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The present study assesses the risk approach for maternalriskfactors for LBW newborn in Thailand. This study can be considered as a managerial tool for developing local strategies and is particularly useful in the field of maternal and child health care. A summary of maternalriskfactors for LBW newborn as listed in Table 7 and can be used as a health educational tool for pregnant women and as basic data for marital counseling. It can also be used to keep the public informed about the maternalriskfactors for LBW newborn which will help Thai women of reproductive age avoid the chance of having such babies. PMID:1300361
The objectives of this study were to assess the sociodemographic profile and to identify the riskfactors of ante-partum fetal death which occurs after the age of viability of fetus. This prospective observational study was conducted in the Obstetrics department of Ad-din Women Medical College Hospital during the period of June, 2009 to July, 2010. A total of 14,015 pregnant patients were admitted in the study place after the age of viability, which was taken as 28 weeks of gestation for our facilities. Eighty-three (0.59%) of them were identified as intrauterine fetal death. Assessment of maternal sociodemographic characteristics and maternal-fetal riskfactors were evaluated with a semi structured questionnaire pretested. Majority (81.92%, n=68) of the patients were below 30 years of age, 78.31% belonged to middle socioeconomic group. Almost 58% women had education below SSC level and 28.91% took regular antenatal checkup. About 61.45% patients were multigravida. Most (59.04%) ante-partum deaths were identified below 32 weeks of pregnancy. Out of 83 patients, maternalriskfactors were identified in 41(49.59%) cases where fetal riskfactors were found in 16(19.27%) cases; no riskfactors could be determined in rests. Hypertension (48.78%), diabetes (21.95%), hyperpyrexia (17.3%), abruptio placentae (4.88%) and UTI (7.36%) were identified as maternalfactors; and congenital anomaly (37.5%), Rh incompatibility (37.5%), multiple pregnancy (12.5%) and post-maturity (12.5%) were the fetal riskfactors. Here, proximal biological riskfactors are most important in ante-partum fetal deaths. More investigations and facilities are needed to explain the causes of antepartum deaths. PMID:22561778
Objectives: To study prevalence, riskfactors, and maternal and infant outcomes of women with gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was performed based on 111563 pregnancies delivered between 1991 through 1997 in 39 hospitals in northern and central Alberta, Canada. Multivariate logistic regression was used to estimate the odds ratios with 95% confidence intervals, and to control
X. Xiong; L. D. Saunders; F. L. Wang; N. N. Demianczuk
Purpose This study aimed to identify riskfactors associated with maternal night blindness in rural South India. Methods At delivery, women enrolled in a population-based trial of newborn vitamin A supplementation were asked whether they were night blind at any time during the pregnancy. Multivariate logistic regression was used to identify socioeconomic, demographic, and pregnancy related factors associated with maternal night blindness. Results Women reported night blindness in 687 (5.2%) of 13,171 pregnancies. In a multivariate model, having a concrete roof (Odds Ratio (OR): 0.60, 95% Confidence Interval (CI): 0.47, 0.78), religion other than Hindu (OR: 0.46, 95% CI: 0.27, 0.76), maternal literacy (OR: 0.58, 95% CI: 0.49, 0.69), and maternal age from 25 to 29 years (OR: 0.68, 95%CI: 0.50, 0.93) were associated with a lower risk of night blindness in pregnancy. The odds of night blindness were higher for those leasing rather than owning land (OR: 1.78, 95%CI: 1.08, 2.93), parity 6 or more compared to 0 (OR: 2.11, 95% CI: 1.09, 4.08), and with twin pregnancies (OR: 3.23, 95% CI: 1.93, 5.41). Factors not associated with night blindness in the multivariate model were other markers of socioeconomic status such as electricity in the house, radio and television ownership, type of cooking fuel, and household transportation, and number of children under 5 years of age in the household. Conclusions Maternal night blindness was prevalent in this population. Being pregnant with twins and of higher parity put women at higher risk. Maternal literacy and higher socioeconomic status lowered the risk.
Katz, Joanne; Tielsch, James M.; Thulasiraj, R. D.; Coles, Christian; Sheeladevi, S.; Yanik, Elizabeth L.; Rahmathullah, Lakshmi
Fetuses with neural tube defects (NTDs) may be associated with syndromes, disorders, and maternal and fetal riskfactors. This article provides a comprehensive review of syndromes, disorders, and maternal and fetal riskfactors associated with NTDs, such as omphalocele, OEIS (omphalocele-exstrophy-imperforate anus-spinal defects) complex, pentalogy of Cantrell, amniotic band sequence, limb-body wall complex, Meckel syndrome, Joubert syndrome, skeletal dysplasia, diabetic embryopathy, and single nucleotide polymorphisms in genes of glucose metabolism. NTDs associated with syndromes, disorders, and maternal and fetal riskfactors are a rare but important cause of NTDs. The recurrence risk and the preventive effect of maternal folic acid intake in NTDs associated with syndromes, disorders and maternalriskfactors may be different from those of nonsyndromic multifactorial NTDs. Perinatal identification of NTDs should alert the clinician to the syndromes, disorders, and maternal and fetal riskfactors associated with NTDs, and prompt a thorough etiologic investigation and genetic counseling. PMID:18603496
This report describes an exploratory population-based study of maternal and perinatal riskfactors for childhood leukemia in Sweden. The Swedish National Cancer Registry ascertained 411 cases in successive birth cohorts from 1973 through 1984 recorded in the Swedish Medical Birth Registry. Using the latter, we matched five controls without cancer to each case by sex and month and year of birth. Mothers of children with leukemia were more likely to have been exposed to nitrous oxide anesthesia during delivery than mothers of controls (odds ratio (OR) = 1.3; 95% confidence interval (CI) = 1.0, 1.6). Children with leukemia were more likely than controls to have Down's syndrome (OR = 32.5; 95% CI = 7.3, 144.0) or cleft lip or cleft palate (OR = 5.0; 95% CI = 1.0, 24.8); to have had a diagnosis associated with difficult labor but unspecified complications (OR = 4.5; 95% CI = 1.1, 18.2) or with other conditions of the fetus or newborn (OR = 1.5; 95% CI = 1.1, 2.1), specifically, uncomplicated physiological jaundice (OR = 1.9; 95% CI = 1.2, 2.9); or to have received supplemental oxygen (OR = 2.6; 95% CI = 1.3, 1.3, 4.9). Because multiple potential riskfactors were analyzed in this study, future studies need to check these findings. The authors did not confirm the previously reported higher risks for childhood leukemia associated with being male, having a high birth weight, or being born to a woman of advanced maternal age.
Zack, M.; Adami, H.O.; Ericson, A. (Centers for Disease Control, Atlanta, GA (USA))
A total of 8260 children between the ages of 6-59 months were analyzed to identify the riskfactors associated with childhood anaemia in Ethiopia. The overall mean (SD/standard deviation) haemoglobin (Hgb) level among the under-five children was 10.7 (2.2) g/dl and 50.3% were anaemic. Childhood anaemia demonstrated an increasing trend with maternal anaemia levels of mild, moderate and severe anaemia: odds ratio of 1.82, 2.16 and 3.73 respectively (p< 0.01). Children whose mothers had no formal education were 1.38 times more likely to be anaemic (p<0.01). The poorest and poorer wealth index groups had 1.52 and 1.25 increased odds of childhood anaemia respectively (p< 0.01). Childhood anaemia in Ethiopia is a severe public health problem. Maternal anaemia and socio-economic status were found to be associated with anaemia in children. A holistic approach of addressing mothers and children is of paramount importance. PMID:24069773
Habte, Dereje; Asrat, Kalid; Magafu, Mgaywa G M D; Ali, Ibrahim M; Benti, Tadele; Abtew, Wubeshet; Tegegne, Girma; Abera, Dereje; Shiferaw, Solomon
Objectives: This paper describes a community diagnosis of maternal exposure to riskfactors for congenital defects in the population of Pelotas, RS, Brazil (400,000 inhabitants). The authors investigated biological and demographic factors (maternal age, alcohol ingestion and smoking), social and economic factors (family income and type of work), and welfare factors (prenatal care, illnesses during pregnancy, drug therapy, and vaccinations).
The National Survey on Drug Use and Health (NSDUH) allows an examination of some potential riskfactors for adolescent cigarette use and the extent to which exposure to these riskfactors is associated with an increased likelihood of adolescents becoming ...
Objectives The present study was carried out in seven maternity hospitals to determine the prevalence of maternal syphilis at the time of delivery and the associated riskfactors, to conduct a pilot project of rapid syphilis testing in hospital laboratories, to assure the quality of syphilis testing, and to determine the rate of congenital syphilis in infants born to women
Karen L. Southwick; Stanley Blanco; Ana Santander; Miguel Estenssoro; Faustino Torrico; Guillermo Seoane; William Brady; Martha Fears; Joel Lewis; Victoria Pope; Jeannette Guarner; William C. Levine
The aim of this study was to examine the pathways that link mothers' early life socio economic status (SES) and mothers' experience of childhood maltreatment with birth weight among their later born offspring. Data were drawn from a nationally representative longitudinal survey of school-aged respondents, initially enrolled during adolescence in Wave I (1994-1995) and Wave II (1996) of the National Longitudinal Study of Adolescent Health and followed-up in adulthood in Wave III (2001-2002). Data on offspring birth weight were obtained from nulliparous females (N?=?1,897) who had given birth between Waves II and III. Analyses used structural equation modeling to examine the extent to which early life maternalrisk predicted offspring birth weight, and demonstrated that maternal childhood SES and maternal childhood maltreatment predicted offspring birth weight through several mediated pathways. First, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood SES and offspring birth weight. Second, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Third, adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Fourth, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood maltreatment and offspring birth weight. Finally, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood maltreatment and offspring birth weight. To our knowledge, this is the first study to identify maternal childhood maltreatment as an early life riskfactor for offspring birth weight among a nationally representative sample of young women, and to demonstrate the mechanisms that link childhood SES and maltreatment to offspring birth weight. These findings suggest the importance of designing and implementing prevention and intervention strategies to address early life maternal social conditions in an effort to improve inter generational child health at birth. PMID:21986991
|This study examined the independence and interplay between cognitive riskfactors (poor executive function/emotion understanding) and maternalriskfactors (low education/high depression) for preschool problem behaviors, indexed by multi-measure, multi-informant (mother/teacher/ researcher) ratings. A socio-economically diverse sample of 235…
Results The frequency of PTD among live birth was 16.4%. Prior history of stillbirth or abortion was associated with PTD (adjusted relative risk (ARR) 1.50; 95% CI: 1.06, 2.11). Nutritional factors, including drinking a local non-alcoholic beverage (mahewu) during pregnancy and mother's increasing mid-arm circumference reduced the risk of PTD (ARR = 0.75; 95% CI: 0.60, 0.93 and ARR =
Shingairai A Feresu; Siobán D Harlow; Godfrey B Woelk
|Higher rates of mental health problems, including depression, have consistently been documented among lower-income samples, and the highest rates of depression have been found among low-income mothers with young children. This study examined maternal depressive symptoms as a riskfactor for the development of children who are already at risk by…
OBJECTIVES: This study examined absolute and proportional gestational weight gain and prepregnancy body mass index as predictors of primary cesarean delivery. METHODS: Data were derived from a prospective study of pregnancy outcome riskfactors in 2301 women in greater New Haven, Conn, who had singleton deliveries by primary cesarean (n = 312) or vaginal delivery (n = 1989) and for whom height, prepregnancy weight, and weight gain were available. Women were divided into 4 body mass index groups (underweight, low average, high average, and obese) and further subdivided into 8 groups according to median proportional or absolute weight gain. RESULTS: Risk of cesarean delivery increased with increasing body mass index and gestational weight gain greater than the median for one's body mass index. Proportional weight gain was more predictive of cesarean delivery than absolute weight gain. Underweight women gaining more than 27.8% of their prepregnancy weight had a 2-fold adjusted relative risk of cesarean delivery. CONCLUSIONS: Proportional weight gain is an important predictor of cesarean delivery for underweight women; high body mass index is also predictive of increased risk.
Shepard, M J; Saftlas, A F; Leo-Summers, L; Bracken, M B
Background To identify riskfactors, beyond fetal weight, associated with adverse maternal outcomes in delivering infants with a birthweight of 4000 g or greater, and to quantify their role in maternal complications. Methods All women (n?=?1564) with singleton pregnancies who attempted vaginal delivery and delivered infants weighing at least 4000 g, in two French tertiary care centers from 2005 to 2008, were included in our study. The studied outcome was maternal complications defined as composite item including the occurrence of a third- or fourth-degree perineal laceration, or the occurrence of severe postpartum hemorrhage requiring the use of prostaglandins, uterine artery embolization, internal iliac artery ligation or haemostatic hysterectomy, or the occurrence of blood transfusion. Univariate analysis, multivariable logistic regression and estimation of attributable risk were used. Results Maternal complications were increased in Asian women (adjusted odds ratio [aOR], 3.1; 95% confidence interval [CI], 1.1–9.3, Attributable risk (AR): 3%), in prolonged labor (aOR?=?1.9 [95% CI; 1.1–3.4], AR?=?12%) and in cesarean delivery during labor (aOR?=?2.2 [95% CI; 1.3–3.9], AR?=?17%). Delivering infants with a birthweight?>?4500 g also increased the occurrence of maternal complications (aOR?=?2.7 [95% CI; 1.4–5.1]) but with an attributable risk of only 10%. Multiparous women with a previous delivery of a macrosomic infant were at lower risk of maternal complications (aOR?=?0.5 [95% CI; 0.2–0.9]). Conclusion In women delivering infants with a birthweight of 4000 g or greater, some maternal characteristics as well as labor parameters may worsen maternal outcome beyond the influence of increased fetal weight.
Research shows that mother, child, and home characteristics have direct and indirect effects on the quality of the mother-child interactions. Riskfactors, such as maternal depression, lack of family resources, living in poverty, being a single parent, receiving minimal or no support from one's partner, or having a low birthweight baby, can negatively impact the quality of mother-child interactions and
Background Elevated serum concentrations of insulin-like growth factor (IGF)-1 have been associated with increased risk of breast cancer. Previously, we reported a similar association in samples obtained during pregnancy. The current study was conducted to further characterize the association of IGF-1 during pregnancy with maternal breast cancer risk. Methods A case-control study was nested within the Finnish Maternity Cohort. The study was limited to primiparous women less than 40 years of age, who donated blood samples during early (median, 12 weeks) pregnancy and delivered a single child at term. Seven hundred and nineteen women with invasive breast cancer were eligible. Two controls (n = 1,434) were matched to each case on age and date at blood donation. Serum IGF-1 concentration was measured using an Immulite 2000 analyzer. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results No significant associations were observed between serum IGF-1 concentrations and breast cancer risk in both the overall analysis (OR 1.08 (95% CI 0.80–1.47) and in analyses stratified by histological subtype, lag-time to cancer diagnosis, age at pregnancy or age at diagnosis. Conclusion There was no association between IGF-1 and maternal breast cancer risk during early pregnancy in this large nested case-control study. Impact Serum IGF-1 concentrations during early pregnancy may not be related to maternalrisk of breast cancer.
Objective. The objective of the study was to examine the pattern of low birth weight LBW, maternal complications, and its related factors among Arab women in Qatar. Design. This is a prospective hospital-based study. Setting. The study was carried out in Women's Hospital, Doha. Subjects and Methods. Pregnant women in their third trimester were identified in the log book of Women's Hospital and recruited into the study during first week of January 2010 to July 2011. Only 1674 (out of 2238) Arab women (74.7%) consented to participate in this study. Data on clinical and biochemistry parameters were retrieved from medical records. Follow-up data on neonatal outcome was obtained from labor room register. Results. The incidence of LBW (<2500?g) was 6.7% among Arab women during 2010 in Qatar. Distribution of gestational diabetes mellitus (GDM), antepartum hemorrhage (APH), maternal anemia, premature rupture of membrane (PROM), maternal occupation, parity, sheesha smoking, and parental consanguinity were significantly different (P < 0.05) between mothers of LBW and normal birth weight NBW (?2500?g) babies. Multivariable logistic regression analysis revealed that previous LBW, consanguinity, parity, smoking shesha, GDM, APH, anemia, PROM, maternal occupation, and housing condition were significantly associated with LBW adjusting for gestational age. Conclusion. Maternal complications such as GDM, APH, anemia, PROM, and smoking shesha during pregnancy are significantly increasing the risk of LBW outcome. Screening and prompt treatment for maternal complications and health education for smoking cessation during routine antenatal visits will help in substantial reduction of LBW outcome.
Bener, Abdulbari; Salameh, Khalil M. K.; Yousafzai, Mohammad T.; Saleh, Najah M.
Results Children of supplemented mothers (n = 110, 77 had venipuncture) had lower geometric mean triacylglycerol, T-C, and LDL-C than other children. After adjustment for potential confounding factors, geometric mean ratios were 0.86 (95% CI: 0.75, 0.98), 0.94, (95% CI: 0.90, 0.99) and 0.90, (95% CI: 0.83, 0.98) respectively. The association with T-C and LDL-C was seen principally among children
This longitudinal study examined paternal, perceived maternal, and youth riskfactors at Time 1 (T1) (e.g., substance use, violent victimization, parental rules) as predictors of the stage of substance use in the adolescent child at Time 2 (T2). Participants (N = 296) consisted of drug-abusing fathers and one of their adolescent children, aged 12 to 20 years. Fathers and youths
Felipe González Castro; Judith S. Brook; David W. Brook; Elizabeth Rubenstone
OBJECTIVE Maternal enterovirus infections during pregnancy have been linked to an increased risk of type 1 diabetes in the offspring. The aim of this study was to evaluate this association in a unique series of pregnant mothers whose child progressed to clinical type 1 diabetes. RESEARCH DESIGN AND METHODS Maternal and in utero enterovirus infections were studied in 171 offspring who presented with type 1 diabetes before the age of 11 years and in 316 control subjects matched for date and place of birth, sex, and HLA-DQ risk alleles for diabetes. Acute enterovirus infections were diagnosed by increases in enterovirus IgG and IgM in samples taken from the mother at the end of the first trimester of pregnancy and cord blood samples taken at delivery. RESULTS Signs of maternal enterovirus infection were observed in altogether 19.3% of the mothers of affected children and in 12.0% of the mothers of control children (P = 0.038). This difference was seen in different HLA risk groups and in both sexes of the offspring, and it was unrelated to the age of the child at the diagnosis of diabetes or the age of the mother at delivery. CONCLUSIONS These results suggest that an enterovirus infection during pregnancy is not a major riskfactor for type 1 diabetes in childhood but may play a role in some susceptible subjects.
Riskfactors for child obesity may be influenced by family environment, including maternal depression, family structure, and parenting quality. We tested a path model in which maternal depression and single parent status are associated with parenting quality, which relates to three riskfactors for child obesity: diet, leisure, and sedentary behavior. Participants included 4,601 5th-grade children and their primary caregivers
Regina L. McConley; Sylvie Mrug; M. Janice Gilliland; Richard Lowry; Marc N. Elliott; Mark A. Schuster; Laura M. Bogart; Luisa Franzini; Soledad L. Escobar-Chaves; Frank A. Franklin
Objective This study was aimed at assessing the effect of maternal smoking during pregnancy on metabolic cardiovascular riskfactors in early adulthood in a Brazilian birth cohort, after controlling for possible confounding variables and health behaviors in early adulthood. Methods In 1982, the maternity hospitals in Pelotas, southern Brazil, were visited and all births were identified. Those livebirths whose family lived in the urban area of the city were studied prospectively. In 2004–2005, we attempted to follow the whole cohort, the subjects were interviewed, examined and blood sample was collected. The following outcomes were studied: blood pressure; HDL cholesterol; triglycerides; random blood glucose and C-reactive protein. To explore the effect of maternal smoking, we adjusted the coefficients for the following possible mediators: perinatal factors (low birthweight and preterm births); adult behavioral factors (physical activity, dietary pattern, intake of fat and fiber, and tobacco smoking) and adult anthropometry (body mass index and waist circumference). Results In 2004–2005, we interviewed 4297 subjects, with a follow-up rate of 77.4%. The only significant finding in the unadjusted analyses was lower HDL cholesterol among females. After adjustment for lifestyle variables in early adulthood, birthweight and waist circumference, the difference in HDL levels between offspring of smokers and non-smokers reduced from ?2.10 mg/dL (95% confidence interval: ?3.39; ?0.80) to ?1.03 mg/dL (?2.35; 0.30). Conclusion Evidence that maternal smoking during pregnancy programs offspring metabolic cardiovascular riskfactors are scarce, and reported associations are likely due to postnatal exposure to lifestyle patterns.
Horta, Bernardo Lessa; Gigante, Denise P.; Nazmi, Aydin; Silveira, Vera Maria F.; Oliveira, Isabel; Victora, Cesar G.
|This study examined relations among mothers' discourse about experiences in their families of origin and with child protective services (CPS), attachment-related and current riskfactors, and the quality of mothers' parenting behavior with their young children during supervised visits. Twenty-nine 2- to 6-year-old children in foster care and…
Schoppe-Sullivan, Sarah J.; Mangelsdorf, Sarah C.; Haight, Wendy L.; Black, James E.; Sokolowski, Margaret Szewczyk; Giorgio, Grace; Tata, Lakshmi
BACKGROUND: It is well known that miscarriage risk increases with age. However, studies usually investigate only maternal age effects. We investigated both maternal age and paternal age effects on miscarriage risk to provide insight into this frequent reproductive failure. METHODS: The last planned pregnancies (n 3174) that ended in a birth or miscarriage were analysed in a retrospective population-based study
Background Maternal smoking during pregnancy is associated with offspring obesity. However, little is known about whether maternal smoking in pregnancy predicts other offspring cardiovascular riskfactors including waist circumference (WC), waist-hip-ratio (WHR), pulse rate (PR), systolic (SBP), and diastolic blood pressure (DBP). Methods We studied a sub-sample of 2038 (50% males) young adults who were born in Brisbane, Australia to investigate the prospective association of maternal smoking during pregnancy with young adult cardiovascular riskfactors. We compared offspring mean BMI, WC, WHR, SBP, DBP and PR and the risk of being overweight and obese at 21 years by three mutually exclusive categories of maternal smoking status defined as never smoked, smoked before and/or after pregnancy but not in pregnancy or smoked during pregnancy and other times. Results Offspring of mothers who smoked during pregnancy had greater mean BMI, WC, WHR and PR and they were at greater risk of being obese at 21 years compared to offspring of those mothers who never smoked. The mean of these riskfactors among those adult offspring whose mothers stopped smoking during pregnancy, but who then smoked at other times in the child's life, were similar to those mothers who never smoked. These results were independent of a range of potential confounding factors. Conclusion The findings of this study suggest a prospective association of maternal smoking during pregnancy and offspring obesity as well as PR in adulthood, and reinforce the need to persuade pregnant women not to smoke.
Mamun, Abdullah A.; O'Callaghan, Michael J.; Williams, Gail M.; Najman, Jake M.
Aims: To determine whether current and postpartum maternal depression and low maternal intelligence are riskfactors for malnutrition in children. Methods: In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence. Results: Major depression in the postpartum period (OR 5.0, 95% CI 1.0 to 24.0), current major depression (OR 3.2, 95% CI 1.1 to 9.5), and low maternal intelligence (OR 3.8, 95% CI 1.3 to 11.1) were associated with malnutrition in the child. Low birth weight (OR 2.9, 95% CI 1.2 to 6.8) was also significantly associated with infant malnutrition. Conditional logistic regression adjusting for all other determinants yielded the following results: major depression during the postpartum period (OR 7.8; 95% CI 1.6 to 38.51), current major depression (OR 3.1; 95% CI 0.9 to 9.7), low maternal intelligence (OR 4.6; 95% CI 1.5 to 14.1), and low birth weight (OR 2.7; 95% CI 2.5 to 6.8). The interactions between current maternal depression and low birth weight and between postpartum depression and low maternal intelligence were statistically significant. The level of maternal intelligence was associated with nutritional status. The severity of malnutrition was also significantly associated with major depression during the postpartum period and low maternal intelligence. Conclusion: There is evidence for an association between postpartum maternal depression, low maternal intelligence, and low birth weight with malnutrition in children aged 6–12 months.
Anoop, S; Saravanan, B; Joseph, A; Cherian, A; Jacob, K
Objective: To characterize the presentation of burns in children and riskfactors associated with their occurrence in a developing country as a basis for future prevention programs. Design: Case-control study. Setting: Burn unit of the National Institute of Child Health (Instituto Nacional de Salud del Niño) in Lima, Peru. Methods: A questionnaire was administered to all consenting guardians of children admitted to the burns (cases) and general medicine (controls) units during a period of 14 months. Guardians of patients were questioned regarding etiology of the injury, demographic and socioeconomic data. Results: 740 cases and controls were enrolled. Altogether 77.5% of the cases burns occurred in the patient's home, with 67.8% in the kitchen; 74% were due to scalding. Most involved children younger than 5 years. Lack of water supply (odds ratio (OR) 5.2, 95% confidence interval (CI) 2.1 to 12.3), low income (OR 2.8, 95% CI 2.0 to 3.9), and crowding (OR 2.5, 95%CI 1.7 to 3.6) were associated with an increased risk. The presence of a living room (OR 0.6, 95% CI 0.4 to 0.8) and better maternal education (OR 0.6, 95% CI 0.5 to 0.9) were protective factors. Conclusions: To prevent burns interventions should be directed to low socioeconomic status groups; these interventions should be designed accordingly to local riskfactors.
Delgado, J; Ramirez-Cardich, M; Gilman, R; Lavarello, R; Dahodwala, N; Bazan, A; Rodriguez, V; Cama, R; Tovar, M; Lescano, A
Summary Background Severe maternal morbidity (SMM) is a serious health condition potentially resulting in death without immediate medical attention, including organ failure, obstetric shock, and elcampsia. SMM affects 20,000 US women every year; however, few population-based studies have examined SMM riskfactors. Methods We conducted a population-based case-control study linking birth certificate and hospital discharge data from Washington State (1987–2008), identifying 9,485 women with an antepartum, intrapartum, or postpartum SMM with ?3-day hospitalization or transfer from another facility and 41,112 random controls. Maternal age, race, smoking during pregnancy, parity, preexisting medical condition, multiple birth, prior cesarean delivery, and BMI were assessed as riskfactors with logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusted for education and delivery payer source. Results Older women [35–39: OR 1.65 CI 1.52, 1.79; 40+: OR 2.48 CI 2.16, 2.81], non-white women [Black: OR 1.82 CI 1.64, 2.01; American Indian: OR 1.52 CI 1.32, 1.73; Asian/Pacific Islander: OR 1.30 CI 1.19, 1.41; Hispanic: OR 1.17 CI 1.07, 1.27], and women at parity extremes [OR 1.83 CI 1.72, 1.95, nulliparous; OR 1.34 CI 1.23, 1.45, parity 3+] were at greater risk of SMM. Women with a preexisting medical condition [OR 2.10 CI 1.88, 2.33], a multiple birth [OR 2.54 CI 2.26, 2.82], and a prior cesarean delivery [OR 2.08 CI 1.93, 2.23] were also at increased risk. Conclusion The riskfactors identified are not modifiable at the individual level; therefore, provider and system-level factors may be the most appropriate target for preventing SMM.
Gray, Kristen E; Wallace, Erin R; Nelson, Kailey R; Reed, Susan D; Schiff, Melissa A
\\u000a Maternal infection can alter the intrauterine environment, placing the developing fetus at risk. Serious infections of the\\u000a mother or the fetus can cause severe problems or even miscarriage. The more common and seemingly benign infections, such as\\u000a influenza, do not appear associated with such severe outcomes. However, recent work has shown that maternal inflammation associated\\u000a with any infection has the
Stephen E. P. Smith; Elaine Hsiao; Paul H. Patterson
Objectives: To determine the maternalriskfactors of low birthweight (LBW) in Thailand and to address the possible activities to reduce the incidence of LBW. Material and Method: The data were obtained from the Prospective Cohort Study in Thai Children (PCTC). Three thousand five hundred twenty two pregnancies initiated the follow-up in the year 2000 at four districts across Thailand.
Because chronic alcohol abuse alters immune defenses and increases infection in adults, we tested the hypothesis that maternal alcohol use during pregnancy would increase the risk of sepsis in very low birth weight (VLBW) premature newborns. We performed a case-controlled analysis of VLBW newborns born at Grady Memorial Hospital (Atlanta, GA). Alcohol exposure, as the predictive variable, was assessed by
Theresa W. Gauthier; Martha H. Manar; Lou Ann S. Brown
While maternal socioeconomic status and health predict in part children’s future health and socioeconomic prospects, it is possible that the intergenerational association flows in the other direction such that child health affects maternal outcomes. Previous research demonstrates that poor child health increases the risk of adverse maternal physical and mental health outcomes. We hypothesize that poor child health may also increase the risk of poor maternal health outcomes through an interaction between child health and factors associated with health outcomes, such as marital status, marital quality, and socioeconomic status. Using data on women in the National Longitudinal Study of Youth 1979 cohort (N = 2,279), we find evidence that the effects of certain maternal marital quality and socioeconomic factors on maternal physical and mental health depend on child health status and vice versa.
Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortality. New molecular insights offer new possibilities of early diagnosis of elevated maternalrisk. Maternalriskfactors, biophysical parameters like Doppler examination of the uterine arteries and biochemical parameters allow early risk calculation. Preventive and effective therapeutic agents like acetylsalicylacid can be started in the early second trimester. This article reviews the diagnostic possibilities of early risk calculation to detect women having high risk for preeclampsia and the potential benefits for them, the offspring and health care systems. We provide risk calculation for preeclampsia as an important and sensible part of first trimester screening.
Background Maternal age is a known riskfactor for stillbirth and delayed childbearing is a societal norm in developed country settings. The timing and reasons for age being a riskfactor are less clear. This study aimed to document the gestational specific risk of maternal age throughout pregnancy and whether the underlying causes of stillbirth differ for older women. Methods Using linkage of state maternity and perinatal death data collections the authors assessed riskfactors for antepartum stillbirth in New South Wales Australia for births between 2002 – 2006 (n = 327,690) using a Cox proportional hazards model. Gestational age specific risk was calculated for different maternal age groups. Deaths were classified according to the Perinatal Mortality Classifications of the Perinatal Society of Australia and New Zealand. Results Maternal age was a significant independent riskfactor for antepartum stillbirth (35 – 39 years HR 1.4 95% CI 1.12 – 1.75; ? 40 years HR 2.41 95% CI 1.8 – 3.23). Other significant riskfactors were smoking HR 1.82 (95% CI 1.56 –2.12) nulliparity HR 1.23 (95% CI 1.08 – 1.40), pre-existing hypertension HR 2.77 (95% CI 1.94 – 3.97) and pre-existing diabetes HR 2.65 (95% CI 1.63 – 4.32). For women aged 40 or over the risk of antepartum stillbirth beyond 40 weeks was 1 in 455 ongoing pregnancies compared with 1 in 1177 ongoing pregnancies for those under 40. This risk was increased in nulliparous women to 1 in 247 ongoing pregnancies. Unexplained stillbirths were the most common classification for all women, stillbirths classified as perinatal infection were more common in the women aged 40 or above. Conclusions Women aged 35 or older in a first pregnancy should be counselled regarding stillbirth risk at the end of pregnancy to assist with informed decision making regarding delivery. For women aged 40 or older in their first pregnancy it would be reasonable to offer induction of labour by 40 weeks gestation.
Complications of childbirth and pregnancy are leading causes of death among women of reproductive age. Developing countries account for 99% of maternal deaths. The aim of this study was to explore levels, causes and riskfactors associated with maternal mortality in rural Tanzania. Longitudinal data (2002-2006) from Rufiji HDSS was used where a total of 26 427 women aged 15-49 years were included in the study; 64 died and there were 15 548 live births. Cox proportional hazards regression was used to assess the riskfactors associated with maternal deaths. MMR was 412 per 100 000 live births. The main causes of death were haemorrhage (28%), eclampsia (19%) and puerperal sepsis (8%). An increased risk of 154% for maternal death was found for women aged 30-39 versus 15-19 years (HR=2.54, 95% CI=1.001-6.445). Married women had a protective effect of 62% over unmarried ones (HR=0.38, 95% CI=0.176-0.839). PMID:24069774
Objective: Managed care plans have adopted risk assessment tools as part of pregnancy disease state management strategies to assist in reducing poor pregnancy outcomes and related costs. We evaluated the relationships of maternalriskfactors to determine which pregnancy riskfactors were associated with neonatal intensive care unit (levels II and III) admission. Study Design: Risk assessments were performed through
Michael G. Ross; Catherine A. Downey; Rose Bemis-Heys; Men Nguyen; Debbie L. Jacques; Gary Stanziano
This incident case-referent study was conducted at Harare Maternity Hospital in 1989–1990 on 104 consecutive cases of stillbirth with unknown aetiology and 96 age- and parity-matched referents. Information was collected by interviewing the women following a standardized form and by review of antenatal cards. None of the women refused to participate. The most significant obstetric riskfactors were prevalence of
S. R. Moyo; S. A. Tswana; L. Nyström; K. Mahomed; S. Bergström; Å. Ljungh
Objective Compared to non-Natives in Alaska, the Alaska Native population has a postneonatal mortality rate 2.3 times higher (95% CI\\u000a 1.9, 2.7). The objective of the study was to identify variables that account for this elevated risk. Methods The dataset used included birth and death certificate records for all Alaska-resident live births and infant deaths occurring\\u000a during 1992–2004. Race was defined
In many societies the prevalence of behavioural problems in school-aged children varies by national origin. We examined the association between national origin and behavioural problems in 1½-year-old children. Data on maternal national origin and the Child Behavior Checklist for toddlers (n?=?4943) from a population-based cohort in the Netherlands were used. Children from various non-Dutch backgrounds all had a significantly higher mean behavioural problem score. After adjustment for family riskfactors, like family income and maternal psychopathology, the differences attenuated, but remained statistically significant. Non-Dutch mothers with immigration riskfactors, such as older age at immigration or no good Dutch language skills, reported significantly more behavioural problems in their offspring. In conclusion, the present study indicated more behavioural problems in immigrant toddlers from various backgrounds. Researchers and policymakers aiming to tackle disparities in behavioural problems should take into account that risks associated with national origin are intertwined with unfavourable family and immigration characteristics.
Jansen, Pauline W.; Raat, Hein; Mackenbach, Johan P.; Jaddoe, Vincent W. V.; Hofman, Albert; van Oort, Floor V.; Verhulst, Frank C.
Low birth weight (LBW) is an important riskfactor for neonatal and infant mortality and morbidity in adults.. However, no large scale study on the prevalence of LBW and related maternalriskfactors in China has been published. To explore the effects of maternalfactors on LBW for term birth in China, we conducted a hospital-based retrospective study of 55, 633 Chinese pregnancy cases between 2001 and 2008. Maternal sociodemographic data, history of infertility and contraceptive use were obtained. Their medical status and diseases during pre-pregnancy were examined by physical examination at the first antenatal care visit. Maternal medical status before childbirth and pregnancy outcomes, including body weight, infant gender, multiple pregnancy and congenital anomalies, were recorded. Univariate and multivariate logistic regression, and linear regression were used to investigate the relationship between maternalfactors and term LBW. The general incidence of term LBW was 1.70% in the developed area of China. After preliminary analysis using the univariate model, low primary education, anemia, hypertensive disorders, placental previa, oligohydramnios and premature rupture of membrane were predicted as independent factors of term LBW in the multivariate model. Furthermore, the decrease in annual frquencies of these riskfactors were major causes of gradual decline in the incidence of LBW (from 2.43% in 2001 to 1.21% in 2008). The study demonstrated that among maternalfactors, primary education, anemia and hypertensive disorders could contribute to LBW for term birth even in the most developed area of China. PMID:23554789
Background Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the riskfactors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. Methods This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. Results The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p?=?0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p?0.001) and (43.3% vs. 12.6%, p?0.001) respectively. In rural communities, the risk of stunted mothers having children with stunting was about 7 times higher than those who were not (OR 6.7, 95% CI?=?1.4-32.0, p?=?0.007). In urban communities, undernourished mothers have about 11 and 12 times risk of having children with underweight and wasting respectively (OR 11.2, 95% CI?=?1.4-86.5, p?=?0.005) and (OR 12.3, 95% CI?=?1.6-95.7, p?=?0.003) respectively. The identified riskfactors for maternal and child under nutrition differs across rural and urban communities. Conclusions The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing riskfactors specific for each community.
This study examines the relationship between severe diarrhoeal disease and maternal knowledge and behaviours related to hygiene and sanitation. Some 107 paediatric cases admitted to two hospitals in Kinshasa, Zaire in 1988 were matched on age and nearest-neighbour status to 107 controls. Personal interviews and observational methods were used to assess knowledge and behaviours related to hygiene and sanitation. Cases and controls had equivalent socioeconomic status, demographic profiles and access to water and sanitation facilities. However, cases generally exhibited lower levels of knowledge and less sanguine sanitary practices than did controls. Of particular interest was the finding that very specific behavioural items distinguished cases from controls. The disposal of the child faeces and household garbage and mother's knowledge that poor caretaker cleanliness was a cause of diarrhoea in children showed the strongest associations with risk of diarrhoea. There was an exponential relationship between the number of these items a mother answered incorrectly and the odds of diarrhoeal disease. The risk attributable to these three variables was as high as 70%. These findings provide further support for the view that focused educational interventions may have a substantial impact on the occurrence of severe diarrhoeal disease in low-income countries. PMID:8505192
This prospective study was done to find out the maternal and foetal riskfactors and complications during hospital stay. It was conducted in Special Care Neonatal Unit (SCANU), Department of Child Health, Bangabandhu Memorial Hospital (BBMH), University of Science and Technology Chittagong (USTC) from1st October 2001 to 30th March 2002 and cases were 35 very low birth weight (VLBW) newborns. Common complications of VLBW babies of this series were frequent apnea (40%), Septicemia (25.71%), Hypothermia (17.14%), NEC (14.28%), Convulsion (11.43%), Hyper-bilirubinaemia (8.57%), Anemia (5.71%), IVH (5.71%), RDS (2.86%), HDN (2.86%), CCF (2.86%), ARF (2.86%), either alone or in combination with other clinical conditions. Newborns 62.86% male, 37.14% female & their mortality rate were 40.91% & 38.46% respectively; Preterm 88.57% & their mortality (41.93%) were higher than term babies (25.00%); AGA 62.86%, SGA 37.14% & mortality rate of AGA babies (45.46%) were higher than of SGA (30.77%) babies. The mortality rate of VLBW infants of teen age (? 18 years) mothers (57.14%) & high (? 30 years) aged mothers (50.00%) were higher than average (19-26 yrs) maternal age mothers (33.33%). Mortality rate was higher among the babies of primi (41.67%) than multiparous (36.36%), poor socioeconomic group (53.33%) than middle class (30.00%) & mothers on irregular ANC (47.83%) than regular ANC (25.00%). It has been also noted the mortality rate of home delivered babies (50.00%) higher than institutional delivered (34.78%) babies; higher in LUCS babies (46.15%) than normal vaginal delivered babies (31.58%); higher in the babies who had antenatal maternal problem (48.15%) than no maternal problems babies (12.50%); higher in the babies who had fetal distress (50.00%) and twin (46.67%) than no foetal riskfactors (28.57%) during intrauterine life; higher in the babies who had problems at admission (46.67%) than no problems (35.00%); and mortality higher in twin (46.67%) than singleton babies (35.00%). Maximum VLBW babies who died during hospital stay had multiple problems and mortality was varied from ?60-100%. The babies who had frequent apnea have been carried relative better outcome (mortality rate 35.72%). In this study out of total 35 studied baby 21(60.00%) survived and 14(40.00%) died. Frequent apnea, sepsis, hypothermia, NEC, convulsion, jaundice, anemia, IVH, and RDS are common complications in VLBW babies. Male sex, prematurity, primiparity, average (middle) socio-economic status, irregular ANC, preterm labor, toxemia of pregnancy, prolonged rupture of membrane, malnutrition, multiple gestations and foetal distress are riskfactor for VLBW delivery. Clinical outcome depends on maturity, birth weight, centile for weight, maternal age, parity, maternal nutrition & socio-economic status, ANC, place & mode of delivery, maternal problems during antenatal & perinatal period, number of gestation, fetal condition, presentation at admission, postnatal problems, time of start of management & referral and level of care. PMID:23134911
Mannan, M A; Jahan, N; Dey, S K; Uddin, M F; Ahmed, S
|The high prevalence of alcohol and substance abuse by adolescents poses a significant threat to the wellness of youth. Adolescents appear to use drugs for a variety of reasons. In addition to the multiple etiologic and riskfactors present for substance abuse, there are many pathways teenagers may follow on their way to substance abuse. The…
We present an hypothesis integrating epidemiological, clinical case, and basic biomedical research to explain why only relatively few women who drink alcohol during pregnancy give birth to children with alcohol-related birth defects (ARBDs), in particular, Fetal Alcohol Syndrome (FAS). We argue that specific sociobehavioral riskfactors, e.g., low socioeconomic status, are permissive for FAS in that they provide the context
In laboratory rats and mice, differences in maternal care during the first week of life have been shown to exert long-lasting consequences on cognitive functioning and stress processing of the offspring. Such epigenetic programming is also assumed to play an important role in the transgenerational transmission of PTSD in humans. Here we studied whether even subtle within-subject differences in maternal
Anja Siegmund; Maik Dahlhoff; Ursula Habersetzer; Anna Mederer; Eckhard Wolf; Florian Holsboer; Carsten T. Wotjak
Background Previous research in South Africa revealed very high rates of fetal alcohol syndrome (FAS), of 46 to 89 per 1,000 among young children. Maternal and child data from studies in this community summarize the multiple predictors of FAS and partial fetal alcohol syndrome (PFAS). Method Sequential regression was employed to examine influences on child physical characteristics and dysmorphology from four categories of maternal traits: physical, demographic, childbearing, and drinking. Then, a structural equation model (SEM) was constructed to predict influences on child physical characteristics. Results Individual sequential regressions revealed that maternal drinking measures were the most powerful predictors of a child’s physical anomalies (R2 = .30, p < .001), followed by maternal demographics (R2 = .24, p < .001), maternal physical characteristics (R2 = .15, p < .001), and childbearing variables (R2 = .06, p< .001). The SEM utilized both individual variables and the four composite categories of maternal traits to predict a set of child physical characteristics, including a total dysmorphology score. As predicted, drinking behavior is a relatively strong predictor of child physical characteristics (? = 0.61, p < .001), even when all other maternalrisk variables are included; higher levels of drinking predict child physical anomalies. Conclusions Overall, the SEM model explains 62% of the variance in child physical anomalies. As expected, drinking variables explain the most variance. But this highly controlled estimation of multiple effects also reveals a significant contribution played by maternal demographics and, to a lesser degree, maternal physical and childbearing variables.
May, Philip A.; Tabachnick, Barbara G.; Gossage, J. Phillip; Kalberg, Wendy O.; Marais, Anna-Susan; Robinson, Luther K.; Manning, Melanie; Buckley, David; Hoyme, H. Eugene
Congenital heart defects (CHDs) are the most prevalent of all birth malformations arising from the complex interplay of environmental exposures and genes. Modifiable environmental riskfactors are still largely unknown, especially for paternal exposure. The aim of the present study was to examine the association between the environmental exposures of both parents and CHD risk and to explore the modification effect of metabolizing gene polymorphisms in children who lack the genetic capacity to produce the glutathione S-transferase (GST) GSTM1 and GSTT1 enzymes. A total of 330 parents of a child with CHD and 330 parents of a child without any congenital malformations were compared in terms of lifestyle habits and toxicant exposure. GST gene polymorphisms were investigated in 180 patients with CHD (104 males, age 4.9 ± 5.8 years). Paternal smoking (?15 cigarettes/day) was significantly associated with CHD risk (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.3 to 3.5, p = 0.002). Both maternal (OR 2.6, 95% CI 1.6 to 4.2, p <0.0001) and paternal (OR 2.5, 95% CI 1.6 to 3.8, p <0.0001) occupational/environmental exposures increased the risk of CHD. Also, a significant additive risk (OR 4.5, 95% CI 2.5 to 8.3, p <0.0001) was found when both parents were exposed to toxicants. Both maternal (OR 3.6, 95% CI 1.1 to 11.2, p = 0.03) and paternal (OR 3.3, 95% CI 1.0 to 10.8, p = 0.03) exposure to toxicants increased the CHD risk in children who carried the combined null GST genotypes. The effect for the combined null GST genotypes was also stronger (OR 6.5, 95% CI 1.5 to 28.0) when both parents were exposed. In conclusion, paternal smoking and exposure to toxicants for both parents affect the risk of children with CHD. Polymorphisms in GST genes can modify a person's risk of toxicant exposure-induced disease. PMID:21890078
Cresci, Monica; Foffa, Ilenia; Ait-Ali, Lamia; Pulignani, Silvia; Gianicolo, Emilio Antonio Luca; Botto, Nicoletta; Picano, Eugenio; Andreassi, Maria Grazia
Folate metabolism deficiency has been related to increased occurrence of maternal non-disjunction resulting in trisomy 21.\\u000a Several polymorphisms in genes coding for folate metabolism enzymes have been investigated for association with the maternal\\u000a risk of Down syndrome (DS) yielding variable results. We performed a meta-analysis of case-control studies obtained through\\u000a the PubMed database. The studies on polymorphisms in the MTHFR,
Igor Medica; Ales Maver; Goncalo Figueiredo Augusto; Borut Peterlin
|In sample of 177 clinic-referred children aged 7-13, association was found between diagnosis of conduct disorder and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parent adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant…
In a sample of 177 clinic-referred children aged 7–13, an association was found between a diagnosis of conduct disorder (CD) and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parental adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant disorder (ODD) were intermediate to families of children with CD and clinic
Paul J. Frick; Benjamin B. Lahey; Rolf Loeber; Magda Stouthamer-Loeber; Mary Anne G. Christ; Kelly Hanson
Background. Congenital syphilis (CS) is the oldest recognized congenital infection in the world. CS infection can affect multiple organs and can even cause neonatal death. CS is largely preventable when maternal syphilis is treated in an adequate and timely manner. During the decade of the nineties, rates of CS in Texas have often exceeded the overall US rate. Few studies,
We studied the prevalence of anemia during pregnancy and its relationship with low birth weight (LBW; birth weight < 2,500 g) in Benin. We analyzed 1,508 observations from a randomized controlled trial conducted from 2005 to 2008 showing equivalence on the risk of LBW between two drugs for Intermittent Preventive Treatment of malaria during pregnancy (IPTp). Despite IPTp, helminth prophylaxis, and iron and folic acid supplementations, the proportions of women with severe anemia (hemoglobin [Hb] concentration < 80 g/L) and anemia (Hb < 110 g/L) were high throughout pregnancy: 3.9% and 64.7% during the second and 3.7% and 64.1% during the third trimester, but 2.5% and 39.6% at the onset of labor, respectively. Compared with women without anemia (Hb ? 110 g/L) during the third trimester, women with severe anemia (Hb < 80 g/L) were at higher risk of LBW after adjustment for potential confounding factors (prevalence ratio [PR] = 2.8; 95% confidence interval [1.4–5.6]).
We studied the prevalence of anemia during pregnancy and its relationship with low birth weight (LBW; birth weight < 2,500 g) in Benin. We analyzed 1,508 observations from a randomized controlled trial conducted from 2005 to 2008 showing equivalence on the risk of LBW between two drugs for Intermittent Preventive Treatment of malaria during pregnancy (IPTp). Despite IPTp, helminth prophylaxis, and iron and folic acid supplementations, the proportions of women with severe anemia (hemoglobin [Hb] concentration < 80 g/L) and anemia (Hb < 110 g/L) were high throughout pregnancy: 3.9% and 64.7% during the second and 3.7% and 64.1% during the third trimester, but 2.5% and 39.6% at the onset of labor, respectively. Compared with women without anemia (Hb ? 110 g/L) during the third trimester, women with severe anemia (Hb < 80 g/L) were at higher risk of LBW after adjustment for potential confounding factors (prevalence ratio [PR] = 2.8; 95% confidence interval [1.4-5.6]). PMID:21896797
We investigated the relationship between depression and parental sense of competence to child cognitive outcomes for a sample\\u000a of 49 adolescent mothers and their young children (Mean age=9 1\\/2 months) enrolled in a student parenting program. Cognitive development of the infants and toddlers was assessed using\\u000a the Bayley Scales of Infant Development. Maternal depression was assessed with the CES-D and
This Report provides estimates of maternal mortality for the period 1997-2003. The study shows that overall MMR which was in the vicinity of 400 in 1997-98, has come down to about 300 in 2001-03, thus registering a decline of 24 per cent during this period based on SRS data. The decline is impressive but still a lot would need to
This longitudinal study examines the role of depressive symptoms and low literacy among mothers receiving welfare in predicting outcomes for both parents and children (mothers' psychological and employment-related outcomes and children's development across multiple domains). For African-American single mothers (n = 351), depressive symptoms in mothers are an important predictor of their later psychological well-being, while maternal literacy affects both
Elizabeth C. Hair; Sharon M. McGroder; Martha J. Zaslow; Surjeet K. Ahluwalia; Kristin A. Moore
The objective of this study is to explore riskfactors associated with overweight and high blood pressure in Chinese American children. Students and their parents were recruited from Chinese language schools in the San Francisco Bay Area. Data were collected on 67 children and their mothers, and included children's weight, height, waist and hip circumferences, blood pressure, level of physical activity, dietary intake, usual food choice, knowledge about nutrition and physical activity, and self-efficacy regarding diet and physical activity. Mothers completed questionnaires on demographic data and acculturation. About 46% of children had a body mass index exceeding the 85th percentile. Lower level of maternal acculturation is a riskfactor for overweight and higher waist to hip ratio. Children's unhealthy food choices were predictive of high body mass index and high systolic blood pressure, whereas older age and less physical activity in children were predictors of high diastolic blood pressure. Developing culturally sensitive and developmentally appropriate interventions to reduce overweight and high blood pressure is critical to reduce health disparities among minority children. PMID:19757055
Chen, Jyu-Lin; Weiss, Sandra; Heyman, Melvin B; Lustig, Robert
The riskfactors for maternal anemia (hemoglobin level less than 110 g/L) were studied in human immunodeficiency virus–negative pregnant women in Benin at the time of first antenatal visit and prior to any prevention. Data for the first 1,005 pregnant women included in a multicentre randomized controlled trial were analyzed. Anemia was common (68.3%), and malaria and helminth infestations were prevalent in 15.2% and 11.1% of the women. A total of 33.3%, 31.3% and 3.6% of the women were iron, folic acid and vitamin B12 deficient, respectively. These parasitic infections and nutrient deficiencies were associated with a high risk of anemia. Twenty-one percent, 15%, 12%, 11% and 7% of anemia were attributable to malnutrition, malaria, iron, folic acid deficiencies, and helminth infestations, respectively. Most anemia was caused by factors that could be prevented by available tools, stressing the need to reinforce their implementation and to evaluate their effectiveness throughout the course of the pregnancy.
Ouedraogo, Smaila; Koura, Ghislain K.; Accrombessi, Manfred M. K.; Bodeau-Livinec, Florence; Massougbodji, Achille; Cot, Michel
|It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in…
Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto
Aims This study examines associations between maternal smoking and family, social or child riskfactors when the child is aged 5 and adolescent smoking. The influence of mothers who smoke in pregnancy or continue to smoke at 14 years was also examined. Design The Mater-University of Queensland Study of Pregnancy is a prospective cohort study. Participants Participants included 8556 women
Frances V. O'Callaghan; Michael O'Callaghan; Jake M. Najman; Gail M. Williams; William Bor; Rosa Alati
BackgroundWe have previously examined the associations between perfluorooctanoic acid (PFOA) exposure, birth weight and gestational age in individuals exposed to PFOA-contaminated residential drinking water from the Little Hocking Water Association (LHWA). In this investigation, we expand the scope of our analysis to examine the associations between PFOA, congenital anomalies, labor and delivery complications and maternalriskfactors.
Lynda A. Nolan; John M. Nolan; Frances S. Shofer; Nancy V. Rodway; Edward A. Emmett
Abstract Objective. It remains unclear whether or not the vulnerability of depression in women of reproductive age is related with pregnancy or perinatal period. The aim of the study was to determine the prevalence of depressive disorders and related factors in a large sample of non-perinatal women of reproductive age. Method. This study involved 589 women of reproductive age. At baseline, sociodemographic data and premenstrual assessment forms were completed, and screening tests for the assessment of the severity of depressive symptoms were administered to all of the participants. Participants who had over scale scores of the cut-off point in the screening instruments were assessed with module A of the Structured Clinical Interview for DSM Disorders (SCID-I) to determine DSM IV Axis I disorders. Results. The prevalence of depressive disorders was 32.8%. Depressive disorders had high rates in women who were married at younger ages and who had three or more children. Although the prevalence of depressive disorders was 32.8%, only 10.4% of the women had follow-up and treatment in a psychiatric outpatient clinic. Conclusion. Low education levels, early maternal age, and having more than three children and higher premenstrual symptom scores were riskfactors for depressive disorders in non-perinatal reproductive age. PMID:23822181
Aras, Neriman; Oral, Elif; Aydin, Nazan; Gulec, Mustafa
Objective: The prevalence of maternal overweight and fetal macrosomia is increasing. Fetal macroso- mia is associated with increased risk of maternal and neonatal complications. The objective of the present study was to investigate if maternal metabolic parameters associated with maternal overweight were independent determinants of macrosomia (birth weight . 4500 g or above the 95 percentile of the z-score for
T Clausen; T K Burski; N Øyen; K Godang; J Bollerslev; T Henriksen
Objective A substantial number of mothers of young children suffer from depression. One understudied consequence of maternal depression is how it affects toddlers' injury risk. This study examined links between chronic maternal depression and child injury. Methods A national sample of 1,364 American children was studied. Results Chronic levels of severe maternal depression placed children at increased risk of concurrent
Objective. To identify maternal and early childhood riskfactors for obesity and overweight among children at age 5 in the state of Alabama. Methods. We recruited 740 mothers during early pregnancy from University of Alabama Prenatal Clinics in a prospective cohort study and followed them throughout pregnancy. We followed their children from birth until 5 years of age. The main outcome measure was obesity (BMI for age and sex ? 95th percentile) at 5 years of age. We used poisson regression with robust variance estimation to compute risk ratio (RR). Results. At the 5th year of followup, 71 (9.6%) of the children were obese and 85 (11.5%) were overweight (BMI ? 85th-<95th percentile). In multivariable analysis, maternal prepregnancy overweight (RR: 2.30, 95% CI: 1.29-4.11) and obesity (RR: 2.53, 95% CI: 1.49-4.31), and child's birth weight >85th percentile (RR: 2.04, 95% CI: 1.13-3.68) were associated with childhood obesity. Maternal prepregnancy BMI, birth weight, and maternal smoking were associated with the child being overweight 1-12 cigarettes/day versus 0 cigarettes/day (RR: 1.40, 95% CI: 1.02-1.91). Conclusion. Children of overweight and obese mothers, and children with higher birth weight, are more likely to be obese and overweight at age 5. Maternal smoking 1-12 cigarettes per day is associated with the child being overweight. PMID:23056928
Janjua, Naveed Zafar; Mahmood, Bushra; Islam, M Aminul; Goldenberg, Robert L
Objective. To identify maternal and early childhood riskfactors for obesity and overweight among children at age 5 in the state of Alabama. Methods. We recruited 740 mothers during early pregnancy from University of Alabama Prenatal Clinics in a prospective cohort study and followed them throughout pregnancy. We followed their children from birth until 5 years of age. The main outcome measure was obesity (BMI for age and sex ? 95th percentile) at 5 years of age. We used poisson regression with robust variance estimation to compute risk ratio (RR). Results. At the 5th year of followup, 71 (9.6%) of the children were obese and 85 (11.5%) were overweight (BMI ? 85th–<95th percentile). In multivariable analysis, maternal prepregnancy overweight (RR: 2.30, 95% CI: 1.29–4.11) and obesity (RR: 2.53, 95% CI: 1.49–4.31), and child's birth weight >85th percentile (RR: 2.04, 95% CI: 1.13–3.68) were associated with childhood obesity. Maternal prepregnancy BMI, birth weight, and maternal smoking were associated with the child being overweight 1–12 cigarettes/day versus 0 cigarettes/day (RR: 1.40, 95% CI: 1.02–1.91). Conclusion. Children of overweight and obese mothers, and children with higher birth weight, are more likely to be obese and overweight at age 5. Maternal smoking 1–12 cigarettes per day is associated with the child being overweight.
Janjua, Naveed Zafar; Mahmood, Bushra; Islam, M. Aminul; Goldenberg, Robert L.
Objective: To explore the relationship between genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR), methionine\\u000a synthase reductase (MTRR), the central enzymes in folate metabolism that affects DNA methylation and synthesis, and the risk\\u000a of Down syndrome in China. Methods: Genomic DNA was isolated from the peripheral lymphocytes of 64 mothers of children with\\u000a Down syndrome and 70 age matched control subjects. Polymerase
Background We have previously examined the associations between perfluorooctanoic acid (PFOA) exposure, birth weight and gestational age in individuals exposed to PFOA-contaminated residential drinking water from the Little Hocking Water Association (LHWA). In this investigation, we expand the scope of our analysis to examine the associations between PFOA, congenital anomalies, labor and delivery complications and maternalriskfactors. Objectives To compare the incidence of congenital anomalies, labor and delivery complications and maternalriskfactors in neonates and their mothers residing in zip codes with public water service provided completely, partially or not at all by the LHWA. Methods Logistic regression analyses were performed on singleton neonatal birth outcome data supplied by the Ohio Department of Health to examine the associations between LHWA water service category and the outcomes of interest. When possible, models were adjusted for maternal age, preterm birth, neonatal sex, race, maternal education, alcohol use, tobacco use and diabetic status. Results Increased PFOA exposure, as assessed by water service category, was not associated with an overall increase in the likelihood of congenital anomalies or any specific diagnosis (Adjusted OR: 1.4, 95%CI: 0.34–3.3). The overall likelihood of labor and delivery complications was significantly lower among mothers with water service provided by the LHWA, as compared to mothers not serviced by the LHWA (Adjusted OR: 0.65, 95% CI: 0.46–0.92). A significant increase in the likelihood of anemia (Crude OR: 11, 95%CI: 1.8–64) and dysfunctional labor (Crude OR: 5.3 95%CI: 1.2–24) was noted for mothers residing within zip codes serviced by the LHWA, but the number of reported cases was very small. Conclusion At the levels measured in the LHWA, we conclude that PFOA is not associated with increased incidence of congenital anomalies and most labor and delivery complications and maternalriskfactors. Additional research is required to assess the observed associations between PFOA, anemia and dysfunctional labor.
Nolan, Lynda A.; Nolan, John M.; Shofer, Frances S.; Rodway, Nancy V.; Emmett, Edward A.
Data were obtained from three samples of women of childbearing age. One sample of women is from prenatal clinics serving Plains Indian women. The second sample is of women from the Plains whose children were referred to special diagnostic developmental clinics, as their children were believed to have developmental issues consistent with prenatal alcohol consumption. The third sample is of women from South Africa, each of whom has given birth to a child diagnosed with full fetal alcohol syndrome (FAS). Data across samples conform to expected trends on many variables. For example, the maternal age at time of pregnancy, a major riskfactor for FAS, ranged from a mean of 23.5 years for the prenatal clinic sample, to 23.8 years for the developmental clinic sample, to 27.6 for the sample of women who have delivered children with FAS. Other variables of maternalrisk for FAS expected from the extant literature, such as high gravidity and parity, binge drinking, heavy intergenerational drinking in the mother's extended family and immediate social network, and length of drinking career, were compared across the three samples with variable results. However, normative measures of drinking problems are unreliable when reported across cultures. An unexpected finding from this three-sample comparison was the differential risk found when comparing U.S. women to South African women. Women in the U.S. Plains Indian samples report a high consumption of alcohol in a binge pattern of drinking, yet there is less detectable damage to the fetus than among the South African women. Body mass index (BMI) and lifelong and current nutrition may have a substantial impact, along with the above factors, in relative risk for an FAS birth. The level of risk for producing a child with FAS is influenced by environmental and behavioral conditions that vary between populations and among individual women. Also, because many syndromes are genetically based, there is a need for full behavioral and genetic histories of the mother, family, and child being studied. Collecting extensive behavioral information as well as genetic histories will provide the requisite information for making an accurate diagnosis of FAS. PMID:15095467
May, Philip A; Gossage, J Phillip; White-Country, Mary; Goodhart, Karen; Decoteau, Sara; Trujillo, Phyllis M; Kalberg, Wendy O; Viljoen, Denis L; Hoyme, H Eugene
It is not known whether reproductive factors early in the mother’s life influence risk of autism spectrum disorders (ASD).\\u000a We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to\\u000a first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in a cohort study of\\u000a 61,596 women, including 743
Kristen LyallDavid; David L. Pauls; Susan Santangelo; Donna Spiegelman; Alberto Ascherio
There is a general recognition of the role of low birthweight (LBW) as a major determinant of infant mortality rates. Since\\u000a the rate of LBW has been increasing over the past fifteen years in Japan, we decided to ascertain the riskfactors related\\u000a to it, and also to verify whether or not maternal leisure-time physical activities including sports activities, before
OBJECTIVE Elevated concentrations of Interleukin-6 (IL-6), C-reactive protein (CRP), and Matrix Metalloproteinase-9 (MMP-9) in fetal and neonatal compartments have been associated with an increased risk for preterm birth (PTB) and/or neonatal morbidity. The purpose of this study was to determine if the maternal serum concentration of IL-6, CRP, and MMP-9 in women at risk for preterm birth (PTB) who are not in labor, and have intact membranes, are associated with an increased risk for preterm birth < 32 weeks and/or neonatal morbidity. STUDY DESIGN Maternal serum samples collected from 475 patients enrolled in a multicenter randomized controlled trial of single versus weekly corticosteroids for women at increased risk for preterm delivery were assayed. Serum was collected at randomization (24-32 weeks gestation). Maternal serum concentrations of IL-6, CRP, and MMP-9 were subsequently determined using enzyme-linked immunoassays. Multivariate logistic regression analysis was performed to explore the relationship between maternal serum concentrations of IL-6, CRP and MMP-9, and preterm birth < 32 weeks, Respiratory Distress Syndrome (RDS), Chronic Lung Disease (CLD), Intraventricular Hemorrhage (IVH), Necrotizing Enterocolitis (NEC) and Any Sepsis (S). RESULTS Maternal serum concentrations of IL-6 and CRP, but not MMP-9, above the 90th percentile, at the time of randomization, were associated with preterm birth < 32 weeks. In contrast, there was no significant relationship between RDS and NEC and the maternal serum concentration of IL-6, CRP, or MMP-9 (univariate analysis). The development of CLD was associated with a high (above 90th percentile) IL-6 and CRP in maternal serum, even after adjustment for gestational age (GA) at randomization, and treatment group. However, when GA at delivery was added to the model, this finding was non-significant. Neonatal sepsis was more frequent in neonates born to mothers with a high maternal serum concentration of CRP (above >90th percentile). However, there was no significant association after adjustment for GA at randomization, and treatment group. Logistic regression analysis for each analyte indicated that high maternal serum concentrations of IL-6 and CRP, but not MMP-9, were associated with an increased risk of IVH (O.R. 4.60, 95% C.I. 1.86-10.68; O.R. 4.07, 95% C.I. 1.63-9.50), after adjusting for GA at randomization and treatment group. Most babies (25/30) had grade I IVH. When GA at delivery was included, elevated IL-6 remained significantly associated with IVH (O.R. 2.77, 95% C.I. 1.02-7.09). CONCLUSION An elevated maternal serum concentration of IL-6 and CRP are riskfactors for preterm birth < 32 weeks and subsequent development of neonatal IVH. An elevated maternal serum IL-6 appears to confer additional risk for IVH even after adjusting for gestational age at delivery.
Sorokin, Yoram; Romero, Roberto; Mele, Lisa; Wapner, Ronald J.; Iams, Jay D.; Dudley, Donald J.; Spong, Catherine Y.; Peaceman, Alan M.; Leveno, Kenneth J.; Harper, Margaret; Caritis, Steve N.; Miodovnik, Menachem; Mercer, Brian M.; Thorp, John M.; O'Sullivan, Mary Jo; Ramin, Susan M.; Carpenter, Marshall W.; Rouse, Dwight J.; Sibai, Baha
... on the characteristics we inherit from our parents. Environmental RiskFactors Many studies have been performed on a number of potential environmental riskfactors. Of the many factors studied, only one— ...
Logistic regression and spatial analytic techniques are used to model fetal distress risk as a function of maternal exposure to Hurricane Andrew. First, monthly time series compare the proportion of infants born distressed in hurricane affected and unaffected areas. Second, resident births are analyzed in Miami-Dade and Broward counties, before, during, and after Hurricane Andrew. Third, resident births are analyzed in all Florida locales with 100,000 or more persons, comparing exposed and unexposed gravid females. Fourth, resident births are analyzed along Hurricane Andrew's path from southern Florida to northeast Mississippi. Results show that fetal distress risk increases significantly with maternal exposure to Hurricane Andrew in second and third trimesters, adjusting for known riskfactors. Distress risk also correlates with the destructive path of Hurricane Andrew, with higher incidences of fetal distress found in areas of highest exposure intensity. Hurricane exposed African-American mothers were more likely to birth distressed infants. The policy implications of?in utero?costs of natural disaster exposure are discussed. PMID:20626684
Zahran, Sammy; Snodgrass, Jeffrey G; Peek, Lori; Weiler, Stephan
There is increasing evidence that human pregnancy outcome can be significantly compromised by suboptimal maternal nutritional status. Poor diet results in a maternal-fetal environment in which the teratogenicity of other insults such as alcohol might be amplified. As an example, there is evidence that zinc (Zn) can interact with maternal alcohol exposure to influence the risk for fetal alcohol spectrum disorders (FASD). Studies with experimental animals have shown that the teratogenicity of alcohol is increased under conditions of Zn deficiency, whereas its teratogenicity is lessened when animals are given Zn-supplemented diets or Zn injections before the alcohol exposure. Alcohol can precipitate an acute-phase response, resulting in a subsequent increase in maternal liver metallothionein, which can sequester Zn and lead to decreased Zn transfer to the fetus. Importantly, the teratogenicity of acute alcohol exposure is reduced in metallothionein knockout mice, which can have improved Zn transfer to the conceptus relative to wild-type mice. Consistent with the above, Zn status has been reported to be low in alcoholic women at delivery. Preliminary data from two basic science and clinical nutritional studies that are ongoing as part of the international Collaborative Initiative on Fetal Alcohol Spectrum Disorders support the potential role of Zn, among other nutritional factors, relative to risk for FASD. Importantly, the nutrient levels being examined in these studies are relevant to general clinical populations and represent suboptimal levels rather than severe deficiencies. These data suggest that moderate deficiencies in single nutrients can act as permissive factors for FASD, and that adequate nutritional status or intervention through supplementation may provide protection from some of the adverse effects of prenatal alcohol exposure. PMID:20333752
Keen, Carl L; Uriu-Adams, Janet Y; Skalny, Anatoly; Grabeklis, Andrei; Grabeklis, Sevil; Green, Kerri; Yevtushok, Lyubov; Wertelecki, Wladimir W; Chambers, Christina D
There is increasing evidence that human pregnancy outcome can be significantly compromised by suboptimal maternal nutritional status. Poor diet results in a maternal-fetal environment in which the teratogenicity of other insults such as alcohol might be amplified. As an example, there is evidence that zinc (Zn) can interact with maternal alcohol exposure to influence the risk for fetal alcohol spectrum disorders (FASD). Studies with experimental animals have shown that the teratogenicity of alcohol is increased under conditions of Zn deficiency, while its teratogenicity is lessened when animals are given Zn supplemented diets or Zn injections prior to the alcohol exposure. Alcohol can precipitate an acute phase response resulting in a subsequent increase in maternal liver metallothionein, which can sequester Zn and lead to decreased Zn transfer to the fetus. Importantly, the teratogenicity of acute alcohol exposure is reduced in metallothionein knockout mice, which can have improved Zn transfer to the conceptus relative to wild-type mice. Consistent with the above, Zn status has been reported to be low in alcoholic women at delivery. Preliminary data from two basic science and clinical nutritional studies that are ongoing as part of the international Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) support the potential role of Zn, among other nutritional factors, relative to risk for FASD. Importantly, the nutrient levels being examined in these studies are relevant to general clinical populations and represent suboptimal levels rather than severe deficiencies. These data suggest that moderate deficiencies in single nutrients can act as permissive factors for FASD, and that adequate nutritional status or intervention through supplementation may provide protection for some of the effects of prenatal alcohol exposure.
Keen, Carl L.; Uriu-Adams, Janet Y.; Skalny, Anatoly; Grabeklis, Andrei; Grabeklis, Sevil; Green, Kerri; Yevtushok, Lyubov; Wertelecki, W. W.; Chambers, Christina D.
Objectives: Maternal-infant bedsharing is a common but controversial practice. Little has been published about who bedshares in the United\\u000a States. This information would be useful to inform public policy, to guide clinical practice and to help focus research. The\\u000a objective was to explore the prevalence and determinants of bedsharing in Oregon.\\u000a \\u000a \\u000a Methods. Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) surveys
Martin B. Lahr; Kenneth D. Rosenberg; Jodi A. Lapidus
Background Although many studies indicate that maternal smoking during pregnancy (SDP) is correlated with later offspring antisocial behavior (ASB), recent quasi-experimental studies suggest that background familial factors confound the association. The present study sought to test alternative etiological hypotheses using multiple indices of adolescent ASB, comparing differentially exposed siblings, and testing assumptions in the sibling-comparison design. Methods The study examined the association between maternal SDP and adolescent-reported ASB, criminal convictions, and membership in a group of individuals with early-starting and chronic ASB among 6,066 offspring of women from the National Longitudinal Survey of Youth, a representative sample of women in the United States. The analyses controlled for statistical covariates and examined associations while comparing differentially exposed siblings. Results At the population-level, each additional pack of cigarettes/day predicted greater mean adolescent-reported ASB symptoms (ratio of means=1.15, 95% CIs=1.08–1.22), odds of being in the top 10% of ASB (OR=1.34, 95% CIs=1.10–1.65), hazard of a criminal conviction (HR=1.51, 95% CIs=1.34–1.68), and odds of chronic ASB (OR=1.57, 95% CIs=1.25–1.99). SDP robustly predicted most assessments of ASB while controlling for measured covariates. When siblings exposed to differing levels of SDP were compared, however, all of the associations were attenuated and were not statistically significant: adolescent-reported mean ASB (ratio of means=0.86, 95% CIs=0.74–1.01), High ASB (OR=0.67, 95% CIs=0.41–1.12), criminal conviction (HR=0.98, 95% CIs=0.66–1.44), and Chronic ASB (OR=0.80, 95% CIs=0.46–1.38). Conclusions The results strongly suggest that familial factors account for the correlation between SDP and offspring adolescent ASB, rather than a putative causal environmental influence of SDP.
D'Onofrio, Brian M.; Van Hulle, Carol A.; Goodnight, Jackson A.; Rathouz, Paul J.; Lahey, Benjamin B.
Little is known on environmental riskfactors for cryptorchidism and\\u000a hypospadias, which are among the most frequent congenital abnormalities.\\u000a The aim of our study was to identify riskfactors for cryptorchidism and\\u000a hypospadias, with a focus on potential endocrine disruptors in parental\\u000a diet and occupation. In a case-control study nested within a cohort of\\u000a 8,698 male births, we compared 78
Frank H. Pierik; Alex Burdorf; James A. Deddens; Rikard E. Juttmann; Rob F. A. Weber
Objectives. We defined riskfactors for fetal alcohol syndrome (FAS) in a region with the highest documented prevalence of FAS in the world. Methods. We compared mothers of 53 first-grade students with FAS (cases) with 116 randomly selected mothers of first-grade students without FAS (controls). Results. Differences between case and control mothers in our study population existed regarding socioeconomic status,
Philip A. May; J. Phillip Gossage; Lesley E. Brooke; Cudore L. Snell; Anna-Susan Marais; Loretta S. Hendricks; Julie A. Croxford; Denis L. Viljoen
This study examines the association between maternalfactors and low birth weight among newborns at a tertiary hospital in Malaysia. This was a cross-sectional study where mothers were followed through from first booking till delivery. There were 666 mothers who delivered from May 2007 to March 2008. Infants' birth weight were compared with maternal age, pre-pregnancy BMI, fathers BMI, parity, ethnicity, per capita monthly income, and maternal blood pressure during pregnancy. A multiple logistic regressions was used to determine the relationship of maternalfactors and low birth weight, while the ROC curve was constructed to assess the sensitivity and specificity of the predictive model. Among the significant riskfactors of low birth weight were older age (35 years and above), low pre-pregnancy BMI (<20 kg/m2), parity of 4 and above, Indian origin, economically under privileged, and low and high blood pressure. Blood pressure during pregnancy was an important riskfactor for LBW, by using this parameter alone the risk of LBW could be predicted with a sensitivity rate of 70% and a specificity rate of 70%. The sensitivity and specificity was further improved to 80% and 75% percent respectively when other factors like maternalfactors such as maternal age, pre-pregnancy BMI, ethnicity, and per capita monthly income were included in the analysis. PMID:23466766
Aim:? Mother-to-child transmission (MTCT) is the major transmission pathway of hepatitis C virus (HCV) in children. However, its riskfactors remain unsettled for introduction of putative intervention. Methods:? Pregnant women screened for HCV and MTCT in children born to antibody-positive mothers were prospectively studied in Tottori, Japan. Results:? Among 41?856 screened women, 188 (0.45%) were HCV antibody-positive, of whom 61% had detectable HCV RNA. While 10 of the 34 children (29%) born to high viral load (HVL: ?6.0?×?10(5) ?IU/mL) mothers were infected, none born to RNA-detectable but non-HVL mothers were infected (P?0.001). MTCT among vaginally delivered children born to HVL mothers was analyzed. Children delivered after 4?h or more of labor were more frequently infected than were those born within 4?h of labor (P?=?0.019). Premature rupture of fetal membranes was significantly more common in infected children than in uninfected children (P?0.001). Durations of membrane rupture and labor were longer in infected children than in uninfected children (P?=?0.008 and P?=?0.040, respectively). Elective cesarean section that eliminates these riskfactors, other than HVL, significantly reduced MTCT from nine of 22 (41%) to none of nine children (0%) (P?=?0.032). Conclusion:? Our data suggest that contamination of the fetus in the birth canal with infected maternal blood is a major riskfactor for HCV MTCT, in addition to maternal HVL. To rationalize intervention by elective cesarean section, the natural history of infected children should be carefully evaluated. PMID:22404371
Female sexual dysfunction is a common health problem for many women all over the world. This study was constructed to determine\\u000a riskfactors and prevalence of female sexual dysfunction among Turkish women, in Ordu province of Turkey between May 2008\\u000a and December 2008. Four hundred and twenty-five married women, between 18 and 56 years of age, who consented to participate,\\u000a were
The objective of this study is to explore riskfactors associated with overweight and high blood pressure in Chinese American\\u000a children. Students and their parents were recruited from Chinese language schools in the San Francisco Bay Area. Data were\\u000a collected on 67 children and their mothers, and included children’s weight, height, waist and hip circumferences, blood pressure,\\u000a level of physical
Jyu-Lin Chen; Sandra Weiss; Melvin B. Heyman; Robert Lustig
... or not. The study, published in the Journal of the American Heart Association, found that depression and anxiety considerably raise ... factor for heart disease and stroke. Below is the percentage of U.S. adults with heart disease and stroke riskfactors in 2005–2006. ...
Abnormal folate/homocysteine metabolism due to polymorphisms in genes involved in this pathway has been implicated as an etiologic factor in Down syndrome (DS). This case-control study aimed to evaluate the effect of maternal C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) as riskfactors for the development of DS and congenital heart defects (CHD). The distribution of these genotypic variants was similar between mothers of children with DS (n = 239) and control mothers of normal children (n = 197), but the combined genotypes 677CT or TT and 1298AA increased the risk of having offspring with DS (OR = 1.99; 95% CI 1.11-3.55). The presence of the 677T allele in case mothers resulted in a 2.07-fold higher odds of CHD in the offspring (P < 0.01). Among the 57 mothers of CHD-affected children with DS who carried the MTHFR 677CT or TT genotypes and did not have periconceptional folic acid intake, we observed a 2.26-fold increased odds (95% CI 1.25-4.09) of having any CHD-affected child with DS. Our results show that MTHFR genetic polymorphisms may be involved in the etiology of DS in our population when controlling for age. We noted a borderline significant association for the C677T polymorphism (P = 0.05). Maternal 677T allele may be associated with an increased occurrence of CHD in children with DS and we anticipate that women who carry this polymorphism would benefit from periconceptional folic acid supplementation. (c) 2009 Wiley-Liss, Inc. PMID:19725133
Brandalize, Ana Paula Carneiro; Bandinelli, Eliane; dos Santos, Pollyanna Almeida; Roisenberg, Israel; Schüler-Faccini, Lavínia
BackgroundPrevious research in South Africa revealed very high rates of fetal alcohol syndrome (FAS), of 46–89 per 1000 among young children. Maternal and child data from studies in this community summarize the multiple predictors of FAS and partial fetal alcohol syndrome (PFAS).
Philip A. May; Barbara G. Tabachnick; J. Phillip Gossage; Wendy O. Kalberg; Anna-Susan Marais; Luther K. Robinson; Melanie Manning; David Buckley; H. Eugene Hoyme
|As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…
|In many societies the prevalence of behavioural problems in school-aged children varies by national origin. We examined the association between national origin and behavioural problems in 1 1/2-year-old children. Data on maternal national origin and the Child Behavior Checklist for toddlers (n = 4943) from a population-based cohort in the…
Jansen, Pauline W.; Raat, Hein; Mackenbach, Johan P.; Jaddoe, Vincent W. V.; Hofman, Albert; van Oort, Floor V.; Verhulst, Frank C.; Tiemeier, Henning
Objectives. We examined the associations of intimate partner violence (IPV) and maternalriskfactors with maternal child maltreatment risk within a diverse sample of mothers. Methods. We derived the study sample (N = 2508) from the Fragile Families and Child Well-Being Study. We conducted regression analyses to examine associations between IPV, parenting stress, major depression, key covariates, and 4 proxy variables for maternal child maltreatment. Results. Mothers reported an average of 25 acts of psychological aggression and 17 acts of physical aggression against their 3-year-old children in the year before the study, 11% reported some act of neglect toward their children during the same period, and 55% had spanked their children during the previous month. About 40% of mothers had experienced IPV by their current partner. IPV and maternal parenting stress were both consistent riskfactors for all 4 maltreatment proxy variables. Although foreign-born mothers reported fewer incidents of child maltreatment, the IPV relative risk for child maltreatment was greater for foreign-born than for US-born mothers. Conclusions. Further integration of IPV and child maltreatment prevention and intervention efforts is warranted; such efforts must carefully balance the needs of adult and child victims.
Guterman, Neil B.; Lee, Shawna J.; Rathouz, Paul J.
In many societies the prevalence of behavioural problems in school-aged children varies by national origin. We examined the\\u000a association between national origin and behavioural problems in 1½-year-old children. Data on maternal national origin and\\u000a the Child Behavior Checklist for toddlers (n?=?4943) from a population-based cohort in the Netherlands were used. Children from various non-Dutch backgrounds all had\\u000a a significantly higher
Pauline W. Jansen; Hein Raat; Johan P. Mackenbach; Vincent W. V. Jaddoe; Albert Hofman; Floor V. van Oort; Frank C. Verhulst; Henning Tiemeier
Objective This study examines how emotion regulation deficits in the area of anger arousal and reactivity are associated with child abuse potential in mothers with substance use and depressive disorders in order to identify targeted areas for prevention and treatment. Methods A sample of 152 urban mothers was interviewed on measures of substance use, diagnosis of depression, anger arousal and reactivity, and child abuse potential. Results Linear hierarchical regressions revealed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. Additionally, anger arousal and reactivity was found to be a partial mediator of the relationship between diagnostic category and child abuse potential. Conclusions Findings are discussed in relation to a multifaceted model of child abuse potential which broadens the existing literature to include an examination of depression and emotion regulation in order to more fully understand how substance use and child abuse potential are linked. Practice implications Models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful, and may be most readily applied in such populations.
AIMS: Periconceptional folate supplementation prevents neural tube defects and possibly congenital heart defects (CHD) as well. The search for candidate genes involved in the folate metabolism includes the methylenetetrahydrofolate reductase (MTHFR) 677C > T polymorphism. We studied the association between MTHFR 677C > T variants and CHD risk. The interaction with periconceptional folate supplementation was also investigated. METHODS AND RESULTS:
I. M. van Beijnum; Livia Kapusta; Martin den Heijer; Sita H. H. M. Vermeulen; Margreet Kouwenberg; Otto Daniels; Henk J. Blom
Neuroblastoma is the most common cancer among infants, suggesting an etiologic role for prenatal factors. In this case-cohort study, neuroblastoma cases (n = 529) diagnosed between 1985 and 2001 were identified from the New York State Cancer Registry and were matched to the electronic birth records for 1983-2001 from New York State and New York City. Controls (n = 12,010) were selected from the same birth cohorts. Analysis was stratified by age at diagnosis, with one to six months (younger infants), seven to 18 months (older infants), and older than 18 months (older children) analyzed separately. Perinatal exposure data was obtained from the birth certificates. No riskfactors were identified to be consistently associated with risk across all three age groups. Generally, more riskfactors were identified as associated with neuroblastoma among younger infants relative to older ages, including high birth weight, heavier maternal gestational weight gain, maternal hypertension, older maternal age, ultrasound, and respiratory distress. Among older infants, low birth weight was associated with increased risk while heavier maternal gestational weight gain was protective. In the oldest age group, first born status, primary cesarean delivery, prolonged labor and premature rupture of the membranes were associated with increased risk. PMID:18941915
McLaughlin, Colleen C; Baptiste, Mark S; Schymura, Maria J; Zdeb, Michael S; Nasca, Philip C
Purpose Neural tube defects, including spina bifida and anencephaly, are the second most common birth defects with an incidence in\\u000a Italy of 0.4–1\\/1,000. Information on factors playing a role in the pathogenesis of spina bifida is based on populations with\\u000a different exposures, lifestyle, social and cultural habits compared to Italian people. Our objective was to fill this gap\\u000a by using data
Patrizia De Marco; Elisa Merello; Maria Grazia Calevo; Samantha Mascelli; Daniela Pastorino; Lucia Crocetti; Pierangela De Biasio; Gianluca Piatelli; Armando Cama; Valeria Capra
There is increasing evidence that dietary folic acid deficiency in utero may increase the risk of developing the 'cleft lip with or without cleft palate' (CL±P) variant of orofacial cleft. Coeliac disease is a common cause of folic acid malabsorption, and in the majority of cases remains undiagnosed. This pilot study assessed the seroprevalence of undiagnosed coeliac disease in a cohort of mothers of infants with CL±P in the Hyderabad area of India. The seroprevalence of coeliac disease of 1.15% (95% confidence interval 0.37-2.66%) was little different from the expected figure based on published population studies, making a clinically significant association unlikely. PMID:23664420
Reddy, S G; Reddy, R R; Vaidhyanathan, A; Markus, A; Snook, J
Objectives. We compared the association between advancing maternal age and risk of preterm delivery across 4 groups (Black smokers, Black nonsmokers, White smokers, White nonsmokers) and within the context of neighborhood deprivation levels. Methods. We obtained data from linked census and birth records for singletons (n = 182 938) delivered by women aged 20 to 39 years in Philadelphia, Pennsylvania; Baltimore, Maryland; 16 Michigan cities; 3 Maryland counties; and 2 North Carolina counties. Results from area-specific multilevel logistic regression models were combined to obtain pooled estimates of relations between maternal age and risk of preterm delivery. We repeated the models after categorizing women by neighborhood deprivation level (low, medium, and high). Results. Among multiparous women, there was a significant age-related increase in preterm delivery in 3 of the 4 groups. The adjusted odds ratio per 5-year age increase was 1.31 in Black smokers, 1.11 in Black nonsmokers, and 1.16 in White smokers. In each group, the odds ratio increased as neighborhood deprivation increased. Conclusions. These results support the “weathering” hypothesis, suggesting that Black women, women with high-risk behaviors, and women living in high-deprivation neighborhoods may develop “accelerated aging” that increases preterm delivery risk.
Eyster, Janet; Kleyn, Mary; Messer, Lynne C.; Kaufman, Jay S.; Laraia, Barbara A.; O'Campo, Patricia; Burke, Jessica G.; Culhane, Jennifer; Elo, Irma T.
There is inadequate data about the association between specific psychosocial factors and pediatric health care use. We hypothesized that maternal substance abuse, depression, and low social support would be associated with increased medical visits, emergency room (ER) use, visits for injuries and delays in immunization. We conducted a prospective study of 202 U.S. families with preschool children in a clinic
Objective To study the associations between physically demanding work and occupational exposure to chemicals and hypertensive disorders during pregnancy within a large birth cohort study, the Generation R Study. Methods Associations between occupational characteristics and hypertensive disorders during pregnancy were studied in 4465 pregnant woman participating in a population-based prospective cohort study from early pregnancy onwards in the Netherlands (2002–2006). Mothers who filled out a questionnaire during mid-pregnancy (response 77% of enrolment), were included if they conducted paid employment, had a spontaneously conceived singleton live born pregnancy, and did not suffer from pre-existing hypertension (n?=?4465). Questions on physical demanding work were obtained from the Dutch Musculoskeletal Questionnaire and concerned questions on manually handling loads of 25 kg or more, long periods of standing or walking, night shifts, and working hours. To assess occupational exposure to chemicals, job titles and task descriptions were linked to a job-exposure-matrix (JEM), an expert judgment on exposure to chemicals at the workplace. Information on hypertensive disorders during pregnancy was obtained from medical records. Results We observed no consistent associations between any of the work related riskfactors, such as long periods of standing or walking, heavy lifting, night shifts, and working hours, nor exposure to chemicals with hypertensive disorders during pregnancy. Conclusion This prospective birth cohort study suggests that there is no association of hypertensive disorders during pregnancy with physically demanding work or exposure to chemicals. However, the low prevalence of PIH and PE, combined with the low prevalence of occupational riskfactors limit the power for inference and larger studies are needed to corroborate or refute these findings.
Nugteren, Jaap Jan; Snijder, Claudia A.; Hofman, Albert; Jaddoe, Vincent W. V.; Steegers, Eric A. P.; Burdorf, Alex
BACKGROUND. Washington State birth certificates were used to conduct a population-based case-control study to assess the possible association of maternal smoking with polyhydramnios. METHODS. All singleton births complicated by polyhydramnios (n = 557) were identified from the vital records for the years 1984 to 1987. For comparison, 1671 records were randomly selected for the same years from singleton births uncomplicated by polyhydramnios. RESULTS. Women who reportedly smoked prenatally were found to be at increased risk for polyhydramnios (relative risk [RR] = 1.7, 95% confidence interval [CI] = 1.5-2.1, adjusted for marital status, maternal age, and parity). When women with conditions known to be associated with polyhydramnios were excluded, the risk for those who smoked prenatally remained elevated (RR = 1.8, 95% CI = 1.1-2.3). CONCLUSION. Overdistention of the uterus from polyhydramnios may cause a variety of pregnancy complications. The observed association of smoking with polyhydramnios may be a further indication for public health interventions aimed at preventing smoking during pregnancy.
Introduction An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascual endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of preeclampsia and/or delivery of an SGA neonate. Methods This longitudinal case-control study included 402 singleton pregnancies in the following groups: 1) normal pregnancies with appropiate for gestational age (AGA) neonates (n=201); 2) patients who delivered an SGA neonate (n=145); and 3) patients who developed PE (n=56). Maternal plasma samples were obtained at the time of each prenatal visit, scheduled at 4-week intervals from the first or early second trimester until delivery. In this study, we included two samples per patient: 1) first sample obtained between 6 and 15 weeks of gestation (“first trimester” sample); and 2) second sample obtained between 20 and 25 weeks of gestation (“second trimester” sample). Plasma concentrations of s-Eng, sVEGFR-1 and PlGF were determined by specific and sensitive immunoassays. Changes in the maternal plasma concentrations of these angiogenesis-related factors were compared among normal patients and those destined to develop PE or deliver an SGA neonate while adjusting for maternal age, nulliparity and body mass index (BMI). General linear models and polytomous logistic regression models were used to relate the analyte concentrations, ratios, and product to the subsequent development of delivery of an SGA neonate. Results 1) An increase in the maternal plasma concentration of s-Eng between the first and second trimesters conferred risk for the development of preterm PE and SGA (OR 14.9, 95% CI 4.9-45.0, and OR 2.9, 95% CI 1.5-5.6, respectively); 2) An increase in the maternal plasma concentration of sVEGFR-1 between the first and second trimester conferred risk for the development of preterm PE (OR 3.9, 95% CI 1.2-12.6); 3) A subnormal increase in maternal plasma PlGF concentration between the first and the second trimester was a riskfactor for the subsequent development of preterm and term PE (OR 4.3, 95% CI 1.2-15.5, and OR 2.7, 95% CI 1.2-5.9, respectively); 4) In addition, the combination of the three analytes into a pro-angiogenic versus anti-angiogenic ratio [PlGF/(sEng x VEGFR-1)] conferred risk for the subsequent development of preterm preeclampsia (OR 3.7, 95% CI 1.1-12.1); 5) Importantly, patients with a high change in the s-Eng x sVEGFR-1 product had an OR of 10.38 (95% CI 3.18-33.84) for the development of preterm PE and 1.62 (95% CI 1.01-2.60) for the development of SGA. Conclusion Changes in the maternal plasma concentrations of s-Eng, sVEGFR-1, PlGF or their ratios between the first and second trimesters of pregnancy confer an increased risk to deliver a SGA neonate and/or develop PE.
... risk include those treated for Hodgkin disease and women with breast cancer treated with radiation after a mastectomy (but not a lumpectomy). Diet Scientists are studying many different foods and dietary ...
To determine if older maternal age (35 years and older) at first birth was an independent riskfactor for spontaneous preterm labor, we conducted a retrospective population-based cohort study. Using provincial perinatal data, we developed separate risk models for low- and high-risk women using multivariate logistic regression. We found that older maternal age exerted a direct and independent effect on
Safina Hassan Mcintyre; Christine V. Newburn-Cook; Beverley OBrien; Nestor N. Demianczuk
BACKGROUND: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternalfactors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth
Christina Nicolaidis; Cynthia W Ko; Somnath Saha; Thomas D Koepsell
Objective: Studies have suggested an association between maternal hair dye use and elevated risk of childhood cancer, including neuroblastoma. We analyzed data from a large case–control study to investigate the relationship between maternal hair dye use around pregnancy and risk of neuroblastoma in offspring.
Erin E. McCall; Andrew F. Olshan; Julie L. Daniels
The leading cause of Down syndrome (DS) is nondisjunction of chromosome 21 occurring during the formation of gametes. In this review, we discuss the progress made to identify riskfactors associated with this type of chromosome error occurring in oogenesis and spermatogenesis. For errors occurring in oocytes, the primary riskfactors are maternal age and altered recombination. We review the
S. L. Sherman; S. B. Freeman; E. G. Allen; N. E. Lamb
Maternal enterovirus infections during pregnancy may increase the risk of offspring developing type 1 diabetes during childhood. The aim of this study was to investigate whether gestational enterovirus infections increase the offspring's risk of type 1 diabetes later in life. Serum samples from 30 mothers without diabetes whose offspring developed type 1 diabetes between 15 and 25 years of age were analyzed for enterovirus-specific immunoglobulin M (IgM) antibodies and enterovirus genome (RNA), and compared to a control group. Among the index mothers, 9/30 (30%) were enterovirus IgM-positive, and none was positive for enterovirus RNA. In the control group, 14/90 (16%) were enterovirus IgM-positive, and 4/90 (4%) were positive for enterovirus RNA (n.s.). Boys of enterovirus IgM-positive mothers had approximately 5 times greater risk of developing diabetes (OR 4.63; 95% CI 1.22-17.6), as compared to boys of IgM-negative mothers (P < .025). These results suggest that gestational enterovirus infections may be related to the risk of offspring developing type 1 diabetes in adolescence and young adulthood. PMID:18670622
Background Prior studies have suggested an increased risk of oral clefts after exposure to amoxicillin in early pregnancy, but findings have been inconsistent. Methods Among participants in the Slone Epidemiology Center Birth Defects Study from 1994 to 2008, we identified 877 infants with cleft lip with/without cleft palate (CL/P) and 471 with cleft palate alone (CP). Controls included 6952 non-malformed infants. Mothers were interviewed about demographic, reproductive and medical factors, and details of medication use. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of amoxicillin in the first trimester using conditional logistic regression and adjusting for known riskfactors for oral clefts, as well as for infections, fever, and concomitant treatments. Results In the control group, 3% of women had used amoxicillin in the first trimester. Maternal use of amoxicillin was associated with an increased risk of CL/P (adjusted OR= 2.0 [95% CI= 1.0–4.1]), with an OR of 4.3 (1.4–13.0) for third-gestational-month use. Risks were not elevated for use of other penicillins or cephalosporins. For CP, the OR for first-trimester amoxicillin was 1.0 (0.4–2.3), with an OR of 7.1 (1.4–36.4) for third-gestational-month use. Conclusions Amoxicillin use in early pregnancy may be associated with an increased risk of oral clefts.
Despite the maternal and infant morbidity associated with gestational diabetes mellitus (GDM), few modifiable riskfactors have been identified. We explored the relation between recreational physical activity performed during the year before and during the first 20 weeks of pregnancy and the risk of GDM. 155 GDM cases and 386 normotensive, non-diabetic pregnant controls provided information about the type, intensity,
Jennifer C. Dempsey; Carole L. Butler; Tanya K. Sorensen; I-Min Lee; Mary Lou Thompson; Raymond S. Miller; Ihunnaya O. Frederick; Michelle A. Williams
The cause of testicular cancer is not known and recent hypotheses have suggested an altered hormonal milieu may increase the risk of testis cancer. This study examined modulation of testicular cancer risk by hormonal factors, specifically: environmental xenoestrogens (e.g. organochlorines), prenatal maternal estrogens, testosterone indices (age at puberty, severe adolescent acne, self-reported balding), sedentary lifestyle and dietary consumption of fats
High levels of alcohol use among pregnant women have been associated with a spectrum of birth defects. Greater maternal age has been related to an increased risk of drinking during pregnancy. Although the context, process, and outcomes of pregnancy and alcohol use vary by maternal age, no studies have examined predictors of prenatal drinking by age. This study addresses this gap by examining potential riskfactors associated with prenatal alcohol use (any versus none) by maternal age (<20, 20-25, 26-34, and 35 years or older). Descriptive and logistic regression analyses were completed on survey data from 9,004 pregnant women from the north central U.S. Descriptive statistics revealed teens in general had a higher level or greater occurrence of riskfactors previously identified with prenatal drinking compared to older women, yet women of advanced maternal age (35 years or older) were most likely to drink alcohol during pregnancy. Based on the regression by age, 20-25 year old women had the greatest number of significant riskfactors associated with prenatal drinking including being employed, white, unmarried, first birth, smoking prenatally, greater levels of depressed mood, and more experiences related to alcohol abuse. The number and patterns of significant predictors of drinking alcohol while pregnant by age encourage greater investigation of other social, contextual factors that might contribute to the risk of prenatal drinking. This is especially salient for women of advanced maternal age, for whom very few significant predictors emerged. PMID:22307728
Aim: Infant sleep behaviours, particularly night wakings, have been identified as one of the most common concerns of parents. Despite this, few empirical studies have examined how mothers distinguish between normative and problematic infant sleep behaviours. Methods: In this study, we examined infant and maternalfactors associated with maternal perceptions of infant sleep problems in an internet sample of Canadian
Aim: Infant sleep behaviours, particularly night wakings, have been identified as one of the most common concerns of parents. Despite this, few empirical studies have examined how mothers distinguish between normative and problematic infant sleep behaviours. Methods: In this study, we examined infant and maternalfactors associated with maternal perceptions of infant sleep problems in an internet sample of Canadian
This study investigated birth riskfactors for school-identified specific language impairment among 244,619 students. Very low birth weight, low 5-min Apgar scores, late or no prenatal care, high birth order and low maternal education were associated with high individual-level risk, and low maternal education and unmarried mothers were associated…
Stanton-Chapman, Tina L.; Chapman, Derek A.; Bainbridge, Nicolette L.; Scott, Keith G.
Riskfactors for tuberculosis. P.D.O. Davies. The risk of developing tuberculosis is dependent on both the risk of being infected and the risk of infection lead- ing on to active disease. The former will depend on the inci- dence of tuberculosis in the community where the individual lives or works. The latter will depend on many factors im- pinging on
|The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk…
Evans, Gary W.; Kim, Pilyoung; Ting, Albert H.; Tesher, Harris B.; Shannis, Dana
This study examined maternal parenting stress in a sample of 430 boys and girls including those at risk for externalizing\\u000a behavior problems. Children and their mothers were assessed when the children were ages 2, 4, and 5. Hierarchical linear modeling\\u000a (HLM) was used to examine stability of parenting stress across early childhood and to examine child and maternalfactors predicting
Amanda P. Williford; Susan D. Calkins; Susan P. Keane
Few studies have investigated the role of early maternal enabling and psychosocial factors on subsequent adolescent caries experience. In this retrospective cohort study of 224 adolescents, we hypothesized that the causal pathway between early maternal enabling factors (education, cognitive abilities, psychological distress) and adolescent caries experience (DMFT) at age 14 yrs is mediated by maternal psychosocial factors (stress, coping, social support) and adolescent dental behavior/access. Maternal data on socio-demographic, medical, and psychosocial variables were measured when the child was 3, 8, and 14 yrs old. A structural equations model (SEM) evaluated the causal pathway, with latent variables for maternal enabling factors (MEF), stress, coping, and social support. Poor MEF was associated with increased stress and poorer coping when the child was 3 yrs old, which in turn affected adolescent dental visits and behavior. Greater social support at child’s age 3 was directly associated with lower mean DMFT in adolescence. Maternal psychosocial factors measured when children are young are important mediators for adolescent mean DMFT, but these factors measured when children are adolescents are not. Better early and concurrent MEF, however, was associated directly/indirectly (through dental visits and insurance) with adolescent DMFT. Early maternalfactors are important predictors for adolescent caries.
Background The number of women who delay childbirth to their late 30s and beyond has increased significantly over the past several decades. Studies regarding the relation between older maternal age and the risk of stillbirth have yielded inconsistent conclusions. In this systematic review we explored whether older maternal age is associated with an increased risk of stillbirth. Methods We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles (original studies and systematic reviews) published up to Dec. 31, 2006. We included all cohort and case–control studies that measured the association between maternal age and risk of stillbirth. Two reviewers independently abstracted data from all included studies using a standardized data abstraction form. Methodologic and statistical heterogeneities were reviewed and tested. Results We identified 913 unique citations, of which 31 retrospective cohort and 6 case–control studies met our inclusion criteria. In 24 (77%) of the 31 cohort studies and all 6 of the case–control studies, we found that greater maternal age was significantly associated with an increased risk of stillbirth; relative risks varied from 1.20 to 4.53 for older versus younger women. In the 14 studies that presented adjusted relative risk, we found no extensive change in the direction or magnitude of the relative risk after adjustment. We did not calculate a pooled relative risk because of the extreme methodologic heterogeneity among the individual studies. Interpretation Women with advanced maternal age have an increased risk of stillbirth. However, the magnitude and mechanisms of the increased risk are not clear, and prospective studies are warranted.
Huang, Ling; Sauve, Reg; Birkett, Nicholas; Fergusson, Dean; van Walraven, Carl
Introduction: Congenital heart disease (CHD) is associated with multiple riskfactors, consanguinity may be one such significant factor. The role of consanguinity in the etiology of CHD is supported by inbreeding studies, which demonstrate an autosomal recessive pattern of inheritance of some congenital heart defects. This study was done to find out the riskfactors for CHD. Methods: A case-control study was done on pediatric patients at a tertiary care hospital, Aga Khan University Hospital, located in Karachi, Pakistan. A total of 500 patients, 250 cases and 250 controls were included in the study. Results: Amongst the 250 cases (i.e. those diagnosed with CHD), 122 patients (48.8%) were born of consanguineous marriages while in the controls (i.e. non-CHD) only 72 patients (28.9%) showed a consanguinity amongst parents. On multivariate analysis, consanguinity emerged as an independent riskfactor for CHD; adjusted odds ratio 2.59 (95% C. I. 1.73 - 3.87). Other riskfactors included low birth weight, maternal co-morbidities, family history of CHD and first born child. On the other hand, medications used by the mother during the index pregnancy, maternal age and gender of the child did not significantly increase the risk of developing CHD. Conclusions: Analyses of our results show that parental consanguinity, family history of CHD, maternal co-morbidities, first born child and low birth weight are independent riskfactors for CHD.
Abstract Background Early childhood obesity, like other health disparities, disproportionately affects low-income populations. The purpose of this study is to determine the association between maternal sociodemographic factors and child overweight and obesity in a sample of low-income Mexican Americans. Methods The current study is a secondary analysis of baseline data that were collected as part of a longitudinal study of 374 children aged 12–24 months receiving Women, Infants, and Children (WIC) services in a large metropolitan area in central/south Texas. Measures used in this secondary analysis were: Measured weight and height of the child and mother to calculate weight-for-stature and BMI, respectively; maternal sociodemographic variables (age, education, marital status, employment status, and nativity); maternal acculturation level; and child breastfed status. Descriptive statistics are reported as frequencies, percentages, means, and standard deviations (SD). Chi-squared Fisher exact tests assessed differences in maternalfactors by child weight (healthy weight and overweight). Odds ratios (OR), 95% confidence intervals (CI), and levels of significance are reported. Results Of the 372 mothers, most were young (mean age 26.1 years, SD=6.1), 47.3% had graduated high school, 33.6% were employed at the time of the study, and 72.1% were U.S. born. No significant differences were observed for the maternalfactors by child weight-for-stature z-score. However, maternal BMI statistically differed by child weight. Healthy weight mothers were more likely to have healthy weight children than overweight mothers. Maternal nativity and maternal acculturation were not statistically associated with child weight in this sample of low-income Mexican Americans. Conclusions The findings of the current study reinforce the importance of addressing the influence of maternal sociodemographic factors on child weight, in particular, maternal weight. A more comprehensive investigation of ecological factors' influence on obesity onset and control in young Mexican-American children is needed.
Roncancio, Angelica; Hinojosa, Martha B.; Reifsnider, Elizabeth
A case-control study of 712 Brazilian mother-baby pairs was performed to assess maternal nutritional factors, more specifically low or marginal concentrations of vitamin A, folate and iron, as riskfactors for intrauterine growth retardation (IUGR). Newborns were classified as being IUGR according to the Lubchenco classification. The gestational age of the newborns was evaluated by the Capurro method. Vitamin A, folate, ferritin and haemoglobin were measured by high-performance liquid chromatography, radioimmunoassay, immunoenzymetric assay and by the cyanmethaemoglobin method respectively. The relationship between maternal nutritional status and IUGR was investigated using stratification and logistic regression. According to the final logistic regression model, the riskfactors for IUGR were: maternal body weight, per capita income, cigarette smoking, maternal weight gain, prior history of low birthweight, high maternal ferritin, beer intake and coffee intake. Specific interventions likely to have the major short-term impact in this region are not directly related to nutritional factors, but to efforts to reduce or eliminate toxic exposures. Over the long term, improvement in maternal nutritional status and socioeconomic conditions would be expected to produce important benefits. PMID:9131708
Rondó, P H; Abbott, R; Rodrigues, L C; Tomkins, A M
The present research work aims to study the effect of young maternal age on the prevalence of sexually transmitted diseases (STDs) and anaemia using National Family Health Survey-3 (NFHS-3) data for India. Analysis has been done for currently married women in the reproductive age group and who had their first birth in the age group 29 or below. Data have
Increased incidence of schizophrenia has been observed following maternal infections with either viral or bacterial pathogens during pregnancy. This suggests that infection during pregnancy might contribute to the pathophysiology of schizophrenia through adverse effects on brain development. Animal models in which live viruses, bacterial endotoxin or viral mimics are administered during pregnancy have begun to delineate acute and long term
The present study examined riskfactors for depression during pregnancy in a very large population sample. Two research questions\\u000a have been addressed: first, the association between demographic factors and past negative obstetrical outcomes on depression\\u000a severity scores, and second, the differences in these factors between women recruited at a university medical center and maternal\\u000a health centers (MHC). The study included
Hristina Koleva; Scott Stuart; Michael W. O’Hara; Jennifer Bowman-Reif
BACKGROUND: Utilization of maternal health services is associated with improved maternal and neonatal health outcomes. Considering global and national interests in the Millennium Development Goal and Nigeria's high level of maternal mortality, understanding the factors affecting maternal health use is crucial. Studies on the use of maternal care services have largely overlooked community and other contextual factors. This study examined
ObjectiveTo investigate the influence of maternal working conditions on fertility and pregnancy outcomes.Methods8880 women were enrolled in a large prospective birth cohort during early (76%), mid (21%) or late pregnancy (3%) (61% participation). Complete questionnaire information was available for 6302 women (71% response). Outcomes were prolonged time to pregnancy (TTP) (>6 months), preterm birth (<37 weeks) and decreased birth weight
A Burdorf; T Brand; V W Jaddoe; A Hofman; J P Mackenbach; E A P Steegers
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The recurrence of cerebral palsy in the same family is uncommon. We, however, report on two families with two or more affected siblings. In both families, numerous potential riskfactors were identified including environmental, obstetric, and possible maternal effects. We hypothesize that multiple riskfactors may lead to the increased risk of recurrence of cerebral palsy in families. Intrinsic and maternalriskfactors should be investigated in all cases of cerebral palsy to properly counsel families on the risk of recurrence. Recent studies of genetic polymorphisms associated with cerebral palsy are considered with reference to our observations in these two families.
Richer, Lawrence P.; Dower, Nancy A.; Leonard, Norma; Chan, Alicia K. J.; Robertson, Charlene M. T.
Background A significant association between parental PTSD and the occurrence of PTSD in offspring has been noted, consistent with the idea that risk for PTSD is transmitted from parent to child. Two recent reports linking maternal PTSD and low cortisol in offspring prompted us to examine the relative contributions of maternal vs. paternal PTSD in the prediction of PTSD and other psychiatric diagnoses. Methods 117 men and 167 women, recruited from the community, were evaluated using a comprehensive psychiatric battery designed to identify traumatic life experiences and lifetime psychiatric diagnoses. 211 of the subjects were the adult offspring of Holocaust survivors and 73 were demographically comparable Jewish controls. Participants were further subdivided based on whether their mother, father, neither, or both parents met the diagnostic criteria for lifetime PTSD. Results A higher prevalence of lifetime PTSD, mood, anxiety disorders, and to a lesser extent, substance abuse disorders, was observed in offspring of Holocaust than controls. The presence of maternal PTSD was specifically associated with PTSD in adult offspring. However, the other diagnoses did not show specific effects associated with maternal PTSD. Conclusion The tendency for maternal PTSD to make a greater contribution to PTSD risk suggests that classic genetic mechanisms are not the sole model of transmission, and pave way for the speculation that epigenetic factors may be involved. In contrast, PTSD in any parent contributes to risk for depression, and parental traumatization is associated with increased anxiety disorders in offspring.
Yehuda, Rachel; Bell, Amanda; Bierer, Linda M.; Schmeidler, James
Summary Maternal obesity in pregnancy has been linked with several adverse outcomes in offspring including schizophrenia. The rising prevalence of obesity may contribute to an increase in the number of schizophrenia cases in the near future; therefore, it warrants further exploration. We reviewed current evidence regarding maternal body mass index (BMI) in pregnancy and risk of schizophrenia in adult offspring. We searched PubMed and Embase databases and included studies that were based on large and representative population-based datasets. A qualitative review was undertaken due to heterogeneity between studies. Four studies with 305 cases of schizophrenia and 24,442 controls were included. Maternal obesity (pre-pregnant BMI over 29 or 30 compared with mothers with low or average BMI) was associated with two- to threefold increased risk of schizophrenia in the adult offspring in two birth cohorts. High maternal BMI at both early and late pregnancy also increased risk of schizophrenia in the offspring. Discrepant findings from one study could be attributable to sample characteristics and other factors. The area needs more research. Future studies should take into account obstetric complications, diabetes, maternal infections and immune responses that might potentially mediate this association.
Relationship between major riskfactors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro?environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre?term delivery and\\/or infant low birth weight, prone sleep position, maternal smoking during pregnancy, and infant–parent(s) bed?sharing are among well?established riskfactors of SIDS.
Preeclampsia is a leading cause of perinatal morbidity and mortality. This disorder is thought to be multifactorial in origin, with multiple genes, environmental and social factors, contributing to disease. One proposed mechanism is placental hypoxia-driven imbalances in angiogenic and anti-angiogenic factors, causing endothelial cell dysfunction. Catechol-O-methyltransferase (Comt)-deficient pregnant mice have a preeclampsia phenotype that is reversed by exogenous 2-methoxyestradiol (2-ME), an estrogen metabolite generated by COMT. 2-ME inhibits Hypoxia Inducible Factor 1?, a transcription factor mediating hypoxic responses. COMT has been shown to interact with methylenetetrahydrofolate reductase (MTHFR), which modulates the availability of S-adenosylmethionine (SAM), a COMT cofactor. Variations in MTHFR have been associated with preeclampsia. By accounting for allelic variation in both genes, the role of COMT has been clarified. COMT allelic variation is linked to enzyme activity and four single nucleotide polymorphisms (SNPs) (rs6269, rs4633, rs4680, and rs4818) form haplotypes that characterize COMT activity. We tested for association between COMT haplotypes and the MTHFR 677 C?T polymorphism and preeclampsia risk in 1103 Chilean maternal-fetal dyads. The maternal ACCG COMT haplotype was associated with reduced risk for preeclampsia (P?=?0.004), and that risk increased linearly from low to high activity haplotypes (P?=?0.003). In fetal samples, we found that the fetal ATCA COMT haplotype and the fetal MTHFR minor “T” allele interact to increase preeclampsia risk (p?=?0.022). We found a higher than expected number of patients with preeclampsia with both the fetal risk alleles alone (P?=?0.052) and the fetal risk alleles in combination with a maternal balancing allele (P<0.001). This non-random distribution was not observed in controls (P?=?0.341 and P?=?0.219, respectively). Our findings demonstrate a role for both maternal and fetal COMT in preeclampsia and highlight the importance of including allelic variation in MTHFR.
Hill, Lori D.; York, Timothy P.; Kusanovic, Juan P.; Gomez, Ricardo; Eaves, Lindon J.; Romero, Roberto; Strauss, Jerome F.
Current research provides evidence that a higher prevalence of obesity, a more centralized fat pattern and a clustering of cardiovascular riskfactors (i.e., overweight/obesity, hypertension, hyperinsulinemia, insulin resistance, dyslipidemia, neurohumora...
Objective A systematic review was conducted to assess the possible association between omega-3 polyunsaturated fatty acid (PUFA) supplementation and intake in the perinatal period and the risk of maternal perinatal depression. Methods Two PubMed searches and a BIOSIS Preview, a Web of Science and a PsychInfo search were conducted with the search terms ‘DHA, pregnancy and depression’ and ‘omega-3 fatty acids, pregnancy and depression’. Results Ten articles – three longitudinal cohort studies, five randomized controlled trials and two pilot trials– that met selection criteria were reviewed. Six found no association, two found mixed results, and two found a positive association between omega-3 PUFAs and reduced incidence of maternal perinatal depression. The heterogeneity of results can be explained by dissimilar study designs, including differences in study duration, time period of measurement and number of participants, and in varied dosages and types of supplemental PUFAs. Some of the larger studies and those that found a positive effect were more likely to be using higher doses, close to 2 g of docosahexaeonic acid (DHA) + eicosapentaenoic acid (EPA), and began the supplementation earlier in pregnancy. Conclusions Future RCTs to investigate the role of PUFA supplementation and risk for maternal perinatal depression should begin supplementation early in pregnancy and use a dosage closer to 2 g of DHA + EPA. Depression should also be measured using a diagnostic interview schedule in addition to a screener.
The objective of this study was to examine the association between maternal asthma medication use during the periconceptional period and the risk of gastroschisis. In this case-control study, the authors used data on deliveries enrolled in the National Birth Defects Prevention Study (1997-2002) from eight collaborating centers. The cases included 381 infants with isolated gastroschisis, and the controls were 4,121
Shao Lin; Jean Pierre; W. Munsie; Michele L. Herdt-Losavio; Erin Bell; Charlotte Druschel; Paul A. Romitti; Richard Olney
This study examined the relation between maternal prepregnant body mass index (BMI) and development of schizophrenia and schizophrenia spectrum disorders in adult offspring from the Prenatal Determinants of Schizophrenia Study. The study drew on a previously studied cohort of births occurring between 1959 and 1967 to women enrolled in a prepaid health plan. Computerized treatment registries were used to identify possible cases of schizophrenia and spectrum disorders in adult offspring belonging to the health plan from 1981 to 1997. Diagnostic interviews and medical record reviews resulted in diagnosis of 63 cases of schizophrenia and spectrum disorders; these cases and 6,570 unrelated and unaffected cohort members whose mothers also had prepregnancy measures of BMI comprised the sample for analyses. High (> or = 30.0), compared with average (20.0-26.9), maternal prepregnant BMI (kg/m2) was significantly associated with schizophrenia and spectrum disorders in the adult offspring (relative risk [RR] = 2.9; 95% confidence interval [CI] 1.3-6.6), independently of maternal age, parity, race, education, or cigarette smoking during pregnancy. Low (< or = 19.9) maternal BMI was not associated with schizophrenia and spectrum disorders (RR = 1.2; 95% CI 0.64-2.2). Future studies of this cohort will examine factors that may help explain the relationship of high maternal prepregnant BMI with schizophrenia, including nutritional and metabolic factors, toxic exposures, and obstetrical complications. PMID:10885630
Schaefer, C A; Brown, A S; Wyatt, R J; Kline, J; Begg, M D; Bresnahan, M A; Susser, E S
Aims: To determine the factors that affect why some infants receive higher exposures relative to the mother's body burden than do others. Methods: A total of 159 mother-infant pairs from a cohort of women receiving prenatal care at Magee-Womens Hospital in Pittsburgh, PA from 1992 to 1995 provided blood samples at delivery for lead determination. The difference between cord and maternal blood lead concentration (PbB) and a dichotomous variable indicator of higher cord than maternal PbB, were examined as indicators of relative transfer. Women were interviewed twice during the pregnancy about lifestyle, medical history, calcium nutrition, and physical activity. Results: Higher blood pressure was associated with relatively greater cord compared with maternal PbB, as was maternal alcohol use. Sickle cell trait and higher haemoglobin were associated with a lower cord relative to maternal blood lead PbB. No association was seen with smoking, physical exertion, or calcium consumption. Conclusion: While reduction in maternal exposure will reduce fetal exposure, it may also be possible to mitigate infant lead exposure by reducing transfer from the pregnant woman. Interventions aimed at reducing blood pressure and alcohol consumption during pregnancy may be useful in this regard.
Harville, E; Hertz-Picciotto, I; Schramm, M; Watt-Morse, M; Chantala, K; Osterloh, J; Parsons, P; Rogan, W
To investigate reproductive maternalriskfactors of intrapartum fetal asphyxia, we analyzed 556 women with singleton pregnancies complicated by intrapartum fetal asphyxia who gave birth at Kuopio University Hospital from January 1990 to December 1998. The general obstetric population (N=21746) was selected as the reference group and logistic regression analysis was used to identify independent reproductive riskfactors. The incidence
Discovering genetic predictors of childhood acute lymphoblastic leukemia (ALL) necessitates the evaluation of novel factors including maternal genetic effects, which are a proxy for the intrauterine environment, and robust epidemiologic study designs. Therefore, we evaluated five maternal and offspring xenobiotic metabolism haplotypes and the risk of childhood ALL among 120 case-parent triads. Two of the five haplotypes were significantly associated with risk: GSTM3/GSTM4 (P=0.01) and GSTP1 (P=0.02). The EPHX1 haplotype was marginally associated with risk (P=0.05), whereas haplotypes in CYP1B1 and GSTA4 were not. Our results suggest genetic variation in xenobiotic metabolism is important in childhood ALL etiology. PMID:23433810
Nousome, Darryl; Lupo, Philip J; Okcu, M Fatih; Scheurer, Michael E
BACKGROUND: Fetal exposure to maternal diabetes mellitus (DM) is associated with high birth weight, congenital heart malformations, childhood adiposity, DM, hypertension and dyslipidemia. The long term cardiovascular consequences of fetal exposure to maternal DM during pregnancy and high birth weight are not known. METHOD: All individuals born in Sweden 1973-1988 (n=1,551,603) were included in the study. The Swedish Medical Birth Register was merged with the Swedish Prescribed Drug Register. The association between offspring's adult consumption of cardiovascular medication and i) maternal DM during pregnancy and ii) birth weight were analyzed. Follow up time ranged between 17 and 36years. RESULTS: Offspring exposed to maternal DM in utero had an increased risk of non-malformation cardiovascular disease (NMCVD), odds ratio (OR) 1.46 (95% confidence interval (CI) 1.16-1.83). After also excluding offspring with insulin dependent DM, no increased risk of NMCVD was found, OR 1.19 (95% CI 0.92-1.55). No increased risk of NMCVD was found in offspring born large for gestational age, OR 1.02 (95% CI 0.96-1.08). An increased risk of NMCVD was found in offspring born small for gestational age, OR 1.29 (95% CI 1.24-1.35). CONCLUSIONS: Exposure to maternal DM during pregnancy was not associated with NMCVD in offspring at a maximum of 36years of follow up. Low birth weight was confirmed to be a riskfactor for NMCVD while high birth weight was not. PMID:23562336
Stuart, Andrea; Amer-Wåhlin, Isis; Persson, Jonas; Källen, Karin
The relationship between maternal intrinsic factors and placental traits was investigated on three Southern Mediterranean breed of sheep; Cukurova Assaf (CA), Cukurova (C) and Cukurova Meat Sheep (CMS). The effect of parity and birth type were also considered in the study as a potential influencing factor. Our hypothesis was to show that while differences in placental traits between breed, parity and birth type affected lamb condition and survivability, its correlation to maternal intrinsic behavioral factors may also be a strong indicator. The study found breed related differences of maternal behavioral factors and also showed significant correlation of these behavioral patterns to various placental traits. It confirmed earlier findings that parity played a major role in the refinement of these behavioral patterns. Significant differences in birth weight (P<0.05), placental weight (P<0.05), number of cotyledons (P<0.01) and cotyledon length (P<0.05) was seen between breeds. Cotyledon weight (P<0.05), width (P<0.01) and length (P<0.05) were found to differ by parity. Breed and parity interaction significantly influenced cotyledon quantity. While we detected breed specific differences in relation to maternal intrinsic factors we also noticed significant variance within breeds to these behavioral patterns when linked to placental traits. Further study is required on the correlation between placental traits and postnatal behavior on not just the ewes but also on their lambs. This could have a significant bearing on how producers manage and maximize lamb survivability. PMID:23602010
Puerperal infections are an important cause of maternal morbidity and mortality in developing nations. Investigators have noted several riskfactors for developing puerperal sepsis. However, the relative importance of these riskfactors varies and has to be determined for each setting. Therefore the aim of the present work was to determine the riskfactors for puerperal sepsis in Alexandria, Egypt. A case-control design was used to study the riskfactors of puerperal sepsis in Alexandria. The study included 160 puerperal sepsis cases and 160 controls. Puerperal sepsis cases were recruited from the fever hospital as well as from 3 rural health units and three urban health offices in Alexandria. A pre-designed interviewing questionnaire was used to collect data about riskfactors of puerperal sepsis. Logistic regression analysis indicated that very low socio-economic score (OR = 6.4), no ANC (OR = 4.5), delivery at a governmental maternity hospital (OR = 203.4), frequent vaginal examinations (OR = 5.1), anemia during puerperium (OR = 4.3), unsanitary vaginal douching during puerperium (OR = 19.9) and unhygienic preparation of diapers used immediately after delivery (OR = 12.1) were significantly related to the occurrence of puerperal sepsis. Improving infection control measures during delivery, limiting the frequency of vaginal examinations, and avoiding all unhygienic practices related to delivery are strongly recommended. PMID:16918152
El-Mahally, Azza A; Kharboush, Ibrahim F; Amer, Naila H; Hussein, Mohamed; Abdel Salam, Tawfik; Youssef, Adel A
The risk of progression from exposure to the tuberculosis bacilli to the development of active disease is a two-stage process governed by both exogenous and endogenous riskfactors. Exogenous factors play a key role in accentuating the progression from exposure to infection among which the bacillary load in the sputum and the proximity of an individual to an infectious TB case are key factors. Similarly endogenous factors lead in progression from infection to active TB disease. Along with well-established riskfactors (such as human immunodeficiency virus (HIV), malnutrition, and young age), emerging variables such as diabetes, indoor air pollution, alcohol, use of immunosuppressive drugs, and tobacco smoke play a significant role at both the individual and population level. Socioeconomic and behavioral factors are also shown to increase the susceptibility to infection. Specific groups such as health care workers and indigenous population are also at an increased risk of TB infection and disease. This paper summarizes these factors along with health system issues such as the effects of delay in diagnosis of TB in the transmission of the bacilli.
Schizophrenia and human leukocyte antigen (HLA) matching between couples or between mothers and offspring have independently been associated with prenatal\\/obstetric complications, including preeclampsia and low birth weight. Here, we report the results of a family-based candidate-gene study that brings together these two disparate lines of research by assessing maternal-fetal genotype matching at HLA-A, -B, and -DRB1 as a riskfactor
Christina G. S. Palmer; Hsin-Ju Hsieh; Elaine F. Reed; Jouko Lonnqvist; Leena Peltonen; J. Arthur Woodward; Janet S. Sinsheimer
Objective: Childhood obesity is an ever increasing problem in today's modern world. This study aimed at trying to recognize the role of maternal, child and family factors in childhood obesity. Methods: There were 2 groups in the study, the study group comprising of 80 obese primary school boys and their mothers and the control group that comprised of 80 normal
This study examined the factors that influence the use of maternal healthcare services in Ethiopia and particularly assessed the use of antenatal and delivery-care services. Data for the study were drawn from the 2000 Ethiopia Demographic and Health Survey. Multivariate logistic regression analysis was employed to explore the relative importance of a number of demographic and sociocultural variables in the
Two studies examined the nature and processes underlying the joint role of interparental aggression and maternal antisocial personality as predictors of children's disruptive behavior problems. Participants for both studies included a high-risk sample of 201 mothers and their 2-year-old children in a longitudinal, multimethod design. Addressing the form of the interplay between interparental aggression and maternal antisocial personality as riskfactors for concurrent and prospective levels of child disruptive problems, the Study 1 findings indicated that maternal antisocial personality was a predictor of the initial levels of preschooler's disruptive problems independent of the effects of interparental violence, comorbid forms of maternal psychopathology, and socioeconomic factors. In attesting to the salience of interparental aggression in the lives of young children, latent difference score analyses further revealed that interparental aggression mediated the link between maternal antisocial personality and subsequent changes in child disruptive problems over a 1-year period. To identify the family mechanisms that account for the two forms of intergenerational transmission of disruptive problems identified in Study 1, Study 2 explored the role of children's difficult temperament, emotional reactivity to interparental conflict, adrenocortical reactivity in a challenging parent-child task, and experiences with maternal parenting as mediating processes. Analyses identified child emotional reactivity to conflict and maternal unresponsiveness as mediators in pathways between interparental aggression and preschooler's disruptive problems. The findings further supported the role of blunted adrenocortical reactivity as an allostatic mediator of the associations between parental unresponsiveness and child disruptive problems. PMID:22781856
Davies, Patrick T; Sturge-Apple, Melissa L; Cicchetti, Dante; Manning, Liviah G; Vonhold, Sara E
A demographic study carried out in a rural area of the Gambia between January 1993 and December 1998 recorded 74 deaths among women aged 15-49 years. Reported here is an estimation of maternal mortality among these 74 deaths based on a survey of reproductive age mortality, which identified 18 maternal deaths by verbal autopsy. Over the same period there were 4245 live births in the study area, giving a maternal mortality ratio of 424 per 100,000 live births. This maternal mortality estimate is substantially lower than estimates made in the 1980s, which ranged from 1005 to 2362 per 100,000 live births, in the same area. A total of 9 of the 18 deaths had a direct obstetric cause--haemorrhage (6 deaths), early pregnancy (2), and obstructed labour (1). Indirect causes of obstetric deaths were anaemia (4 deaths), hepatitis (1), and undetermined (4). Low standards of health care for obstetric referrals, failure to recognize the severity of the problem at the community level, delays in starting the decision-making process to seek health care, lack of transport, and substandard primary health care were identified more than once as probable or possible contributing factors to these maternal deaths.
Walraven, G.; Telfer, M.; Rowley, J.; Ronsmans, C.
In order to make appropriate decisions, patients must be able to understand and use the context-specific health information with which they have been provided, and health providers must be able to convey information to patients who possess varying degrees of health literacy. Adherence to medical recommendations often depends on patient perception of their medical risks and the importance they attach to those risks. In obstetrics, maternity patients are generally identified as high risk or non-high risk (routine). Conferring the designation of "high risk" may confer additional benefits in educational efforts, literacy evaluation, and relief of educational barriers to care that are reflected in high-risk patients' higher assessments of their risks. In this study, medically identified riskfactors were reviewed for patients in the high-risk and routine obstetrical clinics. Patients labeled as "routine" might still possess significant numbers and types of medically identified riskfactors (MIFs) due to patients' socioeconomic status and health risks. If prenatal risk is a spectrum, adaptation of obstetrical health care materials and culturally appropriate counseling may mitigate gaps between patient understanding of their MIF number and type and patient risk perception in order to reach the goal of universally improved patient adherence to medical recommendations. PMID:19860304
Background Maternal allergy is believed to be a riskfactor for peanut allergy (PNA) in children. However, there is no direct evidence of maternal transmission of PNA susceptibility, and it is unknown whether maternal peanut (PN) exposure affects the development of PNA in offspring. Objective To investigate the influence of maternal PNA on offspring reactions to the first PN exposure, and whether maternal low dose PN exposure during pregnancy and lactation influences these reactions and PN sensitization in a murine model. Methods Five-week-old offspring of PNA C3H/HeJ mothers (PNA-M) were challenged intragastrically (i.g.) with PN (first exposure), and reactions were determined. In a subset of the experiment, PNA-M were fed low dose of PN (PNA-M/PN) or not fed PN (PNA-M/none) during pregnancy and lactation. Their 5-week-old offspring were challenged intragastrically with PN, and reactions were determined. In another subset of the experiment, offspring of PNA-M /PN or PNA-M/none were sensitized with PN i.g. for 6 weeks and serum PN-specific antibodies were determined. Results PNA-M offspring exhibited anaphylactic reactions at first exposure to PN which were associated with PN-specific IgG1 levels, and prevented by a platelet activation factor antagonist. In a subset experiment, PNA-M/PN offspring showed significantly reduced first exposure PN reactions, increased IgG2a, and reduced mitogen-stimulated splenocyte cytokine production compared to PNA-M/none offspring. In additional experiment, PNA-M/PN offspring showed reduction of PN-specific IgE to active PN sensitization. Conclusion We show for the first time maternal transmission of susceptibility to first exposure PN reactions and active PN sensitization. Low dose PN exposure during pregnancy and lactation reduced this risk. Clinical Implications Maternal peanut allergy is a riskfactor for offspring peanut anaphylaxis in a mouse model. Low dose peanut exposure during pregnancy and lactation reduced first PN exposure reactions, and inhibited active peanut sensitization after weaning. Capsule Summary Low dose peanut exposure of peanut allergic mice during pregnancy and lactation reduced susceptibility of offspring to peanut allergy. Strict avoidance of PN and other food allergens during pregnancy and lactation may be counterproductive.
We performed a large nested case-control study within the Finnish and Icelandic maternity cohorts to verify/falsify the association of maternal EBV infection with an increased risk of acute lymphoblastic leukemia (ALL) in the offspring found in previous studies. All hematologic malignancies diagnosed among children born during 1983 to 2006 in Finland and 1997 to 2005 in Iceland were identified through national cancer registries. For each index mother of a leukemia case, three matched control mothers with cancer-free offspring were identified. First trimester sera from 561 ALL and 144 non-ALL index mothers and from 2,105 control mothers were analyzed for antibodies to EBV viral capsid antigen (IgG and IgM), early antigen (IgG) and ZEBRA protein (IgG). Conditional logistic regression-based estimates of odds ratios and 95% confidence intervals adjusted for birth order and sib-ship size were calculated. Overall, there was no evidence of increased risk of ALL associated to EBV viral capsid antigen IgM (odds ratio, 0.9; 95% confidence interval, 0.5-1.8). The early antigen and ZEBRA antibodies (EBV reactivation markers) were also not associated with risk. The data argue against a role of EBV in ALL. PMID:19755652
Riskfactors for Type 2 diabetes; Diabetes riskfactors ... You have a higher risk for diabetes if you have any of the following: Age greater than 45 years Diabetes during a previous pregnancy Excess body weight (especially around ...
Perioperative anaphylactic as well as anaphylactoid reactions can be elicited by drugs, diagnostic agents, antiseptics, disinfectants and latex. In some individuals, allergic reactions occur in the absence of any evident riskfactor. Previous history of specific safe exposure to a product does not permit to exclude the risk of having a reaction. We have systematically reviewed characteristics in the patient's history or clinical parameters that affect the risk of developing reactions during anesthesia. Evidence shows that patients with previous unexplained reaction during anesthesia are at risk for perioperative allergic reactions. An allergic reaction to an agent is associated with previous reaction to a product that is related with the culprit agent. Multiple surgery procedures, professional exposure to latex and allergy to fruit are associated with an increased frequency of latex allergy. It has been shown that in some instances, allergic perioperative reactions may be more common in atopic patients and in females. PMID:22014923
Caffarelli, C; Stringari, G; Pajno, G B; Peroni, D G; Franceschini, F; Dello Iacono, I; Bernardini, R
Background Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternalfactors associated with children who screened at risk of developmental problems at school entry. Methods An existing cohort of 791 mothers who had been followed since early pregnancy was mailed a questionnaire when the children were aged four to six years. The questionnaire included a screening tool for developmental problems, an assessment of the child's social competence, health care utilization and referrals, and maternalfactors, including physical health, mental health, social support, parenting morale and sense of competence, and parenting support/resources. Results Of the 491 mothers (62%) who responded, 15% had children who were screened at high risk of developmental problems. Based on a logistic regression model, independent predictors of screening at high risk for developmental problems at age 5 were male gender (OR: 2.3; 95% CI: 1.3, 4.1), maternal history of abuse at pregnancy (OR: 2.4; 95% CI: 1.3, 4.4), and poor parenting morale when the child was 3 years old (OR: 3.9; 95% CI: 2.1, 7.3). A child with all of these riskfactors had a 35% predicted probability of screening at high risk of developmental problems, which was reduced to 13% if maternalfactors were favourable. Conclusions Riskfactors for developmental problems at school entry are related to maternal well being and history of abuse, which can be identified in the prenatal period or when children are preschool age.
Maternal smoking during pregnancy is associated with attention deficit hyperactivity disorder (ADHD) in offspring. It is assumed by many that this association is causal. Others suggest that observed associations are due to unmeasured genetic factors or other confounding factors. The authors compared risks of maternal smoking during pregnancy with those of paternal smoking during pregnancy. With a causal intrauterine effect, no independent association should be observed between paternal smoking and offspring ADHD. If the association is due to confounding factors, risks of offspring ADHD should be of similar magnitudes regardless of which parent smokes. This hypothesis was tested in 8,324 children from a well-characterized United Kingdom prospective cohort study, the Avon Longitudinal Study of Parents and Children (data from 1991-2000). Associations between offspring ADHD and maternal and paternal smoking during pregnancy were compared using regression analyses. Offspring ADHD symptoms were associated with exposure to both maternal and paternal smoking during pregnancy (mothers: ? = 0.25, 95% confidence interval: 0.18, 0.32; fathers: ? = 0.21, 95% confidence interval: 0.15, 0.27). When paternal smoking was examined in the absence of maternal smoking, associations remained and did not appear to be due to passive smoking exposure in utero. These findings suggest that associations between maternal smoking during pregnancy and child ADHD may be due to genetic or household-level confounding rather than to causal intrauterine effects. PMID:22791738
Langley, Kate; Heron, Jon; Smith, George Davey; Thapar, Anita
Background: Elevated morning cortisol is a prospective predictor of major depression and may serve as a vulnerability marker. We examined the relation between morning cortisol and two prominent riskfactors for depression in preschool-aged children: maternal depression and child temperament. We also explored whether maternal depression during the…
Dougherty, Lea R.; Klein, Daniel N.; Olino, Thomas M.; Dyson, Margaret; Rose, Suzanne
|Background: Elevated morning cortisol is a prospective predictor of major depression and may serve as a vulnerability marker. We examined the relation between morning cortisol and two prominent riskfactors for depression in preschool-aged children: maternal depression and child temperament. We also explored whether maternal depression during the…
Dougherty, Lea R.; Klein, Daniel N.; Olino, Thomas M.; Dyson, Margaret; Rose, Suzanne
N-nitroso compounds and their precursors, nitrites and nitrates, have been hypothesized as riskfactors, and vitamins C and E, which inhibit N-nitroso formation, as protective factors for brain tumors. A case-control study of maternal diet during pregnancy and risk of astrocytoma, the most common childhood brain tumor, was conducted by the Childrens Cancer Group. The study included 155 cases under
Greta R. Bunin; René R. Kuijten; Carl P. Boesel; Jonathan D. Buckley; Anna T. Meadows
Objective: To investigate the associations of birth characteristics and maternal reproductive factors with risk of childhood acute lymphoblastic leukemia (ALL) by immunophenotypic subtypes. Methods: Data collected from a case–control study including 1842 ALL cases (age Results: Factors associated with risk of ALL from all subgroups combined included high birth weight (OR = 1.4, 95% CI = 1.1–1.8), high birth order
Xiao Ou Shu; Dehui Han; Richard K. Severson; Zhi Chen; Joseph P. Neglia; Gregory H. Reaman; Jonathan D. Buckley; Leslie L. Robison
Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain riskfactors. The aims of this review are to describe modifiable riskfactors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared riskfactors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable riskfactors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable riskfactors associated with both autism and schizophrenia. We identified three modifiable riskfactors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a riskfactor for schizophrenia in a single meta-analysis and as a riskfactor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risksfactors for autism whilst a meta-analysis of eight studies identified obstetric complications as a riskfactor for schizophrenia. Migrant status was identified as a riskfactor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic riskfactors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. PMID:23123588
Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James
Statewide birth certificate and preschool exceptionality records were integrated to identify riskfactors for developmental delay (DD). Epidemiological methods were used to investigate both individual-level and population-level risk for DD associated with a number of child and maternalfactors. Infants born with very low birth weight were at the greatest individual-level risk for DD, whereas prematurity (gestational age less than
Christine E. F. Delgado; Sara J. Vagi; Keith G. Scott
We analyzed data from a population-based case control study to determine whether maternal prenatal smoking or alcohol drinking might increase the risk of craniosynostosis. Between 1986 and 1989, the Colorado Craniosynostosis Registry ascertained 233 children whose diagnoses were confirmed by an independent radiologist. Of the 212 (91%) cases who participated 86 had lambdoid, 69 had sagittal, 25 had coronal, 18 had metopic, and 14 had multiple suture synostosis. Random sampling of birth certificate records yielded 367 eligible controls, of whom 291 (79%) participated. Study staff interviewed case and control mothers between 1989 and 1991 for prenatal smoking and alcohol drinking. We used Mantel-Haenszel and polychotomous logistic regression techniques to estimate the relative odds of craniosynostosis for smoking and drinking in all cases and in relevant case subgroups. Smoking was associated with a relative odds of craniosynostosis of 1.7 (95% confidence interval, 1.2-2.6). For smoking of more than one pack per day, the relative odds were 3.5 (1.5-8.4) for all types of synostosis combined, and 5.6 (2.1-15.3) for coronal synostosis. No strong or significant association was noted for drinking. Maternal prenatal smoking may increase the risk of craniosynostosis in this population. PMID:7974250
Alderman, B W; Bradley, C M; Greene, C; Fernbach, S K; Barón, A E
In the United States, stroke accounts for 160,000 annual deaths; only 16% of the 1.8 million stroke survivors are fully independent. The incidence of stroke increases with age. Hemorrhagic strokes outnumber ischemic strokes before age 15. Japanese men in this country have a lower stroke mortality than their age peers in Japan. Excessive stroke mortality for US nonwhites may not be entirely due to the greater prevalence of hypertension among blacks. Hypertension emerges as the single most powerful and reversible riskfactor in stroke and for survival after stroke. Impaired cardiac function is the second most important precursor of stroke. The recurrence of stroke in survivors is high. The frequency of completed stroke is high in persons with transient ischemic attacks, but not in those with asymptomatic carotid bruits. Other reversible riskfactors are smoking, the use of oral contraceptives, alcoholic excess, a low level of physical activity, blood hyperviscosity and drug abuse.
Background Significant health inequities exist around maternal and infant health for M?ori, the indigenous people of New Zealand. The infants of M?ori are more likely to die in their first year of life and also have higher rates of hospital admission for respiratory illnesses, with the greatest burden of morbidity being due to bronchiolitis in those under one year of age. Timely immunisations can prevent some respiratory related hospitalisations, although for M?ori, the proportion of infants with age appropriate immunisations are lower than for non-M?ori. This paper describes the protocol for a retrospective cohort study that linked local hospital and national health information datasets to explore maternalriskfactors and obstetric outcomes in relation to respiratory admissions and timely immunisations for infants of M?ori and non-M?ori women. Methods/Design The study population included pregnant women who gave birth in hospital in one region of New Zealand between 1995 and 2009. Routinely collected local hospital data were linked via a unique identifier (National Health Index number) to national health information databases to assess rates of post-natal admissions and access to health services for M?ori and non-M?ori mothers and infants. The two primary outcomes for the study are: 1. The rates of respiratory hospitalisations of infants (? 1 yr of age) calculated for infants of both M?ori and non-M?ori women (for mothers under 20 years of age, and overall) accounting for relationship to parity, maternal age, socioeconomic deprivation index, maternal smoking status. 2. The proportion of infants with age appropriate immunisations at six and 12 months, calculated for both infants born to M?ori women and infants born to non-M?ori women, accounting for relationship to parity, maternal age, socioeconomic deprivation index, smoking status, and other riskfactors. Discussion Analysis of a wide range of routinely collected health information in which maternal and infant data are linked will allow us to directly explore the relationship between key maternalfactors and infant health, and provide a greater understanding of the causes of health inequalities that exist between the infants of M?ori and non-M?ori mothers.
This study compares the maternal sociodemographic and prenatal care characteristics and birth outcomes of US resident white and Japanese-American mothers, using data from the state of Hawaii. The specific focus is to determine to what extent these factors can explain variations in newborn maturity and mortality indicators. Single livebirths to resident, non-military dependent white and Japanese-American mothers were selected for analysis from the 1979-1990 linked livebirth-infant death files from Hawaii. Compared with white mothers, Japanese-American mothers were significantly more likely to be married, age 18 years and older, have higher educational attainment, and have adequate prenatal care utilisation. The majority of Japanese-American mothers were born in Hawaii, while the majority of white mothers were born on the US mainland. The mean birthweight of Japanese-American infants was 200 g lighter than that of white infants. Infant mortality rates (IMRs) for both groups were below the US Year 2000 Health Objective. After controlling for maternal sociodemographic and prenatal care factors with logistic regression, Japanese-American infants had significantly higher risks of low birthweight, preterm and very preterm birth and of being small-for-gestational age. These findings indicate that populations with preferential maternal sociodemographic and prenatal care risk indicators may still exhibit higher low birthweight percentages, but achieve comparatively low IMRs. PMID:7724414
Mor, J M; Alexander, G R; Kogan, M D; Kieffer, E C; Ichiho, H M
Women who take folic acid periconceptionally reduce their risk of having a child with a neural tube defect (NTD) by 150%. A variant form of methylenetetrahydrofolate reductase (MTHFR) (677CrT) is a known riskfactor for NTDs, but the prevalence of the risk genotype explains only a small portion of the protective effect of folic acid. This has prompted the search
Lawrence C. Brody; Mary Conley; Christopher Cox; Peadar N. Kirke; Mary P. McKeever; James L. Mills; Anne M. Molloy; Valerie B. O’Leary; Anne Parle-McDermott; John M. Scott; Deborah A. Swanson
|The authors review research on riskfactors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized riskfactor over onset of the disorder is established. They illustrate how studies of sociocultural riskfactors and biological factors have progressed on parallel tracks and propose that major…
The authors review research on riskfactors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized riskfactor over onset of the disorder is established. They illustrate how studies of sociocultural riskfactors and biological factors have progressed on parallel tracks and propose that major advances in understanding the etiology of eating disorders require
A community-based survey on maternal mortality was carried out in the Ejisu health district of Ghana in January and February 1990 to identify all women who died in pregnancy, delivery or the puerperium from January 1985 to December 1989, determine their characteristics, the presumptive causes of death and related factors. Forty-four women who died in pregnancy, delivery or the puerperium were identified over the stated period. 59% were aged between 20 and 34 years. Eighty-two percent were married and sixty-six percent had at least primary education. Based on an average crude birth rate of 40 per 1000 population for the district over the period, the lowest maternal mortality rate occurred in 1988, 120 per 100,000 total births and the highest occurred a year later, 235 per 100,000 total births. The main presumptive causes of maternal mortality in the district were postpartum haemorrhage 45.5%, jaundice in pregnancy 22.7%, obstructed labour 6.8%, eclampsia 6.8% and fever 4.6%. 59% of them died in a hospital, 2% died at a Government Maternity Home and 7% died during referral from health facilities in the district. Thirty-four percent of the women who died did not attend any antenatal clinic. The actual number of deaths may be underestimated due to the sampling method used and the difficulties encountered in linking survey data with hospital records. Based on the survey findings and other related PMM research, plans have been developed to reduce maternal mortality in the district as outline in the conclusion. PMID:7821246
Martey, J O; Djan, J O; Twum, S; Browne, E N; Opoku, S A
Perfluoroalkyl substances (PFASs) can cross the placenta, enter fetal circulation, and were found to correlate with adverse fetal growth. However, determinants of cord blood PFASs are not fully characterized. The study aimed to explore the association between PFASs and neonatal-maternalfactors within a Taiwanese birth cohort. We selected subjects from Taiwan Birth Panel Study, which enrolled 486 infant-mother pairs in 2004-2005. We collected cord blood and analyzed perfluorooctanoic acid (PFOA), perfluorooctanyl sulfonate (PFOS), perfluorononanoic acid (PFNA) and perfluoroundecanoic acid (PFUA) using a simple protein precipitation and an ultra-high performance liquid chromatography/tandem mass spectrometry. We retrieved information pertaining to maternal socio-demographics, lifestyle- and dietary-related factors through structured questionnaires during the postpartum hospital stay. A total of 439 subjects, with 90% response rate, have completed serum analysis and questionnaire survey. The median concentrations for PFOA, PFOS, PFNA, and PFUA in cord blood were 1.86, 5.67, 3.00, and 13.5ngmL(-1), respectively. After adjusting for potential confounders, multiple linear regression models revealed that log10-PFOA was positively associated with maternal age (?=0.011) and negatively associated with multiparity (?=-0.044). Log10-PFOS was negatively correlated with birth weight (?=-0.011) and higher maternal education (senior high school: ?=-0.067; university: ?=-0.088). Log10-PFUA tended to negatively associate with gender, male infants (?=-0.075), and using cosmetics during pregnancy (?=-0.065). Interestingly, presence of cockroaches in the home was positively associated with log10-PFOA (?=0.041) and 1og10-PFNA (?=0.123). In conclusion, this study demonstrated several factors to correlate with cord blood PFASs and further investigation are still needed for confirmation of exposure routes. PMID:23689097
Objective To assess the risks and benefits associated with caesarean delivery compared with vaginal delivery. Design Prospective cohort study within the 2005 WHO global survey on maternal and perinatal health. Setting 410 health facilities in 24 areas in eight randomly selected Latin American countries; 123 were randomly selected and 120 participated and provided data Participants 106?546 deliveries reported during the three month study period, with data available for 97?095 (91% coverage). Main outcome measures Maternal, fetal, and neonatal morbidity and mortality associated with intrapartum or elective caesarean delivery, adjusted for clinical, demographic, pregnancy, and institutional characteristics. Results Women undergoing caesarean delivery had an increased risk of severe maternal morbidity compared with women undergoing vaginal delivery (odds ratio 2.0 (95% confidence interval 1.6 to 2.5) for intrapartum caesarean and 2.3 (1.7 to 3.1) for elective caesarean). The risk of antibiotic treatment after delivery for women having either type of caesarean was five times that of women having vaginal deliveries. With cephalic presentation, there was a trend towards a reduced odds ratio for fetal death with elective caesarean, after adjustment for possible confounding variables and gestational age (0.7, 0.4 to 1.0). With breech presentation, caesarean delivery had a large protective effect for fetal death. With cephalic presentation, however, independent of possible confounding variables and gestational age, intrapartum and elective caesarean increased the risk for a stay of seven or more days in neonatal intensive care (2.1 (1.8 to 2.6) and 1.9 (1.6 to 2.3), respectively) and the risk of neonatal mortality up to hospital discharge (1.7 (1.3 to 2.2) and 1.9 (1.5 to 2.6), respectively), which remained higher even after exclusion of all caesarean deliveries for fetal distress. Such increased risk was not seen for breech presentation. Lack of labour was a riskfactor for a stay of seven or more days in neonatal intensive care and neonatal mortality up to hospital discharge for babies delivered by elective caesarean delivery, but rupturing of membranes may be protective. Conclusions Caesarean delivery independently reduces overall risk in breech presentations and risk of intrapartum fetal death in cephalic presentations but increases the risk of severe maternal and neonatal morbidity and mortality in cephalic presentations.
Advances have been made in identifying genetic etiologies of congenital heart defects. Through this knowledge, preventive strategies have been designed and instituted, and prospective parents are counseled regarding their risk of having an affected child. Great strides have been made in genetic variant identification, and genetic susceptibility to environmental exposures has been hypothesized as an etiology for congenital heart defects. Unfortunately, similar advances in understanding have not been made regarding strategies to prevent nongenetic riskfactors. Less information is available regarding the potential adverse effect of modifiable riskfactors on the fetal heart. This review summarizes the available literature on these modifiable exposures that may alter the risk for congenital heart disease. Information regarding paternal characteristics and conditions, maternal therapeutic drug exposures, parental nontherapeutic drug exposures, and parental environmental exposures are presented. Factors are presented in terms of risk for congenital heart defects as a group. These factors also are broken down by specific defect type. Although additional investigations are needed in this area, many of the discussed riskfactors present an opportunity for prevention of potential disease. PMID:23963188
Background Recruitment of eligible participants remains one of the biggest challenges to successful completion of randomised controlled trials (RCTs). Only one third of trials recruit on time, often requiring a lengthy extension to the recruitment period. We identified factors influencing recruitment success and potentially effective recruitment strategies. Methods We searched MEDLINE and EMBASE from 1966 to December Week 2, 2006, the Cochrane Library Methodology Register in December 2006, and hand searched reference lists for studies of any design which focused on recruitment to maternal/perinatal trials, or if no studies of maternal or perinatal research could be identified, other areas of healthcare. Studies of nurses' and midwives' attitudes to research were included as none specifically about trials were located. We synthesised the data narratively, using a basic thematic analysis, with themes derived from the literature and after discussion between the authors. Results Around half of the included papers (29/53) were specific to maternal and perinatal healthcare. Only one study was identified which focused on factors for maternal and perinatal clinicians and only seven studies considered recruitment strategies specific to perinatal research. Themes included: participant assessment of risk; recruitment process; participant understanding of research; patient characteristics; clinician attitudes to research and trials; protocol issues; and institutional or organisational issues. While no reliable evidence base for strategies to enhance recruitment was identified in any of the review studies, four maternal/perinatal primary studies suggest that specialised recruitment staff, mass mailings, physician referrals and strategies targeting minority women may increase recruitment. However these findings may only be applicable to the particular trials and settings studied. Conclusion Although factors reported by both participants and clinicians which influence recruitment were quite consistent across the included studies, studies comparing different recruitment strategies were largely missing. Trials of different recruitment strategies could be embedded in large multicentre RCTs, with strategies tailored to the factors specific to the trial and institution.
Tooher, Rebecca L; Middleton, Philippa F; Crowther, Caroline A
This longitudinal study examined whether the risk and positive factors contributing to the delinquent behaviors and internalizing\\u000a problems of 454 Latino adolescents varied across maternal linguistic acculturation and adolescent gender. Although the level\\u000a of cumulative risk to which the 10-to-14-year old adolescents were exposed did not vary by maternal linguistic acculturation,\\u000a the factors contributing to their subsequent adjustment 16 months
Alexandra Loukas; Marie-Anne Suizzo; Hazel M. Prelow
Background: Events during pregnancy and labour may influence the future health and well-being of offspring. Many studies rely on maternal reports of pre and peri-natal factors. Both maternal and child characteristics may potentially influence the reliability and accuracy of maternal recall. However, this has not been previously examined. Aims: To examine agreement between information from maternally reported questionnaires and medical
Frances Rice; Allyson Lewis; Gordon Harold; Marianne van den Bree; Jacky Boivin; Dale F. Hay; Michael J. Owen; Anita Thapar
Gender of a fetus is associated with maternal hormonal milieu and may therefore modify maternalrisk of ovarian cancer following a birth. We evaluated the relation between gender of offspring and mater- nal risk of epithelial ovarian cancer in a large case- control study nested within a nationwide cohort. Cohort members were identified in the Swedish Fertility Register. Cases of
Inkyung Baik; Mats Lambe; Qin Liu; Sven Cnattingius; Lorelei A. Mucci; Tomas Riman; Anders Ekbom; Hans-Olov Adami; Chung-Cheng Hsieh
AIMS AND OBJECTIVE: Evaluation of C677T polymorphisms of the methylenetetra hydrofolate reductase (MTHFR) gene and its association with level of serum homocysteine, folate, and vitamin B12 as possible maternalriskfactors for Down syndrome. DESIGN: This was a case–control study. MATERIAL AND METHODS Fifty-two mothers (mean age 27.6 years) with babies having free trisomy 21 of North Indian ethnicity and 52 control nonlactating mothers (mean age 24.9 years) of same ethnicity attending services of genetic lab for bloodletting for other causes were enrolled after informed written consent. Fasting blood was collected and was used for determination of plasma homocysteine, vitamin B12, and folate (serum and RBC), and for PCR amplification of the MTHFR gene. RESULTS: The prevalence of MTHFR C677T polymorphism in north Indian mothers of babies with trisomy 21 Down syndrome was 15.38% compared to 5.88 % in controls. The difference between two groups was not statistically significant (P = 0.124). Low serum folate was demonstrated in 34.62% of cases vs. 11.54% in controls, which was significant (P = 0.005). Low RBC folate was found in 30.7% of cases versus 11.53% in controls, which was not significant (P = 0.059), when analyzed independently. But on multiple regression analysis the difference was statistically significant. Low serum vitamin B12 was found in 42.31% of cases versus 34.62% in controls, which was not significant (P = 0.118). The mean serum homocysteine in cases was 10.35 ± 0.68 while controls were 9.02 ± 0.535. CONCLUSION: Serum levels of folate were low in cases. The RBC folate levels were comparable in both groups. However the combined serum folate and RBC folate were low in cases compared to control groups. Homocysteine levels in our study were higher in Down syndrome mothers compared to controls; however high-serum level of Homocysteine had no association with MTHFR polymorphism. No association of serum vitamin B12 with MTHFR polymorphism in occurrence of Down syndrome births was found. Peri- or preconceptional folate supplementation may therefore lead to a decline in DS births, if supported by larger studies.
Neural tube defects (NTDs) are common, serious malformations with a complex etiology that suggests involvement of both genetic and environmental factors. The authors evaluated maternal or offspring folate-related gene variants and interactions between the gene variants and maternal intake of folates on the risk of NTDs in their offspring. A case-control study was conducted on mothers and/or their fetuses and infants who were born in California from 1999–2003 with an NTD (cases n = 222, including 24 mother-infant pairs) or without a major malformation (controls n = 454, including 186 mother-infant pairs). Maternal intake of folates was assessed by food frequency questionnaire and genotyping was performed on samples from mothers and infants. For mothers in the lowest folate-intake group, risk of NTDs in offspring was significantly decreased for maternal MTHFR SNPs rs1476413, rs1801131 and rs1801133 (odds ratio (OR) = 0.55, 80% confidence interval (CI): 0.20, 1.48; OR = 0.58, 80% CI: 0.24, 1.43; OR = 0.69, 80% CI: 0.41, 1.17, respectively), and TYMS SNPs rs502396 and rs699517 (OR= 0.91, 80% CI: 0.53, 1.56; OR = 0.70, 80% CI: 0.38, 1.29). A gene-only effect was observed for maternal SHMT1 SNP rs669340 (OR = 0.69, 95% CI: 0.49, 0.96). When there was low maternal folate intake, risk of NTDs was significantly increased for infant MTHFD1 SNPs rs2236224, rs2236225 and rs11627387 (OR = 1.58, 80% CI: 0.99, 2.51; OR = 1.53, 80% CI: 0.95, 2.47; OR = 4.25, 80% CI: 2.33, 7.75, respectively) and SHMT1 SNP rs12939757 (OR = 2.01, 80% CI: 1.20, 3.37), but decreased for TYMS SNP rs2847153 (OR = 0.73, 80% CI: 0.37, 1.45). Although power to detect interaction effects was low for this birth defects association study, the gene-folate interactions observed in this study represent preliminary findings that will be useful for informing future studies on the complex etiology of NTDs.
Etheredge, Analee J.; Finnell, Richard H.; Carmichael, Suzan L.; Lammer, Edward J.; Zhu, Huiping; Mitchell, Laura E.; Shaw, Gary M.
Neural tube defects (NTDs) are common, serious malformations with a complex etiology that suggests involvement of both genetic and environmental factors. The authors evaluated maternal or offspring folate-related gene variants and interactions between the gene variants and maternal intake of folates on the risk of NTDs in their offspring. A case-control study was conducted on mothers and/or their fetuses and infants who were born in California from 1999 to 2003 with an NTD (cases n = 222, including 24 mother-infant pairs) or without a major malformation (controls n = 454, including 186 mother-infant pairs). Maternal intake of folates was assessed by food frequency questionnaire and genotyping was performed on samples from mothers and infants. For mothers in the lowest folate-intake group, risk of NTDs in offspring was significantly decreased for maternal MTHFR SNPs rs1476413, rs1801131, and rs1801133 (odds ratio [OR] = 0.55, 80% confidence interval [CI]: 0.20, 1.48; OR = 0.58, 80% CI: 0.24, 1.43; OR = 0.69, 80% CI: 0.41, 1.17, respectively), and TYMS SNPs rs502396 and rs699517 (OR = 0.91, 80% CI: 0.53, 1.56; OR = 0.70, 80% CI: 0.38, 1.29). A gene-only effect was observed for maternal SHMT1 SNP rs669340 (OR?=?0.69, 95% CI: 0.49, 0.96). When there was low maternal folate intake, risk of NTDs was significantly increased for infant MTHFD1 SNPs rs2236224, rs2236225, and rs11627387 (OR = 1.58, 80% CI: 0.99, 2.51; OR = 1.53, 80% CI: 0.95, 2.47; OR = 4.25, 80% CI: 2.33, 7.75, respectively) and SHMT1 SNP rs12939757 (OR = 2.01, 80% CI: 1.20, 3.37), but decreased for TYMS SNP rs2847153 (OR = 0.73, 80% CI: 0.37, 1.45). Although power to detect interaction effects was low for this birth defects association study, the gene-folate interactions observed in this study represent preliminary findings that will be useful for informing future studies on the complex etiology of NTDs. PMID:22903727
Etheredge, Analee J; Finnell, Richard H; Carmichael, Suzan L; Lammer, Edward J; Zhu, Huiping; Mitchell, Laura E; Shaw, Gary M
We conducted a systematic review of studies examining riskfactors for the development of type 2 diabetes among women with previous gestational diabetes. Our search strategy yielded 14 articles that evaluated 9 categories of riskfactors of type 2 diabetes in women with gestational diabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal lifestyle factors,
Kesha Baptiste-Roberts; Bethany B. Barone; Tiffany L. Gary; Sherita H. Golden; Lisa M. Wilson; Eric B. Bass; Wanda K. Nicholson
Little is known about the ways in which the accumulation of maternalfactors increases or reduces risk for girls' disruptive behavior during preadolescence. In the current study, maternalrisk and promotive factors and the severity of girls' disruptive behavior were assessed annually among girls' ages 7-12 in an urban community sample (N?=?2043). Maternalrisk and promotive factors were operative at different time points in girls' development. Maternal warmth explained variance in girls' disruptive behavior, even after controlling for maternalriskfactors and relevant child and neighborhood factors. In addition, findings supported the cumulative hypothesis that the number of riskfactors increased the chance on girls' disruptive behavior disorder (DBD), while the number of promotive factors decreased this probability. Daughters of mothers with a history of Conduct Disorder (CD) were exposed to more riskfactors and fewer promotive factors compared to daughters of mothers without prior CD. The identification of malleable maternalfactors that can serve as targets for intervention has important implications for intergenerational intervention. Cumulative effects show that the focus of prevention efforts should not be on single factors, but on multiple factors associated with girls' disruptive behavior. PMID:22127641
van der Molen, Elsa; Hipwell, Alison E; Vermeiren, Robert; Loeber, Rolf
Both genetic and environmental factors seem to predispose to the development of food allergy. A most notable factor is diet,\\u000a particularly during infancy. Possible other factors include maternal diet during pregnancy and lactation, birth by cesarean\\u000a section, exposure to tobacco smoke, multivitamin supplementation, and intake of antacids. It is important to identify and\\u000a control such riskfactors to reduce the
Background Causes of infant death remain unknown in significant proportions of human and nonhuman primate pregnancies. Methods A closed breeding colony with high rates of infant mortality had pregnancies assessed (n=153) by fetal measurements and maternal characteristics. Infant outcome was classified as neonatal death (stillborn or died <48 hours from birth), postnatal death (died 2 – 30 days) or surviving (alive after 30 days). Results Fetal size did not predict outcome. Poor maternal glycemic control and low social ranking increased odds for adverse outcome (OR=3.72, p=0.01 and 2.27, p=0.04 respectively). Male sex was over-represented in stillbirths (p=0.04) and many were macrosomic, but size did not associate with maternal glycemic control measured as glycated hemoglobin A1c. Postnatally dead infants were smaller (p<0.01), which associated with behavioral factors and glycemic control. Conclusions Fetal growth estimates predicted gestational age but not fetal outcome. Maternal social status and metabolic health, particularly glycemic control, increased risks of adverse pregnancy outcome.
Kavanagh, Kylie; Dozier, Brandy L.; Chavanne, Tara J.; Fairbanks, Lynn A.; Jorgensen, Matthew J.; Kaplan, Jay R.
Nine incidents of multiple-victim homicide in American secondary schools are examined and common riskfactors are identified. The literature dealing with individual, family, social, societal, and situational riskfactors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of riskfactors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed. PMID:10660827
The brain corticotropin-releasing factor (CRF) system triggers a variety of neuroendocrine and behavioural responses to stress. Whether maternal behaviour and emotionality in lactation are modulated by CRF has rarely been investigated. In the present study, we measured CRF mRNA expression within the parvocellular part of the paraventricular nucleus in virgin and lactating Wistar rats bred for high (HAB) and low (LAB) anxiety-related behaviour or non-selected for anxiety (NAB). Further, we intracerebroventricularly infused synthetic CRF or the CRF receptor (CRF-R) antagonist D-Phe to manipulate CRF-R1/2 non-specifically in lactating HAB, LAB, and NAB dams, and monitored maternal care, maternal motivation, maternal aggression, and anxiety. The CRF mRNA expression in the parvocellular part of the paraventricular nucleus was higher in HAB vs. LAB rats independent of reproductive status. The lactation-specific decrease of CRF mRNA was confirmed in LAB and NAB dams but was absent in HAB dams. Intracerebroventricular CRF decreased maternal care under basal conditions in the home cage in all breeding lines and reduced attack behaviour in HAB and LAB dams during maternal defence. In contrast, D-Phe rescued maternal care after exposure to maternal defence in the home cage without influencing maternal aggression. Furthermore, D-Phe decreased and CRF tended to increase anxiety in HAB/NAB and LAB dams, respectively, suggesting an anxiogenic effect of CRF in lactating females. In conclusion, low CRF-R activation during lactation is an essential prerequisite for the adequate occurrence of maternal behaviour. PMID:23742269
Klampfl, Stefanie M; Neumann, Inga D; Bosch, Oliver J
Dystocia (difficult labor) is an important component of the management of nonhuman primates and results in significant fetal and maternal morbidity and increased use of veterinary resources. Dystocias can arise from abnormalities of the maternal pelvis or fetus or uncoordinated uterine activity. Although riskfactors for stillbirths have been established in nonhuman primates, riskfactors for dystocias have not. The objective of this study was to determine maternal and fetal riskfactors for dystocia in macaques. Retrospective data were collected from 83 pigtailed macaques (Macaca nemestrina) diagnosed with dystocia. The diagnosis of dystocia was made based on clinical or pathologic evidence. Maternal records of age, reproductive history, experimental history, clinical records, and fetal birth weight and any applicable fetal necropsy reports were reviewed. The gestational age of the fetus, the infant's birth weight, total previous births by the dam, and the proportions of both viable delivery (inverse effect) and surgical pregnancy interventions (direct effect) in the dam's history generated a model that maximized the experimental variance for predicting dystocia in the current pregnancy and explained 24% of the dystocia deliveries. The number of total previous births and proportion of previous cesarean sections accounted for the greatest effect. This model can identify individual dams within a colony that are at risk for dystocias and allow for changes in breeding colony management, more intense monitoring of dams at risk, or allocation of additional resources.
Stockinger, Diane E; Torrence, Anne E; Hukkanen, Renee R; Vogel, Keith W; Hotchkiss, Charlotte E; Ha, James C
Pregnancies complicated by maternal diabetes have long been known to carry a higher risk for congenital malformations, such as neural tube defects. Using the FVB inbred mouse strain and the Streptozotocin-induced diabetes model, we tested whether the incidence of neural tube defects in diabetic pregnancies can be modulated by maternal diet. In a comparison of two commercial mouse diets, which are considered nutritionally replete, we found that maternal consumption of the unfavorable diet was associated with a more than three-fold higher rate of neural tube defects. Our results demonstrate that maternal diet can act as a modifier of the risk for abnormal development in high-risk pregnancies, and provide support for the possibility that neural tube defects in human diabetic pregnancies might be preventable by optimized maternal nutrition.
Kappen, Claudia; Kruger, Claudia; MacGowan, Jacalyn; Salbaum, J. Michael
|The present study investigated the relationship between maternal appraisal styles, family risk status, and anger biases in children. Participants included 90 mothers and their children between 3-6 years of age. Eighty families were followed up 1 year later. Maternal appraisal styles were assessed via a naturalistic story-reading method, and Time…
BackgroundA significant association between parental PTSD and the occurrence of PTSD in offspring has been noted, consistent with the idea that risk for the development of PTSD is transmitted from parent to child. Two recent reports linking maternal PTSD and low offspring cortisol prompted us to examine the relative contributions of maternal vs. paternal PTSD in the prediction of PTSD
Rachel Yehuda; Amanda Bell; Linda M. Bierer; James Schmeidler
This longitudinal study investigated the relative contributions of infant temperament, maternal sensitivity, and psychosocial risk to individual differences in preschool children's cognitive development. It also examined specific moderating effects between predictors as well as the specific mediating role of maternal sensitivity in the relation…
Lemelin, Jean-Pascal; Tarabulsy, George M.; Provost, Marc A.
The present study investigated the relationship between maternal appraisal styles, family risk status, and anger biases in children. Participants included 90 mothers and their children between 3–6 years of age. Eighty families were followed up 1 year later. Maternal appraisal styles were assessed via a naturalistic story-reading method, and Time 1 and Time 2 emotion biases included teacher ratings of
Schizophrenia and human leukocyte antigen (HLA) matching between couples or between mothers and offspring have independently been associated with prenatal/obstetric complications, including preeclampsia and low birth weight. Here, we report the results of a family-based candidate-gene study that brings together these two disparate lines of research by assessing maternal-fetal genotype matching at HLA-A, -B, and -DRB1 as a riskfactor of schizophrenia. We used a conditional-likelihood modeling approach with a sample of 274 families that had at least one offspring with schizophrenia or a related spectrum disorder. A statistically significant HLA-B maternal-fetal genotype–matching effect on schizophrenia was demonstrated for female offspring (P=.01; parameter estimate 1.7 [95% confidence interval 1.22–2.49]). Because the matching effect could be associated with pregnancy complications rather than with schizophrenia per se, these findings are consistent with the neurodevelopmental hypothesis of schizophrenia and with accumulating evidence that the prenatal period is involved in the origins of this disease. Our approach demonstrates how genetic markers can be used to characterize the biology of prenatal riskfactors of schizophrenia.
Palmer, Christina G. S.; Hsieh, Hsin-Ju; Reed, Elaine F.; Lonnqvist, Jouko; Peltonen, Leena; Woodward, J. Arthur; Sinsheimer, Janet S.
Abstract Background This study examined the association between social, demographic, and psychologic factors and smoking status among Appalachian Ohio women. A secondary aim examined whether specific factors could be identified and segmented for future tailored treatment of tobacco dependence. Methods A cross-sectional survey (n=570) obtained information about social, demographic, and psychologic factors and smoking. Logistic regression described associations between these characteristics and smoking status. Chi-square automatic interaction detection (CHAID) analyses identified subgroups at risk for smoking. Results Fifty-two percent never smoked, with 20.5% and 27.5% categorized as former and current smokers, respectively. Women with low adult socioeconomic position (SEP) were more likely to smoke (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.74-5.34) compared to high SEP women. Other factors associated with current smoking included age 31–50 (OR 2.30, 95% CI 1.22-4.33), age 18–30 (OR 3.29, 95% CI 1.72-5.34), Center for Epidemiologic Studies Depression scale (CES-D) score?16 (OR 1.99, 95% CI 1.31-3.05), and first pregnancy at age<20 (OR 1.74, 95% CI 1.14-2.66). The prevalence of smoking was 50% among those with four or more riskfactors compared to 10% for those reporting no riskfactors. CHAID analyses identified low adult SEP and depressive symptoms as the combination of riskfactors most strongly associated with smoking; 49.3% of women in this subgroup currently smoked. Conclusions Low SEP in adulthood, maternal circumstances, and depressive symptoms are associated with current smoking. Tailored cessation interventions that address these riskfactors should be developed and further evaluated in an attempt to reduce disparities in smoking prevalence among this vulnerable group of women.
To identify prospectively measured riskfactors of sexual assault (SA) among girls age 17 and younger. The data come from the Panel Study of Income Dynamics and are derived from interviews with 1,087 girls, their primary caregivers, and household heads. The data were collected from the girls' first year of life through their early twenties. Factors measured during childhood were used to predict whether the girls experienced a subsequent first sexual assault before the age of 18. Prospectively measured riskfactors associated with subsequent child SA included the absence of one or both parents, maternal education less than college, family income below 400% of the federal poverty threshold, low caregiver warmth, child internalizing and externalizing behaviors, impulsivity, low achievement scores, and having been classified by their school as needing special education. Girls with behavioral health problems and learning challenges are at heightened risk for sexual assault. Research on behavioral health consequences of SA should control for preexisting SA riskfactors to more accurately estimate the impact of child SA on subsequent behavioral health. PMID:23899536
Obesity may be the consequence of various environmental or genetic factors, which may be highly correlated with each other. We aimed to examine whether grandmaternal and maternal obesity and environmental riskfactors are related to obesity in daughters. Daughters (n = 182) recruited from female students, their mothers (n = 147) and their grandmothers (n = 67) were included in this study. Multivariable logistic regression was used to analyze the association between the daughter's obesity and maternal, grandmaternal, and environmental factors. Maternal heights of 161-175cm (OD: 8.48, 95% CI: 3.61-19.93) and 156-160 cm (2.37, 1.14-4.91) showed positive associations with a higher height of daughter, compared to those of 149-155 cm. Mothers receiving a university or a higher education had a significant OR (3.82, 1.27-11.50) for a higher height of daughter compared to those having a low education (elementary school). Mother having the heaviest weight at current time (59-80 kg, 3.78, 1.73-8.28) and the heaviest weight at 20 years of age (51-65 kg, 3.17, 1.53-6.55) had significant associations with a higher height of daughters, compared to those having the lightest weight at the same times. There was no association between the height, weight, and BMI of daughters and the characteristics and education of her grandmothers. In conclusion, although genetic factors appear to influence the daughter's height more than environmental factors, the daughter's weight appears to be more strongly associated with individual factors than the genetic factors.
Shin, Mi Na; Lee, Kyung Hea; Lee, Hye Sang; Sasaki, Satoshi; Oh, Hea Young; Lyu, Eun Soon
We examined the risk and protective factors and mental health problems of 105 low SES, urban adolescents whose mothers were coping with alcohol abuse and other drug problems. Approximately half of the mothers were also HIV-infected. As hypothesized, there were few differences between adolescents of HIV-infected and HIV-uninfected mothers in…
Leonard, Noelle R.; Gwadz, Marya Viorst; Cleland, Charles M.; Vekaria, Pooja C.; Ferns, Bill
BACKGROUND Subfertility shares common pathways with cardiovascular disease (CVD), including polycystic ovarian syndrome, obesity and thyroid disorders. Women with prior 0–1 pregnancies are at an increased risk of incident CVD when compared with women with two pregnancies. It is uncertain whether history of subfertility among women eventually giving birth is a riskfactor for CVD. METHODS Among Swedish women with self-reported data on subfertility in the Swedish Medical Birth Register (n = 863 324), we used Cox proportional hazards models to relate a history of subfertility to CVD risk after adjustment for age, birth year, highest income, education, birth country, hypertension, diabetes, preterm birth, small for gestational age (SGA), smoking and for BMI in separate models. In additional analyses, we excluded women with: (i) pregnancy-related or non-pregnancy-related hypertension and/or diabetes; and (ii) preterm births and/or SGA babies. RESULTS Among nulliparous women eventually having a childbirth (between 1983 and 2005, the median follow-up time 11.9; 0–23 years and 9 906 621 person-years of follow-up), there was an increased risk of CVD among women reporting ?5 years of subfertility versus 0 years (hazard ratio 1.19, 95% confidence interval 1.02–1.39). There were not significantly elevated CVD risks for women with 1–2 or 3–4 years of subfertility versus 0 years. Accounting for BMI did not change results. Excluding women with hypertension and/or diabetes attenuated associations, whereas exclusion of women with preterm and/or SGA births did not change findings. CONCLUSIONS Subfertility among women eventually having a childbirth is a riskfactor for CVD even upon accounting for cardiovascular riskfactors and adverse pregnancy outcomes. Future studies should explore the mechanisms underlying this association.
Parikh, Nisha I.; Cnattingius, Sven; Mittleman, Murray A.; Ludvigsson, Jonas F.; Ingelsson, Erik
OBJECTIVES. Reduced options for fertility control over the past decade have increased the rates of unwanted pregnancy. We evaluated whether a woman's negative attitude toward her pregnancy increased the risk of perinatal mortality, in a large, prospective cohort study. METHODS. The association between attitude toward the pregnancy and perinatal mortality was evaluated in a longitudinal cohort study of 8823 married, pregnant patients enrolled from 1959 to 1966 in the Child Health and Development Studies. RESULTS. Women who reported during the first trimester of prenatal care that the pregnancy was unwanted were more than two times more likely to deliver infants who died within the first 28 days of life than were women reporting accepted pregnancies. A positive attitude toward pregnancy was not associated with fetal death or post-neonatal death. CONCLUSIONS. These data, collected when induced abortions were illegal, may have important implications for the 1990s. If maternal attitude toward the pregnancy is associated with neonatal mortality and abortion laws change such that access is restricted, infant mortality may increase because a greater proportion of births will be unwanted.
OBJECTIVES. This study identified factors predicting adherence to medical recommendations in maternal phenylketonuria, which can result in severe fetal damage. METHODS. Sixty-nine women with phenylketonuria, 68 of their acquaintances, and 69 women with diabetes mellitus were interviewed annually for 5 years. A model in which each stage in the maternal phenylketonuria life cycle represented a treatment-related goal provided a means to assess adherence. RESULTS. At the stages of prevention of unplanned pregnancy, treatment initiation, and diet continuation throughout pregnancy, attitudes and social support were associated with adherence to medical recommendations. No specific variables were associated with outcome at reproductive decision making, but women with phenylketonuria were more likely to delay making a decision, resulting in unplanned and, hence, untreated or late-treated pregnancy. CONCLUSIONS. Women with phenylketonuria differed from their acquaintances and diabetic women in many respects, suggesting that special programs are needed. Greater emphasis on reproductive decision making is especially needed. Interventions that focus on improving social support networks and attitudes about treatment may increase adherence to recommendations.
Waisbren, S E; Hamilton, B D; St James, P J; Shiloh, S; Levy, H L
... know what causes rhabdomyosarcoma? What are the riskfactors for rhabdomyosarcoma? A riskfactor is anything that affects the chance of having ... such as cancer. Different cancers have different riskfactors. Lifestyle-related riskfactors such as body weight, ...
Intrauterine and early life exposure to folic acid has significantly increased in North America owing to folic acid fortification, widespread supplemental use and periconceptional folic acid supplementation. The effect of maternal and postweaning folic acid supplementation on colorectal cancer risk ...
Background There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious\\u000a mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk\\u000a of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its\\u000a sequelae.
Imran Mahmud; Omar A Abdel-Mannan; Clare J Wotton; Michael J Goldacre
For each riskfactor for Black Death he discovered, John Graunt in 1662 made a recommendation for action, such as fleeing the night air brought to the City of London docks on foreign ships. These stopped the plague for 200 years! In this honored guest lecture, I focus on thinking beyond the riskfactors to their neutralization by effective action without waiting for perfect knowledge of mechanisms. For example, the decreasing risk of repairing atrioventricular septal defect resulted from riskfactors that stimulated focused research to devise a better operation. General reduction in risk reduced mortality of aortic valve replacement in patients with chronic aortic regurgitation and severe left ventricular dysfunction. Optimal timing of surgery after stabilizing patients reduced risk of the Norwood procedure. Managing intractable cardiogenic shock reduced risk-adjusted mortality in post-infarct ventricular septal defect. However, we must think beyond traditional riskfactors to neutralization of those brought by patient characteristics, imponderables, treatment delivery systems, institutions delivering care to groups of patients, and society caring for its population. There are limitations to thinking beyond riskfactors. First, neutralizing strategies require improving processes or introducing new ones. Yet there may be process-outcome disconnect, or even counterintuitive or contradictory relations among outcomes and what are thought to be best processes. Nevertheless, thinking beyond riskfactors to their neutralization by research, innovation, and application of knowledge can be as spectacularly successful as was fleeing foul air in halting Black Death. PMID:16616854
Black infant mortality rates (IMRs) are approximately twice those of whites in Georgia and nationwide. This study evaluates maternalfactors, particularly marital status, that influence racial differences in infant mortality. Population-based data on 565,730 live births and 7269 infant deaths in Georgia from 1980 to 1985 were examined. The IMR ratio for unmarried compared to married mothers was calculated and adjusted singly for maternal education, age and race, and infant birthweight. In addition, racial differences in IMR were estimated using stratified analysis on the basis of four factors: infant birthweight, maternal age, marital status, and education. When only normal birthweight infants were considered, the IMR, adjusted for maternal education level, was highest for infants born to unmarried black teens (9.5/1000 live births), followed by that for infants born to married black teens (9.1), unmarried black adults (7.5), married black adults (4.8), married white teens (4.4), married white adults (3.4), unmarried white adults (2.4), and unmarried white teens (1.3). When only low birthweight infants were considered, the highest IMR per 1000 was found in infants born to married black adults (119), followed by unmarried black adults (103), married black teens (99.9), unmarried black teens (92.5), married white adults (92.1), married white teens (79.0), unmarried white adults (38.0), and unmarried white teens (26.3). These differences led to a black-to-white IMR risk ratio from 1.3 for low birthweight infants born to unmarried teen or adult mothers to 3.7 for normal birthweight infants born to unmarried teen mothers.(ABSTRACT TRUNCATED AT 250 WORDS)
Sung, J. F.; Taylor, B. D.; Blumenthal, D. S.; Sikes, K.; Davis-Floyd, V.; McGrady, G.; Lofton, T. C.; Wade, T. E.
One of the most important tasks of clinical and experimental nephrology is to identify the riskfactors of progression of renal failure. A major renal riskfactor which has not been sufficiently acknowledged despite increasing evidence is cigarette smoking. Diabetologists were the first to recognize the adverse effects of smoking on the kidney: both in type 1 and in type
Objective To asses he association between intake of folate and B vitamins and the incidence of spontaneous abortion (SA) according to the maternal methylenetetrahydrofolate reductase (MTHFR) polymorphisms (677 C>T and 1298 A>C). Material and Methods We conducted a nested case-control study within a perinatal cohort of women recruited in the state of Morelos, Mexico. Twenty-three women with SA were compared to 74 women whose pregnancy survived beyond week 20th. Intake of folate and B vitamins respectively, was estimated using a validated food frequency questionnaire. Maternal MTHFR polymorphisms were determined by PCR-RFLP and serum homocysteine levels by HPLC. Results Carriers of MTHFR 677TT and 1298AC genotypes respectively showed an increased risk of SA (OR 677TT vs. CC/CT=5.0; 95% CI: 1.2, 20.9 and OR 1298 AC vs. AA=5.5; 95% CI: 1.1, 26.6). Conclusions Our results support the role of MTHFR polymorphisms as a riskfactor for SA, regardless of dietary intake of B vitamins.
Rodriguez-Guillen, Maria del Rosario; Torres-Sanchez, Luisa; Chen, Jia; Galvan-Portillo, Marcia; Silva-Zolezzi, Irma; Blanco-Munoz, Julia; Hernandez-Valero, Maria A.; Lopez-Carrillo, Lizbeth
Genetic mechanisms for selective mutagenesis in female mammals might include alterations of genomic imprinting, maternally derived molecules, mitochondrial DNA or sex chromosome loci. one of these mechanisms provides an obvious explanation for the higher mutational rates observed...
Cardiovascular diseases (CVD) are the primary cause of death in women. Guidelines for identifying high-risk individuals have been developed, e.g. the Dutch Guideline on Cardiovascular Risk Management. In the most recent version of this guideline, diabetes mellitus (DM) and rheumatoid arthritis (RA) are cited as cardiovascular riskfactors; therefore, individuals with these conditions are identified as being at high risk. As with DM and RA, there is strong evidence that the experience of having a hypertensive disorder during pregnancy is a cardiovascular riskfactor. This is particularly the case for early preeclampsia, which constitutes a 7-fold increased risk of ischemic heart disease. However, in the Netherlands, there are no guidelines and there is no consensus on how to screen or treat these women. Trial evidence is therefore urgently needed to substantiate the value of cardiovascular risk management for those women with a history of hypertension during pregnancy. PMID:23965245
Autism is a devastating childhood condition that has emerged as an increasing social concern just as it has increased in prevalence in recent decades. Autism and the broader category of autism spectrum disorders are among the increasingly seen examples in which there is a fetal basis for later disease or disorder. Environmental, genetic, and epigenetic factors all play a role in determining the risk of autism and some of these effects appear to be transgenerational. Identification of the most critical windows of developmental vulnerability is paramount to understanding when and under what circumstances a child is at elevated risk for autism. No single environmental factor explains the increased prevalence of autism. While a handful of environmental riskfactors have been suggested based on data from human studies and animal research, it is clear that many more, and perhaps the most significant riskfactors, remain to be identified. The most promising riskfactors identified to date fall within the categories of drugs, environmental chemicals, infectious agents, dietary factors, and other physical/psychological stressors. However, the rate at which environmental riskfactors for autism have been identified via research and safety testing has not kept pace with the emerging health threat posed by this condition. For the way forward, it seems clear that additional focused research is needed. But more importantly, successful risk reduction strategies for autism will require more extensive and relevant developmental safety testing of drugs and chemicals.
Dietert, Rodney R.; Dietert, Janice M.; Dewitt, Jamie C.
Although maternal serum alpha-fetoprotein (AFP), human chorionic gonandotrophin (hCG), and estriol play important roles in immunomodulation and immunoregulation during pregnancy, their relationship to the development of bronchopulmonary dysplasia (BPD) in young infants is unknown despite BPD being associated with pre- and postnatal inflammatory factors. The objective of this population-based study was to examine whether second trimester levels of AFP, hCG, and unconjugated estriol (uE3) were associated with an increased risk of BPD. We found that these serum biomarkers were associated with an increased risk of BPD. Risks were especially high when AFP and/or hCG levels were above the 95th percentile and/or when uE3 levels were below the 5th percentile (relative risks (RRs) 3.1 to 6.7). Risks increased substantially when two or more biomarker risks were present (RRs 9.9 to 75.9). Data suggested that pregnancies which had a biomarker risk and yielded an offspring with BPD were more likely to have other factors present that suggested early intrauterine fetal adaptation to a stress including maternal hypertension and asymmetric growth restriction.
Jelliffe-Pawlowski, Laura L.; Shaw, Gary M.; Stevenson, David K.; Oehlert, John W.; Quaintance, Cele; Santos, Allan J.; Baer, Rebecca J.; Currier, Robert J.; O'Brodovich, Hugh M.; Gould, Jeffrey B.
|This longitudinal study examined whether the risk and positive factors contributing to the delinquent behaviors and internalizing problems of 454 Latino adolescents varied across maternal linguistic acculturation and adolescent gender. Although the level of cumulative risk to which the 10-to-14-year old adolescents were exposed did not vary by…
Loukas, Alexandra; Suizzo, Marie-Anne; Prelow, Hazel M.
This longitudinal study examined whether the risk and positive factors contributing to the delinquent behaviors and internalizing problems of 454 Latino adolescents varied across maternal linguistic acculturation and adolescent gender. Although the level of cumulative risk to which the 10-to-14-year old adolescents were exposed did not vary by…
Loukas, Alexandra; Suizzo, Marie-Anne; Prelow, Hazel M.
Objective:To identify riskfactors for life-threatening maternal outcomes.Study design:Hospital charts were reviewed for cases of maternal mortality or near-miss and for controls overmatched 1:3. Significant riskfactors were identified through simple and best subsets multiple logistic regression.Result:Eight cases of mortality and 69 near-miss cases were found. Significant riskfactors with their odds ratios and 95% confidence intervals are: age 35
D Goffman; R C Madden; E A Harrison; I R Merkatz; C Chazotte
The objective of this study was to identify factors associated with weapon use in a group of filicidal women. Clinical data were gathered from the charts of sixty filicidal women evaluated at Michigan's Center for Forensic Psychiatry or through Connecticut's Psychiatric Security Review Board from 1970 to 1996. Factors associated with weapon use were determined using chi squares, ANCOVAS, and a logistic regression. Results were compared to national statistics for child homicide from the Department of Justice Uniform Crime Reports (UCR). Weapon was defined as knife or gun for the study. Weapons were used by one of four women in our study. Guns were used by 13% of filicidal women and knives by 12%. Odds ratio showed that psychotic women were eleven times more likely to kill their child with a weapon than their non-psychotic counterparts (11.2; p = .008). Psychosis was present in every mother who killed her child with a knife and in seven of eight women who killed their children with a gun. Younger children were less likely to be killed with weapons (ANCOVA; F = 8.28; p = .006). This finding was independent of presence or absence of maternal psychosis. These results show that psychotic women are more likely than non-psychotic women to kill their children with weapons. They also show that mothers are more likely to use weapons to kill older children than younger children. PMID:9608698
Lewis, C F; Baranoski, M V; Buchanan, J A; Benedek, E P
Juvenile recurrent respiratory papillomatosis is caused mainly by human papillomavirus genotypes 6 or 11, acquired at birth or during pregnancy from an infected mother. Recurrent respiratory papillomatosis is characterized by recurring warts growing most commonly in the larynx. Multiple surgical procedures and the risk of airway obstruction contribute to the devastating impact of this disease. Some children will go into remission after a few surgeries whereas others will require repeated interventions over several years. Further understanding of the riskfactors associated with severity may contribute to tailored treatments. A retrospective study of cases diagnosed between January 1995 and December 2008 was conducted to study determinants of severe forms of juvenile recurrent respiratory papillomatosis. Demographic and clinical variables were abstracted from children's medical charts and mothers' delivery charts. Viral factors (HPV genotyping and viral load) were studied from archived biopsies. Specific HLA class II alleles and killer-cell immunoglobulin-like receptors genes were tested from saliva samples. Logistic regression was performed to identify riskfactors for severity. Overall, 31 pediatric cases of recurrent respiratory papillomatosis were identified. The only significant factor associated with severe forms of recurrent respiratory papillomatosis was the maternal history of condylomas during pregnancy (OR: 12.05 [P=0.05]). The analysis failed to identify riskfactors that could be used clinically to identify recurrent respiratory papillomatosis cases likely to take a severe course. Although too early to determine, vaccination against the HPV types involved most commonly in recurrent respiratory papillomatosis may provide the best hope to prevent severe forms of this disease. PMID:23765781
Rodier, Caroline; Lapointe, Annie; Coutlée, François; Mayrand, Marie-Hélène; Dal Soglio, Dorothée; Roger, Michel; Trottier, Helen
Riskfactors for venous thromboembolism (VTE) are often modifiable and overlap with riskfactors for coronary artery disease. Encouraging our patients to adopt a heart-healthy lifestyle by abstaining from cigarettes, maintaining lean weight, limiting red meat intake, and controlling hypertension might lower the risk of pulmonary embolism and deep vein thrombosis (DVT), although a cause-effect relationship has not been firmly established. For hospitalized patients, guidelines have provided evidence-based strategies to identify patients at risk, such as elderly persons and those with cancer, congestive heart failure, or chronic obstructive pulmonary disease or undergoing major surgery. Most should receive pharmacological prophylaxis, which will minimize the risk of VTE. Because approximately 3 of every 4 pulmonary embolism and DVT events occur outside the hospital setting, patients should also be assessed for persistent high-risk of VTE at the time of hospital discharge. PMID:20620709
Both maternal diabetes and obesity have been associated with an increased risk of neural tube defects (NTD), possibly due to a sustained state of hyperglycemia and/or hyperinsulinemia. Data were collected in the Boston University Slone Birth Defects Study (a case-control study) from 1988 to 1998. The authors examined whether high dietary glycemic index (DGI) and high dietary glycemic load (DGL) increased the risk of NTDs in nondiabetic women. Mothers of NTD cases and nonmalformed controls were interviewed in person within 6 months after delivery about diet and other exposures. Odds ratios and 95% confidence intervals were estimated from logistic regression for high DGI (?60) and high DGL (?205), with cutpoints determined by cubic spline. Of 698 case mothers, 25% had high DGI and 4% had high DGL. Of 696 control mothers, 15% had high DGI and 2% had high DGL. After adjustment for sociodemographic factors and other dietary factors, the odds ratio for high DGI was 1.5 (95% confidence interval: 1.1, 2.0); for high DGL, it was 1.8 (95% confidence interval: 0.8, 4.0). Diets with proportionally high DGI or DGL may put the developing fetus at risk of an NTD, adding further evidence that hyperglycemia lies within the pathogenic pathway.
Yazdy, Mahsa M.; Liu, Simin; Mitchell, Allen A.; Werler, Martha M.
The Multiple RiskFactor Intervention Trial is a primary prevention trial to determine the extent to which mortality from coronary heart disease may be reduced by the reduction of blood cholesterol, blood pressure and cigarette smoking in high risk men ag...
The Multiple RiskFactor Intervention Trial is a primary prevention trial to determine the extent to which mortality from coronary heart disease may be reduced by the reduction of blood cholesterol, blood pressure and cigarette smoking in high risk men ag...
Background Previously we reported that insulin-like growth factor (IGF)-I during early pregnancy is positively associated with maternalrisk of breast cancer. To explore this association further we designed a new study limited to women who donated a blood sample during their first full-term pregnancy. Methods A case-control study was nested within the Northern Sweden Maternity Cohort (NSMC) in which repository since 1975, serum specimens remaining after early pregnancy screening for infectious diseases had been preserved. Study subjects were selected among women who donated a blood sample during the full-term pregnancy that led to the birth of their first child. 244 women with invasive breast cancer were eligible. Two controls, matching the index case for age and date at blood donation were selected (n=453). IGF-I was measured in serum samples on an Immulite 2000 analyzer. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals. Results A significant positive association of breast cancer with IGF-I was observed, with OR of 1.73 (95 % CI: 1.14–2.63) for the top tertile, p < 0.009. Sub-group analyses indicated stronger effect of IGF-I in women ? age 25 and > age 30 than in women age 25–30 at index pregnancy. A stronger association of IGF-I with risk was also observed in cases diagnosed within 15 years of blood donation: OR 2.46 (95 % CI: 1.02–5.91). Conclusions The results of the study add further evidence for an adverse effect of elevated IGF-I concentrations during early reproductive life on risk of breast cancer.
This descriptive study of 19 socially high-risk mother-infant dyads in naturalistic interaction focused on maternal response to infant elicitation cues. Maternal response behavior was coded on a continuum from underresponsive to adequate to overresponsive. Maternal affect was rated separately using selected items from an existing scale. As a whole, the maternal sample was emotionally depressed and largely underresponsive to infant cues. When placed by maternal response into adequate, overresponsive, and underresponsive subgroups, adequate mothers more often responded appropriately to infant cues, were never physically unavailable to their infants, showed no anxiety, and were more positively responsive to their infants' smiles and cries. Adequate mothers scored higher in all affective areas. Maternal depression was associated with both overresponse and underresponse. Angry maternal mood was significantly related to underresponse. Considerable maternal strength lies in this high-risk sample and could be the basis for therapeutic intervention to normalize parenting. PMID:7562382
Summary 1. With the aid of a novel survivorship model, an 8-year field study of social and maternalfactors affecting duckling survival in eiders ( Somateria mollissima ) revealed that duckling survival probability varies in accordance with maternal brood-rearing strategy. This variability in survival provides compelling evidence of different annual fitness consequences between females that share brood-rearing and those that
OBJECTIVES. Late-preterm infants (34 -36 weeks' gestation) account for nearly three quarters of all preterm births in the United States, yet little is known about their morbidity risk. We compared late-preterm and term (37- 41 weeks' gestation) infants with and without selected maternal medical conditions and assessed the independent and joint effects of these exposures on newborn morbidity risk. METHODS.
Carrie K. Shapiro-Mendoza; Kay M. Tomashek; Milton Kotelchuck; Wanda Barfield; Angela Nannini; Judith Weiss; Eugene Declercq
Down syndrome is a common chromosomal anomaly causing multiple congenital malformations and mental retardation (MR) in humans. The well-established riskfactor, advanced maternal age, was not found in many of the Down syndrome cases in Egypt, while other possible riskfactors have not been well studied yet. In view of this, we have conducted the present study to clarify that
Genetic factors are clearly important in the etiology of schizophrenia, but the environment in which an individual's genes find expression is also crucial to the development of the illness. In this review of environmental riskfactors for schizophrenia, we consider risks operating prenatally and perinatally, during childhood, and then later in life prior to illness onset. Some of these riskfactors have been well documented, for example, early hazards causing fetal growth retardation or hypoxia, and hazards nearer the onset of illness like drug abuse and migration. Others are much less certain. The importance of interaction between genetic and environmental risk is, however, undoubtedly important and there is emerging evidence for this from a range of sources. As the etiology of schiz-ophrenia is unraveled, the picture becomes more complex, but also more obviously relevant to the plight of the individual patient.
Genetic factors are clearly important in the etiology of schizophrenia, but the environment in which an individual's genes find expression is also crucial to the development of the illness. In this review of environmental riskfactors for schizophrenia, we consider risks operating prenatally and perinatally, during childhood, and then later in life prior to illness onset Some of these riskfactors have been well documented, for example, early hazards causing fetal growth retardation or hypoxia, and hazards nearer the onset of illness like drug abuse and migration. Others are much less certain. The importance of interaction between genetic and environmental risk is, however, undoubtedly important and there is emerging evidence for this from a range of sources. As the etiology of schizophrenia is unraveled, the picture becomes more complex, but also more obviously relevant to the plight of the individual patient. PMID:16060597
Proliferative vitreoretinopathy (PVR) is one of the major causes of failure in retinal detachment surgery. To prevent PVR, it is necessary to determine factors predisposing its development. In primary PVR, large retinal tears, long duration of retinal detachment, vitreous hemorrhages, aphakia and choroidal detachment were demonstrated as clinical riskfactors for PV R. In postoperative PVR, it was revealed that
Background Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub-Saharan countries. Methods An ecological multi-group study compared variables between many countries in Sub-Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP. Results Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health. Conclusions Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.
To estimate levels and determinants of perinatal mortality, we conducted a hospital-based surveillance and case-control study, linked with a population survey, in Ahmedabad, India. The perinatal mortality rate was 79.0 per 1000, and was highest for preterm low-birth-weight babies. The case-control study of 451 stillbirths, 160 early neonatal deaths and 1465 controls showed that poor maternal nutritional status, absence of antenatal care, and complications during labour were independently associated with substantially increased risks of perinatal death. Multivariate analyses indicate that socioeconomic factors largely operate through these proximate factors and do not have an independent effect. Estimates of attributable risk derived from the prevalence of exposures in the population survey suggest that improvements in maternal nutrition and antenatal and intrapartum care could result in marked reductions of perinatal mortality.
Food allergy is a common problem that often affects young children. Numerous factors affect the development of food allergy\\u000a both prenatally and postnatally. These factors are genetic and environmental. Although little can be done post-conception\\u000a to alter a child’s genetic risk for developing food allergy, early identification may permit alterations of the environment\\u000a in which food allergy develops. Environmental factors
To determine modifiable and nonmodifiable riskfactors for term large for gestational age (T-LGA) births in Northern and Central Alberta and their public health importance, a retrospective cohort study (n = 115,198) of singleton live births (1996–2003) was conducted using maternal and newborn data from a provincial perinatal database. After adjusting for potential confounders, predictors of T-LGA births included prepregnancy
Joy V. Jaipaul; Christine V. Newburn-Cook; Beverley OBrien; Nestor Demianczuk
Objective:We aimed at (a) examining the rates of obesity over a 12-year period; (b) studying the effect of obesity and morbid obesity on gestational age and birth weight and (c) determining the influence of race on the association between maternal obesity and the gestational age of a newborn.Study Design:We conducted a retrospective analysis using data from the perinatal data set
H Aly; T Hammad; A Nada; M Mohamed; S Bathgate; A El-Mohandes
Objective. To asses the association between intake of folate and B vitamins and the incidence of spontaneous abortion (SA) according to the maternal methylenetetrahydrofolate reductase (MTHFR) polymorphisms (677 C>T and 1298 A>C). Material and Methods. We conducted a nested case-control study within a perinatal cohort of women re - cruited in the state of Morelos, Mexico. Twenty-three women with SA
María del Rosario Rodríguez-Guillén; Luisa Torres-Sánchez; Jia Chen; Marcia Galván-Portillo; Julia Blanco-Muñoz; Miriam Aracely Anaya; Irma Silva-Zolezzi; María A Hernández-Valero; Lizbeth López-Carrillo
We examined the link between household chaos (i.e., noise, clutter, disarray, lack of routines) and maternal executive function (i.e., effortful regulation of attention and memory), and whether it varied as a function of socioeconomic risk (i.e., single parenthood, lower mother and father educational attainment, housing situation, and father unemployment). We hypothesized that: 1) higher levels of household chaos would be linked with poorer maternal executive function, even when controlling for other measures of cognitive functioning (e.g., verbal ability), and 2) this link would be strongest in the most socioeconomically distressed or lowest-socioeconomic status households. The diverse sample included 153 mothers from urban and rural areas who completed a questionnaire and a battery of cognitive executive function tasks and a verbal ability task in the laboratory. Results were mixed for Hypothesis 1, and consistent with Hypothesis 2. Two-thirds of the variance overlapped between household chaos and maternal executive function, but only in families with high levels of socioeconomic risk. This pattern was not found for chaos and maternal verbal ability, suggesting that the potentially deleterious effects of household chaos may be specific to maternal executive function. The findings implicate household chaos as a powerful statistical predictor of maternal executive function in socioeconomically distressed contexts. PMID:22563703
Deater-Deckard, Kirby; Chen, Nan; Wang, Zhe; Bell, Martha Ann
To test a proposition central to J. Belsky, L. Steinberg, and P. Draper's (1991) evolutionary theory of socialization-that pubertal maturation plays a role in linking early rearing experience with adolescent sexual risk taking (i.e., frequency of sexual behavior) and, perhaps, other risk taking (e.g., alcohol, drugs, delinquency)-the authors subjected longitudinal data on 433 White, 62 Black, and 31 Hispanic females to path analysis. Results showed (a) that greater maternal harshness at 54 months predicted earlier age of menarche; (b) that earlier age of menarche predicted greater sexual (but not other) risk taking; and (c) that maternal harshness exerted a significant indirect effect, via earlier menarche, on sexual risk taking (i.e., greater harshness --> earlier menarche --> greater sexual risk taking) but only a direct effect on other risk taking. Results are discussed in terms of evolutionary perspectives on human development and reproductive strategy, and future directions for research are outlined. PMID:20053011
Belsky, Jay; Steinberg, Laurence; Houts, Renate M; Halpern-Felsher, Bonnie L
This study uses instrumental variable (IV) models with genetic instruments to assess the effects of maternal smoking on the child’s risk of orofacial clefts (OFC), a common birth defect. The study uses genotypic variants in neurotransmitter and detoxification genes relateded to smoking as instruments for cigarette smoking before and during pregnancy. Conditional maximum likelihood and two-stage IV probit models are used to estimate the IV model. The data are from a population-level sample of affected and unaffected children in Norway. The selected genetic instruments generally fit the IV assumptions but may be considered “weak” in predicting cigarette smoking. We find that smoking before and during pregnancy increases OFC risk substantially under the IV model (by about 4–5 times at the sample average smoking rate). This effect is greater than that found with classical analytic models. This may be because the usual models are not able to consider self-selection into smoking based on unobserved confounders, or it may to some degree reflect limitations of the instruments. Inference based on weak-instrument robust confidence bounds is consistent with standard inference. Genetic instruments may provide a valuable approach to estimate the “causal” effects of risk behaviors with genetic-predisposing factors (such as smoking) on health and socioeconomic outcomes.
Virological and clinical data from 73 hepatitis C virus (HCV)-infected pregnant women who gave birth to 75 children were merged retrospectively, by logistic regression analysis, to investigate riskfactors for vertical transmission of HCV. Eighty-two percent of the HCV-infected mothers were HCV-RNA-positive during pregnancy, and 10% were coinfected with human immunodeficiency virus (HIV). Nine children were HCV infected, 1 was HIV infected, but none was HIV-HCV coinfected. Among vaginal deliveries, the mean HCV load of mothers who transmitted HCV to their infants was higher than that of those who did not (8.1 x 10(5) vs. 1.4 x 10(4) copies/mL; P=.056). A reduction in umbilical cord-blood pH (relative risk, 3.9; P=.04) or the occurrence of perineal or vaginal laceration (relative risk, 6.4; P=.028) during vaginal delivery significantly increased the risk of vertical HCV transmission. In conclusion, high maternal viremia, infantile hypoxia, and intrapartum exposure to virus-contaminated maternal blood increased the risk of HCV transmission during vaginal deliveries. Consequently, cesarean section may reduce the risk of vertical HCV transmission in selected cases. PMID:12552417
Maternal periconceptional use of vitamin supplements containing folic acid substantially reduces the risk of neural tube defects (NTDs) in the offspring. The mechanism underlying this reduction in risk is unknown. Several recent studies have reported an association between homozygosity for a variant form (the C677T genotype) of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene and risk for NTDs in individuals. It has
Gary M. Shaw; Rima Rozen; Richard H. Finnell; Cathy R. Wasserman; Edward J. Lammer
Although overall incidence is rare, leukemia is the most common type of childhood cancer. It accounts for 30% of all cancers diagnosed in children younger than 15 years. Within this population, acute lymphocytic leukemia (ALL) occurs approximately five times more frequently than acute myelogenous leukemia (AML) and accounts for approximately 78% of all childhood leukemia diagnoses. Epidemiologic studies of acute leukemias in children have examined possible riskfactors, including genetic, infectious, and environmental, in an attempt to determine etiology. Only one environmental riskfactor (ionizing radiation) has been significantly linked to ALL or AML. Most environmental riskfactors have been found to be weakly and inconsistently associated with either form of acute childhood leukemia. Our review focuses on the demographics of childhood leukemia and the riskfactors that have been associated with the development of childhood ALL or AML. The environmental riskfactors discussed include ionizing radiation, non-ionizing radiation, hydrocarbons, pesticides, alcohol use, cigarette smoking, and illicit drug use. Knowledge of these particular riskfactors can be used to support measures to reduce potentially harmful exposures and decrease the risk of disease. We also review genetic and infectious riskfactors and other variables, including maternal reproductive history and birth characteristics.
The rodent maternal separation (MS) model is frequently used to investigate the impact of early environmental factors on adult neurobiology and behavior. The majority of MS studies assess effects in the offspring and few address the consequences of repeated pup removal in the dam. Such studies are of interest since alterations detected in offspring subjected to MS may, at least in part, be mediated by variations in maternal behavior and the amount of maternal care provided by the dam. The aim of this study was to investigate how daily short (15 min; MS15) and prolonged (360 min; MS360) periods of MS affects the dam by examining postpartum behavioral profiles using the multivariate concentric square field (MCSF) test. The dams were tested on postpartum days 24-25, i.e., just after the end of the separation period and weaning. The results reveal a lower exploratory drive and lower risk-assessment behavior in MS15 dams relative to MS360 or animal facility reared dams. The present results contrast some of the previously reported findings and provide new information about early post-weaning behavioral characteristics in a multivariate setting. Plausible explanations for the results are provided including a discussion how the present results fit into the maternal mediation hypothesis. PMID:20617189
Environmental riskfactors for osteoporosis were reviewed at a conference held at the National Institute for Environmental Health Sciences 8-9 November 1993. The conference was co-sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Disease and the NIH Office of Research in Women's Health. The objective of the conference was to review what is known about riskfactors for osteoporosis and to identify gaps in the present state of knowledge that might be addressed by future research. The conference was divided into two broad themes. The first session focused on current knowledge regarding etiology, riskfactors, and approaches to clinical and laboratory diagnosis. This was followed by three sessions in which various environmental pollutants were discussed. Topics selected for review included environmental agents that interfere with bone and calcium metabolism, such as the toxic metals lead, cadmium, aluminum, and fluoride, natural and antiestrogens, calcium, and vitamin D.
Goyer, R.A.; Korach, K.S. (National Institute of Environmental Health Sciences, Triangle Park, NC (United States)); Epstein, S. (Albert Einstein Medical Center, Philadelphia, PA (United States)); Bhattacharyya, M. (Argonne National Lab., IL (United States)); Pounds, J. (Wayne State Univ., Detroit, MI (United States))
The poor maternal health care service utilization among adolescent women remains an intimidating challenge in Malawi. This study examines the factors associated with the utilization of selected maternal health care services among married adolescent women (aged 15-19 years) using data from the Malawi Demographic and Health Survey, 2010. Maternal age, household economic status, and status of the child were found to be significant factors associated with at least four antenatal care visits; whereas personal barriers, birth order and interval, religion, and ethnic group explain the variation in the utilization of postnatal care within 42 days of delivery. PMID:23679661
Non-genetic maternal effects are widespread across taxa and challenge our traditional understanding of inheritance. Maternal experience with predators, for example, can have lifelong consequences for offspring traits, including fitness. Previous work in threespine sticklebacks showed that females exposed to simulated predation risk produced eggs with higher cortisol content and offspring with altered anti-predator behavior. However, it is unknown whether this maternal effect is mediated via the offspring glucocorticoid stress response and if it is retained over the entire lifetime of offspring. Therefore, we tested the hypothesis that maternal exposure to simulated predation risk has long-lasting effects on the cortisol response to simulated predation risk in stickleback offspring. We measured circulating concentrations of cortisol before (baseline), 15min after, and 60min after exposure to a simulated predation risk. We compared adult offspring of predator-exposed mothers and control mothers in two different social environments (alone or in a group). Relative to baseline, offspring plasma cortisol was highest 15min after exposure to simulated predation risk and decreased after 60min. Offspring of predator-exposed mothers differed in the cortisol response to simulated predation risk compared to offspring of control mothers. In general, females had higher cortisol than males, and fish in a group had lower cortisol than fish that were by themselves. The buffering effect of the social environment did not differ between maternal treatments or between males and females. Altogether the results show that while a mother's experience with simulated predation risk might affect the physiological response of her adult offspring to a predator, sex and social isolation have much larger effects on the stress response to predation risk in sticklebacks. PMID:23628383
The purpose of this study was to evaluate riskfactors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the Englishlanguage literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and ?1 riskfactors. For each riskfactor, 2 blinded, independent reviewers evaluated the overall trend of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate analyses. Our results demonstrate several correlates that are consistently related to an increased risk of depressive symptoms during pregnancy.
Lancaster, Christie A.; Gold, Katherine J.; Flynn, Heather A.; Yoo, Harim; Marcus, Sheila M.; Davis, Matthew M.
BACKGROUND Lactation has been associated with improvements in maternal glucose metabolism. METHODS We explored the relationships between lactation and risk of type-2 diabetes in a well-characterized, population-representative cohort of women, aged 40–78, who were members of a large integrated health delivery organization in California and enrolled in the Reproductive Riskfactors for Incontinence Study at Kaiser (RRISK), between 2003 and 2008. Multivariable logistic regression was used to control for age, parity, race, education, hysterectomy, physical activity, tobacco and alcohol use, family history of diabetes, and body mass index (BMI), while examining the impact of duration, exclusivity and consistency of lactation on risk of having developed type-2 diabetes. RESULTS Of 2233 women studied, 1828 were mothers; 56% had breastfed an infant for ?1 month. In fully-adjusted models, the risk of type-2 diabetes among women who consistently breastfed all of their children for ?1 month remained similar to that of women who had never given birth (OR=1.01, 95% CI=0.56–1.81). In contrast, mothers who had never breastfed an infant were more likely to have developed type-2 diabetes than nulliparous women (OR=1.92, 95% CI=1.14–3.27). Mothers who never exclusively breastfed were more likely to have developed type-2 diabetes than mothers who exclusively breastfed for 1–3 months (OR=1.52, 95% CI=1.11–2.10). CONCLUSIONS Risk of type-2 diabetes increases when term pregnancy is followed by <1 month of lactation, independent of physical activity and BMI in later life. Mothers should be encouraged to exclusively breastfeed all of their infants for at least 1 month.
Schwarz, E.B.; Brown, J.S.; Creasman, J.M.; Stuebe, A.; McClure, C.K; Van Den Eeden, S.K.; Thom, D.
To better understand pathological gambling, potential riskfactors were assessed within three domains—gambling behaviors, substance abuse and other problem behaviors, and sociodemographic factors. A random-digit-dial telephone survey was conducted in 1999–2000 with a representative sample of the U.S. population aged 18 or older. The current analyses uses data from the 2168 respondents who gambled in the year before the interview.
John W. Welte; Grace M. Barnes; William F. Wieczorek; Marie-Cecile O. Tidwell; John C. Parker
Objective: The goal of this study was to explore neighborhood environmental factors associated with obesity in a sample of adults living in a major U.S. metropolitan area.Research Methods and Procedures: This was a multi-level study combining data from the U.S. Behavioral RiskFactor Surveillance System with data from the U.S. Census. A total of 15,358 subjects living in 327 zip
There is limited discussion of maternal competency in the consultation-liaison psychiatry literature. As awareness and reporting of child abuse is increasing, maternal ability to care for newborns is more often called into question. Maternalriskfactors for harm and neglect have been identified, and positive signs of maternal ability have also been recognized as important to appraise. Specific domains in the maternal competency exam should be assessed by the psychiatrist, nursing staff, social work staff and pediatrician. The competency exam by the psychiatrist requires a sensitive and nonjudgmental inquiry into maternal behavior and thoughts. The authors present a case study of an inpatient maternal competency consultation that illustrates some of the dilemmas encountered. Future directions should include more involvement by psychiatrists in preventive efforts and interventions that focus on pregnant women at risk in prenatal clinics and in the community. PMID:11110117
Protein-L-isoaspartate (D-aspartate) O-methyltransferase 1 (PCMT1) gene encodes for the protein repair enzyme L-isoaspartate (D-aspartate) O-methyltransferase (PIMT), which is known to protect certain neural cells from Bax-induced apoptosis. Previous study has shown that PCMT1 polymorphisms rs4552 and rs4816 of infant are associated with spina bifida in the Californian population. The association between maternal polymorphism and neural tube defects is still uncovered. A case-control study was conducted to investigate a possible association between maternal PCMT1 and NTDs in Lvliang high-risk area of Shanxi Province in China, using a high-resolution DNA melting analysis genotyping method. We found that increased risk for anencephaly in isolated NTDs compared with the normal control group was observed for the G (vs. A) allele (p=0.034, OR=1.896, 95% CI, 1.04-3.45) and genotypes GG+GA (p=0.025, OR=2.237, 95% CI, 1.09-4.57). Although the significance was lost after multiple comparison correction, the results implied that maternal polymorphisms in PCMT1 might be a potential genetic riskfactor for isolated anencephaly in this Chinese population. PMID:22647835
Background Utilization of maternal health services is associated with improved maternal and neonatal health outcomes. Considering global and national interests in the Millennium Development Goal and Nigeria's high level of maternal mortality, understanding the factors affecting maternal health use is crucial. Studies on the use of maternal care services have largely overlooked community and other contextual factors. This study examined the determinants of maternal services utilization in Nigeria, with a focus on individual, household, community and state-level factors. Methods Data from the 2005 National HIV/AIDS and Reproductive Health Survey - an interviewer-administered nationally representative survey - were analyzed to identify individual, household and community factors that were significantly associated with utilization of maternal care services among 2148 women who had a baby during the five years preceding the survey. In view of the nested nature of the data, we used multilevel analytic methods and assessed state-level random effects. Results Approximately three-fifths (60.3%) of the mothers used antenatal services at least once during their most recent pregnancy, while 43.5% had skilled attendants at delivery and 41.2% received postnatal care. There are commonalities and differences in the predictors of the three indicators of maternal health service utilization. Education is the only individual-level variable that is consistently a significant predictor of service utilization, while socio-economic level is a consistent significant predictor at the household level. At the community level, urban residence and community media saturation are consistently strong predictors. In contrast, some factors are significant in predicting one or more of the indicators of use but not for all. These inconsistent predictors include some individual level variables (the woman's age at the birth of the last child, ethnicity, the notion of ideal family size, and approval of family planning), a community-level variable (prevalence of the small family norm in the community), and a state-level variable (ratio of PHC to the population). Conclusion Factors influencing maternal health services utilization operate at various levels - individual, household, community and state. Depending on the indicator of maternal health services, the relevant determinants vary. Effective interventions to promote maternal health service utilization should target the underlying individual, household, community and policy-level factors. The interventions should reflect the relative roles of the various underlying factors.
Some life styles and systemic pathologies represent riskfactors for the periodontal disease. Cigarette smoking in particular increases the speed of progression of periodontitis. Other conditions such as diabetes mellitus, presence of genetic markers and some bacteria are significantly correlated with the periodontal disease. PMID:12660616
We studied the denning ecology of giant pandas (Ailuropoda melanoleuca) in the Foping Nature Reserve, China. We identified 17 used and 21 unused cavities of appropriate size to accommodate denning and measured several variables potentially affecting the suitability of these cavities for panda denning. Principal component analysis, combined with traditional univariate tests, indicated that maternal females preferred deeper cavities with
ZEJUN ZHANG; RONALD R. SWAISGOOD; HUA WU; MING LI; YANGE YONG; JINCHU HU; FUWEN WEI
Background—Few studies have examined the effects of paternal and maternal history of myocardial infarction (MI), including age at MI, on cardiovascular disease (CVD) risk, particularly among women. Methods and Results—We prospectively studied 22 071 men from the Physicians' Health Study and 39 876 women from the Women's Health Study with data on parental history and age at MI. Among men,
Howard D. Sesso; I-Min Lee; J. Michael Gaziano; Kathryn M. Rexrode; Robert J. Glynn; Julie E. Buring
|Objective: We conducted a meta-analysis of epidemiological studies investigating the association between maternal age and autism. Method: Using recommended guidelines for performing meta-analyses, we systematically selected, and extracted results from, epidemiological scientific studies reported before January 2012. We calculated pooled risk…
Sandin, Sven; Hultman, Christina M.; Kolevzon, Alexander; Gross, Raz; MacCabe, James H.; Reichenberg, Abraham
|We investigated the independent contributions of maternal history of antisocial behavior and parenting practices to the worsening course of sons' behavior problems in a sample of young urban boys at risk for antisocial behavior. Mothers reported on boys' behavior problems at baseline and one year later, as well as on their own history of…
We investigated the independent contributions of maternal history of antisocial behavior and parenting practices to the worsening course of sons' behavior problems in a sample of young urban boys at risk for antisocial behavior. Mothers reported on boys' behavior problems at baseline and one year later, as well as on their own history of antisocial behavior before and after age
Miriam K. Ehrensaft; Gail A. Wasserman; Lena Verdelli; Steven Greenwald; Laurie S. Miller; Mark Davies
|Objective: This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. Methods: A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714).…
Contaminated sport fish consumption may result in exposure to various reproductive and developmental toxicants, including pesticides and other suspected endocrine disruptors. We investigated the relation between maternal sport fish meals and risk of major birth defects among infants born to members of the New York State (NYS) Angler Cohort between 1986 and 1991 (n=2237 births). Birth defects (n=125 cases) were
Pauline Mendola; Luther K. Robinson; Germaine M. Buck; Charlotte M. Druschel; Edward F. Fitzgerald; Lowell E. Sever; John E. Vena
BackgroundAnimal models of schizophrenia suggest a link between maternal crowding during pregnancy and increased risk of the offspring to develop physiological, developmental, and behavioral abnormalities that are comparable to those observed in schizophrenia. We tested the hypothesis that a similar link is present in humans.
David Kimhy; Susan Harlap; Shmuel Fennig; Lisa Deutsch; Benjamin G. Draiman; Cheryl Corcoran; Deborah Goetz; Daniella Nahon; Dolores Malaspina
This paper, based on a review of the literature, evaluates the risks to infants of maternal drug use during lactation. The potential harm of a particular drug to the breastfed infant is related both to the complex mechanism of milk synthesis and secretion and the mode of passage of the drug from plasma into milk. The 1st part of the paper discusses mammary cell and milk synthesis, milk secretion and composition, the mode of passage of drugs into milk, and factors influencing drug concentrations in milk. Drug concentrations in milk are dependent on 6 major factors: drug dosage, proportion bound in plasma, molecular weight, lipid solubility, degree of ionization, and pH difference between plasma and milk. Drugs that are weak acids are ionized to a greater extent and are more protein-bound than weak alkaline drugs. The 2nd part of the paper evaluates the risks to breastfed infants of selected pharmacons. Some categories of drugs that contain pharmacons that should be limited or avoided by nursing mothers are alkylating agents, analgesics and anti-inflammatory agents, anticoagulants, anticonvulsants, anti-infective agents, central nervous system stimulants, hormones, laxatives, minerals, provitamins, psychotherapeutic agents, thyroid affecting agents, and vitamins. The following precautions are suggested to minimize the risks of potentially harmful pharmacons: 1) all unnecessary medications should be avoided by nrusing mothers; 2) if medication is necessary during lactation, drug dosage should be controlled and the infant should be monitored for adverse symptoms; 3) drugs should be administered shortly after breastfeeding and the interval prolonged before the next feeding; and 4) if the infant must be fed soon after a potentially harmful drug has been taken by the mother, bottle feeding is recommended. PMID:6147939
Background: Placental abruption is one of the most common causes of bleeding during pregnancy. Multiple factors are known to be associated with increase of risk of placental abruption such as alcohol, cocaine use and cigarette smoking. The objective of this study was to identify riskfactors for placental abruption in an Iranian women population. Materials and Methods: In a retrospective case – control study birth records included 78 cases with placental abruption and 780 randomly selected controls were investigated. Statistical analysis for comparing the studied riskfactors between groups was performed using Pearson's Chi-square test along with presenting relevant odds ratio (OR). Results: From 7301 deliveries included in the study, 78 (1%) was complicated placental abruption. Women aged 35 or more likely for experiencing (OR = 3.650, 95% confidence interval [CL] = 1.57-6.83) and those who had a previous cesarean section (OR = 2.65, 95% CL = 3.91- 33.41) were in higher risk for placental abruption ([50 cases] 64% vs. [28 cases] 36% P < 0.01). Conclusion: The results indicate that among the placental abruption is one of the most common causes of bleeding during the pregnancy and one of the major obstetrical emergency.
The short- and long-term effects of pregnancy on breast cancer risk are well documented. Insight into potential biological\\u000a mechanisms for these associations may be gained by studying breast cancer risk and pregnancy characteristics (e.g., preeclampsia,\\u000a twining), which may reflect hormone levels during pregnancy. To date, no review has synthesized the published literature for\\u000a pregnancy characteristics and maternal breast cancer using
BackgroundEvidence is accumulating for a role of vitamin D in maintaining normal glucose homeostasis. However, studies that prospectively examined circulating concentrations of 25-hydroxyvitamin D (25-[OH] D) in relation to diabetes risk are limited. Our objective is to determine the association between maternal plasma 25-[OH] D concentrations in early pregnancy and the risk for gestational diabetes mellitus (GDM).MethodsA nested case-control study
Cuilin Zhang; Chunfang Qiu; Frank B. Hu; Robert M. David; Rob M. van Dam; Alexander Bralley; Michelle A. Williams; Per Westermark
To examine the association between exposure to tobacco compounds in breast milk and risk of childhood overweight, we used historical data for a subset of 21,063 mother-child pairs in the US Collaborative Perinatal Project. Based on self-reports, mothers were classified as non-smokers, light (1-9 cigarettes/day), moderate (10-19), or heavy (20+) smokers. Feeding type (exclusive breastfeeding or bottle-feeding) was observed during nursery stay after birth. We stratified children by maternal smoking and feeding type, and then fit interaction terms to isolate exposure to tobacco compounds via breast milk from exposure in uterus and in ambient air after birth. Using measured weight and height, overweight at age 7 was defined as a body mass index ?85th percentile by sex and age. Among exclusively bottle-fed children, adjusted odds ratios (ORs) of overweight at age 7 were 1.24 (95% confidence interval [CI], 1.12-1.38; vs. non-smoking) for light maternal smoking, 1.43 (95% CI, 1.25-1.63) for moderate maternal smoking, and 1.46 (95% CI, 1.28-1.66) for heavy maternal smoking. Among exclusively breastfed children, the corresponding ORs were 1.33 (95% CI, 0.96-1.84) for light, 1.86 (95% CI, 1.27-2.73) for moderate, and 2.22 (95% CI, 1.53-3.20) for heavy maternal smoking. There was a modest positive interaction between breastfeeding and heavy maternal smoking on overweight risk at age 7. Tobacco compounds via breast milk of smoking mothers (significantly for heavy smokers) appear to be associated with a modest elevation in childhood overweight risk at 7 years of age. More aggressive intervention is needed to help pregnant and breastfeeding women to quit smoking. PMID:22714798
Wen, Xiaozhong; Shenassa, Edmond D; Paradis, Angela D
Examines riskfactors for sudden infant death syndrome based on Swedish births between 1983 and 1985. Results indicate that maternal smoking doubles the risk of infant death, and infants of smokers also died sooner. The more the mother smoked the more likely her infant was to die. (JS)
|The current investigation examined the role of cumulative risk, family routines, maternal monitoring, mother-child relationship quality, and youth socioemotional competence in adjustment outcomes of 521 10- to 14-year-old low-income Latino early adolescents. Results showed that, as the number of riskfactors increased, levels of externalizing and…
Purpose This study aimed to examine extended postoperative ileus and its riskfactors in patients who have undergone abdominal surgery, and discuss the techniques of prevention and management thereof the light of related riskfactors connected with our study. Methods This prospective study involved 103 patients who had undergone abdominal surgery. The effects of age, gender, diagnosis, surgical operation conducted, excessive small intestine manipulation, opioid analgesic usage time, and systemic inflammation on the time required for the restoration of intestinal motility were investigated. The parameters were investigated prospectively. Results Regarding the factors that affected the restoration of gastrointestinal motility, resection operation type, longer operation period, longer opioid analgesics use period, longer nasogastric catheter use period, and the presence of systemic inflammation were shown to retard bowel motility for 3 days or more. Conclusion Our study confirmed that unnecessary analgesics use in patients with pain tolerance with non-steroid anti-inflammatory drugs, excessive small bowel manipulation, prolonged nasogastric catheter use have a direct negative effect on gastrointestinal motility. Considering that an exact treatment for postoperative ileus has not yet been established, and in light of the riskfactors mentioned above, we regard that prevention of postoperative ileus is the most effective way of coping with intestinal dysmotility.
Kutun, Suat; Ulucanlar, Haluk; Tarcan, Oguz; Demir, Abdullah; Cetin, Abdullah
Individual, dyadic, and triadic influences on the development of the family system were examined in the context of developmental risk. Participants were 145 couples and their 4-month-old first-born child in six groups: controls, three mother-risk groups (depressed, anxious, comorbid), and two infant-risk groups (preterm, intrauterine growth retardation). Dyadic and triadic interactions were observed. Differences in parent-infant reciprocity and intrusiveness were found, with mother-risk groups scoring less optimally than controls and infant-risk groups scoring the poorest. Similar results emerged for family-level cohesion and rigidity. Structural modeling indicated that father involvement had an influence on the individual level, by reducing maternal distress, as well as on the triadic level, by increasing family cohesion. Maternal emotional distress affected the reciprocity component of early dyadic and triadic relationships, whereas infant negative emotionality impacted on the intrusive element of parenting and family-level relationships. Discussion considered the multiple and pattern-specific influences on the family system as it is shaped by maternal and child risk conditions. PMID:17459172
Zaria is a university town with a population of 200,000 people, mostly Hausas, who are rural farmers and small scale traders. The Ahmadu Bello University Teaching Hospital has over 300 beds and serves nearly 500,000 people. Maternal and other services are provided free of charge. The number of women having babies in the hospital has more than doubled in the last 5 years, as has the number of doctors, but not the number of midwives and nurses. In 1976-77 the maternal morality rate was 10/1000, nearly 50 times as high as in Western Europe. The main influences on maternal death were anemia, prolonged labor, parity, age, health and reproductive history prior to each pregnancy. Early marriages are common as are pregnancies between the ages of 14-16. Blood transfusion is often refused because it is believed to do harm. Operative deliveries are also refused because it is shameful for a woman not to deliver herself. Purdah is the practice among Muslims of restricting the women to their matrimonial homes to avoid infidelity. Lives may be lost because no one is available to give a woman permission to leave the house. As education becomes more widespread and medical facilities improve, more and more demands will be made on the health delivery system. The National Youth Service Corps is relieving the personnel shortage in rural areas, and the government is emphasizing preventive care. PMID:7384428
Children of anxious parents have been shown to be at an increased risk of developing an anxiety disorder. Thus, it is critically important to identify factors that increase or decrease that risk. The depression literature has shown that maternal sensitivity decreases negative child outcome associated with maternal depression. The current study was designed to determine whether maternal sensitivity may buffer
Sarah J. Kertz; Carrie L. Smith; L. Kevin Chapman; Janet Woodruff-Borden
|Across development, maternal depression has been found to be a riskfactor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two…
Tompson, Martha C.; Pierre, Claudette B.; Boger, Kathryn Dingman; McKowen, James W.; Chan, Priscilla T.; Freed, Rachel D.
Full-term pregnancies are associated with long-term reductions in maternalrisk of breast cancer, but the biological determinants of the protection are unknown. Experimental observations suggest that human Chorionic Gonadotropin (hCG), a major hormone of pregnancy, could play a role in this association. A case-control study (242 cases, 450 controls) nested within the Northern Sweden Maternity Cohort included women who had donated a blood sample during the first trimester of a first full-term pregnancy. Total hCG was determined on Immulite 2000 analyzer. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through conditional logistic regression. Maternal breast cancer risk decreased with increasing hCG (upper tertile OR, 0.67; CI, 0.46-0.99) especially for pregnancies before age 25 (upper tertile OR, 0.41; CI, 0.21-0.80). The association diverged according to age at diagnosis: risk was reduced after age 40 (upper tertile OR: 0.60; CI, 0.39-0.91) and appeared to increase before age 40 (upper tertile OR: 1.78; CI, 0.72-4.38). Risk was reduced among those diagnosed 10 years or longer after blood draw (upper tertile OR, 0.60; CI, 0.40-0.90), but not so among those diagnosed within 10 years (upper tertile OR, 4.33; CI, 0.86-21.7). These observations suggest that the association between pregnancy hCG and subsequent maternalrisk of breast cancer is modified by age at diagnosis. While the hormone appears to be a determinant of the reduced risk around or after age 50, it might not confer protection against, or it could even increase the risk of, cancers diagnosed in the years immediately following pregnancy.
This study examined the relationship between reported perinatal riskfactors and sensory processing difficulties in young\\u000a children. The biological mothers of 152 preschool-age children completed two measures: the Maternal Perinatal Scale (MPS),\\u000a a maternal self-report that surveys complications of pregnancies and medical conditions of the mother, and the Short Sensory\\u000a Profile (SSP), a measure designed to provide information about the
SUMMARY 1. Adaptive maternal programming occurs when mothers alter their offspring's phenotype in response to environmental information such that it improves offspring fitness. When a mother's environment is predictive of the conditions her offspring are likely to encounter, such transgenerational plasticity enables offspring to be better-prepared for this particular environment. However, maternal effects can also have deleterious effects on fitness. 2. Here, we test whether female threespined stickleback fish exposed to predation risk adaptively prepare their offspring to cope with predators. We either exposed gravid females to a model predator or not, and compared their offspring's antipredator behaviour and survival when alone with a live predator. Importantly, we measured offspring behaviour and survival in the face of the same type of predator that threatened their mothers (Northern pike). 3. We did not find evidence for adaptive maternal programming; offspring of predator-exposed mothers were less likely to orient to the predator than offspring from unexposed mothers. In our predation assay, orienting to the predator was an effective antipredator behaviour and those that oriented, survived for longer. 4. In addition, offspring from predator-exposed mothers were caught more quickly by the predator on average than offspring from unexposed mothers. The difference in antipredator behaviour between the maternal predator-exposure treatments offers a potential behavioural mechanism contributing to the difference in survival between maternal treatments. 5. However, the strength and direction of the maternal effect on offspring survival depended on offspring size. Specifically, the larger the offspring from predator-exposed mothers, the more vulnerable they were to predation compared to offspring from unexposed mothers. 6. Our results suggest that the predation risk perceived by mothers can have long-term behavioural and fitness consequences for offspring in response to the same predator. These stress-mediated maternal effects can have nonadaptive consequences for offspring when they find themselves alone with a predator. In addition, complex interactions between such maternal effects and offspring traits such as size can influence our conclusions about the adaptive nature of maternal effects.
McGhee, Katie E.; Pintor, Lauren M.; Suhr, Elissa L.; Bell, Alison M.
The risk for multifactorial diseases is determined by riskfactors that frequently apply across disorders (universal risk\\u000a factors). To investigate unresolved issues on etiology of and individual’s susceptibility to multifactorial diseases, research\\u000a focus should shift from single determinant-outcome relations to effect modification of universal riskfactors. We present\\u000a a model to investigate universal riskfactors of multifactorial diseases, based on
Ronald P. Stolk; Judith G. M. Rosmalen; Dirkje S. Postma; Rudolf A. de Boer; Gerjan Navis; Joris P. J. Slaets; Johan Ormel; Bruce H. R. Wolffenbuttel
Between 1987 and 2005, the authors conducted a nested case-control study based on the Swedish Multi-Generation Register to investigate whether early life exposures, namely, maternal age at delivery and exposure to siblings, are associated with an increased risk of amyotrophic lateral sclerosis (ALS). The study comprised 768 ALS cases and five controls per case matched by birth year and gender. Odds ratios and their corresponding 95% confidence intervals for ALS were estimated by conditional logistic regression modeling. Low maternal age (?20 years) and high maternal age (?41 years) were both associated with higher risk of ALS (odds ratio (OR) = 1.5, 95% confidence interval (CI): 1.1, 2.0 and OR = 1.7, 95% CI: 1.1, 2.4, respectively). The relative risk of ALS increased slightly with increasing number of younger siblings (OR = 1.1, 95% CI: 1.0, 1.1; p = 0.02). Children whose first younger sibling was born after the age of 6 years had the greatest relative risk (OR = 1.8, 95% CI: 1.2, 2.7). Exposure to older siblings was not associated with the risk of ALS. Although the strength of the observed associations was modest, these results provided further support for the theory that early life exposures might contribute to the disease pathogenesis.
Background.?The epidemiology of congenital malaria was investigated in a hospital-based malaria surveillance study in Papua, Indonesia. Methods.?From April 2005 to January 2010, 4878 delivering women and their newborns underwent prospective clinical review and malaria screening by peripheral blood microscopy. Findings.?Congenital malaria occurred in 8 per 1000 (38/4884) live births, with Plasmodium falciparum accounting for 76.3% (29) and P. vivax for 15.8% (6) of infections. Maternal malaria at delivery (adjusted odds ratio [AOR], 9.5; 95% confidence interval [CI], 4.2–21.5; P < .001), age ? 16 years (AOR, 4; 95% CI, 1.4–12.1; P = .011), and prior malaria during pregnancy (AOR, 2.2; 95% CI, 1.1–4.4, P = .022) were independent riskfactors for vertical transmission. Of 29 mothers and neonates with contemporaneous peripheral parasitemia, 17% (5) had discordant parasite species, suggesting possible antenatal malaria transmission. Newborns with malaria were at significantly greater risk of low birth weight (AOR, 2.8; 95% CI, 1.2–6.6; P = .002). Following introduction of dihydroartemisinin-piperaquine for uncomplicated malaria in the second and third trimesters of pregnancy, congenital malaria incidence fell from 3.2% to 0.2% (odds ratio, 0.07; 95% CI, .03–.15; P < .001). Conclusions.?Congenital malaria is an important cause of neonatal morbidity in this region co-endemic for P. falciparum and P. vivax malaria. The introduction of artemisinin-combination therapy was associated with a significant risk reduction in the vertical transmission of malaria.
Poespoprodjo, J. R.; Fobia, W.; Kenangalem, E.; Hasanuddin, A.; Sugiarto, P.; Tjitra, E.; Anstey, N. M.
Women of advanced maternal age have a higher risk of having a child affected by a chromosomal disorder than younger childbearing women and are frequently offered invasive testing during pregnancy. The aim of our systematic review was to identify and analyse the current evidence base regarding factors that influence the uptake of invasive fetal testing by pregnant women of advanced maternal age. We conducted a systematic review. A search of The Cochrane Library, CINAHL, Embase and Medline databases was undertaken for papers published in English and Italian from January 2002 to May 2012. Eleven studies satisfied the inclusion criteria, were subjected to quality assessment and included in the review. We analysed the data using thematic analysis. The factors influencing women were classified as either external or psychosocial factors. External factors included the opportunity for screening, screening results and use of genetic counselling. Psychosocial factors related to ethnicity, socio-demographic status and attendance of partners during counselling. It is difficult to draw firm conclusions as to the principle factors that influence uptake of invasive tests by women of AMA. More research is needed to enhance understanding of relevant factors to ensure that services are offered in a way that acknowledges practical as well as psychosocial influences. This type of research will help to equip midwives and other professionals caring for women during pregnancy to ensure that women are supported to make the choices that are appropriate for them and their families. PMID:23453699
Trial of labor after cesarean (TOLAC) delivery is currently a hot obstetrical topic owing to the acute rise in the rate of cesarean deliveries, both primary and repeat. When the physician and patient are considering TOLAC, several factors should be considered: risk of uterine rupture, contraindications, minimizing risk and morbidity, choosing the appropriate candidate and whether or not to induce. Each patient has her own set of individual riskfactors that may decrease her chance of successful vaginal birth after cesarean delivery or increase her risks with TOLAC. Once all things are considered, the risk:benefit of TOLAC should be weighed up before a decision is reached. Each of these factors is discussed in respect to maternalrisk:benefit, with the focus on evidence presented in the current literature. PMID:22757729
Clark, Shannon M; Carver, Alissa R; Hankins, Gary D V
We studied the risk for specific birth defects among infants of mothers with gestational and chronic diabetes using data collected by the Spanish Collaborative Study of Congenital Malformations (ECEMC). For the years 1976 to 1985, we identified 10,087 infants with malformations and 9,994 control infants; 155 of the case infants and 89 of the controls were born to diabetic mothers.
M. A. Ramos-Arroyo; E. Rodriguez-Pinilla; J. F. Cordero
OBJECTIVES. Reduced options for fertility control over the past decade have increased the rates of unwanted pregnancy. We evaluated whether a woman's negative attitude toward her pregnancy increased the risk of perinatal mortality, in a large, prospective cohort study. METHODS. The association between attitude toward the pregnancy and perinatal mortality was evaluated in a longitudinal cohort study of 8823 married,
|This study examined maternal parenting stress in a sample of 430 boys and girls including those at risk for externalizing behavior problems. Children and their mothers were assessed when the children were ages 2, 4, and 5. Hierarchical linear modeling (HLM) was used to examine stability of parenting stress across early childhood and to examine…
Williford, Amanda P.; Calkins, Susan D.; Keane, Susan P.
This study examined maternal parenting stress in a sample of 430 boys and girls including those at risk for externalizing behavior problems. Children and their mothers were assessed when the children were ages 2, 4, and 5. Hierarchical linear modeling (HLM) was used to examine stability of parenting stress across early childhood and to examine…
Williford, Amanda P.; Calkins, Susan D.; Keane, Susan P.
OBJECTIVE: The antenatal and intrapartum management of women with autoimmune thrombocytopenia is controversial. The current approach emphasizes an effort to identify maternal characteristics predictive of severe neonatal thrombocytopenia or to measure fetal platelet counts and perform cesarean section in patients considered to be at risk for neonatal intracranial hemorrhage. In the current study we review our experience with maternal autoimmune
Susan D. Payne; Robert Resnik; Thomas R. Moore; Herman L. Hedriana; Thomas F. Kelly
|The purpose of the present study was to examine longitudinal associations among maternal responsiveness, self-regulation, and behavioral adjustment in adolescents. The authors used structural equation modeling to test a model that demonstrates that the effects of early cumulative risk on behavioral problems is mediated by maternal responsiveness…
Doan, Stacey N.; Fuller-Rowell, Thomas E.; Evans, Gary W.
The GSTP1 gene, highly expressed early in fetal life, is the most abundant phase 2 xenobiotic metabolism enzyme in a human placenta. Fetal inherited GSTP1 Ile105Val polymorphism may modify the metabolism and excretion of xenobiotics from fetal tissue and increase the risk of congenital heart disease (CHD). This study aimed to analyze the joint effects of GSTP1 genetic polymorphism (Ile105Val) and maternal environmental exposure on CHD risk. Within a case-control design, a total of 190 children with CHD (104 boys age 4 ± 5.6 years) and 190 healthy children (114 newborn boys) were genotyped for the GSTP1 Ile105Val polymorphism. Mothers completed a structured questionnaire on the demographics as well as the preconceptional and lifestyle exposures. A higher frequency of mothers of children with CHD (38 %) reported a positive history of exposure to toxicants (occupational and environmental) than mothers of healthy children (23 %) (p = 0.0013). Logistic regression analysis showed that maternal occupational and environmental exposures increased the risk of CHD (odds ratio, 2.6; 95 % confidence interval, 1.6-4.2; p < 0.0001). No significant differences in Ile105Val genotype frequencies were observed between the children with CHD and the healthy children (p = 0.9). Furthermore, case-control analysis showed no evidence of significant interaction between the maternal exposures and GSTP1 polymorphism. Maternal exposure to toxicants increased the risk of children with CHD. However, fetal GSTP1 Ile105Val polymorphism did not increase the risk of CHD. PMID:22815093
Cresci, Monica; Foffa, Ilenia; Ait-Ali, Lamia; Pulignani, Silvia; Kemeny, Alessandra; Gianicolo, Emilio Antonio Luca; Andreassi, Maria Grazia
Objective: To determine the factors contributing to unexplained antepartum stillbirth in Scotland. Study Design: A 10-year birth database in Scotland was used to compare the unexplained antepartum stillbirth with other birth outcomes. The sample unit was a pregnant mother with a gestational age of 20 weeks and above and with a fetal birth weight of 200?g and above. Result: Maternal age of 35 years and above, lower deprivation category, inaccessible area of residence, maternal smoking, maternal height of <160?cm and gestational age of above 39 weeks were significantly associated with unexplained antepartum stillbirth. In multivariable analysis only maternal age (adjusted odds ratio (OR): 1.8, confidence interval (CI): 1.1 to 3.0, P=0.02), smoking during pregnancy (adjusted OR: 2.0, CI: 1.1 to 3.5, P=0.02), and maternal height (adjusted OR: 1.4, CI: 1.1 to 1.8, P=0.01), remain significant. Screening of pregnancies based on these three riskfactors had 4.2% sensitivity and 99.4% specificity. The prevalence of stillbirth for this population was 0.2%. A positive predictive value of only 1.2% implies that only 1 in 83 women with these three riskfactors will have antepartum stillbirth. The remaining 82 will suffer needless anxiety and potentially diagnostic procedures. Conclusion: Advanced maternal age, maternal smoking, and shorter maternal height were associated risk for unexplained antepartum stillbirth but screening based on these factors would be of limited value.
Sutan, R; Campbell, D; Prescott, G J; Smith, W C S
For a risk model to provide a realistic picture of the risks of an insurance or reinsurance enterprise, it is essential that the model capture systemic risks and parameter risks that are often neglected, including market risks (e.g. pricing and underwriting), parameter risks related to embedded projections (e.g. trend and development), and risks related to processes in the external environment
In addition to the revascularization and glycemic management interventions assigned at random, the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) design includes the uniform control of major coronary artery disease riskfactors, including dyslipidemia, hypertension, smoking, central obesity, and sedentary lifestyle. Target levels for riskfactors were adjusted throughout the trial to comply with changes in recommended clinical practice guidelines. At present, the goals are low-density lipoprotein cholesterol <2.59 mmol/L (<100 mg/dL) with an optional goal of <1.81 mmol/L (<70 mg/dL); plasma triglyceride level <1.70 mmol/L (<150 mg/dL); blood pressure level <130 mm Hg systolic and <80 mm Hg diastolic; and smoking cessation treatment for all active smokers. Algorithms were developed for the pharmacologic management of dyslipidemia and hypertension. Dietary prescriptions for the management of glycemia, plasma lipid profiles, and blood pressure levels were adapted from existing clinical practice guidelines. Patients with a body mass index >25 were prescribed moderate caloric restriction; after the trial was under way, a lifestyle weight-management program was instituted. All patients were formally prescribed both endurance and resistance/flexibility exercises, individually adapted to their level of disability and fitness. Pedometers were distributed as a biofeedback strategy. Strategies to achieve the goals for riskfactors were designed by BARI 2D working groups (lipid, cardiovascular and hypertension, and nonpharmacologic intervention) and the ongoing implementation of the strategies is monitored by lipid, hypertension, and lifestyle intervention management centers.
Albu, Jeanine; Gottlieb, Sheldon H.; August, Phyllis; Nesto, Richard W.; Orchard, Trevor J.
Objectives The aims of the present study are to describe the secular trend of breast-feeding rates in Japanese twins in comparison with\\u000a the general population, and then to clarify the maternal and infants’ obstetric factors associated with breast-feeding in\\u000a twins.\\u000a \\u000a \\u000a \\u000a Methods Breast-feeding rates from 0 to 6 full months and related maternal and infant obstetric factors were analyzed using 4,023 Japanese\\u000a twins,
Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother's quality of life, and mother's risk for depression in a sample of 1,110 mothers recruited from a web-based registry of families with children with an ASD. Higher autism symptomatology and a greater number of co-occurring psychiatric disorders in the child were associated with an increased risk for current treatment of maternal depression and a lower maternal quality of life. The results highlight the importance of screening for depression, particularly in mothers of children with ASD and mental health and behavioral challenges. PMID:23263770
The ability to price (monetize) software development risks can benefit various aspects of software development. Cost estimators predict project cost by adjusting a project's nominal cost on the basis of riskfactors' (cost drivers') expected values, but the predicted cost is often inaccurate because riskfactors' actual values normally deviate from expectations. Because variability is a widely used risk measure
Attempted to document clinical observations of increased psychological stress among mothers of at-risk infants. Ss were 100 mothers, primarily from low-socioeconomic and minority groups, who had recently delivered infants representing a wide range of neonatal conditions. Assessments conducted between Postpartum Days 1–5 included the Depression Check List, State–Trait Anxiety Inventory, Neonatal Perception Inventory, Embedded Figures Test, Maternal Attitude Toward Pregnancy
Objectives: Identifying adolescents who are at increased risk for a particularly difficult pregnancy and adjustment into parenthood\\u000a is important, as the physical and psychological development of their infants rest in the well-being of these new mothers.\\u000a This study aims to examine the effects of prenatal stress and parenting stress and the association with: (1) adolescent maternal\\u000a adjustment; and (2) postpartum
Christina K. Holub; Trace S. Kershaw; Kathleen A. Ethier; Jessica B. Lewis; Stephanie Milan; Jeannette R. Ickovics
|Background: Co-occurrence of psychosocial riskfactors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial riskfactors. Methods: Latent class analysis (LCA) was applied to 17 putative psychosocial riskfactors in a representative population sample of 920 children ages 9 to 17. The resultant class…
Copeland, William; Shanahan, Lilly; Costello, E. Jane; Angold, Adrian
There is increasing evidence that riskfactors for vascular disease and stroke are associated with cognitive impairment and Alzheimer’s disease. This paper reviews current knowledge on the relationship between riskfactors for stroke and Alzheimer’s disease. The focus will be on ‘classical’ riskfactors, including age and gender, socioeconomic status, diabetes, cholesterol, prior cardiovascular disease, atrial fibrillation, cigarette smoking and
Monique M. B. Breteler; Michiel L. Bots; Alewijn Ott; Albert Hofman
Background Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery. Methods An indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs) in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR) directly. Adjusted RRs were calculated adjusting for propensity score and medical indications. Results The incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4). The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9). The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9) than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications or urinary tract infection. Conclusions In nulliparous women who were at low risk, caesarean section was associated with a higher rate of post-partum morbidity. Those requesting the surgical procedure with no conventional medical indication, should be advised of the potential risks.
Objective To estimate the effect of increasing severity of obesity on postcesarean wound complications and surgical characteristics.Study Design We performed a retrospective cohort study of consecutive cesarean deliveries at a tertiary care facility from 2004 to 2008. Four comparison groups were defined by body mass index (BMI; kg/cm2): < 30 (n = 728), 30 to 39.9 (n = 1,087), 40 to 49.9 (n = 428), or ?50 (n = 201). The primary outcome was wound complication, defined as wound disruption or infection within 6 weeks postoperatively. Surgical characteristics were compared between groups including administration of preoperative antibiotics, type of skin incision, estimated blood loss (EBL), operative time, and type of skin closure.Results Of the 2,444 women with complete follow-up data, 266 (10.9%) developed a wound complication. Compared with nonobese women (6.6%), increasing BMI was associated with an increased risk of wound complications: BMI 30.0 to 39.9, 9.2%, adjusted odds ratio (aOR) 1.4 (95% confidence interval [CI] 0.99 to 2.0); BMI 40.0 to 49.9, 16.8%, aOR 2.6 (95% CI 1.7 to 3.8); BMI ?50, 22.9%, aOR 3.0 (95% CI 1.9 to 4.9). Increasing BMI was also associated with increased rates of midline vertical incision, longer operative time, higher EBL, and lower rates of subcuticular skin closure.Conclusion A dose-response relationship exists between increasing BMI and risk of postcesarean wound complications. Increasing obesity also significantly influences operative outcomes. PMID:23765707
Conner, Shayna N; Verticchio, Juliana C; Tuuli, Methodius G; Odibo, Anthony O; Macones, George A; Cahill, Alison G
The protective effect of full-term pregnancy against breast cancer is thought to be induced by two placental hormones: human chorionic gonadotropin and human chorionic somato- tropin hormone (CSH) produced by the placental trophoblas- tic cells. We hypothesized that variants in placental genes encoding these hormones may alter maternal breast cancer risk subsequent to pregnancy. We conducted a case-control study to
Muhammad G. Kibriya; Farzana Jasmine; Regina M. Santella; Ruby T. Senie; Habibul Ahsan
Maternal diabetes increases the risk of congenital malformations in the offspring of affected pregnancies. This increase arises from the teratogenic effect of the maternal diabetic milieu on the developing embryo, although the mechanism of this action is poorly understood. In the present study, we examined whether the vitamin A metabolite retinoic acid (RA), a common drug with well-known teratogenic properties, may interact with maternal diabetes to alter the incidence of congenital malformations in mice. Our results show that when treated with RA, embryos of diabetic mice are significantly more prone than embryos of nondiabetic mice to develop caudal regression, a defect that is highly associated with diabetic pregnancy in humans. By studying the vestigial tail (Wnt-3a(vt)) mutant, we provide evidence that Wnt-3a, a gene that controls the development of the caudal region, is directly involved in the pathogenic pathway of RA-induced caudal regression. We further show that the molecular basis of the increased susceptibility of embryos of diabetic mice to RA involves enhanced downregulation of Wnt-3a expression. This positive interaction between RA and maternal diabetes may have implications for humans in suggesting increased susceptibility to environmental teratogens during diabetic pregnancy. PMID:12196475
Chan, Billy W H; Chan, Kwok-Siu; Koide, Tsuyoshi; Yeung, Sau-Man; Leung, Maran B W; Copp, Andrew J; Loeken, Mary R; Shiroishi, Toshihiko; Shum, Alisa S W
AIM—To examine the hypothesis that the maternal insulin-like growth factor system may constrain fetal growth.?METHODS—A prospective observational study of maternal serum insulin-like growth factor binding protein-1 (IGFBP-1) and fetal growth was undertaken in neonates with birthweights below the 5th centile. They had been classified either as having fetal growth restriction (FGR) due to placental dysfunction (increased umbilical artery Doppler pulsatility index (PI); n = 25) or as being small for gestational age (SGA; normal umbilical artery PI, growth velocity and amniotic fluid; n = 27). Eighty nine controls had normal birthweights (5th-95th centile), umbilical artery PI, growth velocity, and amniotic fluid. IGFBP-1 was measured by radioimmunoassay.?RESULTS—Among the controls, there was no significant correlation between IGFBP-1 and birthweight after allowing for body mass index (BMI). Maternal BMI was high in FGR and after adjusting for this, IGFBP-1 was increased (109 ng/ml) compared with SGA babies (69ng/ml) and controls (57 ng/ml) and correlated with the umbilical artery PI.?CONCLUSIONS—Maternal IGFBP-1 is probably not part of normal placental function. Its increase in FGR could be the cause or consequence of impaired placental perfusion, but high IGFBP-1 concentrations might further reduce the availability of maternal IGF-I to the placenta. This could worsen placental function and so adversely affect fetal growth.?
The objective of this study was to examine the influence of anthropometric measurements of pregnant women, gestational weight gain, fundal height, and maternalfactors, namely age, education, family income, parity along with maternal hemoglobin, on birth weight of neonates. A cross sectional study was performed in Khoy City in north west of Iran. Four hundred and fifty healthy pregnant women in the age between 16-40 years were selected for this study from seven health urban centers and one referral hospital. Findings showed that the mean age, height, fundal height, maternal weight, and gestational weight gain during pregnancy were 26.1 years, 159.1 cm, 32.9 cm, 72.0 kg, 11.8 kg respectively. The mean birth weight of neonates was 3.2 kg and 11% of neonates showed low birth weight. Age, family income, maternal height, weight, gestational weight gain and fundal height were significantly associated with birth weight of neonates. Using binary logistic regression analysis, fundal height, maternal hemoglobin, family income and gestational weight gain of pregnant women could be considered as predictive factors of birth weight of neonates.
Objectives The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective\\u000a of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction\\u000a between sub-standard and “appropriate” health facilities. Methods The data are from a maternal health project carried out in two
Jean-Christophe Fotso; Alex Ezeh; Nyovani Madise; Abdhallah Ziraba; Reuben Ogollah
Pregnancy reduces maternalrisk of breast cancer in the long term, but the biological determinants of the protection are unknown. Animal experiments suggest that estrogens and progesterone could be involved, but direct human evidence is scant. A case-control study (536 cases and 1,049 controls) was nested within the Finnish Maternity Cohort. Eligible were primiparous women who delivered at term a singleton offspring before age 40. For each case, two individually matched controls by age (± 6 months) and date of sampling (± 3 months) were selected. Estradiol, estrone and progesterone in first-trimester serum were measured by high-performance liquid chromatography tandem mass spectrometry and sex-hormone binding globulin (SHBG) by immunoassay. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through conditional logistic regression. In the whole study population there was no association of breast cancer with any of the studied hormones. In analyses stratified by age at diagnosis, however, estradiol concentrations were positively associated with risk of breast cancer before age 40 (upper quartile OR, 1.81; CI, 1.08-3.06), but inversely associated with risk in women who were diagnosed ? age 40 (upper quartile OR, 0.64; CI, 0.40-1.04), p(interaction) 0.004. Risk estimates for estrone mirrored those for estradiol but were less pronounced. Progesterone was not associated with risk of subsequent breast cancer. Our results provide initial evidence that concentrations of estrogens during the early parts of a primiparous pregnancy are associated with maternalrisk of breast cancer and suggest that the effect may differ for tumors diagnosed before and after age 40. PMID:21413009
Pregnancy reduces maternalrisk of breast cancer in the long-term, but the biological determinants of the protection are unknown. Animal experiments suggest that estrogens and progesterone could be involved, but direct human evidence is scant. A case-control study (536 cases, 1,049 controls) was nested within the Finnish Maternity Cohort. Eligible were primiparous women, who delivered at term a singleton offspring before age 40. For each case, two individually matched controls by age (±6 months) and date of sampling (±3 months) were selected. Estradiol, estrone, and progesterone in first-trimester serum were measured by High Performance Liquid Chromatography Tandem Mass Spectrometry and sex-hormone binding globulin (SHBG) by immunoassay. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through conditional logistic regression. In the whole study population, there was no association of breast cancer with any of the studied hormones. In analyses stratified by age at diagnosis, however, estradiol concentrations were positively associated with risk of breast cancer before age 40 (upper quartile OR, 1.81; CI, 1.08-3.06), but inversely associated with risk in women who were diagnosed ?age 40 (upper quartile OR, 0.64; CI, 0.40-1.04), pinteraction 0.004. Risk estimates for estrone mirrored those for estradiol, but were less pronounced. Progesterone was not associated with risk of subsequent breast cancer. Our results provide initial evidence that concentrations of estrogens during the early parts of a primiparous pregnancy are associated with maternalrisk of breast cancer and suggest that the effect may differ for tumors diagnosed before and after age 40.
Background: Munroe Regional Center’s Stroke & Vascular Center was created to increase public awareness of riskfactors and symptoms of stroke and cardiac and vascular disease. Methods: Clients were made aware of personal riskfactors during community health screenings. Eleven thousand eight hundred and fifty-six persons were screened for stroke risk. Screenings performed by RNs included: health history, blood pressure,
In Europe, different studies have identified immigrant women coming from developing countries as a risk group for maternal death. In Spain, an ecological study showed higher maternal mortality rates among foreign mothers compared with Spanish mothers during 2003-04. To examine whether the maternal death risk among foreign mothers in Spain is increased, we performed a population-based matched case-control study. Each case of maternal death during 1999-2006 was matched with four mothers who had given birth during the same year the case occurred. The National Statistics Institute provided the data. The variables in the study were maternal age and country of origin. We used a conditional logistic regression analysis. Adjusted by age, the risk of maternal death was 87% higher among foreign mothers. This study confirms that there is an increased risk of maternal death among foreign mothers in Spain. It would be desirable to analyse the socio-economic and healthcare circumstances surrounding the deaths. PMID:20570961
Luque Fernández, Miguel Ángel; Gutiérrez Garitano, Ignacio; Cavanillas, Aurora Bueno
Childhood emotional and behavioural disorders are prevalent, can cause significant maladaptation and often persist into adulthood. Previous literature investigating the potential influence of postpartum depression (PPD) is inconsistent. The present study examined the association between PPD and childhood behavioural/emotional outcomes, while considering a number of potentially important factors. Data were analyzed prospectively from the National Longitudinal Survey of Children and Youth at two follow-up periods (ages 2-3, N = 1,452 and ages 4-5, N = 1,357). PPD was measured using the diagnostic criteria of the DSM-IV-TR. Four behavioural/emotional outcomes were analyzed at each follow-up. For both age groups, logistic regression models were used to estimate the associations between PPD and each of the behavioural and emotional outcomes adjusting for child, obstetric, environmental and socio-demographic factors. PPD was associated with the Emotional Disorder-Anxiety among 2-3 year olds [OR = 2.38, 95 % CI 1.15, 4.91]. Among 2-3 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 1.88, 95 % CI 1.14, 3.11] and Physical Aggression-Opposition [OR = 2.95, 95 % CI 1.77, 4.92]. Among 4-5 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 2.34, 95 % CI 1.22, 4.47], Emotional Disorder-Anxiety [OR = 2.16, 95 % CI 1.00, 4.67], Physical Aggression-Conduct Disorder [OR = 1.96, 95 % CI 1.09, 3.53] and Indirect Aggression [OR = 1.87, 95 % CI 1.09, 3.21]. The findings of the present study do not suggest that PPD is independently associated with any enduring sequelae in the realm of child behavioural/emotional psychology, though the symptoms of PPD may be giving way to other important mediating factors such as parenting style. PMID:22744292
Walker, Meghan J; Davis, Caroline; Al-Sahab, Ban; Tamim, Hala
|These studies explored attitudes toward maternal culpability in cases of alleged fetal abuse. In experiment one, general culpability for the use of various substances during pregnancy was assessed as well as the impact of other potentially relevant factors. One hundred and twenty students completed the survey. Participants overwhelmingly…
|The aim of this study was to investigate the relations between pregnancy and childbirth factors and subsequent quality of maternal interactive behavior in a sample of 116 full-term infants and their mothers. Mothers reported on the conditions of childbirth when infants were 6-8 months of age, and their interactive behavior was observed during a…
Bernier, Annie; Jarry-Boileau, Veronique; Tarabulsy, George M.; Miljkovitch, Raphaele
This study aimed to assess the main maternalriskfactors associated with preterm birth in the Gaza Strip. A hospital-based case-control study was carried out at El-Shifa and Khan-Younis hospitals with 200 women with preterm births and 200 control women. Significant riskfactors for preterm birth were: maternal age > or = 35 years, being a refugee, inadequate antenatal care, failure to gain adequate weight during pregnancy and previous history of preterm birth. Other significant riskfactors included: short stature, short interval between the last 2 pregnancies, presence of congenital gynaecological abnormalities, previous history of caesarean delivery and previous history of stillbirth. PMID:18290407
Background: Elevated morning cortisol is a prospective predictor of major depression and may serve as a vulnerability marker. We examined the relation between morning cortisol and two prominent riskfactors for depression in preschool-aged children: maternal depression and child temperament. We also explored whether maternal depression during the child's life, parental hostility and life stress explained these associations. Methods: 94 children provided a morning salivary cortisol sample, and 92 children provided an evening sample. Child temperament and parenting were assessed using observational measures, and maternal depression and life stress were assessed with clinical interviews. Results: Maternal history of melancholic depression and child temperamental low positive emotionality were significantly associated with higher morning cortisol. These relations persisted after controlling for children's negative emotionality and concurrent depressive symptoms, parental hostility, and life stress. Conclusions: Our findings support the hypothesis that elevated morning cortisol may serve as an early-emerging vulnerability factor for depression, and highlight the importance of anhedonia in risk for depression.
Dougherty, Lea R.; Klein, Daniel N.; Olino, Thomas M.; Dyson, Margaret; Rose, Suzanne
Objectives: To examine and compare the risk of low birth weight associated with delayed childbearing in four ethnic groups using nationally representative data in the United States. Methods: We compared the risk of low (Results: African Americans and Puerto Ricans, and to a lesser extent Mexican Americans, had higher risk differences associated with advanced maternal age. For first births, the
In the current U.S. Environmental Protection Agency reference dose (RfD) for methylmercury, the one-compartment pharmacokinetic model is used to convert fetal cord blood mercury (Hg) concentration to a maternal intake dose. This requires a ratio relating cord blood Hg concentration to maternal blood Hg concentration. No formal analysis of either the central tendency or variability of this ratio has been done. This variability contributes to the overall variability in the dose estimate. A ratio of 1.0 is implicitly used in the model, but an uncertainty factor adjustment is applied to the central tendency estimate of dose to address variability in that estimate. Thus, incorporation of the cord:maternal ratio and its variability into the estimate of intake dose could result in a significant change in the value of the RfD. We analyzed studies providing data on the cord:maternal blood Hg ratio and conducted a Monte Carlo-based meta-analysis of 10 studies meeting all inclusion criteria to generate a comprehensive estimate of the central tendency and variability of the ratio. This analysis results in a recommended central tendency estimate of 1.7, a coefficient of variation of 0.56, and a 95th percentile of 3.4. By analogy to the impact of the similar hair:blood Hg ratio on the overall variability in the dose estimate, incorporation of the cord:maternal ratio may support a 3-fold uncertainty factor adjustment to the central tendency estimate of dose to account for pharmacokinetic variability. Whether the information generated in this analysis is sufficient to warrant a revision to the RfD will depend on the outcome of a comprehensive reanalysis of the entire one-compartment model. We are currently engaged in such an analysis.
|Determined ranking of suicide riskfactors by 81 psychiatrists. Hopelessness was ranked as most important riskfactor, followed by Suicidal Ideation, Previous Attempts, Level of Mood and Affect, Quality of Relationships, Signs and Symptoms of Depression, and Social Integration. Notes less highly ranked factors and discusses significance of…
We compared the short-term maternal and neonatal outcomes of women who deliver by cesarean without labor compared with women who deliver by cesarean after labor or by vaginal birth. This was a retrospective cohort study of women delivering a first baby from 1998 to 2002. Hospital discharge diagnostic coding identified unlabored cesarean deliveries (UCDs), labored cesarean deliveries (LCDs), and vaginal births (VBs). Medical records were abstracted and mode of delivery confirmed. The three outcomes of interest were maternal bleeding complications, maternal febrile morbidity, and neonatal respiratory complications. Using logistic regression for each outcome, we investigated whether mode of delivery was associated with the outcome, independent of other factors. The study groups included 513 UCDs, 261 LCDs, and 251 VBs. Compared with the UCD group, the adjusted odds of bleeding complications was higher in the LCD comparison group (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.21, 4.53) and the VB comparison group (OR 1.96; 95% CI 0.95, 4.02). The incidence of febrile morbidity was similar for both cesarean groups but lower in the VB group. Both comparison groups had lower odds of neonatal complications than the UCD group (OR for LCD comparison group 0.52; 95% CI 0.27, 0.95 and OR for VB comparison group 0.26; 95% CI 0.098, 0.59). Scheduled cesarean is associated with increased odds of neonatal respiratory complications but decreased odds of maternal bleeding complications.
Quiroz, Lieschen H.; Chang, Howard; Blomquist, Joan L.; Okoh, Yvonne K.; Handa, Victoria L.
We investigate the relationship between maternal exposure to benzene and birth weight outcomes for resident births in the United States in 1996 and 1999, taking advantage of a natural experiment afforded by the regulation of benzene content of gasoline in various American cities. Regression results show that a unit increase (?g/m(3)) in maternal exposure to benzene reduces birth weight by 16.5 g (95% CI, 17.6 to 15.4). A unit increase in benzene exposure increases the odds of a low birth weight event by 7%. Similarly, a 1 ?g/m(3) increase in benzene concentration increases the odds of very low birth weight event by a multiplicative factor of 1.23 (95% CI, 1.19 to 1.28). Difference-in-differences analyses show that birth weight increased by 13.7 g (95% CI, 10.7 to 16.8) and the risk of low birth weight decreased by a factor of .95 (95% CI, .93 to .98) in counties experiencing a 25% decline in benzene concentrations from 1996 to 1999. Public health policy and economic implications of results are discussed. PMID:22177084
Zahran, Sammy; Weiler, Stephan; Mielke, Howard W; Pena, Anita Alves
OBJECTIVES: This study reviewed evidence on the effect of maternal smoking on early weaning. METHODS: The following databases and journals were searched: Medline, Scientific Citation Index, Pediatrics, Journal of Pediatrics, New England Journal of Medicine, and Lancet. Analysis was restricted to studies in which infants who had never been breastfed were excluded or the prevalence of breastfeeding initiation was more than 90%. RESULTS: In smoking vs nonsmoking mothers, the random effects odds ratio for weaning before 3 months was 1.93 (95% confidence interval [CI] = 1.55, 2.40). An adjusted odds ratio of 1.50 (95% CI = 1.34, 1.68) was shown in studies that had lost-to-follow-up rates below 15% and included adequate adjustment for confounding. CONCLUSIONS: Maternal smoking increases the risk of early weaning.
From February 2006 to March 2008, 42 pregnant women homozygous for the 677CT-methylenetetrahydrofolate reductase (MTHFR) allele were recruited in our obstetrics service for pregnancy at risk. All had antithrombotic prophylaxis with low-dose aspirin and/or low-molecular-weight heparin, supplemented with folic acid. In all, 2 women lost the fetus and 4 were lost to follow-up before delivery. A total of 36 women delivered term infants who all underwent transfontanellar ultrasonography within 24 hours of birth. Six (16.6%) had ischemic or hemorrhagic cerebral lesions. No differences were observed in gestational age, birth weight, or umbilical cord pH between the 30 healthy infants and the 6 with cerebral lesions. Neonatal outcomes were negative in spite of maternal folic acid supplementation and antithrombotic prophylaxis during pregnancy. This suggests a relationship between maternal homozygous mutation in the 677CT-MTHFR allele and neonatal cerebral lesions. PMID:20357240
Background Prior research has shown that resources have an impact on birth outcomes. In this paper we ask how combinations of telemedical and hospital-level resources impact transports of mothers expecting very low birth weight (VLBW) babies in Arkansas. Methods Using de-identified birth certificate data from the Arkansas Department of Health, data were gathered on transports of women carrying VLBW babies for two six-month periods: a period just before the start of ANGELS (12/02-05/03), a telemedical outreach program for high-risk pregnancies, and a period after the program had been running for six months (12/03-05/04). For each maternal transport, the following information was recorded: maternal race-ethnicity, maternal age, and the birth weight of the infant. Logistic regression was used to assess the relationship between the predictors (telemedicine, hospital level, maternal characteristics) and the probability of a transport. Results Having a telemedical site available increases the probability of a mother carrying a VLBW baby being transported to a level III facility either before or during birth. Having at least a level II nursery also increases the chance of a maternal transport. Where both level II nurseries and telemedical access are available, the odds of VLBW maternal transports are only modestly increased in comparison to the case where neither is present. At the individual level, Hispanic mothers were less likely to be transported than other mothers, and teenaged mothers were more likely to be transported than those 18 and over. A mother's being Black or being over 35 did not have an impact on the odds of being transported to a level III facility. Conclusion Combinations of resources have an impact on physician decisions regarding VLBW transports and are interpretable in terms of the capacity to diagnose and absorb risk. We suggest a collegial review of transport patterns and birth outcomes from areas with different levels of resources as a vehicle for moving the entire system of care forward over time. With such an evidence-based review in place, the collegial relations among level III specialists and obstetricians from around the state can, over time, develop workable protocols for when and how level III facilities should be involved.
Britt, David W; Bronstein, Janet; Norton, Jonathan D
Fasting hyperhomocysteinemia is an independent riskfactor for coronary artery disease, stroke, peripheral vascular atherosclerosis, and for arterial and venous thromboembolism. The risk for cardiovascular disease with homocysteine is similar to conventional riskfactors. The interaction of hyperhomocysteinemia with hypertension and smoking is strong and the combined effect is more than multiplicative. The combined effect of homocysteine and cholesterol is
Purpose: To replicate earlier research findings on riskfactors for youth violence and to explore the effects on violent behavior of constructs shown to increase risk for other problem behaviors, within a developmental frame.Methods: Data were from the Seattle Social Development Project (SSDP), a prospective study involving a panel of youths followed since 1985. Potential riskfactors for violence at
Todd I Herrenkohl; Eugene Maguin; Karl G Hill; J. David Hawkins; Robert D Abbott; Richard F Catalano
Background Excessive gestational weight gain (GWG) increases risk of large for gestational age neonates and subsequent tracking of excess weight throughout the life course for both mother and child. Although the physiological mechanisms underlying these associations are incomplete, the insulin-like growth factor (IGF) axis has garnered attention for its role in fetal growth and development. Our purpose was to characterize the IGF axis protein expression patterns in mother–infant dyads in respect of excessive GWG. Methods We obtained fasting serum samples and corresponding cord blood from eight controls (ADHERE group: ie, those who gained in accordance with 2009 Institute of Medicine GWG recommendations) and 13 exceeders (EXCEED group: ie, those who exceeded Institute of Medicine GWG recommendations). At study completion, we examined protein expression of IGF-I, IGF-II, IGF binding protein (IGFBP)-1, IGFBP-3, IGFBP-4, and hormone concentrations in both maternal and cord blood. Results Between-group comparisons were made and revealed elevated maternal leptin (P ? 0.05) concentrations in gravidas who exceeded recommendations. There was a significantly higher number of obese women in the EXCEED group (P < 0.05). After adjustment, maternal leptin levels were positively correlated with maternal homeostasis model of assessment for insulin resistance score and excessive GWG (P ? 0.01). However, serum IGFBP-3 expression in the EXCEED mothers was greater than that in the ADHERE group (P ? 0.05). Conclusion These findings provide preliminary evidence suggesting that small deviations in IGFBP-regulated IGF bioavailability arising from excessive GWG/positive energy balance may affect adipocyte differentiation through subclinical insulin resistance.
Ferraro, Zachary M; Qiu, Qing; Gruslin, Andree; Adamo, Kristi B
|Despite potential sex differences in base rates, predictors, and maintaining processes for children's externalizing behaviors, little prospective research has examined sex differences in the relations between concurrent, proximal family riskfactors and children's externalizing behaviors. The current study examined the relations among maternal…
Immunization of pregnant women can be an efficient strategy to induce early protection in infants in developing countries. Pneumococcal protein-based vaccines may have the capacity to induce pneumococcal serotype-independent protection. To understand the potential of maternal pneumococcal protein-specific antibodies in infants in high-risk areas, we studied the placental transfer of naturally acquired antibodies to pneumolysin (Ply) and pneumococcal surface protein A family 1 and 2 (PspA1 and PspA2) in relation to onset of pneumococcal nasopharyngeal carriage in infants in Papua New Guinea (PNG). In this study, 76% of the infants carried Streptococcus pneumoniae in the upper respiratory tract within the first month of life, at a median age of 19 days. Maternal and cord blood antibody titers to Ply (? = 0.824, P < 0.001), PspA1 (? = 0.746, P < 0.001), and PspA2 (? = 0.631, P < 0.001) were strongly correlated. Maternal pneumococcal carriage (hazard ratio [HR], 2.60; 95% confidence interval [CI], 1.25 to 5.39) and younger maternal age (HR, 0.74; 95% CI, 0.54 to 1.00) were independent riskfactors for early carriage, while higher cord Ply-specific antibody titers predicted a significantly delayed onset (HR, 0.71; 95% CI, 0.52 to 1.00) and cord PspA1-specific antibodies a significantly younger onset of carriage in PNG infants (HR, 1.57; 95% CI, 1.03 to 2.40). Maternal vaccination with a pneumococcal protein-based vaccine should be considered as a strategy to protect high-risk infants against pneumococcal disease by reducing carriage risks in both mothers and infants.
Francis, Jacinta P.; Richmond, Peter C.; Pomat, William S.; Michael, Audrey; Keno, Helen; Phuanukoonnon, Suparat; Nelson, Jan B.; Whinnen, Melissa; Heinrich, Tatjana; Smith, Wendy-Anne; Prescott, Susan L.; Holt, Patrick G.; Siba, Peter M.; Lehmann, Deborah; van den Biggelaar, Anita H. J.
Microsystem risk and protective factors associated with early sexual intercourse among low-income adolescents were assessed using bioecological theory and a risk and resiliency framework. Waves 1 and 2 of Welfare, Children and Families: A Three-City Study were used (N=984, 10–14 years). Findings showed age, gender, race, two-parent households, separated households, households where the mother formed a union between waves, transitioning onto welfare between waves, and delinquency increased the odds that adolescents were sexually active. Protective factors for early sexual activity included maternal education and father involvement. Riskfactors for early sexual debut were age, gender, race, two-parent households, separated households, and delinquency. A protective factor for early sexual debut was maternal education. Findings differed by gender, race, and race*gender. Policy implications include increasing social and human capital among low-income mothers to promote family stability and providing diversified sexual education programs due to gender differences.
The RiskFactor Monitoring and Methods Branch examines individual and societal riskfactors that affect the cancer burden. Working collaboratively with representatives from government and academia, we monitor these factors among the population and develop tools and techniques to improve methods of assessment.
Objective: We investigate whether each of the following: HPA-1, Factor V Leiden, prothrombin gene variant and the methylene tetrahydrofolate reductase gene (MTHFR) mutation, are riskfactors for acute coronary disease in Portuguese patients. Material and Methods: 100 blood donors and 52 patients with an established diagnosis of myocardial infarction or unstable angina were evaluated for genetic riskfactors, by determining
F. Araújo; A. Santos; V. Araújo; I. Henriques; F. Monteiro; E. Meireles; I. Moreira; D. David; M. J. Maciel; L. M. Cunha-Ribeiro
This paper describes a research program intended to provide a better understanding of the influence of several putative riskfactors for schizophrenia on child development and psychosis. Two related components of the overall program are described: the retrospective EnviroGen projects, which use a variety of putative riskfactors to explain variance in several dimensions of schizophrenia and in psychotic symptoms in community controls, and Project Ice Storm, which prospectively examines the effects of prenatal maternal stress in the children of women who were exposed to the 1998 Quebec ice storm during their pregnancies. The EnviroGen projects have been successful in explaining variance in several dimensions of illness, including premorbid adjustment and severity of dissociative symptoms. Project Ice Storm has demonstrated the noxious effects of prenatal stress on cognitive and language development in children. We have also found that "ice storm children" exposed in specific weeks of gestation show greater dermatoglyphic asymmetry, as has been reported for samples of patients with schizophrenia. In both studies, prenatal maternal stress has been associated with more severe childhood behaviour problems. The combination of retrospective and prospective studies is a rich source of triangulated results providing information about developmental psychopathology. PMID:16151539
Leptin a regulator of body weight is involved in reproductive and developmental functions. Leptin promoter DNA methylation (LEP) regulates gene expression in a tissue-specific manner and has been linked to adverse pregnancy outcomes. In non-pathologic human pregnancies, we assessed LEP methylation, genotyped the single nucleotide polymorphism (SNP) rs2167270 in placental (n=81), maternal and cord blood samples (n=60), and examined the association between methylation, genotype, and perinatal factors. Maternal blood LEP methylation was lower in pre-pregnancy obese women (P=0.01). Cord blood LEP methylation was higher in small for gestational age (SGA) (P=4.6×10(-3)) and A/A genotype (P=1.6×10(-4)), lower (-1.47, P=0.03) in infants born to pre-pregnancy obese mothers and correlated (P=0.01) with maternal blood LEP. Gender was associated with placental LEP methylation (P=0.05). These results suggest that LEP epigenetic control may be influenced by perinatal factors including: maternal obesity, infant growth, genotype and gender in a tissue-specific manner and may have multigenerational implications. PMID:23911897
Lesseur, Corina; Armstrong, David A; Paquette, Alison G; Koestler, Devin C; Padbury, James F; Marsit, Carmen J
|Background: Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternalfactors. We aimed to determine the role of…
A stress fracture represents the inability of the skeleton to withstand repetitive bouts of mechanical loading, which results\\u000a in structural fatigue and resultant signs and symptoms of localized pain and tenderness. To prevent stress fractures, an appreciation\\u000a of their riskfactors is required. These are typically grouped into extrinsic and intrinsic riskfactors. Extrinsic riskfactors\\u000a for stress fractures are
Background. Early Childhood Caries (ECC) is the most common chronic infectious disease of childhood worldwide. Seven of ten American children have one or more decayed or filled primary teeth by age five. ECC prevalence is especially high in lower socio-economic ethnic populations. Commonly recognized as a diet-induced disease, focal etiological factors include cariogenic bacteria, fermentable carbohydrates, and a susceptible newly
Low birth weight due to maternal malnutrition is associated with increased risk of developing diseases in adulthood, for example, cardiovascular disease. Postnatal oxytocin treatment has previously been shown to have positive effects on blood pressure and corticosterone levels in adult offspring from malnourished dams. The aims of this study were to investigate if maternal food restriction during gestation alters plasma
Hanna Olausson; Moira Lewitt; Kerstin Brismar; Kerstin Uvnas-Moberg; Annica Sohlstrom
Context: Injuries to the anterior cruciate ligament (ACL) are immediately disabling and are associated with long-term consequences, such as posttraumatic osteoarthritis. It is important to have a comprehensive understanding of all possible riskfactors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 2 of a 2-part series, highlights what is known and still unknown regarding hormonal, genetic, cognitive function, previous injury, and extrinsic riskfactors for ACL injury. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and riskfactors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic case-control and prospective cohort study designs to evaluate riskfactors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in parts 1 and 2. Twenty-one focused on hormonal, genetic, cognitive function, previous injury, and extrinsic riskfactors. Conclusions: Several riskfactors are associated with increased risk of suffering ACL injury—such as female sex, prior reconstruction of the ACL, and familial predisposition. These riskfactors most likely act in combination with the anatomic factors reviewed in part 1 of this series to influence the risk of suffering ACL injury.
Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra; Beynnon, Bruce D.
Background Although modifiable riskfactors have been included in previous models that estimate or project breast cancer risk, there remains a need to estimate the effects of changes in modifiable riskfactors on the absolute risk of breast cancer. Methods Using data from a case–control study of women in Italy (2569 case patients and 2588 control subjects studied from June 1, 1991, to April 1, 1994) and incidence and mortality data from the Florence Registries, we developed a model to predict the absolute risk of breast cancer that included five non-modifiable riskfactors (reproductive characteristics, education, occupational activity, family history, and biopsy history) and three modifiable riskfactors (alcohol consumption, leisure physical activity, and body mass index). The model was validated using independent data, and the percent risk reduction was calculated in high-risk subgroups identified by use of the Lorenz curve. Results The model was reasonably well calibrated (ratio of expected to observed cancers = 1.10, 95% confidence interval [CI] = 0.96 to 1.26), but the discriminatory accuracy was modest. The absolute risk reduction from exposure modifications was nearly proportional to the risk before modifying the riskfactors and increased with age and risk projection time span. Mean 20-year reductions in absolute risk among women aged 65 years were 1.6% (95% CI = 0.9% to 2.3%) in the entire population, 3.2% (95% CI = 1.8% to 4.8%) among women with a positive family history of breast cancer, and 4.1% (95% CI = 2.5% to 6.8%) among women who accounted for the highest 10% of the total population risk, as determined from the Lorenz curve. Conclusions These data give perspective on the potential reductions in absolute breast cancer risk from preventative strategies based on lifestyle changes. Our methods are also useful for calculating sample sizes required for trials to test lifestyle interventions.
Venous thromboembolic disease and placental vascular pathology are responsible for an important maternal and foetal morbi-mortality with a modification of the hemostasis parameters. As these biological factors combined with particular clinical features can increase or reduce the risk of occurrence of these diseases, knowing the riskfactors would help to prevent problems during the pregnancy. Several antithrombotic therapies exist, including very recent ones. Furthermore, a lot of recommendations are available in the literature. A lot of data are thus at our disposal but their synthesis is necessary to be really useful. We review here the riskfactors, therapies and recommendations to help improve the management of these women. PMID:22516050
Background: Reported rises in the prevalence of hypospadias and other abnormalities of the male reproductive system may be a result of exposure to endocrine disrupting chemicals. Aims: To analyse the relation between risk of hypospadias and maternal occupation, particularly with regard to exposure to potential endocrine disrupting chemicals (EDCs). Methods: Data (1980–96) from the National Congenital Anomaly System (NCAS) were used to analyse the proportion of all congenital anomaly cases (n = 35 962) which were notified with hypospadias (n = 3471) by occupational codes (348 individual job titles) and by categories of exposure to potential EDCs from a job exposure matrix. Results: Five individual occupations (of 348) showed nominally statistically significant excesses, none of which had possible or probable exposure to potential EDCs. Odds ratios for "possible" or "probable" compared to "unlikely" exposure to potential EDCs did not show statistically significant increases in any of the EDC categories after adjustment for social class of the mother and father, nor was there evidence of an upward trend in risk with likelihood of exposure. In the 1992–96 time period odds ratios were increased for hairdressers (the largest group exposed to potential EDCs) and for probable exposure to phthalates (of which hairdressers form the largest group) before social class adjustment. Conclusions: There was little evidence for a relation between risk of hypospadias and maternal occupation or occupational exposure to potential EDCs, but as the exposure classification was necessarily crude, these findings should be interpreted with caution.
Vrijheid, M; Armstrong, B; Dolk, H; van Tongeren, M; Botting, B
|The authors test the hypothesis that separation from a violent husband or partner improves maternal parenting in Japan and examine how childhood abuse history (CAH), experience of domestic violence (DV), mental health problems, husband or partner's child maltreatment, and other demographic factors affect maternal parenting after such separation.…
Aims To evaluate the association between parental occupational exposure to agricultural work and the risk of anencephaly in three Mexican states. Methods A paired case control study (1:1) was done based on records of the Epidemiological Surveillance System of Neural Tube Defects in Mexico; 151 cases of anencephaly of more than 20?weeks' gestation were selected between March 2000 and February 2001. Controls were selected from the same maternity services as those of the cases and were born alive without congenital malformations. Information was obtained from both parents by means of a general questionnaire, a food frequency questionnaire, and a specific questionnaire on occupational exposure to pesticides. Exposures were analysed with emphasis on the three months before and one month after the last menstruation periods (acute risk period (ARP)), as well as exposure prior to the abovementioned period (non?acute risk period (NARP)). Results The children of mothers who worked in agriculture in the ARP had a greater risk of anencephaly (OR?=?4.57, 95% CI 1.05 to 19.96). The risk of fathers having a child with anencephaly was greater in those who applied pesticides irrespective of whether it was done in the ARP or the NARP (OR?=?2.50, 95% CI 0.73 to 8.64; and OR?=?2.03, 95% CI 0.58 to 7.08, respectively). Conclusions These results support the hypothesis of the effect of maternal exposure to agricultural work on anencephaly and suggest that exposure of the father to pesticides in the periconceptional period or prior to this can also increase the risk of having an anencephalic child.
Lacasana, M; Vazquez-Grameix, H; Borja-Aburto, V H; Blanco-Munoz, J; Romieu, I; Aguilar-Garduno, C; Garcia, A M
Objective To determine whether the variation in unadjusted rates of caesarean section derived from routine data in NHS trusts in England can be explained by maternal characteristics and clinical riskfactors. Design A cross sectional analysis using routinely collected hospital episode statistics was performed. A multiple logistic regression model was used to estimate the likelihood of women having a caesarean section given their maternal characteristics (age, ethnicity, parity, and socioeconomic deprivation) and clinical riskfactors (previous caesarean section, breech presentation, and fetal distress). Adjusted rates of caesarean section for each NHS trust were produced from this model. Setting 146 English NHS trusts. Population Women aged between 15 and 44 years with a singleton birth between 1 January and 31 December 2008. Main outcome measure Rate of caesarean sections per 100 births (live or stillborn). Results Among 620?604 singleton births, 147?726 (23.8%) were delivered by caesarean section. Women were more likely to have a caesarean section if they had had one previously (70.8%) or had a baby with breech presentation (89.8%). Unadjusted rates of caesarean section among the NHS trusts ranged from 13.6% to 31.9%. Trusts differed in their patient populations, but adjusted rates still ranged from 14.9% to 32.1%. Rates of emergency caesarean section varied between trusts more than rates of elective caesarean section. Conclusion Characteristics of women delivering at NHS trusts differ, and comparing unadjusted rates of caesarean section should be avoided. Adjusted rates of caesarean section still vary considerably and attempts to reduce this variation should examine issues linked to emergency caesarean section.
This study examined parenting as a function of child medical risks at birth and parental genotype (dopamine D4 receptor; DRD4). Our hypothesis was that the relation between child risks and later maternal sensitivity would depend on the presence/absence of a genetic variant in the mothers, thus revealing a gene by environment interaction (GXE). Risk at birth was defined by combining risk indices of children's gestational age at birth, birth weight, and admission to the neonatal intensive care unit. The DRD4-III 7-repeat allele was chosen as a relevant genotype as it was recently shown to moderate the effect of environmental stress on parental sensitivity. Mothers of 104 twin pairs provided DNA samples and were observed with their children in a laboratory play session when the children were 3.5 years old. Results indicate that higher levels of risk at birth were associated with less sensitive parenting only among mothers carrying the 7-repeat allele, but not among mothers carrying shorter alleles. Moreover, mothers who are carriers of the 7-repeat allele and whose children scored low on the risk index were observed to have the highest levels of sensitivity. These findings provide evidence for the interactive effects of genes and environment (in this study, children born at higher risk) on parenting, and are consistent with a genetic differential susceptibility model of parenting by demonstrating that some parents are inherently more susceptible to environmental influences, both good and bad, than are others.
Fortuna, Keren; van IJzendoorn, Marinus H.; Mankuta, David; Kaitz, Marsha; Avinun, Reut; Ebstein, Richard P.; Knafo, Ariel
Research Findings: This study examined relations between contextual risk, maternal negative emotionality, and preschool teacher reports of the negative emotion dysregulation of children from economically disadvantaged families. Contextual risk was represented by cumulative indexes of family and neighborhood adversity. The results showed a direct…
|Research Findings: This study examined relations between contextual risk, maternal negative emotionality, and preschool teacher reports of the negative emotion dysregulation of children from economically disadvantaged families. Contextual risk was represented by cumulative indexes of family and neighborhood adversity. The results showed a direct…
Aims To study the influence of maternal socioeconomic and emotional factors on infant weight gain and weight faltering (failure to thrive) in the first year of life. Methods The Gateshead Millennium Baby Study is a population birth cohort in northeast England studied prospectively from birth, via parental questionnaires and a health check aged 13?months. Data were collected on maternal education, deprivation, eating attitudes, and depression, using the Edinburgh Post Natal Depression Scale (EPDS) at 3?months. Weight gain was assessed using change in weight SD score, conditional on birth weight (Thrive Index); weight faltering was defined as conditional weight gain below the 5th centile. Results Of 923 eligible infants born at term, 774 (84%) had both weight and questionnaire data. Replicating a previous finding, both the highest and the lowest levels of deprivation were associated with weight faltering; this was independent of the type of milk feeding. No relation was found with maternal educational status. Maternal eating restraint was unrelated to weight gain. Infants of mothers with high depression symptom scores (EPDS >12) had significantly slower weight gain and increased rates of weight faltering up to 4 months (relative risk 2.5), especially if they came from deprived families, but by 12?months they were no different from the remainder of the cohort. Conclusions In this setting, social and maternal characteristics had little influence on infants' weight gain, apart from a strong, but transient effect of postnatal depression.
We report on a 21-year-old pregnant patient with IgA nephropathy who was initiated on intensive hemodialysis (8 hours of hemodialysis 3 times a week) at a gestational age of 26 weeks on the basis of worsening kidney function resulting in rapidly progressive fatigue and difficulties in metabolic control. Throughout the pregnancy, and while on intensive hemodialysis, 24-hour ambulatory blood pressure control was within the target, and results of weekly 24-hour measurement of central hemodynamics and pulse wave velocity, and of serial levels of circulating (anti-)angiogenic factors were comparable to normal pregnancies. Estimated fetal growth evolved along the 50th percentile, and no polyhydramnios was detected. After induction for a sudden, unexplained increase in blood pressure, she delivered a healthy boy of 2480?g at a gestational age of 36 weeks. This case adds to the expanding literature that supports the use of intensive hemodialysis in pregnant patients with end-stage renal disease and illustrates, for the first time, the potential use of serial (anti-) angiogenic factors and 24-hour measurements of blood pressure and hemodynamic indices in order to facilitate monitoring of these complicated patients. PMID:23551420
Cornelis, Tom; Spaanderman, Marc; Beerenhout, Charles; Perschel, Frank H; Verlohren, Stefan; Schalkwijk, Casper G; van der Sande, Frank M; Kooman, Jeroen P; Hladunewich, Michelle
Background: Women age 35 and older account for an increasing proportion of births and are at increased risk of having difficulties conceiving\\u000a and of delivering a multiple birth, low birth weight infant, and\\/or preterm infant. Little is known about men’s and women’s\\u000a understanding of the maternal age related risks to pregnancy.Objectives: 1) To determine the factors influencing the timing of
The role of early allergen exposure has been a central focus in the effort to curtail the rising rates of allergic disease.\\u000a Exposures in pregnancy have been of interest because the first signs of disease are often seen in early infancy. However,\\u000a so far, strategies to avoid or reduce allergen exposure in pregnancy have had disappointing results in reducing disease.
The molecular mechanisms underlying lethality of F1 hybrids between diverged parents are one target of speciation research. Crosses between diploid and tetraploid individuals of the same genotype can result in F1 lethality, and this dosage-sensitive incompatibility plays a role in polyploid speciation. We have identified variation in F1 lethality in interploidy crosses of Arabidopsis thaliana and determined the genetic architecture of the maternally expressed variation via QTL mapping. A single large-effect QTL, DR. STRANGELOVE 1 (DSL1), was identified as well as two QTL with epistatic relationships to DSL1. DSL1 affects the rate of postzygotic lethality via expression in the maternal sporophyte. Fine mapping placed DSL1 in an interval encoding the maternal effect transcription factor TTG2. Maternal parents carrying loss-of-function mutations in TTG2 suppressed the F1 lethality caused by paternal excess interploidy crosses. The frequency of cellularization in the endosperm was similarly affected by both natural variation and ttg2 loss-of-function mutants. The simple genetic basis of the natural variation and effects of single-gene mutations suggests that F1 lethality in polyploids could evolve rapidly. Furthermore, the role of the sporophytically active TTG2 gene in interploidy crosses indicates that the developmental programming of the mother regulates the viability of interploidy hybrid offspring.
Dilkes, Brian P; Spielman, Melissa; Weizbauer, Renate; Watson, Brian; Burkart-Waco, Diana; Scott, Rod J; Comai, Luca
Purpose The purpose of this study is to describe and clarify the birth and prenatal characteristics of a large cohort of children with optic nerve hypoplasia. Methods This is a descriptive report of 204 patients aged ? 36 months and enrolled in a prospective study at the Children’s Hospital Los Angeles. Birth characteristics, including complications, were abstracted from study files and medical records. Systematic maternal interviews were conducted to obtain detailed prenatal histories. National birth data were used for comparison with birth findings. Results Birth characteristics were unremarkable for birthweight and gestation, but significant for increased frequency of caesarean delivery and fetal and neonatal complications. Young maternal age and primaparity were dominating maternal features. Preterm labour, gestational vaginal bleeding, low maternal weight gain and weight loss during pregnancy were prevalent. Conclusions These findings confirm young maternal age and primaparity as associated riskfactors, challenge many other suggested factors such as alcohol and drug abuse, and introduce potentially significant prenatal characteristics such as maternal weight loss and early gestational vaginal bleeding as aetiological correlates.
Garcia-Filion, Pamela; Fink, Cassandra; Geffner, Mitchell E.; Borchert, Mark
The placental vasculature is critical for nutrient, gas, and waste exchange between the maternal and fetal systems. Its development depends on the proper expression and interaction of angiogenesis and associated growth factors. Heme oxygenase (HMOX), the enzyme for heme degradation, plays a role in angiogenesis and is highly expressed in the placenta. To evaluate the role of maternal HMOX1, the inducible HMOX isozyme, on placental vasculature formation, mice with a partial deficiency in Hmox1 (Hmox1+/?) were used. Three-dimensional images of placental vasculatures as well as spiral arteries from Hmox1+/+ or Hmox1+/? placentas were created by vascular corrosion casting technique and imaged by micro-computerized tomography (microCT). The structures and morphologies of fetomaternal interfaces were observed by histological staining and the ultrastructure of uterine natural killer (uNK) cells, a major regulator in spiral artery remodeling, was analyzed by transmission electron microscopy. A group of growth factors and angiogenic factors from the decidua/mesometrial lymphoid aggregate of pregnancy (MLAp) as well as labyrinth regions were quantified using an angiogenesis PCR array kit and compared between Hmox1+/+ or Hmox1+/? placentas. In conclusion, a partial deficiency of maternal Hmox1 resulted in the malformation of fetomaternal interface, insufficiency of spiral artery remodeling, and alteration of uNK cell differentiation and maturation. These changes were independent of the fetal genotype, but relied on the maternal HMOX1 level, which determined the balance of expression levels of pro- and antiangiogenic factors in the decidua/MLAp region. These results implied that Hmox1 polymorphisms among the human population might contribute to some unexplained cases of pregnancy disorders, such as fetal growth retardation and preeclampsia.
Zhao, Hui; Azuma, Junya; Kalish, Flora; Wong, Ronald J.; Stevenson, David K.
Objectives To date a number of studies have examined the association between maternal weight and testicular cancer risk although results have been largely inconsistent. This systematic review and meta-analysis investigated the nature of this association. Methods Search strategies were conducted in Ovid Medline (1950—2009), Embase (1980—2009), Web of Science (1970—2009), and CINAHL (1937—2009) using keywords for maternal weight (BMI) and testicular cancer. Results The literature search produced 1,689 hits from which 63 papers were extracted. Only 7 studies met the pre-defined criteria. Random effects meta-analyses were conducted. The combined unadjusted OR (95% CI) of testicular cancer in the highest reported category of maternal BMI compared with the moderate maternal BMI was 0.82 (0.65 – 1.02). The Cochran’s Q P value was 0.83 and the corresponding I2 was 0%, both indicating very little variability among studies. The combined unadjusted OR (95% CI) for testicular cancer risk in the lowest reported category of maternal BMI compared to a moderate maternal BMI category was 0.92 (0.75 – 1.12). The Cochran’s Q P value was 0.05 and the corresponding I2 was 54%, indicating evidence of statistical heterogeneity. No association was observed when maternal BMI was treated as a continuous variable. Conclusion This meta-analysis, which included a small number of studies, showed an inverse association between high maternal BMI and testicular cancer risk of borderline statistical significance. Further primary studies with adjustment for appropriate confounders are required.
Although prostate cancer is among the most common male cancers, little information is available on riskfactors. The paper reviews trends in prostate cancer incidence, and possible riskfactors are discussed. Incidence appears to have peaked and is predicted to stabilize at a higher level due to screening. Besides heredity, epidemiological studies on prostate cancer produce equivocal results. Lifestyle and environment are likely to have an important impact on prostate cancer risk, but significant and clinically relevant riskfactors have yet to be identified. PMID:17553361
Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis riskfactors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable riskfactors…
Background: Although cardiovascular disease (CVD) is the leading cause of death in women in the United States, a knowledge gap persists regarding the mechanisms and management of CVD in women. Before treatment can be optimized, the role of cardiovascular riskfactors must be elucidated.Objective: This review provides an updated assessment of cardiovascular riskfactors in women, with a focus on
The two most common causes of vascular dementia (VAD) are dementia evolving in connection with multiple small or large strokes and dementia related to ischemic white-matter lesions (WMLs) of the brain. The knowledge about riskfactors for these disorders is still scarce. Besides sharing riskfactors with stroke, dementia with multiple small or large brain infarcts is also associated with
|A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental riskfactors for paraphilia. Emotional abuse and family dysfunction was found to be a riskfactor for pedophilia, exhibitionism, rape, or multiple…
Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony
Cardiovascular riskfactors as well as morbidity and mortality from coronary heart disease among Turkish adults are herein reviewed. Lipids and lipoproteins are in focus, but other relevant riskfactors are also discussed. Turks have distinctively low levels of total and high-density lipoprotein (HDL)-cholesterol, associated with high levels of hepatic lipase and fasting triglycerides. In addition, physical inactivity is common
Breast cancer is the most common form of cancer and the principal cause of death from cancer among women worldwide. Riskfactors for breast cancer are manifold. Certain riskfactors, such as age and family history are well established. Research in the past decade has further elucidated disease aetiology, in particular the role of hormones and the discovery of breast
Background. Multinodular goitre (MNG) is quite often associated with thyroid carcinoma, but the riskfactors for malignancy are not well known. The aim is to analyse patients with thyroid carcinoma associated with MNG to determine the clinical riskfactors for malignancy.Method. From a series of 672 MNGs we analysed a subgroup of 59 patients presenting with an associated thyroid carcinoma.
A R??os; J. M Rodr??guez; M Canteras; P. J Galindo; M. D Balsalobre; P Parrilla
BACKGROUND: Manganese (Mn) is an essential element and a potential toxicant for developing organism. Deficiency and excess of it were both deleterious to fetal growth in experimental animals. However, literature on relationship between Mn status and birth outcome in humans is sparse. METHODS: Mn concentrations were measured in mother whole blood (MWB) and umbilical cord blood (UCB) in 125 pairs of mother-infant; birth size was examined and relationship between them was analysed. Potentially environmental factors influencing Mn loads in maternal and fetal organisms were investigated through epidemiological method. RESULTS: Mn level in UCB was significantly higher than that in MWB (mean value: 54.98 vs. 78.75 ?g/L), and a significant positive correlation was shown between them. There was a quadratic curvilinear (inverted U-shaped curve) relationship between MWB Mn and birth size, and between UCB Mn and birth size. Both univariate analysis and multiple linear regression analysis showed that exposure to harmful occupational factors during gestation remarkably increased maternal and fetal Mn levels. Living close to major transportation routes (<500 m) also increased the MWB Mn levels. CONCLUSION: Our results suggested that lower or higher Mn level in maternal and umbilical blood may induce adverse effect on birth size in humans. In addition, increased levels of Mn in MWB or UCB may be associated with exposure to some environmental hazard factors. PMID:23543679
We develop a model of the dynamic structure of capacity factorrisk. It incorporates the risk that the capacity factor may vary widely from year-to-year, and also the risk that the reactor may be permanently shutdown prior to the end of its anticipated useful life. We then fit the parameters of the model to the IAEA’s PRIS dataset of historical
Associations between salivary cortisol and maternal psychological distress and well-being were examined prospectively on 112 women with normally progressing, singleton pregnancies between 24 and 38 weeks gestation. At each of 5 visits, conducted in 3-week intervals, women provided a saliva sample and completed questionnaires measuring trait anxiety, depressive symptoms, pregnancy-specific hassles and uplifts, and psychological well-being. Maternal salivary cortisol was unrelated to psychological measures with the exception of minor associations detected with measures of anxiety and depressive symptoms between 30 and 32 weeks only. Findings indicate that self-reported maternal psychological distress and well-being are not associated with significant variation in maternal salivary cortisol levels during the second half of gestation. This suggests that studies that measure psychological factors in pregnancy but do not measure maternal cortisol should exercise caution in assuming activation of the maternal hypothalamic-pituitary-adrenal axis is the mechanism through which maternal psychological factors are transduced to the fetus. PMID:23269500
Voegtline, Kristin M; Costigan, Kathleen A; Kivlighan, Katie T; Laudenslager, Mark L; Henderson, Janice L; DiPietro, Janet A
Since registration started in the 1950s, the incidence of testicular cancer (TC) in the Western world has increased, which is also the case in Norway. Men born in Norway during World War II (WWII), however, have a lower TC incidence than men born in the years before or after WWII. Increased fetal exposure to estrogen during the first trimester of pregnancy has been proposed as a riskfactor for the development of TC later in life. Increased maternal weight is associated with higher insulin levels, leading to lower sex hormone-binding globulin levels and thereby increased levels of bioavailable estrogens for transplacental transfer from mother to fetus. The aim of the present study was therefore to examine whether there was an association between maternal weight and the incidence of TC among those who were born in a time period where the nutritional conditions changed, i.e., around the time of WWII. We compared data for a random sample of women giving birth in Oslo, Norway, in the years 1931 to 1955 with the TC incidence among men born in the whole country in the same time period. Maternal weight at delivery was used as a proxy for first-trimester weight. We found a correlation (Spearman's rho = 1.00, p < 0.01; Pearson's r = 0.95, p = 0.02) between the TC incidence and maternal weight adjusted for birth weight and maternal age. Although one cannot draw firm conclusions from ecologic correlations, these findings suggest that the increase in TC incidence over the past decades could be at least partly attributed to the increased maternal body weight observed in most populations in the relevant time period since TC is thought to be associated with in utero conditions. PMID:15800917
Aschim, Elin L; Grotmol, Tom; Tretli, Steinar; Haugen, Trine B
Elevated maternal phenylalanine levels during pregnancy are teratogenic, and may result in embryo-foetopathy, which could lead to stillbirth, significant psychomotor handicaps and birth defects. This foetal damage is known as maternal phenylketonuria. Women of childbearing age with all forms of phenylketonuria, including mild variants such as hyperphenylalaninaemia, should receive detailed counselling regarding their risks for adverse foetal effects, optimally before contemplating pregnancy. The most assured way to prevent maternal phenylketonuria is to maintain the maternal phenylalanine levels within the optimal range already before conception and throughout the whole pregnancy. Authors review the comprehensive programme for prevention of maternal phenylketonuria at the Metabolic Center of Budapest, they survey the practical approach of the continuous maternal metabolic control and delineate the outcome of pregnancies of mothers with phenylketonuria from the introduction of newborn screening until most recently. PMID:23628728
Bókay, János; Kiss, Erika; Simon, Erika; Sz?nyi, László
Aims This study investigated associations between smoking and maternal asthma and two indicators of pregnancy outcome: birth weight and preterm delivery. Methods Data were gathered as part of the Pacific Islands Families (PIF) Study. Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand during 2000 were interviewed when their infants were 6 weeks old. Mothers
Sarnia Carter; Teuila Percival; Janis Paterson; Maynard Williams
Background Animal models of schizophrenia suggest a link between maternal crowding during pregnancy and increased risk of the offspring to develop physiological, developmental, and behavioral abnormalities that are comparable to those observed in schizophrenia. We tested the hypothesis that a similar link is present in humans. Method We investigated whether prenatal exposure to household crowding was associated with the risk of schizophrenia in a subcohort of the Jerusalem Perinatal Study (JPS) consisting 11,015 individuals born between 1964 and 1976. During these years mothers participated in face to face interviews in early pregnancy. The prenatal and birth data, including the number of rooms and individuals living in the mothers' household, was cross-linked with the Israel Psychiatric Registry by ministry personnel. Results 104 schizophrenia cases were identified in the cohort. Offspring who, while in utero, their mother resided in a household with five or more individuals had RR of 1.47 (95% CI: 0.99–2.16, p=0.05) to develop schizophrenia, compared to those whose mother resided with four or fewer individuals. However, when adjusted for paternal age, the RR was reduced to 1.18 (95% CI: 0.76–1.84, p=0.46). The number of rooms in the household and the household crowding during pregnancy did not significantly impact the offspring's risk to develop schizophrenia. Conclusion The link between maternal household crowding during pregnancy and the offspring's risk of schizophrenia was explained primarily by the impact of paternal age. The authors discuss the results in view of findings from animal and human studies.
Objective To determine if polymorphisms in the Transforming Growth Factor Beta-3 (TGF-?3) gene are associated with risk of pregnancy-induced hypertension (PIH) in case-control mother-baby dyads. Study Design Cases (N=136) and controls (N=169) were recruited from the Los Angeles County + University of Southern California Women's and Children's Hospital. We genotyped four TGF-?3 polymorphisms and examined association with PIH using logistic regression, adjusting for parity, maternal age, gestational age at delivery, fetal (or maternal) genotypes for the polymorphism in question, and for the three other polymorphisms within the TGF-?3 gene. Results Only one of the TGF-?3 polymorphisms (rs11466414) was associated with PIH. Mothers who carried a baby with a minor allele were at decreased risk (ORmulti-locus adj= 0.32, 95% CI: 0.14, 0.77). Maternal TGF-?3 variants had no effect on risk of PIH. Conclusion A fetal TGF-beta3 polymorphism (rs11466414) is associated with pregnancy-induced hypertension in a predominantly Hispanic population.
WILSON, Melissa L.; DESMOND, Daniel H.; GOODWIN, T. Murphy; MILLER, David A.; INGLES, Sue Ann
... To find out where you stand with Life's Simple 7®, take the My Life Check ® Assessment . In just a few minutes, you can get your own personal health score and life plan to help you reduce your risk of stroke. ...
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This article examines the narratives of women who breastfeed their children for ‘extended’ periods of time, as a means of exploring the relationship between risk-consciousness, infant feeding and maternal identity. The paper shows that whilst these women practice a form of infant feeding which is validated by wider policy directives emphasising the risks associated with formula milk use, their ‘identity
We investigated the correlation of bone mineral density (BMD) with riskfactors and laboratory parameters (e.g., markers of\\u000a bone turnover, biochemical indicators, and hormonal factors) in males without secondary osteoporosis. A total of 105 males\\u000a were divided into two groups: Group 1 (n: 52) <60 years, and Group 2 (n:53) ? 60 years. The subjects were evaluated for risk\\u000a factors
Özlem Seven; Hale Karapolat; Sibel Eyigor; Yesim Kirazl?; Berrin Durmaz
Today, low birth weight--weight less than 2,500 grams (5 pounds 8 ounces)--is recognized as the single most significant characteristic of the newborn associated with a greater risk of mortality and morbidity. This paper highlights maternal and infant health factors associated with low birth weight, using data from the 1972 and 1980 National Natality Surveys. Both surveys provide important information related to low birth weight that is not typically available from standard birth certificates and therefore not part of the usual natality vital statistics. In addition, induction of labor and cesarean section deliveries (first and repeat cesareans) were examined for 1980 to assess whether their use has exerted an influence on low birth weight.
|Objective: To explore the factors that encompass maternal self-efficacy in providing food for the home. Methods: In-depth interviews were conducted with 19 mothers of nutritionally at risk children in an urban area of East Jakarta, Indonesia. This study was based on Social Cognitive Theory, Family Stress Models, and Ecological Frameworks. Data…
Objective: To explore the factors that encompass maternal self-efficacy in providing food for the home. Methods: In-depth interviews were conducted with 19 mothers of nutritionally at risk children in an urban area of East Jakarta, Indonesia. This study was based on Social Cognitive Theory, Family Stress Models, and Ecological Frameworks. Data…
The relationship between selected baseline riskfactors and subsequent coronary heart disease (CHD) death and total mortality among participants in the Multiple RiskFactor Intervention Trial (MRFIT) was studied in order to determine whether the three riskfactors used to identify high-risk men for the trial were associated with CHD death; whether other riskfactors measured at baseline, especially lipoprotein
The aim of this study was to determine the prevalence of cardiovascular riskfactors in adolescents and to verify its association with age and gender. 644 high school students from public schools in the city of Londrina, Paraná State, Brazil, participated in the study. A two-step sampling process was used. Behavioral riskfactors (physical inactivity, inadequate consumption of fruits and vegetables, and smoking) and biological riskfactors (overweight and high blood pressure) were investigated. Nearly 90% of adolescents showed at least one riskfactor. Inadequate consumption of fruits (56.7%) and vegetables (43.9%) and physical inactivity (39.2%) were the most prevalent riskfactors. Prevalence rates for high blood pressure and overweight were 18.6 and 12.7%, respectively. Cardiovascular riskfactors were more frequent among boys (PR = 1.20; 95%CI = 1.01-1.42). In conclusion, cardiovascular riskfactors are a prevalent health issue among students in the city of Londrina. PMID:19009137
Romanzini, Marcelo; Reichert, Felipe Fossati; Lopes, Adair da Silva; Petroski, Edio Luiz; de Farias Júnior, José Cazuza
This Milemarkers bibliography includes selected references to sources of information for iden- tifying the environmental and biological riskfactors that are most associated with child devel- opmental delays and poor functioning. References to research and practice pertaining to risk assessment procedures are also included. The information should be useful to practitioners who have responsibility for early identifi cation and evaluation
To identify and quantify riskfactors for preterm and term low birthweight (LBW) we conducted a hospital-based case-control study, linked with a population survey in Ahmedabad, India. The case-control study of 673 term LBW, 644 preterm LBW cases and 1465 controls showed that low maternal weight, poor obstetric history, lack of antenatal care, clinical anaemia and hypertension were significant independent riskfactors for both term and preterm LBW. Short interpregnancy interval was associated with an increased risk of preterm LBW birth while primiparous women had increased risk of term LBW. Muslim women were at a reduced risk of term LBW, but other socioeconomic factors did not remain significant after adjusting for these more proximate factors. Estimates of the prevalence of riskfactors from the population survey was used to calculate attributable risk. This analysis suggested that a substantial proportion of term and preterm LBW births may be averted by improving maternal nutritional status, anaemia and antenatal care. PMID:1428479
SUMMARY We examined whether hypospadias was associated with several aspects of the diet, including intake of animal products, intake of several nutrients and food groups related to a vegetarian diet and estrogen metabolism, and diet quality. The study included deliveries from 1997 to 2005 that were part of the National Birth Defects Prevention Study. Diet was assessed by food frequency questionnaire during maternal telephone interviews, and two diet quality indices were developed based on existing indices. Analyses included 1,250 cases with second or third degree hypospadias (urethra opened at the penile shaft, scrotum or perineum) and 3,118 male, liveborn, non-malformed controls. All odds ratios (ORs) and 95% confidence intervals (CI) were estimated from logistic regression models that included several potential confounders, including energy intake. Intake of animal products was not associated with hypospadias; e.g., the adjusted OR for any versus no intake of meat was 1.0 (95% CI 0.6, 1.6). Frequency of intake of meat or other animal products was also not associated with hypospadias, nor was intake of iron or several nutrients that are potentially related to estrogen metabolism. Diet quality was also not associated with hypospadias; the ORs for diet quality in the highest versus lowest quartile for the two diet quality indices were 1.0 (95% CI 0.6, 1.6) and 0.9 (95% CI 0.7, 1.1). In conclusion, this large study does not support an association of a vegetarian diet or worse diet quality with hypospadias.
Carmichael, Suzan L.; Ma, Chen; Feldkamp, Marcia L.; Munger, Ronald G.; Olney, Richard S.; Botto, Lorenzo D.; Shaw, Gary M.; Correa, Adolfo
Little is known about the relative predictive utility of maternal characteristics and parenting skills on the development of girls' disruptive behavior. The current study used five waves of parent- and child-report data from the ongoing Pittsburgh Girls Study to examine these relationships in a sample of 1,942 girls from age 7 to 12 years. Multivariate generalized estimating equation analyses indicated that European American race, mother's prenatal nicotine use, maternal depression, maternal conduct problems prior to age 15, and low maternal warmth explained unique variance. Maladaptive parenting partly mediated the effects of maternal depression and maternal conduct problems. Both current and early maternalriskfactors have an impact on young girls' disruptive behavior, providing support for the timing and focus of the prevention of girls' disruptive behavior. PMID:21391016
van der Molen, Elsa; Hipwell, Alison E; Vermeiren, Robert; Loeber, Rolf
Objective To examine the association of maternal caffeine intake with fetal growth restriction. Design Prospective longitudinal observational study. Setting Two large UK hospital maternity units. Participants 2635 low risk pregnant women recruited between 8-12 weeks of pregnancy. Investigations Quantification of total caffeine intake from 4 weeks before conception and throughout pregnancy was undertaken with a validated caffeine assessment tool. Caffeine half life (proxy for clearance) was determined by measuring caffeine in saliva after a caffeine challenge. Smoking and alcohol were assessed by self reported status and by measuring salivary cotinine concentrations. Main outcome measures Fetal growth restriction, as defined by customised birth weight centile, adjusted for alcohol intake and salivary cotinine concentrations. Results Caffeine consumption throughout pregnancy was associated with an increased risk of fetal growth restriction (odds ratios 1.2 (95% CI 0.9 to 1.6) for 100-199 mg/day, 1.5 (1.1 to 2.1) for 200-299 mg/day, and 1.4 (1.0 to 2.0) for >300 mg/day compared with <100 mg/day; test for trend P<0.001). Mean caffeine consumption decreased in the first trimester and increased in the third. The association between caffeine and fetal growth restriction was stronger in women with a faster compared to a slower caffeine clearance (test for interaction, P=0.06). Conclusions Caffeine consumption during pregnancy was associated with an increased risk of fetal growth restriction and this association continued throughout pregnancy. Sensible advice would be to reduce caffeine intake before conception and throughout pregnancy.
|This article explores potential risks faced by children with disabilities who are left at home alone. The importance of assessing children's needs and skills for safely staying home alone is stressed and suggestions offered for concepts to teach children, alternate methods of supervision, and other practical concerns. (PB)|
Until the 1990s, venous thromboembolism (VTE) was viewed primarily as a complication of hospitalization for major surgery (or associated with the late stage of terminal illness). However, recent trials in patients hospitalized with a wide variety of acute medical illnesses have demonstrated a risk of VTE in medical patients comparable with that seen after major general surgery. In addition, epidemiologic
Background: There are increasing concerns regarding antimicrobial resistance in Canada. Data are limited on the prevalence, patterns of resistance and risk fac- tors associated with resistant organisms, including coliforms, in children. This study was done to address these issues as they relate to urinary tract isolates of Escherichia coli in a tertiary care pediatric centre in Ottawa. Methods: A surveillance
Upton D. Allen; Noni MacDonald; Louise Fuite; Frank Chan; Derek Stephens
... Talk with your doctor for more information. Environmental/occupational exposure. Exposure to sawdust and chemicals used in the leather industry, pesticides, and some industrial solvents may increase the risk of a type of salivary gland cancer that occurs in the nose and sinuses. Other ...
Death rates from coronary heart disease (CHD) in Northern Ireland are among the highest in the world. However, no data have been available to test the hypothesis that the high prevalence of CHD is reflected by the risk status of the childhood population. A randomly selected 2% population sample of 1015 children aged 12 and 15 years was studied to
C Boreham; J M Savage; D Primrose; G Cran; J Strain
There appears to be an incompressible high rate of preterm births among populations of African origin irrespective of their geographic location. The objective of this study was to assess the riskfactors for preterm birth in a French Caribbean population of African descent, offered medical care comparable to that on the French mainland, but presenting a higher rate of preterm birth. The study was based on a birth cohort at maternity hospitals in Guadeloupe (French West Indies) including 911 singleton pregnancies enrolled during their third trimester check-up visits. Associations between riskfactors and the risk of preterm delivery (spontaneous and induced) were assessed using a multivariate Cox model. In addition, prevalences of sociodemographic and medical factors in Guadeloupe were compared with those on the French mainland. 144 women (15.8 %) delivered preterm, medically induced in 52 %. Women delivering preterm were more often over 35 years old (37 %), single (54 %), and had higher prevalence of prior preterm birth (20 %), prior miscarriage (37 %), lupus (3 %), asthma (14 %), gestational hypertension (26 %), gestational diabetes (13 %) and urinary tract infection (24 %) than women with term births. In the whole cohort, these riskfactors were also more frequent than in mainland France. Our results suggest highly prevalent medical riskfactors for preterm births in Guadeloupe. This observation combined with specific social riskfactors (older maternal age, single living) less frequent on the French mainland probably explains a large part of a higher prevalence of preterm births in this population despite similar medical provision. PMID:22923284
Background Maternal postpartum depression has an impact on mother-infant interaction. Mothers with depression display less positive affect\\u000a and sensitivity in interaction with their infants compared to non-depressed mothers. Depressed women also show more signs\\u000a of distress and difficulties adjusting to their role as mothers than non-depressed women. In addition, depressive mothers\\u000a are reported to be affectively more negative with their sons
Anna Sidor; Elisabeth Kunz; Daniel Schweyer; Andreas Eickhorst; Manfred Cierpka
Abstract Background. It has long been recognized that some human breast cancers are hormone dependent. Preeclampsia is a syndrome of pregnancy defined by the onset of hypertension and proteinuria and characterized by dysfunction of the maternal endothelium. Many hormonal changes occur with preeclampsia, and we hypothesize that these changes may influence the risk of maternal breast cancer. We also analyzed the relation between pregnancy-induced hypertension (PIH) and maternalrisk of breast cancer. Methods. Among 13 relevant publications about preeclampsia and six relevant publications about PIH, some studies find preeclampsia associated with a lower risk of breast cancer, but others did not. Therefore, these results are inconclusive. We conducted meta-analysis to evaluate more precisely the relationship between preeclampsia, PIH and maternalrisk of breast cancer. Results. The pooled estimate of the hazard ratio (HR) associated with preeclampsia was 0.86 (95% CI 0.73-1.01), and that associated with PIH was 0.83 (0.66-1.06), both based on the random effects model. Conclusion. Some suggestive but not entirely consistent nor conclusive evidence was found on the association between the history of preeclampsia or PIH with the subsequent risk of breast cancer. PMID:23240638
Kim, Jung Sun; Kang, Eun Joo; Woo, Ok Hee; Park, Kyong Hwa; Woo, Sang Uk; Yang, Dae Sik; Kim, Ae-Ree; Lee, Jae-Bok; Kim, Yeul Hong; Kim, Jun Suk; Seo, Jae Hong
OBJECTIVE: The main objective of this study was to investigate the riskfactors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the riskfactors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ?4 mm and an attachment loss ?3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.
de Vasconcellos Piscoya, Maria Dilma Bezerra; de Alencar Ximenes, Ricardo Arraes; da Silva, Genivaldo Moura; Jamelli, Silvia Regina; Coutinho, Sonia Bechara
Objective: To determine whether maternal plasma fibronectin and advanced oxidative protein products (AOPP) can be used for the prediction of preeclampsia in high-risk women. Study Design: One hundred pregnant women at high risk of preeclampsia were enrolled in this prospective cohort study. Maternal plasma total fibronectin and AOPP levels were measured at 19–25 weeks of gestation. AOPP levels were also
Autosomal dominant conditions are known to be associated with advanced paternal age, and it has been suggested that retinoblastoma (Rb) also exhibits a paternal age effect due to the paternal origin of most new germline RB1 mutations. To further our understanding of the association of parental age and risk of de novo germline RB1 mutations, we evaluated the effect of parental age in a cohort of Rb survivors in the United States. A cohort of 262 Rb patients was retrospectively identified at one institution, and telephone interviews were conducted with parents of 160 survivors (65.3%). We classified Rb survivors into three groups: those with unilateral Rb were classified as sporadic if they had no or unknown family history of Rb, those with bilateral Rb were classified as having a de novo germline mutation if they had no or unknown family history of Rb, and those with unilateral or bilateral Rb, who had a family history of Rb, were classified as familial. We built two sets of nested logistic regression models to detect an increased odds of the de novo germline mutation classification related to older parental age compared to sporadic and familial Rb classifications. The modeling strategy evaluated effects of continuous increasing maternal and paternal age and 5-year age increases adjusted for the age of the other parent. Mean maternal ages for survivors classified as having de novo germline mutations and sporadic Rb were similar (28.3 and 28.5, respectively) as were mean paternal ages (31.9 and 31.2, respectively), and all were significantly higher than the weighted general US population means. In contrast, maternal and paternal ages for familial Rb did not differ significantly from the weighted US general population means. Although we noted no significant differences between mean maternal and paternal ages between each of the three Rb classification groups, we found increased odds of a survivor being in the de novo germline mutation group for each 5-year increase in paternal age, but these findings were not statistically significant (de novo vs. sporadic ORs 30-34 = 1.7 [0.7-4], ? 35 = 1.3 [0.5-3.3]; de novo vs. familial ORs 30-34 = 2.8 [1.0-8.4], ? 35 = 1.6 [0.6-4.6]). Our study suggests a weak paternal age effect for Rb resulting from de novo germline mutations consistent with the paternal origin of most of these mutations. PMID:22203219
Mills, Melissa B; Hudgins, Louanne; Balise, Raymond R; Abramson, David H; Kleinerman, Ruth A
The literature on shift work, morbidity and mortality from cardiovascular disease, and changes in traditional riskfactors is reviewed. Seventeen studies have dealt with shift work and cardiovascular disease risk. On balance, shift workers were found to have a 40% increase in risk. Causal mechanisms of this risk via known cardiovascular riskfactors, in relation to circadian rhythms, disturbed sociotemporal patterns, social support, stress, behavior (smoking, diet, alcohol, exercise), and biochemical changes (cholesterol, triglycerides, etc) are discussed. The risk is probably multifactorial, but the literature has focused on the behavior of shift workers and has neglected other possible causal connections. In most studies methodological problems are present; these problems are related to selection bias, exposure classification, outcome classification, and the appropriateness of comparison groups. Suggestions for the direction of future research on this topic are proposed. PMID:10360463
The goal of this study was to evaluate the relation between kittens' birth weights and biometrical factors from the kittens and the mother during pregnancy. Knowing fetal birth weight could help in detecting abnormalities before parturition. A Caesarean-section or a postnatal management plan could be scheduled. Consequently, the neonatal mortality rate should be decreased. We used ultrasonographic measurements of femur length (FL) or fetal biparietal diameter (BPD), pregnancies, and maternalfactors to obtain a model of prediction. For this purpose, linear mixed-effects models were used because of random effects (several fetuses for one queen and a few paired measurements) and fixed effects (litter size, pregnancy rank, weight, wither height, and age of the queen). This study was performed in 24 purebred queens with normal pregnancies and normal body conditions. Queens were scanned in the second half of pregnancy, using a micro-convex probe. They gave birth to 140 healthy kittens whose mean birth weight was 104 g (ranged 65 to 165 g). No correlation between the birth weight and the age of the queen, as a maternalfactor alone, was observed. But the birth weight was found to be inversely proportional to the pregnancy rank and the litter size. Moreover, birth weight increased when the weight and wither height of queen increased. BPD and FL increased linearly during pregnancy so a model was used to estimate mean birth weight. Using this model, we found a correlation between mean birth weights and an association of parameters: maternalfactors (wither height and age), and litter size. PMID:21820718
Gatel, L; Rosset, E; Chalvet-Monfray, K; Buff, S; Rault, D N
Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a riskfactor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4-8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB), low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4-8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children's developmental outcomes increase over time. PMID:24039856
Taylor, Catherine L; Christensen, Daniel; Lawrence, David; Mitrou, Francis; Zubrick, Stephen R
Purpose Hepatitis B virus (HBV) infection is endemic in many countries, but the riskfactors for HBV carriage in the obstetric population\\u000a are unclear.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A survey on 1,580 women attending the antenatal clinic in an endemic region was conducted in order to examine the prevalence\\u000a of and factors associated with maternal HBV carriage, including socio-demographic, medical, and previous obstetrical and family
O. K. Chan; T. T. Lao; S. S. H. Suen; T. K. Lau; T. Y. Leung
A generalized classification methodology which employs riskfactor fusion, normalization, DKLT based transformation, feature selection, and parametric classifier design is developed to predict the presence or absence of a multifactorial disease. The valid...
... Hospitals; Nursing Homes; Elementary Schools (K-5). Restaurants. ... All riskfactors for nursing homes stayed relatively static during the study period. ... More results from www.fda.gov/food/guidanceregulation/retailfoodprotection
Atherosclerosis begins during childhood. A strong relationship has been shown between the prevalence and extent of asymptomatic atherosclerosis and cardiovascular riskfactors such as elevated body mass index, blood pressure and plasma lipid concentrations, starting in childhood. These riskfactors are influenced by genetic predisposition, but also by environmental factors, and particularly diet. The Nutrition Committee of the French Pediatrics Society of Pediatrics has reviewed the scientific basis of dietary recommendations for children, in order to limit riskfactors and thereby to reduce the risk of cardiovascular disease in later life. This review focuses on the effects of prenatal nutrition; the beneficial effects of breast-feeding on cholesterolemia, blood pressure and corpulence in later life; the impact of dietary lipids on plasma lipid concentrations; the effects of salt and potassium intake on blood pressure; and the relation between lifestyle and corpulence. PMID:22292299
BACKGROUND: Recent evidence, both animal and human, suggests that modifiable factors during fetal and infant development predispose for cardiovascular disease in adult life and that they may become possible future targets for prevention. One of these factors is maternal psychosocial stress, but so far, few prospective studies have been able to investigate the longer-term effects of stress in detail, i.e.
Aimée E van Dijk; Manon van Eijsden; Karien Stronks; Reinoud JBJ Gemke; Tanja GM Vrijkotte
Methods: Two controls matched for sex, year of birth, and municipality were selected randomly for children with the following defects: central nervous system (CNS) defects, cardiac defects, respiratory system defects, oesophageal defects, and clubfoot. The distances between maternal addresses, during pregnancy, and power lines were obtained from maps mainly of scale 1:5000. The magnetic fields in the residences were estimated based on distance, current, voltage, and configuration. Results: The highest increased risks were seen for hydrocephalus (OR 1.73, 95% CI 0.26 to 11.64) and for cardiac defects (OR 1.54, 95% CI 0.89 to 2.68). Conclusion: This study does not support the hypothesis that residential exposure to electromagnetic fields from power lines causes any of the investigated outcomes.
Studies have been reviewed to indicate that (a) prematurity and other perinatal hazards impose congenital constraints upon the behavior of the young infant, (b) experimental deficits within the earliest days and weeks of life can compound the risk, (c) infants who succumb to crib death (sudden infant death syndrome) have demonstrably more riskfactors present in their prenatal and neonatal
The primary objective of the Multiple RiskFactor Intervention Trial (MRFIT) is to determine whether for a group of men at high risk of death from coronary heart disease, a special intervention program will result in a significant reduction in mortality f...
Normal levels of male sex hormones are essential to men’s health. Many studies demonstrate that hypogonadal men are at higher risk for developing a host of metabolic derangements, including dyslipidemia, type 2 diabetes mellitus, obesity, and hypertension. We examined the most recent studies supporting this notion of hypogonadism as a cardiac riskfactor by reviewing all relevant PubMed data. Most
Background: Unintentional injuries represent a major cause of morbidity and mortality in rural communities. This study aimed to determine the distribution of injury riskfactors in a rural Iowa community and to identify the rural subgroups at highest risk for injury.Methods: We reported on 1583 participants, aged ?25 years, from Round One of the Keokuk County Rural Health Study, a
Craig Zwerling; James A Merchant; David L Nordstrom; Ann M Stromquist; Leon F Burmeister; Stephen J Reynolds; Kevin M Kelly
Dietary trans fatty acids/hydrogenated fat has been associated with increased risk of developing cardiovascular disease (CVD), possibly greater than predicted from changes in lipoprotein levels. To explore this issue further potential riskfactors were assessed in thirty-six subjects provided with ...
The Behavioral RiskFactor Surveillance System (BRFSS), the world's largest telephone survey, tracks health risks in the United States. Information from the survey is used to improve the health of the American people. Since the early 1980s, BRFSS data have been used to identify e...
Objectives: The purpose of this study was to determine what riskfactors play a role in the development of retinopathy of prematurity\\u000a (ROP). Study design: Data were collected on 157 infants born and cared for in one institution between January 1991 and July 1994. Initially we\\u000a evaluated all children enrolled in the study to determine potential riskfactors for the
Bruce A. Brown; Allen B. Thach; Jonathon C. Song; Jeffrey L. Marx; Robert C. Kwun; Donald A. Frambach