Thanks to @Amanda_Dettmer, @AnthroFuentes, @MammalsSuck, @RobinGNelson, and @RickWASmith for their invaluable insight on earlier versions of these ideas and this manuscript; and my daughter for embodying and complicating my experience of motherhood and intergenerationality. 20/

@Mammals_Suck, that is.

Amazing photo courtesy of the extraordinarily talented @KathyWestStudio!

@NICHD_NIH, that is.